Effect of Oral Nutritional Supplementation on Growth in Children with Undernutrition: A Systematic Review and Meta-Analysis

Zhang, Zhiying; Li, Fēi; Hannon, Bridget A.; Hustead, Deborah S.; Aw, Marion; Liu, Zhongyuan; Chuah, Khun Aik; Low, Yen Ling; Huynh, Dieu Thi Thu

doi:10.3390/nu13093036

Cited by 17 publications

(6 citation statements)

References 53 publications

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“…Identifying these children would allow clinicians to connect patients with community-based nutrition interventions (e.g., maternal support for safe introduction of weening foods, small quantity lipid nutrient supplements, etc. ; Bhutta et al, 2013 ; Bhutta et al, 2008 ; Cole, 2020 ; Zhang et al, 2021 ) to prevent additional effects of chronic malnutrition, namely irreversible stunting. Given our ability to predict growth faltering in healthy controls in GEMS, community screening for those at risk of growth faltering (not just those presenting with acute diarrhea) may also be prudent.…”

Section: Discussionmentioning

confidence: 99%

Derivation and external validation of clinical prediction rules identifying children at risk of linear growth faltering

Ahmed

Brintz

Pavlinac

et al. 2023

eLife

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Background: Nearly 150 million children under-5 years of age were stunted in 2020. We aimed to develop a clinical prediction rule (CPR) to identify children likely to experience additional stunting following acute diarrhea, to enable targeted approaches to prevent this irreversible outcome.Methods: We used clinical and demographic data from the Global Enteric Multicenter Study (GEMS) study to build predictive models of linear growth faltering (decrease of 0.5 or 1.0 in height-for-age z-score [HAZ] at 60 day follow-up) in children ≤59 months presenting with moderate-to-severe diarrhea (MSD), and community controls, in Africa and Asia. We screened variables using random forests, and assessed predictive performance with random forest regression and logistic regression using 5-fold cross-validation. We used the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) study to A) re-derive, and B) externally validate our GEMS-derived CPR.Results: Of 7639 children in GEMS, 1744 (22.8%) experienced severe growth faltering (≥0.5 decrease in HAZ). In MAL-ED, we analyzed 5683 diarrhea episodes from 1322 children, of which 961(16.9%) episodes experienced severe growth faltering. Top predictors of growth faltering in GEMS were: age, HAZ at enrollment, respiratory rate, temperature, and number of people living in the household. The maximum AUC was 0.75 (95% CI: 0.75, 0.75) with 20 predictors, while 2 predictors yielded an AUC of 0.71 (95% CI: 0.71, 0.72). Results were similar in the MAL-ED re-derivation. A 2-variable CPR derived from children 0-23 months in GEMS had an AUC=0.63 (95% CI 0.62, 0.65), and AUC=0.68 (95% CI: 0.63, 0.74) when externally validated in MAL-ED.Conclusions:; Our findings indicate that use of prediction rules could help identify children at risk of poor outcomes after an episode of diarrheal illness. They may also be generalizable to all children, regardless of diarrhea status.Funding: This work was supported by the National Institutes of Health under Ruth L. Kirschstein National Research Service Award NIH T32AI055434 and by the National Institute of Allergy and Infectious Diseases (R01AI135114).

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Section: Discussionmentioning

confidence: 99%

Derivation and external validation of clinical prediction rules identifying children at risk of linear growth faltering

Ahmed

Brintz

Pavlinac

et al. 2023

eLife

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“…maternal support for safe introduction of weening foods, small quantity lipid nutrient supplements (SQ-LNS), etc. (45)(46)(47)(48)) to prevent additional effects of chronic malnutrition, namely irreversible stunting.…”

Section: Discussionmentioning

confidence: 99%

Derivation and external validation of clinical prediction rules identifying children at risk of linear growth faltering (stunting) presenting for diarrheal care

Ahmed

Brintz

Pavlinac

et al. 2022

Preprint

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Background: Nearly 150 million children under-5 years of age were stunted in 2020. We aimed to develop a clinical prediction rule (CPR) to identify children likely to experience additional stunting following acute diarrhea, to enable targeted approaches to prevent this irreversible outcome. Methodology: We used clinical and demographic data from the Global Enteric Multicenter Study (GEMS) study to build predictive models of linear growth faltering (decrease of ≥0.5 or ≥1.0 in height-for-age z-score [HAZ] at 60 day follow-up) in children ≤59 months presenting with moderate-to-severe diarrhea (MSD), and community controls, in Africa and Asia. We screened variables using random forests, and assessed predictive performance with random forest regression and logistic regression using 5-fold cross-validation. We used the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) study to A) re-derive, and B) externally validate our GEMS-derived CPR. Results: Of 7642 children in GEMS, 1745 (22.8%) experienced severe growth faltering (≥0.5 decrease in HAZ). In MAL-ED, we analyzed 5683 diarrhea episodes from 1322 children, of which 961(16.9%) episodes experienced severe growth faltering. Top predictors of growth faltering in GEMS were: age, HAZ at enrollment, respiratory rate, temperature, and number of people living in the household. The maximum AUC was 0.74 (95% CI: 0.74, 0.75) with 20 predictors, while 2 predictors yielded an AUC of 0.70 (95% CI: 0.70, 0.71). Results were similar in the MAL-ED re-derivation. A 2-variable CPR derived from children 0-23 months in GEMS had an AUC=0.63 (95% CI 0.62, 0.65), and AUC=0.64 (95% CI: 0.60, 0.68) when externally validated in MAL-ED. Conclusions: Our findings indicate that use of prediction rules could help identify children at risk of poor outcomes after an episode of diarrheal illness.

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“…Similar results were found in subgroup analyses of studies comparing ONS + DC to DC alone. 9 Since it was a pilot study, the intervention was administered for only monthly and even the post intervention assessment was done for only once immediately after the one month administration of Davanegere Mix, probability of improvement in height of the preschool children in very less. Hence, the researcher has decided to address this issue in the main study, where the intervention will be administered for three months and follow up assessments will be done for three months as well.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Davanegere Mix on Nutritional Status of Preschool Children with Malnutrition - A Pilot Study

Chilapur¹,

Natekar²

2022

Int J Sci Healthcare Res

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Background: Nutrition is essential for human development and the focal point of health and well-being. It is accepted that the lack of proper nutrition leads to irreversible effects, endangering survival and development of the child. Aim: To assess effectiveness of Davanagere Mix on Nutritional Status of Pre School children with malnutrition. Materials and Methods: The study conducted using Randomized block design. 19 children (10 in Experimental Group and 9 in Control group) aged between 3 to 6 years attending Anganawadis of Aihole Village of Bagalkot District with mild or moderate malnutrition were selected by complete enumeration method as per the inclusion criteria. WHO Anthro software was used to screen the children for enrolment. The data regarding socio demographic factors was collected using structured interview schedule. Anthropometric measurements were done using standard techniques. Davanagere mix was administered for experimental group children for one months i.e weekly four days (Monday, Tuesday, Wednesday, Thursday). Whereas the parents of control group children were given with health education on nutritional supplementation to improve the children’s nutritional status Results: Findings shows that, there was a significant difference in post test scores of weight (t=2.491, P< 0.05) and mid upper arm circumference (t=3.947, P< 0.01) between experimental and control group subjects. Hence, Davanagere Mix was effective in improving the nutritional status of children with malnutrition in terms of gain in their weight and mid upper arm circumference. No significant difference was found between post test scores of height (t=0.540, P> 0.05) between experimental and control group subjects. Conclusion: Use of foods rich in protein is highly essential strategy to bridge the gap between growth of children and their nutrition. Supplementary feeding of infants and young children with good quality protein as ground nuts and Bengal grams nut flour is a cheap food protein, hence one of the best provisions is to treat malnutrition with Davanagere mixture. Keywords: Davanegere Mix, Nutritional Status, Preschool Children, Malnutrition

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Effect of Oral Nutritional Supplementation on Growth in Children with Undernutrition: A Systematic Review and Meta-Analysis

Cited by 17 publications

References 53 publications

Derivation and external validation of clinical prediction rules identifying children at risk of linear growth faltering

Derivation and external validation of clinical prediction rules identifying children at risk of linear growth faltering

Derivation and external validation of clinical prediction rules identifying children at risk of linear growth faltering (stunting) presenting for diarrheal care

Efficacy of Davanegere Mix on Nutritional Status of Preschool Children with Malnutrition - A Pilot Study

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