{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T12:52:04Z","timestamp":1791982324016,"version":"4.4.0"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Recent reports indicate a rising prevalence of acute malnutrition among children in Afghanistan. This retrospective hospital\u2010based study was conducted at Guzara District Hospital in Herat and aimed to investigate the severity, treatment outcomes, and monthly trends of acute malnutrition among children aged 0\u201359 months and potential determinants from May 2020 to March 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      For this study, the data were collected from the hospital malnutrition treatment register, a standardized logbook in which demographic, anthropometric, treatment, and outcome data of admitted children were recorded. The study included 253 children, with malnutrition severity assessed using weight\u2010for\u2010height\n                      <jats:italic>Z<\/jats:italic>\n                      \u2010scores (WHZ), mid\u2010upper arm circumference (MUAC), and bilateral oedema. Information on age, sex, and location was also collected. In addition, treatment outcomes were obtained from the hospital registration book. WHZ, MUAC, age, sex, location, and oedema refer to characteristics recorded at baseline (admission). Group differences were analysed using Chi\u2010squared and Kruskal\u2013Wallis tests, with Monte Carlo simulations for small counts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Results showed a high burden of severe acute malnutrition (SAM). Based on WHZ, 77.9% of children were classified as SAM, and 14.68% presented with bilateral oedema. Among children older than 6 months, and among children with available MUAC data (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009109), 74.3% had a MUAC\u2009&lt;\u2009115\u2009mm. Moderate acute malnutrition (MAM) was identified in 11.46% using WHZ and 18.34% using MUAC. Regarding outcomes, 42.29% recovered, and 41.50% were referred to outpatient care, while 7.11% were referred to inpatient care, 3.55% defaulted, and 5.53% had missing outcome data. Treatment outcomes varied, with children aged 6\u201359 months and those with oedema requiring more extended care. Additionally, malnutrition cases increased in summer 2021.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study highlights the significant burden of SAM at Guzara Hospital, especially among children under 12 months, a seasonal rise in cases, and the association between treatment outcomes and malnutrition indicators.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.73342","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T07:27:54Z","timestamp":1791185274000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Severity and Outcomes of Acute Malnutrition in Children Aged 0\u201359 Months at Guzara District Hospital, Herat: A Retrospective Study"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4297-5752","authenticated-orcid":false,"given":"Nademah","family":"Tamkin","sequence":"first","affiliation":[{"name":"Medical Department Herat University Herat Afghanistan"},{"name":"University of Cambridge, Institute of Metabolic Science and MRC Metabolic Research Laboratories, Addenbrooke's Hospital Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2531-1804","authenticated-orcid":false,"given":"Uttara","family":"Partap","sequence":"additional","affiliation":[{"name":"Department of Global Health and Population Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Leming","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital\/Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.5772\/intechopen.92006"},{"key":"e_1_2_12_3_1","volume-title":"Malnutrition","author":"World Health Organization","year":"2019"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70362-6"},{"key":"e_1_2_12_5_1","unstructured":"Afghanistan Ministry of Public Health; UNICEF.National nutrition survey Afghanistan (2013): survey report. (Afghanistan Ministry of Public Health;2013).http:\/\/reliefweb.int\/sites\/reliefweb.int\/files\/resources\/Report%20NNS%20Afghanistan%202013%20(July%2026-14).pdf."},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12288"},{"issue":"1","key":"e_1_2_12_7_1","first-page":"41","article-title":"Acute Malnutrition Among Under\u2010Five Children in Faryab, Afghanistan: Prevalence and Causes","volume":"78","author":"Frozanfar M. K.","year":"2016","journal-title":"Nagoya Journal of Medical Science"},{"key":"e_1_2_12_8_1","volume-title":"Afghanistan Service Provision Assessment 2018\u201319","author":"Ministry of Public Health (Afghanistan); ICF","year":"2019"},{"key":"e_1_2_12_9_1","volume-title":"Afghanistan Health System","author":"World Health Organization","year":"2018"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-020-05845-8"},{"key":"e_1_2_12_11_1","unstructured":"UNICEF.Nutrition: Good Nutrition for the Most Vulnerable Children and Mothers.2018.https:\/\/www.unicef.org\/afghanistan\/nutrition."},{"key":"e_1_2_12_12_1","first-page":"15","volume-title":"Concern Worldwide and Welthungerhilfe","author":"Von Grebmer K.","year":"2020"},{"key":"e_1_2_12_13_1","volume-title":"Hunger and Nutrition Commitment Index Global: Key Data for Afghanistan","author":"Institute of Development Studies; Irish Aid","year":"2019"},{"key":"e_1_2_12_14_1","volume-title":"Half of Afghanistan's Children Under Five Expected to Suffer from Acute Malnutrition as Hunger Takes Root for Millions","author":"World Food Programme","year":"2021"},{"key":"e_1_2_12_15_1","volume-title":"Afghanistan Nutrition Cluster","author":"UNICEF","year":"2018"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002934"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/641784"},{"key":"e_1_2_12_18_1","volume-title":"Afghanistan Nutrition Cluster 2020 Annual Report","author":"UNICEF","year":"2020"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0b013e32830c6ede"},{"key":"e_1_2_12_20_1","volume-title":"Updates on the Management of Severe Acute Malnutrition in Infants and Children: Guideline","author":"World Health Organization","year":"2013"},{"key":"e_1_2_12_21_1","volume-title":"Food and Agriculture Organization of the United Nations. 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