Potential consequences of expanded MUAC-only programs on targeting of acutely malnourished children and ready-to-use-therapeutic-food allocation: lessons from cross-sectional surveys
| Autor: | Danka Pantchova, Alexia Couture, Benjamin Guesdon, Oleg O. Bilukha |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Cross-sectional study
Endocrinology Diabetes and Metabolism Population RUTF Medicine (miscellaneous) lcsh:TX341-641 Disease cluster Malnutrition in children Environmental health medicine education Survey Wasting Nutrition education.field_of_study lcsh:R5-920 Nutrition and Dietetics lcsh:TP368-456 business.industry WHZ MUAC Humanitarian Public Health Environmental and Occupational Health Anthropometry medicine.disease Malnutrition lcsh:Food processing and manufacture Therapeutic food medicine.symptom business lcsh:Medicine (General) lcsh:Nutrition. Foods and food supply Research Article |
| Zdroj: | BMC Nutrition, Vol 6, Iss 1, Pp 1-13 (2020) BMC nutrition |
| ISSN: | 2055-0928 |
| Popis: | Background Some of the recently piloted innovative approaches for the management of acute malnutrition in children use the “expanded MUAC-only” approach, with Mid Upper Arm Circumference (MUAC) Methods We analyzed data from 550 population representative cross-sectional cluster surveys conducted since 2007. We retrieved all children classified as SAM and MAM according to currently used case definitions, and calculated the proportions of SAM children who would be excluded from treatment, misclassified as MAM, or whose specific risks (because of having both MUAC and weight-for height deficits) would be ignored. We also analyzed the expected changes in the number and demographics (sex, age) of children meant to receive RUTF according to the new approach. Results We found that approximately one quarter of SAM children would not be detected and eligible for treatment under the “expanded MUAC-only” scenario, and another 20% would be classified as MAM. A further 17% of the total SAM children would be admitted and followed only according to their MUAC or oedema status, while they also present with a severe weight-for height deficit on admission. Considering MAM targeting, about half of the MAM children would be left undetected. This scenario also shows a 2.5 time increase in the number of children targeted with RUTF, with approximately 70% of MAM and 30% of SAM cases among this new RUTF target. Conclusions This empirical evidence suggests that adoption of “expanded MUAC-only” programs would likely lead to a priori exclusion from treatment or misclassifying as MAM a large proportion of SAM cases, while redirecting programmatic costs in favor of those less in need. It underscores the need to explore other options for improving the impact of programs addressing the needs of acutely malnourished children. |
| Databáze: | OpenAIRE |
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