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Published on: September 20, 2019
Home-based therapy for oedematous malnutrition with ready-to-use therapeutic food
Michael A Ciliberto1, Mark J Manary, Macdonald J Ndekha
1Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63110, USA, and Paediatric Research Centre, Tampere University Hospital, Finland.
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.
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