Global Acute Malnutrition (GAM)
Conditions
Keywords
MUAC, Acute malnutrition, RUTF, Children, Burkina Faso
Brief summary
MUAC only is a pilot trial external control carried out between January 2017 and December 2017 in the Yako district (northern region), Burkina Faso. The objective of this study is to evaluate an integrated protocol for acute malnourished children without medical complication. The hypotheses of the integrated protocol include : 1. A global treatment of acute malnutrition (moderate and severe) with a single treatment (RUTF) would improve the functioning of the program through early identification of acutely malnourished children, while achieving a better coverage and using a single supply chain. 2. A gradual reduction of RUTF dosage according to a child's MUAC status could significantly increase the number of children on treatment without increasing overall RUTF quantity while maintaining similar recovery rates.
Detailed description
Objectives : Main objective : To ensure the recovery rate of the integrated protocol for treatment of acute malnutrition is significantly greater than 75% (reference value of the national program in BF). Secondary objectives : * To ensure the mortality rate of the integrated protocol for treatment of acute malnutrition is significantly lower than 3% (reference value of the national BF program). * To ensure the default rate of the integrated protocol for treatment of acute malnutrition is significantly lower than 15% (reference value of the national BF program). * To ensure the non-response rate of the integrated protocol for treatment of acute malnutrition is significantly lower than 8%. * To ensure the hospitalization rate of the integrated protocol for treatment of acute malnutrition is significantly lower than 15%. * To ensure the coverage rate of the program increases by 30% after the year the integrated protocol was introduced (specific protocol annexed). * To estimate the relapse rate of the integrated protocol for treatment of acute malnutrition. * To compare RUTF rations per child of the integrated protocol compared to the national protocol Methods : The study population will include all acutely malnourished children aged between 6 and 59 months seeking consultations at all of the health centers in Yako District between January 2017 and December 2017. The study will be implemented in Burkina Faso's Yako District, which includes 54 health centers.
Interventions
MUAC used as the primary admission and exit criteria for children with MUAC \<125mm and no medical complication. Single treatment of RUTF for severe and moderate malnourished children and gradual reduction of doses according to the MUAC and the weight of the child during treatment. MUAC split into 3 categories: * MUAC \<115 mm: 175 kcal /kg/day * 115 \<MUAC \<120mm: 125kcal/kg/day * 120 \<MUAC \<125mm: 75kcal/kg/day
Sponsors
Institut National de la Santé Et de la Recherche Médicale, France
Association Keoogo
Institut de Recherche en Sciences de la Sante, Burkina Faso
SOS médecins Burkina Faso
Alliance for International Medical Action
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
6 Months to 59 Months
Healthy volunteers
No
Inclusion criteria
* Being between 6 and 59 months old * New admission * Acute malnutrition defined as follows: * MUAC\<125mm * MUAC\> 125mm AND WHZ (Z-score) \<-3 (WHO standard) * Edema * Resident in the study area (Yako district) * Signed informed consent of the mother or the child's guardian
Exclusion criteria
* Children allergic to milk, peanuts and / or RUTF
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Recovery rate | Between 4 and 12 weeks | The recovery is defined as below : * Minimum of 4 weeks of participation in the program * MUAC\> = 125 mm on 2 consecutive visits * No edema for minimum 2 weeks * Good Clinical Health |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Default rate | Between 3 and 12 weeks | Patient absent for 3 consecutive visits |
| Non-respondent rate | 12 weeks after inclusion | Patient who not reach the recovery criteria after twelve weeks in the program |
| Mortality rate | Between inclusion and week 12 | — |
| Relapse rate | up to 3 months | Patient having reached the recovery criteria and returning for a new episode of malnutrition (MUAC\<125mm). The children's MUAC will be measured at home 3 months after program exit. For organizational and financial reasons, this data will not be collected for all children. A specific protocol explaining the sampling and organization of data collection will be annexed to the protocol. |
| RUTF rations | Between inclusion and week 12 | Total number of RUTF bags received per child during participation in the program. |
| Hospitalization rate | Between inclusion and week 12 | — |
Countries
Burkina Faso
Outcome results
None listed