A randomized controlled facility based trial to assess the impact of indigenously prepared ready to use therapeutic food (rutf) for children with severe acute malnutrition in india

ORIGINAL ARTICLE

A Randomized Controlled Facility Based Trial to Assess the Impact of Indigenously Prepared Ready to Use Therapeutic Food (RUTF) for Children with Severe Acute Malnutrition in India

Alka Jadhav¹, Bina Dias¹, Narendra Shah², Lavina Fernandes¹, Sneha Fernandes¹, Aparna Surve², Hiteshi Dhami-Shah¹, Shivram Murty³, Nandan Joshi⁴, Mamta Manglani¹.

¹Department of Pediatrics, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India,
²Centre for technological alternatives in Rural areas CTARA, IIT Bombay, India,
³Toddler Food Partners, Minneapolis, USA,
⁴General Mills, Mumbai, India.

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Abstract
Aim: Ready to Use Therapeutic Food (RUTF) is a standard of care for children with severe acute malnutrition (SAM) worldwide. There is limited data on its use in India, therefore we conducted this study to determine the efficacy of indigenously prepared RUTF also termed as Medical Nutrition Therapy (MNT).

Methods and Materials: Three hundred and twenty one children between 6 months – 5 years of age suffering from SAM were enrolled in the study of which 242 children who completed two weeks of intervention were analyzed. The study was a facility based open randomized controlled trial. Subjects were divided into two groups: study group (received MNT) and control group [received Standard Nutrition Therapy (SNT)] for eight weeks. Thereafter each patient was followed up for four months. Primary outcome variables were rate of weight gain in gm/kg/day, proportion of children achieving target weight and change in nutritional status.

Results: Of 242 patients, 138 completed eight weeks of intervention. At the end of two and four weeks, the rate of weight gain was significantly greater in MNT group i.e. 5.63 g/kg/day at 2 weeks (n=129) and 4.72 g/kg/day at 4 weeks (n=44) than in the SNT group i.e. 3.43 g/kg/day at 2 weeks (n=113) and 2.82 g/kg/day at 4 weeks (n=46) (p<0.05). Target weight was achieved in 61.2 % of children on MNT group as compared to 47.7% in SNT group. At 8 weeks, 82.8% of children on MNT moved out of SAM status compared to 64.4% of children on SNT (p<0.005).

Conclusion: MNT is significantly superior to SNT in promoting weight gain in SAM children. Indigenously prepared MNT is useful to treat SAM in children.

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