Efficacy of Home-Based Fortified Diet in Rehabilitation of Malnourished Children in Resource Restrained Country: An Institution Based Retrospective Study
Abstract Background: Globally, it is estimated that 50 million children under five are wasted. National nutrition survey-2018 has shown that 23.3% and 45.5% of children are wasted and stunted in Pakistan. Many studies have shown that hospital-based management of malnutrition is not practical due to high cost and iatrogenic infections and currently WHO recommends community-based management of malnutrition with provision of therapeutic food. There is limited evidence of community rehabilitation of malnourished children by using home fortified diet in Pakistan. This study aims to evaluate effectiveness of using energy dense, home fortified diet in weight gain of malnourished children in Karachi, through a retrospective chart review.Methods: A retrospective chart review of pediatric patients (aged 6 month–5 years) seen in Indus Hospital between January 2017 to June 2018 was conducted. A pre-designed data abstraction form was used to record detailed information about demographic characteristics, feeding, anthropometric, micronutrient, and nutritional details at enrollment and on follow-up.Results: A total of 361 patients were included in the final analysis. The median age (IQR) of children was 15 (14) months. Forty eight percent (n= 172) children had diarrhea and 54% (n= 195) children had respiratory tract infection. The median length of stay in the program was 28 days. The median (IQR) for average weight gain was 4.8 (0-10.3) g/Kg/day, 64.6% (n=226) children defaulted, 29% (n=102) were cured and 3% (n=10) died.Conclusion: This study revealed adequate weight gain and recovery in malnourished children by using home fortified diet in real life situations without using therapeutic food or monetary support. Home fortified diets may serve as effective strategy in community-based rehabilitation of malnourished children.