Jones Kelsey D J, Berkley James A
Paediatr Int Child Health. 2014 Dec;34 Suppl 1(Suppl 1):S1-S29. doi: 10.1179/2046904714Z.000000000218.
Severe acute malnutrition (SAM) is associated with increased severity of common infectious diseases, and death amongst children with SAM is almost always as a result of infection. The diagnosis and management of infection are often different in malnourished versus well-nourished children. The objectives of this brief are to outline the evidence underpinning important practical questions relating to the management of infectious diseases in children with SAM and to highlight research gaps. Overall, the evidence base for many aspects covered in this brief is very poor. The brief addresses antimicrobials; antipyretics; tuberculosis; HIV; malaria; pneumonia; diarrhoea; sepsis; measles; urinary tract infection; nosocomial Infections; soil transmitted helminths; skin infections and pharmacology in the context of SAM. The brief is structured into sets of clinical questions, which we hope will maximise the relevance to contemporary practice.
重度急性营养不良(SAM)与常见传染病的严重程度增加相关,患有SAM的儿童死亡几乎总是由感染导致。营养不良儿童与营养良好儿童在感染的诊断和管理方面往往有所不同。本简报的目的是概述与患有SAM的儿童传染病管理相关的重要实际问题的依据,并突出研究空白。总体而言,本简报涵盖的许多方面的证据基础非常薄弱。简报涉及抗菌药物、退烧药、结核病、艾滋病毒、疟疾、肺炎、腹泻、败血症、麻疹、尿路感染、医院感染、土壤传播的蠕虫、皮肤感染以及SAM背景下的药理学。简报按一系列临床问题进行编排,我们希望这将最大限度地提高与当代实践的相关性。