The pattern you describe can certainly occur without there being a reason that the child should be put into the hospital.  The child may have developed malaria, diarhhea or another infectious condition.  Does the mother report any fever, cough or diarrhea?  When you see the child is he/ she able to eat?  If weight gain was increased the first 2 weeks, but < 50g per week, then this might indicate no real improvement, but no deterioriation.  No change in condition after 4 weeks should be investiagted by a clinician, but may not need hsopitalization.

Yes, if a child's weight improves in the first and second visits to an outpatient therapeutic program (OTP/SAM) but then returns to the same or less than the admission weight in the third visit, this is considered a primary failure in therapeutic treatment and requires transfer to a therapeutic feeding center (TFC).

This is because it indicates that the child is not responding well to the treatment provided in the OTP/SAM. TFCs provide more intensive care and support, such as closer monitoring, higher-calorie foods, and nasogastric tube feeding if necessary.

Here are the World Health Organization (WHO) guidelines for the management of primary failure in therapeutic treatment:

Transfer the child to a TFC.
Identify and address the underlying cause of the failure. This may involve things like treating infections, providing psychosocial support, or adjusting the child's feeding plan.
Continue to monitor the child's progress closely.
Once the child has stabilized and is gaining weight consistently, the child can be transferred back to the OTP/SAM for follow-up care.
It is important to note that not all cases of primary failure in therapeutic treatment require transfer to a TFC. In some cases, the child's condition may be improved by making adjustments to the child's treatment plan, such as increasing the frequency of feeding or providing more specialized care. However, it is important to consult with a healthcare professional to determine the best course of action for each individual child.

Hello everyone,

In our context, cases of moderate acute malnutrition are treated on an outpatient basis. To answer the question of non-response or failure to treatment, several factors that we can classify into three may be linked to the non-response:

- factors linked to the treatment center (breakage of therapeutic input, medication for systematic treatment, poorly trained agent for the PEC of malnutrition, etc.),

- factors linked to the community (sharing of the child's ration, lack of hygiene, etc.)

- factors linked to the child (underlying pathologies.....)

Added to this are admission errors, hence the need for an appetite test for all patients, particularly SAM.

I advise you to investigate all these parameters before declaring a no response.

Sincerely