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OBJECTIVES: Moderate acute malnutrition (MAM) is widespread and a persistent public health problem in developing countries. Currently, the management approach of MAM is focused on food supplementation, but it is limited to chronically food-insecure areas. This study aims to develop local-ingredients based supplement (LIBS) and evaluate if it is comparable to the corn-soya blend plus (CSB+) in treating MAM among children aged 6 to 59 months in Wolaita, Ethiopia. METHODS: Collection of food ingredients that have the potential for making LIBS was done. Sorting, soaking, roasting, and milling of ingredients were done. The LIBS, with an improved amount of nutrients, was used to test the effectiveness in treating MAM. To evaluate the effectiveness of LIBS compared with CSB+ in treating MAM, we used a randomized controlled non-inferiority trial among 324 moderately wasted children aged 6 to 59 months in Wolaita, Ethiopia. The daily ration was: 100 gm of LIBS plus 25.2 gm of sugar with 8 ml oil in the intervention group and 150 gm of CSB+ with 16 ml of oil in the control group. A chi-square test was used for the comparison of recovery rates between two groups. Kaplan-Meier (log-rank) survival analysis was done to estimate the recovery time and survival curves. RESULTS: Four food samples of LIBS were made with different portions of ingredients. One of the LIBS with the highest portion of pumpkin seed and selected for testing had an improved amount of protein, fat, energy, iron, zinc and potassium contents. Its proximate composition indicated protein and fat contents of 22.6 g/100 g and 32.9 g/100 g respectively. The trial results showed that there is no difference in baseline characteristics between the two groups (p > 0.05). The recovery rate for LIBS (n = 105 of 162; 64.8%) was similar to that for CSB+ (n = 108 of 162; 66.7%) (P = 0.6). The duration of recovery was similar for the LIBS group, with a median of 56 days compared to 63 days for the CSB+ group (P = 0.92). CONCLUSIONS: The LIBS has contained adequate amount of nutrients needed for the treatment of MAM. There was no difference in recovery rates as well as recovery times for those who received LIBS and those who received CSB+ . Thus, LIBS has the same potential to treat MAM as CSB+ . FUNDING SOURCES: Norwegian Agency for Development Cooperation (NORAD); Norwegian Program for Capacity Development in Higher Education and Research for Development Program (NORHED). |
