Cost-Effectiveness of 4 Specialized Nutritious Foods in the Prevention of Stunting and Wasting in Children Aged 6-23 Months in Burkina Faso: A Geographically Randomized Trial.

Autor:	Cliffer IR; Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA., Nikiema L; Institut de Recherche en Sciences de la Santé, Centre National de Recherche Scientifique et Technologique, Ouagadougou, Burkina Faso., Langlois BK; Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA., Zeba AN; Institut de Recherche en Sciences de la Santé, Centre National de Recherche Scientifique et Technologique, Ouagadougou, Burkina Faso., Shen Y; Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA., Lanou HB; Institut de Recherche en Sciences de la Santé, Centre National de Recherche Scientifique et Technologique, Ouagadougou, Burkina Faso., Suri DJ; Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.; Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA., Garanet F; Institut de Recherche en Sciences de la Santé, Centre National de Recherche Scientifique et Technologique, Ouagadougou, Burkina Faso., Chui K; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA., Vosti S; Department of Agricultural and Resource Economics, Social Sciences and Humanities, University of California, Davis, Davis, CA, USA., Walton S; Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA., Rosenberg I; Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA., Webb P; Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA., Rogers BL; Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	Current developments in nutrition [Curr Dev Nutr] 2020 Jan 23; Vol. 4 (2), pp. nzaa006. Date of Electronic Publication: 2020 Jan 23 (Print Publication: 2020).
DOI:	10.1093/cdn/nzaa006
Abstrakt:	Background: There is a variety of specialized nutritious foods available for use in programs targeting undernutrition, but evidence supporting the choice of product is limited. Objectives: We compared the cost-effectiveness of 4 specialized nutritious foods to prevent stunting and wasting in children aged 6-23 mo in Burkina Faso. Methods: Four geographic regions were randomly assigned to 1 of 4 intervention arms: Corn-Soy Blend Plus (CSB+) programmed with separate fortified vegetable oil (the reference food), Corn-Soy-Whey Blend (CSWB; a new formulation) with oil, SuperCereal Plus (SC+), and ready-to-use supplementary food (RUSF). We compared the effects of each intervention arm on growth (length-for-age z score (LAZ), weight-for-length z score (WLZ), end-line stunting (LAZ < -2), and total monthly measurements of wasting (WLZ < -2). Rations were ∼500 kcal/d, distributed monthly. Children were enrolled in the blanket supplementary feeding program at age ∼6 mo and measured monthly for ∼18 mo. Average costs per child reached were linked with effectiveness to compare the cost-effectiveness of each arm with CSB+ with oil. Results: In our sample of 6112 children (CSB+, n  = 1519; CSWB, n  = 1503; SC+, n  = 1564; RUSF, n  = 1526), none of the foods prevented declines in growth. Children in the SC+ and RUSF arms were not significantly different than those in the CSB+ with oil arm. Children in the CSWB with oil arm experienced higher end-line (measurement at age 22.9-23.9 mo) stunting (OR: 2.07; 95% CI: 1.46, 2.94) and more months of wasting (incidence rate ratio: 1.29; 95% CI: 1.09, 1.51). CSB+ with oil was the least-expensive ration in all costing scenarios ($113-131 2018 US dollars/enrolled child) and similar in effectiveness to SC+ and RUSF, and thus the most cost-effective product for the defined purposes. Conclusions: CSB+ with oil was the most cost-effective ration in the prevention of wasting and stunting in this trial. This trial was registered at clinicaltrials.gov as NCT02071563. (Copyright © The Author(s) 2020.)
Databáze:	MEDLINE
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