Consequences of Acute Malnutrition
Assessment of Long-Term Health Consequences of Acute Malnutrition (ACAM)
Principal Investigator: Alemseged Abdissa1
Co-investigators: Tsinuel Girma1, Mekides Shimekit1, Getu Gizaw1, Yaregal Asres1, Teshome Kabeta1, Mubarek Abera1, Fisseha Mikre1, Teferi Daba1, Kora Tushune1, PalukuBahwere2, BarnardetteCihon2, Kate Sadler2
Collaborating Institutions: 1) Jimma University, 2) Valid International 3) Plan International
Background, objectives and methods: The treatment of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) been standardized and huge progress has been achieved in improving children’s catch-up growth and reducing mortality but very little is known about the long-term prognosis of acutely malnourished children managed according to current strategies. The main aim of this study is therefore to examine the long-term health and nutrition outcomes of children currently aged between 4 and 8 years who presented an episode of MAM or SAM. We looked at whether mortality (only SAM cohort), physical growth, cellular health, body composition, risk of metabolic syndrome, mental health, cognitive development and school performance of cases are different from those of controls.
We did a cross-sectional study consisting of the long-term follow up of children assessing the outcome of MAM when there is no supplementary feeding program (MAM cohort) and assessing the 12-months of children successfully treated for SAM in a community-based management program (SAM cohort). The post-MAM and post-SAM children were compared to apparently healthy community controls matched by age, sex and village. The study was conducted in four Woredas of Jimma zone namely Dedo, Mana, Omonada and Seka and 474 children of the SAM cohort and 884 children of the MAM cohorts were traced and enrolled. For each child of the MAM cohort traced, a matched control was selected in the immediate neighborhood. Interviewer administered questionnaires were employed and standard anthropometric methods were used. Bio impedance analysis body composition analyzers (BODY STAT 4000 Quad scan), deuterium dilution technique, tri-axial accelerometer (ActiGraph GT3X+; ActiGraph, Pensacola, Florida), pediatric hand grip dynamoter, PeabodyPicture Vocabulary Test (PPVT-III) package, the Cognitive Development Assessment–Quantity Test package and school records were also used. Blood and saliva samples were collected in a sub-sample. The outcomes of interest included: proportion of children who had been referred or admitted in OTP since the last follow up, prevalence of stunting, frequency of severe disease episodes as measured by frequency disease related death or admission for inpatient treatment for any diseases, average cognitive development score as measured by vocabulary score, numeracy score and attained grade and relative risk of metabolic syndrome.
Funding source: USAID through Plan International USA
Study period: Oct 2017-July 2018