A short-term intervention for the treatment of severe malnutrition in a post-conflict country: results of a survey in Guinea Bissau

Public Health Nutr. 2008 Dec;11(12):1357-64. doi: 10.1017/S1368980008003297. Epub 2008 Jul 24.


Objectives: To determine (i) the extent of malnutrition and the risk factors for severe malnutrition in Guinea Bissau, a post-conflict country experiencing long-term consequences of civil war; and (ii) the feasibility and effectiveness of a short-term intervention characterized by outpatient treatment with locally produced food for the treatment of severe malnutrition during the rainy season.

Design and setting: Social, clinical, nutritional information were collected for children reaching the paediatric outpatient clinic of the Hospital 'Comunità di Sant'Egidio' in Bissau, Guinea Bissau, from 1 July to 12 August 2003. Severely malnourished children (weight-for-age <-3sd) in poor health status were admitted for daily nutritional and pharmacological treatment until complete recovery. Social and health indicators were analysed to define risk factors of severe malnutrition.

Results: In total, 2642 children were visited (age range: 1 month-17 years). Fever, cough and dermatological problems were the main reasons for access. Social data outlined poor housing conditions: 86.4 % used water from unprotected wells, 97.3 % did not have a bathroom at home, 78.2 % lived in a mud house. Weight-for-age was <-2sd in 23.0 % of the children and <-3sd in 10.3 %; thirty-seven children (1.4 %) were severely malnourished and admitted for day care. All recovered with a weight gain of 4.45 g/kg per d, none died or relapsed after 1 year. Severely malnourished children were mainly infants, part of large families and had illiterate mothers.

Conclusion: Short-term interventions performed in post-conflict countries during seasons of high burden of disease and malnutrition are feasible and successful at low cost; day-care treatment of severe malnutrition with locally produced food is an option that can be tested in other settings.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child Nutritional Physiological Phenomena / physiology*
  • Child, Preschool
  • Cost-Benefit Analysis
  • Developing Countries
  • Educational Status
  • Feasibility Studies
  • Female
  • Guinea-Bissau
  • Health Status
  • Humans
  • Infant
  • Male
  • Malnutrition / epidemiology
  • Malnutrition / etiology
  • Malnutrition / pathology
  • Malnutrition / therapy*
  • Nutrition Assessment
  • Nutritional Status*
  • Poverty*
  • Risk Factors
  • Rural Population
  • Seasons
  • Severity of Illness Index
  • Treatment Outcome
  • Warfare*
  • Weight Gain