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Nutrients
Volume 13
Issue 4
10.3390/nu13041054
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Article

Response to Malnutrition Treatment in Low Weight-for-Age Children: Secondary Analyses of Children 6–59 Months in the ComPAS Cluster Randomized Controlled Trial

by
Jeanette Bailey
1,2,*,
Natasha Lelijveld
3,
Tanya Khara
3,
Carmel Dolan
3,
Heather Stobaugh
4,
Kate Sadler
3,
Richard Lino Lako
5,
André Briend
6,7,
Charles Opondo
8,
Marko Kerac
2,9 and
Mark Myatt
10
1
International Rescue Committee, New York, NY 10168, USA
2
Department of Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
3
Emergency Nutrition Network, Oxford OX5 2DN, UK
4
Action Against Hunger, New York, NY 10004, USA
5
Department of Policy, Planning, Budgeting and Research, Ministry of Health, Juba, South Sudan
6
Center for Child Health Research, Faculty of Medicine and Health Technology, Tampere University, FI-33014 Tampere, Finland
7
Department of Nutrition, Exercise and Sports, University of Copenhagen, DK-2200 Copenhagen, Denmark
8
Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
9
Centre for Maternal, Adolescent, Reproductive, & Child Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
10
Brixton Health, Llwyngwril, Gwynedd LL37 2JD, Wales, UK
*
Author to whom correspondence should be addressed.
Academic Editor: Riccardo Caccialanza
Nutrients 2021, 13(4), 1054; https://doi.org/10.3390/nu13041054
Received: 22 January 2021 / Revised: 15 March 2021 / Accepted: 19 March 2021 / Published: 24 March 2021
(This article belongs to the Section Nutrition and Public Health)
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Abstract

Weight-for-age z-score (WAZ) is not currently an admission criterion to therapeutic feeding programs, and children with low WAZ at high risk of mortality may not be admitted. We conducted a secondary analysis of RCT data to assess response to treatment according to WAZ and mid-upper arm circumference (MUAC) and type of feeding protocol given: a simplified, combined protocol for severe and moderate acute malnutrition (SAM and MAM) vs. standard care that treats SAM and MAM, separately. Children with a moderately low MUAC (11.5–12.5 cm) and a severely low WAZ (<−3) respond similarly to treatment in terms of both weight and MUAC gain on either 2092 kJ (500 kcal)/day of therapeutic or supplementary food. Children with a severely low MUAC (<11.5 cm), with/without a severely low WAZ (<−3), have similar recovery with the combined protocol or standard treatment, though WAZ gain may be slower in the combined protocol. A limitation is this analysis was not powered for these sub-groups specifically. Adding WAZ < −3 as an admission criterion for therapeutic feeding programs admitting children with MUAC and/or oedema may help programs target high-risk children who can benefit from treatment. Future work should evaluate the optimal treatment protocol for children with a MUAC < 11.5 and/or WAZ < −3.0. View Full-Text
Keywords: acute malnutrition; weight-for-age; mid-upper arm circumference; ready-to-use therapeutic food; community-based management of acute malnutrition; wasting; stunting; concurrent wasting and stunting acute malnutrition; weight-for-age; mid-upper arm circumference; ready-to-use therapeutic food; community-based management of acute malnutrition; wasting; stunting; concurrent wasting and stunting
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MDPI and ACS Style

Bailey, J.; Lelijveld, N.; Khara, T.; Dolan, C.; Stobaugh, H.; Sadler, K.; Lino Lako, R.; Briend, A.; Opondo, C.; Kerac, M.; Myatt, M. Response to Malnutrition Treatment in Low Weight-for-Age Children: Secondary Analyses of Children 6–59 Months in the ComPAS Cluster Randomized Controlled Trial. Nutrients 2021, 13, 1054. https://doi.org/10.3390/nu13041054

AMA Style

Bailey J, Lelijveld N, Khara T, Dolan C, Stobaugh H, Sadler K, Lino Lako R, Briend A, Opondo C, Kerac M, Myatt M. Response to Malnutrition Treatment in Low Weight-for-Age Children: Secondary Analyses of Children 6–59 Months in the ComPAS Cluster Randomized Controlled Trial. Nutrients. 2021; 13(4):1054. https://doi.org/10.3390/nu13041054

Chicago/Turabian Style

Bailey, Jeanette, Natasha Lelijveld, Tanya Khara, Carmel Dolan, Heather Stobaugh, Kate Sadler, Richard Lino Lako, André Briend, Charles Opondo, Marko Kerac, and Mark Myatt. 2021. "Response to Malnutrition Treatment in Low Weight-for-Age Children: Secondary Analyses of Children 6–59 Months in the ComPAS Cluster Randomized Controlled Trial" Nutrients 13, no. 4: 1054. https://doi.org/10.3390/nu13041054

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