Response to malnutrition treatment in low weight-for-age children: Secondary analyses of children 6–59 months in the compas cluster randomized controlled trial

Jeanette Bailey; Natasha Lelijveld; Tanya Khara; Carmel Dolan; Heather Stobaugh; Kate Sadler; Richard Lino Lako; André Briend; Charles Opondo; Marko Kerac; Mark Myatt

doi:10.3390/nu13041054

Response to malnutrition treatment in low weight-for-age children: Secondary analyses of children 6–59 months in the compas cluster randomized controlled trial

Jeanette Bailey^*
, Natasha Lelijveld
, Tanya Khara
, Carmel Dolan
, Heather Stobaugh
, Kate Sadler
, Richard Lino Lako
, André Briend
, Charles Opondo
, Marko Kerac
, Mark Myatt

^*Corresponding author for this work

Research output: Contribution to journal › Article › Scientific › peer-review

12 Citations (Scopus)

12 Downloads (Pure)

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.

Original language	English
Article number	1054
Journal	Nutrients
Volume	13
Issue number	4
DOIs	https://doi.org/10.3390/nu13041054
Publication status	Published - 2021
Publication type	A1 Journal article-refereed

Funding

The ComPAS trial was funded by the United States Agency for International Development Office of U.S. Foreign Disaster Assistance (https://www.usaid.gov/who-we-are/organization/ bureaus/bureau-democracy-conflict-and-humanitarian-assistance/office-us) (accessed on 23 March 2021), grant number AID-OFDA-G-14-00208 awarded to the International Rescue Committee, and the Children?s Investment Fund Foundation (https://ciff.org/) grant reference title ?Reinventing community management of acute malnutrition? awarded to Action Against Hunger. The Emergency Nutrition Network author contributions to this paper were made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of ENN and do not necessarily reflect the views of USAID or the United States Government. The funders had no role in the design, analysis, or writing of this article.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 2 Zero Hunger
SDG 3 Good Health and Well-being

Keywords

Acute malnutrition
Community-based management of acute malnutrition
Concurrent wasting and stunting
Mid-upper arm circumference
Ready-to-use therapeutic food
Stunting
Wasting
Weight-for-age

Publication forum classification

Publication forum level 1

ASJC Scopus subject areas

Food Science
Nutrition and Dietetics

Access to Document

10.3390/nu13041054

nutrients-13-01054
CC BY
Final published version, 1.6 MBLicence: CC BY

http://urn.fi/URN:NBN:fi:tuni-202107306423Licence: CC BY

Cite this

Bailey, J., Lelijveld, N., Khara, T., Dolan, C., Stobaugh, H., Sadler, K., Lako, R. L., Briend, A., Opondo, C., Kerac, M., & Myatt, M. (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(4), Article 1054. https://doi.org/10.3390/nu13041054

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title = "Response to malnutrition treatment in low weight-for-age children: Secondary analyses of children 6–59 months in the compas cluster randomized controlled trial",

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.",

keywords = "Acute malnutrition, Community-based management of acute malnutrition, Concurrent wasting and stunting, Mid-upper arm circumference, Ready-to-use therapeutic food, Stunting, Wasting, Weight-for-age",

author = "Jeanette Bailey and Natasha Lelijveld and Tanya Khara and Carmel Dolan and Heather Stobaugh and Kate Sadler and Lako, \{Richard Lino\} and Andr{\'e} Briend and Charles Opondo and Marko Kerac and Mark Myatt",

note = "Funding Information: The ComPAS trial was funded by the United States Agency for International Development Office of U.S. Foreign Disaster Assistance (https://www.usaid.gov/who-we-are/organization/ bureaus/bureau-democracy-conflict-and-humanitarian-assistance/office-us) (accessed on 23 March 2021), grant number AID-OFDA-G-14-00208 awarded to the International Rescue Committee, and the Children?s Investment Fund Foundation (https://ciff.org/) grant reference title ?Reinventing community management of acute malnutrition? awarded to Action Against Hunger. The Emergency Nutrition Network author contributions to this paper were made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of ENN and do not necessarily reflect the views of USAID or the United States Government. The funders had no role in the design, analysis, or writing of this article. Publisher Copyright: {\textcopyright} 2021 by the authors. Licensee MDPI, Basel, Switzerland.",

year = "2021",

doi = "10.3390/nu13041054",

language = "English",

volume = "13",

journal = "Nutrients",

issn = "2072-6643",

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T1 - Response to malnutrition treatment in low weight-for-age children

T2 - Secondary analyses of children 6–59 months in the compas cluster randomized controlled trial

AU - Bailey, Jeanette

AU - Lelijveld, Natasha

AU - Khara, Tanya

AU - Dolan, Carmel

AU - Stobaugh, Heather

AU - Sadler, Kate

AU - Lako, Richard Lino

AU - Briend, André

AU - Opondo, Charles

AU - Kerac, Marko

AU - Myatt, Mark

N1 - Funding Information: The ComPAS trial was funded by the United States Agency for International Development Office of U.S. Foreign Disaster Assistance (https://www.usaid.gov/who-we-are/organization/ bureaus/bureau-democracy-conflict-and-humanitarian-assistance/office-us) (accessed on 23 March 2021), grant number AID-OFDA-G-14-00208 awarded to the International Rescue Committee, and the Children?s Investment Fund Foundation (https://ciff.org/) grant reference title ?Reinventing community management of acute malnutrition? awarded to Action Against Hunger. The Emergency Nutrition Network author contributions to this paper were made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of ENN and do not necessarily reflect the views of USAID or the United States Government. The funders had no role in the design, analysis, or writing of this article. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

PY - 2021

Y1 - 2021

N2 - 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.

AB - 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.

KW - Acute malnutrition

KW - Community-based management of acute malnutrition

KW - Concurrent wasting and stunting

KW - Mid-upper arm circumference

KW - Ready-to-use therapeutic food

KW - Stunting

KW - Wasting

KW - Weight-for-age

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DO - 10.3390/nu13041054

M3 - Article

C2 - 33805040

AN - SCOPUS:85102877967

SN - 2072-6643

VL - 13

JO - Nutrients

JF - Nutrients

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ER -

Response to malnutrition treatment in low weight-for-age children: Secondary analyses of children 6–59 months in the compas cluster randomized controlled trial

Abstract

Funding

UN SDGs

Keywords

Publication forum classification

ASJC Scopus subject areas

Access to Document

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Cite this