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Padhani ZA, Cichon B, Das JK, Salam RA, Stobaugh HC, Mughal M, Rutishauser-Perera A, Black RE, Bhutta ZA. Systematic Review of Management of Moderate Wasting in Children over 6 Months of Age. Nutrients 2023; 15:3781. [PMID: 37686813 PMCID: PMC10490450 DOI: 10.3390/nu15173781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/25/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
The effective management of the 33 million children with moderate acute malnutrition (MAM) is key to reducing childhood morbidity and mortality. In this review, we aim to evaluate the effectiveness of specially formulated foods (SFFs) compared to non-food-based approaches to manage MAM in children >6 months old. We conducted a search on ten databases until 23 August 2021 and included five studies, covering 3387 participants. Meta-analysis of four studies comparing SFFs to counselling or standard of care showed that SFFs likely increase recovery rate, reduce non-response, and may improve weight-for-height z-score, weight-for-age z-score and time to recovery, but have little or no effect on MUAC gain. One study on a multicomponent intervention (SFFs, antibiotics and counselling provided to high-risk MAM) compared to counselling only was reported narratively. The intervention may increase weight gain after 24 weeks but may have little or no effect on weight gain after 12 weeks and on non-response and mortality after 12 and 24 weeks of enrollment. The effect of this intervention on recovery was uncertain. In conclusion, SFFs may be beneficial for children with moderate wasting in humanitarian contexts. Programmatic recommendations should consider context and cost-effectiveness.
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Affiliation(s)
- Zahra A. Padhani
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, SA 5000, Australia
- Institute for Global Health and Development, Aga Khan University, Karachi 74800, Pakistan; (J.K.D.); or (Z.A.B.)
| | | | - Jai K. Das
- Institute for Global Health and Development, Aga Khan University, Karachi 74800, Pakistan; (J.K.D.); or (Z.A.B.)
- Division of Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Rehana A. Salam
- Centre of Research Excellence, Melanoma Institute Australia, University of Sydney, Sydney, NSW 2006, Australia;
| | - Heather C. Stobaugh
- Action against Hunger USA, Technical Services and Innovation Department, Washington, DC 20463, USA;
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Muzna Mughal
- Action against Hunger UK, London SE10 0ER, UK; (M.M.); (A.R.-P.)
| | | | - Robert E. Black
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Zulfiqar A. Bhutta
- Institute for Global Health and Development, Aga Khan University, Karachi 74800, Pakistan; (J.K.D.); or (Z.A.B.)
- Division of Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
- Centre for Global Child Health, Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
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