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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
A multi-country, prospective cohort study to measure rate and risk of relapse among children recovered from severe acute malnutrition in Mali, Somalia, and South Sudan: a study protocol
BMC Nutrition, Volume 8, No. 1, Article 90, Year 2022
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Description
Background: The Community-Based Management of Acute Malnutrition (CMAM) model transformed the treatment of severe acute malnutrition (SAM) by shifting treatment from inpatient facilities to the community. Evidence shows that while CMAM programs are effective in the initial recovery from SAM, recovery is not sustained for some children requiring them to receive treatment repeatedly. This indicates a potential gap in the model, yet little evidence is available on the incidence of relapse, the determinants of the phenomena, or its financial implications on program delivery. Methods: This study is a multi-country prospective cohort study following “post-SAM” children (defined as children following anthropometric recovery from SAM through treatment in CMAM) and matched community controls (defined as children not previously experiencing acute malnutrition (AM)) monthly for six months. The aim is to assess the burden and determinants of relapse to SAM. This study design enables the quantification of relapse among post-SAM children, but also to determine the relative risk for, and excess burden of, AM between post-SAM children and their matched community controls. Individual -, household-, and community-level information will be analyzed to identify potential risk-factors for relapse, with a focus on associations between water, sanitation, and hygiene (WASH) related exposures, and post-discharge outcomes. The study combines a microbiological assessment of post-SAM children’s drinking water, food, stool via rectal swabs, dried blood spots (DBS), and assess for indicators of enteric pathogens and immune function, to explore different exposures and potential associations with treatment and post-treatment outcomes. Discussion: This study is the first of its kind to systematically track children after recovery from SAM in CMAM programs using uniform methods across multiple countries. The design allows the use of results to: 1) facilitate understandings of the burden of relapse; 2) identify risk factors for relapse and 3) elucidate financial costs associated with relapse in CMAM programs. This protocol’s publication aims to support similar studies and evaluations of CMAM programs and provides opportunities for comparability of an evidence-based set of indicators for relapse to SAM. © 2022, The Author(s).
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC9404649/bin/40795_2022_576_MOESM1_ESM.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC9404649/bin/40795_2022_576_MOESM2_ESM.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC9404649/bin/40795_2022_576_MOESM3_ESM.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC9404649/bin/40795_2022_576_MOESM4_ESM.docx
Authors & Co-Authors
King, Sarah
United States, New York
Action Against Hunger
D’Mello-Guyett, Lauren
United Kingdom, London
London School of Hygiene & Tropical Medicine
Yakowenko, Ellyn
United States, New York
Action Against Hunger
Riems, Bram
France, Paris
Action Contre la Faim
Gallandat, Karin
United Kingdom, London
London School of Hygiene & Tropical Medicine
Mama Chabi, Sherifath
Spain, Madrid
🇪🇸 Fundacion Accion Contra el Hambre
Mohamud, Feysal Abdisalan
United States, New York
Action Against Hunger
Ayoub, Khamisa
South Sudan, Juba
South Sudan Ministry of Health
Olad, Ahmed Hersi
Unknown Affiliation
Aliou, Bagayogo
Unknown Affiliation
Marshak, Anastasia
United States, Medford
Tufts University
Trehan, Indi
United States, Seattle
University of Washington
Cumming, Oliver
United Kingdom, London
London School of Hygiene & Tropical Medicine
Stobaugh, Heather C.
United States, New York
Action Against Hunger
United States, Medford
Tufts University
Statistics
Citations: 1
Authors: 14
Affiliations: 7
Identifiers
Doi:
10.1186/s40795-022-00576-x
ISSN:
20550928
Research Areas
Environmental
Food Security
Maternal And Child Health
Study Design
Cohort Study
Study Approach
Quantitative
Study Locations
Multi-countries
Mali
Somalia
South Sudan
Sudan