ArticleMaternal & child nutrition2021
Relapse and regression to severe wasting in children under 5 years: A theoretical framework.
Article in Maternal & child nutrition, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Household-level water, sanitation and hygiene factors and interventions and the prevention of relapse after severe acute malnutrition recovery: A systematic review.Maternal & child nutrition · 2024Pooled it
- Burden and risk factors for relapse following successful treatment of uncomplicated severe acute malnutrition in young children: Secondary analysis from a randomised trial in Niger.Maternal & child nutrition · 2022Trial
- Formative research on a post-discharge monitoring program using SQ-LNS to reduce acute malnutrition relapse risk in Mali : a qualitative study.BMC public health · 2026Article
- Gut microbiome associations with acute malnutrition relapse in South Sudan.Microbiology spectrum · 2026Article
- Levels and determinants of child wasting relapse: a prospective cohort study from Somalia.Journal of global health · 2026Article
- Reducing relapse in children after recovery from severe acute malnutrition in Mali: participatory development of a theory of change for post-treatment monitoring including SQ-LNS supplementation.Frontiers in nutrition · 2026Article
- Reducing relapses after acute malnutrition treatment: evidence from a simplified approach in emergency settings of Mali.Frontiers in public health · 2026Article
- Relapse Burden of Severe Acute Malnutrition Post-Recovery Using SPHERE Performance Indicators: A Systematic Review and Meta-Analysis.Health science reports · 2025Review
- Development of core outcome sets for effectiveness trials focused on infants and children with wasting and nutritional oedema.BMJ global health · 2025Article
- Addressing dual deficiencies of SAM indicators; gaps and insights from inpatient admission to outpatient discharge, in conflict-affected Yemen; a retrospective study.Conflict and health · 2025Article
- Article
- Risk factors for food contamination among children discharged from community management of acute malnutrition programmes in South Sudan: A cross-sectional study and hazard analysis critical control point approach.Maternal & child nutrition · 2024Article
- Post-Recovery Relapse of Children Treated with a Simplified, Combined Nutrition Treatment Protocol in Mali: A Prospective Cohort Study.Nutrients · 2023Article
- A multi-country, prospective cohort study to evaluate the economic implications of relapse among children recovered from severe acute malnutrition: a study protocol.BMC nutrition · 2022Article
- Relapse and regression to severe wasting in children under 5 years: A theoretical framework.Maternal & child nutrition · 2021Article
- Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Systematic reviews have highlighted that repeated severe wasting after receiving treatment is likely to be common, but standardised measurement is needed urgently. The Council of Research & Technical Advice for Acute Malnutrition (CORTASAM) released recommendations on standard measurement of relapse (wasting within 6 months after exiting treatment as per recommended discharge criteria), regression (wasting within 6 months after exiting treatment before reaching recommended discharge criteria) and reoccurrence (wasting after 6 months of exit from treatment as per recommended discharge criteria). We provide a theoretical framework of post-treatment relapse and regression to severe wasting to guide discussions, risk factor analyses, and development and evaluations of interventions. This framework highlights that there are factors that may impact risk of relapse and regression in addition to the impact of contextual factors associated with incidence and reoccurrence of severe wasting more generally. Factors hypothesised to be associated with relapse and regression relate specifically to the nutrition and health status of the child on admission to, during and exit from treatment and treatment interventions, platforms and approaches as well as type of exit from treatment (e.g., before reaching recommended criteria). These factors influence whether children reach full recovery, and poorer nutritional and immunological status at exit from treatment are more proximate determinants of risk of severe wasting after treatment, although post-treatment interventions may modify risks. The evidence base for many of these factors is weak. Our framework can guide research to improve our understanding of risks of relapse and regression and how to prevent them and inform programmes on what data to collect to evaluate relapse. Implementation research is needed to operationalise results in programmes and reduce post-treatment severe wasting at scale.
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