ArticleHealth policy and planning2025
Cost-effectiveness of a simplified acute malnutrition program: a secondary analysis of the OptiMA randomized clinical trial in the Democratic Republic of the Congo.
Article in Health policy and planning, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Assessing WHO prioritisation criteria for children 6-59 months treated for moderate wasting in a MUAC-based protocol: a multicountry analysis in West and Central Africa.BMJ global health · 2026Observational
- Comparative Effectiveness of Fixed and Standard RUTF Dosing Protocols for Treatment of Uncomplicated Severe Acute Malnutrition in Afghanistan.Maternal & child nutrition · 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
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Authors and funding
19 authors.
Funding
Abstract
Acute malnutrition (AM) causes large loss of life and disability in children in Africa. Researchers are testing innovative approaches to increase the efficiency of treatment programs This paper presents results of a cost-effectiveness analysis of one such program in the Democratic Republic of the Congo (DRC) based on a secondary analysis of a randomized controlled trial Optimizing Treatment for Acute Malnutrition (OptiMA), conducted in DRC in 2018-20. A total of 896 children aged 6-59 months with a mid-upper arm circumference (MUAC) <125 mm or with oedema were treated and followed for 6 months. The cost-effectiveness of OptiMA using ready-to-use therapeutic food (RUTF) at a tapered dose was compared with the standard national program in which severe cases (SAM) received RUTF proportional to weight, and moderate cases (MAM) were referred to another clinic for a fixed dose regimen of ready-to-use supplementary food. Cost analysis from the provider perspective used data collected during the trial and from administrative records. Statistical differences were derived using t-tests. The mean cost per enrolled child under OptiMA was $123 [95% confidence interval (CI): 114-132], not statistically different from the standard group [$127 (95%CI: 118-136), P = 0.549], while treatment success (i.e. recovery to MUAC > 125 mm and no relapse for 6 months) under OptiMA was 9% higher (72 vs 63%, P = 0.004). Among children with SAM at enrollment, there was no significant difference in treatment success between OptiMA and standard care (70 vs 62%, P = 0.12), but OptiMA's mean cost per enrolled child was 23% lower ($128 vs $166, P < 0.0001). OptiMA was more effective at preventing progression to SAM among those enrolled with MAM (5 vs 16%, P < 0.0001), with an incremental cost-effectiveness ratio of $234 per progression to SAM prevented. Overall, OptiMA had significantly better outcomes and was no more expensive than standard care. Its adoption could enable more children to be successfully treated in contexts where therapeutic food products are scarce.
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