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Published on: August 21, 2015
2030 Countdown to combating malnutrition in Burundi: comparison of proactive approaches for case detection and
Emmanuel Nene Odjidja1, Cathryn Christensen2, Ghislaine Gatasi1
1Village Health Works, BP 1604, Bujumbura, Burundi.
Insights
Clinic systematic screening effectively detects more cases of acute and chronic malnutrition in children than community-based mass screening, leading to higher treatment enrollment rates in Burundi.
Area of Science:
- Global Health
- Pediatrics
- Nutritional Science
Background:
- Burundi faces high rates of child malnutrition, with 55% of children under five affected by chronic malnutrition.
- Despite a national treatment program, child enrollment in malnutrition treatment remains a challenge.
- This study evaluates two screening methods for detecting and enrolling malnourished children.
Purpose of the Study:
- To compare the effectiveness of community-based mass screening versus clinic-based systematic screening in detecting and enrolling children with malnutrition.
- To identify the optimal screening approach for improving malnutrition treatment access in Burundi.
Main Methods:
- Observational data from two screening approaches were analyzed.
- Children were classified as acutely or chronically malnourished using a z-score cut-off between -2 and 2.
- Detection and enrollment rates were compared between community-based mass screening and clinic-based systematic screening.
Main Results:
- Clinic-based systematic screening identified a higher prevalence of Global Acute Malnutrition (14.1%) compared to community-based mass screening (8.3%).
- Enrollment in treatment was significantly higher with clinic-based screening (98%) versus community-based screening (8%).
- Clinic systematic screening was 1.82 times more likely to detect acute malnutrition and 1.35 times more likely to detect chronic malnutrition.
Conclusions:
- Strengthening health systems for systematic child screening is crucial for effective malnutrition detection and treatment.
- Clinic-based systematic screening demonstrates superior effectiveness in identifying and enrolling malnourished children into treatment programs.
- The findings highlight the importance of leveraging existing health infrastructure for proactive malnutrition case finding.
Background:
Burundi has one of the highest rates of malnutrition in the world, particularly chronic malnutrition, which affects 55% of all children <5 y of age. Although it rolled out a national treatment programme to combat all forms of malnutrition, enrolment of children remains difficult. In this study, we use observational data from two screening approaches to assess the effectiveness in detection and enrolment into treatment.
Methods:
Individual data from each screening approach was classified as either acutely malnourished or normal and either chronically malnourished or normal using a cut-off z-score between -2 and 2.
Results:
While the Global Acute Malnutrition rate for the community-based mass screening was 8.3% (95% CI 5.6 to 11), with 8% enrolled in treatment, that of clinic-based systematic screening was 14.1% (95% CI 12.2 to 16.1), 98% of which were enrolled in treatment. Clinic systematic screening was 1.82 times (OR, 95% CI 1.26 to 2.62, p<0.001) and 1.35 times (95% CI 1.09 to 1.68, p=0.06) more likely to detect acute and chronic malnutrition, respectively, than community-based mass screening.
Conclusions:
Although different mechanisms are relevant to proactively detect cases, strengthening the health system to systematically screen children could yield the best results, as it remains the primary contact for the sicker population, who may be at risk of increased infection as a result of underlying malnutrition.
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