Department of Public Health Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
School of Public Health, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia.
BMC Pediatr. 2023 Jul 5;23(1):340. doi: 10.1186/s12887-023-04168-x.
The therapeutic feeding unit (TFU) provides comprehensive inpatient clinical care for children suffering from severe acute malnutrition (SAM) in three stages: stabilization, transition, and rehabilitation. During the transitional and rehabilitation phases, children receive either F-100 or ready-to-use therapeutic food (RUTF). Although both promote weight gain, RUTF is more energy dense than F-100. There is limited and contrasting evidence regarding their effect on recovery time. Therefore, this study aimed to assess the effect of RUTF on time to recovery among SAM children aged 6-59 months admitted to the TFU in Ethiopia.
Health Facility-based prospective cohort study was conducted among 476 children treated in three hospitals and four health centers in the Sidama region from September 2021 to January 2022. A structured questionnaire adopted from the Ethiopian national protocol for the management of SAM was used for data collection. Data were entered into EpiData version 3.1 and exported to SPSS version 20 for analysis. The Kaplan-Meir curve and log-rank test were used to compare time to recovery between children who received RUTF and F-100. Multivariable Cox proportional hazard analysis was conducted to assess the association between time to recovery and the type of therapeutic food, controlling for the confounding variables.
The median recovery time was significantly shorter in children receiving RUTF (7 days; 95% CI: 6.62-7.38) compared to F-100 (10 days; 95% CI: 8.94-11.06). Children below 24 months (AHR = 0.54, 95% CI: 0.42-0.69), dehydrated (AHR = 1.34, 95% CI: 1.07-1.75), edematous malnutrition (AHR = 1.29, 95% CI: 1.03-1.61), and anemic (AHR = 2.57, 95% CI: 1.90-3.48) during admission were associated with time to recovery.
Children who received RUTF recovered faster than children who received F-100. Administering RUTF to children below 24 months, who present with anemia and dehydration can improve their recovery rate and shorten their stay in the health facility.
治疗喂养单位 (TFU) 为患有严重急性营养不良 (SAM) 的儿童提供全面的住院临床护理，分为三个阶段：稳定期、过渡期和康复期。在过渡和康复阶段，儿童接受 F-100 或即食治疗食品 (RUTF)。虽然两者都能促进体重增加，但 RUTF 的能量密度高于 F-100。关于它们对恢复时间的影响，证据有限且相互矛盾。因此，本研究旨在评估 RUTF 对埃塞俄比亚 TFU 收治的 6-59 月龄 SAM 儿童恢复时间的影响。
2021 年 9 月至 2022 年 1 月，在西达玛地区的 3 家医院和 4 家卫生中心，对 476 名儿童进行了基于卫生机构的前瞻性队列研究。使用从埃塞俄比亚国家 SAM 管理方案中采用的结构化问卷收集数据。数据输入 EpiData 版本 3.1 并导出到 SPSS 版本 20 进行分析。采用 Kaplan-Meier 曲线和对数秩检验比较接受 RUTF 和 F-100 的儿童之间的恢复时间。多变量 Cox 比例风险分析用于评估恢复时间与治疗食品类型之间的关联，同时控制混杂变量。
与接受 F-100 的儿童相比，接受 RUTF 的儿童的中位恢复时间明显缩短（7 天；95%CI：6.62-7.38）。24 个月以下的儿童（AHR=0.54，95%CI：0.42-0.69）、脱水（AHR=1.34，95%CI：1.07-1.75）、水肿性营养不良（AHR=1.29，95%CI：1.03-1.61）和贫血（AHR=2.57，95%CI：1.90-3.48）的儿童恢复时间更长。
接受 RUTF 的儿童比接受 F-100 的儿童恢复更快。对 24 个月以下、贫血和脱水的儿童给予 RUTF 可提高其恢复率并缩短其在医疗机构的停留时间。
