title: Preventive Effects of Long-Term Supplementation with 2 Nutritious Food Supplements in Young Children in Niger.
abstract: BACKGROUND
  In nutritional crises, large-scale preventive distributions of specialized nutritious foods are recommended to prevent acute and chronic malnutrition in young children. Among the available specialized nutritious foods, the World Food Programme and UNICEF recommend lipid-based nutrient supplements (LNSs) and Super Cereal Plus (SC+). Although the effectiveness of short-term distributions for prevention of severe acute malnutrition (SAM) is well documented, evidence for long-term strategies and the role of distribution of specialized nutritious foods for prevention of stunting is weaker.
  
  
  OBJECTIVE
  The objective of this study was to compare long-term supplementation of LNSs and SC+ on the incidence of acute malnutrition and stunting in young children.
  
  
  METHODS
  We conducted two 15-mo-long supplementation interventions with the use of LNSs (500 kcal/d) and SC+ (810 kcal/d) and half rations during 5 mo of the nonlean season, for the prevention of acute malnutrition and stunting in children aged 6-23 mo. The study was designed as a prospective cohort in 11 villages in Madarounfa, Niger. We compared the incidence of acute malnutrition and stunting with the use of Cox proportional hazards models and report on sharing and use of these food supplements.
  
  
  RESULTS
  Characteristics of children at baseline were similar across groups. A total of 1967 children were included in the analysis (845 in the SC+ group and 1122 in the LNS group). No significant differences in the incidence of moderate acute malnutrition (SC+ compared with LNS: adjusted HR: 0.79; 95% CI: 0.61, 1.02) or SAM (HR: 0.84; 95% CI: 0.52, 1.34) were found. No difference in the incidence of stunting (HR: 1.08; 95% CI: 0.95, 1.24) or severe stunting (HR: 0.94; 95% CI: 0.71, 1.22) over the follow-up period were found.
  
  
  CONCLUSIONS
  These findings in young children in Niger suggest that both products should be considered when planning preventive distributions and choice of long-term supplementation should be guided by context-specific factors such as acceptability, cost, and operational feasibility, among others. Additional research is essential to improving child health. The study was registered at clinicaltrials.gov as NCT01828814.
authors.affiliation: Epicentre, Paris, France; jessica.sayyad@epicentre.msf.org.
authors.forename: Jessica
authors.initials: J
authors.lastname: Sayyad-Neerkorn
authors.affiliation: Epicentre, Paris, France;
authors.forename: Céline
authors.initials: C
authors.lastname: Langendorf
authors.affiliation: Epicentre, Paris, France;
authors.forename: Thomas
authors.initials: T
authors.lastname: Roederer
authors.affiliation: Doctors without Borders (MSF), Paris, France;
authors.forename: Stéphane
authors.initials: S
authors.lastname: Doyon
authors.affiliation: Epicentre, Niamey, Niger;
authors.forename: Abdoul-Aziz
authors.initials: AA
authors.lastname: Mamaty
authors.affiliation: Epicentre, Niamey, Niger;
authors.forename: Lynda
authors.initials: L
authors.lastname: Woi-Messe
authors.affiliation: Regional Department of the Ministry of Public Health, Maradi, Niger;
authors.forename: Mahamane L
authors.initials: ML
authors.lastname: Manzo
authors.affiliation: Niger Health Forum (FORSANI), Niamey, Niger;
authors.forename: Souley
authors.initials: S
authors.lastname: Harouna
authors.affiliation: Nutrition Division, World Food Programme, Rome, Italy; and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA.
authors.forename: Saskia
authors.initials: S
authors.lastname: de Pee
authors.affiliation: Epicentre, Paris, France;
authors.forename: Rebecca F
authors.initials: RF
authors.lastname: Grais
mesh_terms: D004041:Dietary Fats / Q000008:administration & dosage; D002523:Edible Grain; D005260:Female; D005500:Follow-Up Studies; D006130:Growth Disorders / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D044342:Malnutrition / Q000517:prevention & control*; D009548:Niger / Q000453:epidemiology; D009752:Nutritional Status; D015995:Prevalence; D011446:Prospective Studies; D019282:Wasting Syndrome / Q000517:prevention & control*
chemical_list: D004041:Dietary Fats
keywords: Niger; Super Cereal Plus; acute malnutrition; child malnutrition; lipid-based nutrient supplements; prevention; stunting