Briefing Papers Number 14, February 2012

Peggy Koniz-Booher Malnutrition, Illnesses, and Infectious Diseases Assessing nutritional status with Mid-Upper Arm Circumference (MUAC) is a relatively easy and cheap way to rapidly screen/assess for acute malnutrition and a good predictor of immediate risk of death. A volunteer or health extension worker can easily use MUAC in the community and it has been proven to increase the routine assessment and nutritional categorization of clients.* * Bergmann, Heather, and Maryanne Stone-Jiménez. 2011. NuLife—Food and Nutrition Interventions for Uganda: Nutritional Assessment, Counseling, and Support. Arlington, VA: USAID’s AIDS Support and Technical Assistance Resources, AIDSTAROne, Task Order 1. integrate nutrition into HIV services—can be scaled up to integrate nutrition into clinical and community health services and thus, rapidly expand access to nutrition services. Screening a child’s growth and nutritional status60 and advising parents based on the results should be part of routine primary health care rather than an isolated activity. Similarly, treatment for childhood illnesses such as pneumonia or diarrhea should include not only the appropriate antibiotics but also the appropriate nutritional assessment counseling, education, and support to help the child recover quickly and avoid new infections. NACS helps detect and treat malnutrition and supports prevention practices such as optimal infant feeding and correction of micronutrient deﬁciencies. The NACS approach also provides specialized food— therapeutic foods (for SAM) and supplementary foods (for MAM). These are nutritionally dense, fortiﬁed food products that treat acute malnutrition and are prescribed as medicine. Now with the availability of lipid-based ready-to-use therapeutic foods such as the peanut butter-based Plumpy’nut, which do not require preparation at home and are less susceptible to bacterial contamination than milk-based foods, children can often be treated at home. This can reduce expenses, ease overcrowding in hospitals, and lessen the strain on mothers, who must often forego income and leave their other children unattended to stay with a hospitalized child.61, 62 Additionally, prescribing lipid-based therapeutic foods in health facilities has been proven to dramatically improve nutritional status and quality of life for patients.63 10 Brieﬁng Paper, February 2012 A healthy immune system protects a person from the majority of infectious diseases, but malnutrition weakens the immune system. Undernutrition increases both susceptibility to and severity of common illnesses and infectious diseases. Infectious diseases—particularly diarrhea, malaria, and respiratory illness—also contribute to stunting of children under two. Complications of seemingly minor illnesses are more common. Since malnutrition often affects the way infections manifest themselves—for example, fast breathing is a common symptom of pneumonia, but malnourished children can have pneumonia without fast breathing64—health workers may need specialized training to provide the correct treatments. Many different types of infections (e.g., bacterial, viral, intestinal) make the body less able to absorb nutrients. Studies have shown that children with diarrhea can absorb as much as 40 percent less of the protein they consume than healthy children.65 Poor absorption leads to malnutrition, which in turn increases a child’s susceptibility to infection.66, 67, 68, 69, 70, 71 This vicious cycle generally cannot be broken through diet alone; medical treatment of the infection is also needed. In addition, more and more research is showing that even if a child survives very early malnutrition, \

Briefing Papers Number 14, February 2012 | Page 10