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It is usually only patients with treatment failure criteria that must have a thorough clinical
examination and laboratory. Time and trained personnel resources should be used in good èchent:
for training, supervision, diagnosis and treatment of patients not responding to standard treatment.
The absence or failure to standard treatment is a diagnosis in itself. Criteria for treatment failure.
For the CNAS, the main reasons are social and psychological in general; this may also be the case for
patients NITC but less commonly.
transition phase
This phase prepares the patient in the rehabilitation phase CNTI or its transfer to the outpatient
CNAS. The transition phase lasts from 1 to 5-days but it may be longer, in particular when another
condition is associated as TB and HIV / AIDS.
Nutrition therapy
The only difference with Acute phase is the change in dietary regimen: one passes using the F75 or
F100 has ATPE- if RUTF N4EST NOT ACCEPTED BY THE PATIENT. It is best to use RUTF during the
transition phase. Sick patients will continue treatment as an outpatient should get used to the RUTF
before returning to their home.
use RUTF
Gives the total volume of RUTF for the day according to Table 33;
Table 33: Amount of RUTF for the day according to the table
Weight class Pate grams Pate bags Bars bars Total kcal
Use the F100 (130ml = 130 Kcal). When the F100 is used, the volume of meals remain the
same in Transition phase and Acute phase.
Ask the mother to breastfeed, 30 minutes before meals;
Prepare food from small bags F100 (114g), add 500ml of drinking boiled water, warmed, or
from large bags F100 (456g) add 2 liters of water.
Leave 6 (or 5) meals a day.
Note the CNTI scorecard gives volume and taken.
Warning. The F100 should not be keep in its liquid form at room temperature for more than three
hours before consumption;
Monitoring
With RUTF or F100 milk, increases the energy intake of 100 kcal / kg / day to 130 Kcal / kg / day
If the patient has an increased number of bowel movement when changing diet, this should be
ignored if it does not lose weight. Several watery stools without weight loss is not a passing criterion
of transition to the Acute Phase
In exceptional cases (lack of CNAS in the area, or the presence of serious social problems) that
require patient survi in the CNT in phase 2, the same criteria as the transfer to the CNAS are used for
passage the transition phase the phases 2 internally