Impact of a simplified treatment protocol for moderate acute malnutrition with a decentralized treatment approach in emergency settings of Niger
IntroductionOf the 45.4 million children under five affected by acute malnutrition in the world, the majority (31.8 million) are affected by moderate acute malnutrition (MAM). Its treatment is particularly complex in emergency settings such as the Diffa region in Niger. This study aims to evaluate t...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-11-01
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| Series: | Frontiers in Nutrition |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2023.1253545/full |
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| author | Luis Javier Sánchez-Martínez Pilar Charle-Cuéllar Abdoul Aziz Gado Abdias Ogobara Dougnon Atté Sanoussi Nassirou Ousmane Ramatoulaye Hamidou Lazoumar Fanta Toure Antonio Vargas Candela Lucía Hernández Noemí López-Ejeda Noemí López-Ejeda |
| author_facet | Luis Javier Sánchez-Martínez Pilar Charle-Cuéllar Abdoul Aziz Gado Abdias Ogobara Dougnon Atté Sanoussi Nassirou Ousmane Ramatoulaye Hamidou Lazoumar Fanta Toure Antonio Vargas Candela Lucía Hernández Noemí López-Ejeda Noemí López-Ejeda |
| author_sort | Luis Javier Sánchez-Martínez |
| collection | DOAJ |
| description | IntroductionOf the 45.4 million children under five affected by acute malnutrition in the world, the majority (31.8 million) are affected by moderate acute malnutrition (MAM). Its treatment is particularly complex in emergency settings such as the Diffa region in Niger. This study aims to evaluate the effectiveness and coverage of a simplified treatment protocol with Community Health Workers (CHWs) as treatment providers.MethodsThis study is a non-randomized controlled trial. The control group (n = 181) received the standard protocol currently used in country, delivered by nursing staff only in health centres and health posts, while the intervention group (n = 483) received the simplified protocol which included nursing at health centres and CHWs at health post as treatment providers.ResultsThe recovery rate was higher in the simplified protocol group (99.6% vs. 79.56%, p < 0.001) recording lower time to recover and higher anthropometric gain. Treatment coverage in the intervention group increased from 28.8% to 84.9% and reduced in the control group (25.3% to 13.6%). No differences were found in the recovery rate of children treated by CHWs and nursing staff.ConclusionThe outcomes using the simplified protocol exceeded humanitarian requirements and demonstrated improvements compared to the standard protocol showing that the simplified protocol could be safely provided by CHWs in an emergency context. Further research in other contexts is needed to scale up this intervention. |
| first_indexed | 2024-03-09T14:06:10Z |
| format | Article |
| id | doaj.art-b0a2f75c70d74a9490ca1ba9a76b74ec |
| institution | Directory Open Access Journal |
| issn | 2296-861X |
| language | English |
| last_indexed | 2024-03-09T14:06:10Z |
| publishDate | 2023-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Nutrition |
| spelling | doaj.art-b0a2f75c70d74a9490ca1ba9a76b74ec2023-11-30T04:50:16ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2023-11-011010.3389/fnut.2023.12535451253545Impact of a simplified treatment protocol for moderate acute malnutrition with a decentralized treatment approach in emergency settings of NigerLuis Javier Sánchez-Martínez0Pilar Charle-Cuéllar1Abdoul Aziz Gado2Abdias Ogobara Dougnon3Atté Sanoussi4Nassirou Ousmane5Ramatoulaye Hamidou Lazoumar6Fanta Toure7Antonio Vargas8Candela Lucía Hernández9Noemí López-Ejeda10Noemí López-Ejeda11Unit of Physical Anthropology, Department of Biodiversity, Ecology and Evolution, Faculty of Biological Sciences, Complutense University of Madrid, Madrid, SpainAction Against Hunger, Madrid, SpainAction Against Hunger, Niamey, NigerAction Against Hunger, West and Central Africa Regional Office, Dakar, SenegalNutrition Direction, Ministry of Health, Niamey, NigerNutrition Direction, Ministry of Health, Niamey, NigerCentre de Recherche Médicale et Sanitaire (CERMES), Niamey, NigerAction Against Hunger, West and Central Africa Regional Office, Dakar, SenegalAction Against Hunger, Madrid, SpainUnit of Physical Anthropology, Department of Biodiversity, Ecology and Evolution, Faculty of Biological Sciences, Complutense University of Madrid, Madrid, SpainUnit of Physical Anthropology, Department of Biodiversity, Ecology and Evolution, Faculty of Biological Sciences, Complutense University of Madrid, Madrid, SpainEPINUT Research Group (Ref. 920325), Faculty of Medicine, Complutense University of Madrid, Madrid, SpainIntroductionOf the 45.4 million children under five affected by acute malnutrition in the world, the majority (31.8 million) are affected by moderate acute malnutrition (MAM). Its treatment is particularly complex in emergency settings such as the Diffa region in Niger. This study aims to evaluate the effectiveness and coverage of a simplified treatment protocol with Community Health Workers (CHWs) as treatment providers.MethodsThis study is a non-randomized controlled trial. The control group (n = 181) received the standard protocol currently used in country, delivered by nursing staff only in health centres and health posts, while the intervention group (n = 483) received the simplified protocol which included nursing at health centres and CHWs at health post as treatment providers.ResultsThe recovery rate was higher in the simplified protocol group (99.6% vs. 79.56%, p < 0.001) recording lower time to recover and higher anthropometric gain. Treatment coverage in the intervention group increased from 28.8% to 84.9% and reduced in the control group (25.3% to 13.6%). No differences were found in the recovery rate of children treated by CHWs and nursing staff.ConclusionThe outcomes using the simplified protocol exceeded humanitarian requirements and demonstrated improvements compared to the standard protocol showing that the simplified protocol could be safely provided by CHWs in an emergency context. Further research in other contexts is needed to scale up this intervention.https://www.frontiersin.org/articles/10.3389/fnut.2023.1253545/fullwastingsimplified approachescommunity health workers (CHWs)mid-upper arm circumference (MUAC)ready-to-use therapeutic food (RUTF)moderate wasting |
| spellingShingle | Luis Javier Sánchez-Martínez Pilar Charle-Cuéllar Abdoul Aziz Gado Abdias Ogobara Dougnon Atté Sanoussi Nassirou Ousmane Ramatoulaye Hamidou Lazoumar Fanta Toure Antonio Vargas Candela Lucía Hernández Noemí López-Ejeda Noemí López-Ejeda Impact of a simplified treatment protocol for moderate acute malnutrition with a decentralized treatment approach in emergency settings of Niger Frontiers in Nutrition wasting simplified approaches community health workers (CHWs) mid-upper arm circumference (MUAC) ready-to-use therapeutic food (RUTF) moderate wasting |
| title | Impact of a simplified treatment protocol for moderate acute malnutrition with a decentralized treatment approach in emergency settings of Niger |
| title_full | Impact of a simplified treatment protocol for moderate acute malnutrition with a decentralized treatment approach in emergency settings of Niger |
| title_fullStr | Impact of a simplified treatment protocol for moderate acute malnutrition with a decentralized treatment approach in emergency settings of Niger |
| title_full_unstemmed | Impact of a simplified treatment protocol for moderate acute malnutrition with a decentralized treatment approach in emergency settings of Niger |
| title_short | Impact of a simplified treatment protocol for moderate acute malnutrition with a decentralized treatment approach in emergency settings of Niger |
| title_sort | impact of a simplified treatment protocol for moderate acute malnutrition with a decentralized treatment approach in emergency settings of niger |
| topic | wasting simplified approaches community health workers (CHWs) mid-upper arm circumference (MUAC) ready-to-use therapeutic food (RUTF) moderate wasting |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2023.1253545/full |
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