Children Successfully Treated for Moderate Acute Malnutrition Remain at Risk for Malnutrition and Death in the Subsequent Year after Recovery

Abstract

Moderate acute malnutrition (MAM) affects 11% of children <5 y old worldwide and increases their risk for morbidity and mortality. It is assumed that successful treatment of MAM reduces these risks. A total of 1967 children aged 6-59 mo successfully treated for MAM in rural Malawi following randomized treatment with corn-soy blend plus milk and oil (CSB++), soy ready-to-use supplementary food (RUSF), or soy/whey RUSF were followed for 12 mo. The initial supplementary food was given until the child reached a weight-for-height Z-score (WHZ) >-2. The median duration of feeding was 2 wk, with a maximum of 12 wk. The hypothesis tested was that children treated with either RUSF would be more likely to remain well-nourished than those treated with CSB++. The primary outcome, remaining well-nourished, was defined as mid-upper arm circumference ≥12.5 cm or WHZ ≥-2 for the entire duration of follow-up. During the 12-mo follow-up period, only 1230 (63%) children remained well-nourished, 334 (17%) relapsed to MAM, 190 (10%) developed severe acute malnutrition, 74 (4%) died, and 139 (7%) were lost to follow-up. Children who were treated with soy/whey RUSF were more likely to remain well-nourished (67%) than those treated with CSB++ (62%) or soy RUSF (59%) (P = 0.01). A seasonal pattern of food insecurity and adverse clinical outcomes was observed. This study demonstrates that children successfully treated for MAM with soy/whey RUSF are more likely to remain well-nourished; however, all children successfully treated for MAM remain vulnerable.

Efficacy of sorghum peanut blend and corn soy blend plus in the treatment of moderate acute malnutrition in children aged 6&ndash;59 months in Karamoja, Uganda: a cluster randomized trial

“…1 Studies have shown that children previously suffering from MAM remain at risk of malnutrition and death in the year following recovery. 3 A child with MAM is normally treated with fortified blended flours, specifically corn soy blend plus (CSB+) or recently with corn soy blend "plus plus" CSB++. 4 These food supplements are effective in treating MAM but are short-term rather than sustainable intervention for management of recurrent malnutrition in poverty stricken countries.…”

Implementasi Penatalaksanaan Kasus Gizi Buruk Di Wilayah Kerja Puskesmas Cilacap Utara I

“…Malnutrisi akut sedang atau gizi buruk mempengaruhi 11% dari anak-anak balita di seluruh dunia dan meningkatkan risiko morbiditas dan mortalitas. Resiko mortalitas 3 kali lebih besar dari anak status gizi baik dan mengalami morbiditas seperti terkena penyakit menular dan tertunda fisik serta perkembangan kognitif anak (Chang, et al 2013;Nurwitasari, 2015). Malnutrisi juga akan mempengaruhi kualitas hidup, terutama dari segi status kesehatan, prestasi belajar, dan produktivitas (Oktaviana, 2013dan Utami, 2014.…”

Severe and moderate acute malnutrition detection in a rural hospital pediatric outpatient clinic and their comparison with the IAP charts: a two-year study

“…Moderate acute malnutrition (MAM), defined as having a weight-for-height Z-score (WHZ) <-2 and >-3 without edema, affects 11% of the children worldwide under the age of 5 years. 1 Children with MAM are not only at 3 times greater risk of death than well-nourished children but also face greater risk of morbidity from infectious diseases and delayed physical and cognitive development.…”

“…1 In India, prevalence of severe acute malnutrition (SAM) is 6.4% in children below 5 years with 100 focus districts having high prevalence of malnutrition being situated in 6 states: Bihar, Jharkhand, Madhya Pradesh, Rajasthan, Orissa and Uttar Pradesh. 2,3 For proper utilization of funds and manpower, there is phase-wise implementation of nutritional rehabilitation centers (NRC) in these areas by UNICEF.…”