Standard nutritional treatment of moderate acute malnutrition (MAM) relies on fortified blended flours though their importance to treat this condition is a matter of discussion. With the newly introduced World Health Organization growth standards, more children at an early stage of malnutrition will be treated following the dietary protocols as for severe acute malnutrition, including ready-to-use therapeutic food (RUTF). We compared the effectiveness of RUTF and a corn/soy-blend (CSB)-based pre-mix for the treatment of MAM in the supplementary feeding programmes (SFPs) supported by Médecins Sans Frontières, located in the Zinder region (south of Niger). Children measuring 65 to <110 cm, newly admitted with MAM [weight-for-height (WHM%) between 70% and <80% of the NCHS median] were randomly allocated to receive either RUTF (Plumpy'Nut®, 1000 kcal day(-1)) or a CSB pre-mix (1231 kcal day(-1)). Other interventions were similar in both groups (e.g. weekly family ration and ration at discharge). Children were followed weekly up to recovery (WHM% ≥ 85% for 2 consecutive weeks). In total, 215 children were recruited in the RUTF group and 236 children in the CSB pre-mix group with an overall recovery rate of 79.1 and 64.4%, respectively (p < 0.001). There was no evidence for a difference between death, defaulter and non-responder rates. More transfers to the inpatient Therapeutic Feeding Centre (I-TFC) were observed in the CSB pre-mix group (19.1%) compared to the RUTF group (9.3%) (p = 0.003). The average weight gain up to discharge was 1.08 g kg(-1) day(-1) higher in the RUTF group [95% confidence interval: 0.46-1.70] and the length of stay was 2 weeks shorter in the RUTF group (p < 0.001). For the treatment of childhood MAM in Niger, RUTF resulted in a higher weight gain, a higher recovery rate, a shorter length of stay and a lower transfer rate to the I-TFC compared to a CSB pre-mix. This might have important implications on the efficacy and the quality of SFPs.

Malnutrition exists in both urban and rural areas in Niger. An analysis of food and nutrition situation was carried out in the urban municipality of Zinder in order to contribute to a better understanding of the situation.This work was done from February to March 2018, at the household level,sampled by probabilistic method.The study involved 168 children from 6 to 59 months selected from 150 households in 15neighborhoods in the urban municipalities of Zinder. An analysis of the Food Consumption Score and Household Food Diversity Score showed acceptable food consumption and high food diversity respectively in58.7% and 67.3% of households.Furthermore, the results showed that the socio-economic characteristics that determined Score of food consumption were the main activities of heads of households and their wives. Food diversity was generally acceptable, although 2.7 %of households still had low dietary diversity in the study area.Also,food diversity remained low overall for nearly 8.9% of children with a rate of 6.0% for households headed by a woman.Nevertheless, the latter female-headed households had an estimated 13.7% of children with average individual food diversity. The prevalence of acute global malnutrition is 13.1% with the severe form at3%. It should be noted that girls were much more affected by this severe form (3.4%) compared to 2.5% for boys.However, stunting was more prevalent in males than in females with 57.5% and 46.6%,respectively. Moderate form accounting for 28.4% in females compared to 17.5% in males.This nutritional status reflects the relatively acceptable food situation in which these children lived. Furthermore, the appreciation of different foods and modes of consumption have shown on the one hand that the diet remains monotonous. On the other hand, this analysis revealed that cereal-based dishes accompanied by vegetable/leafy sauces predominated in these households in the study area.This situation exposes the members of these households and especially young children to the risk of malnutrition.