Domiciliary Treatment of Severe Acute Malnutrition - Domiciliary Treatment of Severe Acute Malnutrition - Open Access Pub

Background Severe acute malnutrition (SAM) is rampant in the children of hilly and inaccessible tribal region of Nandurbar, Maharashtra in India. It is estimated that nearly 5% of the children under five years have SAM. Objectives To assess the therapeutic efficacy of 3 types of nutrition protocols administered largely at home in SAM children from Nandurbar, Maharashtra. Methodology This study is a part of a larger three arm open label trial using 3 therapeutic feeds i.e. C-RUTF (Centrally produced ready to use therapeutic food), L-RUTF (locally prepared ready to use therapeutic food) and ARF (locally prepared amylase rich food) in children of SAM who attended the health facility and completed the treatment protocols for 8 weeks (All ‘per protocol patients’) and were between 1 to 3 years of age. The larger study included children aged 6 months to 59 months who were given same therapeutic feeding protocol. Findings A total of 450 SAM babies between 12-36 months. attended the outpatient therapeutic program during the period of July 2014 to December 2015 and completed the given protocol of therapeutic feeding program. 242(53.7%) were males and 208(46.2%) females. Out of these, 150 received C-RUTF, 150 received L-RUTF and 150 received ARF. Out of C-RUTF group 83(55.3%) recovered, in L-RUTF 70(46.7%) recovered and from ARF group 69(46.0%) recovered. The difference was statistically significant.(p=0.03) Total recovery rate was 49.3% in comparison to another under publication study by our group on 3418 children aged 6 months to 59 months, where recovery was 36.8%. Average weight gain per day was 3.54 ± 2.36 g/kg/day, 2.61 ± 2.12 g/kg/day, 2.60 ± 1.50 g/kg/day in the 3 arms respectively. Conclusion This study proves that domiciliary treatment with 3 types of therapeutic feeds gives recovery rate of 49.3%, there by meaning that SAM Children without complications can be treated at home with visit to health facility once a week. Of all the therapeutic feeding protocols C-RUTF had best recovery rates (55.3%) compared to others, the difference being statistically significant. Average weight gain per kg per day inC-RUTF group was 35.8 % higher than the other 2 groups. Severe acute malnutrition (SAM) is rampant in the children of hilly and inaccessible tribal region of Nandurbar, Maharashtra in India. It is estimated that nearly 5% of the children under five years have SAM. To assess the therapeutic efficacy of 3 types of nutrition protocols administered largely at home in SAM children from Nandurbar, Maharashtra. This study is a part of a larger three arm open label