Indigenously Prepared Ready-to-use Therapeutic Food (RUTF) in Children with Severe Acute Malnutrition

ABSTRACT

Objective: To compare efficacy of indigenous Ready-to-useTherapeutic Food (Medical Nutrition Therapy) with StandardNutrition Therapy in children with Severe acute malnutrition.Design: Two facility-based and two community-based models(i) Open prospective randomized controlled trial comparingIndigenous Ready-to-use Therapeutic Food (Medical NutritionTherapy) with Standard Nutrition Therapy; (ii) Only IndigenousReady-to-use Therapeutic Food (Medical Nutrition Therapy); (iii)Doorstep Child Care Centre; and (iv) Community-basedManagement of Acute Malnutrition.Setting: (i) Urban Health Center, Dharavi, Mumbai; (ii) Two daycare centers of Non-governmental Organization SNEHA –Mumbai; (iii) Urban slums, M East and L Ward, MumbaiParticipants: 1105 children aged 6-60 months in community orhospital inpatient/ outpatient department diagnosed as SevereAcute Malnutrition by WHO definition.Intervention All subjects received either Indigenous Ready-to-use Therapeutic Food (Medical Nutrition Therapy) or StandardNutrition Therapy (protein calorie rich diet) for eight weeks andfollowed up for next four months.Main outcome measures: Mean rate of weight gain (g/kg/day), target weight, change in nutritional status.Results: Rate of weight gain was higher (P<0.05) at 2 weeks onindigenous Ready-to-use Therapeutic Food (Medical NutritionTherapy) (5.63 g/kg/day) as compared to Standard NutritionTherapy (3.43 g/kg/day). 61.2% subjects achieved target weightcompared to 47.7% controls. At 8 weeks, 82.8% subjectsrecovered from Severe Acute Malnutrition compared to 19.3%controls (P<0.005). The results obtained in community werecomparable to facility-based indigenous Ready-to-useTherapeutic Food (Medical Nutrition Therapy). The morbidity wasless in study group at follow-up.Conclusions: Indigenous Ready-to-use Therapeutic Food(Medical Nutrition Therapy) appeared to be superior to StandardNutrition Therapy in promoting weight gain in children with SevereAcute Malnutrition.KeywordsMedical Nutrition Therapy, Micronutrients, Nutritionalrehabilitation, Protein energy malnutrition. Ready-to-use-food