Response to malnutrition treatment in low weight-for-age children: Secondary analyses of children 6–59 months in the ComPAS Cluster Randomized Controlled Trial

Jeanette Bailey*, Natasha Lelijveld, Tanya Khara, Carmel Dolan, Heather Stobaugh, Kate Sadler, Richard Lino Lako, André Briend, Charles Opondo, Marko Kerac, Mark Myatt

*Corresponding author for this work

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Abstract

Weight-for-age z-score (WAZ) is not currently an admission criterion to therapeutic feeding programs, and children with low WAZ at high risk of mortality may not be admitted. We conducted a secondary analysis of RCT data to assess response to treatment according to WAZ and mid-upper arm circumference (MUAC) and type of feeding protocol given: a simplified, combined protocol for severe and moderate acute malnutrition (SAM and MAM) vs. standard care that treats SAM and MAM, separately. Children with a moderately low MUAC (11.5–12.5 cm) and a severely low WAZ (<−3) respond similarly to treatment in terms of both weight and MUAC gain on either 2092 kJ (500 kcal)/day of therapeutic or supplementary food. Children with a severely low MUAC (<11.5 cm), with/without a severely low WAZ (<−3), have similar recovery with the combined protocol or standard treatment, though WAZ gain may be slower in the combined protocol. A limitation is this analysis was not powered for these sub-groups specifically. Adding WAZ < −3 as an admission criterion for therapeutic feeding programs admitting children with MUAC and/or oedema may help programs target high-risk children who can benefit from treatment. Future work should evaluate the optimal treatment protocol for children with a MUAC < 11.5 and/or WAZ < −3.0.

Original languageEnglish
Article number1054
JournalNutrients
Volume13
Issue number4
Number of pages16
ISSN2072-6643
DOIs
Publication statusPublished - 2021

Keywords

  • Acute malnutrition
  • Community-based management of acute malnutrition
  • Concurrent wasting and stunting
  • Mid-upper arm circumference
  • Ready-to-use therapeutic food
  • Stunting
  • Wasting
  • Weight-for-age

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