Alternative Ready-To-Use Therapeutic Food Yields Less Recovery Than the Standard for Treating Acute Malnutrition in Children From Ghana
| Autor: | Matilda Steiner-Asiedu, Mark J. Manary, Carly Edwards, Kwesi Firibu Saalia, Meghan Callaghan-Gillespie, Julia M. Gauglitz, Kristin Kohlmann |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Food Handling Cost-Benefit Analysis Severe Acute Malnutrition Malnutrition in children Weight Gain Child Nutrition Disorders Ghana law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Double-Blind Method law medicine Humans 030212 general & internal medicine Wasting 030219 obstetrics & reproductive medicine business.industry Wasting Syndrome Infant Standard of Care General Medicine Original Articles medicine.disease Home Care Services Intention to Treat Analysis Malnutrition Treatment Outcome Therapeutic food Child Preschool Fast Foods Female Underweight medicine.symptom business Weight gain |
| Zdroj: | Global Health: Science and Practice |
| ISSN: | 2169-575X |
| Popis: | In Ghana, an alternative ready-to-use food (RUTF) formulation that met all specifications was not as good as standard RUTF in affecting recovery from acute malnutrition among children aged 6 to 59 months. Background: Only 20% of children with severe acute malnutrition (SAM) have access to ready-to-use therapeutic food (RUTF), and RUTF cost limits its accessibility. Methods: This randomized, double-blind controlled study involved a clinical equivalence trial comparing the effectiveness of an alternative RUTF with standard RUTF in the home-based treatment of uncomplicated SAM and moderate malnutrition in Ghanaian children aged 6 to 59 months. The primary outcome was recovery, equivalence was defined as being within 5 percentage points of the control group, and an intention-to-treat analysis was used. Alternative RUTF was composed of whey protein, soybeans, peanuts, sorghum, milk, sugar, and vegetable oil. Standard RUTF included peanuts, milk, sugar, and vegetable oil. The cost of alternative RUTF ingredients was 14% less than standard RUTF. Untargeted metabolomics was used to characterize the bioactive metabolites in the RUTFs. Results: Of the 1,270 children treated for SAM or moderate malnutrition, 554 of 628 (88%) receiving alternative RUTF recovered (95% confidence interval [CI]=85% to 90%) and 516 of 642 (80%) receiving standard RUTF recovered (95% CI=77% to 83%). The difference in recovery was 7.7% (95% CI=3.7% to 11.7%). Among the 401 children with SAM, the recovery rate was 130 of 199 (65%) with alternative RUTF and 156 of 202 (77%) with standard RUTF (P=.01). The default rate in SAM was 60 of 199 (30%) for alternative RUTF and 41 of 202 (20%) for standard RUTF (P=.04). Children enrolled with SAM who received alternative RUTF had less daily weight gain than those fed standard RUTF (2.4 ± 2.4 g/kg vs. 2.9 ± 2.6 g/kg, respectively; P |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|