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 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 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 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 Comparison study on efficacy of UNICEF specified therapeutic food (F-75/F-100) with traditionally used home based food in management of severe acute malnutrition

2018 ◽  
Vol 5 (4) ◽  
pp. 1674
Author(s):  
Anand Shukla ◽  
Y. K. Rao
Keyword(s):  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Severe Malnutrition ◽  
Comparison Study ◽  
Medical College ◽  
Home Based ◽  
Appropriate Therapy ◽  
Moderate Malnutrition ◽  
Therapeutic Food

Background: The management of malnutrition depends on its severity. While mild to moderate malnutrition can be managed on ambulatory basis, severe malnutrition is preferably managed in hospital settings. This study was undertaken to find the magnitude of SAM in children (6 months to 60 months) and to compare the UNICEF specified therapeutic food (F-75/F-100) with traditionally used home based food in treatment of severe acute malnutrition.Methods: This prospective and observational study was conducted in the Department of Pediatrics of G.S.V.M. Medical College, L.L.R. and Associated Hospitals, Kanpur. Logarithmic transformation was achieved by SPSS 20.Results: The prevalence of SAM in children between 6 months to 60 months of age to be 18%. Clinical spectrum of SAM showed 95.24% of marasmus 3.57% of Kwashiorkor and 1.19% of marasmic kwashiorkor.    There was significant increase in weight of hospitalized patient receiving F75/F100 at 28 days of follow up. Weight gain was not statistically significant in patients treated at home.Conclusions: SAM should preferably be treated in hospital with appropriate therapy rather than home based management.

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 STUDY TO EVALUATE THE SPECTRUM OF DIFFERENT CO-MORBIDITIES IN CHILDREN SUFFERING FROM SEVERE ACUTE MALNUTRITION WITH UNEXPECTED DYSELECTROLYTEMIA IN DIARRHEA

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Arunabh Kumar ◽  
Ashok Kumar ◽  
Manish Ranjan
Keyword(s):  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
P Value ◽  
Medical College ◽  
Institutional Ethics ◽  
Co Morbidity ◽  
Significant Difference ◽  
Study Population ◽  
Hiv 1 ◽  
Morbid Conditions

Aim: to evaluate the spectrum of co-morbidities in severe acute malnutrition with unexpected dyselectrolytemia in diarrhea. Material and methods: The study was an observational study which was carried in the Department of pediatrics, Darbhanga Medical College and Hospital, Laheriasarai, Darbhanga Bihar, India for 2 years.  after taking the approval of the protocol review committee and institutional ethics committee. Total 200 Children below 5 year age were included in this study. Various co morbid conditions in study population were identified. All the laboratory examination was done with standard method. Results: Total 200 cases were included in study of which 96% were associated co-morbid conditions in SAM. Majority of children with SAM were having co-morbidity in the form of Anaemia (88%), Diarrhoea (60%) followed by pneumonia (32%), Rickets (31%), Tuberculosis (14%), Otitis    media    (12%),    UTI    (11%),    Celiac   (4%), Hypothyroidism (2%), & HIV (1%). Mean age (SD) of the diarrheal cases was 25(6) months (95% C.I. 24.1- 25.8) of which 70 were male (58.33%). Mean age (SD) of non-diarrheal cases was 19(6). (95% C.I. 16.6 – 19.4) of which 45 were male(75%). 120 (60%) SAM children presented with diarrhea of which 117 had dysnatremia in the form of Hyponatremia in 117 cases (58.5%) & Hypernatremia in 3 cases (1.5%) No statistically significant difference was found with hyponatremia in diarrheal or non-diarrheal cases of SAM (P value of 0.07). It was found that 20% SAM children were having hypokalemia. Hypokalemia was found in 15% of diarrheal cases & 5% in non- diarrheal cases. A statistically significant difference was found with hypokalemia in SAM (P value of 0.019) between Diarrheal & Non diarrheal cases. Conclusion: Dyselectrolytemia is high in complicated SAM and mainly sodium disturbances in form of hyponatremia are common in different co-morbid conditions. Keywords: Co-morbidities, Dyselectrolytemia, Potassium, Severe acute malnutrition, Sodium

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