Energy needs in the treatment of uncomplicated severe acute malnutrition: Secondary analysis to optimize delivery of ready‐to‐use therapeutic foods
Abstract Outpatient therapeutic feeding protocols for the treatment of uncomplicated severe acute malnutrition in children were initially based on weight gain data from inpatient settings and expert knowledge of the physiological requirements during recovery. However, weight gain and energy requirem...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-10-01
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| Series: | Maternal and Child Nutrition |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/mcn.12989 |
| _version_ | 1830460466115117056 |
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| author | Sheila Isanaka Christopher T. Andersen Kerstin E. Hanson Fatou Berthé Rebecca F. Grais André Briend |
| author_facet | Sheila Isanaka Christopher T. Andersen Kerstin E. Hanson Fatou Berthé Rebecca F. Grais André Briend |
| author_sort | Sheila Isanaka |
| collection | DOAJ |
| description | Abstract Outpatient therapeutic feeding protocols for the treatment of uncomplicated severe acute malnutrition in children were initially based on weight gain data from inpatient settings and expert knowledge of the physiological requirements during recovery. However, weight gain and energy requirements from historic inpatient settings may differ from modern outpatient settings and therefore may not be appropriate to guide current therapeutic feeding protocols. We calculated the weight gain and average estimated total daily energy requirement of children successfully treated for uncomplicated severe acute malnutrition as outpatients in Niger (n = 790). Mean energy provided by six therapeutic feeding protocols was calculated and compared with average estimated energy requirements in the study population. Overall weight gain was 5.5 g·kg−1·day−1 among recovered children. Average energy requirements ranged from 92 to 110 kcal·kg−1·day−1 depending on the estimation approach. Two current therapeutic feeding protocols were found to provide an excess of energy after the first week of treatment in our study population, whereas four research protocols tended to provide less energy than the estimated requirement after the first week of treatment. Alternative feeding protocols have the potential to simplify and lead to important savings for programmes but should be evaluated to show adequacy to meet the energy needs of children under treatment, as well as feasibility and cost efficiency. Our findings rely on theoretical calculations based on several assumptions and should be confirmed in field studies. |
| first_indexed | 2024-12-21T11:12:34Z |
| format | Article |
| id | doaj.art-f474e8faa88343b3a9eef862d35ab270 |
| institution | Directory Open Access Journal |
| issn | 1740-8695 1740-8709 |
| language | English |
| last_indexed | 2024-12-21T11:12:34Z |
| publishDate | 2020-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Maternal and Child Nutrition |
| spelling | doaj.art-f474e8faa88343b3a9eef862d35ab2702022-12-21T19:06:02ZengWileyMaternal and Child Nutrition1740-86951740-87092020-10-01164n/an/a10.1111/mcn.12989Energy needs in the treatment of uncomplicated severe acute malnutrition: Secondary analysis to optimize delivery of ready‐to‐use therapeutic foodsSheila Isanaka0Christopher T. Andersen1Kerstin E. Hanson2Fatou Berthé3Rebecca F. Grais4André Briend5Department of Nutrition Harvard T.H. Chan School of Public Health Boston Massachusetts USADepartment of Epidemiology Harvard T.H. Chan School of Public Health Boston Massachusetts USAMédecins Sans Frontières Operational Center Paris Paris FranceEpicentre Niamey NigerEpicentre Paris FranceCenter for Child Health Research University of Tampere School of Medicine Tampere FinlandAbstract Outpatient therapeutic feeding protocols for the treatment of uncomplicated severe acute malnutrition in children were initially based on weight gain data from inpatient settings and expert knowledge of the physiological requirements during recovery. However, weight gain and energy requirements from historic inpatient settings may differ from modern outpatient settings and therefore may not be appropriate to guide current therapeutic feeding protocols. We calculated the weight gain and average estimated total daily energy requirement of children successfully treated for uncomplicated severe acute malnutrition as outpatients in Niger (n = 790). Mean energy provided by six therapeutic feeding protocols was calculated and compared with average estimated energy requirements in the study population. Overall weight gain was 5.5 g·kg−1·day−1 among recovered children. Average energy requirements ranged from 92 to 110 kcal·kg−1·day−1 depending on the estimation approach. Two current therapeutic feeding protocols were found to provide an excess of energy after the first week of treatment in our study population, whereas four research protocols tended to provide less energy than the estimated requirement after the first week of treatment. Alternative feeding protocols have the potential to simplify and lead to important savings for programmes but should be evaluated to show adequacy to meet the energy needs of children under treatment, as well as feasibility and cost efficiency. Our findings rely on theoretical calculations based on several assumptions and should be confirmed in field studies.https://doi.org/10.1111/mcn.12989community‐based management of acute malnutritionenergy requirementNigerready‐to‐use therapeutic foodsevere acute malnutritionweight gain |
| spellingShingle | Sheila Isanaka Christopher T. Andersen Kerstin E. Hanson Fatou Berthé Rebecca F. Grais André Briend Energy needs in the treatment of uncomplicated severe acute malnutrition: Secondary analysis to optimize delivery of ready‐to‐use therapeutic foods Maternal and Child Nutrition community‐based management of acute malnutrition energy requirement Niger ready‐to‐use therapeutic food severe acute malnutrition weight gain |
| title | Energy needs in the treatment of uncomplicated severe acute malnutrition: Secondary analysis to optimize delivery of ready‐to‐use therapeutic foods |
| title_full | Energy needs in the treatment of uncomplicated severe acute malnutrition: Secondary analysis to optimize delivery of ready‐to‐use therapeutic foods |
| title_fullStr | Energy needs in the treatment of uncomplicated severe acute malnutrition: Secondary analysis to optimize delivery of ready‐to‐use therapeutic foods |
| title_full_unstemmed | Energy needs in the treatment of uncomplicated severe acute malnutrition: Secondary analysis to optimize delivery of ready‐to‐use therapeutic foods |
| title_short | Energy needs in the treatment of uncomplicated severe acute malnutrition: Secondary analysis to optimize delivery of ready‐to‐use therapeutic foods |
| title_sort | energy needs in the treatment of uncomplicated severe acute malnutrition secondary analysis to optimize delivery of ready to use therapeutic foods |
| topic | community‐based management of acute malnutrition energy requirement Niger ready‐to‐use therapeutic food severe acute malnutrition weight gain |
| url | https://doi.org/10.1111/mcn.12989 |
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