Hi Pascale,
We are currently also facing malnutrition in over 5 & especially elderly in the refugee camps in South Sudan. As you said, people are not able to eat more than 3 to 4 RUTF sachets per day. See below, the protocol we use for ATFC. We provide 2000 Kcal/ day, considering that they will get the remaining through family food (We propose eventually to mix different RUTF to improve acceptability).
Phase 2
- Teenagers: minimum 100 kcal/kg/day, up to 3000 kcal/day
- Adults: minimum 80 kcal/kg/day, up to 3000 kcal/day
- Elderly: minimum 70 kcal/kg/day, up to 3000 kcal/day
5.2 Dietary protocol - Ambulatory
As soon as the patient recovered from medical conditions and has good appetite, he/she can be send home and continue his/her treatment in ATFC. He/she should therefore receive:
MUAC >170 and <185 mm: 3 PPN/day or 2 PPN + 2 BP5*
or BP100: 5 bars/ day or 3 bars + 2 BP5
MUAC = 170 mm: 4 PPN/day or 3 PPN + 2 BP5
or BP100 7 bars/day or 5 bars + 2 BP5
Family ration: BP5: 6 boxes/week
* to improve compliance
We started only few weeks ago, so I don't have much data yet to evaluate the results.
Hope this help