Effectiveness of acute malnutrition treatment with a simplified, combined protocol in Central African Republic

An observational cohort study

Bibliographic Data

ID15537176
AuthorsGrace Heymsfield (0009-0004-2614-2215, International Rescue Committee, corresponding author), Zachary Tausanovitch (International Rescue Committee), Loubah Gondjé Christian (University of Bangui), M'bary Siolo Mada Bebelou (University of Bangui), Benedict Tabiojong Mbeng (University of Bangui), Anne Marie Dembele (University of Bangui), A Fossi (University of Bangui), Théophile Bansimba (University of Bangui), Issa Niamanto Coulibaly (Mali-Folkecenter), Victor Nikièma (0000-0001-8334-8579, World Food Programme), Suvi T Kangas (0000-0003-1477-7649, International Rescue Committee)
Year2024
Volume20
Issue4
Pagese13691-e13691
Publication date2024-07-02
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueMaternal and Child Nutrition (JOURNAL)
Journal identifiersISSN: 1740-8695 • E-ISSN: 1740-8709
PublisherWiley (PUBLISHER • GB)
DOI10.1111/mcn.13691
PMID38956431
OpenAlexW4400305662
LanguageEN
Citations received2
References cited10

A simplified, combined protocol admitting children with a mid-upper-arm circumference (MUAC) of <125 mm or oedema to malnutrition treatment with ready-to-use therapeutic food (RUTF) uses two sachets of RUTF per day of those with MUAC < 115 mm and/or oedema and one sachet of RUTF per day for those with MUAC 115-<125 mm. This treatment previously demonstrated noninferior programmatic outcomes compared with standard treatment and high recovery in a routine setting. We aimed to observe the protocol's effectiveness in a routine setting at scale, in two health districts of the Central African Republic through an observational cohort study. The pilot enrolled children for 1 year in consortium by the Ministry of Health and nongovernmental partners. A total of 7909 children were admitted to the simplified, combined treatment. Treatment resulted in an 81.2% overall recovery, with a mean length of stay (LOS) of 38.7 days and a mean RUTF consumption of 43.4 sachets per child treated. Among children admitted with MUAC < 115 mm or oedema, 67.9% recovered with a mean LOS of 48.1 days and consumed an average of 70.9 RUTF sachets. Programme performance differed between the two districts, with an overall defaulting rate of 31.1% in the Kouango-Grimari health district, compared to 8.2% in Kemo. Response to treatment by children admitted with severe acute malnutrition (SAM) by MUAC and SAM by oedema was similar. The simplified, combined protocol resulted in a satisfactory overall recovery and low RUTF consumption per child treated, with further need to understand defaulting in the context

Alternative medicine · Cohort · Cohort study · Intensive care medicine · Malnutrition · Observational study · Pathology · Protocol (science · Child Nutrition and Water Access · Food Security and Health in Diverse Populations · Medicine · Poverty, Education, and Child Welfare · Internal Medicine · Pediatrics

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