Effect of a low-cost food on the recovery and death rate of malnourished children.
OBJECTIVE
Nutritional rehabilitation in Africa relies mainly on imported skim milk enriched with a sugar and salt mixture. We evaluated whether milk plus porridge made from local ingredients improves the outcome of childhood nutritional rehabilitation versus milk alone.


METHODS
This study was conducted in a nutritional unit in Lacor (Northern Uganda). The porridge, made from cheap locally available ingredients (maize flour, dried fish or meat, peanut butter and oil) supplemented with proteins and fats, provides 1.1 energy units, 4.4 kJ/g. We randomly sampled the files of 100 cases discharged in October, November and December 2001 (preintervention), in 2002 (soon after intervention onset) and in 2003 (more than 1 year after intervention onset). We recorded the average hospital days and average oedema-free weight gain at discharge in the 3 groups.


RESULTS
Average oedema-free weight gain increased from 21 g/d (95% confidence interval [CI], 12-29) in 2001 to 35 g/d (95% CI, 25-45) in 2002 and reached 59 g/d (95% CI, 51-65) in 2003. Mortality decreased from 22% to 7.8%, and nutritional failures (insufficient weight gain) decreased by greater than 50%.


CONCLUSIONS
The low-cost porridge supplement (2640 euros/yr per 100 children) was effective in treating malnutrition. Widespread use of the porridge, which resulted in better outcomes than milk alone, could produce a savings in the medium- to long-term, thereby releasing resources for other uses. A high-energy porridge that is made from locally available ingredients and does not require imported foods seems to be appropriate for supplementary feeding after mother's milk in this setting.
Greco
Luigi
L
European Laboratory for Food Induced Disease, Department of Pediatrics, University of Naples Federico II, Naples, Italy. ydongre@unina.it
Balungi
Jacquie
J
Amono
Kevin
K
Iriso
Robert
R
Corrado
Bruno
B
D000818:Animals; D002648:Child; D046688:Child Mortality; D015362:Child Nutrition Disorders / Q000178:diet therapy* / Q000401:mortality; D002675:Child, Preschool; D015331:Cohort Studies; D002523:Edible Grain / Q000191:economics; D002149:Energy Intake; D005502:Food / Q000191:economics; D005527:Food, Fortified; D006801:Humans; D007223:Infant; D008892:Milk / Q000191:economics; D011502:Protein-Energy Malnutrition / Q000178:diet therapy* / Q000401:mortality; D016019:Survival Analysis; D016896:Treatment Outcome; D014454:Uganda; D015430:Weight Gain