Local Dishes versus “Ready-to-Use Therapeutic Foods” in the Management of Severe Acute Malnutrition during the Rehabilitation Phase: A Randomized, Single-Blind Study — Oak Academic Publishing
Research ArticleOpen AccessGoogle Scholar indexed
Local Dishes versus “Ready-to-Use Therapeutic Foods” in the Management of Severe Acute Malnutrition during the Rehabilitation Phase: A Randomized, Single-Blind Study
Faculty of Medicine and Biomedical Sciences, University of Garoua, Garoua, Cameroon
,
Faculty of Medicine and Biomedical Sciences, University of Garoua, Garoua, Cameroon
,
Faculty of Medicine and Biomedical Sciences, University of Garoua, Garoua, Cameroon
,
Faculty of Medicine and Biomedical Sciences, University of Garoua, Garoua, Cameroon
,
Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon
,
Mokolo Regional Hospital Annex, Mokolo, Cameroon
,
Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon
1 Faculty of Medicine and Biomedical Sciences, University of Garoua, Garoua, Cameroon
2 Faculty of Medicine and Biomedical Sciences, University of Garoua, Garoua, Cameroon
3 Faculty of Medicine and Biomedical Sciences, University of Garoua, Garoua, Cameroon
4 Faculty of Medicine and Biomedical Sciences, University of Garoua, Garoua, Cameroon
5 Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon
Background: In a context of frequent shortages of ready-to-use therapeutic foods (RUTFs), this study aimed at assessing the effectiveness of the use of local dishes combined with nutritional education for children with severe acute malnutrition (SAM) during the rehabilitation phase. Methods: This work is based on a randomized, single-blind trial conducted over a period of 11 months. Children aged between 6 to 59 months, hospitalized for SAM and undergoing treatment during the rehabilitation phase, were included. Randomization was performed by consecutive inclusion based on even order numbers (control group under RUTFS) and odd order numbers (intervention group with local dishes). The minimum sample size, according to Kelsey’s formula, was 24 patients. Data were recorded on a data sheet and analyzed using IBM SPSS 27 software. Ethical considerations were respected. Results: A total of 30 patients were included. The duration of the rehabilitation phase was longer in the intervention group. Weight gain, expressed in g/kg/day, was 12.98 (control group) and 17.90 (intervention group). Mean brachial circumference or Mid-Upper Arm Circumference (MUAC) at discharge was greater in the control group. All these observed differences were not statistically significant (p > 0.05); no cases of death were recorded. Conclusions: Patient outcomes at the end of the study were similar, despite a relapse in the intervention group. The use of local dishes, coupled with nutritional education, in the treatment of SAM during the rehabilitation phase has similar efficacy to conventional treatment with RUTFS.
Bocquet, A., Brancato, S., Turck, D., Briend, A., Chalumeau, M., Darmaun, D., et al. (2023) “Child-Led Dietary Diversification” (CDD): Progress in Infant Feeding or Risky Practice? Perfect En Pédiatrie , 6, 40-55.
Chiabi, A., Kago Tague, D.A., Nguefack, F.D., Laksira, A., Nguefack, S., Mah, E., et al. (2020) Dietary Diversification in Infants Aged 6 to 24 Months at Garoua Regional Hospital, Cameroon. Journal de Pédiatrie et de Puériculture , 33, 77-82. https://doi.org/10.1016/j.jpp.2019.07.006
National de la Statistique (INS) and ICF (2020) Enquete Démographique et de la Santé Institut du Cameroun 2018. INS and ICF.
Dama, U., Tchoffo, D., Onana Akoa, F.A., Abanda, J.N., Dzeuta, M.F., Asobochia, A.T., et al. (2024) Prevalence of Malnutrition in Children under 5 Years of Age in the Departments of Mayo-Tsanaga and Logone et Chari, Far North, Cameroon. PAMJ Clinical Medicine , 14, Article 3. https://doi.org/10.11604/pamj-cm.2024.14.3.41534
Golden, M. and Grellety, Y. (2006) Guidelines for the Management of the Severely Malnourished. ACF International.
Irena, A.H., Bahwere, P., Owino, V.O., Diop, E.I., Bachmann, M.O., Mbwili‐Muleya, C., et al. (2015) Comparison of the Effectiveness of a Milk‐Free Soy‐Maize‐Sorghum‐based Ready‐to‐Use Therapeutic Food to Standard Ready‐to‐Use Therapeutic Food with 25% Milk in Nutrition Management of Severely Acutely Malnourished Zambian Children: An Equivalence Non‐Blinded Cluster Randomised Controlled Trial. Maternal & Child Nutrition , 11, 105-119. https://doi.org/10.1111/mcn.12054
Kohlmann, K., Callaghan-Gillespie, M., Gauglitz, J.M., Steiner-Asiedu, M., Saalia, K., Edwards, C., et al. (2019) Alternative Ready-to-Use Therapeutic Food Yields Less Recovery than the Standard for Treating Acute Malnutrition in Children from Ghana. Global Health : Science and Practice , 7, 203-214. https://doi.org/10.9745/ghsp-d-19-00004
Koum, D., Dissongo, J., Penda, C., Njankou, Y., Ngalle, J., Ngwa, V., Guifo, O. and Ndombo, P. (2014) Malnutrition aiguë sévère chez les enfants de 6 à 59 mois hospitalisés à Douala Cameroun. Revue de Médecine et de Pharmacie , 3, No. 2. https://www.ajol.info/index.php/rmp/article/view/102351
Chrisman, M. and Diaz Rios, L.K. (2019) Evaluating Myplate after 8 Years: A Perspective. Journal of Nutrition Education and Behavior , 51, 899-903. https://doi.org/10.1016/j.jneb.2019.02.006
World Health Organization and United Nations Children’s Fund (2009) WHO Child Growth Standards and the Identification of Severe Acute Malnutrition in Infants and Children. WHO Press.
Nguefack, F., Adjahoung, C.A., Keugoung, B., Kamgaing, N. and Dongmo, R. (2015) Hospital Management of Severe Acute Malnutrition in Children with F-75 and F-100 Alternative Local Preparations: Results and Challenges. Pan African Medical Journal , 21, Article 329. https://doi.org/10.11604/pamj.2015.21.329.6632
Noel, A., Morel, F.B. and Marion-Letellier, R. (2024) Severe Acute Malnutrition: From Pathophysiology to Management. Nutrition Clinique et Métabolisme , 38, 2-10. https://doi.org/10.1016/j.nupar.2023.11.003
Sackou Kouakou, J.G., Aka, B.S., Hounsa, A.E., Attia, R., Wilson, R., Ake, O., et al. (2016) Malnutrition: Prevalence and Risk Factors among the Children Younger than Five Years in a Semi-Urban Area of Abidjan. Médecine et Santé Tropicales , 26, 312-317. https://doi.org/10.1684/mst.2016.0591
Savadogo, L., Zoetaba, I., Donnen, P., Hennart, P., Sondo, B.K. and Dramaix, M. (2007) Prise en charge de la malnutrition aiguë sévère dans un centre de réhabilitation et d’éducation nutritionnelle urbain au Burkina Faso. Revue d ’ Épidémiologie et de Santé Publique , 55, 265-274. https://doi.org/10.1016/j.respe.2007.05.006
Tchagbele, O.-B., Segbedji, K.A.R., Talboussouma, S.M., Toï, A., Agoro, S., Djadou, K.E., et al. (2023) Evaluation of Feeding Practices among Infants Aged 6 to 23 Months in the City of Kara. Journal de Pédiatrie et de Puériculture , 36, 223-230. https://doi.org/10.1016/j.jpp.2023.06.007
Tougri, H., Yaya Bocoum, F., Compaore, R., Ouedraogo, A.M., Congo, B., Pietra, V. and Kouanda, S. (2021) Evaluation de la mise en oeuvre du dépistage de la malnutrition aiguë sévère chez les enfants de moins de cinq ans par les mères dans la région du Centre-Ouest au Burkina Faso: Assessment of the Implementation of Screening for Severe Acute Malnutrition in under 5 Children by the Mothers in the Central West Region of Burkina Faso. Sciences de la Santé , 42, No. 2. https://revuesciences-techniquesburkina.org/index.php/sciences_de_la_sante/article/view/148
Tournier, C. and Nicklaus, S. (2024) Introduction des aliments de différentes textures lors de la diversification alimentaire: Enjeux, connaissances et recommandations françaises. Cahiers de Nutrition et de Diététique , 59, 82-91. https://doi.org/10.1016/j.cnd.2023.12.007
Traore, F., Maiga, B., Diall, H., Sissoko, S., Sacko, K., Konate, D., et al. (2020) Management of Acute Malnutrition in Children in a Sahelian Secondary Hospital. Mali Médical , 35, 32-37.
World Health Organization (2024) Management of Severe Acute Malnutrition. WHO Regional Office for Africa. https://www.afro.who.int/fr/news/prise-en-charge-de-la-malnutrition-aigue-severe
World Health Organization and United Nations Children’s Fund (UNICEF) (2009) WHO Growth Standards and Identification of Severe Acute Malnutrition in Children: Joint Statement by the World Health Organization and the United Nations Children’s Fund.
World Health Organization, United Nations Children’s Fund (UNICEF) and World Bank (2021) Levels and Trends in Child Malnutrition: UNICEF/WHO/The World Bank Group Joint Child Malnutrition Estimates: Key Findings of the 2021 Edition. World Health Organization. https://iris.who.int/handle/10665/341135
Bailey, J., Opondo, C., Lelijveld, N., Marron, B., Onyo, P., Musyoki, E.N., et al. (2020) A Simplified, Combined Protocol versus Standard Treatment for Acute Malnutrition in Children 6-59 Months (ComPAS Trial): A Cluster-Randomized Controlled Non-Inferiority Trial in Kenya and South Sudan. PLOS Medicine , 17, e1003192. https://doi.org/10.1371/journal.pmed.1003192