Home-based therapy for oedematous malnutrition with ready-to-use therapeutic food

Background: Standard recommendations are that children with oedematous malnutrition receive inpatient therapy with a graduated feeding regimen. Aim: To investigate exclusive home-based therapy for children with oedematous malnutrition. Methods: Children with oedematous malnutrition, good appetite and no complications were treated at home with ready-to-use therapeutic food (RUTF) and followed up fortnightly for up to 8 wk. Setting and participants: 219 children aged 1-5 y with oedema enrolled in one of two therapeutic nutritional studies in Malawi in 2003-2004. Results: The overall recovery rate was 83% (182/219), and the case-fatality rate was 5% (11/219). For children with wasting and oedematous malnutrition, 65% (55/85) recovered and 7% (6/85) died. The average weight gain was 2.8±3.2 g/kg/d (mean±SD). Conclusion: This preliminary observation suggests that children with oedematous malnutrition and good appetite may be successfully treated with home-based therapy; a randomized, controlled trial to evaluate this is warranted.