A 2-year-old child in a tribal community is found to have bilateral pitting edema of feet, depigmented hair, a 'flaky paint' skin rash on the buttocks, and is extremely irritable. Weight-for-height Z score is −2.8. Serum albumin is 1.4 g/dL. What is the therapeutic food of choice as recommended by WHO/UNICEF for community-based management?
- A Ready-to-use therapeutic food (RUTF) — Plumpy'Nut or equivalent ✓
- B F-75 therapeutic milk formula
- C High-protein milk (F-100) given immediately
- D Oral rehydration solution with zinc supplementation
Explanation
This child has kwashiorkor (SAM with edema) based on bilateral pitting edema, skin changes, hair depigmentation, and low albumin. The current WHO protocol for community-based management of uncomplicated SAM (no medical complications, clinically stable) uses Ready-to-Use Therapeutic Food (RUTF) such as Plumpy'Nut (peanut-based paste with milk proteins, sugar, fat, and micronutrients). F-75 is used in facility-based management during the initial stabilization phase (dangerous in home setting — risk of refeeding syndrome if used first), and F-100 is used in the rehabilitation phase in facility. RUTF is nutritionally equivalent to F-100 in home-based treatment due to its stability and palatability without requiring water preparation.
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.