Comparison of Four Different Supplementary Foods in the Treatment of Moderate Acute Malnutrition (MAM) in Children Under Five in Sierra Leone

Abstract

ObjectiveA prospective cluster randomized control trial, supported by WFP and USAID, compared the effectiveness of four supplementary foods in the treatment of moderate acute malnutrition (MAM) in children 6‐59 months of age in normal programmatic settings in Sierra Leone.MethodsTwenty clinics in Kenema District were randomly assigned to one of four treatment foods: Super Cereal (SC) plus fortified vegetable oil (FVO) and sugar (acting as the comparison group), Super Cereal Plus (SC+), Corn Soy Blend 14 (CSB14) plus FVO, and Plumpy'Sup (PS). Children 6‐59 months with MAM (MUAC > 11.0 cm and < 12.5 cm) were enrolled in the clinic‐based supplementary feeding programs, receiving a food ration every 2 weeks for 12 weeks or until recovered from MAM (determined by MUAC 蠅 12.5 cm). Beneficiaries' anthropometric data were collected during each clinic visit including MUAC, height, and weight.ResultsThe study was terminated early due to the Ebola outbreak and our sample size was reduced from 5000 to 1153 children who enrolled and completed the study. Out of these, recovery rates were 61% in the SC plus FVO group (comparison), 56% in the CSB14 group, 57% in the PS group, and 63% in the SC+ group. There were no significant differences in recovery rates, SAM, or failure to respond between each study arm and the SC comparison group; death rates were significantly higher in SC+ compared with SC (0.9% vs 3.2%, p=0.046).ConclusionWe found no significant difference in MAM recovery rates among the four supplementary foods. However, due to our limited sample size the power to detect a significant difference was reduced.