Home-based therapy for oedematous malnutrition with ready-to-use therapeutic food.

Michael A Ciliberto, Mark J Manary, Macdonald J Ndekha, Andre Briend, Per Ashorn

Journal: Acta paediatrica (Oslo, Norway : 1992) 2007;95(8):1012-5

PMID: 16882579

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Abstract

BACKGROUND

Standard recommendations are that children with oedematous malnutrition receive inpatient therapy with a graduated feeding regimen.

AIM

To investigate exclusive home-based therapy for children with oedematous malnutrition.

METHODS

Children with oedematous malnutrition, good appetite and no complications were treated at home with ready-to-use therapeutic food (RUTF) and followed up fortnightly for up to 8 wk.

SETTING AND PARTICIPANTS

219 children aged 1-5 y with oedema enrolled in one of two therapeutic nutritional studies in Malawi in 2003-2004.

RESULTS

The overall recovery rate was 83% (182/219), and the case-fatality rate was 5% (11/219). For children with wasting and oedematous malnutrition, 65% (55/85) recovered and 7% (6/85) died. The average weight gain was 2.8+/-3.2 g/kg/d (mean+/-SD).

CONCLUSION

This preliminary observation suggests that children with oedematous malnutrition and good appetite may be successfully treated with home-based therapy; a randomized, controlled trial to evaluate this is warranted.

Address: Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63110, USA, and Paediatric Research Centre, Tampere University Hospital, Finland.

DOI: 10.1080/08035250600606803

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MeSH Terms: Body Height, Child Nutrition Disorders, Child, Preschool, Edema, Female, Follow-Up Studies, Food, Formulated, Home Care Services, Hospital-Based, Humans, Infant, Male, Prospective Studies, Treatment Outcome, Weight Gain