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BookletNortheastern Nigeria: Assessing drivers of acute malnutrition relapse in children
Study aiming at enhancing programming, August 2024
2024Also available in:
No results found.The ongoing crisis in northeastern Nigeria, mainly linked to conflict, climate extremes and economic challenges, has significantly impacted agricultural livelihoods, leading to increased levels of acute food insecurity and malnutrition. In 2023, Nigeria recorded the highest number of acutely malnourished children under the age of five and pregnant and breastfeeding women in the African drylands, with over 1.5 million people affected in northeastern Nigeria alone.While outpatient treatment programmes are effective in supporting the initial recovery from severe acute malnutrition, a considerable proportion of children experience relapse, requiring repeated treatments. This indicates a severe shortcoming of current approaches and highlights the need to better understand the determinants of relapse to improve preventative strategies. To this end, FAO carried out a study to provide programme recommendations in order to address these drivers and prevent relapse. -
Book (series)Microbiological safety of lipid-based ready-to-use foods for management of moderate acute malnutrition and severe acute malnutrition 2016
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No results found.Consistent with the need to provide safe food for young children, particularly during the complementary feeding period between 6 and 24 months and the period of rapid development to age 59 months, FAO and WHO convened a technical meeting in FAO headquarters, Rome, Italy, from 11 to 14 December 2012 that addressed the microbial safety of ready-to-use foods (RUF) for the management of acute malnutrition. The meeting was held at the request of the WFP and UNICEF to help them formulate a science-ba sed response to the finding of Cronobacter spp. in lipid-based RUF and to provide guidance on appropriate microbiological specifications to include among other purchase requirements to enhance the safety of lipid-based RUF. This report provides an overview of the assessment of the risk posed by Cronobacter spp in this product and provides guidance to agencies distributing the product as well of the producers on how to manage this problem and minimise the risk to the vulnerable consuming popula tion. -
Book (series)Microbial safety of lipid-based ready-to-use foods for management of moderate acute malnutrition and severe acute malnutrition – Second report 2021
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No results found.Lipid-based ready-to-use foods (RUFs) for the nutritional management of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) are provided to children from 6 months to 59 months of age within the context of emergency feeding programmes supervised by governments. Based on the review, the expert committee considered that children with SAM have an increase in susceptibility to bacteraemia and sepsis that is probably between twofold and fivefold compared with children who are not malnourished and are of the same age and live in the same communities. On the basis of its common occurrence as a cause of infections and serious illnesses in children with SAM, and its documented ability to contaminate, survive in, and cause outbreaks of illness associated with low-moisture foods similar to RUFs, the expert committee concluded that Salmonella is the pathogen of most concern in lipid-based RUFs. Many outbreaks of foodborne salmonellosis have been determined to be associated with low-moisture foods that were contaminated at low levels. Therefore, the expert committee carefully considered the qualitative microbiological analyses of RUFs and the contamination levels that could be inferred, and entered into an extended deliberation of dose-response modelling to find a path toward a reasonable approximation of the likely morbidity and mortality in SAM children that could be anticipated from consumption of RUFs contaminated at the estimated levels and observed frequency. The expert committee described three approaches that purchasers of RUFs might use to establish microbiological criteria to assure the safety of RUFs and to communicate to manufacturers their safety expectations. These approaches are: (i) reference to existing standards established for similar low-moisture foods; (ii) determining an acceptable increase in risk over the pre-existing baseline of illness from other sources of exposure; and (iii) process verification sampling using the moving window technique. The microbiological criteria derived by each of these approaches accomplish different purposes, and which is most appropriate is determined by the conditions of manufacture and use.
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