Non-milk based Local Therapeutic Feed Plus Home-based Diet as Compared to Home-based Diet Alone for Nutritional Rehabilitation of Severe Acute Malnutrition Following Discharge: A Randomised Clinical Trial SC05-SC08
Dr. Halak Hasmukhbhai Chauhan,
B5, Shaligram Raghuvanshi Society, Chital Road, Amreli, Gujarat, India.
Introduction: Recovery of Patients of Severe Acute Malnutrition (SAM) after discharge from Nutrition Rehabilitation Centre (NRC) is unsatisfactory on Home-based diet. Authors, therefore, compared recovery of children with SAM on discharge between patients given home-based diet with those given Local Therapeutic Feed (LTF) in addition to home-based diet.
Aim: To compare weight gain between SAM children on discharge from NRC taking non-milk based LTF with home-based diet with those taking only home-based diet.
Materials and Methods: Eighty Children of SAM were divided into two groups on discharge from NRC. One group was given non-milk based LTF in addition to home-based diet. Another group was given only home-based diet. Both groups were followed up for six weeks. Children with allergy to peanut protein, those likely to leave the study before six weeks and those having underlying heart disease or CNS malformation were excluded. Weight gain of the patient, height gain, Mid Upper Arm Circumference (MUAC) and Weight for Height were recorded. Data were analysed by applying unpaired t-test using MEDCAL C software (version 12.5.0).
Results: Thirty-nine children in intervention (non-milk based LTF) group and 38 in the control group completed the follow-up. Rate of weight gain in intervention group was 5.48 g/kg/day (SD=0.55) while in the control group was 2.47 g/kg/day (SD=0.36). The difference was statistically highly significant (p<0.001). Gain of height during six weeks was 1.59 cm and 1.08 cm in intervention and control group respectively. (p<0.001) No patient in intervention group has MUAC of <11.5 cm. compared to 28.9% (n=11) in control group. An 89.4% patients had weight for height of > -2 SD compared to 44.73% of patients in control group at the end of study. An 87.5% (n=35) patients were labeled as cured after three follow-ups in intervention group compared to 43.5% (n=17) in the control group.
Conclusion: Introduction of non-milk based LTF significantly improves post discharge weight gain and hastens recovery in patients of SAM.