Supplementation with ready-to-use therapeutic food has no effect on adverse outcomes among undernourished children aged 6–59 months with severe pneumonia
ObjectivesTo investigate the effect of supplementation with ready-to-use therapeutic food (RUTF) on adverse outcomes among undernourished children aged 6–59 months with severe pneumonia.MethodsThis secondary analysis of the COAST-Nutrition (ISRCTN10829073) included children hospitalized for severe p...
Saved in:
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-06-01
|
| Series: | Frontiers in Nutrition |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2025.1507360/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850130906787872768 |
|---|---|
| author | Damalie Nalwanga Damalie Nalwanga Elisa Giallongo Victor Musiime Victor Musiime Sarah Kiguli Peter Olupot Olupot Florence Alaroker Robert Opoka Robert Opoka Abner Tagoola Mainga Hamaluba Christabel Mogaka Eva Nabawanuka Charles Karamagi Charles Karamagi André Briend André Briend Kathryn Maitland Kathryn Maitland |
| author_facet | Damalie Nalwanga Damalie Nalwanga Elisa Giallongo Victor Musiime Victor Musiime Sarah Kiguli Peter Olupot Olupot Florence Alaroker Robert Opoka Robert Opoka Abner Tagoola Mainga Hamaluba Christabel Mogaka Eva Nabawanuka Charles Karamagi Charles Karamagi André Briend André Briend Kathryn Maitland Kathryn Maitland |
| author_sort | Damalie Nalwanga |
| collection | DOAJ |
| description | ObjectivesTo investigate the effect of supplementation with ready-to-use therapeutic food (RUTF) on adverse outcomes among undernourished children aged 6–59 months with severe pneumonia.MethodsThis secondary analysis of the COAST-Nutrition (ISRCTN10829073) included children hospitalized for severe pneumonia in Uganda and Kenya. Undernutrition was defined as having either a weight-for-age z score, height-for-age z score, or weight-for-height/length z score below the median of the WHO reference population (< 0) or mid-upper arm circumference (MUAC) below 13.5 cm. Participants were randomized to receive 1 sachet of RUTF daily for 8 weeks in addition to the usual diet (intervention) or usual diet alone (control). The primary composite outcome for adverse events was any one of mortality, re-admission, or deterioration of nutritional status by day 90 of follow-up.ResultsOf 846 main trial participants, 741 (88%) met the inclusion criteria (intervention: 374 versus control: 367). Of 687 (93%) participants in whom the primary outcome was assessed, 370 (54%) experienced an adverse event, [intervention: 184/348 (53%) versus control: 186/339(54%)]. There was no difference in the primary outcome between groups, aOR 0.92 (95% CI 0.68, 1.24), p = 0.572. Adverse outcome risk reduced with increasing age, aOR 0.53, (95% CI 0.45, 0.62), p < 0.001.ConclusionRUTF supplementation did not reduce the high frequency of adverse outcomes in children aged 6–59 months following hospital admission with severe pneumonia. Nutritional support directly targeting metabolic needs post-pneumonia should be considered in the future.Clinical trial registrationISRCTN10829073, PACTR202106635355751. |
| format | Article |
| id | doaj-art-de51145f1b45450ba0bdeb56dc9b2ba8 |
| institution | OA Journals |
| issn | 2296-861X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Nutrition |
| spelling | doaj-art-de51145f1b45450ba0bdeb56dc9b2ba82025-08-20T02:32:33ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-06-011210.3389/fnut.2025.15073601507360Supplementation with ready-to-use therapeutic food has no effect on adverse outcomes among undernourished children aged 6–59 months with severe pneumoniaDamalie Nalwanga0Damalie Nalwanga1Elisa Giallongo2Victor Musiime3Victor Musiime4Sarah Kiguli5Peter Olupot Olupot6Florence Alaroker7Robert Opoka8Robert Opoka9Abner Tagoola10Mainga Hamaluba11Christabel Mogaka12Eva Nabawanuka13Charles Karamagi14Charles Karamagi15André Briend16André Briend17Kathryn Maitland18Kathryn Maitland19Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, UgandaPaediatrics Research Group, Makerere University Lung Institute, Kampala, UgandaIntensive Care National Audit & Research Centre, London, United KingdomDepartment of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, UgandaJoint Clinical Research Centre, Kampala, UgandaDepartment of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, UgandaMbale Clinical Research Institute, Mbale, UgandaSoroti Regional Referral Hospital, Soroti, UgandaDepartment of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, UgandaAga Khan University, Medical College East Africa, Nairobi, KenyaJinja Regional Referral Hospital, Jinja, UgandaKEMRI Wellcome Trust Research Programme, Kilifi, KenyaKEMRI Wellcome Trust Research Programme, Kilifi, KenyaDepartment of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, UgandaDepartment of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda0Clinical Epidemiology Unit, Department of Internal Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda1Tampere Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland2Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, DenmarkKEMRI Wellcome Trust Research Programme, Kilifi, Kenya3Department of Infectious Disease, Institute of Global Health and Innovation, Imperial College London, London, United KingdomObjectivesTo investigate the effect of supplementation with ready-to-use therapeutic food (RUTF) on adverse outcomes among undernourished children aged 6–59 months with severe pneumonia.MethodsThis secondary analysis of the COAST-Nutrition (ISRCTN10829073) included children hospitalized for severe pneumonia in Uganda and Kenya. Undernutrition was defined as having either a weight-for-age z score, height-for-age z score, or weight-for-height/length z score below the median of the WHO reference population (< 0) or mid-upper arm circumference (MUAC) below 13.5 cm. Participants were randomized to receive 1 sachet of RUTF daily for 8 weeks in addition to the usual diet (intervention) or usual diet alone (control). The primary composite outcome for adverse events was any one of mortality, re-admission, or deterioration of nutritional status by day 90 of follow-up.ResultsOf 846 main trial participants, 741 (88%) met the inclusion criteria (intervention: 374 versus control: 367). Of 687 (93%) participants in whom the primary outcome was assessed, 370 (54%) experienced an adverse event, [intervention: 184/348 (53%) versus control: 186/339(54%)]. There was no difference in the primary outcome between groups, aOR 0.92 (95% CI 0.68, 1.24), p = 0.572. Adverse outcome risk reduced with increasing age, aOR 0.53, (95% CI 0.45, 0.62), p < 0.001.ConclusionRUTF supplementation did not reduce the high frequency of adverse outcomes in children aged 6–59 months following hospital admission with severe pneumonia. Nutritional support directly targeting metabolic needs post-pneumonia should be considered in the future.Clinical trial registrationISRCTN10829073, PACTR202106635355751.https://www.frontiersin.org/articles/10.3389/fnut.2025.1507360/fullsevere pneumoniaundernutritionnutritional interventionAfrican childrenadverse outcomes |
| spellingShingle | Damalie Nalwanga Damalie Nalwanga Elisa Giallongo Victor Musiime Victor Musiime Sarah Kiguli Peter Olupot Olupot Florence Alaroker Robert Opoka Robert Opoka Abner Tagoola Mainga Hamaluba Christabel Mogaka Eva Nabawanuka Charles Karamagi Charles Karamagi André Briend André Briend Kathryn Maitland Kathryn Maitland Supplementation with ready-to-use therapeutic food has no effect on adverse outcomes among undernourished children aged 6–59 months with severe pneumonia Frontiers in Nutrition severe pneumonia undernutrition nutritional intervention African children adverse outcomes |
| title | Supplementation with ready-to-use therapeutic food has no effect on adverse outcomes among undernourished children aged 6–59 months with severe pneumonia |
| title_full | Supplementation with ready-to-use therapeutic food has no effect on adverse outcomes among undernourished children aged 6–59 months with severe pneumonia |
| title_fullStr | Supplementation with ready-to-use therapeutic food has no effect on adverse outcomes among undernourished children aged 6–59 months with severe pneumonia |
| title_full_unstemmed | Supplementation with ready-to-use therapeutic food has no effect on adverse outcomes among undernourished children aged 6–59 months with severe pneumonia |
| title_short | Supplementation with ready-to-use therapeutic food has no effect on adverse outcomes among undernourished children aged 6–59 months with severe pneumonia |
| title_sort | supplementation with ready to use therapeutic food has no effect on adverse outcomes among undernourished children aged 6 59 months with severe pneumonia |
| topic | severe pneumonia undernutrition nutritional intervention African children adverse outcomes |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2025.1507360/full |
| work_keys_str_mv | AT damalienalwanga supplementationwithreadytousetherapeuticfoodhasnoeffectonadverseoutcomesamongundernourishedchildrenaged659monthswithseverepneumonia AT damalienalwanga supplementationwithreadytousetherapeuticfoodhasnoeffectonadverseoutcomesamongundernourishedchildrenaged659monthswithseverepneumonia AT elisagiallongo supplementationwithreadytousetherapeuticfoodhasnoeffectonadverseoutcomesamongundernourishedchildrenaged659monthswithseverepneumonia AT victormusiime supplementationwithreadytousetherapeuticfoodhasnoeffectonadverseoutcomesamongundernourishedchildrenaged659monthswithseverepneumonia AT victormusiime supplementationwithreadytousetherapeuticfoodhasnoeffectonadverseoutcomesamongundernourishedchildrenaged659monthswithseverepneumonia AT sarahkiguli supplementationwithreadytousetherapeuticfoodhasnoeffectonadverseoutcomesamongundernourishedchildrenaged659monthswithseverepneumonia AT peterolupotolupot supplementationwithreadytousetherapeuticfoodhasnoeffectonadverseoutcomesamongundernourishedchildrenaged659monthswithseverepneumonia AT florencealaroker supplementationwithreadytousetherapeuticfoodhasnoeffectonadverseoutcomesamongundernourishedchildrenaged659monthswithseverepneumonia AT robertopoka supplementationwithreadytousetherapeuticfoodhasnoeffectonadverseoutcomesamongundernourishedchildrenaged659monthswithseverepneumonia AT robertopoka supplementationwithreadytousetherapeuticfoodhasnoeffectonadverseoutcomesamongundernourishedchildrenaged659monthswithseverepneumonia AT abnertagoola supplementationwithreadytousetherapeuticfoodhasnoeffectonadverseoutcomesamongundernourishedchildrenaged659monthswithseverepneumonia AT maingahamaluba supplementationwithreadytousetherapeuticfoodhasnoeffectonadverseoutcomesamongundernourishedchildrenaged659monthswithseverepneumonia AT christabelmogaka supplementationwithreadytousetherapeuticfoodhasnoeffectonadverseoutcomesamongundernourishedchildrenaged659monthswithseverepneumonia AT evanabawanuka supplementationwithreadytousetherapeuticfoodhasnoeffectonadverseoutcomesamongundernourishedchildrenaged659monthswithseverepneumonia AT charleskaramagi supplementationwithreadytousetherapeuticfoodhasnoeffectonadverseoutcomesamongundernourishedchildrenaged659monthswithseverepneumonia AT charleskaramagi supplementationwithreadytousetherapeuticfoodhasnoeffectonadverseoutcomesamongundernourishedchildrenaged659monthswithseverepneumonia AT andrebriend supplementationwithreadytousetherapeuticfoodhasnoeffectonadverseoutcomesamongundernourishedchildrenaged659monthswithseverepneumonia AT andrebriend supplementationwithreadytousetherapeuticfoodhasnoeffectonadverseoutcomesamongundernourishedchildrenaged659monthswithseverepneumonia AT kathrynmaitland supplementationwithreadytousetherapeuticfoodhasnoeffectonadverseoutcomesamongundernourishedchildrenaged659monthswithseverepneumonia AT kathrynmaitland supplementationwithreadytousetherapeuticfoodhasnoeffectonadverseoutcomesamongundernourishedchildrenaged659monthswithseverepneumonia |