Post-Recovery Relapse of Children Treated with a Simplified, Combined Nutrition Treatment Protocol in Mali: A Prospective Cohort Study

Suvi T. Kangas*, Issa Niamanto Coulibaly, Zachary Tausanovitch, Bareye Ouologuem, Bethany Marron, Elizabeth Radin, Christian Ritz, Salimou Dembele, Césaire T. Ouédraogo, Jeanette Bailey


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The present study aimed to determine the 6-month incidence of relapse and associated factors among children who recovered from acute malnutrition (AM) following mid-upper arm circumference (MUAC)-based simplified combined treatment using the ComPAS protocol. A prospective cohort of 420 children who had reached a MUAC ≥ 125 mm for two consecutive measures was monitored between December 2020 and October 2021. Children were seen at home fortnightly for 6 months. The overall 6-month cumulative incidence of relapse [95%CI] into MUAC < 125 mm and/or edema was 26.1% [21.7; 30.8] and 1.7% [0.6; 3.6] to MUAC < 115 mm and/or edema. Relapse was similar among children initially admitted to treatment with a MUAC < 115 mm and/or oedema and among those with a MUAC ≥ 115 mm but <125 mm. Relapse was predicted by lower anthropometry both at admission to and discharge from treatment, and a higher number of illness episodes per month of follow-up. Having a vaccination card, using an improved water source, having agriculture as the main source of income, and increases in caregiver workload during follow-up all protected from relapse. Children discharged as recovered from AM remain at risk of relapsing into AM. To achieve reduction in relapse, recovery criteria may need to be revised and post-discharge strategies tested.

Udgave nummer11
Antal sider16
StatusUdgivet - jun. 2023

Bibliografisk note

Funding Information:
The implementation of this research was funded by The Rockefeller Foundation and by grant number 1909-59874. The data analysis and manuscript write-up work was funded under the Thompson Family Foundation. The findings and conclusions contained withing are those of the authors and do not necessarily reflect positions or policies of the funders.

Publisher Copyright:
© 2023 by the authors.


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