Acceptability of locally produced ready‐to‐use therapeutic foods in Ethiopia, Ghana, Pakistan and India

Abstract

Successful treatment of severe acute malnutrition has been achieved with ready-to-use therapeutic food (RUTF), but only 15% of children with severe acute malnutrition receive RUTF. The objective of this study was to determine whether new formulations of RUTF produced using locally available ingredients were acceptable to young children in Ethiopia, Ghana, Pakistan and India. The local RUTFs were formulated using a linear programming tool that allows for inclusion of only local ingredients and minimizes cost. The study consisted of 4 two-arm, crossover, site-randomized food acceptability trials to test the acceptability of an alternative RUTF formula compared with the standard peanut-based RUTF containing powdered milk. Fifty children with moderate wasting in each country were enrolled in the 2-week study. Acceptability was measured by overall consumption, likeability and adverse effects reported by caregivers. Two of the four RUTFs did not include peanut, and all four used alternative dairy proteins rather than milk. The ingredient cost of all of the RUTFs was about 60% of standard RUTF. In Ethiopia, Ghana and India, the local RUTF was tolerated well without increased reports of rash, diarrhoea or vomiting. Children consumed similar amounts of local RUTF and standard RUTF and preferred them similarly as well. In Pakistan, local RUTF was consumed in similar quantities, but mothers perceived that children did not enjoy it as much as standard RUTF. Our results support the further investigation of these local RUTFs in Ethiopia, Ghana and India in equivalency trials and suggest that local RUTFs may be of lower cost.

Sensory evaluation and volatile compounds of an alternative ready‐to‐use therapeutic food for malnourished children

“…However, our consumer test results are only preliminary, because only healthy adults are included. Indeed, it is well known that children/adults with SAM would also be more willing to consume RUTF than well‐nourished children/adults (Weber et al., 2017).…”

“…In some recent reviews (Brixi, 2018; Weber et al., 2017) and papers (Owino, Irena, Dibari, & Collins, 2014), it was reported that several RUTF formulations were proposed in several countries, such as Ethiopia, Ghana, Pakistan, and India, containing different legumes (almond, lentil, and soy), cereals (maize and oat), other oils (canola, rapeseed, coconut, and sunflower), and different forms of whey (acid whey milk and whey protein concentrate). In all the alternative RUTF formulations proposed, the inclusion of a vitamin and mineral premix was necessary, to ensure a balanced micronutrient intake of the final product.…”

“…In all the alternative RUTF formulations proposed, the inclusion of a vitamin and mineral premix was necessary, to ensure a balanced micronutrient intake of the final product. However, the use of country‐specific formulations had the potential to increase the practice of community‐based treatments, therefore, reducing the morbidity and mortality of severe acute malnutrition (SAM) in settings, where RUTF was not widely used (Brixi, 2018; Weber et al., 2017).…”

Functional and structural abnormalities of the kidney and urinary tract in severely malnourished children - A hospital based study

“…All children were managed according to National Integrated Management of Neonatal and Childhood Illnesses (IMNCI) guidelines for SAM and associated infections and other complications like hypothermia and hypoglycemia 11. Immunization status was considered as complete if vaccinated according to WHO schedule 12…”

Acceptability of locally‐produced Ready‐to‐Use Supplementary Food (RUSF) for children under two years in Cambodia: A cluster randomised trial

“…There is an acknowledged need for the development of novel RUFs and their comparison with existing products (S. de Pee, Bloem, MW, ; Kuusipalo, Maleta, Briend, Manary, & Ashorn, ; Lazzerini, ; Manary, ; WHO, ). In the past decade, numerous studies have aimed to contribute to an understanding of the use of locally produced specialised foods (Ackatia‐Armah et al, ; Ahmed et al, ; Anderson, Bediako‐Amoa, & Steiner‐Asiedu, Anderson, Bediako‐Amoa, & Steiner‐Asiedu, ; Arimond et al, ; Bauserman et al, ; Bogard et al, ; Flax et al, ; Hy Ta & Martinaud, ; Iuel‐Brockdorf et al, ; Lagrone, Cole, Schondelmeyer, Maleta, & Manary, ; Lagrone et al, ; Skau et al, ; Weber et al, ).…”