How age and sex affect treatment outcomes for children with severe malnutrition: A multi-country secondary data
Susan Thurstans1, Charles Opondo2,3, Jeanette Bailey4
1Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Insights
Childhood wasting treatment outcomes showed few differences by sex or age. Boys had lower daily weight gain, but overall recovery and length of stay were similar, suggesting current protocols are appropriate.
Area of Science:
- Global Health
- Pediatrics
- Nutrition Science
Background:
- Childhood wasting affects millions globally, with age and sex influencing risk.
- Understanding treatment outcomes across demographics is crucial for effective interventions.
Purpose of the Study:
- To investigate differences in wasting treatment outcomes based on age and sex in children under five.
- To inform potential adjustments to therapeutic and supplementary feeding programs.
Main Methods:
- Logistic and linear regression analyses were applied to data from 6929 children in the ComPAS trial (Stage 1).
- Outcomes assessed included recovery, death, default, non-response, transfer, length of stay, and daily weight gain.
- Geographic locations included Kenya, Chad, Yemen, and South Sudan.
Main Results:
- Girls in therapeutic feeding programs showed a trend towards lower recovery rates in some regions (Chad, Yemen).
- Multinomial analysis revealed no significant difference in recovery between sexes overall.
- Boys exhibited consistently lower mean daily weight gain compared to girls, while older children had shorter lengths of stay.
Conclusions:
- Few significant differences in childhood wasting treatment outcomes were observed by sex or age.
- Current program inclusion criteria and treatment protocols appear appropriate.
- Further research is recommended to explore underlying causes for observed sex-based differences in weight gain and recovery in specific settings.
Abstract:
Age and sex influence the risk of childhood wasting. We aimed to determine if wasting treatment outcomes differ by age and sex in children under 5 years, enroled in therapeutic and supplementary feeding programmes. Utilising data from stage 1 of the ComPAS trial, we used logistic regression to assess the association between age, sex and wasting treatment outcomes (recovery, death, default, non-response, and transfer), modelling the likelihood of recovery versus all other outcomes. We used linear regression to calculate differences in mean length of stay (LOS) and mean daily weight gain by age and sex. Data from 6929 children from Kenya, Chad, Yemen and South Sudan was analysed. Girls in therapeutic feeding programmes were less likely to recover than boys (pooled odds ratio [OR]: 0.84, 95% confidence interval [CI]: 0.72-0.97, p = 0.018). This association was statistically significant in Chad (OR: 0.61, 95% CI: 0.39-0.95, p = 0.030) and Yemen (OR: 0.47, 95% CI: 0.27-0.81, p = 0.006), but not in Kenya and South Sudan. Multinomial analysis, however, showed no difference in recovery between sexes. There was no difference between sexes for LOS, but older children (24-59 months) had a shorter mean LOS than younger children (6-23 months). Mean daily weight gain was consistently lower in boys compared with girls. We found few differences in wasting treatment outcomes by sex and age. The results do not indicate a need to change current programme inclusion requirements or treatment protocols on the basis of sex or age, but future research in other settings should continue to investigate the aetiology of differences in recovery and implications for treatment protocols.
Related Concept Videos
01:20Comparing the Survival Analysis of Two or More Groups
01:52Regression Toward the Mean
02:20Longitudinal Research
01:21Cancer Survival Analysis
01:50Cross-Sectional Research
01:20Study Designs in Epidemiology
Observational studies are those where the researcher does not intervene but rather observes natural variations. They include cross-sectional, cohort, and...