Evidence map›Paper›PMID 31139441›Full record

ArticleBMJ global health2019

Cost-effectiveness of community-based screening and treatment of moderate acute malnutrition in Mali.

Sheila Isanaka, Dale A Barnhart, Christine M McDonald, Robert S Ackatia-Armah, Roland Kupka, Seydou Doumbia, Kenneth H Brown, Nicolas A Menzies

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ global health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01015950 (Randomized, Community-Based Effectiveness Trial of Selected Dietary Strategies for the Management of Young Malian Children With Moderate Acute Malnutrition), which is not on this map. Cited by 33 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 7 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.

NCT01015950 nacompletednot on this map

Randomized, Community-Based Effectiveness Trial of Selected Dietary Strategies for the Management of Young Malian Children With Moderate Acute Malnutrition (MAM) in the Context of the National Community Management of Acute Malnutrition

TypeinterventionalSponsorHelen Keller InternationalRan2010 to 2012Enrolled1,260ConditionsModerate Acute Malnutrition (MAM)ArmsPlumpy'Sup, Local food supplement, Misola, SCSB
3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 7 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

8 authors.

Sheila Isanaka *Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Dale A Barnhart *Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Christine M McDonaldChildren's Hospital Oakland Research Institute, Oakland, California, USA.
Robert S Ackatia-ArmahDepartment of Nutrition and Program in International and Community Nutrition, University of California, Davis, CA, USA.
Roland KupkaUnited Nations Children's Fund, Nutrition Section, New York, NY, USA.
Seydou DoumbiaFaculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technology of Bamako, Bamako, Mali.
Kenneth H BrownDepartment of Nutrition and Program in International and Community Nutrition, University of California, Davis, CA, USA.
Nicolas A MenziesGlobal Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionModerate acute malnutrition (MAM) causes substantial child morbidity and mortality, accounting for 4.4% of deaths and 6.0% of disability-adjusted life years (DALY) lost among children under 5 each year. There is growing consensus on the need to provide appropriate treatment of MAM, both to reduce associated morbidity and mortality and to halt its progression to severe acute malnutrition. We estimated health outcomes, costs and cost-effectiveness of four dietary supplements for MAM treatment in children 6-35 months of age in Mali.

methodsWe conducted a cluster-randomised MAM treatment trial to describe nutritional outcomes of four dietary supplements for the management of MAM: ready-to-use supplementary foods (RUSF; PlumpySup); a specially formulated corn-soy blend (CSB) containing dehulled soybean flour, maize flour, dried skimmed milk, soy oil and a micronutrient pre-mix (CSB++; Super Cereal Plus); Misola, a locally produced, micronutrient-fortified, cereal-legume blend (MI); and locally milled flour (LMF), a mixture of millet, beans, oil and sugar, with a separate micronutrient powder. We used a decision tree model to estimate long-term outcomes and calculated incremental cost-effectiveness ratios (ICERs) comparing the health and economic outcomes of each strategy.

resultsCompared to no MAM treatment, MAM treatment with RUSF, CSB++, MI and LMF reduced the risk of death by 15.4%, 12.7%, 11.9% and 10.3%, respectively. The ICER was US$9821 per death averted (2015 USD) and US$347 per DALY averted for RUSF compared with no MAM treatment.

conclusionMAM treatment with RUSF is cost-effective across a wide range of willingness-to-pay thresholds.

trial registrationNCT01015950.

Indexed as

corn soy blendcostcost-effectivenessCSB++Malimoderate acute malnutritionPlumpySupready to use supplementary foodsSuper Cereal

Identifiers

PMID31139441
PMCPMC6509694

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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.