title: Evaluation of the acceptability of improved supplementary foods for the treatment of moderate acute malnutrition in Burkina Faso using a mixed method approach.
abstract: The objective of this study was to evaluate, within the context of a randomized controlled trial of product effectiveness, the acceptability of new formulations of six corn-soy blended flours (CSB) and six lipid-based nutrient supplements (LNS) with different quantities of milk and qualities of soy for the treatment of children with moderate acute malnutrition (MAM). Our study included 1546 children aged 6-23 months and involved questionnaires after one month of supplementation home visits and interviews with a sub-sample of 20 trial participants and their caretakers, and nine focus group discussion. All 12 products were well accepted in terms of organoleptic qualities and received good ratings. However, LNS were more appreciated by caretakers and children. Additionally, an effect of soy isolate was detected on child appreciation where products with high milk content also received better ratings. CSB were not consumed as readily; 33.9% (n = 257) of children receiving CSB were reported to have leftovers compared to 17.3% (n = 134) of children receiving LNS (p=<0.001). Both CSB and LNS were referred to as foods with medicinal properties and perceived as beneficial to child health. They were both reported to have high priority in the daily feeding of the child. In conclusion, there were minimal differences in acceptability of the various CSB and LNS formulations, although CSB were less readily consumed and required smaller meal volumes. Since all products were well-accepted, decisions regarding whether the more expensive products should be used for the treatment of MAM will need to be based on their effect on child nutrition, growth and health. Future supplementary feeding programs in similar contexts could furthermore consider introducing supplementary foods as a medical treatment, as this may increase adherence and decrease sharing.
authors.affiliation: Médecins Sans Frontières - Denmark, Dronningensgade 68, 3, 1420, Copenhagen, Denmark; Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, DK-1958, Frederiksberg C, Denmark. Electronic address: asbr@nexs.ku.dk.
authors.forename: Ann-Sophie
authors.initials: AS
authors.lastname: Iuel-Brockdorf
authors.affiliation: Department of International Health, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, 2200, Copenhagen, Denmark. Electronic address: taniadraebel@gmail.com.
authors.forename: Tania Aase
authors.initials: TA
authors.lastname: Draebel
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, DK-1958, Frederiksberg C, Denmark. Electronic address: ritz@nexs.ku.dk.
authors.forename: Christian
authors.initials: C
authors.lastname: Ritz
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, DK-1958, Frederiksberg C, Denmark. Electronic address: chfr@nexs.ku.dk.
authors.forename: Christian
authors.initials: C
authors.lastname: Fabiansen
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, DK-1958, Frederiksberg C, Denmark. Electronic address: Bernardette.Cichon@london.msf.org.
authors.forename: Bernardette
authors.initials: B
authors.lastname: Cichon
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, DK-1958, Frederiksberg C, Denmark; Department of Paediatrics, Righospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. Electronic address: vb@msf.dk.
authors.forename: Vibeke
authors.initials: V
authors.lastname: Brix Christensen
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, DK-1958, Frederiksberg C, Denmark; Centre de Recherche en Sciences Biologiques, Alimentaires et Nutritionalles, Université de Ouagadougou, 03 BP 7131, Ouagadougou, Burkina Faso. Electronic address: yamway@yahoo.fr.
authors.forename: Charles
authors.initials: C
authors.lastname: Yameogo
authors.affiliation: ALIMA - The Alliance for International Medical Action, Route de l'Aéroport, Rue NG 96 BP: 12000 Résidence, Dakar, Senegal. Electronic address: ro@alima-ngo.org.
authors.forename: Rouafi
authors.initials: R
authors.lastname: Oummani
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, DK-1958, Frederiksberg C, Denmark. Electronic address: andre.briend@gmail.com.
authors.forename: André
authors.initials: A
authors.lastname: Briend
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, DK-1958, Frederiksberg C, Denmark. Electronic address: kfm@life.ku.dk.
authors.forename: Kim F
authors.initials: KF
authors.lastname: Michaelsen
authors.affiliation: University of Tampere School of Medicine, Lääkärinkatu 1, 33014, University of Tampere, Finland. Electronic address: per.ashorn@uta.fi.
authors.forename: Per
authors.initials: P
authors.lastname: Ashorn
authors.affiliation: London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, Keppel Street, London, WC1E 7HT, UK. Electronic address: Suzanne.Filteau@lshtm.ac.uk.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Filteau
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, DK-1958, Frederiksberg C, Denmark. Electronic address: hfr@nexs.ku.dk.
authors.forename: Henrik
authors.initials: H
authors.lastname: Friis
mesh_terms: D000818:Animals; D002050:Burkina Faso; D003258:Consumer Behavior; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D019587:Dietary Supplements; D005260:Female; D017144:Focus Groups; D005518:Food Preferences; D005527:Food, Fortified; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D062407:Meals; D018977:Micronutrients / Q000008:administration & dosage; D008892:Milk; D000067011:Severe Acute Malnutrition / Q000178:diet therapy*; D013025:Glycine max; D011795:Surveys and Questionnaires; D013649:Taste; D016896:Treatment Outcome; D003313:Zea mays
chemical_list: D004041:Dietary Fats; D004044:Dietary Proteins; D018977:Micronutrients
keywords: Acceptability; Corn soy blend; Lipid-based nutrient supplement; Moderate acute malnutrition; Supplementary food