Lagrone L, Cole S, Schondelmeyer A, Maleta K, Manary M J
Department of Pediatrics, Washington University, St Louis, USA.
Ann Trop Paediatr. 2010;30(2):103-8. doi: 10.1179/146532810X12703901870651.
Typical treatment of moderate acute malnutrition, simple wasting, in sub-Saharan Africa consists of dietary counselling and/or general or targeted distribution of corn/soy-blended flour (CSB). A randomised clinical effectiveness trial in 2007 showed CSB to be less effective than ready-to-use supplementary food (RUSF).
To determine the operational effectiveness of treating moderate acute malnutrition with RUSF.
Children aged 6-59 months were recruited in rural southern Malawi. Each child received 65 kcal/kg/d of locally produced soy/peanut RUSF, a product that provided about 1 RDA of each micronutrient. Anthropometric measurements were taken every 2 weeks and additional rations of RUSF were distributed at this time if the child remained wasted. Study participation lasted up to 8 weeks.
Of the 2417 children enrolled, 80% recovered, 4% defaulted, 0.4% died, 12% remained moderately wasted and 3% developed severe acute malnutrition. Weight, length and MUAC gain were 2.6 g/kg/d, 0.2 mm/d and 0.1 mm/d respectively. Cost per child treated was $5.39.
This intervention proved to be robust, maintaining high recovery rates and low default rates when instituted without the additional supervision and beneficiary incentives of a research setting.
在撒哈拉以南非洲，中度急性营养不良（单纯消瘦）的典型治疗方法包括饮食咨询和/或玉米/大豆混合粉（CSB）的常规或定向分发。2007年的一项随机临床疗效试验表明，CSB的效果不如即食补充食品（RUSF）。
确定使用RUSF治疗中度急性营养不良的实际效果。
在马拉维南部农村招募6至59个月大的儿童。每个儿童每天接受65千卡/千克的当地生产的大豆/花生RUSF，该产品提供每种微量营养素约1个推荐膳食摄入量。每2周进行一次人体测量，如果儿童仍消瘦，则此时额外分发RUSF口粮。研究参与持续长达8周。
在登记的2417名儿童中，80%康复，4%退出，0.4%死亡，12%仍为中度消瘦，3%发展为重度急性营养不良。体重、身长和上臂围的增加分别为2.6克/千克/天、0.2毫米/天和0.1毫米/天。每个接受治疗的儿童的费用为5.39美元。
该干预措施被证明是有效的，在没有研究环境中的额外监督和受益激励措施的情况下实施时，保持了高康复率和低退出率。
