Home-based therapy for oedematous malnutrition with ready-to-use therapeutic food.
BACKGROUND
Standard recommendations are that children with oedematous malnutrition receive inpatient therapy with a graduated feeding regimen.


OBJECTIVE
To investigate exclusive home-based therapy for children with oedematous malnutrition.


METHODS
Children with oedematous malnutrition, good appetite and no complications were treated at home with ready-to-use therapeutic food (RUTF) and followed up fortnightly for up to 8 wk.


METHODS
219 children aged 1-5 y with oedema enrolled in one of two therapeutic nutritional studies in Malawi in 2003-2004.


RESULTS
The overall recovery rate was 83% (182/219), and the case-fatality rate was 5% (11/219). For children with wasting and oedematous malnutrition, 65% (55/85) recovered and 7% (6/85) died. The average weight gain was 2.8+/-3.2 g/kg/d (mean+/-SD).


CONCLUSIONS
This preliminary observation suggests that children with oedematous malnutrition and good appetite may be successfully treated with home-based therapy; a randomized, controlled trial to evaluate this is warranted.
Ciliberto
Michael A
MA
Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63110, USA, and Paediatric Research Centre, Tampere University Hospital, Finland.
Manary
Mark J
MJ
Ndekha
Macdonald J
MJ
Briend
Andre
A
Ashorn
Per
P
D001827:Body Height; D015362:Child Nutrition Disorders / Q000150:complications / Q000178:diet therapy* / Q000401:mortality; D002675:Child, Preschool; D004487:Edema / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005526:Food, Formulated; D018575:Home Care Services, Hospital-Based; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome; D015430:Weight Gain