Proceedings of Secondes Journées Pédiatriques Médecins Sans Frontières (MSF) (Dakar, 2018)

Oral presentation

Effectiveness of a simplified, integrated protocol for treating acute malnutrition (MUAC-only): preliminary results from a non-inferiority trial in Yako, Burkina Faso

Cite this: Pan African Medical Journal - Conference Proceedings. Sep 2018; 9(9): 41. doi:10.11604/pamj.cp.2018.9.41.768

Submitted: 05 Jul 18   Accepted: 16 Jul 18   Published: 21 Sep 18

Key words: Acute malnutrition, MUAC, RUTF

© Kevin Phelan et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.proceedings.panafrican-med-journal.com/conferences/2018/9/41/abstract

Corresponding author: Kevin Phelan, Alliance for International Medical Action (ALIMA), Dakar, Senegal (kevin.phelan@alima.ngo)

This abstract is published as part of the proceedings of Secondes Journées Pédiatriques Médecins Sans Frontières (MSF)(SENEGAL, )

Effectiveness of a simplified, integrated protocol for treating acute malnutrition (MUAC-only): preliminary results from a non-inferiority trial in Yako, Burkina Faso

Kevin Phelan1,&, Maguy Daures2, Mariama Issoufou2, Seni Kouanda3, Bertine Ouango4, Susan Shepherd2, Renaud Becquet1

 

1Alliance for International Medical Action (ALIMA), Dakar, Senegal, 2National Institute of Health and Medical Research (INSERM), France, 3Research Institute of Health Sciences, Burkina Faso, 4Ministry of Health, Burkina Faso

 

 

&Corresponding author
Kevin Phelan, Alliance for International Medical Action (ALIMA), Dakar, Senegal

 

 

Abstract

Introduction: even though acute malnutrition is a continuum condition, severe and moderate acute malnutrition (SAM and MAM) are managed separately, with programs overseen by different UN agencies, using different protocols and products, and sometimes operating in different physical locations. Such separate systems can lead to stock challenges, contribute to high default, low coverage rates and confusion among caregivers. Often treatment is only available for SAM children at higher cost. This study aimed at evaluating whether a simplified, integrated protocol can improve program coverage and maintain quality outcomes while being more cost-effective.

 

Methods: this non-inferiority trial with external control (SPHERE standards) is being carried out from January 1 to December 31, 2017 at 54 health centers in Burkina Fasos Yako district. The study protocol has three major elements: training families to screen for malnutrition in the home by mid-upper arm circumference (MUAC) and edema, admitting children by an expanded MUAC criteria of <125mm (and edema) and using one product (ready to use therapeutic food, RUTF) with dosage gradually reduced based on MUAC status.

 

Results: from January to July 2017, 3,326 children were admitted with median MUAC at admission of 120mm. Of the 2,863 children discharged, 2,702 (94%) recovered, 119 (4%) defaulted, 27 (1%) were non-responders, and 15 (< 1%) died. Average length of stay was 38 days and average RUTF consumption was 80 sachets per child treated. In February, single coverage estimation for SAM and MAM was 58.3% [CI 95%: 51.3, 65.4], and a second survey planned for November.

 

Conclusion: preliminary analysis shows that a simplified, integrated protocol results in performance indicators exceeding sphere standards. The reduction of RUTF dosage based on MUAC allows for a significant increase in children treated without an increase in overall RUTF needs.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Dakar)

Country:

Dates: 15 Dec 17 - 16 Dec 17

Venue: Hotel Ngor Diarama

Organizers:

Secretariat: paediatricdays@msf.org

Contact person: Dr. Laurent Hiffler (paediatricdays@msf.org)