Soya, maize and sorghum ready-to-use therapeutic foods are more effective in correcting anaemia and iron deficiency than the standard ready-to-use therapeutic food: Randomized controlled trial

Autor: Paluku Bahwere, Kate Sadler, Hitoshi Murakami, Sylvester Kathumba, Chrissy Banda, Steve Collins, Elizabeth Maganga, Peter Akomo
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Malawi
Arachis
Logistic regression
Gastroenterology
Santé publique
law.invention
0302 clinical medicine
Randomized controlled trial
law
Epidemiology
Prevalence
030212 general & internal medicine
biology
Anemia
Iron-Deficiency
lcsh:Public aspects of medicine
Iron deficiency
Treatment Outcome
Milk
Severe acute malnutrition
Child
Preschool
Female
Analysis of variance
Research Article
medicine.medical_specialty
Iron
Severe Acute Malnutrition
030209 endocrinology & metabolism
Anaemia
Zea mays
03 medical and health sciences
Ready-to-use therapeutic food
Internal medicine
medicine
Animals
Humans
Sorghum
Soluble transferrin receptor
Food
Formulated
business.industry
Public Health
Environmental and Occupational Health
Infant
lcsh:RA1-1270
medicine.disease
Therapeutic food
biology.protein
Soybeans
business
Edible Grain
Zdroj: BMC public health, 19 (1
BMC Public Health
BMC Public Health, Vol 19, Iss 1, Pp 1-15 (2019)
Popis: Background: The prevalence of anaemia and iron deficiency (ID) among children with severe acute malnutrition (SAM) and their correction during nutritional rehabilitation are not well documented. This study assessed anaemia and ID prevalence and their predictors at start of SAM treatment, and the efficacy of their treatment and effect on gut health of two novel Ready-To-Use Therapeutic foods (RUTF) prepared from soybean, maize and sorghum (SMS) with (MSMS-RUTF) or without added milk (FSMS-RUTF) compared to those of the standard formulation prepared from peanut and milk (PM-RUTF). Methods: This was a 3-arms parallel groups, simple randomised, controlled non-inferiority trial in 6-59 months old Central Malawian children with SAM. Anaemia was defined using altitude- and ethnicity-adjusted haemoglobin. Iron status was defined using soluble transferrin receptor (sTfR) and body iron stores (BIS). We used Pearson's chi-square test, t-test for paired or unpaired data, Kruskal-Wallis test for between-arm differences as appropriate and logistic regression to identify independent predictors of anaemia or iron deficiency anaemia (IDA). Results: The sample size was 389. At admission, the prevalence [%(95%CI)] of anaemia was 48.9(41.4-56.5)% while that of ID and IDA were 55.7(48.6-62.5)% and 34.3(28.2-41.0)% when using sTfR criterion and 29.1(24.4-34.4)% and 28.9(23.7-34.9)% when using BIS criterion, respectively. At discharge, nutrition rehabilitation with SMS-RUTF was associated with the lowest prevalence of anaemia [12.0(6.9-20.3)% for FSMS-RUTF, 18.2(11.9-26.8)% for MSMS-RUTF and 24.5(15.8-35.9)% for PM-RUTF; p = 0.023] and IDA [7.9(3.4-17.3)% for FSMS-RUTF, 10.9(4.8-22.6)% for MSMS-RUTF and 20.5(10.7-35.5)% for PM-RUTF; p = 0.028]. SMS-RUTF was also associated with the highest increase in BIS [Change in BIS (95%CI)] among the iron deplete at admission [6.2 (3.7; 8.6), 3.2 (0.8; 5.6), 2.2 (0.2; 4.3) for the same study arms; Anova p = 0.045]. Compared to P-RUTF, FSMS-RUTF had the highest adjusted recovery rate [OR (95%CI = 0.3 (0.2-0.5) with p < 0.001 for FSMS-RUTF and 0.6 (0.3-1.0) with p = 0.068 for MSMS-RUTF]. No effect of iron content on risk of iron overload or gut inflammation was observed. Conclusions: Anaemia and ID are common among children with SAM. FSMS-RUTF is more efficacious in treating anaemia and correcting BIS among this group than PM-RUTF. Trial registration: This study was registered on 15 April 2015 (PACTR201505001101224).
SCOPUS: ar.j
info:eu-repo/semantics/published
Databáze: OpenAIRE
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