Efficacy and safety of therapeutic nutrition products for home based therapeutic nutrition for severe acute malnutrition

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The use of therapeutic nutrition products like ready to use therapeutic foods (RUTF) for home based management of uncomplicated severe acute malnutrition (SAM) appears to be safe and efficacious. There is need to generate more robust evidence, design similar products locally and establish their efficacy and cost-effectiveness in a ‘non-emergency’ setting, particularly in the Indian context.

In India, SAM affecting children can pose a serious public health problem and has been associated with increased morbidity and mortality. Current WHO recommendations for the treatment of SAM are founded in facility based treatments. This review aimed to assess the efficacy and safety of home based management of SAM using RUTF, as well as efficacy in comparison with F-100 and home-based diet. Eighteen trials were included for review, graded according to CEBM guidelines. Results showed RUTF to be at least as efficacious as F-100 in increasing weight and more effective than home based dietary therapies. Home based RUTFs were shown to be as effective as imported RUFTs. Energy intake for RUTFs and F-100 were comparable. Recovery rates from SAM were high for RUTFs, with mortality rates observed to be below 1%. The use of home based RUTFs to treat uncomplicated SAM was supported by the evidence evaluated.

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