Outcomes of a food voucher program and factors associated with the recovery rate of children with moderate acute malnutrition in Far North Cameroon.

BACKGROUND: Research on moderate acute malnutrition (MAM) is limited, despite its high prevalence. This study examined outcomes of bi-weekly locally available foods provided via a food voucher program (FVP) on nutritional recovery [mid-upper arm circumference (MUAC) ≥ 125 mm] from MAM (defined as MUAC between 115 and 124 mm) and identified the factors associated with recovery rate in Kaélé health district, Far North Region of Cameroon. METHODS: This was a prospective study with 474 MAM children aged 6-59 months. Food voucher distribution and MUAC screening were conducted at 6 bi-weekly visits or until the child was recovered. Time to recovery was evaluated with multivariate Cox proportional regression hazard models with associations quantified using adjusted hazard ratio (aHR). The trend for MUAC, including its determinants, was examined with multivariate linear mixed effect models. RESULTS: The recovery rate was 78.3% by 6 weeks after the first food basket; 3.4% remained MAM, and 5.9% were transferred for treatment for severe acute malnutrition (SAM defined as MUAC < 115 mm). Boys were 34% more likely to recover from MAM than girls [aHR = 1.34, 95%CI (1.09, 1.67)]. Children aged 24-53 months were 30% more likely to recover than those aged 6-11 months [aHR = 1.30, 95%CI (0.99, 1.70)]. A one unit increase in weight-for-height Z-score (WHZ) was associated with 1.89-fold greater likelihood of recovery [aHR = 1.89, 95%CI (1.66, 2.14)]. Male children had on average 1.82 mm greater increase in MUAC than female children (p < 0.001). One unit increase in WHZ was associated with 3.42 mm increase in MUAC (p = 0.025). Children aged 12-23 and 24-53 months had 1.03 mm and 2.44 mm, respectively, greater increase in MUAC over the program than children aged 6-11 months (all p < 0.01). CONCLUSION: The recovery rate of MAM children treated with the FVP met the Sphere standards for targeted supplementary feeding programs (> 75%). Child's WHZ, gender and age were significant factors associated with MUAC increase and recovery from MAM in the FVP. These findings indicate the FVP approach shows promise as an effective alternative treatment for MAM with consideration of associated factors and merits further evaluation.

Antifungal activity and acute toxicity of stem bark extracts of Drypetes gossweileri S. Moore-euphorbiaceae from Cameroon.

Drypetes gossweilleri S. Moore is a plant used in traditional medicine in Cameroon. The antifungal properties of its stem-bark crude extract and fractions DG(1), DG(2), DG(3), DG(4), DG(5), DG(6), DG(7), DG(8) and DG(9) were assayed by agar and broth dilution methods on solid and liquid media against C. Krusei, C. albicans, C. glabrata, T. mentagerophytes, M. langeroinii, M. gypeum, M. audouini, T. rubrum, T. soudanense, T. terrestre, A. flavus and A. niger. The results revealed a substantial antifungal effect with minimal inhibitory concentrations ranging respectively from 24.11µg/ml to 1562µg/ml for yeasts and from 3125µg/ml to 12500µg/ml for filamentous fungi. Among the fractions, fraction DG4 exerted the highest antifungal activity. Moreover, no toxic effect was noticed in male and female albinos Wistar rats treated per os with the crude stem bark's extract of Drypetes gossweileri at a dose up to 12g/kg of body weight. The phytochemical screening of the crude extract and fractions showed the presence of alkaloids, phenols, flavonoids, saponins, anthocyanines, anthraquinones, sterols, lipids and essential oils. Therefore, Drypetes gossweileri may be safe as phytomedecine for the treatment of fungal infections.