Effect of a Low-Cost Food on the Recovery and Death Rate of Malnourished Children
Journal of Pediatric Gastroenterology and Nutrition - JPGN
Objectives: Nutritional rehabilitation in Africa relies mainly on imported skim milk enriched with a sugar and salt mixture. We evaluated whether milk plus porridge made from local ingredients improves the outcome of childhood nutritional rehabilitation versus milk alone. Patients and Methods: This study was conducted in a nutritional unit in Lacor (Northern Uganda). The porridge, made from cheap locally available ingredients (maize flour, dried fish or meat, peanut butter and oil) supplemented
... d oil) supplemented with proteins and fats, provides 1.1 energy units, 4.4 kJ/g. We randomly sampled the files of 100 cases discharged in October, November and December 2001 (preintervention), in 2002 (soon after intervention onset) and in 2003 (more than 1 year after intervention onset). We recorded the average hospital days and average oedema-free weight gain at discharge in the 3 groups. Results: Average oedema-free weight gain increased from 21 g/d (95% confidence interval [CI], 12Y29) in 2001 to 35 g/d (95% CI, 25Y45) in 2002 and reached 59 g/d (95% CI, 51Y65) in 2003. Mortality decreased from 22% to 7.8%, and nutritional failures (insufficient weight gain) decreased by greater than 50%. Conclusions: The low-cost porridge supplement (A2640/yr per 100 children) was effective in treating malnutrition. Widespread use of the porridge, which resulted in better outcomes than milk alone, could produce a savings in the medium-to long-term, thereby releasing resources for other uses. A high-energy porridge that is made from locally available ingredients and does not require imported foods seems to be appropriate for supplementary feeding after mother's milk in this setting. JPGN 43:512Y517, 2006.