guidelines for the integrated management of severe acute malnutrition

ACF-In Guidelines for the integrated management of SAM Annexes 155
Heigh
t
very
sever
e
sever
e
SAM
Weight Kg – Z-score
moderat
e MAM
dischar
ge
IMAM
Use for both boys and girls
media
n
Heigh
t
very
sever
e
sever
e
SAM
Weight Kg – Z-score
moderat
e MAM
discharg
e IMAM
cm -4.0 -3 -2 -1.5 -1 0 cm -4.0 -3 -2 -1.5 -1 0
Use Height for more than or equal to 87 cm
87 9.0 9.6 10.4 10.8 11.2 12.2 104 12.0 13 14 14.6 15.2 16.5
87.5 9.0 9.7 10.5 10.9 11.3 12.3 104.5 12.1 13.1 14.2 14.7 15.4 16.7
88 9.1 9.8 10.6 11 11.5 12.4 105 12.2 13.2 14.3 14.9 15.5 16.8
88.5 9.2 9.9 10.7 11.1 11.6 12.5 105.5 12.3 13.3 14.4 15 15.6 17
89 9.3 10 10.8 11.2 11.7 12.6 106 12.4 13.4 14.5 15.1 15.8 17.2
89.5 9.4 10.1 10.9 11.3 11.8 12.8 106.5 12.5 13.5 14.7 15.3 15.9 17.3
90 9.5 10.2 11 11.5 11.9 12.9 107 12.6 13.7 14.8 15.4 16.1 17.5
90.5 9.6 10.3 11.1 11.6 12 13 107.5 12.7 13.8 14.9 15.6 16.2 17.7
91 9.7 10.4 11.2 11.7 12.1 13.1 108 12.8 13.9 15.1 15.7 16.4 17.8
91.5 9.8 10.5 11.3 11.8 12.2 13.2 108.5 13.0 14 15.2 15.8 16.5 18
92 9.9 10.6 11.4 11.9 12.3 13.4 109 13.1 14.1 15.3 16 16.7 18.2
92.5 9.9 10.7 11.5 12 12.4 13.5 109.5 13.2 14.3 15.5 16.1 16.8 18.3
93 10.0 10.8 11.6 12.1 12.6 13.6 110 13.3 14.4 15.6 16.3 17 18.5
93.5 10.1 10.9 11.7 12.2 12.7 13.7 110.5 13.4 14.5 15.8 16.4 17.1 18.7
94 10.2 11 11.8 12.3 12.8 13.8 111 13.5 14.6 15.9 16.6 17.3 18.9
94.5 10.3 11.1 11.9 12.4 12.9 13.9 111.5 13.6 14.8 16 16.7 17.5 19.1
95 10.4 11.1 12 12.5 13 14.1 112 13.7 14.9 16.2 16.9 17.6 19.2
95.5 10.4 11.2 12.1 12.6 13.1 14.2 112.5 13.9 15 16.3 17 17.8 19.4
96 10.5 11.3 12.2 12.7 13.2 14.3 113 14.0 15.2 16.5 17.2 18 19.6
96.5 10.6 11.4 12.3 12.8 13.3 14.4 113.5 14.1 15.3 16.6 17.4 18.1 19.8
97 10.7 11.5 12.4 12.9 13.4 14.6 114 14.2 15.4 16.8 17.5 18.3 20
97.5 10.8 11.6 12.5 13 13.6 14.7 114.5 14.3 15.6 16.9 17.7 18.5 20.2
98 10.9 11.7 12.6 13.1 13.7 14.8 115 14.5 15.7 17.1 17.8 18.6 20.4
98.5 11.0 11.8 12.8 13.3 13.8 14.9 115.5 14.6 15.8 17.2 18 18.8 20.6
99 11.1 11.9 12.9 13.4 13.9 15.1 116 14.7 16 17.4 18.2 19 20.8
99.5 11.2 12 13 13.5 14 15.2 116.5 14.8 16.1 17.5 18.3 19.2 21
100 11.2 12.1 13.1 13.6 14.2 15.4 117 15.0 16.2 17.7 18.5 19.3 21.2
100.5 11.3 12.2 13.2 13.7 14.3 15.5 117.5 15.1 16.4 17.9 18.7 19.5 21.4
101 11.4 12.3 13.3 13.9 14.4 15.6 118 15.2 16.5 18 18.8 19.7 21.6
101.5 11.5 12.4 13.4 14 14.5 15.8 118.5 15.3 16.7 18.2 19 19.9 21.8
102 11.6 12.5 13.6 14.1 14.7 15.9 119 15.4 16.8 18.3 19.1 20 22
102.5 11.7 12.6 13.7 14.2 14.8 16.1 119.5 15.6 16.9 18.5 19.3 20.2 22.2
103 11.8 12.8 13.8 14.4 14.9 16.2 120 15.7 17.1 18.6 19.5 20.4 22.4
103.5 11.9 12.9 13.9 14.5 15.1 16.4
These tables are derived from the WHO2006 standards for Boys. Because using separate tables for
boys and girls may lead to many more boys being admitted to therapeutic programs than girls, the use
of the boys table for both sexes is recommended to avoid discrimination against female children. It is
recommended that the discharge criteria should be -1.5Z where there are adequate follow up
arrangements and/or a supplementary feeding program to which the children can be referred. ©
Michael Golden
media
n