The Effect of Adding Ready-to-Use Supplementary Food to a General Food Distribution on Child Nutritional Status and Morbidity: A Cluster-Randomized Controlled Trial
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{"title"=>"The Effect of Adding Ready-to-Use Supplementary Food to a General Food Distribution on Child Nutritional Status and Morbidity: A Cluster-Randomized Controlled Trial", "type"=>"journal", "authors"=>[{"first_name"=>"Lieven", "last_name"=>"Huybregts", "scopus_author_id"=>"16024596500"}, {"first_name"=>"Freddy", "last_name"=>"Houngbé", "scopus_author_id"=>"55365777100"}, {"first_name"=>"Cécile", "last_name"=>"Salpéteur", "scopus_author_id"=>"55366474700"}, {"first_name"=>"Rebecca", "last_name"=>"Brown", "scopus_author_id"=>"55495931600"}, {"first_name"=>"Dominique", "last_name"=>"Roberfroid", "scopus_author_id"=>"6507249637"}, {"first_name"=>"Myriam", "last_name"=>"Ait-Aissa", "scopus_author_id"=>"55365681900"}, {"first_name"=>"Patrick", "last_name"=>"Kolsteren", "scopus_author_id"=>"6603882639"}], "year"=>2012, "source"=>"PLoS Medicine", "identifiers"=>{"scopus"=>"2-s2.0-84866720498", "doi"=>"10.1371/journal.pmed.1001313", "sgr"=>"84866720498", "isbn"=>"1549-1676 (Electronic)\\n1549-1277 (Linking)", "pmid"=>"23028263", "issn"=>"15491277", "pui"=>"365720717"}, "id"=>"e9210a10-b5fd-32c9-bee6-9cc9876206af", "abstract"=>"BACKGROUND: Recently, operational organizations active in child nutrition in developing countries have suggested that blanket feeding strategies be adopted to enable the prevention of child wasting. A new range of nutritional supplements is now available, with claims that they can prevent wasting in populations at risk of periodic food shortages. Evidence is lacking as to the effectiveness of such preventive interventions. This study examined the effect of a ready-to-use supplementary food (RUSF) on the prevention of wasting in 6- to 36-mo-old children within the framework of a general food distribution program.\\n\\nMETHODS AND FINDINGS: We conducted a two-arm cluster-randomized controlled pragmatic intervention study in a sample of 1,038 children aged 6 to 36 mo in the city of Abeche, Chad. Both arms were included in a general food distribution program providing staple foods. The intervention group was given a daily 46 g of RUSF for 4 mo. Anthropometric measurements and morbidity were recorded monthly. Adding RUSF to a package of monthly household food rations for households containing a child assigned to the intervention group did not result in a reduction in cumulative incidence of wasting (incidence risk ratio: 0.86; 95% CI: 0.67, 1.11; p = 0.25). However, the intervention group had a modestly higher gain in height-for-age (+0.03 Z-score/mo; 95% CI: 0.01, 0.04; p<0.001). In addition, children in the intervention group had a significantly higher hemoglobin concentration at the end of the study than children in the control group (+3.8 g/l; 95% CI: 0.6, 7.0; p = 0.02), thereby reducing the odds of anemia (odds ratio: 0.52; 95% CI: 0.34, 0.82; p = 0.004). Adding RUSF also resulted in a significantly lower risk of self-reported diarrhea (-29.3%; 95% CI: 20.5, 37.2; p<0.001) and fever episodes (-22.5%; 95% CI: 14.0, 30.2; p<0.001). Limitations of this study include that the projected sample size was not fully attained and that significantly fewer children from the control group were present at follow-up sessions.\\n\\nCONCLUSIONS: Providing RUSF as part of a general food distribution resulted in improvements in hemoglobin status and small improvements in linear growth, accompanied by an apparent reduction in morbidity.\\n\\nTRIAL REGISTRATION: ClinicalTrials.gov NCT01154595 Please see later in the article for the Editors' Summary.", "link"=>"http://www.mendeley.com/research/effect-adding-readytouse-supplementary-food-general-food-distribution-child-nutritional-status-morbi", "reader_count"=>137, "reader_count_by_academic_status"=>{"Unspecified"=>5, "Professor > Associate Professor"=>1, "Librarian"=>3, "Researcher"=>30, "Student > Doctoral Student"=>4, "Student > Ph. D. 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Student"=>27, "Student > Postgraduate"=>6, "Student > Master"=>37, "Other"=>6, "Student > Bachelor"=>9, "Lecturer"=>4, "Lecturer > Senior Lecturer"=>1, "Professor"=>4}, "reader_count_by_subject_area"=>{"Unspecified"=>11, "Agricultural and Biological Sciences"=>28, "Arts and Humanities"=>1, "Business, Management and Accounting"=>3, "Computer Science"=>1, "Earth and Planetary Sciences"=>1, "Economics, Econometrics and Finance"=>2, "Engineering"=>1, "Environmental Science"=>3, "Nursing and Health Professions"=>10, "Biochemistry, Genetics and Molecular Biology"=>1, "Materials Science"=>1, "Mathematics"=>1, "Medicine and Dentistry"=>53, "Psychology"=>2, "Social Sciences"=>18}, "reader_count_by_subdiscipline"=>{"Materials Science"=>{"Materials Science"=>1}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>53}, "Social Sciences"=>{"Social Sciences"=>18}, "Psychology"=>{"Psychology"=>2}, "Mathematics"=>{"Mathematics"=>1}, "Unspecified"=>{"Unspecified"=>11}, "Environmental Science"=>{"Environmental Science"=>3}, "Arts and Humanities"=>{"Arts and Humanities"=>1}, "Engineering"=>{"Engineering"=>1}, "Earth and Planetary Sciences"=>{"Earth and Planetary Sciences"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>2}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>28}, "Computer Science"=>{"Computer Science"=>1}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>3}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>10}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}}, "reader_count_by_country"=>{"Netherlands"=>2, "United States"=>3, "Tanzania"=>1, "France"=>1, "Switzerland"=>1, "Indonesia"=>1, "India"=>1}, "group_count"=>8}

Scopus | Further Information

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Figshare

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  • {"files"=>["https://ndownloader.figshare.com/files/574281"], "description"=>"<p>Composition of a daily dose (46 g) of RUSF.</p>", "links"=>[], "tags"=>["public health and epidemiology", "epidemiology", "pediatrics and child health"], "article_id"=>244775, "categories"=>["Medicine", "Immunology", "Biotechnology"], "users"=>["Lieven Huybregts", "Freddy Houngbé", "Cécile Salpeteur", "Rebecca Brown", "Dominique Roberfroid", "Myriam Ait-Aissa", "Patrick Kolsteren"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001313.t001", "stats"=>{"downloads"=>0, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Composition_of_a_daily_dose_46_g_of_RUSF_/244775", "title"=>"Composition of a daily dose (46 g) of RUSF.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-09-18 01:19:35"}
  • {"files"=>["https://ndownloader.figshare.com/files/574352"], "description"=>"<p>Data are mean (SD), unless stated otherwise.</p>a<p>Hemoglobin concentration was not measured in one child in the control group.</p>", "links"=>[], "tags"=>["characteristics", "inclusion"], "article_id"=>244840, "categories"=>["Medicine", "Immunology", "Biotechnology"], "users"=>["Lieven Huybregts", "Freddy Houngbé", "Cécile Salpeteur", "Rebecca Brown", "Dominique Roberfroid", "Myriam Ait-Aissa", "Patrick Kolsteren"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001313.t002", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Child_characteristics_at_inclusion_by_study_arm_/244840", "title"=>"Child characteristics at inclusion by study arm.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-09-18 01:20:40"}
  • {"files"=>["https://ndownloader.figshare.com/files/574016"], "description"=>"<p>Study flow chart.</p>", "links"=>[], "tags"=>["public health and epidemiology", "epidemiology", "pediatrics and child health"], "article_id"=>244501, "categories"=>["Medicine", "Immunology", "Biotechnology"], "users"=>["Lieven Huybregts", "Freddy Houngbé", "Cécile Salpeteur", "Rebecca Brown", "Dominique Roberfroid", "Myriam Ait-Aissa", "Patrick Kolsteren"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001313.g001", "stats"=>{"downloads"=>0, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Figure_1_/244501", "title"=>"Figure 1", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-09-18 01:15:01"}
  • {"files"=>["https://ndownloader.figshare.com/files/305140", "https://ndownloader.figshare.com/files/305316"], "description"=>"<div><h3>Background</h3><p>Recently, operational organizations active in child nutrition in developing countries have suggested that blanket feeding strategies be adopted to enable the prevention of child wasting. A new range of nutritional supplements is now available, with claims that they can prevent wasting in populations at risk of periodic food shortages. Evidence is lacking as to the effectiveness of such preventive interventions. This study examined the effect of a ready-to-use supplementary food (RUSF) on the prevention of wasting in 6- to 36-mo-old children within the framework of a general food distribution program.</p> <h3>Methods and Findings</h3><p>We conducted a two-arm cluster-randomized controlled pragmatic intervention study in a sample of 1,038 children aged 6 to 36 mo in the city of Abeche, Chad. Both arms were included in a general food distribution program providing staple foods. The intervention group was given a daily 46 g of RUSF for 4 mo. Anthropometric measurements and morbidity were recorded monthly. Adding RUSF to a package of monthly household food rations for households containing a child assigned to the intervention group did not result in a reduction in cumulative incidence of wasting (incidence risk ratio: 0.86; 95% CI: 0.67, 1.11; <em>p</em> = 0.25). However, the intervention group had a modestly higher gain in height-for-age (+0.03 Z-score/mo; 95% CI: 0.01, 0.04; <em>p</em><0.001). In addition, children in the intervention group had a significantly higher hemoglobin concentration at the end of the study than children in the control group (+3.8 g/l; 95% CI: 0.6, 7.0; <em>p</em> = 0.02), thereby reducing the odds of anemia (odds ratio: 0.52; 95% CI: 0.34, 0.82; <em>p</em> = 0.004). Adding RUSF also resulted in a significantly lower risk of self-reported diarrhea (−29.3%; 95% CI: 20.5, 37.2; <em>p</em><0.001) and fever episodes (−22.5%; 95% CI: 14.0, 30.2; <em>p</em><0.001). Limitations of this study include that the projected sample size was not fully attained and that significantly fewer children from the control group were present at follow-up sessions.</p> <h3>Conclusions</h3><p>Providing RUSF as part of a general food distribution resulted in improvements in hemoglobin status and small improvements in linear growth, accompanied by an apparent reduction in morbidity.</p> <h3>Trial registration</h3><p>ClinicalTrials.gov <a href=\"http://clinicaltrials.gov/ct2/show/NCT01154595\">NCT01154595</a></p> <p> <em>Please see later in the article for the Editors' Summary.</em></p> </div>", "links"=>[], "tags"=>["adding", "ready-to-use", "supplementary", "nutritional", "cluster-randomized", "controlled"], "article_id"=>120195, "categories"=>["Medicine", "Immunology", "Biotechnology"], "users"=>["Lieven Huybregts", "Freddy Houngbé", "Cécile Salpeteur", "Rebecca Brown", "Dominique Roberfroid", "Myriam Ait-Aissa", "Patrick Kolsteren"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001313.s001", "https://dx.doi.org/10.1371/journal.pmed.1001313.s002"], "stats"=>{"downloads"=>42, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/The_Effect_of_Adding_Ready_to_Use_Supplementary_Food_to_a_General_Food_Distribution_on_Child_Nutritional_Status_and_Morbidity_A_Cluster_Randomized_Controlled_Trial/120195", "title"=>"The Effect of Adding Ready-to-Use Supplementary Food to a General Food Distribution on Child Nutritional Status and Morbidity: A Cluster-Randomized Controlled Trial", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2012-09-18 00:03:15"}
  • {"files"=>["https://ndownloader.figshare.com/files/574236"], "description"=>"a<p>Calculated by number of recalls×recall duration.</p>b<p>Confidence intervals are estimated from a Poisson model adjusted for clustering.</p>c<p>Analyzed using a mixed Poisson regression model with random effects cluster, household, and child, adjusted for child's age at baseline, child's sex, SES, and morbidity status at baseline.</p>", "links"=>[], "tags"=>["preventive", "rusf"], "article_id"=>244729, "categories"=>["Medicine", "Immunology", "Biotechnology"], "users"=>["Lieven Huybregts", "Freddy Houngbé", "Cécile Salpeteur", "Rebecca Brown", "Dominique Roberfroid", "Myriam Ait-Aissa", "Patrick Kolsteren"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001313.t004", "stats"=>{"downloads"=>1, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Effect_of_preventive_RUSF_on_child_morbidity_/244729", "title"=>"Effect of preventive RUSF on child morbidity.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-09-18 01:18:49"}
  • {"files"=>["https://ndownloader.figshare.com/files/574205"], "description"=>"<p>End point hemoglobin values were unavailable for 31 and 25 participants from the control and intervention groups, respectively.</p>a<p>Analyzed using a linear mixed model with random effects cluster and household, adjusted for child's age at baseline, child's sex, SES, and hemoglobin concentration at baseline.</p>b<p>Analyzed using a mixed logistic regression model with random effects cluster and household, adjusted for child's age at baseline, child's sex, SES, and anemic status at baseline.</p>", "links"=>[], "tags"=>["preventive", "rusf", "hemoglobin", "anemia"], "article_id"=>244691, "categories"=>["Medicine", "Immunology", "Biotechnology"], "users"=>["Lieven Huybregts", "Freddy Houngbé", "Cécile Salpeteur", "Rebecca Brown", "Dominique Roberfroid", "Myriam Ait-Aissa", "Patrick Kolsteren"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001313.t005", "stats"=>{"downloads"=>1, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Effect_of_preventive_RUSF_on_hemoglobin_concentration_and_anemia_at_end_point_/244691", "title"=>"Effect of preventive RUSF on hemoglobin concentration and anemia at end point.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-09-18 01:18:11"}

PMC Usage Stats | Further Information

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Relative Metric

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