Preventive small-quantity lipid-based nutrient supplements reduce severe wasting and severe stunting among young children: an individual participant data meta-analysis of randomized controlled trials

Kathryn G Dewey, Charles D Arnold, K Ryan Wessells, Elizabeth L Prado, Souheila Abbeddou, Seth Adu-Afarwuah, Hasmot Ali, Benjamin F Arnold, Per Ashorn, Ulla Ashorn, Sania Ashraf, Elodie Becquey, Kenneth H Brown, Parul Christian, John M Colford, Sherlie J L Dulience, Lia C H Fernald, Emanuela Galasso, Lotta Hallamaa, Sonja Y HessJean H Humphrey, Lieven Huybregts, Lora L Iannottie, Kaniz Jannat, Anna Lartey, Agnes Le Port, Jef L Leroy, Stephen P Luby, Kenneth Maleta, Susana L Matias, Mduduzi N N Mbuya, Malay K Mridha, Minyanga Nkhoma, Clair Null, Rina R Paul, Harriet Okronipa, Jean-Bosco Ouédraogo, Amy J Pickering, Andrew J Prendergast, Marie Ruel, Saijuddin Shaikh, Ann M Weber, Patricia Wolff, Amanda Zongrone, Christine P Stewart

Tutkimustuotos: ArtikkeliScientificvertaisarvioitu

3 Lataukset (Pure)

Abstrakti

BACKGROUND: Meta-analyses show that small-quantity lipid-based nutrient supplements (SQ-LNS) reduce child wasting and stunting. There is little information regarding effects on severe wasting or stunting.

OBJECTIVE: We aimed to identify the effect of SQ-LNS on prevalence of severe wasting (weight-for-length z-score < -3) and severe stunting (length-for-age z-score < -3).

METHODS: We conducted a two-stage meta-analysis of individual participant data from 14 randomized controlled trials of SQ-LNS provided to children 6 to 24 mo of age. We generated study-specific and subgroup estimates of SQ-LNS vs. control and pooled the estimates using fixed-effects models. We used random effects meta-regression to examine study-level effect modifiers. In sensitivity analyses, we examined whether results differed depending on study arm inclusion criteria and types of comparisons.

RESULTS: SQ-LNS provision led to a relative reduction of 31% in severe wasting (Prevalence Ratio, PR 0.69 (0.55, 0.86), n=34,373) and 17% in severe stunting (PR 0.83 (95% CI: 0.78, 0.90), n=36,795) at endline. Results were similar in most of the sensitivity analyses but somewhat attenuated when comparisons using passive control arms were excluded: PR 0.74 (0.57, 0.96), n=26,327 for severe wasting and PR 0.88 (0.81, 0.95), n=28,742 for severe stunting. Study-level characteristics generally did not significantly modify the effects of SQ-LNS, but results suggested greater effects of SQ-LNS in sites with greater burdens of wasting or stunting, or with poorer water quality or sanitation.

CONCLUSIONS: Including SQ-LNS in preventive interventions to promote healthy child growth and development is likely to reduce rates of severe wasting and stunting. Registered at www.crd.york.ac.uk/PROSPERO as CRD42019146592.

AlkuperäiskieliEnglanti
Sivut1314–1333
JulkaisuAmerican Journal of Clinical Nutrition
Vuosikerta116
Numero5
DOI - pysyväislinkit
TilaJulkaistu - 31 elok. 2022
OKM-julkaisutyyppiA1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä

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