Recovery rate of children with moderate acute malnutrition treated with ready-to-use supplementary food (RUSF) or improved corn-soya blend (CSB+): a randomized controlled trial.

OBJECTIVE: To compare an improved corn-soya blend (CSB+) with a ready-to-use supplementary food (RUSF) to test the hypothesis that satisfactory recovery rate will be achieved with CSB+ or RUSF when these foods provide 50 % of the child's energy requirement, the 50 % remaining coming from usual diet. DESIGN: A comparative efficacy trial study was conducted with moderately wasted children, using a controlled randomized design, with parallel assignment for RUSF or CSB+. Every child received a daily ration of 167 kJ (40 kcal)/kg body weight during 56 d with a follow-up performed every 14 d. Every caregiver received nutrition counselling at enrolment and at each follow-up visit. SETTING: Health districts of Mvog-Beti and Evodoula in the Centre region of Cameroon. SUBJECTS: Eight hundred and thirty-three children aged 6-59 months were screened and eighty-one malnourished children (weight-for-height Z-score between -3 and -2) aged 25-59 months were selected. RESULTS: Of children treated with CSB+ and RUSF, 73 % (95 % CI 59 %, 87 %) and 85 % (95 % CI 73 %, 97 %), respectively, recovered from moderate acute malnutrition, with no significant difference between groups. The mean duration of treatment required to achieve recovery was 44 d in the RUSF group and 51 d in the CSB+ group (log-rank test, P=0·0048). CONCLUSIONS: There was no significant difference in recovery rate between the groups. Both CSB+ and RUSF were relatively successful for the treatment of moderate acute malnutrition in children. Despite the relatively low ration size provided, the recovery rates observed for both groups were comparable to or higher than those reported in previous studies, a probable effect of nutrition education.

Validity of anthropometry- and impedance-based equations for the prediction of total body water as measured by deuterium dilution in Cameroonian haemodialysis patients.

BACKGROUND & AIMS: There is no available information on the validity of anthropometry- and impedance-based equations for predicting total body water (TBW) in Cameroonian haemodialysis patients. This study aimed to validate and develop predictive equations of TBW for Cameroonian haemodialysis patients. METHOD: TBW in 40 Cameroonian haemodialysis patients (28 men and 12 women) was measured by deuterium dilution and compared with the one predicted by 7 anthropometric and 9 BIA equations. Multiple linear regression analysis was used to develop an equation for predicting TBW as measured by deuterium, from anthropometric parameters. RESULTS: Pure errors in predicting TBW showed unacceptable value for all equations tested. In all the cases, unacceptable discrepancies at individual level for clinical purposes were noted. The following equation was developed and showed a better agreement with the deuterium dilution method: TBW = 13.8994 + 0.0017 × Age +0.3190 × Weight +1.8532 × Sex. CONCLUSION: Further development and cross-validation of anthropometric and BIA prediction equations specific to African heamodialysis patient are needed. Meanwhile, the equation developed in this study which provided a better agreement with the isotope dilution could be use for Cameroonian haemodialysis patients.

Body composition of Cameroonian lactating women determined by anthropometry, bioelectrical impedance, and deuterium dilution.

OBJECTIVE: This study compared body composition estimates using deuterium dilution, multiple-frequency bioelectrical impedance analysis (BIA), and skinfold thickness techniques in a group of Cameroonian lactating women. METHODS: Body fat, fat-free mass, and total body water in 44 Cameroonian lactating women (2.63 ± 1.31 mo postpartum) were assessed by deuterium dilution, the Siri or black-specific derived Durnin-Womerley equation, and 12 BIA-prediction equations developed in samples of subjects of white, black, black-and-white, or unspecified racial background, respectively. RESULTS: Compared with deuterium dilution, anthropometry and BIA-based predictive equations overestimated body fat by 2.7 to 11.7 kg; thus, fat-free mass and total body water were underestimated. In all cases, the significant biases resulted in large 95% limits of agreement, yielding unacceptable potential bias at the level of the individual. However, the exclusion of suprailiac skinfold in the calculation, yielding to non-significant (P < 0.05) bias, improved the prediction of body composition in Cameroonian lactating women using the Durnin-Womersley and Siri equations. CONCLUSION: It is essential to adjust the Durnin-Womersley equation before using it in the Siri equation for the prediction of body composition in lactating women. Further development and cross-validation of prediction equations from BIA specific to lactating women is needed.

Validity of impedance-based equations for the prediction of total body water as measured by deuterium dilution in Cameroonian HIV-infected patients treated with antiretroviral treatment.

BACKGROUND & AIMS: No information is available on the validity of impedance-based equations for the prediction of body composition in Cameroonian HIV-infected patients treated with antiretroviral drugs. Equations for the prediction of total body water (TBW) have the tendency to be population-specific, and this may be due to biological factors, such as variable body geometry and physiological state. We tested the validity of equations derived from different racial backgrounds for predicting TBW from bioelectrical impedance analysis measurements. METHOD: The TBW content of 56 Cameroonian HIV patients (19 men and 37 women) treated with the first-line ARV regimen was measured by deuterium dilution and compared with those predicted by 12 equations developed respectively in samples of white, black, black and white, or unspecified racial background subjects. RESULTS: Pure errors in predicting TBW showed acceptable value for all the equations tested. Four equations (three from whites and one from blacks and whites) yielded a non-significant bias; however, equation H which presented the narrower 95% confidence interval and the smaller pure error was recommended for the prediction of TBW in Cameroonian HIV-infected patients treated with antiretroviral drugs. In all other cases, we observed either an overestimation or underestimation of TBW with variable bias values. CONCLUSION: The absence of a clear trend in cross-validation among equations according to their origin and the probable effect of physiological state should encourage further exploration of the causes of the lack of validity.