scholarly journals Effect of Nutritional Status on Response to Treatment with Artemisinin-Based Combination Therapy in Young Ugandan Children with Malaria

2011 ◽  
Vol 55 (6) ◽  
pp. 2629-2635 ◽  
Author(s):  
Wendy J. Verret ◽  
Emmanuel Arinaitwe ◽  
Humphrey Wanzira ◽  
Victor Bigira ◽  
Abel Kakuru ◽  
...  
Keyword(s):  
Blood Smear ◽  
Parasite Clearance ◽  
Response To Treatment ◽  
Malnourished Children ◽  
Antimalarial Therapy ◽  
Hiv Exposed ◽  
The Relationship ◽  
Height For Age ◽  
Weight For Age

ABSTRACTThe relationship between malnutrition and malaria in young children is under debate, and no studies evaluating the association between malnutrition and response to artemisinin-based combination therapies (ACTs) have been published. We evaluated the association between malnutrition and response to antimalarial therapy in Ugandan children treated with ACTs for repeated episodes of malaria. Children aged 4 to 12 months diagnosed with uncomplicated malaria were randomized to dihydroartemisinin-piperaquine (DP) or artemether-lumefantrine (AL) and followed for up to 2 years. All HIV-exposed and HIV-infected children received trimethoprim-sulfamethoxazole prophylaxis (TS). The primary exposure variables included height-for-age and weight-for-agezscores. Outcomes included parasite clearance at days 2 and 3 and risk of recurrent parasitemia after 42 days of follow-up. Two hundred ninety-two children were randomized to DP or AL, resulting in 2,013 malaria treatments. Fewer than 1% of patients had a positive blood smear by day 3 (DP, 0.2%; AL, 0.6% [P= 0.18]). There was no significant association between height-for-age or weight-for-agezscores and a positive blood smear 2 days following treatment. For children treated with DP but not on TS, decreasing height-for-agezscores of <−1 were associated with a higher risk of recurrent parasitemia than a height-for-agezscore of >0 (hazard ratio [HR] for height-for-agezscore of <−1 and ≥−2 = 2.89 [P= 0.039]; HR for height-for-agezscore of <−2 = 3.18 [P= 0.022]). DP and AL are effective antimalarial therapies in chronically malnourished children in a high-transmission setting. However, children with mild to moderate chronic malnutrition not taking TS are at higher risk for recurrent parasitemia and may be considered a target for chemoprevention.

A Randomized Clinical Trial of Home Intervention for Children With Failure to Thrive

PEDIATRICS ◽  
1995 ◽  
Vol 95 (6) ◽  
pp. 807-814 ◽  
Author(s):  
Maureen M. Black ◽  
Howard Dubowitz ◽  
Jacqueline Hutcheson ◽  
Julie Berenson-Howard ◽  
Raymond H. Starr
Keyword(s):  
Low Income ◽  
Motor Development ◽  
Failure To Thrive ◽  
Home Visitors ◽  
Child Interaction ◽  
Home Intervention ◽  
Height For Age ◽  
Weight For Age

Objective. To evaluate the efficacy of a home-based intervention on the growth and development of children with nonorganic failure to thrive (NOFTT). Design. Randomized clinical trial. Participants. The NOFTT sample included 130 children (mean age, 12.7 months; SD, 6.4) recruited from urban pediatric primary care clinics serving low income families. All children were younger than 25 months with weight for age below the fifth percentile. Eligibility criteria included gestational age of at least 36 weeks, birth weight appropriate for gestational age, and no significant history of perinatal complications, congenital disorders, chronic illnesses, or developmental disabilities. Children were randomized into two groups: clinic plus home intervention (HI) (n = 64) or clinic only (n = 66). There were no group differences in children's age, gender, race, or growth parameters, or on any of the family back-ground variables. Most children were raised by single, African-American mothers who received public assistance. Eighty-nine percent of the families (116 of 130) completed the 1-year evaluation. Interventions. All children received services in a multidisciplinary growth and nutrition clinic. A community-based agency provided the home intervention. Families in the HI group were scheduled to receive weekly home visits for 1 year by lay home visitors, supervised by a community health nurse. The intervention provided maternal support and promoted parenting, child development, use of informal and formal resources, and parent advocacy. Measurements. Growth was measured by standard procedures and converted to z scores for weight for height and height for age to assess wasting and stunting. Cognitive and motor development were measured with the Bayley Scales of Infant Development, and language development was measured by the Receptive/Expressive Emergent Language Scale. Both scales were administered at recruitment and at the 12-month follow-up. Parent-child interaction was measured by observing mothers and children during feeding at recruitment and at the 12-month follow-up, and the quality of the home was measured by the Home Observation Measure of the Environment 18 months after recruitment. Analyses. Repeated-measures multivariate analyses of covariance were used to examine changes in children's growth and development and parent-child interaction. Analyses of covariance were used to examine the quality of the home. Independent variables were intervention status and age at recruitment (1.0 to 12.0 vs 12.1 to 24.9 months). Maternal education was a covariate in all analyses. When changes in developmental status and parentchild interaction were examined, weight for height and height for age at recruitment were included as covariates. Results. Children's weight for age, weight for height, and height for age improved significantly during the 12-month study period, regardless of intervention status. Children in the HI group had better receptive language over time and more child-oriented home environments than children in the clinic-only group. The impact of intervention status on cognitive development varied as a function of children's ages at recruitment, with younger children showing beneficial effects of home intervention. There were no changes in motor development associated with intervention status. During the study period, children gained skills in interactive competence during feeding, and their parents became more controlling during feeding, but differences were not associated with intervention status. Conclusions. Findings support a cautious optimism regarding home intervention during the first year of life provided by trained lay home visitors. Early home intervention can promote a nurturant home environment effectively and can reduce the developmental delays often experienced by low income, urban infants with NOFTT. Subsequent investigations of home intervention should consider alternative options for toddlers with NOFTT.

scholarly journals Linear and knemometric growth in the early phase of rehabilitation from severe malnutrition

2001 ◽  
Vol 85 (6) ◽  
pp. 755-759 ◽  
Author(s):  
C. P. Doherty ◽  
M. A. K. Sarkar ◽  
M. S. Shakur ◽  
S. C. Ling ◽  
R. A. Elton ◽  
...  
Keyword(s):  
Linear Growth ◽  
Lower Leg ◽  
Severe Malnutrition ◽  
Maternal Height ◽  
Leg Length ◽  
Malnourished Children ◽  
Catch Up ◽  
The Relationship ◽  
Length Gain ◽  
Height For Age

The relationship between ponderal, linear and lower leg growth in children recovering from severe malnutrition remains unclear. We report on the early growth of 141 severely malnourished Bangladeshi children aged 6 to 36 months of age who were followed for 90 d. Mean (SD) weight for height (WHZ) and height for age (HAZ) catch-up growth Z scores over the 90 d were 1.6 (0.85) and 0.47 (0.325) respectively. mean (SD) lower leg length growth was 10.35 (4.5) mm. Change in HAZ was significantly associated with initial WHZ, but linear growth occurred in the presence of severe wasting and no threshold WHZ score was identified. Lower leg length gain correlated throughout with ponderal indices but with change in HAZ score only after day 45. Only initial WHZ score and maternal height predicted for linear growth and only accounted for 20 % of total variance. We conclude that linear growth occurs early in severely malnourished children but that knemometry behaves as a ponderal index acutely.

scholarly journals Thirty Days Snail Biscuit Supplementation Improved Height-for-age Z-score (HAZ) of Malnourished Children in Slum Surabaya

2017 ◽  
Vol 1 (1) ◽  
pp. 31
Author(s):  
Trias Mahmudiono ◽  
Zeni Firginingtyas ◽  
Qonita Rachmah
Keyword(s):  
Control Group ◽  
P Value ◽  
Z Score ◽  
Achatina Fulica ◽  
Children Under Five ◽  
Under Five ◽  
Malnourished Children ◽  
Score Improvement ◽  
Height For Age ◽  
Weight For Age

Background: Indonesia is now still suffering from malnutrition. It was reported that at least 1.39% out of 136,155 children under-five in Surabaya were severely. Severe malnutrition caused by direct factors including infectious diseases and food intake. Therefore, an alternative to overcome that problem is crucial, such as using snail flour for a weaning food. Snail is known as one of the good protein source with complete essential amino acid.Objective: This research aims to determine the effect of snail biscuit (Achatina fulica) toward z-score improvement in severely malnourished children under five according weight for age and height for age index in Ujung sub-district, Surabaya.Methods: This was an experimental research which divided into two groups; case group that given snail biscuit for a month and control group that given coconut biscuit in a same time period. Paired t-test was done to analyze the different between before and after treatment.Results: The result showed that there was no effect of snail biscuit to weight-for-age z-score (WAZ) improvement in children under five (p-value>0.05). However, a month snail biscuit intervention improved height-for-age z-score (HAZ) in children under five (p-value=0.02); while the control group did not show significant result (p-value=0.84). The strength of intervention shown by Exp(B) value=1.02 means that children under five who consume snail biscuit for a month had 1.02 higher height-for-age z-score improvement compared to those who consumed coconut biscuit.Conclusion: It can be concluded that snail biscuit give better improvement of nutritional status based on height-for-age z-score compared to coconut biscuit in malnourished children under five. It is suggested for the intervention study to expand intervention period to 90 days similar to government supplementary feeding intervention. ABSTRAK Latar belakang: Malnutrisi masih menjadi masalah gizi utama yang dialami di Indonesia. Dinas Kesehatan Kota Surabaya pada tahun 2009 melaporkan sebesar 1,888 (1.39%) dari 136,155 balita mengalami gizi buruk. Penyebab gizi buruk terdiri dari faktor langsung dan tidak langsung, dimana faktor langsung terdiri dari penyakit infeksi dan asupan makanan. Salah satu alternatif yang dapat digunakan adalah penggunaan tepung bekicot sebagai makanan pendamping. Bekicot diketahui sebagai salah satu sumber protein dengan kandungan asam amino esensial yang lengkap.Tujuan: Penelitian ini bertujuan untuk mengetahui efek pemberian biskuit bekicot  (Achatina fulica) pada perbaikan z-score berat badan menurut usia dan tinggi badan menurut usia balita gizi buruk di Kelurahan Ujung, Surabaya.Metode: Penelitian ini menggunakan desain studi eksperimental dengan pembagian dua kelompok; kelompok intervensi yang diberikan biskuit bekicot selama 30 hari dan kelompok kontrol yang diberikan biskuit kelapa dalam jangka waktu yang sama. Uji statistik yang digunakan yaitu paired t-test.Hasil: Hasil analisis menunjukkan tidak ada efek pemberian biskuit bekicot selama satu bulan pada indeks status gizi berat badan menurut umur (BB/U) (P-value>0,05). Namun, intervensi pemberian biskuit bekicot secara statistik mempengaruhi perbaikan status gizi tinggi badan menurut usia (TB/U) pada balita gizi buruk, sedangkan biskuit kelapa tidak mempengaruhi TB/U balita gizi buruk (P-value=0.84). Kekuatan pengaruh intervensi berdasarkan perhitungan Exp(B)=1.02, artinya bahwa balita gizi buruk yang mengonsumsi biskuit bekicot memiliki 1.02 kali perbaikan yang lebih baik pada status gizi TB/U dibandingkan balita yang mengonsumsi biskuit kelapa.Kesimpulan: Dapat disimpulkan bahwa biskuit bekicot dapat menjadi alternatif perbaikan status gizi balita gizi buruk. Penelitian selanjutnya disarankan dapat memperpanjang durasi intervensi hingga 90 hari seperti anjuran pemerintah dalam pemberian makan tambahan.

scholarly journals Effect of community-based food supplementation on improving growth of underweight children under five years of age in West Nusa Tenggara

2017 ◽  
Vol 57 (5) ◽  
pp. 246
Author(s):  
Aman Bhakti Pulungan ◽  
Dini A. Mirasanti
Keyword(s):  
Normal Weight ◽  
Food Supplementation ◽  
Z Score ◽  
Community Based ◽  
Normal Height ◽  
Supplementary Food ◽  
Under Five ◽  
Height For Age ◽  
Weight For Age

Background The prevalence of underweight children in West Nusa Tenggara is as high as 30%. This region had the third largest number of stunted children in the country. The local government has attempted to tackle this problem by providing supplementary food to underweight children.Objective To assess the success of the community-based food supplementation program onimproving children’s growth in West Nusa Tenggara.Methods We conducted a prospective cohort study for 10 months in Paruga District Primary Health Care Unit, Bima, West Nusa Tenggara, in year 2012. Children were given supplementary food according to the Ministry of Health’s guidelines, consisting of formula milk, high calorie biscuits, and a 60-day supply of eggs, estimated to be sufficient to normalize their weights, for their age and sex.  A child’s weight and height were measured every 3 months and the results plotted on WHO growth charts for weight-for-age, height-for-age, and weight-for-height (nutritional status). Z-score <-3 SD was classified as severely underweight, severely stunted, or severely wasted, respectively; Z-score between -2 and -3 SD was classified as underweight, stunted, or wasted, respectively; and Z–score >-2 SD was classified as normal for all three categories.Results Twenty-five children under five years of age participated in this study. Subjects’ median age was 29 months. None of the subjects had normal weight-for-age Z-score at the beginning of the study. Eighty-four percent (21/25) of the subjects were severely underweight. Only 8% (2/25) of the subjects had normal height-for-age Z-score and 88% (22/25) of them were severely stunted. However, 80% (20/25) of subjects had normal nutritional status (weight-for-height). Changes in weight-for-age Z-score varied throughout the study. The highest median score was in the tenth month of follow up (-3.82). The highest median height-for-age score and weight-for-height score were also in the last month of follow up. At the end of the study, only one subject had normal weight-for-age score (4%) and none of the subjects had normal height-for-age scores.  Conclusion The 10-month supplementary food program for under-five children in the Paruga District is not successful in improving body weight and height.

scholarly journals Effect of malnutrition on the pharmacokinetics of anti-TB drugs in Ghanaian children

2021 ◽  
Vol 25 (1) ◽  
pp. 36-42
Author(s):  
N. A. H. Seneadza ◽  
S. Antwi ◽  
H. Yang ◽  
A. Enimil ◽  
A. Dompreh ◽  
...  
Keyword(s):  
Area Under The Curve ◽  
Normal Range ◽  
Plasma Exposure ◽  
Intensive Phase ◽  
Tb Treatment ◽  
Malnourished Children ◽  
Drug Concentrations ◽  
Poor Treatment ◽  
Height For Age ◽  
Weight For Age

BACKGROUND: Anti-TB drugs dosing based on weight alone may contribute to suboptimal drug concentrations and poor treatment outcomes in malnourished children. We examined the effect of malnutrition on the pharmacokinetics (PK) of first-line anti-TB drugs in children.METHODS: Drug concentrations were measured in Ghanaian children during the intensive phase of TB treatment. Weight-for-age (WFA), height-for-age (HFA), weight-for-height (WFH) and body mass index-for-age (BFA) were calculated and children with Z-scores < −2 SD (standard deviations) were considered as having malnutrition. PK differences of anti-TB drugs were compared by nutritional status.RESULTS: Of 100 participants, 24/48 (50.0%) of those younger than 5 years had wasting, 58/86 (67.4%) were underweight, and 56/99 (56.6%) had stunting; 22/51 (43.1%) children aged ≥5 years had low BFA. Children with stunting were more likely than controls to have lower mean peak concentration (Cmax) and area under the curve (AUC0–8h) of rifampin (RIF) and pyrazinamide (PZA), as well as a higher frequency of Cmax below the normal range. Wasting and underweight were associated with lower mean ethambutol (EMB) Cmax and AUC0–8h.CONCLUSIONS: The current WHO-recommended dosages were associated with lower plasma exposure of RIF, PZA and EMB in children with stunting, wasting and underweight. Anti-TB drugs dosing models for children may need to include height.

scholarly journals Growth of HIV-uninfected children born to HIV-infected mothers in Guangdong, China: an 18-month longitudinal follow-up study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Bing Li ◽  
Liu-ying Tang ◽  
Zhi-qiang Wang ◽  
Shuang Gao ◽  
Yun-tao Wu ◽  
...  
Keyword(s):  
Anthropometric Measurement ◽  
Growth Standards ◽  
Immunodeficiency Virus ◽  
Z Scores ◽  
The Mean ◽  
Hiv Exposed ◽  
Mother To Child ◽  
Exposed Uninfected ◽  
Weight For Age

Abstract Background To evaluate the early growth (weight and length) of HIV-exposed uninfected (HEU) children from the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) program in Guangdong Province, China. Methods A total of 731 HEU children were longitudinally followed up at 7 time points, with anthropometric measurement conducted of weight and length (supine) in the first 18 months. Z scores were calculated, with and without adjustment for gestational age. Results A total of 708 HEU children were included in the final follow-up cohort, and 105 (14.83%) children completed all 7 follow-up visits. The mean of adjusted weight-for-age Z scores in these children was above zero and showed a decreasing trend in 18 months. The mean of adjusted length-for-age Z scores showed a decreasing trend and was above zero in the first 12 months; this declined to under zero at age 18 months. The proportion of underweight was 0.28–2.19% and that of stunting was 0.71–4.63% at each follow-up month-age. Slower growth in HEU children was associated with no sustained food subside after 6 month, mothers’ hemoglobin content less than 100 g/L during pregnancy, preterm birth, and low birth weight (p < 0.05). Conclusions HEU children could catch up to WHO growth standards in first 18 months in Guangdong; however, growth declined after 12 months, and these children need sustained nutritional support.

Malnutrition in Paediatrics: Stationary Screening & Follow-up

2019 ◽  
Vol 232 (01) ◽  
pp. 20-28
Author(s):  
Dorothea Werner ◽  
Klaus-Peter Zimmer ◽  
Gunter P. Eckert ◽  
Jan de Laffolie
Keyword(s):  
Gastrointestinal Diseases ◽  
Tertiary Hospital ◽  
Real World Data ◽  
Tertiary Centre ◽  
Arm Circumference ◽  
Z Scores ◽  
Mid Upper Arm Circumference ◽  
Height For Age ◽  
Weight For Age

Abstract Objective The prevalence and follow-up of the clinical real-world data focussing on existing or risk of malnutrition in a tertiary hospital general paediatric ward including 4 months of follow-up was assessed. Methods Measurements included anthropometric measurements, a nutrition interview and an extended version of the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP). R Studio 3.4.2 was used for statistical analysis and diagnosing malnutrition by calculating height-for-age (HfAz)-, weight-for-age (WfAz)- weight-for-height (WfHz)-, body mass index-for-age (BMIz) and mid-upper-arm circumference (MUACz)-z-scores with the childsds package with KIGGS and WHO for reference. Results The median age of the 68 participants was 8.00 (4.00–13.00) years. The main reasons for hospitalisation in the tertiary centre were gastrointestinal diseases, diabetes mellitus and rheumatic diseases. At admission 39.71%, at the second examination 36.00% and at the third examination 45.90% were malnourished. 68% of inpatients lost weight during their clinical stay, of which 35.29% lost more than 3% of their initial weight. However, changes were not significantly different. Conclusion A significant share of patients was diagnosed to be malnourished at admission, the majority of patients lost weight during their hospital stay and the 4 months after admission. Due to the far reaching consequences for patients, doctors, health insurance and politics, the early diagnosis and treatment of malnutrition should take greater account in the future.

scholarly journals Investigating Differences in Nutritional Parameters in Ugandan Children with Plasmodium falciparum Severe Malaria

2020 ◽  
Vol 3 ◽  
Author(s):  
Lucy Brown ◽  
Katrina Co ◽  
Robert Opoka ◽  
Dibyadyuti Datta ◽  
Chandy John
Keyword(s):  
Severe Malaria ◽  
Nutrition Intervention ◽  
African Region ◽  
Nutritional Parameters ◽  
Z Scores ◽  
Neurodevelopmental Impairment ◽  
Community Controls ◽  
Height For Age ◽  
Weight For Age

Background: In 2018, malaria produced an estimated 272,000 deaths in children <5 years of age, accounting for 67% of all malaria deaths worldwide, with a majority in the WHO African Region. Malnutrition is an important risk factor for malaria. Wasting, Stunting and Underweight are crucial indicators of malnutrition. Annually, 14 million children <5 are classified as wasted and 59 million children are classified as stunted.   Objective: The objective of this study is to determine the association between each of the major manifestations of severe malaria (SM) and nutritional parameters – weight-for-age (WAZ), height-for-age (HAZ), and weight-for-height (WHZ) – in children from the Ugandan cities Mulago and Jinja.   Methods: To assess differences in WAZ, HAZ, and WHZ by the five types of SM and community controls (CC), we evaluated Z-scores from children <5 years old enrolled in a prospective cohort study (NDI, Neurodevelopmental Impairment in Children with Severe Malaria) at enrollment and 12-month follow-up.   Results: WAZ and WHZ at baseline were significantly lower among SM groups than in CC (p<0.001), but there were no significant differences observed at 12-month follow-up. There were no major differences in HAZ between the SM and CC groups. WAZ and HAZ at baseline were significantly lower among High Mortality (HM) versus Low Mortality (LM) groups (p<0.01). At 12-month follow-up, HAZ remained significantly lower in HM versus LM (p<0.01). There were no major differences in WHZ between the HM and LM groups. Compared to those who survived, the 27 children who died had significantly lower WAZ (p<0.05), but no major differences in HAZ or WHZ.  Conclusion: Underweight, stunting, and wasting may be risk factors for SM. Overall, a more comprehensive understanding of how SM elicits adverse effects in children is necessary. Nutrition intervention programs must be implemented to prevent child stunting, wasting, underweight, and mortality. 

scholarly journals Effect of community-based food supplementation on improving growth of underweight children under five years of age in West Nusa Tenggara

2018 ◽  
Vol 57 (5) ◽  
pp. 246
Author(s):  
Aman Bhakti Pulungan ◽  
Dini A. Mirasanti
Keyword(s):  
Normal Weight ◽  
Food Supplementation ◽  
Z Score ◽  
Community Based ◽  
Normal Height ◽  
Supplementary Food ◽  
Under Five ◽  
Height For Age ◽  
Weight For Age

Background The prevalence of underweight children in West Nusa Tenggara is as high as 30%. This region had the third largest number of stunted children in the country. The local government has attempted to tackle this problem by providing supplementary food to underweight children.Objective To assess the success of the community-based food supplementation program onimproving children’s growth in West Nusa Tenggara.Methods We conducted a prospective cohort study for 10 months in Paruga District Primary Health Care Unit, Bima, West Nusa Tenggara, in year 2012. Children were given supplementary food according to the Ministry of Health’s guidelines, consisting of formula milk, high calorie biscuits, and a 60-day supply of eggs, estimated to be sufficient to normalize their weights, for their age and sex.  A child’s weight and height were measured every 3 months and the results plotted on WHO growth charts for weight-for-age, height-for-age, and weight-for-height (nutritional status). Z-score <-3 SD was classified as severely underweight, severely stunted, or severely wasted, respectively; Z-score between -2 and -3 SD was classified as underweight, stunted, or wasted, respectively; and Z–score >-2 SD was classified as normal for all three categories.Results Twenty-five children under five years of age participated in this study. Subjects’ median age was 29 months. None of the subjects had normal weight-for-age Z-score at the beginning of the study. Eighty-four percent (21/25) of the subjects were severely underweight. Only 8% (2/25) of the subjects had normal height-for-age Z-score and 88% (22/25) of them were severely stunted. However, 80% (20/25) of subjects had normal nutritional status (weight-for-height). Changes in weight-for-age Z-score varied throughout the study. The highest median score was in the tenth month of follow up (-3.82). The highest median height-for-age score and weight-for-height score were also in the last month of follow up. At the end of the study, only one subject had normal weight-for-age score (4%) and none of the subjects had normal height-for-age scores.  Conclusion The 10-month supplementary food program for under-five children in the Paruga District is not successful in improving body weight and height.

scholarly journals Thirty Days Snail Biscuit Supplementation Improved Height-for-age Z-score (HAZ) of Malnourished Children in Slum Surabaya

2017 ◽  
Vol 1 (1) ◽  
pp. 31
Author(s):  
Trias Mahmudiono ◽  
Zeni Firginingtyas ◽  
Qonita Rachmah
Keyword(s):  
Control Group ◽  
P Value ◽  
Z Score ◽  
Achatina Fulica ◽  
Children Under Five ◽  
Under Five ◽  
Malnourished Children ◽  
Score Improvement ◽  
Height For Age ◽  
Weight For Age

Background: Indonesia is now still suffering from malnutrition. It was reported that at least 1.39% out of 136,155 children under-five in Surabaya were severely. Severe malnutrition caused by direct factors including infectious diseases and food intake. Therefore, an alternative to overcome that problem is crucial, such as using snail flour for a weaning food. Snail is known as one of the good protein source with complete essential amino acid.Objective: This research aims to determine the effect of snail biscuit (Achatina fulica) toward z-score improvement in severely malnourished children under five according weight for age and height for age index in Ujung sub-district, Surabaya.Methods: This was an experimental research which divided into two groups; case group that given snail biscuit for a month and control group that given coconut biscuit in a same time period. Paired t-test was done to analyze the different between before and after treatment.Results: The result showed that there was no effect of snail biscuit to weight-for-age z-score (WAZ) improvement in children under five (p-value>0.05). However, a month snail biscuit intervention improved height-for-age z-score (HAZ) in children under five (p-value=0.02); while the control group did not show significant result (p-value=0.84). The strength of intervention shown by Exp(B) value=1.02 means that children under five who consume snail biscuit for a month had 1.02 higher height-for-age z-score improvement compared to those who consumed coconut biscuit.Conclusion: It can be concluded that snail biscuit give better improvement of nutritional status based on height-for-age z-score compared to coconut biscuit in malnourished children under five. It is suggested for the intervention study to expand intervention period to 90 days similar to government supplementary feeding intervention. ABSTRAK Latar belakang: Malnutrisi masih menjadi masalah gizi utama yang dialami di Indonesia. Dinas Kesehatan Kota Surabaya pada tahun 2009 melaporkan sebesar 1,888 (1.39%) dari 136,155 balita mengalami gizi buruk. Penyebab gizi buruk terdiri dari faktor langsung dan tidak langsung, dimana faktor langsung terdiri dari penyakit infeksi dan asupan makanan. Salah satu alternatif yang dapat digunakan adalah penggunaan tepung bekicot sebagai makanan pendamping. Bekicot diketahui sebagai salah satu sumber protein dengan kandungan asam amino esensial yang lengkap.Tujuan: Penelitian ini bertujuan untuk mengetahui efek pemberian biskuit bekicot  (Achatina fulica) pada perbaikan z-score berat badan menurut usia dan tinggi badan menurut usia balita gizi buruk di Kelurahan Ujung, Surabaya.Metode: Penelitian ini menggunakan desain studi eksperimental dengan pembagian dua kelompok; kelompok intervensi yang diberikan biskuit bekicot selama 30 hari dan kelompok kontrol yang diberikan biskuit kelapa dalam jangka waktu yang sama. Uji statistik yang digunakan yaitu paired t-test.Hasil: Hasil analisis menunjukkan tidak ada efek pemberian biskuit bekicot selama satu bulan pada indeks status gizi berat badan menurut umur (BB/U) (P-value>0,05). Namun, intervensi pemberian biskuit bekicot secara statistik mempengaruhi perbaikan status gizi tinggi badan menurut usia (TB/U) pada balita gizi buruk, sedangkan biskuit kelapa tidak mempengaruhi TB/U balita gizi buruk (P-value=0.84). Kekuatan pengaruh intervensi berdasarkan perhitungan Exp(B)=1.02, artinya bahwa balita gizi buruk yang mengonsumsi biskuit bekicot memiliki 1.02 kali perbaikan yang lebih baik pada status gizi TB/U dibandingkan balita yang mengonsumsi biskuit kelapa.Kesimpulan: Dapat disimpulkan bahwa biskuit bekicot dapat menjadi alternatif perbaikan status gizi balita gizi buruk. Penelitian selanjutnya disarankan dapat memperpanjang durasi intervensi hingga 90 hari seperti anjuran pemerintah dalam pemberian makan tambahan.

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