A day centre for malnourished children [letter]

A day center for children with protein-energy malnutrition (PEM) was begun in Luanda Angola in 1986 within the casualty department of the teaching hospital Hospital Josina Machel. Children stay with their mothers for 6 days from 0800-1800 for nutrition and education by nurses. Patients were classified evaluated treated for other diseases immunized and fed 6 meals/day. Liquid meals of dried skimmed milk oil and sugar adapted from WHO were given to those with edema. Others were fed 3 solid meals/day. On Saturday afternoons and Sundays meals were provided to be fed at home. Criteria for discharge was a weight for height of 80% of the standard usually achieved after an average of 3 weeks. 167 children were admitted 128 completed criteria and 35 were successfully followed up. Of the 128 who completed treatment there were 28% with marasmus 54% with kwashiorkor and 18% with both. 84% had anemia 45% diarrhea 36% pneumonia 31% urinary tract infections and 23% parasites. Those with kwashiorkor had the best results.