Related Experiment Videos
[A home nutritional rehabilitation trial for severly malnourished children]
1Service de médecine préventive et santé publique, faculté de médecine, Hôpital d'Enfants Albert Royer, CHU de Fann, Dakar, Sénégal.
Insights
Home-based nutritional rehabilitation for severely malnourished children showed better weight gain than center-based programs, though both remained below WHO recommendations. Maternal involvement and education were key factors in home-based success.
Area of Science:
- Pediatrics
- Public Health
- Nutrition Science
Background:
- Severe childhood malnutrition remains a critical public health issue in low-income settings.
- Nutritional recovery centers (CRENs) are established interventions, but home-based care offers an alternative approach.
Purpose of the Study:
- To compare the effectiveness of home-based nutritional rehabilitation versus center-based programs for severely malnourished children.
- To identify factors contributing to successful nutritional rehabilitation in young children.
Main Methods:
- A trial involving 148 severely malnourished children (6-36 months) in Dakar, Senegal.
- Children were randomized to home-based care (n=97) or CREN (n=51) for two months, followed by weight monitoring.
- Data collected included weight gain, weight-for-height Z-scores, dropout rates, and mortality.
Main Results:
- Home-based rehabilitation resulted in significantly better average weight gain compared to CREN, though both fell short of the WHO's 50 g/day target.
- All children remained underweight post-intervention, with average Z-scores below -2.5 (home) and -2.9 (CREN).
- Dropout and mortality rates were similar between the two groups.
Conclusions:
- Home-based nutritional rehabilitation appears more effective than CREN, particularly when mothers are actively involved and receive tailored health education.
- Interpersonal communication and maternal support are crucial elements for successful pediatric malnutrition interventions.
- Further research is needed to optimize home-based strategies to meet WHO growth targets.
Abstract:
A nutritional rehabilitation trial for severely malnourished children aged 6 to 36 months (weight/height index using Z-score of less than -3 as the reference mean) was conducted in the poor suburban areas of Dakar, Senegal. Its purpose was to determine the effectiveness of a rehabilitation programme delivered in the home as compared to one provided in a nutritional recovery center (CREN). Ninety-seven children benefited from rehabilitation at home and 51 at the CREN. At the end of two months of rehabilitation and after five months of charting their weight, the average weight gain was better in the group followed at home, but it still remained well under the 50 g/day recommended by WHO. Within the two groups, all of the children stayed underweight, with an average weight/height index Z-score of less than -2.5 in the group followed at home, and a Z-score of less than -2.9 in the other group. The dropouts and the death rates in the two groups were comparable. The presence and availability of the mother as well as health education sessions adapted to each specific case through interpersonal communication seem to be the elements favouring the most effective rehabilitation being in the home.