title: Ready-to-use therapeutic food for catch-up growth in children after an episode of Plasmodium falciparum malaria: an open randomised controlled trial.
abstract: BACKGROUND
  Catch-up growth after an infection is essential for children to maintain good nutritional status. To prevent malnutrition, WHO recommends that children are given one additional healthy meal per day during the 2 weeks after onset of illness. We investigated to what extent ready-to-use therapeutic food (RUTF) promotes catch-up growth in children after an acute, uncomplicated episode of Plasmodium falciparum malaria.
  
  
  METHODS
  We did an open randomised trial of children aged 6-59 months with confirmed malaria who attended a Médecins Sans Frontières-supported outpatient clinic in Katanga Province, Democratic Republic of Congo. All children received a clinical examination and malaria treatment. Patients were then randomly assigned to either an RUTF group, who received daily supplemental RUTF (a high-protein peanut-based paste) for 14 days, or to a control group, who received no supplemental food. Children were weighed at baseline and on days 14 and 28. The primary outcome was mean weight change after 14 days' RUTF. Analysis was by intention-to-treat.
  
  
  RESULTS
  93 children received RUTF and 87 received no food supplementation. At day 14, the RUTF group had a mean weight gain of 353 g compared with 189 g in the control group (difference 164 [95%CI 52-277], p = 0.005). However, at day 28 there was no statistically significant difference between the groups (539 g versus 414 g, respectively [p = 0.053]). Similarly, rate of weight gain per kg bodyweight per day was significantly higher at day 14 in the RUTF group (2.4 g/kg per day versus 1.3 g/kg per day, p = 0.005) but at day 28 was 1.9 g/kg per day in the RUTF group versus 1.5 g/kg per day in the control group (p = 0.076).
  
  
  CONCLUSIONS
  Children receiving RUTF for 14 days after effective treatment of an uncomplicated malaria episode had a faster weight gain than children not given supplementation, reducing the period that children were at risk of malnutrition.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT00819858.
authors.affiliation: Médecins Sans Frontières, Amsterdam, The Netherlands. saskia.vd.kam@amsterdam.msf.org
authors.forename: Saskia
authors.initials: S
authors.lastname: van der Kam
authors.forename: Todd
authors.initials: T
authors.lastname: Swarthout
authors.forename: Oscar
authors.initials: O
authors.lastname: Niragira
authors.forename: Alyson
authors.initials: A
authors.lastname: Froud
authors.forename: Eric Mukomena
authors.initials: EM
authors.lastname: Sompwe
authors.forename: Clair
authors.initials: C
authors.lastname: Mills
authors.forename: Stephanie
authors.initials: S
authors.lastname: Roll
authors.forename: Peter
authors.initials: P
authors.lastname: Tinnemann
authors.forename: Leslie
authors.initials: L
authors.lastname: Shanks
mesh_terms: D010367:Arachis; D015362:Child Nutrition Disorders / Q000178:diet therapy* / Q000209:etiology / Q000517:prevention & control*; D002675:Child, Preschool; D015023:Democratic Republic of the Congo; D057140:Fast Foods; D048788:Growth and Development / Q000187:drug effects*; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000150:complications*; D015430:Weight Gain / Q000187:drug effects