Effectiveness of acute malnutrition treatment with a simplified, combined protocol in Central African Republic: An observational cohort study
Abstract A simplified, combined protocol admitting children with a mid‐upper‐arm circumference (MUAC) of <125 mm or oedema to malnutrition treatment with ready‐to‐use therapeutic food (RUTF) uses two sachets of RUTF per day of those with MUAC < 115 mm and/or oedema and one sachet of RUTF per d...
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| Format: | Article |
| Language: | English |
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Wiley
2024-10-01
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| Series: | Maternal and Child Nutrition |
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| Online Access: | https://doi.org/10.1111/mcn.13691 |
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| author | Grace Heymsfield Zachary Tausanovitch Loubah Gondjé Christian M'bary Siolo Mada Bebelou Benedict Tabiojong Mbeng Anne Marie Dembele Annie Fossi Théophile Bansimba Issa Niamanto Coulibaly Victor Nikièma Suvi T. Kangas |
| author_facet | Grace Heymsfield Zachary Tausanovitch Loubah Gondjé Christian M'bary Siolo Mada Bebelou Benedict Tabiojong Mbeng Anne Marie Dembele Annie Fossi Théophile Bansimba Issa Niamanto Coulibaly Victor Nikièma Suvi T. Kangas |
| author_sort | Grace Heymsfield |
| collection | DOAJ |
| description | Abstract A simplified, combined protocol admitting children with a mid‐upper‐arm circumference (MUAC) of <125 mm or oedema to malnutrition treatment with ready‐to‐use therapeutic food (RUTF) uses two sachets of RUTF per day of those with MUAC < 115 mm and/or oedema and one sachet of RUTF per day for those with MUAC 115–<125 mm. This treatment previously demonstrated noninferior programmatic outcomes compared with standard treatment and high recovery in a routine setting. We aimed to observe the protocol's effectiveness in a routine setting at scale, in two health districts of the Central African Republic through an observational cohort study. The pilot enrolled children for 1 year in consortium by the Ministry of Health and nongovernmental partners. A total of 7909 children were admitted to the simplified, combined treatment. Treatment resulted in an 81.2% overall recovery, with a mean length of stay (LOS) of 38.7 days and a mean RUTF consumption of 43.4 sachets per child treated. Among children admitted with MUAC < 115 mm or oedema, 67.9% recovered with a mean LOS of 48.1 days and consumed an average of 70.9 RUTF sachets. Programme performance differed between the two districts, with an overall defaulting rate of 31.1% in the Kouango‐Grimari health district, compared to 8.2% in Kemo. Response to treatment by children admitted with severe acute malnutrition (SAM) by MUAC and SAM by oedema was similar. The simplified, combined protocol resulted in a satisfactory overall recovery and low RUTF consumption per child treated, with further need to understand defaulting in the context. |
| format | Article |
| id | doaj-art-f5bc155aecee4aeea758ebbf8c139bed |
| institution | Kabale University |
| issn | 1740-8695 1740-8709 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Maternal and Child Nutrition |
| spelling | doaj-art-f5bc155aecee4aeea758ebbf8c139bed2024-11-19T11:34:12ZengWileyMaternal and Child Nutrition1740-86951740-87092024-10-01204n/an/a10.1111/mcn.13691Effectiveness of acute malnutrition treatment with a simplified, combined protocol in Central African Republic: An observational cohort studyGrace Heymsfield0Zachary Tausanovitch1Loubah Gondjé Christian2M'bary Siolo Mada Bebelou3Benedict Tabiojong Mbeng4Anne Marie Dembele5Annie Fossi6Théophile Bansimba7Issa Niamanto Coulibaly8Victor Nikièma9Suvi T. Kangas10International Rescue Committee New York New York USAInternational Rescue Committee New York New York USAInternational Rescue Committee Bangui Central African RepublicMinistry of Health and Population Bangui Central African RepublicWorld Food Programme Bangui Central African RepublicUnited Nations Children's Fund Bangui Central African RepublicCommunity Humanitarian Emergency Board International Bangui Central African RepublicUnited Nations Children's Fund Bangui Central African RepublicInternational Rescue Committee Bamako MaliWorld Food Programme Dakar SenegalInternational Rescue Committee New York New York USAAbstract A simplified, combined protocol admitting children with a mid‐upper‐arm circumference (MUAC) of <125 mm or oedema to malnutrition treatment with ready‐to‐use therapeutic food (RUTF) uses two sachets of RUTF per day of those with MUAC < 115 mm and/or oedema and one sachet of RUTF per day for those with MUAC 115–<125 mm. This treatment previously demonstrated noninferior programmatic outcomes compared with standard treatment and high recovery in a routine setting. We aimed to observe the protocol's effectiveness in a routine setting at scale, in two health districts of the Central African Republic through an observational cohort study. The pilot enrolled children for 1 year in consortium by the Ministry of Health and nongovernmental partners. A total of 7909 children were admitted to the simplified, combined treatment. Treatment resulted in an 81.2% overall recovery, with a mean length of stay (LOS) of 38.7 days and a mean RUTF consumption of 43.4 sachets per child treated. Among children admitted with MUAC < 115 mm or oedema, 67.9% recovered with a mean LOS of 48.1 days and consumed an average of 70.9 RUTF sachets. Programme performance differed between the two districts, with an overall defaulting rate of 31.1% in the Kouango‐Grimari health district, compared to 8.2% in Kemo. Response to treatment by children admitted with severe acute malnutrition (SAM) by MUAC and SAM by oedema was similar. The simplified, combined protocol resulted in a satisfactory overall recovery and low RUTF consumption per child treated, with further need to understand defaulting in the context.https://doi.org/10.1111/mcn.13691acute malnutritionCentral African Republiccommunity management of acute malnutrition (CMAM)mid‐upper arm circumference (MUAC)operational pilotready to use therapeutic food (RUTF) |
| spellingShingle | Grace Heymsfield Zachary Tausanovitch Loubah Gondjé Christian M'bary Siolo Mada Bebelou Benedict Tabiojong Mbeng Anne Marie Dembele Annie Fossi Théophile Bansimba Issa Niamanto Coulibaly Victor Nikièma Suvi T. Kangas Effectiveness of acute malnutrition treatment with a simplified, combined protocol in Central African Republic: An observational cohort study Maternal and Child Nutrition acute malnutrition Central African Republic community management of acute malnutrition (CMAM) mid‐upper arm circumference (MUAC) operational pilot ready to use therapeutic food (RUTF) |
| title | Effectiveness of acute malnutrition treatment with a simplified, combined protocol in Central African Republic: An observational cohort study |
| title_full | Effectiveness of acute malnutrition treatment with a simplified, combined protocol in Central African Republic: An observational cohort study |
| title_fullStr | Effectiveness of acute malnutrition treatment with a simplified, combined protocol in Central African Republic: An observational cohort study |
| title_full_unstemmed | Effectiveness of acute malnutrition treatment with a simplified, combined protocol in Central African Republic: An observational cohort study |
| title_short | Effectiveness of acute malnutrition treatment with a simplified, combined protocol in Central African Republic: An observational cohort study |
| title_sort | effectiveness of acute malnutrition treatment with a simplified combined protocol in central african republic an observational cohort study |
| topic | acute malnutrition Central African Republic community management of acute malnutrition (CMAM) mid‐upper arm circumference (MUAC) operational pilot ready to use therapeutic food (RUTF) |
| url | https://doi.org/10.1111/mcn.13691 |
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