Download Free Medical MALNUTRITION - Screening and referral PowerPoint Presentation

MALNUTRITION - Screening and referral PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Check out this medical presentation on Child Nutrition, which is titled "MALNUTRITION - Screening and referral", to know about the basics about undernutrition.

Tags : Child Nutrition, MALNUTRITION, Screening, referral

Published on : Jul 07, 2021 | Views : 3487 | Downloads : 23

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

9 juillet 2021 MALNUTRITION – Screening and referral BALKH Nutrition Team
Slide 2-

9 juillet 2021 2 Objectives of training To understand basics about undernutrition: definition, causes and consequences To know how to perform anthropometric measurements – identify MAM and SAM children / PLW To know and understand the management of acute malnutrition
Slide 3-

9 juillet 2021 3 NUTRITIONAL REQUIREMENTS FOOD INTAKE Nutrition Nutritional status: balance physiological state of an individual, which results from: the relationship between nutrient intake and requirements, and the body’s ability to digest, absorb and use these nutrients.
Slide 4-

9 juillet 2021 4 FOOD INTAKE NUTRITIONAL REQUIREMENTS Nutritional Status: not well balanced diet Over-nutrition Obesity
Slide 5-

9 juillet 2021 5 FOOD INTAKE NUTRITIONAL REQUIREMENTS Nutritional Status: not well balanced diet Under-nutrition
Slide 6-

9 juillet 2021 6 Non-balanced nutrition can be caused by : Sufficient quantity but insufficient quality of food (lack of diversified food) Sufficient quality but insufficient quantity of food (lack of intake) Insufficient quantity and quality of food (lack of intake and diversified food) MALNUTRITION : Term for bad nutritional status Definition: situation when the body does not receive the sufficient quantity and/or quality of nutrients.
Slide 7-

9 juillet 2021 7 Food intake Food intake depends on different factors: Availability of the food For example: food available in the market Accessibility of the food For example: cost of the food in the market Possible influences?? Harvest, price, soil, culture/beliefs, etc
Slide 8-

The tree of malnutrition 09/07/2021 Malnutrition unbalanced nutritional status Over nutrition overweight OBESITY Micronutrient deficiency Under-nutrition Chronic malnutrition stunting Under-weight Acute malnutrition wasting MAM SAM Installed status Episodic status MALNUTRITION Incorrect definition: Malnutrition= acute undernutrition Correct definition: Mal + nutrition= “bad nutrition” ACF: Focus on Acute malnutrition ++
Slide 9-

Consequences of malnutrition Short term consequences Mortality, morbidity, disability Long term consequences Intellectual capacity Economic productivity Reproductive performance Diseases Future psychological well being 9 juillet 2021 9
Slide 10-

9 juillet 2021 10 Consequences and risks of malnutrition... Reduced physical activity Lowered resistance to disease Even not dangerous disease becomes dangerous Increased risk of mortality Learning difficulties
Slide 11-

9 juillet 2021 11 Acute Malnutrition Acute Malnutrition = DISEASE Acute malnutrition Sudden deprivation / Short-term process Sudden weight loss More vulnerable population : Children 6-59 months and PLW Consequences if no treatment : DEATH
Slide 12-

9 juillet 2021 12 Under-nutrition : Causes Malnutrition & mortality Insufficient food intake Diseases Poor acces, availability and quality of food Inadequate child care practices and psychological environment Poor acces, availability and quality of health services, unhealthy environment Quantity, quality, and control of true resources (human, economic, institutional) Potential resources Manifestations Immediate Causes Underlying Causes Basic causes within society Impairs growth and development
Slide 13-

9 juillet 2021 13 Classification of Acute malnutrition 2 classifications according to gravity: Moderate Acute Malnutrition (MAM) Lost of weight is started Precede severe acute malnutrition if not treated Severe Acute Malnutrition (SAM)
Slide 14-

09 July 2021 14 Severe Acute malnutrition 3 forms MARASMUS Severely wasted KWASHIORKOR Bilateral Oedema MARASMIC-KWASHIORKOR Both
Slide 15-

9 juillet 2021 15 Marasmus Skinny: underweight Old man’s face, Sunken eyes Irritability Subcutaneous fat and muscles loss Distended abdomen Impression of too much skin at the buttock Hungry
Slide 16-

9 juillet 2021 16 Kwashiorkor Nutritional bilateral oedema Skin lesions Lethargy Moon face Depigmentation: skin and hair Anaemia No appetite
Slide 17-

9 juillet 2021 17 Marasmic-kwashiorkor Combination of Weight loss AND Nutritional bilateral oedema Skinny arms and swollen feet
Slide 18-

9 juillet 2021 18 Different types of severe acute malnutrition Marasmus Marasmus-kwashiorkor Kwashiorkor
Slide 19-

Acute malnutrition How can we measure it ?? 09/07/2021
Slide 20-

Anthropometric measurement Anthropometry is human body measurement: nutritional status of a person is estimated by the measure of some corporeal parameters. In addition to the clinical picture, malnutrition diagnosis will be confirmed by anthropometric measurements. That’s why they need to be taken properly and be accurate 9 juillet 2021 20
Slide 21-

Diagnosis of malnutrition 9 juillet 2021 21
Slide 22-

Anthropometric measurements What is necessary to do a good anthropometric measurement? Good measurement equipment Standardized measurement procedure Well trained personnel … 9 juillet 2021 22
Slide 23-

MUAC Measurement 09/07/2021
Slide 24-

MUAC measurement 09/07/2021 MUAC : Mid Upper Arm circumference CHILDREN >6 months On the left folded arm, between shoulder bone and tip of the elbow Put the tape to the length of the folded arm, Mark midpoint
Slide 25-

MUAC measurement 09/07/2021 Left arm is unfolded and relaxed; Tape is wrapped aroune the arm,at the midpoint, neither too tighten or too loose/slack. Do not lean fingers on the tape or the arm Read the measure between the arrows of 1mm for precise
Slide 26-

How check oedema ? 09/07/2021 Have a light pressure for 3 seconds on the top of the feet at the same time Observe the depression on both feet = pit If it is the case => check the legs, then hands, then face
Slide 27-

Oedema Graduation of oedema according severity: Grade 1+ : Bilateral pitting oedema of the feet Grade 2+(or ++) :Bilateral oedema of the feet and lower limbs / hands Grade 3+(or +++) : Generalised oedema of feet, lower limbs, hands and periorbital 9 juillet 2021 27
Slide 28-

Bilateral oedema Immune and inflammatory fonctions are severly affected for kwashiorkor children, in such a way that cutaneous lesions aren’t painful for them. 09/07/2021
Slide 29-

Height measurement For all children < 87cm Child straight along the scale, chin raised and feet down flat on the cursor Read the measure on the cursor level of 1mm for precise 9 juillet 2021 29
Slide 30-

Height measurement 09/07/2021 Correct position
Slide 31-

9 juillet 2021 31 Height measurement Ideal position
Slide 32-

9 juillet 2021 32 Standing height measurement For all children > 87cm Child straight along the scale, joint feet Straight head, maintain the chin Arms along the body Read the measure on the cursor level of 1mm for precise
Slide 33-

9 juillet 2021 33 Standing height measurement
Slide 34-

Weight measurement SALTER scale Tare the scale before each weighing, with the empty basin or pants (the needle need to be in front of the 0) Put the child in the pants Calm down the child if needed Place yourself in front of the scale, your eyes at the same level as the needles Read the weight indicated, of 100g for precise 9 juillet 2021 34
Slide 35-

9 juillet 2021 35 What are the common mistakes?
Slide 36-

ppt slide no 36 content not found
Slide 37-

ppt slide no 37 content not found
Slide 38-

ppt slide no 38 content not found
Slide 39-

ppt slide no 39 content not found
Slide 40-

ppt slide no 40 content not found
Slide 41-

ppt slide no 41 content not found
Slide 42-

ppt slide no 42 content not found
Slide 43-

ppt slide no 43 content not found
Slide 44-

How identify malnourished children? Using combination of indexes : Index = difference between the value of the measured parameter and the reference value (mean or median) in the international standards 2 indexes: MUAC index W/H index + oedema 9 juillet 2021 44
Slide 45-

9 juillet 2021 45 Weight for Height Emaciated child has a lower weight than a « standard » child, who has the same Height and Sex. Weight for Height (W/H) measure the child’s corpulence . Weight gain is sensitive to the actual situation. So W/H reflects a recent situation. It is a reliable and admitted. Doesnt require age estimation It is used for show recent food or health situation.
Slide 46-

W/H reference table Exercice 9 juillet 2021 46 Exercice Weight for Height Reference Card (WHO, 2006)
Slide 47-

9 juillet 2021 47 Identification of malnourished children 6-59 months Classification of acute malnutrition in children 6-59 months based on anthropometry
Slide 48-

9 juillet 2021 48 Identification of malnourished children less than 6 months or < 4Kg Criteria for referral of infants aged less than 6 months to inpatient SAM treatment
Slide 49-

Identification of malnourished PLW 09/07/2021 49 Eligibility criteria for identification of malnourished PLW is only MUAC
Slide 50-

IMAM Implementation IMAM = Integrated Management of Acute Malnutrition Integrated to BPHS (and EPHS at provincial level) Target children 0-59 months and PLW 2 levels Community Health Facility 9 juillet 2021 50 Community - Active screening and referral - Sensitization - Follow-up (home visits) Health Facility - Passive screening / orientation - Treatment / Follow-up - Sensitization CHWs Health staffs CHS
Slide 51-

IMAM Implementation : COMMUNITY Goals of community outreach Maximize coverage and access Maximize the timeliness of treatment Maximize compliance with treatment 9 juillet 2021 51
Slide 52-

IMAM Implementation : COMMUNITY Focal point in community : CHWs Main activities: Active case finding => screening (house to house / massive screening) : MUAC and Oedema Early Referral => referral slip Sensitization / health education => to raise knowledge about malnutrition and its treatment (prevention ++) Follow-up => home visits (Beneficiaries, absentees, defaulters..) : increase the impact and sustainability of nutrition activities 9 juillet 2021 52
Slide 53-

ACTIVE CASE FINDINGS/SCREENING and EARLY REFERRAL 9 juillet 2021 53
Slide 54-

IT IS ALSO… The HOME VISITS for the high-risk cases Non-response/ absents/ defaulters of the program… AWARENESS SESSIONS/SENSITIZATION/HEALTH EDUCATION Nutrition, health, hygiene promotion... © ACF, Christina Lionnet - Tchad 9 juillet 2021 54
Slide 55-

IMAM : HEALTH FACILITY Reception of referral from community : check again anthropometric measurements to confirm diagnosis Passive screening : each child from 0-59 months and PLW (from 2nd trimester of pregnancy to 6 months of breastfeeding) Orientation : MAM/SAM identified => orientation to the right service (OPD-MAM / OPD-SAM / IPD-SAM) Treatment and follow-up : nutritional product and systematic medical treatment, follow-up of nutritional status (referral if needed) Transversal => Sensitization-Counseling nutrition / health topics 9 juillet 2021 55
Slide 56-

In HF where treatment is available 9 juillet 2021 56 PASSIVE SCREENING All children 0-59m APPETITE TEST CLINICAL EXAM ORIENTATION TO THE RIGHT SERVICE (OPD-MAM/SAM or IPD-SAM) All the children who fit the criteria for acute malnutrition Depending on: - Anthropo measures - Appetite result - Clinical result TREATMENT & FOLLOW-UP
Slide 57-

Appetite test For each child identified as acutely malnourished (MAM/SAM) Aim: To see if the child is able to eat sufficient quantity of nutritional product to recover The loss of appetite in a child with acute malnutrition may indicate a serious pathophysiology Appetite test: Part of the initial diagnosis At every follow-up visit 9 juillet 2021 57
Slide 58-

Complications associated to acute malnutrition (during clinical exam) 9 juillet 2021 58 + any other diseases that need to be treated at the hospital (inpatient)
Slide 59-

Referral and treatment of acute malnutrition 09/07/2021 59 Inpatient Department for SAM Outpatient Department for SAM* Child has SAM and No complications Appetite for RUTF Child has MAM and No complications Appetite for RUSF Child has SAM and Any complications No appetite for RUTF Inpatient Department for SAM Outpatient Department for SAM* Child has SAM and No complications Appetite for RUTF Child has MAM and No complications Appetite for RUSF Child has SAM and Any complications No appetite for RUTF Acute Malnutrition Child has SAM and - Any complications and/or - No appetite for RUTF Child has SAM and - No complications and - Appetite for RUTF Child has MAM and - No complications - Appetite for RUSF Inpatient Department for SAM (IPD-SAM) Outpatient Department for SAM (OPD-SAM) Outpatient Department for MAM (OPD-MAM)
Slide 60-

60