Introduction/Background: Severe acute malnutrition (SAM) in children is a significant public health problem in India with associated increased morbidity and mortality. The current WHO recommendations on management of SAM are based on facility based treatment. Given the large number of children with SAM in India and the involved costs to the care-provider as well as the care-seeker, incorporation of alternative strategies like home based management of uncomplicated SAM is important.
Aim & Objectives: To evaluate the effectiveness of a locally made ready-to-use therapeutic food (RUTF) Mushpro Health Drink Powder in decreasing malnutrition in Tribal area.
Methods/Study Design: Open-labeled Randomized Controlled trial
Eligibility criteria for participants: Children aged 6—72 months but not requiring hospitalization for severe malnutrition (SAM) and Moderate acute malnutrition (MAM) were considered eligible for study. Children less than 6 months were excluded as several of them were receiving breast milk. Also children having other diseases incriminated as a cause of severe malnutrition, including cerebral palsy, chromosomal malformation, known metabolic diseases, malignancies, congenital heart disorders, hemolytic anaemia, known malabsorption syndrome, or hepatic disorder were excluded.
Study Setting: Anganwadi centers’ run by ICDS program in tribal areas of Amravati District of Maharashtra. Interventions: Children with Severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) in 26 Intervention Anganwadi centre received RUTF (MHDP) 3 gm/kg/per day (SAM) & 2 gm/kg/day MAM two times a day from October to December 2011. Children in the 27 Noninterventional Anganwadi centers’ did not receive Mushpro supplementation. For both the groups the supplementations as per ICDS protocol were given & both arms included continuation of family diets. Main outcome measures: Mean Weight gain and Mean Height gain.
Results / Findings: The Mean weight gain at 2 months was higher in the Intervention group (n=121): 1.7 gm/kg/day as compared to control group (n=123): 0.19 gm/kg/day kg (p < 0.000). The weight gain per kg body weight was directly proportional to severity of the malnutrition. Mean weight gain in gram per gay in experimental group and Mean Height gain in cms/ month in experimental group was more than National and International Standard. Mean weight gain in SAM was 755gm and in MAM was 656 gm amongst Experimental group while in control group in SAM 106 gm & MAM 79.6 gm.
Discussion/Conclusion: Community based treatment by locally made nutritious food MHDP showed significant weight gain and height gain in Experimental group than control group and proved to be more effective in management of SAM and MAM.
Vinod R. Wasnik , Manoj Rathi