Managing acute malnutrition in children under five years of age in low-income and middle-income countries
Citation: Das JK, Salam RA, Saeed M, et al. Effectiveness of Interventions for Managing Acute Malnutrition in Children under Five Years of Age in Low-Income and Middle-Income Countries: A Systematic Review and Meta-Analysis. Nutrients 2020;12:116.
Language: English.
Free to view? Yes.
What is this? There is uncertainty around the most effective methods to treat acute or chronic malnutrition in young children.
In this systematic review, the authors searched for studies of the effects of various strategies targeting the management of children (<5 years) with severe (SAM) or moderate acute malnutrition (MAM). They did not restrict their searches by date, language or type of publication and did the search in February 2019. They included 33 randomised trials, 6 quasi-experimental studies and 3 cost-effectiveness studies.
What was found? Limited data suggest benefit of integrated community-based and outpatient management on improving recovery when compared to standard care and inpatient management.
Cost data suggest that community or outpatient management of children with uncomplicated SAM is the most cost-effective strategy.
Facility-based management of SAM with ready-to-use therapeutic food (RUTF) has similar effects to F100 (therapeutic milk Formula 100) on weight gain and mortality.
RUTF is comparable with other foods for recovery and mortality for SAM; but may improve weight gain when compared to non-milk/peanut butter based RUTF and F100.
Ready-to-use supplementary food (RUSF) may improve recovery and weight gain when compared with Corn-Soy blend (CSB) for MAM.
Local food and whey RUSF have comparable effects to standard RUSF on recovery rate and weight gain in MAM, while standard RUSF has additional benefits to CSB.
Prophylactic antibiotics improve recovery and probably weight gain and reduce mortality in children with uncomplicated SAM
According to limited data, high-dose and low-dose vitamin A supplementation are comparable for weight gain and mortality among children with SAM.
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