Effectiveness of ready-to-use therapeutic food compared to a corn/soy-blend-based pre-mix for the treatment of childhood moderate acute malnutrition in Niger.

Hdl Handle:
http://hdl.handle.net/10144/188269
Title:
Effectiveness of ready-to-use therapeutic food compared to a corn/soy-blend-based pre-mix for the treatment of childhood moderate acute malnutrition in Niger.
Authors:
Nackers, Fabienne; Broillet, France; Oumarou, Diakité; Djibo, Ali; Gaboulaud, Valérie; Guerin, Philippe J; Rusch, Barbara; Grais, Rebecca F; Captier, Valérie
Journal:
Journal of tropical pediatrics
Abstract:
Standard nutritional treatment of moderate acute malnutrition (MAM) relies on fortified blended flours though their importance to treat this condition is a matter of discussion. With the newly introduced World Health Organization growth standards, more children at an early stage of malnutrition will be treated following the dietary protocols as for severe acute malnutrition, including ready-to-use therapeutic food (RUTF). We compared the effectiveness of RUTF and a corn/soy-blend (CSB)-based pre-mix for the treatment of MAM in the supplementary feeding programmes (SFPs) supported by Médecins Sans Frontières, located in the Zinder region (south of Niger). Children measuring 65 to <110 cm, newly admitted with MAM [weight-for-height (WHM%) between 70% and <80% of the NCHS median] were randomly allocated to receive either RUTF (Plumpy'Nut®, 1000 kcal day(-1)) or a CSB pre-mix (1231 kcal day(-1)). Other interventions were similar in both groups (e.g. weekly family ration and ration at discharge). Children were followed weekly up to recovery (WHM% ≥ 85% for 2 consecutive weeks). In total, 215 children were recruited in the RUTF group and 236 children in the CSB pre-mix group with an overall recovery rate of 79.1 and 64.4%, respectively (p < 0.001). There was no evidence for a difference between death, defaulter and non-responder rates. More transfers to the inpatient Therapeutic Feeding Centre (I-TFC) were observed in the CSB pre-mix group (19.1%) compared to the RUTF group (9.3%) (p = 0.003). The average weight gain up to discharge was 1.08 g kg(-1) day(-1) higher in the RUTF group [95% confidence interval: 0.46-1.70] and the length of stay was 2 weeks shorter in the RUTF group (p < 0.001). For the treatment of childhood MAM in Niger, RUTF resulted in a higher weight gain, a higher recovery rate, a shorter length of stay and a lower transfer rate to the I-TFC compared to a CSB pre-mix. This might have important implications on the efficacy and the quality of SFPs.
Affiliation:
Epicentre, Paris, France; Medecins San Frontieres, Switzerland; Ministry of Health, Niger; Hopital Avicenne, Assistance Publique Hopitaux de Paris, France
Issue Date:
23-Mar-2010
URI:
http://hdl.handle.net/10144/188269
DOI:
10.1093/tropej/fmq019
PubMed ID:
20332221
Additional Links:
http://tropej.oxfordjournals.org/content/56/6/407
Submitted date:
2011-03-03
Type:
Article
Language:
en
ISSN:
1465-3664
Appears in Collections:
Nutrition

Full metadata record

DC FieldValue Language
dc.contributor.authorNackers, Fabienneen
dc.contributor.authorBroillet, Franceen
dc.contributor.authorOumarou, Diakitéen
dc.contributor.authorDjibo, Alien
dc.contributor.authorGaboulaud, Valérieen
dc.contributor.authorGuerin, Philippe Jen
dc.contributor.authorRusch, Barbaraen
dc.contributor.authorGrais, Rebecca Fen
dc.contributor.authorCaptier, Valérieen
dc.date.accessioned2011-11-01T09:39:03Z-
dc.date.available2011-11-01T09:39:03Z-
dc.date.issued2010-03-23-
dc.date.submitted2011-03-03-
dc.identifier.citationJ. Trop. Pediatr 2010;56(6):407-13en
dc.identifier.issn1465-3664-
dc.identifier.pmid20332221-
dc.identifier.doi10.1093/tropej/fmq019-
dc.identifier.urihttp://hdl.handle.net/10144/188269-
dc.description.abstractStandard nutritional treatment of moderate acute malnutrition (MAM) relies on fortified blended flours though their importance to treat this condition is a matter of discussion. With the newly introduced World Health Organization growth standards, more children at an early stage of malnutrition will be treated following the dietary protocols as for severe acute malnutrition, including ready-to-use therapeutic food (RUTF). We compared the effectiveness of RUTF and a corn/soy-blend (CSB)-based pre-mix for the treatment of MAM in the supplementary feeding programmes (SFPs) supported by Médecins Sans Frontières, located in the Zinder region (south of Niger). Children measuring 65 to <110 cm, newly admitted with MAM [weight-for-height (WHM%) between 70% and <80% of the NCHS median] were randomly allocated to receive either RUTF (Plumpy'Nut®, 1000 kcal day(-1)) or a CSB pre-mix (1231 kcal day(-1)). Other interventions were similar in both groups (e.g. weekly family ration and ration at discharge). Children were followed weekly up to recovery (WHM% ≥ 85% for 2 consecutive weeks). In total, 215 children were recruited in the RUTF group and 236 children in the CSB pre-mix group with an overall recovery rate of 79.1 and 64.4%, respectively (p < 0.001). There was no evidence for a difference between death, defaulter and non-responder rates. More transfers to the inpatient Therapeutic Feeding Centre (I-TFC) were observed in the CSB pre-mix group (19.1%) compared to the RUTF group (9.3%) (p = 0.003). The average weight gain up to discharge was 1.08 g kg(-1) day(-1) higher in the RUTF group [95% confidence interval: 0.46-1.70] and the length of stay was 2 weeks shorter in the RUTF group (p < 0.001). For the treatment of childhood MAM in Niger, RUTF resulted in a higher weight gain, a higher recovery rate, a shorter length of stay and a lower transfer rate to the I-TFC compared to a CSB pre-mix. This might have important implications on the efficacy and the quality of SFPs.en
dc.language.isoenen
dc.relation.urlhttp://tropej.oxfordjournals.org/content/56/6/407en
dc.rightsPublished by Oxford University Press Archived on this site with kind permission from Oxford University Pressen
dc.subject.meshBody Heighten
dc.subject.meshBody Weighten
dc.subject.meshChild, Preschoolen
dc.subject.meshFemaleen
dc.subject.meshFood, Fortifieden
dc.subject.meshHumansen
dc.subject.meshInfanten
dc.subject.meshLength of Stayen
dc.subject.meshMaleen
dc.subject.meshMalnutritionen
dc.subject.meshNigeren
dc.subject.meshSoybean Proteinsen
dc.subject.meshTreatment Outcomeen
dc.subject.meshWeight Gainen
dc.subject.meshZea maysen
dc.titleEffectiveness of ready-to-use therapeutic food compared to a corn/soy-blend-based pre-mix for the treatment of childhood moderate acute malnutrition in Niger.en
dc.typeArticleen
dc.contributor.departmentEpicentre, Paris, France; Medecins San Frontieres, Switzerland; Ministry of Health, Niger; Hopital Avicenne, Assistance Publique Hopitaux de Paris, Franceen
dc.identifier.journalJournal of tropical pediatricsen
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