Malnutrition and dehydration in the third world: practical treatment.

Malnutrition coupled with dehydration (usually secondary to diarrhea) is one of the major causes of morbidity and death in the Third World. The mortality rate is high, especially in children; four to five million die each year. However, diagnosis and treatment of these problems has improved in the past decade. In therapeutic feeding programs, which are designed for markedly malnourished children, oral rehydration solution is likely the most important medicine that can be offered. After initial rehydration, the malnutrition can be treated with six to nine meals daily, and/or nasal-gastric feeding and special high energy milk formulas. Patients usually require four to six weeks before moving to a supplementary program, which supplies an additional 350-500 kilocalories and an extra 15 g of protein to the daily diet. This program is for those at high risk: children under age five, pregnant and lactating women, and certain debilitated patients.