Nutrition Cluster Coordinator - Haiti
Normal user
7 Sep 2011, 16:56
Does anyone know of any reference regarding the effect of rapid dehydration caused by cholera or AWD on MUAC of children especially the younger ones?
In Haiti we have set up a specific nutrition response in cholera treatment centers, including screening for SAM in U5 with cholera, using MUAC or bilateral oedema to indicate when to apply a more gentle rehydration protocol than otherwise suggested by the standard cholera protocol for non severely malnourished children.
The question we are trying to answer is whether a misclassification of SAM in young children (6-12months) might be possible due to a smaller MUAC caused by rapid dehydration rather than undernutrition which would further complicate balancing the survival risks of a slower rehydration of cholera versus the risk of cardiac failure form overhydration...
Frequent user
8 Sep 2011, 08:21
Dear Stephano
We have recently completed a study on anthropometric changes with dehydration and rehydration. In short, yes, MUAC does change in very dehydrated children leading to significant misclassification. It should be up on the Nutrition Journal website within a week or two:
Mwangome M, Fegan G, Prentice A, Berkley J: Are diagnostic criteria for
acute malnutrition affected by hydration status in hospitalized
children? A repeated measures study. Nutrition Journal 2011, In press.
If you are able to collect any data to verify our findings in a different setting, taking MUAC, weight and height before and after rehydration in patients with cholera would be valuable and would be a nice follow up short report.
Jay
Frequent user
13 Sep 2011, 07:57
For anyone interested in how dehydration affects anthropometry, our atricle is now available oneline at: http://www.nutritionj.com/content/10/1/92
Jay