Page 2 of 4
Criteria for deciding on treatment and management options
Not all SAM children need to be admitted into inpatient care. SAM children without complications can be managed at home in a community-based programme where they are supervised either as outpatients or by home visits. Let’s see the criteria you can use to determine who can be managed in the community and who should be managed in a hospital.
Criteria for Home/Community-based Management for Acute Malnutrition (CMAM)
• Severe wasting (MUAC <115mm or weight-for-height <-3SD)
OR
• Oedema grade + or ++
AND all of the following:
• Clinically well and alert
• Good appetite
• Aged 6 months or older
• Good appetite
Criteria for hospital-based management
• Generalised oedema (grade +++)
OR
• Severe wasting AND any of the following:-
◦ Poor appetite
◦ Clinically unwell (e.g. high fever, hypothermia, fast breathing,
dehydration, raw skin or fissures)
◦ Severe anaemia
◦ Not alert
OR
• Age <6months
Criteria for Home/Community-based Management for Acute Malnutrition (CMAM)
CMAM, originally termed Community-based Therapeutic Care (CTC), offers great potential for treating the majority of children with SAM. The criteria to use for selecting SAM children for community-based management are;
• Severe wasting (MUAC <115mm or weight-for-height <-3SD)
OR
• Oedema grade + or ++
AND all of the following:
• Clinically well and alert
• Good appetite
• Aged 6 months or older
• Good appetite
The criteria for admitting a child into inpatient care are:
• Generalised oedema (grade +++)
OR
• Severe wasting AND any of the following:-
◦ Poor appetite
◦ Clinically unwell (e.g. high fever, hypothermia, fast breathing,
dehydration, raw skin or fissures)
◦ Severe anaemia
◦ Not alert
OR
• Age <6months
Click on each criterion to see further information.
