Community-based management of acute malnutrition for infants under 6 months of age is safe and effective: analysis of operational data
Abstract Objective: To assess the effectiveness of outpatient management with ready-to-use and supplementary foods for infants under 6 months (u6m) of age who were unable to be treated as inpatients due to social and economic barriers. Design: Review of operational acute malnutrition treatment r...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2023-01-01
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| Series: | Public Health Nutrition |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S1368980021004894/type/journal_article |
| _version_ | 1797742042710802432 |
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| author | Maeve M Woeltje Anastasia B Evanoff Beth A Helmink Diana L Culbertson Kenneth M Maleta Mark J Manary Indi Trehan |
| author_facet | Maeve M Woeltje Anastasia B Evanoff Beth A Helmink Diana L Culbertson Kenneth M Maleta Mark J Manary Indi Trehan |
| author_sort | Maeve M Woeltje |
| collection | DOAJ |
| description |
Abstract
Objective:
To assess the effectiveness of outpatient management with ready-to-use and supplementary foods for infants under 6 months (u6m) of age who were unable to be treated as inpatients due to social and economic barriers.
Design:
Review of operational acute malnutrition treatment records.
Setting:
Twenty-one outpatient therapeutic feeding clinics in rural Malawi.
Participants:
Infants u6m with acute malnutrition treated as outpatients because of barriers to inpatient treatment. The comparison group consisted of acutely malnourished children 6–9 months of age who were being treated at the same time in the same location in the context of two different randomised clinical trials.
Results:
A total of 323 infants u6m were treated for acute malnutrition (130 severe and 193 moderate). A total of 357 infants 6–9 months old with acute malnutrition (seventy-four severe and 283 moderate) were included as contemporaneous controls. Among infants u6m with severe acute malnutrition, 98 (75·4 %) achieved nutritional recovery; in comparison, 56 (75·7 %) of those with severe acute malnutrition 6–9 months old recovered. Among infants u6m with moderate acute malnutrition, 157 (81·3 %) recovered; in comparison, 241 (85·2 %) of those aged 6–9 months recovered.
Conclusions:
In a rural Malawian population of infants u6m who had generally already stopped exclusive breast-feeding and were now acutely malnourished, treatment with therapeutic or supplementary foods under the community management of acute malnutrition model was safe and effective. In settings where social and financial factors make hospital admission challenging, consideration should be given to lowering the recommended age of ready-to-use therapeutic and supplementary foods to infants u6m.
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| first_indexed | 2024-03-12T14:35:20Z |
| format | Article |
| id | doaj.art-87a64ce5fd23475187c3f2492675cc97 |
| institution | Directory Open Access Journal |
| issn | 1368-9800 1475-2727 |
| language | English |
| last_indexed | 2024-03-12T14:35:20Z |
| publishDate | 2023-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Public Health Nutrition |
| spelling | doaj.art-87a64ce5fd23475187c3f2492675cc972023-08-17T10:00:44ZengCambridge University PressPublic Health Nutrition1368-98001475-27272023-01-012624625510.1017/S1368980021004894Community-based management of acute malnutrition for infants under 6 months of age is safe and effective: analysis of operational dataMaeve M Woeltje0Anastasia B Evanoff1Beth A Helmink2Diana L Culbertson3Kenneth M Maleta4https://orcid.org/0000-0002-2536-3938Mark J Manary5Indi Trehan6https://orcid.org/0000-0002-3364-6858Department of Pediatrics, University of Washington, 4800 Sand Point Way NE, M/S MB.7.520, Seattle, WA 98105, USA Seattle Children’s Hospital, Seattle, USADepartment of Psychiatry, Harvard University, Boston, USADepartment of Surgery, Washington University in St. Louis, St Louis, USASeattle Children’s Hospital, Seattle, USASchool of Public Health and Family Medicine, Kamuzu University of Health Sciences, Blantyre, MalawiSchool of Public Health and Family Medicine, Kamuzu University of Health Sciences, Blantyre, Malawi Department of Pediatrics, Washington University in St. Louis, St Louis, USADepartment of Pediatrics, University of Washington, 4800 Sand Point Way NE, M/S MB.7.520, Seattle, WA 98105, USA Seattle Children’s Hospital, Seattle, USA Department of Global Health, University of Washington, Seattle, USA Department of Epidemiology, University of Washington, Seattle, USA Abstract Objective: To assess the effectiveness of outpatient management with ready-to-use and supplementary foods for infants under 6 months (u6m) of age who were unable to be treated as inpatients due to social and economic barriers. Design: Review of operational acute malnutrition treatment records. Setting: Twenty-one outpatient therapeutic feeding clinics in rural Malawi. Participants: Infants u6m with acute malnutrition treated as outpatients because of barriers to inpatient treatment. The comparison group consisted of acutely malnourished children 6–9 months of age who were being treated at the same time in the same location in the context of two different randomised clinical trials. Results: A total of 323 infants u6m were treated for acute malnutrition (130 severe and 193 moderate). A total of 357 infants 6–9 months old with acute malnutrition (seventy-four severe and 283 moderate) were included as contemporaneous controls. Among infants u6m with severe acute malnutrition, 98 (75·4 %) achieved nutritional recovery; in comparison, 56 (75·7 %) of those with severe acute malnutrition 6–9 months old recovered. Among infants u6m with moderate acute malnutrition, 157 (81·3 %) recovered; in comparison, 241 (85·2 %) of those aged 6–9 months recovered. Conclusions: In a rural Malawian population of infants u6m who had generally already stopped exclusive breast-feeding and were now acutely malnourished, treatment with therapeutic or supplementary foods under the community management of acute malnutrition model was safe and effective. In settings where social and financial factors make hospital admission challenging, consideration should be given to lowering the recommended age of ready-to-use therapeutic and supplementary foods to infants u6m. https://www.cambridge.org/core/product/identifier/S1368980021004894/type/journal_articleSevere acute malnutritionModerate acute malnutritionReady-to-use therapeutic foodReady-to-use supplementary foodWastingKwashiorkorMarasmus |
| spellingShingle | Maeve M Woeltje Anastasia B Evanoff Beth A Helmink Diana L Culbertson Kenneth M Maleta Mark J Manary Indi Trehan Community-based management of acute malnutrition for infants under 6 months of age is safe and effective: analysis of operational data Public Health Nutrition Severe acute malnutrition Moderate acute malnutrition Ready-to-use therapeutic food Ready-to-use supplementary food Wasting Kwashiorkor Marasmus |
| title | Community-based management of acute malnutrition for infants under 6 months of age is safe and effective: analysis of operational data |
| title_full | Community-based management of acute malnutrition for infants under 6 months of age is safe and effective: analysis of operational data |
| title_fullStr | Community-based management of acute malnutrition for infants under 6 months of age is safe and effective: analysis of operational data |
| title_full_unstemmed | Community-based management of acute malnutrition for infants under 6 months of age is safe and effective: analysis of operational data |
| title_short | Community-based management of acute malnutrition for infants under 6 months of age is safe and effective: analysis of operational data |
| title_sort | community based management of acute malnutrition for infants under 6 months of age is safe and effective analysis of operational data |
| topic | Severe acute malnutrition Moderate acute malnutrition Ready-to-use therapeutic food Ready-to-use supplementary food Wasting Kwashiorkor Marasmus |
| url | https://www.cambridge.org/core/product/identifier/S1368980021004894/type/journal_article |
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