Home-based therapy with ready-to-use therapeutic food is of benefit to malnourished, HIV-infected Malawian children.
OBJECTIVE
To determine if home-based nutritional therapy will benefit a significant fraction of malnourished, HIV-infected Malawian children, and to determine if ready-to-use therapeutic food (RUTF) is more effective in home-based nutritional therapy than traditional foods.


METHODS
93 HIV-positive children >1 y old discharged from the nutrition unit in Blantyre, Malawi were systematically allocated to one of three dietary regimens: RUTF, RUTF supplement or blended maize/soy flour. RUTF and maize/soy flour provided 730 kJ x kg(-1) x d(-1), while the RUTF supplement provided a fixed amount of energy, 2100 kJ/d. These children did not receive antiretroviral chemotherapy. Children were followed fortnightly. Children completed the study when they reached 100% weight-for-height, relapsed or died. Outcomes were compared using regression modeling to account for differences in the severity of malnutrition between the dietary groups.


RESULTS
52/93 (56%) of all children reached 100% weight-for-height. Regression modeling found that the children receiving RUTF gained weight more rapidly and were more likely to reach 100% weight-for-height than the other two dietary groups (p < 0.05).


CONCLUSIONS
More than half of malnourished, HIV-infected children not receiving antiretroviral chemotherapy benefit from home-based nutritional rehabilitation. Home-based therapy RUTF is associated with more rapid weight gain and a higher likelihood of reaching 100% weight-for-height.
Ndekha
M J
MJ
College of Medicine, University of Malawi, Malawi.
Manary
M J
MJ
Ashorn
P
P
Briend
A
A
D000886:Anthropometry; D015362:Child Nutrition Disorders / Q000178:diet therapy* / Q000821:virology; D002675:Child, Preschool; D005526:Food, Formulated; D015658:HIV Infections / Q000150:complications / Q000178:diet therapy*; D006801:Humans; D007223:Infant; D007228:Infant Nutrition Disorders / Q000178:diet therapy* / Q000821:virology; D008295:Malawi; D011446:Prospective Studies; D012044:Regression Analysis; D016037:Single-Blind Method