| SGA Options | A = 1 point | B = 2 points | C = 3 points |
| 1. Weight change in last 6 months | A: <5% | B: 5% - 10% | C: >10% |
| 2. Weight change in last 4 weeks | A: Increased | B: Unchanged | C: Decreased |
| 3. Dietary intake overall change | A: Increased | B: Unchanged | C: Decreased |
| 4. Dietary change duration from last review (in weeks or months) Clinician’s subjective rating | A: Increased | B: Unchanged | C: Decreased |
| 5. Type of Dietary change. Clinician’s subjective rating | A: Solid in reduced quantity | B: Semi-solid diet/ Liquid diet | C: Intravenous fluid |
| 6. Gastrointestinal symptoms persisting > 2 weeks (Clinician’s subjective rating): Symptoms: Anorexia, Nausea, Vomiting, Diarrhoea | A (none/normal) | B (mild/moderate): having some symptoms | C (severe): having most of the symptoms |
| 7. Functional capacity overall impairment | A: none (Ambulating) | B: mild/moderate Bedridden > 1/2 of day | C: severe Bedridden > whole day |
| 8. Metabolic demand of HIV on nutritional requirement( considering current symptoms and signs) | A = No stress | B = Low/moderate stress | C = Severe stress |
| Physical: Physicians subjective assessment, for each trait specify: 0 = normal, 1 = mild, 2 = moderate, 3 = severe a)loss of subcutaneous fat (chest, zygomatic bone prominence)........ b) ankle edema..... c) muscle wasting (prominent clavicle, and shin bones)....... d) sacral edema....... e) ascites........ | |||
| SGA rating: | Well nourished | Moderately malnourished | Severely malnourished |