Evidence map›Paper›PMID 29580238›Full record

Trial reportBMC health services research2018

The effectiveness of treatment for Severe Acute Malnutrition (SAM) delivered by community health workers compared to a traditional facility based model.

J L Alvarez Morán, G B Franck Alé, P Charle, N Sessions, S Doumbia, S Guerrero

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06287827 (Evaluation of the Treatment of Moderate and Severe Acute Malnutrition in Outpatient Care Services in Venezuela), which is not on this map. Cited by 35 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 3 pooled it
–field-weighted citation impact
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.

NCT06287827 completednot on this mapstarted 2024, after this paper: background citation

Evaluation of the Treatment of Moderate and Severe Acute Malnutrition in Outpatient Care Services in Venezuela: a Multicentric and Prospective Cohort Research

TypeobservationalSponsorUNICEF - VenezuelaRan2024 to 2024Enrolled299ConditionsAcute Malnutrition in Childhood, Wasting, Child MalnutritionArmsSimplified protocol, Standard protocol
3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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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

6 authors.

J L Alvarez MoránAction Against Hunger UK, First Floor, Rear Premises, 161-163 Greenwich High Road, London, SE10 8JA, UK. j.alvarez@actionagainsthunger.org.uk.
G B Franck AléArea of Preventive Medicine and Public Health, Rey Juan Carlos University, Avda. Atenas s/n, 28922, Alcorcón, Madrid, Spain.
P CharleFundación Acción Contra el Hambre | ACF-Spain, C/ del Duque de Sevilla 3, 28002, Madrid, Spain.
N SessionsAction Against Hunger UK, First Floor, Rear Premises, 161-163 Greenwich High Road, London, SE10 8JA, UK.
S DoumbiaFaculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technology of Bamako, BP 1805, Bamako, Mali.
S GuerreroAction Against Hunger USA, One Whitehall St, New York, NY, 10004, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn most health systems, Community Health Workers (CHWs) identify and screen for severe acute malnutrition (SAM) in the community. This study aimed to investigate the potential of integrating SAM identification and treatment delivered by CHWs, in order to improve the coverage of SAM treatment services.

methodsThis multicentre, randomised intervention study was conducted in Kita, Southwest Mali between February 2015 and February 2016. Treatment for uncomplicated SAM was provided in health facilities in the control area, and by Community Health Workers and health facilities in the intervention area. Clinical outcomes (cure, death and defaulter ratios), treatment coverage and quality of care were examined in both the control and intervention group.

resultsSix hundred ninety nine children were admitted to the intervention group and 235 children to the control group. The intervention group reported cure ratios of 94.2% compared to 88.6% in the control group (risk ratio 1.07 [95% CI 1.01; 1.13]). Defaulter ratios were twice as high in the control group compared to the intervention group (10.8% vs 4.5%; RR 0.42 [95% CI 0.25; 0.71]). Differences in mortality ratios were not statistically significant (0.9% in the intervention group compared to 0.8% in the control group). Coverage rates in December 2015 were 86.7% in intervention group compared to 41.6% in the control (p < 0.0001).

conclusionsWith minimal training, CHWs are able to appropriately treat SAM in the community. Allowing CHWs to treat SAM reduces defaulter ratios without compromising treatment outcomes and can lead to improved access to treatment.

trial registrationRetrospectively registered in ISRCTN Register with ISRCTN33578874 on March 7th 2018.

Indexed as

Community Health WorkersHealth FacilitiesModels, OrganizationalChild, PreschoolFemaleHealth Services ResearchHumansInfantMaleMaliSevere Acute MalnutritionTreatment OutcomeChild nutritionCommunity-based Management of Acute Malnutrition (CMAM)Community health workersCoverageSevere acute malnutrition (SAM)

Identifiers

PMID29580238
PMCPMC5870488

What OpenQuestion holds

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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.