Evidence map›Paper›PMID 28588982›Full record

ArticleBMJ global health2016

Efficacy of three feeding regimens for home-based management of children with uncomplicated severe acute malnutrition: a randomised trial in India.

Nita Bhandari, Sanjana Brahmawar Mohan, Anuradha Bose, Sharad D Iyengar, Sunita Taneja, Sarmila Mazumder, Ruby Angeline Pricilla, Kirti Iyengar, Harshpal Singh Sachdev, Venkata Raghava Mohan and 4 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ global health, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01705769 (To Evaluate the Impact of Three Feeding Regimens on the Recovery of Children From Uncomplicated Severe Acute Malnutrition), which is not on this map. Cited by 34 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 5 pooled it
5.0field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01705769 nacompletednot on this map

To Evaluate the Impact of Three Feeding Regimens on the Recovery of Children From Uncomplicated Severe Acute Malnutrition (SAM) in India and to Use the Evidence to Inform National Policy

TypeinterventionalSponsorSociety for Applied StudiesRan2012 to 2015Enrolled911ConditionsUncomplicated Severe Acute MalnutritionArmsReady to Use Therapeutic Food-Centrally produced, Ready to Use Therapeutic Food-Locally produced, High energy and micronutrient rich foods
3 · Its place in the literature

Who cites it

34 citing papers in PubMed, 5 syntheses or guidelines pooled it, 70 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 6 institutions in 3 countries.

Nita BhandariCentre for Health Research and Development, Society for Applied Studies, New Delhi, India.ORCID 0000-0003-0349-087X
Sanjana Brahmawar MohanCentre for Health Research and Development, Society for Applied Studies, New Delhi, India.
Anuradha BoseChristian Medical College, Vellore, Tamil Nadu, India.
Sharad D IyengarAction Research and Training for Health, Udaipur, Rajasthan, India.
Sunita TanejaCentre for Health Research and Development, Society for Applied Studies, New Delhi, India.
Sarmila MazumderCentre for Health Research and Development, Society for Applied Studies, New Delhi, India.
Ruby Angeline PricillaChristian Medical College, Vellore, Tamil Nadu, India.
Kirti IyengarAction Research and Training for Health, Udaipur, Rajasthan, India.
Harshpal Singh SachdevSitaram Bhartia Institute of Science and Research, New Delhi, India.
Venkata Raghava MohanChristian Medical College, Vellore, Tamil Nadu, India.
Virendra SuhalkaAction Research and Training for Health, Udaipur, Rajasthan, India.
Sachiyo YoshidaDepartment of Maternal, Newborn, Child and Adolescent Health, World Health Organisation, Geneva, Switzerland.
Jose MartinesCentre for Intervention Science in Maternal and Child Health, Centre for International Health, University of Bergen, Bergen, Norway.
Rajiv BahlDepartment of Maternal, Newborn, Child and Adolescent Health, World Health Organisation, Geneva, Switzerland.
Society for Applied Studies · INChristian Medical College, Vellore · INIndia Health Action Trust · INWorld Health Organization · CHSitaram Bhartia Institute of Science and Research · INUniversity of Bergen · NO

Funding

World Health Organization 001
6 · The paper itself

Abstract

objectiveTo assess the efficacy of ready-to-use therapeutic food (RUTF), centrally produced RUTF (RUTF-C) or locally prepared RUTF (RUTF-L) for home-based management of uncomplicated severe acute malnutrition (SAM) compared with micronutrient-enriched (augmented) energy-dense home-prepared foods (A-HPF, the comparison group).

methodsIn an individually randomised multicentre trial, we enrolled 906 children aged 6-59 months with uncomplicated SAM. The children enrolled were randomised to receive RUTF-C, RUTF-L or A-HPF. We provided foods, counselling and feeding support until recovery or 16 weeks, whichever was earlier and measured outcomes weekly (treatment phase). We subsequently facilitated access to government nutrition services and measured outcomes once 16 weeks later (sustenance phase). The primary outcome was recovery during treatment phase (weight-for-height ≥-2 SD and absence of oedema of feet).

resultsRecovery rates with RUTF-L, RUTF-C and A-HPF were 56.9%, 47.5% and 42.8%, respectively. The adjusted OR was 1.71 (95% CI 1.20 to 2.43; p=0.003) for RUTF-L and 1.28 (95% CI 0.90 to 1.82; p=0.164) for RUTF-C compared with A-HPF. Weight gain in the RUTF-L group was higher than in the A-HPF group (adjusted difference 0.90 g/kg/day, 95% CI 0.30 to 1.50; p=0.003). Time to recovery was shorter in both RUTF groups. Morbidity was high and similar across groups. At the end of the study, the proportion of children with weight-for-height Z-score (WHZ) >-2 was similar (adjusted OR 1.12, 95% CI 0.74 to 1.95; p=0.464), higher for moderate malnutrition (WHZ<-2 and ≥-3; adjusted OR 1.46, 95% CI 1.02 to 2.08; p=0.039), and lower for those with SAM (adjusted OR 0.58, 95% CI 0.40 to 0.85; p=0.005) in the RUTF-L when compared with the A-HPF group.

conclusionsThis first randomised trial comparing options for home management of uncomplicated SAM confirms that RUTF-L is more efficacious than A-HPF at home. Recovery rates were lower than in African studies, despite longer treatment and greater support for feeding. TRIAL REGISTRATION NUMBER: NCT01705769; Pre-results.

Identifiers

PMID28588982
PMCPMC5321385
OpenAlexW2563599175

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.