Treatment outcome in patients with severe acute malnutrition managed with protocolised care at malnutrition treatment corner in Rajasthan, India: a prospective observational study (quasi-experimental)

Nagar, R. P.; Nagar, Teena; Bd, Gupta

doi:10.18203/2320-6012.ijrms20160037

Cited by 8 publications

(7 citation statements)

References 7 publications

(16 reference statements)

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“…Nagar et al had a male predominance but with no statistically significant difference. [10][11][12][13][14][15] More than 50% of the admitted children in the study group were between the 1-3 years (13-36 months) of age; wherein 40.40% of these children were in the age group of 13-24 months. The findings are in accordance with the findings of NFHS-III which states peaking of underweight and stunting at 12-23 months of age.…”

Section: Discussionmentioning

confidence: 92%

A study of effectiveness of nutritional interventions on children with severe acute malnutrition admitted in nutrition rehabilitation centers of Bhopal, Madhya Pradesh

Saxena

Pathak

Mahor

et al. 2018

Int J Community Med Public Health

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Background: The prevalence of under-nutrition among under-five children is high and varies widely. Children with severe acute malnutrition require immediate attention along with proper nutritional rehabilitation not only to decrease mortality but also to achieve full potential after recovery. Nutrition rehabilitation centres (NRCs) were started to control severe malnutrition and decrease the prevalence of severe malnourished children to less than 1% among children aged 1–5 years.Methods: The present study was conducted from July 2016 to June 2017; 500 children admitted to five different NRCs in Bhopal district of Madhya Pradesh were observed during their stay at NRCs and children were followed up during a period of 6 months after discharge from NRCs. Mothers of the children were interviewed on various health issues of children and feeding practices at the NRCs using a predesigned and pretested interview schedule.Results: The study group consisted of 252 boys and 248 girls; 51.20% were between 13 and 36 months of age. All 500 children were analysed for anthropometric indicators. A statistically significant difference was obtained between the weight of children at admission, discharge and follow up (ANOVA=106.2, p<0.001); difference of mid upper arm circumference (MUAC) at admission, discharge and follow up was also statistically significant (ANOVA=24.02, p<0.001). The average weight gain during the stay at the centers was 8.95±3.59 g/kg/day. The mothers of the children lacked adequate information on health issues and composition and preparation of nutrient rich diets for their children.Conclusions: The NRCs were effective in improving the condition of admitted children, but the effects were not well sustained following discharge due to lack of adequate parental awareness and action.

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Section: Discussionmentioning

confidence: 92%

A study of effectiveness of nutritional interventions on children with severe acute malnutrition admitted in nutrition rehabilitation centers of Bhopal, Madhya Pradesh

Saxena

Pathak

Mahor

et al. 2018

Int J Community Med Public Health

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“…A total of 18 studies were excluded (Agha 2004 ; Aguayo et al, 2018 ; Ahmed et al, 1999 ; Ashworth et al, 1994 ; Bachou, Tumwine, Mwadime, Ahmed, & Tylleskar, 2008 ; Badaloo et al, 1999 ; Baker, Baker, Margo, & Reuter, 1978 ; Bhandari et al, 2001 ; Burza et al, 2016 ; Donnen et al, 2007 ; Dubray et al, 2008 ; Javan, Kooshki, Afzalaghaee, Aldaghi, & Yousefi, 2017 ; Linneman et al, 2007 ; Nagar, Nagar, & Gupta, 2016 ; Roy et al, 2005 ; Simpore et al, 2006 ; Zongo, Zoungrana, Savadogo, & Traoré, 2013 ). The major reasons for exclusion included study design not being appropriate and intervention not of interest.…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of interventions to manage acute malnutrition in children under 5 years of age in low‐ and middle‐income countries: A systematic review

Das

Saeed

Kazmi

et al. 2020

Campbell Systematic Reviews

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Background Childhood malnutrition is a major public health concern as it is associated with significant short‐ and long‐term morbidity and mortality. Objectives To comprehensively review the evidence for the management of severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) according to the current World Health Organization protocol using facility‐ and community‐based approaches as well as the effectiveness of ready‐to‐use therapeutic food (RUTF), ready‐to‐use supplementary food (RUSF), prophylactic antibiotic use and vitamin A supplementation. Search methods We searched relevant electronic databases till 11 February 2019. No date or language restrictions were applied. Selection criteria We included randomised controlled trials (RCTs) and quasi‐experimental studies including controlled before‐after (CBA) studies and interrupted time series (ITS) studies. Data collection and analysis Two review authors independently screened studies for relevance, extracted data, assessed risk of bias and rated the quality of the evidence using the GRADE approach. We carried out statistical analysis using Review Manager software and set out the main findings of the review in “Summary of findings” tables. Main results This review summarises findings from a total of 42 studies (48 papers) including 35,017 children. Thirty‐three of the included studies were RCTs; six studies were quasi‐experimental and three studies were cost studies. Majority of the studies were judged to be at high risk of bias for blinding of the participants, personnel and outcome assessment. Majority of the outcomes were rated as either moderate or low quality. Outcomes were downgraded mainly due to study limitations, high heterogeneity, imprecision and small sample size. Community‐based strategies to screen and manage SAM/MAM versus no community‐based strategies (two studies): Integrated community‐based management probably improves recovery rate by 4% [risk ratio (RR): 1.04; 95% confidence interval (CI): 1.00 to 1.09; one study; 1,957 participants; moderate‐quality outcome], and reduces weight gain by 0.8 g·kg−1·day−1 [mean difference (MD): −0.80 g·kg−1·day−1; 95% CI: −0.82 to −0.78; one study; 1,957 participants; moderate‐quality outcome] compared with no community‐based strategies, while mortality was similar between the two groups (RR: 0.93; 95% CI: 0.60 to 1.45; one study; 1,957 participants; moderate‐quality outcome). Facility‐based strategies to screen and manage uncomplicated SAM versus other standard of care (four studies): There was no evidence of effect on recovery (RR: 1.00; 95% CI: 0.80, 1.25; one study; 60 participants; very‐low‐quality evidence) and mortality (RR: 1.21; 95% CI: 0.75 to 1.94; two studies; 473 participants; low‐quality outcome). Facility‐based management with RUTF versus F100 (“catch‐up” formula to rebuild wasted tissues containing 100 kcal and 2.9 g protein per 100 ml) for SAM (three studies): There was no evidence of effect on weight gain (MD: 2 g·kg−1·day−1; 95% CI: −0.23 to 4.23; three studies; 266 part...

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“…Another study conducted in Rajasthan observed 46% SAM children returned for follow-up visit, 51.7% of children who came for follow-up had poor rate of weight gain, 31% had moderate and 6.89% patients had good rate of weight gain whereas 4.76% children had weight loss on follow up. 10 While comparing two of the most common methods of nutritional assessment, it was found that categorization of malnutrition is comparable by weight for age and MUAC methods. Any one method can be used as a substitute for the other in conditions of unavailability of instruments which is very common for the peripheral workers.…”

Section: Discussionmentioning

confidence: 99%

An experience of facility based management at one of the malnutrition treatment centre in district Baran of Rajasthan, India

Mulla¹,

Gupta²

2017

Int J Community Med Public Health

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Background: To assess performance of one of the Malnutrition Treatment Centre (MTC) in district Baran of Rajasthan. India. Methods: An observational prospective study was conducted at MTC where 132 Severe Acute Malnutrition (SAM) children were recruited. Their socio-demographic details and anthropometric measurements were recorded. These SAM children were followed till the period of 4 follow-up visits to measure their weight. MTC performance indicators were assessed. Results: Majority of SAM children belong to age group less than 2 years, gender female, caste OBC (Other Backward Class), SC (Scheduled Caste) and ST (Scheduled Tribe). ASHAs (Accredited Social Health Activists) are playing key role in referring them to MTC. Death rate was 0%, cure (recovery) rate 42.4%, defaulter rate 25.8%, mean length of stay (days) at MTC was 8.04 and mean weight gain was 5.926 g/kg/day. Performance indicators are significantly affected by length of stay at MTC. Follow-up rate was poor with no significant weight gain observed after discharge. Conclusions: MTCs are effective in saving lives of SAM children but not in maintaining long term control on malnutrition.

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Treatment outcome in patients with severe acute malnutrition managed with protocolised care at malnutrition treatment corner in Rajasthan, India: a prospective observational study (quasi-experimental)

Cited by 8 publications

References 7 publications

A study of effectiveness of nutritional interventions on children with severe acute malnutrition admitted in nutrition rehabilitation centers of Bhopal, Madhya Pradesh

A study of effectiveness of nutritional interventions on children with severe acute malnutrition admitted in nutrition rehabilitation centers of Bhopal, Madhya Pradesh

Effectiveness of interventions to manage acute malnutrition in children under 5 years of age in low‐ and middle‐income countries: A systematic review

An experience of facility based management at one of the malnutrition treatment centre in district Baran of Rajasthan, India

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