WHO/UNICEF recommended therapeutic food versus home based therapeutic food in the management of severe acute malnutrition: A randomized controlled trial.

Malnutrition is a major public health problem especially in the developing countries. The objective of the study was to compare WHO/UNICEF recommended therapeutic food with home based therapeutic food in the management of severe acute malnutrition. It was a randomized controlled trial at tertiary care level hospital with nutritional rehabilitation centre. Children (6 month to 5 years) having severe acute malnutrition were included in the study. Group A (n=74 children) was given WHO recommended therapeutic food and group B (n=75 children) was given home based therapeutic food. The mean rate of weight gain, gain in height and increase in mid-upper arm circumference were significantly higher (p<0.05) in the group received home based therapeutic food. Mean duration to achieve target weight was 21.44±3.33 days in group A and 16.28±2.11 days in group B (p<o.ooo1). Group B children had higher rate of increase in urinary creatinine (p<0.0001). Affordability (p<0.0001), Feasibility (p=0.027) and Average frequency of feeding per day (p<0.0001) was found significantly higher in group B. Difficulty in making therapeutic food was significantly low in group B (p<0.05). Both kinds of therapeutic food were effective for the management of severe acute malnutrition, but the home based therapeutic food was found to be more effective. This could be explained by better acceptability in terms of better palatability, more affordability, increased frequency of feeding, and having less difficulty in making.