Locally produced ready-to-use supplementary food is an effective treatment of moderate acute malnutrition in an operational setting.
BACKGROUND
Typical treatment of moderate acute malnutrition, simple wasting, in sub-Saharan Africa consists of dietary counselling and/or general or targeted distribution of corn/soy-blended flour (CSB). A randomised clinical effectiveness trial in 2007 showed CSB to be less effective than ready-to-use supplementary food (RUSF).


OBJECTIVE
To determine the operational effectiveness of treating moderate acute malnutrition with RUSF.


METHODS
Children aged 6-59 months were recruited in rural southern Malawi. Each child received 65 kcal/kg/d of locally produced soy/peanut RUSF, a product that provided about 1 RDA of each micronutrient. Anthropometric measurements were taken every 2 weeks and additional rations of RUSF were distributed at this time if the child remained wasted. Study participation lasted up to 8 weeks.


RESULTS
Of the 2417 children enrolled, 80% recovered, 4% defaulted, 0.4% died, 12% remained moderately wasted and 3% developed severe acute malnutrition. Weight, length and MUAC gain were 2.6 g/kg/d, 0.2 mm/d and 0.1 mm/d respectively. Cost per child treated was $5.39.


CONCLUSIONS
This intervention proved to be robust, maintaining high recovery rates and low default rates when instituted without the additional supervision and beneficiary incentives of a research setting.
Department of Pediatrics, Washington University, St Louis, USA.
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Lagrone
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Cole
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Schondelmeyer
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Maleta
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MJ
Manary
D000886:Anthropometry; D001827:Body Height; D001835:Body Weight; D002675:Child, Preschool; D057140:Fast Foods; D005260:Female; D005523:Food Supply; D006801:Humans; D007223:Infant; D008295:Malawi; D008297:Male; D044342:Malnutrition / Q000628:therapy*