Community-Based Management of Acute Malnutrition for Infants under 6 Months of Age Is Safe and Effective: Analysis of Operational Data

Maeve M. Woeltje, Anastasia B. Evanoff, Beth A. Helmink, Diana L. Culbertson, Kenneth M. Maleta, Mark J. Manary, Indi Trehan

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective: To assess the effectiveness of outpatient management with ready-to-use and supplementary foods for infants under 6 months (u6m) of age who were unable to be treated as inpatients due to social and economic barriers. Design: Review of operational acute malnutrition treatment records. Setting: 21 outpatient therapeutic feeding clinics in rural Malawi. Participants: Infants u6m with acute malnutrition treated as outpatients because of barriers to inpatient treatment. The comparison group consisted of acutely malnourished children 6-9 months of age who were being treated at the same time in the same location in the context of two different randomized clinical trials. Results: A total of 323 infants u6m were treated for acute malnutrition (130 severe and 193 moderate). A total of 357 infants 6-9 months old with acute malnutrition (74 severe and 283 moderate) were included as contemporaneous controls. Among infants u6m with severe acute malnutrition, 98 (75.4%) achieved nutritional recovery; in comparison, 56 (75.7%) of those with SAM 6-9 months old recovered. Among infants u6m with moderate acute malnutrition, 157 (81.3%) recovered; in comparison 241 (85.2%) of those aged 6-9 months recovered. Conclusions: In a rural Malawian population of infants u6m who had generally already stopped exclusive breastfeeding and were now acutely malnourished, treatment with therapeutic or supplementary foods under the community management of acute malnutrition model was safe and effective. In settings where social and financial factors make hospital admission challenging, consideration should be given to lowering the recommended age of ready-to-use therapeutic and supplementary foods to infants u6m.

Original languageEnglish
JournalPublic Health Nutrition
DOIs
StateAccepted/In press - 2021

Keywords

  • acute malnutrition
  • infants
  • kwashiorkor
  • marasmus
  • moderate acute malnutrition
  • operational research
  • ready-to-use supplementary food
  • ready-to-use therapeutic food
  • severe acute malnutrition
  • wasting

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