Reducing wasting in young children with preventive supplementation: a cohort study in Niger

Hdl Handle:
http://hdl.handle.net/10144/112688
Title:
Reducing wasting in young children with preventive supplementation: a cohort study in Niger
Authors:
Isanaka, Sheila; Roederer, Thomas; Djibo, Ali; Luquero, Francisco J; Nombela, Nohelly; Guerin, Philippe J; Grais, Rebecca F
Journal:
Pediatrics
Abstract:
OBJECTIVE: To compare the incidence of wasting, stunting, and mortality among children aged 6 to 36 months who are receiving preventive supplementation with either ready-to-use supplementary foods (RUSFs) or ready-to-use therapeutic foods (RUTFs). SUBJECTS AND METHODS: Children aged 6 to 36 months in 12 villages of Maradi, Niger, (n = 1645) received a monthly distribution of RUSFs (247 kcal [3 spoons] per day) for 6 months or RUTFs (500-kcal sachet per day) for 4 months. We compared the incidence of wasting, stunting, and mortality among children who received preventive supplementation with RUSFs versus RUTFs. RESULTS: The effectiveness of RUSF supplementation depended on receipt of a previous preventive intervention. In villages in which a preventive supplementation program was previously implemented, the RUSF strategy was associated with a 46% (95% confidence interval [CI]: 6%-69%) and 59% (95% CI: 17%-80%) reduction in wasting and severe wasting, respectively. In contrast, in villages in which the previous intervention was not implemented, we found no difference in the incidence of wasting or severe wasting according to type of supplementation. Compared with the RUTF strategy, the RUSF strategy was associated with a 19% (95% CI: 0%-34%) reduction in stunting overall. CONCLUSION: We found that the relative performance of a 6-month RUSF supplementation strategy versus a 4-month RUTF strategy varied with receipt of a previous nutritional intervention. Contextual factors will continue to be important in determining the dose and duration of supplementation that will be most effective, acceptable, and sustainable for a given setting.
Affiliation:
Departments of Epidemiology and Nutrition, Harvard School of Public Health, Boston, MA; Harvard Humanitarian Initiative, Harvard University, Cambridge, MA; Epicentre, Paris, France; Ministry of Health, Niger, Niamey, Niger; Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
Issue Date:
26-Jul-2010
URI:
http://hdl.handle.net/10144/112688
DOI:
10.1542/peds.2009-2814
PubMed ID:
20660552
Type:
Article
Language:
en
ISSN:
1098-4275
Appears in Collections:
Nutrition

Full metadata record

DC FieldValue Language
dc.contributor.authorIsanaka, Sheilaen
dc.contributor.authorRoederer, Thomasen
dc.contributor.authorDjibo, Alien
dc.contributor.authorLuquero, Francisco Jen
dc.contributor.authorNombela, Nohellyen
dc.contributor.authorGuerin, Philippe Jen
dc.contributor.authorGrais, Rebecca Fen
dc.date.accessioned2010-10-08T13:32:48Z-
dc.date.available2010-10-08T13:32:48Z-
dc.date.issued2010-07-26-
dc.identifier.citationPediatrics 2010;126(2):e442-50en
dc.identifier.issn1098-4275-
dc.identifier.pmid20660552-
dc.identifier.doi10.1542/peds.2009-2814-
dc.identifier.urihttp://hdl.handle.net/10144/112688-
dc.description.abstractOBJECTIVE: To compare the incidence of wasting, stunting, and mortality among children aged 6 to 36 months who are receiving preventive supplementation with either ready-to-use supplementary foods (RUSFs) or ready-to-use therapeutic foods (RUTFs). SUBJECTS AND METHODS: Children aged 6 to 36 months in 12 villages of Maradi, Niger, (n = 1645) received a monthly distribution of RUSFs (247 kcal [3 spoons] per day) for 6 months or RUTFs (500-kcal sachet per day) for 4 months. We compared the incidence of wasting, stunting, and mortality among children who received preventive supplementation with RUSFs versus RUTFs. RESULTS: The effectiveness of RUSF supplementation depended on receipt of a previous preventive intervention. In villages in which a preventive supplementation program was previously implemented, the RUSF strategy was associated with a 46% (95% confidence interval [CI]: 6%-69%) and 59% (95% CI: 17%-80%) reduction in wasting and severe wasting, respectively. In contrast, in villages in which the previous intervention was not implemented, we found no difference in the incidence of wasting or severe wasting according to type of supplementation. Compared with the RUTF strategy, the RUSF strategy was associated with a 19% (95% CI: 0%-34%) reduction in stunting overall. CONCLUSION: We found that the relative performance of a 6-month RUSF supplementation strategy versus a 4-month RUTF strategy varied with receipt of a previous nutritional intervention. Contextual factors will continue to be important in determining the dose and duration of supplementation that will be most effective, acceptable, and sustainable for a given setting.en
dc.language.isoenen
dc.rightsPublished by the American Academy of Pediatrics Archived on this site with kind permission from Pediatrics, copyright 2010 by the American Academy of Pediatricsen
dc.subject.meshMalnutritionen
dc.subject.meshNigeren
dc.subject.meshChilden
dc.subject.meshInfanten
dc.subject.meshFood Supplementationen
dc.titleReducing wasting in young children with preventive supplementation: a cohort study in Nigeren
dc.typeArticleen
dc.contributor.departmentDepartments of Epidemiology and Nutrition, Harvard School of Public Health, Boston, MA; Harvard Humanitarian Initiative, Harvard University, Cambridge, MA; Epicentre, Paris, France; Ministry of Health, Niger, Niamey, Niger; Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerlanden
dc.identifier.journalPediatricsen
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