Abstract

Dr. Shantisena Mishra, Dr. Pratibha Rai, Prof. Arakhita Swain and Dr. Saiprasanna Behera*

ABSTRACT

Background: Severe acute malnutrition (SAM) remains as one of the major killers of children under five years of age. As per WHO’s guidelines for the inpatient management of SAM, after initial stabilization phase, dietary management plays a big role in the longer rehabilitation phase of management of SAM. Milk used for making F-100 diets used for the same has disadvantages like short shelf-life, liable to get adulterated and can act as a medium for pathogenic bacteria. RUTFs are now being used as a substitute to F-100 diet in the management of SAM around the globe. Aims and Objectives: To compare the efficacy of locally prepared ready-to-use therapeutic food (LRUTF) and F-100 diet in promoting weight-gain in children with severe acute malnutrition during rehabilitation phase in hospital. To assess the effectiveness of LRUTF diet in the recovery of children with severe acute malnutrition. To compare the duration of hospital stay among children receiving LRUTF diet with that of F-100 diet. Materials and Methods: It was a hospital based randomized controlled trial conducted over a period of 2 years (Oct 2015 to Sept. 2017) at paediatrics ward of SCB Medical College, Cuttack, India. A total of 120 children were included in the study. Children aged 6 to 60 months, diagnosed as severe acute malnutrition as per WHO criteria and hospitalized during study period and in rehabilitation phase. Random group allocation was followed for selection of study (LRUTF) and control (F-100) cohorts. The control cohort enrolled received F-100 while the study cohort received LRUTF diet. Both the groups received 6 feeds per day which included 3 feeds of either LRUTF or F100 as per the allocation and 3 feeds from family pot amounting to an intake of approximately 150kcal/kg/day and 1.5-2gm/kg of protein to both groups. Children were examined daily for clinical status and anthropometry. Children were discharged once they gain at least 15% of admission weight and were followed up every 15 days till they reach weight of 1 S.D. below mean for height. Results: There were 60 subjects in each group. Both groups were comparable in terms of initial Social, demographic and anthropometric profiles at the time of admission. Rate of weight gain was found to be (9.15 ± 3.39 gm/kg/day) in LRUTF group and (6.72 ± 1.05 gm/kg/day) in F-100 group. Significant difference in rate of weight gain was observed in LRUTF group (P