Sarah N., 1

Sarah is the only child of her parents. The family lives in a modest two-room iron-sheet rental house, for which they pay KSh 1,500 per month. Her father is the sole provider, working as an unskilled laborer at construction sites whenever he can find work. Her mother is currently unemployed. According to the mother, Sarah initially developed symptoms of a common cold, followed by the appearance of reddish rashes on her body. She also mentioned that Sarah has generally been unwell. Hoping it would help, she gave her paracetamol at home. However, a few days later, Sarah experienced a nosebleed, prompting her mother to take her to Rwambwa Health Centre. On arrival, the child was examined and found to have signs of severe acute malnutrition, including visible wasting, poor appetite, and general weakness. She was then referred to Siaya County Referral Hospital for further management.

The child was brought to the hospital with a high fever, nosebleeds, and a widespread skin rash. Upon assessment, she was found to have severe acute malnutrition, severe anaemia, and gastroenteritis, conditions that required immediate admission. During her stay in the ward, she received a blood transfusion, was started on a strict therapeutic feeding program, and was treated with broad-spectrum antibiotics. She showed good improvement and was later discharged with oral medications to continue at home. Her guardian was also counselled on proper nutrition and how to support the child’s recovery through adequate feeding.

Sarah’s condition of severe acute malnutrition (SAM) places her at high risk of life-threatening complications, including infections, anemia, and metabolic imbalances, if not promptly and adequately managed. However, there was timely admission, specialized nutritional rehabilitation, and treatment of underlying conditions and so her prognosis is fair to good.