Treatment of Moderate Acute Malnutrition Using Plumpy Sup among Children Aged 6 to 59 Months in Turkana County, Kenya
Majwa, Philimon Omondi
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In Kenya, 26% of children are moderately stunted, 11.4% severely stunted, 6.7% moderately underweight, 2.6% severely underweight, and 13.0% moderately wasted, with 2.5% severely. In Turkana County, 25.6% of children are moderately stunted, and 17.4% are moderately wasted. Plumpy Sup is used to treat moderate acute malnutrition through the supplementary feeding programme. With the increased reports of relapse and overstay of children aged 6 to 59 months in the supplementary feeding programme, there is limited documentation of the effectiveness of plumpy sup in a community-based programme in Turkana county. This prospective cohort study assessed the effectiveness of Plumpy sup in the management of moderate acute malnutrition among 300 children aged 6 to 59 months in Turkana central sub-county. The study employed stratified and multistage sampling, with data collected via desk review, key informant interviews, focused group discussions, and household interviews. Data on child morbidity status was collected using a two -week-day recall period, while a 24-hour dietary recall was used to collect data on the type and amount of food that the child consumed. Nutrient analysis was done using the Nutri-surv software in conjunction with the Kenya Food Consumption Table. Descriptive and inferential statistics were used to analyze the variables of interest. Survival analysis and log-rank test were used to establish the recovery rate of the children. At the 90th day, the mean energy intake, 556.1±56.9 kcal per day, of children aged six to 11months was below the recommended daily allowance of 675 to 806 kcal; Protein intake for children aged 6 to 11 months was 11.3±3.9 g per day; while Carbohydrate intake was 74.3±5.7 g per day, all below the recommended daily allowance. Morbidity prevalence was high (76.3% at baseline) at with 39.3% suffering from malaria, 21.7% from diarrhoea, and 7.7% from an eye infection.. Access to water and sanitation services from baseline to day 90 was statistically significant except for treatment with traditional herbs. The median day to recovery was 84 days for females and 70 days for males. The difference observed in recovery rate between males and females was not statistically significant. There was a significant relationship between caregivers’ socioeconomic status and the recovery rate of children on day one and day 42. There was no statistically significant difference in caregivers’ attitude on IYCF and recovery rate for all the days. There was no statistically significant association, all p>0.05, between the effectiveness of Plumpy sup and the morbidity status of the child. On factors affecting the effectiveness of Plumpy sup, a full model containing all predictors was statistically significant, χ2 (8, N=300) = 17.847, p=0.022; the model could distinguish between children who recovered and those who did not recover.