EC Nutrition

Research Article Volume 11 Issue 5 - 2017

Effectiveness of Chickpea-Based Ready-to-Use-Supplementary Foods for Management of Moderate Acute Malnutrition in Ethiopia: A Cluster-Randomized Control Trial

Tesfaye Hailu1*, Masresha Tessema1, Biniyam Tesfaye1, Aweke Kebede1, Adamu Belay1, Girmay Ayana1, Yosef Beyene1, Temesgen Awoke1, Desalegn Kuche1, Andinet Abera1, Tsehai Assefa1, Dilnesaw Zerfu1, Tibebu Moges1, Aregash Samuel1, Mekonen Tadesse1, Tewodros Getachew1, Mesret W/Yohanes1, Birhanu Wedajo1, Mesfin Gose2, Barbara Tembo2 and Yibeltal Assefa1

1Ethiopian Public Health Institute, Adddis Ababa, Ethiopia
2World Food Program Ethiopia Country Office, Kirrkos Sub-City, Addis Ababa, Ethiopia
*Corresponding Author: Tesfaye Hailu, Ethiopian Public Health Institue, Addis Ababa, Ethiopia.
Received: September 14, 2017; Published: October 24, 2017



Background: Children with moderate acute malnutrition have nutritional requirements that differ from non-malnourished and severely malnourished children. They require increased intake of energy and essential nutrients over and above those required by non-malnourished children and, when necessary, treatment for any associated medical conditions. The study was aimed to evaluate chickpea only (Formula 1) and chickpea-maize-soya (Formula 2) ready-to-use food against two other widely-used supplementary foods: Super Cereal and the improved product, Super Cereal PLUS, for their effectiveness in the supplementary feeding programs.

Method: The design of the study was a cluster-randomized controlled effectiveness trial that was conducted in four regions of Ethio- pia from 9th June 2014 to 22nd October 2014. According to Disaster Risk Management and Food Security Sector (DRMFSS) Hotspot Priority Report of April 2014, Oromia had 75 hotspot Priority 2 woredas, followed by Somali with 55; Amhara with 26; Tigray with 13 and SNNPR, 5. The study subject was taken from HHs based in hotspot priority 2 woreda.

Result: Statistically significant higher overall recovery rate (42%) was observed in children fed Super Cereal PLUS. Children in the lower age group (< 24 months) were more likely to recover than children in the higher age group (> 24 months). Super Cereal PLUS had a statistically significant higher rate of recovery compared to Super Cereal, Formula 1, and Formula 2. There was no significant difference among Super Cereal, Formula 1, and Formula 2 in terms of recovery rate. However, taking into account the result of cost effectiveness along with recovery rates, Formula 2 proved to be the most efficient in treatment of moderate acute malnutrition.

Recommendation: Therefore, Formula 2 is recommended for the treatment of MAM in Ethiopia for the pilot study under close follow-up to minimize all the limitations observed in current effectiveness trials study.

keywords: Effectiveness Trial; Supplementary Products; Moderate Acute Malnutrition

  • WFP, UNICE, MOH, DRMFSS, and ENCU. “Management of Moderate Acute Malnutrition at Health Post: A tot Course Guideline for Woreda level program Coordinators/officers: An extract from the National MAM guideline” (2011).
  • “WHO child growth standards: length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: methods and development”. Geneva, World Health Organization (2006).
  • “State of the world’s children”. New York: UNICEF (2008).
  • Central Statistical Agency of Ethiopia. “Ethiopia Demographic and Health Survey Report”. Addis Ababa Ethiopia (2011).
  • Black RE., et al. “Global, regional, and national causes of child mortality in 2008: a systematic analysis”. Lancet9730 (2010): 1969-1987.
  • Pelletier DL. “The potentiating effect of Malnutrition on Child mortality: Epidemiological Evidence and Police Implication” (1994).
  • World Food Programme Strategy and Policy Division Technical Unit (Nutrition). Food and Nutrition Handbook (1999).
  • Ashworth A and Ferguson E. “Dietary counseling in the management of moderate malnourishment in children”. Food and Nutrition Bulletin3 (2009): S405-S433.
  • World Health Organization. “Technical note: supplementary foods for the management of moderate acute malnutrition in infants and children 6-59 months of age”. Geneva (2012).
  • De Pee S and Bloem M. “Current and potential role of specially formulated foods and food supplements for preventing malnutrition among 6-23 months old and treating moderate malnutrition among 6-59 months old children”. Food and Nutrition Bulletin3 (2009): 434-463.
  • Tsinuel G., et al. “Targeted Supplementary Food (TSF) Outcome Evaluation Study in Ethiopia” (2012).
  • Dewey KG and Adu-Afarwuah S. “Systematic review of the efficacy and effectiveness of complementary feeding interventions in developing countries”. Maternal Child Nutrition1 (2008): 24-85.
  • Karakochuk C. “Evaluating the effectiveness of Corn Soya Blend and Ready-to-Use Supplementary Food for the treatment of moderate acute malnutrition in children in WFP supplementary feeding programs in Ethiopia”. WFP Internal Report (2010).
  • The SPHERE Project: Humanitarian Charter and Minimum Standards in Disaster Response (2004).
  • Mikkelsen J. “World Food Programme Ethiopia program briefing note: nutrition and education section”. Internal document (2009).
  • “Briefing documents for ready-to-use foods” (2008).
  • WHO, WFP, UNICEF and UNSS. “Community-based Management of Severe Acute Malnutrition” (2007).
  • Collins S. “Changing the way we address severe malnutrition during famine”. Lancet9280 (2001): 498-501.
  • Briend A. “Highly nutrient-dense spreads: a new approach to delivering multiple micronutrients to high-risk groups”. British Journal of Nutrition2 (2001): S175-S179.
  • Matilsky DK., et al. “Supplementary feeding with fortified spreads results in higher recovery rates than with a corn/soy blend in moderately wasted children”. Journal of Nutrition4 (2009): 773-778.
  • Golden MH. “Proposed recommended nutrient densities for moderately malnourished children”. Food and Nutrition Bulletin3 (2009): S267-S342.
  • Abinet Tekele., et al. “Sensory Evaluation Acceptability for a Food Supplementary Chickpea-Based Ready-to-Use among Moderately Malnourished Children Aged 6-59 Months”. Journal of Agricultural Science and Technology B 5 (2015): 216-230.
  • Karakochuk C., et al. “Treatment of moderate acute malnutrition with ready-to-use supplementary food results in higher overall recovery rates compared with a corn-soya blend in children in southern Ethiopia: An operations research trial”. American Journal of Clinical Nutrition4 (2012): 911-916.
  • Manary M and Chang CY. “Comparing Milk Fortified Corn-SoyBlend (CSB++), Soy Ready-to-Use Supplementary Food (RUSF), and Soy/Whey RUSF (Supplementary Plumpy®) in the Treatment of Moderate Acute Malnutrition” (2012).

    • Tesfaye Hailu., et al. “Effectiveness of Chickpea-Based Ready-to-Use-Supplementary Foods for Management of Moderate Acute Malnutrition in Ethiopia: A Cluster-Randomized Control Trial”. EC Nutrition  11.5 (2017): 201-215.

    ECronicon Journal

    Our Services

    Quick Links

    Information

    Creative Commons LicenseOpen Access by ECronicon is licensed under a Creative Commons Attribution 4.0 International License
    Based on a work at www.ecronicon.net