Poster Topical Area: Maternal, Perinatal and Pediatric Nutrition

Location: Hall D

Poster Board Number: 383

P13-126 - Household-level factors associated with relapse following discharge from treatment for moderate acute malnutrition

Sunday, Jun 10
8:00 AM – 6:00 PM

Objective: Factors associated with relapse to acute malnutrition among children who are discharged after reaching a threshold denoted as "recovered" from moderate acute malnutrition (MAM) are not well understood. The aim of this study was to identify factors associated with sustained recovery, defined as maintaining a mid-upper arm circumference (MUAC) ≥ 12.5 cm with no oedema for 1 year following release from MAM treatment.


Methods: We analysed data from an in-depth household survey on a sub-sample of participants within a larger cluster randomised controlled trial (cRCT) that followed children for 1 year following recovery from MAM. Surveys included indicators related to socioeconomic status, household food security, infant and young child feeding practices, and water, sanitation, and hygiene.


Results: Out of 1497 children participating in the cRCT, a subset of 315 participated in this sub-study. Controlling for other factors, households with fitted lids on water storage containers was a significant predictor of sustained recovery (P=0.004). In addition, caregivers observed to have clean hands (P=0.053) and the use of an improved sanitation facility (P=0.083) were marginally significant predictors of sustained recovery.In contrast, socioeconomic status and infant and young child feeding practices at the time of discharge and household food security throughout the follow-up period were not significantly associated with sustained recovery.


Conclusions: We hypothesize that improved water, sanitation, and hygiene (WASH) conditions in tandem with management of MAM through supplemental feeding programs has the possibility to decrease relapse following recovery from MAM. Furthermore, the absence of associations between relapse and nearly all household-level factors indicates that causal factors of relapse may be related mostly to the child's individual underlying health and nutrition status.




Funding Source:

This research was funded under a subaward funded by Family Health International under Cooperative Agreement/Grant No. AID-OAA-A-12-0005 funded by USAID. The content of this publication does not necessarily reflect the views, analysis, or policies of FHI 360 or USAID, nor does any mention of trade names, commercial products, or organizations imply endorsement by FHI 360 or USAID.

CoAuthors: Beatrice Rogers – Tufts University; Patrick Webb – Tufts University; Irwin Rosenberg – Tufts University; Kenneth Maleta – University of Malawi; Indi Trehan – Washington University in St. Louis; Mark Manary – Washington University in St. Louis

Heather Stobaugh

International Nutrition Researcher
RTI International
Cary, North Carolina