Prevention Of Malnutrition Research Articles

Developing a model for prevention of malnutrition among children under 5\u2009years old

BackgroundSerious consequences leading to the increase of infectious diseases and mortality of children justifies the importance of interventions for eradication of malnutrition. Thus, this study aimed to provide a model for the prevention of malnutrition among children under 5 years old (CU5) in Iran.MethodsThis paper is part of a bigger study, conducted in 2017 using a mixed methods approach. A model for prevention of malnutrition in CU5 was proposed based on the earlier steps, with the cooperation and consultation of experts and specialists. In the final step, a Delphi method was used to determine the validity of the proposed model.ResultsThe main dimensions of the prevention model of malnutrition for CU5 in Iran included four level: basic causes, interventions, outcomes and impact. The proposed interventions are presented based on twelve areas: structural, intersectoral, political, economic, sanitary, health-oriented, research, educational/cultural, evaluation related, production, infrastructures and legal. Based on these areas, 118 solutions were finally selected for the final model. This model is designed based on the current conditions in different regions of Iran, the factors related to child malnutrition, affective context on policy making, the content of previous policies, the process of policy making in Iran, and key stakeholders and actors in policy making.ConclusionIn order to prevent malnutrition, the causing factors should be identified and resolved. The adopted policies should be, more seriously, based on the presence of key stakeholders and actors. Most of the existing nutritional problems among children are because of inappropriate consumerism culture and habits in families and its transfer to children.

A training module to empower marginalised Northern Borneo islanders for tuberculosis control.

Empowering marginalised urban islanders with limited health accessibility through knowledge transfer program for controlling pulmonary tuberculosis (PTB) requires a specific training module. The study was aimed to develop this training module by adapting and modifying the IMCI (Integrated Management of Childhood Illness) framework. Structuring the content for the knowledge and skills for PTB control in the module was based on the National Strategic Plan for Tuberculosis Control 2016-2020. A total of five knowledge and skills were structured: i) PTB disease and diagnosis, ii) PTB treatment, iii) preventive PTB measures, iv) prevention of malnutrition, and v) psychosocial discrimination. The IMCI framework was modified through 3 ways: i) identifying signs and symptoms of PTB, ii) emphasising the IMCI’s 5 steps of integrated management: assess, diagnose, treat, counsel and detect, and iii) counseling on BCG immunisation, malnutrition, environmental modifications and stigma on PTB.Significance for public healthControlling tuberculosis in high pulmonary tuberculosis (PTB) regions among marginalised islanders with limited health accessibility requires a concerted effort from the community and the healthcare system. An efficient implementation is through community empowerment by transferring adequate knowledge and skills on PTB detection and treatment within the community for reducing the spread of the disease. Developing a training module for the knowledge transfer purpose has to be contextually relevant and adapted to the lack of healthcare resources of the targeted region. Adapting Integrated Management of Childhood Illness (IMCI) framework for developing such training module is feasible for PTB and should be extended to other diseases.

Incidence Correction Factors for Moderate and Severe Acute Child Malnutrition From 2 Longitudinal Cohorts in Mali and Burkina Faso.

Child acute malnutrition (AM) is an important cause of child mortality. Accurately estimating its burden requires cumulative incidence data from longitudinal studies, which are rarely available in low-income settings. In the absence of such data, the AM burden is approximated using prevalence estimates from cross-sectional surveys and the incidence correction factor n}{}K, obtained from the few available cohorts that measured AM. We estimated n}{}K factors for severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) from AM incidence and prevalence using representative cross-sectional baseline and longitudinal data from 2 cluster-randomized controlled trials (Innovative Approaches for the Prevention of Childhood Malnutrition—PROMIS) conducted between 2014 and 2017 in Burkina Faso and Mali. We compared K estimates using complete (weight-for-length z score, mid-upper arm circumference (MUAC), and edema) and partial (MUAC, edema) definitions of SAM and MAM. n}{}K estimates for SAM were 9.4 and 5.7 in Burkina Faso and in Mali, respectively; K estimates for MAM were 4.7 in Burkina Faso and 5.1 in Mali. The MUAC and edema–based definition of AM did not lead to different n}{}K estimates. Our results suggest that n}{}K can be reliably estimated when only MUAC and edema-based data are available. Additional studies, however, are required to confirm this finding in different settings.

Nutritional status of Rohingya under-5 children in Jamtoly Rohingya camp

Introduction: About one million Rohingya people had fled to Cox’s Bazar Bangladesh after experiencing massive atrocities in their homeland Rakhine state of Myanmar. Rohingya people deprived of adequate food supply, education, and health care; resulting in malnutrition rate was very high among their children. Objective: Aim of this study to assess the nutritional status of 1-60 months, Rohingya children. Method: A total of 470 participants were enrolled by a purposive sampling method from patients attending the hospital. Weight-forheight Z-score was calculated based on the 2006 World Health Organization growth standards guideline. Moderate acute malnutrition and severe acute malnutrition have defined as weight-for-height Z-score between –2 SD to –3 SD and <-3 SD respectively. Result: Out of all, 282 (60.0%) belonged to the age group of <2 years, the mean age was 2.16 years (SD, 1.40) and 251 (53.4%) was male. The prevalence of moderate acute malnutrition and severe acute malnutrition were 25.1% and 18.5% respectively. The prevalence of acute malnutrition was significantly different compared to the socio-demographic factor particularly in age and sex (p-value <0.05). Conclusion: Prevention of malnutrition among the refugee is one of the strategic plans of several types of UN agency and National organizations. Despite these efforts, this problem persists.

Nutrição parenteral: panorama das amostras analisadas no Instituto Nacional de Controle de Qualidade em Saúde

Background and objectives: Total parenteral nutrition (TPN) has great clinical importance in malnutrition treatment and prevention in patients with digestive problems. Although good practices for handling TPN are well established, contamination of these products still occurs, and this product remains listed as a higher risk drug by the Institute for Safe Medication Practices. The present study aimed to obtain an overview of the documentary data of the parenteral nutrition samples sent to the National Institute for Quality Control in Health (INCQS) of Fundação Oswaldo Cruz. Methods: This is a qualitative descriptive and quantitative study carried out based on a cross-section of TPN samples analyzed from 2000 to 2016. Results: A total of TPN 134 samples were sent during the study period. 11.20% of the samples were sent in 2001, 0.80% in 2005, 8.20% in 2006, 16.40% in 2007, 63.40% in 2013. Six samples (4.5%) were canceled and 113 submitted to sterility testing, resulting in 13.3% unsatisfactory samples. Conclusion: During the study period, four suspected events of enterobacterial contamination in TPNs administered to patients were reported, three of which have not yet been described in the scientific literature. For the safety of patients using TPN to be guaranteed, it is suggested that the norms that regulate TPN therapy be reviewed and updated, and programs to monitor the quality of these preparations should be established.

Association between Oral Frailty and Nutritional Status among Community-Dwelling Older Adults: the Takashimadaira Study.

Recently, the concept of oral frailty, defined as accumulated deficits in oral health, has been introduced in Japan. However, data about its association with nutritional status are limited. Thus, this cross-sectional study aimed to investigate the association between oral frailty and malnutrition among community-dwelling older adults. Cross-sectional study. Community. One thousand and fifty-four individuals (428 men and 626 women, mean age: 77.0 years) from the Takashimadaira Study. Based on a multifaceted oral health assessment, oral frailty was defined as greater than or equal to three of the following components: (1) low number of remaining teeth, (2) decreased masticatory performance, (3) reduced articulatory oral motor skill, (4) low tongue pressure, and difficulties in (5) eating and (6) swallowing. The nutritional status was evaluated using the Mini Nutritional Assessment®-Short Form (MNA®-SF) and serum albumin. An ordinal logistic regression model was used to evaluate the association between oral frailty and nutritional status. Oral frailty was observed in 217 (20.4%) participants. After adjusting for potential confounders, the participants with oral frailty had higher odds of more severe malnutrition evaluated using MNA®-SF (adjusted odds ratio: 2.17; 95% confidence interval: 1.58-2.98) and serum albumin level (adjusted odds ratio: 1.59; 95% confidence interval: 1.10-2.31). Oral frailty was associated with nutritional status among Japanese older adults. Maintaining comprehensive oral health and function may be effective for malnutrition prevention in community-dwelling older adults. However, further studies must be conducted to validate the generalizability of the results of the current study.

The effectiveness of trained volunteer delivered interventions in adults at risk of malnutrition: A systematic review and meta-analysis

Malnutrition burden is high. Trained volunteers present a growing workforce in the NHS and are increasingly engaged in schemes that may be useful in tackling malnutrition in different settings. A recent systematic review of trained volunteers in a hospital setting reported improved patient satisfaction and some improvement in dietary intake of patients. This review explored the effectiveness of trained volunteers in delivering nutritional interventions in adults at risk of malnutrition in different care settings on patient-centred outcomes and aimed to identify and build an evidence base for a more defined role for trained volunteers in malnutrition prevention in the UK. Six electronic databases were searched to 30th October 2018. Abstracts and full texts of relevant studies of all study designs were screened by two authors independently. Studies were examined for risk of bias and overall quality of evidence of main outcomes was assessed using the GRADE approach. Narrative synthesis and meta-analyses (nutritional intake) were used to combine outcome data. Seventeen eligible studies were included. Three were conducted in the home setting and fourteen were hospital based. Low quality evidence from one small RCT showed significant improvements in physical performance and fear of falling resulting from a volunteer intervention in the home setting. Very low quality evidence from meta-analysis findings indicated that trained volunteer mealtime assistance significantly improved lunchtime energy intake but did not significantly improve daily total energy intake in hospitals. Very low quality evidence also suggested that volunteers improve patient experience and satisfaction and are safe. This paper identified some evidence to suggest trained volunteer interventions may be effective in improving some outcomes in nutritionally at-risk older adults in home and hospital settings. Considering the high prevalence and costs of malnutrition, adequately-powered research is needed in this area to identify the most effective use of resources.

Clinical Decision Support Systems in Nursing Homes: A Scoping Review.

The world population is dramatically ageing, resulting in an increase of the prevalence of older dependent adults living in nursing homes (NHs). Because of insufficient resources in NHs, and nurses' lack of time and knowledge, adverse events, most of them being preventable, are often reported. Clinical decision support systems (CDSSs) have proven to improve the quality of care in various healthcare settings such as hospitals and primary care centers. However, the use of CDSSs in NHs is still limited and little is known about their influence on nursing practices and NH residents' clinical outcomes. We conducted a scoping review of the literature to evaluate CDSS use in NHs. Out of 1,231 retrieved papers, 15 studies were retrieved which assess 10 CDSSs applied to pressure ulcers and malnutrition prevention, drug prescription, and disease management. This review showed CDSSs could be effective in NHs for improving routine clinical practice and patient outcomes, but research is still needed to implement effective CDSSs in NHs.

Prevalence of protein intake below recommended in community-dwelling older adults: a meta-analysis across cohorts from the PROMISS consortium.

BackgroundLower protein intake in older adults is associated with loss of muscle mass and strength. The present study aimed to provide a pooled estimate of the overall prevalence of protein intake below recommended (according to different cut‐off values) among community‐dwelling older adults, both within the general older population and within specific subgroups.MethodsAs part of the PRevention Of Malnutrition In Senior Subjects in the EU (PROMISS) project, a meta‐analysis was performed using data from four cohorts (from the Netherlands, UK, Canada, and USA) and four national surveys [from the Netherlands, Finland (two), and Italy]. Within those studies, data on protein and energy intake of community‐dwelling men and women aged ≥55 years were obtained by either a food frequency questionnaire, 24 h recalls administered on 2 or 3 days, or food diaries administered on 3 days. Protein intake below recommended was based on the recommended dietary allowance of 0.8 g/kg body weight (BW)/d, by using adjusted BW (aBW) instead of actual BW. Cut‐off values of 1.0 and 1.2 were applied in additional analyses. Prevalences were also examined for subgroups according to sex, age, body mass index (BMI), education level, appetite, living status, and recent weight loss.ResultsThe study sample comprised 8107 older persons. Mean ± standard deviation protein intake ranged from 64.3 ± 22.3 (UK) to 80.6 ± 23.7 g/d [the Netherlands (cohort)] or from 0.94 ± 0.38 (USA) to 1.17z ± 0.30 g/kg aBW/d (Italy) when related to BW. The overall pooled prevalence of protein intake below recommended was 21.5% (95% confidence interval: 14.0–30.1), 46.7% (38.3–55.3), and 70.8% (65.1–76.3) using the 0.8, 1.0, and 1.2 cut‐off value, respectively. A higher prevalence was observed among women, individuals with higher BMI, and individuals with poor appetite. The prevalence differed only marginally by age, education level, living status, and recent weight loss.ConclusionsIn community‐dwelling older adults, the prevalence of protein intake below the current recommendation of 0.8 g/kg aBW/d is substantial (14–30%) and increases to 65–76% according to a cut‐off value of 1.2 g/kg aBW/d. To what extent the protein intakes are below the requirements of these older people warrants further investigation.

Assessment of nutritional status, dietary intake and adherence to dietary recommendations in hemodialysis patients

Assessing dietary habits and nutritional status in patients with end stage kidney disease (ESKD) treated with maintenance hemodialysis (HD) plays a crucial role in the prevention of protein energy malnutrition. The aim of this study was, on one hand, to assess nutritional status and dietary intake of HD patients in comparison with the guidelines recommendations and, on the other hand, to determine the characteristics of those who didn’t meet their nutritional needs. In a sample of 156 HD patients (70 women and 86 men), clinical data, anthropometric measurements and two 24 hour dietary recalls were collected to evaluate the nutritional status and dietary intake. The results showed that based on the Body Mass Index (BMI), appropriate nutritional status was reported for only 60.6% of the patients. The mean energy intake was 1904.98 ±592.50 kcal per day, only 16.8% of participants were found compliant regarding the recommended intake of energy density; about 33 % met the recommended minimum of 1.2g/kg of protein per day and only 36.5% have adequate fiber consumption. The protein and energy density were negatively correlated with age, BMI and waist circumference. No patients achieved the recommendations concerning the saturated fat intake. In conclusion, the study data report that a high proportion of dialysis patients did not meet current renal specific dietary requirements and that the diet quality is considered poor. These results call the attention to individual dietetic counseling and promotion of a global dietary approach in hemodialysis patients in order to improve clinical outcomes and the quality of life of chronic kidney patients.

A Systematic Review of the Nutritional Status of Children Living in Institutionalized Care

Abstract Objectives An estimated 2.7 million children live within institutionalized care worldwide. This systematic review aimed to evaluate available data on the nutritional status of children living within institutionalized care. Methods Four databases were searched for articles published between January 1990 to January 2019. Studies were eligible for inclusion if they contained information on anthropometry or micronutrient status of children living within institutionalized care. The review is registered on PROSPERO: CRD42019117103. Results We screened 3602 titles and reviewed 98 full texts, from which 25 papers were determined eligible. The majority of studies were cross sectional (88%). Low birth weight ranged from 25 to 39%. Five (20%) studies included information on children with disabilities reporting prevalence from 8 to 75%. Prevalence of undernutrition varied between ages, sites and countries: stunting ranged from 9 to 72%; wasting from 0 to 27%; underweight from 7 to 79%; low BMI from 5 to 27%. Overweight/obesity ranged between 10 to 32% and small head circumference from 17 to 41%. The prevalence of HIV was between 2 to 23% and anemia from 3 to 90%. Skin conditions or infections ranged between 10 to 31% and parasites from 6 to 76%. Institution-based children were more malnourished than community peers and younger children were more malnourished than older children. A high risk of bias was found in the studies. Conclusions Addressing the nutrition needs of this underrepresented vulnerable population of children is important in the fight against malnutrition worldwide. Prevention and treatment of poor nutrition in this population can have far reaching impacts but there is limited research on their nutritional status. Children in institutions were commonly malnourished; affected by undernutrition, overnutrition and micronutrient deficiencies. Few studies described disabilities, despite disabilities being common in this population and having a big potential impact on nutritional status. Together, these findings suggest a need for greater focus on prevention and treatment of malnutrition in this population, especially for younger children and children with disabilities. More information is needed to support the millions of children living within institutionalized care to address their rights and needs for healthy development. Funding Sources No funding.

MALNUTRITION IN OLDER ADULTS AND ITS CORRELATES WITH ANXIETY AND DEPRESSION

Elderly research suggests inappropriate food intake as a one of the health issue. Malnutrition may have an undesirable effect on the health of the body. Elderly people are most at risk because they are often the result of loss of appetite, difficulties with daily shopping, meal preparation, somatic disorders and mental disorders such as depression. The purpose of the study was to investigate malnutrition among the elderly who are staying in social care institutions and to assess its association with anxiety and depression. The data from the study were obtained using the Universal Malnutrition Screening, Geriatric Alert Scale and the Geriatric Depression Scale as tools. Overall, 102 respondents from two social care institutions participated in the study. The majority were women 64.7% (35.3% were male). Respondents ranged in age from 65 to 91 years. There were 27.44% of participants with malnutrition risk and 45.10% with signs of anxiety. Depression symptoms were detected 60.78% of respondents. Within the research sample, a statistically significant relationship between malnutrition and depression was found (r = 0.302, p&lt; 0.01). Prevention of malnutrition and the early detection of depression among seniors will contribute to the improvement of the quality of their life and quality of health care.

A study to asses knowledge, attitude and practices of mothers of under five children regarding prevention of Protein Energy Malnutrition.

A study to asses knowledge, attitude and practices of mothers of under five children regarding prevention of Protein Energy Malnutrition.

Nutritional Outcomes of patients Undergoing Resection for upper gastroIntestinal cancer in AuStralian Hospitals (NOURISH): protocol for a multicentre point prevalence study

IntroductionNutritional intervention and prevention of malnutrition is significantly important for patients with upper gastrointestinal oesophageal, pancreatic and gastric cancer. However, there is limited information regarding nutritional status, and perioperative nutritional...

Tuberculosis in Siena: evolution of the disease and its treatment, from the Unification of Italy to the 1930s.

SummaryBetween the end of the nineteenth century and the first half of the twentieth century, the city of Siena experienced elevated tuberculosis-related morbidity and mortality, to the point that on January 1, 1929 the newspaper La Nazione wrote that “Siena ranks second in the official Tuberculosis (TB) incidence rate”. The author presents statistical data relating to a time span ranging from 1898 to 1935, interpreting them in light of social and sanitary conditions found in the city. The result is an exhaustive picture of the most important actions implemented at city level to prevent tuberculosis and to assist and treat the sick, such as: the creation of seaside hospices conceived by Carlo Livi for children suffering from scrofula, as well as centers committed to the prevention of childhood poverty and malnutrition; the realization of activities in the green areas of the ramparts of the Fortress, upon recommendation by the great hygienist Achille Sclavo; the establishment of a Preventorium on the premises of the Monastery of Santa Maria Maddalena to accommodate children from families that included pulmonary tuberculosis patients, and countless activities carried out by the Anti-TB Dispensary. Of particular interest is the identification of the main cause of high TB incidence in the unhealthy houses located in some areas of Siena’s district, which, in 1930 engendered a lively debate hinging upon the notion of building restoration.

Malnutrition trends in Rohingya children aged 6-59 months residing in informal settlements in Cox's Bazar District, Bangladesh: An analysis of cross-sectional, population-representative surveys.

BackgroundMore than 700,000 ethnic Rohingya have crossed the border from Rakhine State, Myanmar to Cox’s Bazar District, Bangladesh, following escalated violence by Myanmar security forces. The majority of these displaced Rohingya settled in informal sites on previously forested land, in areas without basic infrastructure or access to services.Methods and findingsThree cross-sectional population-representative cluster surveys were conducted, including all informal settlements of Rohingya refugees in the Ukhia and Teknaf Upazilas of Cox’s Bazar District. The first survey was conducted during the acute phase of the humanitarian response (October–November 2017), and the second and third surveys were conducted 6 (April–May 2018) and 12 (October–November 2018) months later. Anthropometric indices (weight, height, mid-upper arm circumference [MUAC], oedema) and haemoglobin (Hb) were measured in children aged 6–59 months following standard procedures. Final samples for survey rounds 1, 2, and 3 (R1, R2, and R3) included 1,113, 628, and 683 children, respectively, of which approximately half were male (50.7%–53.5% per round) and a third were 6–23 months of age (32.4%–33.3% per round). Prevalence of global acute malnutrition (GAM) as assessed by weight for height in R2 (12.1%, 95% CI: 9.6–15.1) and R3 (11.0%, 95% CI: 8.4–14.2) represent a significant decline from the observed prevalence in R1 (19.4%, 95% CI: 16.8–22.3) (p < 0.001 for both comparisons). Overall, the prevalence of anaemia significantly declined (p < 0.001) between the first 2 rounds (47.9%, 95% CI: 44.1–51.7 and 32.3%, 95% CI: 27.8–37.1, respectively); prevalence increased significantly (p = 0.04) to 39.8% (95% CI, 34.1–45.4) during R3 but remained below R1 levels. Reported receipt of both fortified blended foods (12.8%) and micronutrient powders (10.3%) were low during R1 but increased significantly (p < 0.001 for both) within the first 6 months to 49.8% and 29.9%, respectively. Although findings demonstrate improvement in anthropometric indicators during a period in which nutrition programme coverage increased, causation cannot be determined from the cross-sectional design.ConclusionsThese data document significant improvements in both acute and micronutrient malnutrition among Rohingya children in makeshift settlements. These declines coincide with a scaleup of services aimed at prevention and treatment of malnutrition. Ongoing activities to improve access to nutritional services may facilitate further reductions in malnutrition levels to sustained below-crisis levels.

Cash and voucher assistance and children's nutrition status in Somalia.

To address ongoing food insecurity and acute malnutrition in Somalia, a broad range of assistance modalities are used, including in‐kind food, food vouchers, and cash transfers. Evidence of the impact of cash and voucher assistance (CVA) on prevention of acute malnutrition is limited in humanitarian and development settings. This study examined the impact of CVA on prevention of child acute malnutrition in 2017/2018 in the context of the Somalia food crisis. Changes in diet and acute malnutrition were measured over a 4‐month period among children age 6–59 months from households receiving household transfers of approximately US$450 delivered either as food vouchers or a mix of in‐kind food, vouchers, and cash. Baseline to endline change in children's dietary diversity, meal frequency, minimum acceptable diet (MAD), mid‐upper arm circumference (MUAC), and acute malnutrition (MUAC < 12.5 cm) were compared using difference‐in‐difference analysis with inverse probability weighting. There were no statistically significant changes in dietary diversity, meal frequency, or the proportion of children with MAD for either intervention group. Adjusted change in mean MUAC showed increases of 0.5 cm (confidence interval [CI; 0.0, 0.7 cm]) in the food voucher group and 0.1 cm (CI [−0.1, 0.4]) in the mixed transfer group. In adjusted analysis, prevalence of acute malnutrition among children under 5 years increased by 0.7% (CI [−13.4, 14.4%]) among food voucher recipients and decreased by 4.8% (CI [−9.9, 8.1%]) in mixed transfer recipients. The change over time in both mean MUAC and acute malnutrition prevalence was similar for both interventions, suggesting that cash and vouchers had similar effects on child nutrition status.

Predictors of complementary feeding in infants aged 6 to 18 months: An application of Health Belief Model

Introduction: Complementary feeding plays a vital role in growth and development of children and prevention of malnutrition. Objective: To determine the predictors of complementary feeding in 6 to 18-month-old infants and young children based on the Health Belief Model (HBM). Method: This cross-sectional study was performed on 270 mothers of children aged 6 to 18 months who were randomly selected from those referred to six health centres in Andimeshk city, Iran. Data were gathered using a 53-item questionnaire based on the HBM and were analysed by SPSS statistical software, descriptive statistics, Pearson correlation and multiple regression tests. Results: Mean age of the mothers was 29.8 ± 5.08 years and most of them were homemakers (88.5) and had an under-diploma education (62.2). The HBM constructs predicted a total of 28.9 of the variance of mothers' behaviour in relation to complementary feeding in children. Perceived selfefficacy (p = 0.001) and perceived barriers (p = 0.011) significantly predicted the behaviour. Conclusions: Perceived barriers and perceived self-efficacy are the most important determinants of mothers' behaviour in relation to complementary feeding in children. © 2020, Sri Lanka College of Paediatricians.

Intrahousehold management and use of nutritional supplements during the hunger gap in Maradi region, Niger: a qualitative study

BackgroundNutritional supplements are used for preventing and treating childhood malnutrition. While there is a growing body of evidence on product efficacy, less emphasis has been placed on how they are perceived and used at the household level. Here, we report on the intrahousehold management of three different supplements (Ready to Use Supplementary food (RUSF), medium quantity lipid-based nutrient supplements (LNS-MQ) and Super Cereal Plus (SC+)) in the region of Maradi (Niger). The main objective of this study was to describe the use, consumption and perception of the three different nutritional products at the household level.MethodsThe study was conducted in the Madarounfa district in the region of Maradi (February – March 2012). Female caregivers were purposely selected from eligible households and invited to participate. Data were collected through focus group discussion and interviews and were analyzed using thematic content analysis.ResultsIn total, 114 caregivers participated. Three major themes were initially identified and included preparation and conservation; consumption and sharing practices as well as perception of impact. The data showed good acceptance at the household level including perceived benefits for the target children, health improvement, prevention of illness and malnutrition. Sharing and gifting at both household and community level were also reported.ConclusionsCaregivers displayed positive perceptions toward the investigated supplements. Patterns of actual management should be considered in the design, implementation, monitoring and evaluation of future programs.

Early implementation of a postoperative nutrition support pathway for patients undergoing esophagectomy.

344 Background: A significant risk of malnutrition burdens patients with esophageal cancer undergoing esophagectomy as tumor-related dysphagia and side effects of chemoradiation impair the patients’ ability to maintain adequate nutrition. Moreover, patients lose 10% or more of their preoperative body weight in the first year following surgery. Implementation of nutrition protocols may reduce postoperative weight loss and enhance recovery in these patients. Methods: This is a retrospective study examining a postoperative nutrition protocol initiated in August of 2017. Patients with esophagogastric cancer who underwent Ivor Lewis esophagectomy from July 2016 to July 2019 were identified from a prospectively collected database. Patients that underwent surgery after implementation of this protocol were compared to those operated prior to it. Results: Patients’ and tumor characteristics were similar between the two groups. The protocol included preoperative evaluation by a dietician, postoperative feeding pathway, and regular post-discharge follow up by phone with a dietician. In the post protocol group, we observed a reduction in time to initiation of diet and decreased weight loss at patient follow up (Table). There was no difference in incidence of postoperative complication, length of stay, 30-day readmission, or in hospital mortality. Conclusions: In conclusion, postoperative nutrition support programs may help reduce postoperative weight loss and may have a role in the prevention of malnutrition in these patients. Initial results suggest that more aggressive nutritional supplement program is feasible and may lead to improved postoperative outcomes in patients undergoing esophagectomy. [Table: see text]