Proceedings of the Nutrition Society

Research Article

Symposium 5: Joint BAPEN and Nutrition Society Symposium on ‘Feeding size 0: the science of starvation’ Severe malnutrition: therapeutic challenges and treatment of hypovolaemic shock

Conference on ‘Malnutrition matters’

on 4–5 November 2008, The Annual Meeting of the Nutrition Society and BAPEN, was held at Harrogate International Centre, Harrogate.

Kathryn Maitlanda1 c1

a1 KEMRI-Wellcome Trust Programme, PO Box 230, Kilifi, Kenya


The systematic failure to recognise and appropriately treat children with severe malnutrition has been attributed to the elevated case-fatality rates, often as high as 50%, that still prevail in many hospitals in Africa. Children admitted to Kilifi District Hospital, on the coast of Kenya, with severe malnutrition frequently have life-threatening features and complications, many of which are not adequately identified or treated by WHO guidelines. Four main areas have been identified for research: early identification and better supportive care of sepsis; evidence-based fluid management strategies; improved antimicrobial treatment; rational use of nutritional strategies. The present paper focuses on the identification of children with sepsis and on fluid management strategies.

(Online publication June 03 2009)


c1 Corresponding author: Dr Kathryn Maitland, fax +254 415 22390, email