Abstract
(1) Background: Supplementary feeding programs (SFPs) are effective in the community-based treatment of moderate acute malnutrition (MAM) and prevention of severe acute malnutrition (SAM); (2) Methods: A retrospective study was conducted on a sample of 1266 Zambian malnourished children assisted from 2012 to 2014 in the Rainbow Project SFPs. Nutritional status was evaluated according to WHO/Unicef methodology. We performed univariate and multivariate Cox proportional risk regression to identify the main predictors of mortality. In addition, a time-to event analysis was performed to identify predictors of failure and time to cure events; (3) Results: The analysis included 858 malnourished children (19 months ± 9.4; 49.9% males). Program outcomes met international standards with a better performance for MAM compared to SAM. Cox regression identified SAM (3.8; 2.1–6.8), HIV infection (3.1; 1.7–5.5), and WAZ <−3 (3.1; 1.6–5.7) as predictors of death. Time to event showed 80% of children recovered by SAM/MAM at 24 weeks. (4) Conclusions: Preventing deterioration of malnutrition, coupled to early detection of HIV/AIDS with adequate antiretroviral treatment, and extending the duration of feeding supplementation, could be crucial elements for ensuring full recovery and improve child survival in malnourished Zambian children.
Highlights
Zambia is a sub-Saharan country facing a high burden of child acute malnutrition, with malnutrition remaining one of the most serious problems among children under five years of age [1].According to the Zambian Preliminary Report of Demographic and Health Survey 2013–2014, 40%of children are affected by stunting, 15% are underweight, and 6% of children suffer from wasting, with a high under-five mortality rate (75 deaths per 1000 live births in a year) [2]
We focused on 10 supplementary feeding programs (SFP), eight operating in urban
SFPs, eightand operating in urban areasareas
Summary
Zambia is a sub-Saharan country facing a high burden of child acute malnutrition, with malnutrition remaining one of the most serious problems among children under five years of age [1].According to the Zambian Preliminary Report of Demographic and Health Survey 2013–2014, 40%of children are affected by stunting, 15% are underweight, and 6% of children suffer from wasting, with a high under-five mortality rate (75 deaths per 1000 live births in a year) [2]. Zambia is a sub-Saharan country facing a high burden of child acute malnutrition, with malnutrition remaining one of the most serious problems among children under five years of age [1]. According to the Zambian Preliminary Report of Demographic and Health Survey 2013–2014, 40%. Of children are affected by stunting, 15% are underweight, and 6% of children suffer from wasting, with a high under-five mortality rate (75 deaths per 1000 live births in a year) [2]. Malnourished children who do not quickly break away from the vicious cycle of infectious disease and growth failure are vulnerable to irreversible cognitive damage [3]. Acute malnutrition (wasting), especially in severe form, if untreated, is an attributable cause of the 12.6% of the 6.9 million deaths worldwide. Res. Public Health 2016, 13, 666; doi:10.3390/ijerph13070666 www.mdpi.com/journal/ijerph
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