Prevention of Acute Malnutrition During the Lean Season:Comparison of a Lipid-Based Nutrient Supplement and an Improved Dry Ration, South Darfur,Sudan. A Quasi-Experimental Study

Abstract

Objective: To assess the nutritional impact of a Lipid-Based Nutrient Supplement (LNS) and an Improved Dry Ration (IDR) in blanket supplementary feeding programs. Design: Longitudinal, quasi experimental non-randomized study Setting: Otash and Al Salaam internally displaced persons camps, South Darfur, Sudan Subjects: Children aged 6-36 months were randomly selected for inclusion in the study based on height cut-off of 95 cm and were anthropometrically assessed (weight-for-height z scores [WHZ] based on WHO standards, edema presence, and midupper arm circumference) monthly. IDR was distributed in Otash camp and LNS in Al Salaam. Main findings: At baseline, 658 and 893 children were enrolled and 159 and 187 children were assessed at all 4 distributions in Otash and Al Salaam camps, respectively; There was no significant difference in mean WHZ between the two groups at baseline, (Otash=-1.18 and Al Salaam=-1.03, p=0.17). Children receiving LNS had higher mean WHZ than those receiving IDR. Significant differences were detected at months 2-4, for the mean WHZ of the LNS cohort, and at 4 months, for the difference of the difference in mean WHZ (-0.23) between camps, p= 0.02. Conclusions: LNS may be an option for preventing acute malnutrition in humanitarian settings, however research is needed on the timing, duration of use and cost effectiveness.