title: Peanut-based ready-to-use therapeutic food: acceptability among malnourished children and community workers in Bangladesh.
abstract: OBJECTIVE
  To assess the acceptability of a ready-to-use therapeutic food (Plumpy'nut(®) [PPN]) among 1) care givers of malnourished children and 2) community health workers (CHWs) at a nutrition rehabilitation centre in an urban slum in Dhaka, Bangladesh.
  
  
  METHODS
  This was a cross-sectional semi-structured questionnaire survey conducted between April and June 2011 as part of a nutritional programme run by Médecins Sans Frontières. The study population included care givers of malnourished children aged 6-59 months who received PPN for at least 3 weeks, and CHWs.
  
  
  RESULTS
  Of the 149 care givers (93% female) interviewed, 60% expressed problems with PPN acceptability. Overall, 43% perceived the child's dissatisfaction with the taste, 31% with consistency and 64% attributed side effects to PPN (nausea, vomiting, loose motion, diarrhoea, abdominal distension and pain). It is to be noted that 47% of children needed encouragement or were forced to eat PPN, while 5% completely rejected it after 3 weeks. Of the 29 CHWs interviewed, 48% were dissatisfied with PPN's taste and consistency, and 55% with its smell. However, 91% of the care givers and all CHWs still perceived a therapeutic benefit of PPN for malnourished children.
  
  
  CONCLUSIONS
  Despite a therapeutic benefit, only 4 in 10 care givers perceived PPN as being acceptable as a food product, which is of concern.
authors.affiliation: Medical Department (Operational Research), Médecins Sans Frontières (MSF), Luxembourg, Luxembourg.
authors.forename: E
authors.initials: E
authors.lastname: Ali
authors.affiliation: Medical Department (Operational Research), Médecins Sans Frontières (MSF), Luxembourg, Luxembourg.
authors.forename: R
authors.initials: R
authors.lastname: Zachariah
authors.affiliation: Medical Department (Operational Research), Médecins Sans Frontières (MSF), Luxembourg, Luxembourg.
authors.forename: A
authors.initials: A
authors.lastname: Dahmane
authors.affiliation: Medical Department (Operational Research), Médecins Sans Frontières (MSF), Luxembourg, Luxembourg.
authors.forename: W
authors.initials: W
authors.lastname: Van den Boogaard
authors.affiliation: MSF, Dhaka, Bangladesh.
authors.forename: Z
authors.initials: Z
authors.lastname: Shams
authors.affiliation: MSF, Dhaka, Bangladesh.
authors.forename: T
authors.initials: T
authors.lastname: Akter
authors.affiliation: Brussels Operational Centre, MSF, Brussels, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Alders
authors.affiliation: Medical Department (Operational Research), Médecins Sans Frontières (MSF), Luxembourg, Luxembourg.
authors.forename: M
authors.initials: M
authors.lastname: Manzi
authors.affiliation: Brussels Operational Centre, MSF, Brussels, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Allaouna
authors.affiliation: Brussels Operational Centre, MSF, Brussels, Belgium.
authors.forename: B
authors.initials: B
authors.lastname: Draguez
authors.affiliation: Brussels Operational Centre, MSF, Brussels, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Delchevalerie
authors.affiliation: International Union Against Tuberculosis and Lung Disease, Paris, France ; London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: A D
authors.initials: AD
authors.lastname: Harries
keywords: Bangladesh; Plumpy’nut; acceptability; malnutrition; ready-to-use therapeutic food