How age and sex affect treatment outcomes for children with severe malnutrition: A multi-country secondary data analysis

被引:0
|
作者
Thurstans, Susan [1 ]
Opondo, Charles [2 ,3 ]
Bailey, Jeanette [4 ]
Stobaugh, Heather [5 ]
Loddo, Fabrizio [6 ]
Wrottesley, Stephanie V. [7 ]
Seal, Andy [8 ]
Myatt, Mark [9 ]
Briend, Andre [10 ,11 ,12 ]
Garenne, Michel [13 ,14 ,15 ,16 ]
Mertens, Andrew [17 ]
Wells, Jonathan [18 ]
Sear, Rebecca [1 ]
Kerac, Marko [1 ,19 ]
机构
[1] London Sch Hyg & Trop Med, Dept Populat Hlth, London, England
[2] London Sch Hyg & Trop Med, Dept Med Stat, London, England
[3] Univ Oxford, Nuffield Dept Populat Hlth, Natl Perinatal Epidemiol Unit, Oxford, England
[4] Int Rescue Comm, New York, NY USA
[5] Act Hunger, New York, NY USA
[6] Medecins Frontieres, Paris, France
[7] Emergency Nutr Network, Oxford, England
[8] UCL, Inst Global Hlth, London, England
[9] Brixton Hlth, Llwyngwril, Gwynedd, Wales
[10] Tampere Univ, Tampere Ctr Child Adolescent & Maternal Hlth Res, Tampere, Finland
[11] Tampere Univ Hosp, Tampere, Finland
[12] Univ Copenhagen, Dept Nutr Exercise & Sports, Copenhagen, Denmark
[13] UMI Resiliences, Inst Rech Dev, Bondy, France
[14] Univ Western Cape, Dept Stat & Populat Studies, Cape Town, South Africa
[15] Univ Auvergne, FERDI, Clermont Ferrand, France
[16] Univ Witwatersrand, Fac Hlth Sci, Sch Publ Hlth, MRC Wits Rural Publ Hlth & Hlth Transit Res Unit, Johannesburg, South Africa
[17] Univ Calif Berkeley, Sch Publ Hlth, Berkeley, CA USA
[18] UCL Great Ormond St Inst Child Hlth, Populat Policy & Practice Res & Teaching Dept, London, England
[19] London Sch Hyg & Trop Med, Maternal Adolescent Reprod & Child Hlth Ctr MARCH, London, England
来源
MATERNAL AND CHILD NUTRITION | 2024年 / 20卷 / 03期
关键词
malnutrition; sex; treatment; undernutrition; wasting;
D O I
10.1111/mcn.13596
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Age and sex influence the risk of childhood wasting. We aimed to determine if wasting treatment outcomes differ by age and sex in children under 5 years, enroled in therapeutic and supplementary feeding programmes. Utilising data from stage 1 of the ComPAS trial, we used logistic regression to assess the association between age, sex and wasting treatment outcomes (recovery, death, default, non-response, and transfer), modelling the likelihood of recovery versus all other outcomes. We used linear regression to calculate differences in mean length of stay (LOS) and mean daily weight gain by age and sex. Data from 6929 children from Kenya, Chad, Yemen and South Sudan was analysed. Girls in therapeutic feeding programmes were less likely to recover than boys (pooled odds ratio [OR]: 0.84, 95% confidence interval [CI]: 0.72-0.97, p = 0.018). This association was statistically significant in Chad (OR: 0.61, 95% CI: 0.39-0.95, p = 0.030) and Yemen (OR: 0.47, 95% CI: 0.27-0.81, p = 0.006), but not in Kenya and South Sudan. Multinomial analysis, however, showed no difference in recovery between sexes. There was no difference between sexes for LOS, but older children (24-59 months) had a shorter mean LOS than younger children (6-23 months). Mean daily weight gain was consistently lower in boys compared with girls. We found few differences in wasting treatment outcomes by sex and age. The results do not indicate a need to change current programme inclusion requirements or treatment protocols on the basis of sex or age, but future research in other settings should continue to investigate the aetiology of differences in recovery and implications for treatment protocols. There are few differences in recovery outcomes for wasting treatment by age and sex.Though differences are small, mean daily weight gain (g/kg/day) appears to be significantly lower in boys than girls. Likewise, though differences are small, younger children (6-23 months) often have a significantly longer mean length of stay compared with older children (24-59 months).The strength of our evidence does not indicate the need to change current inclusion criteria for wasting treatment programmes on the basis of age and sex but does suggest the need for further research to understand the effects of different confounders on treatment outcomes.
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页数:14
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