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Ready-to-use therapeutic food for catch-up growth in children after an episode of Plasmodium falciparum malaria: an open randomised controlled trial.

par Van Der Kam, Saskia ;Swarthout, Todd;Nigariga, Oscar;Froud, Alyson;Sompwe, Eric Mukowena;Mills, C.F.;Roll, Stephanie;Tinnemann, Peter;Shanks, Leslie
Référence PloS one, 7, 4, page (1-8), doi:10.1371/journal.pone.0035006
Publication Publié, 2012-04-25

Article révisé par les pairs

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Résumé :

Background: Catch-up growth after an infection is essential for children to maintain good nutritional status. To preventmalnutrition, WHO recommends that children are given one additional healthy meal per day during the 2 weeks after onsetof illness. We investigated to what extent ready-to-use therapeutic food (RUTF) promotes catch-up growth in children afteran acute, uncomplicated episode of Plasmodium falciparum malaria.Methods: We did an open randomised trial of children aged 6–59 months with confirmed malaria who attended a Me´decinsSans Frontie`res-supported outpatient clinic in Katanga Province, Democratic Republic of Congo. All children received aclinical examination and malaria treatment. Patients were then randomly assigned to either an RUTF group, who receiveddaily supplemental RUTF (a high-protein peanut-based paste) for 14 days, or to a control group, who received nosupplemental food. Children were weighed at baseline and on days 14 and 28. The primary outcome was mean weightchange after 14 days’ RUTF. Analysis was by intention-to-treat.Results: 93 children received RUTF and 87 received no food supplementation. At day 14, the RUTF group had a meanweight gain of 353 g compared with 189 g in the control group (difference 164 [95%CI 52–277], p = 0.005). However, atday 28 there was no statistically significant difference between the groups (539 g versus 414 g, respectively [p = 0.053]).Similarly, rate of weight gain per kg bodyweight per day was significantly higher at day 14 in the RUTF group (2.4 g/kg perday versus 1.3 g/kg per day, p = 0.005) but at day 28 was 1.9 g/kg per day in the RUTF group versus 1.5 g/kg per day in thecontrol group (p = 0.076).Conclusions: Children receiving RUTF for 14 days after effective treatment of an uncomplicated malaria episode had a fasterweight gain than children not given supplementation, reducing the period that children were at risk of malnutrition.