A 3-year-old child has weight-for-height Z-score of -3.5 SD, no oedema, and is alert and playful. According to WHO-UNICEF protocol, this child should be managed as:
- A Moderate Acute Malnutrition (MAM) — supplementary feeding programme
- B Severe Acute Malnutrition (SAM) with complications — hospital admission
- C Severe Acute Malnutrition (SAM) without complications — Community-Based Management (CMAM) ✓
- D At-risk child — nutritional counselling only
Correct answer: C. Severe Acute Malnutrition (SAM) without complications — Community-Based Management (CMAM)
Explanation
SAM is defined as WHZ < -3 SD, MUAC < 115 mm, or bilateral pitting oedema. This child has WHZ of -3.5 SD, meeting SAM criteria. However, the absence of appetite failure, oedema, and medical complications (hypoglycaemia, hypothermia, severe infections) classifies this as uncomplicated SAM, appropriate for Community-Based Management of Acute Malnutrition (CMAM) with Ready-to-Use Therapeutic Food (RUTF). Complicated SAM requires Nutritional Rehabilitation Centre (NRC) inpatient management.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.