Treating severe acute malnutrition seriously.

Severe acute malnutrition (SAM) affects approximately 13 million children under the age of 5 and is associated with 1-2 million preventable child deaths each year. In most developing countries, case fatality rates (CFRs) in hospitals treating SAM remain at 20-30% and few of those requiring care actually access treatment. Recently, community-based therapeutic care (CTC) programmes treating most cases of SAM solely as outpatients have dramatically reduced CFRs and increased the numbers receiving care. CTC uses ready-to-use therapeutic foods and aims to increase access to services, promoting early presentation and compliance, thereby increasing coverage and recovery rates. Initial data indicate that this combination of centre-based and community-based care is cost effective and should be integrated into mainstream child survival programmes.