ArticlePloS one2020
Acute malnutrition recovery energy requirements based on mid-upper arm circumference: Secondary analysis of feeding program data from 5 countries, Combined Protocol for Acute Malnutrition Study (ComPAS) Stage 1.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 28 citations in OpenAlex.
- Trial
- Linear Growth During Treatment With a Simplified, Combined Protocol: Secondary Analyses of Severely Wasted Children 6-59 Months in the ComPAS Cluster Randomized Controlled Trial.Maternal & child nutrition · 2025Trial
- Low linoleic acid foods with added DHA given to Malawian children with severe acute malnutrition improve cognition: a randomized, triple-blinded, controlled clinical trial.The American journal of clinical nutrition · 2022Trial
- Treating high-risk moderate acute malnutrition using therapeutic food compared with nutrition counseling (Hi-MAM Study): a cluster-randomized controlled trial.The American journal of clinical nutrition · 2021Trial
- Trial
- Trial
- Micronutrient status in children aged 6-59 months with severe wasting and/or nutritional edema: implications for nutritional rehabilitation formulations.Nutrition reviews · 2025Review
- Effectiveness of acute malnutrition treatment with a simplified, combined protocol in Central African Republic: An observational cohort study.Maternal & child nutrition · 2024Observational
- Effectiveness of a nonweight-based daily dosage of ready-to-use therapeutic food in children suffering from uncomplicated severe acute malnutrition: A nonrandomized, noninferiority analysis of programme data in Afghanistan.Maternal & child nutrition · 2024Article
- How age and sex affect treatment outcomes for children with severe malnutrition: A multi-country secondary data analysis.Maternal & child nutrition · 2024Article
- The recent WHO guideline on acute malnutrition overestimates therapeutic energy requirement.The Lancet regional health. Southeast Asia · 2024Review
- Simplified treatment protocols improve recovery of children with severe acute malnutrition in South Sudan: results from a mixed methods study.Journal of health, population, and nutrition · 2024Article
- Optimising the dosage of ready-to-use therapeutic food in children with uncomplicated severe acute malnutrition in the Democratic Republic of the Congo: a non-inferiority, randomised controlled trial.EClinicalMedicine · 2023Article
- Faster rehabilitation weight gain during childhood is associated with risk of non-communicable disease in adult survivors of severe acute malnutrition.PLOS global public health · 2023Article
- How do children with severe underweight and wasting respond to treatment? A pooled secondary data analysis to inform future intervention studies.Maternal & child nutrition · 2023Article
- Article
- Article
- Weight-for-HeightCurrent developments in nutrition · 2021Article
- Weight and mid-upper arm circumference gain velocities during treatment of young children with severe acute malnutrition, a prospective study in Uganda.BMC nutrition · 2021Article
- An Optimized Dose of Therapeutic Feeding Results in Noninferior Growth in Midupper Arm Circumference Compared with a Standard Dose in Children in Sierra Leone Recovering from Acute Malnutrition.Current developments in nutrition · 2021Article
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSevere and moderate acute malnutrition (SAM and MAM) are currently treated with different food products in separate treatment programs. The development of a unified and simplified treatment protocol using a single food product aims to increase treatment program efficiency and effectiveness. This study, the first stage of the ComPAS trial, sought to assess rate of growth and energy requirements among children recovering from acute malnutrition in order to design a simplified, MUAC-based dosage protocol.
methodsWe obtained secondary data from patient cards of children aged 6-59 months recovering from SAM in outpatient therapeutic feeding programs (TFPs) and from MAM in supplementary feeding programs (SFPs) in five countries in Africa and Asia. We used local polynomial smoothing to assess changes in MUAC and proportional weight gain between clinic visits and assessed their normalized differences for a non-zero linear trend. We estimated energy needs to meet or exceed the growth observed in 95% of visits.
resultsThis analysis used data from 5518 patients representing 33942 visits. Growth trends in MUAC and proportional weight gain were not significantly different, each lower at higher MUAC values: MUAC growth averaged 2mm/week at lower MUACs (100 to <110mm) and 1mm/week at higher MUACs (120mm to <125mm); and proportional weight gain declined from 3.9g/kg/day to 2.4g/kg/day across the same MUAC values. In 95% of visits by children with a MUAC 100mm to <125mm who were successfully treated, energy needs could be met or exceeded with 1,000 kilocalories a day.
conclusionTwo 92g sachets of Ready-to-Use Therapeutic Food (RUTF) (1,000kcal total) is proposed to meet the estimated total energy requirements of children with a MUAC 100mm to <115mm, and one 92g sachet of RUTF (500kcal) is proposed to meet half the energy requirements of children with a MUAC of 115 to <125mm. A simplified, combined protocol may enable a more holistic continuum of care, potentially contributing to increased coverage for children suffering from acute malnutrition.
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