scholarly journals Impact of effective counselling on management of moderate acute malnutrition in a community

2020 ◽  
Vol 7 (2) ◽  
pp. 321
Author(s):  
Vikas Arya ◽  
Ajay Gaur ◽  
Neetu S. Agarwal ◽  
Harsha Chouhan
Keyword(s):  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
P Value ◽  
Case Group ◽  
Average Weight ◽  
Group Counselling ◽  
Target Weight ◽  
Dietary Counselling ◽  
Trained Counsellor ◽  
Moderate Acute Malnutrition

Background: Moderate Acute Malnutrition (MAM) is defined as Weight for Height between -2SD to -3SD, and/or Mid Upper Arm Circumference (MUAC) 11.5 cm to 12.5 cm. Effect of not treating MAM has a significant impact on Severe Acute Malnutrition (SAM) burden. Management of MAM is possible through supplementary feeding or Community centre counselling.Methods: Present study was a prospective case control study done in 2013-14 in 200 children in adjacent communities. Community in which intervention (dietary counselling) was planned, it was labelled as case group. For dietary counselling ‘structured group counselling’ method was selected in which at a time parents of six MAM children were involved. Counselling was done by a trained counsellor using all techniques proposed by IYCF. Counselling sessions were scheduled at 0, 1, 3 and 6 months.Results: 60% children of case group moved to improved or well- nourished nutritional status (p-value 0.00001). Amongst improved group, weight for height improvement is statistically significant (p-value 0.001), average weight attained is 2-3 kg in 6 months with average weight gain of 1.5-3 grams/kg/day. MUAC improvement was also found to be statistically significant (p-value 0.003), there was 47% improvement in case group with average MUAC gain is 0.6 cm to 1 cm in 6 months (0.13 cm/month). Also, there is early rise in weight for height then MUAC. Average duration to achieve target weight for height is 4.3 months in case group as compare to 5.3 months in control group.Conclusions: Structured and integrated group counselling using all counselling skills by a trained counsellor should be an integral part of managing MAM in community. Weight for height should be primary indicator in early phase of response as compare to MUAC in measuring impact of counselling.

scholarly journals Performance and costing of nutrition intervention measures on admitted children in malnutrition treatment center: a case study from Jharkhand, India

2020 ◽  
Vol 7 (10) ◽  
pp. 4048
Author(s):  
Rajesh Kumar Sinha ◽  
Asha Kiran ◽  
Vivek Kashyap ◽  
Praveen Kumar
Keyword(s):  
Severe Acute Malnutrition ◽  
Average Length ◽  
Nutrition Intervention ◽  
Acute Malnutrition ◽  
Treatment Center ◽  
Medical Complication ◽  
Average Weight ◽  
Post Discharge ◽  
Target Weight ◽  
Intervention Measures

Background: Children with severe acute malnutrition (SAM) having medical complications require immediate care at malnutrition treatment centers (MTC). Thus, it becomes important to assess the effect and treatment cost of such children in these facilities. Hence, the present study was done with these aims in two MTCs in Jharkhand, India.Methods: A retrospective record review was done of the children admitted to these two MTCs between 1st April 2017 and 31st March 2018. A predesigned proforma was used to collect child related information. The data collected was entered in Microsoft excel sheet and analysed.Results: Majority of the admitted children (90.6%) were in 6-23 months age group. 358 (51.5%) children were females. Only, 194 (27.9%) children admitted were SAM had any medical complication. 690 (99.3%) children were discharged of whom 499 (72.3%) were discharged after achieving the target weight. The average weight gain during their stay was 8.1±2.4 g/kg/day and average length of stay was 16.7±3.2 days. Post discharge follow up rates were found to be low and only 130 (18.8%) children completed all three follow ups. Average cost per SAM child treated was Rs. 18,599 (US$ 272) and per SAM child cured was Rs. 25,904 (US$ 379).Conclusions: MTCs are effective in managing medically complicated SAM children. However, improvements are necessary to ensure that more such children should be treated at facility level, complimented with a community based programme for managing uncomplicated SAM children to improve coverage and ensure continuum of care.

scholarly journals Essai d’une farine de sevrage dans la réhabilitation nutritionnelle de la malnutrition aigüe en milieu communautaire, au Niger

2020 ◽  
Vol 151 ◽  
pp. 15573-15583
Author(s):  
Maman Mahaman Salissou ◽  
Bako Aminatou Maazou ◽  
Sabo Haoua Seini
Keyword(s):  
Weight Gain ◽  
Acute Malnutrition ◽  
Prise En Charge ◽  
Average Weight ◽  
Target Weight ◽  
The Third ◽  
Étude Prospective ◽  
Peanut Cake ◽  
Moderate Acute Malnutrition ◽  
Average Weight Gain

Objectif : l’objectif vise à évaluer l’efficacité des bouillies à base de mil, tourteaux d’arachide et la poudre de moringa, chez les enfants âgés de 6 à 59 mois admis pour malnutrition au niveau du Centre de Santé Intégré de Dan Issa. Méthodologie et Résultats : Cette étude prospective, s’est déroulée du 23 août au 04 octobre 2019. Elle a concerné 44 enfants de 06 à 59 mois, répartis en trois groupes. Le premier groupe de 20 enfants atteints de malnutrition aigüe modérée, recevant la bouillie ; le deuxième groupe constitué de 12 enfants atteints de malnutrition aigüe légère, reçoit la même bouillie et le troisième groupe constitué de 12 enfants atteints de malnutrition aigüe modérée, reçoit du CSB++. Les données ont été analysées avec le logiciel SPSS version 20. Ainsi, il ressort : pour le premier groupe, l’âge moyen est de 12,20 mois ± 4,336. La moitié des enfants (50%) a observé une amélioration de leur nutritionnel dès la première semaine de traitement avec un gain de poids moyen de 73,92g par jour ± 73,7. Pour le deuxième groupe, l’âge moyen est de 28,92 mois ± 15,163. On a constaté que 75% des enfants ont atteint le poids cible dès la première semaine de prise en charge, avec un gain de poids moyen de 85,11g/j ± 47,22. Pour le troisième groupe ayant reçu le CSB++, on a constaté que seuls 3 enfants sur 12 (25%) ont observé une amélioration de leur état nutritionnel après 14 jours de traitement. Le gain de poids moyen était de 20,53g/j ± 23,14. Cependant, il faut noter que ce dernier groupe n’a reçu le CSB++ qu’une seule fois et le CSI était en rupture jusqu’à la fin de l’étude. En effet, l’action de la bouillie sur le gain pondéral a été remarquable. Tous les enfants ont acceptés la bouillie et qu’aucun signe d’intolérance n’a été noté. Conclusion et application des résultats : la bouillie mis au point à partir du mil, tourteaux d’arachide et la poudre de moringa est une approche pour combattre ou prévenir à long terme la malnutrition chez les enfants de moins de cinq ans au Niger. Cependant, la bouillie seule ne constitue pas le traitement, mais doit être couplée avec des mesures sanitaires, d'hygiène et d’éducation nutritionnelle des mères. Mots-clés : essai, farine, malnutrition, prévention, réhabilitation nutritionnelle, Niger. Maman et al., J. Appl. Biosci. 2020 Essai d’une farine de sevrage dans la réhabilitation nutritionnelle de la malnutrition aigüe en milieu communautaire, au Niger). 15574 ABSTRACT Objective: the objective aims to assess the effectiveness of millet-based porridge, peanut cake and moringa powder, in children aged 6 to 59 months admitted for malnutrition at the Dan Issa Integrated Health Center. Methodology and Results: This prospective study took place from August 23 to October 04, 2019. It involved 44 children from 06 to 59 months, divided into three groups. The first group of 20 children with moderate acute malnutrition, receiving porridge; the second group of 12 children with mild acute malnutrition receives the same porridge and the third group of 12 children with moderate acute malnutrition receives CSB ++. Data were analyzed with SPSS software version 20. Thus, it emerges: for the first group, the average age is 12.20 months ± 4.336. Half the children (50%) observed an improvement in their nutrition from the first week of treatment with an average weight gain of 73.92 g per day ± 73.7. For the second group, the average age is 28.92 months ± 15.163. It was found that 75% of children reached the target weight within the first week of treatment, with an average weight gain of 85.11 g / d ± 47.22. For the third group who received CSB ++, it was found that only 3 out of 12 children (25%) observed an improvement in their nutritional status after 14 days of treatment. The average weight gain was 20.53 g / d ± 23.14. However, it should be noted that the latter group received CSB ++ only once and the CSI was out until the end of the study. Indeed, the action of porridge on weight gain has been remarkable. All the children accepted the porridge and no signs of intolerance were noted. Conclusion and application of the results: the porridge developed from millet, peanut cake and moringa powder is an approach to combat or prevent long-term malnutrition in children under five in Niger. However, porridge alone is not the treatment, but should be combined with sanitary, hygienic and nutritional education measures for mothers. Keywords: trial, flour, malnutrition, prevention, nutritional rehabilitation, Niger.

scholarly journals Severe and moderate acute malnutrition detection in a rural hospital pediatric outpatient clinic and their comparison with the IAP charts: a two-year study

2017 ◽  
Vol 5 (1) ◽  
pp. 110
Author(s):  
Deepali Abhijit Ambike ◽  
Sandhya Vishal Haribhakta ◽  
Subhash Shankar Poyekar ◽  
Aishwarya Santosh Pingley ◽  
Jyotsna Madhu Naidu
Keyword(s):  
Outpatient Clinic ◽  
Severe Acute Malnutrition ◽  
Adverse Outcomes ◽  
Rural Hospital ◽  
Acute Malnutrition ◽  
P Value ◽  
Rehabilitation Centre ◽  
Cross Sectional ◽  
Set Up ◽  
Moderate Acute Malnutrition

Background: Children with moderate acute malnutrition (MAM) have an increased list of mortality, infections and impaired physical and cognitive development compared to well-nourished children. The Objectives of this study were to diagnose Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM) using WHO growth charts as a criterion and to compare the WHO classification with the IAP classification in the diagnosis of SAM and MAM.Methods: A two-year duration cross-sectional study conducted in Pediatric outpatient clinic of a rural hospital from January 2013 to December 2014. In case of moderate acute malnutrition (MAM) was diagnosed as weight-for-height >-3 but <-2 Z scores of the median according to WHO growth standards. We defined MAM as mid-upper am circumference (MUAC) of >11.0 cm and <12.5 cm with no bilateral pitting edema and SAM as MUAC less than 11.5 cm. We compared the values with the IAP charts for diagnosis of malnutrition. Our set up is not a nutrition rehabilitation centre, feeding programmes were not implemented.Results: The distribution of prevalence of SAM and MAM differs significantly across three age groups studied (P-value <0.001). However, it did not differ significantly between boys and girls aged between 6 months to 6 years (P-value >0.05). Of 90 SAM cases, 55 cases (61.1%) had Grade 1 IAP grade of malnutrition, 28 cases (31.1%) had Grade 2 IAP grade of malnutrition, 7 cases (7.8%) had Grade 3 IAP grade of malnutrition. None of the SAM cases fell in Grade 4 IAP. The distribution of prevalence of SAM and MAM differs significantly across various IAP grades of malnutrition (P-value <0.001).Conclusions: The IAP charts used for diagnosing malnutrition did not have any comparative value with the WHO charts used for the SAM MAM detection. WHO grading of SAM and MAM is more sensitive than IAP grading in early diagnosis of under nutrition and facilitate early treatment. Not having a targeted nutrition-specific intervention to address MAM in this set up places these children with MAM at excessive risk of adverse outcomes. Further preventive and curative approaches should urgently be considered.

scholarly journals Incidence Correction Factors for Moderate and Severe Acute Child Malnutrition From 2 Longitudinal Cohorts in Mali and Burkina Faso

2020 ◽  
Vol 189 (12) ◽  
pp. 1623-1627
Author(s):  
Francisco M Barba ◽  
Lieven Huybregts ◽  
Jef L Leroy
Keyword(s):  
Burkina Faso ◽  
Low Income ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Cross Sectional ◽  
Incidence Data ◽  
Moderate Acute Malnutrition ◽  
Cluster Randomized ◽  
Definition Of ◽  
Mid Upper Arm Circumference

Abstract Child acute malnutrition (AM) is an important cause of child mortality. Accurately estimating its burden requires cumulative incidence data from longitudinal studies, which are rarely available in low-income settings. In the absence of such data, the AM burden is approximated using prevalence estimates from cross-sectional surveys and the incidence correction factor $K$, obtained from the few available cohorts that measured AM. We estimated $K$ factors for severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) from AM incidence and prevalence using representative cross-sectional baseline and longitudinal data from 2 cluster-randomized controlled trials (Innovative Approaches for the Prevention of Childhood Malnutrition—PROMIS) conducted between 2014 and 2017 in Burkina Faso and Mali. We compared K estimates using complete (weight-for-length z score, mid-upper arm circumference (MUAC), and edema) and partial (MUAC, edema) definitions of SAM and MAM. $K$ estimates for SAM were 9.4 and 5.7 in Burkina Faso and in Mali, respectively; K estimates for MAM were 4.7 in Burkina Faso and 5.1 in Mali. The MUAC and edema–based definition of AM did not lead to different $K$ estimates. Our results suggest that $K$ can be reliably estimated when only MUAC and edema-based data are available. Additional studies, however, are required to confirm this finding in different settings.

scholarly journals Acceptability of Outpatient Ready-To-Use Food-Based Protocols in HIV-Infected Senegalese Children and Adolescents Within the MAGGSEN Cohort Study

2016 ◽  
Vol 38 (1) ◽  
pp. 27-36 ◽  
Author(s):  
Cecile Cames ◽  
Marie Varloteaux ◽  
Ndeye Ngone Have ◽  
Alhadji Bassine Diom ◽  
Philippe Msellati ◽  
...  
Keyword(s):  
Cohort Study ◽  
Children And Adolescents ◽  
Clinical Management ◽  
Antiretroviral Treatment ◽  
Psychosocial Support ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Controlled Trials ◽  
Intervention Design ◽  
Moderate Acute Malnutrition

Objectives: To assess the acceptability of ready-to-use food (RUF)-based outpatient protocols in HIV-infected children and adolescents with severe acute malnutrition (SAM) and moderate acute malnutrition (MAM). Methods: Plumpy Nut and Plumpy Sup were supplied every 2 weeks and prescribed by weight to SAM and MAM children, respectively. Forty-three children, 24 MAM and 19 SAM, were enrolled. Organoleptic appreciation, feeding modalities, and perceptions surrounding RUF were recorded at week 2. Sachets were counted to measure adherence throughout the study. Results: Median age was 12.2 years (interquartile range: 9.3-14.8), and 91% were on antiretroviral treatment. Overall, 80%, 76%, 68%, and 68% of children initially rated RUF color, taste, smell, and mouth feeling as good. However, feelings of disgust, refusal to eat, fragmentation of intake, self-stigma, and sharing within the household were commonly reported. Eighteen MAM and 7 SAM experienced weight recovery. Recovery duration was 54 days (31-90) in MAM versus 114 days (69-151) in SAM children ( P = .02). Their rate of RUF consumption compared to amount prescribed was approximately 50% from week 2 to week 10. Nine failed to gain weight or consume RUF and were discontinued for clinical management, and 9 dropped out due to distance to the clinic. Conclusion: Initial RUF acceptability was satisfactory. More than half the children had successful weight recovery, although adherence to RUF prescription was suboptimal. However, further research is needed to propose therapeutic foods with improved palatability, alternative and simpler intervention design, and procedures for continuous and tailored psychosocial support in this vulnerable population. Trial registration: NCT01771562 (Current Controlled Trials).

scholarly journals Outcome of nutritional intervention measures at a nutrition rehabilitation centre in Krishna district, Andhra Pradesh

2018 ◽  
Vol 5 (12) ◽  
pp. 5150
Author(s):  
Deepthi Pagali ◽  
Suneetha Bollipo ◽  
Harsha B. Korrapolu ◽  
Mohammed Abdul Rahman
Keyword(s):  
Standard Deviation ◽  
Severe Acute Malnutrition ◽  
Nutritional Intervention ◽  
High Rate ◽  
Acute Malnutrition ◽  
Rehabilitation Centre ◽  
District Health ◽  
Target Weight ◽  
Significant Difference ◽  
Nutrition Rehabilitation

Background: Nutrition rehabilitation centre (NRC) is a unit in a district health facility, where children with severe acute malnutrition are admitted and provided with nutritional and therapeutic care.Methods: Analysis of nutritional data of all the children admitted to NRC at Krishna district from January 2017 to July 2018. Statistical analysis was done using SPSS.Results: A total of 200 children were included in the study. The overall mean weight at admission was found to be 8.30 kg with a standard deviation of 2.35 kg and the mean weight at the time of discharge is 9.57 kg with a standard deviation of 2.61 kg. There is a statistically significant difference in weight and mid arm circumference at admission and discharge. Mean duration of hospital stay is around 18.67±5.4 days. Target weight is achieved in 71% of the study group.Conclusions: Present study reflects that NRCs have been playing a key role to cope up with the problem of severe acute malnutrition as demonstrated by a high rate of weight gain at discharge as well as during follow ups. 

scholarly journals Development and Acceptability of Locally Made Fish-Based, Ready-to-Use Products for the Prevention and Treatment of Malnutrition in Cambodia

2018 ◽  
Vol 39 (3) ◽  
pp. 420-434 ◽  
Author(s):  
Sanne Sigh ◽  
Nanna Roos ◽  
Daream Sok ◽  
Bindi Borg ◽  
Chhoun Chamnan ◽  
...  
Keyword(s):  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Treatment Intervention ◽  
Intervention Trial ◽  
Overall Acceptability ◽  
High Prevalence ◽  
Prevention And Treatment ◽  
Moderate Acute Malnutrition ◽  
Hedonic Scale ◽  
Supplementary Foods

Background: Cambodia has a high prevalence of moderate acute malnutrition and severe acute malnutrition (SAM). The SAM treatment requires ready-to-use therapeutic foods (RUTFs), whereas ready-to-use supplementary foods (RUSFs) are used for prevention of acute malnutrition. Three locally produced fish-based products were developed: an RUTF paste (NumTrey-Paste) for treatment and 2 wafer versions, one for prevention (NumTrey-RUSF) and one for treatment (NumTrey-RUTF). Objective: To assess the acceptability of NumTrey-Paste and NumTrey-RUSF in comparison to a standard biscuit product (BP-100) used for the treatment of SAM. Methods: Acceptability of NumTrey-RUSF and NumTrey-Paste was tested in a nonblinded crossover taste trial among children (n = 52), aged ≥ 6 months to 18 years, and their caregivers. Eight organoleptic qualities were assessed on a 5-point hedonic scale, as well as a ranking test. A score of 1 to 3 was categorized as acceptable. The acceptability of NumTrey-RUTF was assessed using the caregivers’ perception during an SAM treatment intervention. Results: Taste trial: The proportion of children categorizing products as overall acceptable was lowest for NumTrey-Paste compared to for BP-100 and NumTrey-RUSF (21% vs 43% [BP-100] and 36% [NumTrey-RUSF]). No difference was found in the proportion of children who ranked BP-100 or NumTrey-RUSF as “liked most” ( P > .05). Acceptability of NumTrey-RUSF ranked highest in appearance and taste (caregiver), whereas acceptability of NumTrey-Paste was ranked lowest in appearance and smell among the products. Intervention trial: The acceptability of NumTrey-RUTF increased from 72% to 86%. Conclusions: The overall acceptability was ranked lowest for a pure paste product. However, filling the paste into a wafer made the product more acceptable.

scholarly journals An Overview on Acute Malnutrition and Food Insecurity among Children during the Conflict in Yemen

Children ◽  
2019 ◽  
Vol 6 (6) ◽  
pp. 77 ◽  
Author(s):  
Fekri Dureab ◽  
Eshraq Al-Falahi ◽  
Osan Ismail ◽  
Lina Al-Marhali ◽  
Ayoub Al Jawaldeh ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Severe Acute Malnutrition ◽  
Public Health Problem ◽  
Acute Malnutrition ◽  
Nutrition Status ◽  
Surveillance Program ◽  
Children Under Five ◽  
Under Five ◽  
Community Needs ◽  
Moderate Acute Malnutrition

Background: This study aims to describe malnutrition among children under five and to describe the food insecurity status during the current conflict in Yemen. Methods: Data were obtained from a Yemeni nutrition surveillance program (pilot phase) targeting 4142 households with 5276 children under five from two governorates (Ibb and Sana’a). Results: Global acute malnutrition was found in 13.3% of overall screened children, while 4.9% had severe acute malnutrition (SAM) and 8.4% had moderate acute malnutrition. One-fifth of the children under six months of age were acutely malnourished, followed by children under two years at 18.5% based on weight-for-height z scores. Significant associations between malnutrition and other diseases included suspected measles at three times higher rates (4.5%, p < 0.00) among SAM cases than other children. Diarrhea, fever, and cough were significantly higher among the SAM group (p < 0.05). Most households depended on market food purchases in the month preceding this survey (84.7%). Household coping mechanisms to secure daily meals included borrowing food to survive, changing types and quality of food, and decreasing the number of meals per day; some families sent their children to live with relatives. Conclusion: Malnutrition is a serious public health problem. The humanitarian community needs to adopt alternative strategies to improve food security and the nutrition status in Yemen.

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