title: Acceptability of Outpatient Ready-To-Use Food-Based Protocols in HIV-Infected Senegalese Children and Adolescents Within the MAGGSEN Cohort Study.
abstract: OBJECTIVE
  To assess the acceptability of ready-to-use food (RUF)-based outpatient protocols in HIV-infected children and adolescents with severe acute malnutrition (SAM) and moderate acute malnutrition (MAM).
  
  
  METHODS
  Plumpy Nut and Plumpy Sup were supplied every 2 weeks and prescribed by weight to SAM and MAM children, respectively. Forty-three children, 24 MAM and 19 SAM, were enrolled. Organoleptic appreciation, feeding modalities, and perceptions surrounding RUF were recorded at week 2. Sachets were counted to measure adherence throughout the study.
  
  
  RESULTS
  Median age was 12.2 years (interquartile range: 9.3-14.8), and 91% were on antiretroviral treatment. Overall, 80%, 76%, 68%, and 68% of children initially rated RUF color, taste, smell, and mouth feeling as good. However, feelings of disgust, refusal to eat, fragmentation of intake, self-stigma, and sharing within the household were commonly reported. Eighteen MAM and 7 SAM experienced weight recovery. Recovery duration was 54 days (31-90) in MAM versus 114 days (69-151) in SAM children ( P = .02). Their rate of RUF consumption compared to amount prescribed was approximately 50% from week 2 to week 10. Nine failed to gain weight or consume RUF and were discontinued for clinical management, and 9 dropped out due to distance to the clinic.
  
  
  CONCLUSIONS
  Initial RUF acceptability was satisfactory. More than half the children had successful weight recovery, although adherence to RUF prescription was suboptimal. However, further research is needed to propose therapeutic foods with improved palatability, alternative and simpler intervention design, and procedures for continuous and tailored psychosocial support in this vulnerable population.
  
  
  BACKGROUND
  NCT01771562 (Current Controlled Trials).
authors.affiliation: 1 Institut de Recherche pour le Développement (IRD), UMI233 IRD, U1175 INSERM, Universite de Montpellier, Montpellier, France.
authors.forename: Cecile
authors.initials: C
authors.lastname: Cames
authors.affiliation: 1 Institut de Recherche pour le Développement (IRD), UMI233 IRD, U1175 INSERM, Universite de Montpellier, Montpellier, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Varloteaux
authors.affiliation: 2 Centre Hospitalier National d'Enfants Albert Royer, Dakar, Senegal.
authors.forename: Ndeye Ngone
authors.initials: NN
authors.lastname: Have
authors.affiliation: 3 Unite pediatrique de soin et d'accompagnement, Synergie pour l'Enfance - Hôpital Roi Baudouin, Guediawaye, Senegal.
authors.forename: Alhadji Bassine
authors.initials: AB
authors.lastname: Diom
authors.affiliation: 1 Institut de Recherche pour le Développement (IRD), UMI233 IRD, U1175 INSERM, Universite de Montpellier, Montpellier, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Msellati
authors.affiliation: 3 Unite pediatrique de soin et d'accompagnement, Synergie pour l'Enfance - Hôpital Roi Baudouin, Guediawaye, Senegal.
authors.forename: Ngagne
authors.initials: N
authors.lastname: Mbaye
authors.affiliation: 2 Centre Hospitalier National d'Enfants Albert Royer, Dakar, Senegal.
authors.forename: Helene
authors.initials: H
authors.lastname: Mbodj
authors.affiliation: 2 Centre Hospitalier National d'Enfants Albert Royer, Dakar, Senegal.
authors.forename: Haby
authors.initials: H
authors.lastname: Sy Signate
authors.affiliation: 2 Centre Hospitalier National d'Enfants Albert Royer, Dakar, Senegal.
authors.forename: Aminata
authors.initials: A
authors.lastname: Diack
keywords: Africa; HIV; acceptability; acute malnutrition; adolescents; ready-to-use therapeutic food