scholarly journals Locally prepared ready to use therapeutic food for the treatment of children with severe acute malnutrition: a randomized controlled trial

2017 ◽  
Vol 4 (4) ◽  
pp. 1491
Author(s):  
Ravichandra K. R. ◽  
Narendra Behera
Keyword(s):  
Weight Gain ◽  
Hospital Stay ◽  
Severe Acute Malnutrition ◽  
Controlled Trial ◽  
Acute Malnutrition ◽  
Study Cohort ◽  
Rapid Weight Gain ◽  
Duration Of Hospital Stay ◽  
Significant Difference ◽  
Therapeutic Food

Background: Severe acute malnutrition (SAM) remains as one of the major killers of children under five years of age. As per WHO are guidelines, dietary management plays a big role in the longer rehabilitation phase of management of SAM. RUTFs are now being used as a substitute to F-100 diet in the management of SAM around the globe. The objective of the study was to compare the efficacy of locally-prepared ready-to-use therapeutic food (LRUTF) and F-100 diet in promoting weight-gain in children with SAM.Methods: A total of 120 children were included in the study. The control cohort received F-100 while the study cohort received LRUTF diet. Both the groups received a total of 6 feeds per day which included 3 feeds of either LRUTF or F100 and 3 feeds from family pot. Outcome was measured in terms of Rate of weight gain/kg/day, duration of hospital stays and recovery rates.Results: There were 60 subjects in each group. Rate of weight gain was found to be (9.15±3.39 gm/kg/day) in LRUTF group and (6.72±1.05 gm/kg/day) in F-100 group. Significant difference in rate of weight gain was observed in LRUTF group. Duration of hospital stay was lesser in LRUTF group than F-100 group... Recovery rates in LRUTF group were better than F-100 group.Conclusions: LRUTF promotes more rapid weight-gain when compared with F100 in patients with SAM during rehabilitation phase. Duration of hospital stay is lesser in LRUTF group than that of F-100 group.

scholarly journals Serum iron and serum retinol level of severe acute malnourished children on therapeutic intervention with WHO/UNICEF recommended therapeutic food and home based therapeutic food

2021 ◽  
Vol 8 (2) ◽  
pp. 337
Author(s):  
Bharti Bhandari ◽  
Anita Mehta
Keyword(s):  
Serum Iron ◽  
Severe Acute Malnutrition ◽  
Vitamin A Deficiency ◽  
Controlled Trial ◽  
Acute Malnutrition ◽  
P Value ◽  
Serum Retinol ◽  
Home Based ◽  
Significant Difference ◽  
Therapeutic Food

Background: The prevalence of anaemia and vitamin A deficiency among children with severe acute malnutrition (SAM) and their correction during nutritional rehabilitation are not well documented. This study assessed serum iron and serum retinol levels, effect of ready-to-use therapeutic foods (RUTF) and home based treatment on levels of serum iron and serum retinol level in SAM children.Methods: This was a simple randomised controlled trial in 6-59 months old children with SAM. Two groups of 70 each were divided, one was given RUTF and other home based food comparable to RUTF. Serum retinol and serum iron were measured on day 1 and 6 weeks of therapy.Results: Home based food was found better in terms of increase in serum iron than RUTF while there was no difference in rise of serum retinol in both the groups. There was no significant difference between day 1 value of serum iron in both the groups as p value was 0.82 but the level of serum iron at 6 weeks has shown significant difference in both the groups as p value was 0.0014 so there was significant increase in serum iron in group B in comparison to group A; the serum retinol value in both the groups has not shown any significant improvement.Conclusions: It was concluded home based food is better in correcting iron deficiency in SAM children as it is cheap, easily available, palatable, and acceptable than RUTF.

scholarly journals Effectiveness of Ready-to-Use Therapeutic Food in Improving the Developmental Potential and Weight of Children Aged under Five with Severe Acute Malnourishment in Pakistan: A Pretest-Posttest Study

2021 ◽  
Vol 18 (17) ◽  
pp. 9060
Author(s):  
Javeria Saleem ◽  
Rubeena Zakar ◽  
Gul Mehar Javaid Bukhari ◽  
Mahwish Naz ◽  
Faisal Mushtaq ◽  
...  
Keyword(s):  
Weight Gain ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
World Health ◽  
Fine Motor ◽  
Strong Positive Correlation ◽  
Developmental Potential ◽  
Under Five ◽  
Baseline Weight ◽  
Therapeutic Food

The objective of this study was to assess whether the standard therapy of ready-to-use therapeutic food in the treatment of uncomplicated severe acute malnutrition (SAM) is effective in improving developmental potential and weight gain in children aged under five years. A multicenter pretest-posttest study was conducted among 91 children aged under five with uncomplicated SAM in Pakistan. Study participants completed their eight weeks’ therapy of ready-to-use therapeutic food according to the World Health Organization’s (WHO) standard guidelines. The study outcome was the proportion of children with improved developmental potential in all domains in comparison with the pretreatment status and children gaining >15% of their baseline weight; mean weight-for-height/length z-score after completing eight weeks’ therapy of ready-to-use therapeutic food. The Denver Development Screening Tool II was used for developmental screening. Significant changes (p < 0.05) were observed for developmental status milestones in terms of gross motor, fine motor, and personal/social milestones, as well as language and global development milestones. There was a strong positive correlation (r = 0.961) between initial weight and weight at the last visit (p < 0.001). Ready-to-use therapeutic food is effective in improving development potential as well as promoting weight gain in children aged under five with uncomplicated SAM if provided according to WHO guidelines.

scholarly journals Malawian children with fast-breathing pneumonia with and without comorbidities

Pneumonia ◽  
2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Amy Sarah Ginsburg ◽  
Tisungane Mvalo ◽  
Jun Hwang ◽  
Melda Phiri ◽  
Eric D. McCollum ◽  
...  
Keyword(s):  
Clinical Cure ◽  
Severe Acute Malnutrition ◽  
Controlled Trial ◽  
Acute Malnutrition ◽  
Link Type ◽  
Appropriate Treatment ◽  
Treatment Failure Rate ◽  
Significant Difference ◽  
Observational Cohort ◽  
Cure Rates

Abstract Background Due to high risk of mortality, children with comorbidities are typically excluded from trials evaluating pneumonia treatment. Understanding heterogeneity of outcomes among children with pneumonia and comorbidities is critical to ensuring appropriate treatment. Methods We explored whether the percentage of children with fast-breathing pneumonia cured at Day 14 was lower among those with selected comorbidities enrolled in a prospective observational study than among those enrolled in a concurrent randomized controlled trial evaluating treatment with amoxicillin in Lilongwe, Malawi. Results Among 79 children with fast-breathing pneumonia in the prospective observational cohort, 57 (72.2%) had HIV infection/exposure, 20 (25.3%) had malaria, 2 (2.5%) had severe acute malnutrition, and 17 (21.5%) had anemia. Treatment failure rate was slightly (not significantly) lower in children with comorbidities (4.1%, 3/73) compared to those without comorbidities (4.5%, 25/552) similarly treated. There was no significant difference in clinical cure rates by Day 14 (95.8% with vs 96.7% without comorbidity). Conclusions Children with fast-breathing pneumonia excluded from a concurrent clinical trial due to comorbidities did not fare worse. Children at higher risk whose caregivers seek care early and who receive appropriate risk assessment (e.g., pulse oximetry, hemoglobin, HIV/malaria testing) and treatment, can achieve clinical cure by Day 14. Trial registration ClinicalTrials.govNCT02960919; registered November 8, 2016.

scholarly journals Evaluation of Malnutrition in Children Admitted in Nutritional Rehabilitation Home of Pokhara Academy of Health Sciences- A Retrospective Cross-sectional Hospital Based Study

2020 ◽  
Vol 3 (2) ◽  
pp. 281-287
Author(s):  
Amrita Ghimire Paudel ◽  
Gita Ghimire ◽  
Shreekrishna Shrestha ◽  
Ramchandra Bastola ◽  
Yagyaraj Sigdel ◽  
...  
Keyword(s):  
Weight Gain ◽  
Nutritional Status ◽  
Severe Acute Malnutrition ◽  
Nutritional Intervention ◽  
Health Sciences ◽  
Acute Malnutrition ◽  
Nutritional Rehabilitation ◽  
Management Protocol ◽  
Significant Difference ◽  
Moderate Acute Malnutrition

Introduction: The burden of malnutrition is of significant concern in Nepal. The objectives of this study are to classify the nutritional status in children admitted in nutritional rehabilitation home of Pokhara Academy of Health Sciences and to relate the demographic characteristics and the effectiveness of the nutritional intervention measures on status of malnutrition which can help in the policy formulation to tackle the burden of malnutrition. Materials and Methods: This is a hospital based retrospective study in which total of 238 children with malnutrition admitted in nutritional rehabilitation home of Pokhara Academy of Health Sciences during July 2014 to July 2018 were followed. The socio-demographic factors and nutritional status were analyzed at admission and at discharge using the available record. Data was analyzed using SPSS 16. Results: Out of 238 malnourished children, 167(70.2%) were cases of moderate acute malnutrition and 76(29.8%) were cases of severe acute malnutrition. The mean weight at admission was 7.18±1.73 kg, mean weight at discharge was 7.82±1.82 kg and mean weight increased after nutritional intervention was 0.62 kg±0.40. The average weight gain in severe acute malnutrition was 4.7gm/kg/day. A statistically significant difference was obtained between mean weight (p=0.00, t= - 24.62) of children at admission and discharge. There was significant statistical difference between mean weight gain (p<0.05, t= -3.1) in severe acute malnutrition (0.76±0.49 kg) and in moderate acute malnutrition (0.59±0.34 kg). Conclusion: Nutritional rehabilitation homes are effective in improving the nutritional status of undernourished children, more effective in severe acute malnutrition. However it is important to reassess the management protocol to meet the intake targets so that the rate of weight gain is improved.

scholarly journals Ready-to-Use Therapeutic Food Made From Locally Available Food Ingredients Is Well Accepted by Children Having Severe Acute Malnutrition in Bangladesh

2017 ◽  
Vol 39 (1) ◽  
pp. 116-126 ◽  
Author(s):  
Nuzhat Choudhury ◽  
Tahmeed Ahmed ◽  
Md Iqbal Hossain ◽  
M. Munirul Islam ◽  
Shafiqul A. Sarker ◽  
...  
Keyword(s):  
Energy Content ◽  
Severe Acute Malnutrition ◽  
Diarrhoeal Disease ◽  
Acute Malnutrition ◽  
Community Based ◽  
Food Ingredients ◽  
Total Energy Content ◽  
Significant Difference ◽  
The Mean ◽  
Therapeutic Food

Background: With a prevalence of 3.1%, approximately, 450 000 children in Bangladesh are having severe acute malnutrition (SAM). There is currently no national community-based program run by government to take care of these children, one of the reasons being lack of access to ready-to-use therapeutic food (RUTF). Objective: To develop RUTF using locally available food ingredients and test its acceptability. Methods: A checklist was prepared for all food ingredients available and commonly consumed in Bangladesh that have the potential of being used for developing a RUTF. Linear programming was used to identify the combinations of nutrients that would result in an ideal RUTF. To test the acceptability of 2 local RUTFs compared to the prototype RUTF, Plumpy’Nut, a clinical trial with a crossover design was conducted among 30 children in the Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh. The acceptability was determined by using the mean proportion of offered food consumed by the children themselves. Results: Two RUTFs were developed, one based on chickpea and the other on rice–lentils. The total energy content of 100 g of chickpea and rice–lentil-based RUTF were 537.4 and 534.5 kcal, protein 12.9 and 13.5 g, and fat 31.8 and 31.1 g, respectively, without any significant difference among the group. On an average, 85.7% of the offered RUTF amount was consumed by the children in 3 different RUTF groups which implies that all types of RUTF were well accepted by the children. Conclusion: Ready-to-use therapeutic foods were developed using locally available food ingredients—rice, lentil, and chickpeas. Chickpea-based and rice–lentil-based RUTF were well accepted by children with SAM.

scholarly journals Costing of three feeding regimens for home-based management of children with uncomplicated severe acute malnutrition from a randomised trial in India

2018 ◽  
Vol 3 (2) ◽  
pp. e000702 ◽  
Author(s):  
Charu C Garg ◽  
Sarmila Mazumder ◽  
Sunita Taneja ◽  
Medha Shekhar ◽  
Sanjana Brahmawar Mohan ◽  
...  
Keyword(s):  
Severe Acute Malnutrition ◽  
Randomised Trial ◽  
National Income ◽  
Acute Malnutrition ◽  
Home Based ◽  
Life Years ◽  
Significant Difference ◽  
The Government ◽  
Treated Child ◽  
Therapeutic Food

Trial designThree feeding regimens—centrally produced ready-to-use therapeutic food, locally produced ready-to-use therapeutic food, and augmented, energy-dense, home-prepared food—were provided in a community setting for children with severe acute malnutrition (SAM) in the age group of 6–59 months in an individually randomised multicentre trial that enrolled 906 children. Foods, counselling, feeding support and treatment for mild illnesses were provided until recovery or 16 weeks.MethodsCosts were estimated for 371 children enrolled in Delhi in a semiurban location after active survey and identification, enrolment, diagnosis and treatment for mild illnesses, and finally treatment with one of the three regimens, both under the research and government setting. Direct costs were estimated for human resources using a price times quantity approach, based on their salaries and average time taken for each activity. The cost per week per child for food, medicines and other consumables was estimated based on the total expenditure over the period and children covered. Indirect costs for programme management including training, transport, non-consumables, infrastructure and equipment were estimated per week per child based on total expenditures for research study and making suitable adjustments for estimations under government setting.ResultsNo significant difference in costs was found across the three regimens per covered or per treated child. The average cost per treated child in the government setting was estimated at US$56 (<3500 rupees).ConclusionHome-based management of SAM with a locally produced ready-to-use therapeutic food is feasible, acceptable, affordable and very cost-effective in terms of the disability-adjusted life years saved and gross national income per capita of the country. The treatment of SAM at home needs serious attention and integration into the existing health system, along with actions to prevent SAM.Trial registration numberNCT01705769; Pre-results.

scholarly journals Effectiveness of a Locally Produced, Fish-Based Food Product on Weight Gain among Cambodian Children in the Treatment of Acute Malnutrition: A Randomized Controlled Trial

Nutrients ◽  
2018 ◽  
Vol 10 (7) ◽  
pp. 909 ◽  
Author(s):  
Sanne Sigh ◽  
Nanna Roos ◽  
Chhoun Chamnan ◽  
Arnaud Laillou ◽  
Sophanneary Prak ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Weight Gain ◽  
Controlled Trial ◽  
Food Product ◽  
Acute Malnutrition ◽  
Nutrition Interventions ◽  
Randomized Controlled ◽  
High Prevalence ◽  
Lower Weight Gain ◽  
Therapeutic Food

Cambodia continues to have a high prevalence of acute malnutrition. Low acceptability has been found for standard ready-to-use-therapeutic-food (RUTF) products. Therefore, NumTrey, a locally-produced fish-based RUTF, was developed. The objective was to evaluate the effectiveness of NumTrey compared to an imported milk-based RUTF for weight gain among children aged 6–59 months in the home-treatment for acute malnutrition. Effectiveness was tested in a single-blinded randomized controlled trial with weight gain as the primary outcome. Anthropometry was assessed at baseline and bi-weekly follow-ups until endline at Week 8. In total, 121 patients were randomized into BP-100TM (n = 61) or NumTrey (n = 60). There was no statistical difference in mean weight gain between the groups (1.06 g/kg/day; 95% CI (0.72, 1.41) and 1.08 g/kg/day; 95% CI (0.75, 1.41) for BP-100™ and NumTrey, respectively). In addition, no statistically significant differences in secondary outcomes were found. Although the ability to draw conclusions was limited by lower weight gain than the desired 4 g/kg/day in both groups, no superiority was found for eitherRUTF. A locally produced RUTF is highly relevant to improve nutrition interventions in Cambodia. A locally produced fish-based RUTF is a relevant alternative to imported milk-based RUTF for the treatment of SAM in Cambodia.

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