Preventing Acute Malnutrition among Young Children in Crises: A Prospective Intervention Study in Niger

Langendorf, Céline; Roederer, Thomas; Pee, Saskia de; Brown, Denise; Doyon, Stéphane; Mamaty, Abdoul-Aziz; Touré, Lynda W.-M.; Manzo, M; Grais, Rebecca F.

doi:10.1371/journal.pmed.1001714

Cited by 84 publications

(98 citation statements)

References 40 publications

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“…In 2010, our group found that 65-80% of households enrolled in a large-scale preventative program in Niger reported never sharing the provided ready-to-use supplement (24). In 2011, only 30-51% of households in Niger that were enrolled in a preventive program that provided supplemental foods to young children, household food rations, and/or cash reported not sharing the provided supplement (25). Considering the limitations of selfreport, compliance may have been even lower.…”

Section: Discussionmentioning

confidence: 98%

Outpatient treatment of severe acute malnutrition: response to treatment with a reduced schedule of therapeutic food distribution ,

Isanaka

Kodish²,

Berthé

et al. 2017

The American Journal of Clinical Nutrition

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Background: Community-based management of severe acute malnutrition (SAM) has been shown to be safe and cost-effective, but program coverage remains low. Treatment models that maintain high levels of clinical effectiveness but allow for increased coverage are still needed. A reduced schedule of follow-up, in which children receive clinical follow-up and therapeutic foods on a monthly rather than weekly basis, may be one alternative. Objective: We aimed to describe the safety and feasibility of a monthly distribution of ready-to-use therapeutic food (RUTF) in the treatment of uncomplicated SAM, in terms of clinical response to treatment and household RUTF use. Design: We conducted a nonrandomized pilot intervention study in which 115 children eligible for outpatient treatment of SAM were provided a monthly ration of RUTF. Anthropometric measurements were taken weekly for 4 wk to monitor treatment response. Unannounced household spot checks were conducted over 4 wk to assess household use of RUTF and storage practices. Results: Adequate weight and midupper arm circumference (MUAC) gain were found throughout the 4-wk follow-up period. Observed mean 6 SD weight gain from admission was 9.8 6 6.8 g $ kg 21 $ d 21 in week 1 and 4.2 6 2.1 g $ kg 21 $ d 21 by week 4. Unplanned household spot checks found an average surplus of RUTF sachets compared with the number expected based on the date of distribution and recommended dosing throughout the 4 wk of follow-up. The frequency at which more than the recommended dose was used (i.e., deviance of .2 sachets between available and expected stocks) was 4% and 22% of households visited in week 1 and week 4, respectively. Conclusion: Adequate treatment response and RUTF use in the outpatient treatment of SAM was maintained over 4 wk of follow-up with a monthly schedule of RUTF distribution. This study was registered at clinicaltrials.gov as NCT02994212. Am J Clin Nutr 2017;105:1191-7.

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Section: Discussionmentioning

confidence: 98%

Outpatient treatment of severe acute malnutrition: response to treatment with a reduced schedule of therapeutic food distribution ,

Isanaka

Kodish²,

Berthé

et al. 2017

The American Journal of Clinical Nutrition

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“…The commoner type of malnutrition is under nutrition. Malnutrition can be chronic or acute [4]. Chronic malnutrition causes stunting, while acute malnutrition causes wasting [4].…”

Section: Maurice Mhangomentioning

confidence: 99%

“…Malnutrition can be chronic or acute [4]. Chronic malnutrition causes stunting, while acute malnutrition causes wasting [4]. Severe acute malnutrition is characterized by wasting (marasmus), oedema (as a result of kwashiorkor) or both (marasmic kwashiorkor) and occurs mostly in children [5].…”

Section: Maurice Mhangomentioning

confidence: 99%

Determination of risk factors associated with malnutrition among children under the age of five: a case control study at Arthur Davison children’s hospital in Ndola, Zambia

Mhango¹,

Siziya²,

Mwanakasale³

2017

APJHS

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Background: Malnutrition is one of the conditions that contribute to high mortality rate among children under the age of five. Although risk factors for malnutrition are well known ,they tend to vary from population to population. The main objective of this study was to establish risk factors associated with malnutrition among children under the age of five presenting at Arthur Davison Children's Hospital in Ndola, Zambia. Method: A case-control study was conducted in the protein calorie malnutrition unit and other units at Arthur Davison Children's Hospital in Ndola, Zambia from October 2016 to may 2017.Cases were children who were moderately or severely malnourished with or without oedema with weight for height z-score of less than -2 Standard deviation from the median of WHO reference. Controls were children with z-score of greater than -2 Standard deviation. Results: A total of 144 children with 72 cases and 72 controls participated in the study. Independent risk factors which were significantly associated with malnutrition after adjusting for confounders were history of diarrhea (OR=4.20, 95% CI[1.77,9.95], children of fathers who were out of employment (OR= 5.28,95% CI[1.45,19.14]) ,and lack of a balanced diet (OR=0.11,95% CI[ 0.04,0.28]).Conclusion: Diarrhea illnesses, low social-economic status and lack of balanced diet were identified as risk factors significantly associated with malnutrition among children under the age of five presenting at Arthur Davison Children's Hospital, Zambia. As such Mortality rate due to malnutrition may be reduced by coming up with programmes to create more job opportunities, intensive measures to combat diarrhea illnesses such as use of Oral Rehydration Therapy and educating people on how to take a balanced diet.

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“…One randomized controlled trial 31 and one controlled before-and-after study 41 have examined the effect of cash transfers for humanitarian assistance in climate-related disasters on health service use and health outcomes. Both studies investigated the use of cash transfers during droughts.…”

Section: Cash Transfersmentioning

confidence: 99%

“…Evidence on cost–effectiveness, ethics and equity impact of cash transfers for improving health remains weak. Apart from the two studies 31 , 41 on cash transfers used in droughts – there appears to be no high-quality evidence of the usefulness of cash transfers for addressing the adverse health consequences of climate change. The focus of most early research on cash transfers was on poverty reduction rather than health improvement.…”

Section: Research and Evaluationmentioning

confidence: 99%

Climate change, cash transfers and health

Pega

Shaw

Rasanathan

et al. 2015

Bull. World Health Organ.

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The forecast consequences of climate change on human health are profound, especially in low- and middle-income countries and among the most disadvantaged populations. Innovative policy tools are needed to address the adverse health effects of climate change. Cash transfers are established policy tools for protecting population health before, during and after climate-related disasters. For example, the Ethiopian Productive Safety Net Programme provides cash transfers to reduce food insecurity resulting from droughts. We propose extending cash transfer interventions to more proactive measures to improve health in the context of climate change. We identify promising cash transfer schemes that could be used to prevent the adverse health consequences of climatic hazards. Cash transfers for using emission-free, active modes of transport – e.g. cash for cycling to work – could prevent future adverse health consequences by contributing to climate change mitigation and, at the same time, improving current population health. Another example is cash transfers provided to communities that decide to move to areas in which their lives and health are not threatened by climatic disasters. More research on such interventions is needed to ensure that they are effective, ethical, equitable and cost–effective.

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Preventing Acute Malnutrition among Young Children in Crises: A Prospective Intervention Study in Niger

Cited by 84 publications

References 40 publications

Outpatient treatment of severe acute malnutrition: response to treatment with a reduced schedule of therapeutic food distribution ,

Outpatient treatment of severe acute malnutrition: response to treatment with a reduced schedule of therapeutic food distribution ,

Determination of risk factors associated with malnutrition among children under the age of five: a case control study at Arthur Davison children’s hospital in Ndola, Zambia

Climate change, cash transfers and health

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