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Factors associated with non-response and nutrional status of non-responders at 6-month post-discharge: a cohort study nested in a MUAC-based nutrition programme for acutely malnourished children in Mirriah, Niger

dc.rights.licenseopenen_US
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorDAURES, Maguy
dc.contributor.authorHIEN, Jeremie
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorCAZES, Cecile
dc.contributor.authorALITANOU, Rodrigue
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorSAILLET, Laure
dc.contributor.authorSERI, Benjamin
dc.contributor.authorALY, Ahmad Ag Mohamed
dc.contributor.authorMAIDADJI, Oumarou
dc.contributor.authorSANOUSSI, Atte
dc.contributor.authorMAHAMADOU, Aboubacar
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorALTMANN, Mathias
dc.contributor.authorPHELAN, Kevin
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorBECQUET, Renaud
dc.contributor.authorSHEPHERD, Susan
dc.date.accessioned2024-10-10T10:21:52Z
dc.date.available2024-10-10T10:21:52Z
dc.date.issued2024-08-14
dc.identifier.issn2296-2565en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/202381
dc.description.abstractEnBACKGROUND: In the treatment of acute malnutrition (AM), non-response is considered a treatment failure for not meeting recovery criteria within a therapeutic window of 12-16 weeks, but this category of children is misunderstood. As current research emphasizes ways to simplify and optimize treatment protocols, non-response emerges as a new issue to enhance program efficiency. METHODS: A prospective cohort study was conducted from 2019 to 2020 at two health centres in Mirriah, Niger among children aged 6-59 months with uncomplicated AM treated under the Optimising treatment for Acute MAlnutrition (OptiMA) protocol. Children who did not meet recovery criteria by 12 weeks (mid-upper arm circumference (MUAC) ≥125 mm without oedema for two consecutive weeks) were classified as non-responders. Non-responders received a home visit six-months post-discharge. Logistic regression was used to analyze factors associated with non-responders compared with children who recovered. RESULTS: Of the 1,112 children enrolled, 909 recovered and 139 were non-responders, of which 127 (80.6%) had significant MUAC gain (mean: +9.6 mm, sd = 5.1) at discharge. Girls (adjusted hazard ratio (aHR) = 2.07, 95% CI 1.33-3.25), children <12 months of age (aHr = 4.23, 95% CI 2.02-9.67), those with a MUAC <115 mm (aHR = 11.1, 95% CI 7.23-17.4) or severe stunting (aHR = 2.5, 1.38-4.83) at admission and a negative or flat MUAC trajectory between admission and week 4 (aHR = 4.66, 95% CI 2.54-9.13) were more likely to be non-responders. The nutritional status of non-responders had generally improved 6 months after discharge, but only 40% had achieved MUAC ≥125 mm. CONCLUSION: Non-responders are not a homogeneous group; while most children ultimately show significant nutritional improvement, rapid hospital referral is crucial for those not gaining MUAC early in treatment. As efforts to expand MUAC-based programming progress, adapting exit criterion and/or providing additional food supplementation with smaller daily ration for children with risk factors discussed here may help improve programme efficiency without adding to the cost of treatment.
dc.language.isoENen_US
dc.rightsAttribution 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/us/*
dc.subject.enAfrica
dc.subject.enWestern
dc.subject.enAcute Malnutrition
dc.subject.enChildren
dc.subject.enFailure To Treatment
dc.subject.enMid-Upper Arm Circumference
dc.subject.enNon Response
dc.title.enFactors associated with non-response and nutrional status of non-responders at 6-month post-discharge: a cohort study nested in a MUAC-based nutrition programme for acutely malnourished children in Mirriah, Niger
dc.title.alternativeFront Public Healthen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.3389/fpubh.2024.1357891en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed39206006en_US
bordeaux.journalFrontiers in Public Healthen_US
bordeaux.page1357891en_US
bordeaux.volume12en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamGHIGS_BPHen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
bordeaux.identifier.funderIDInstitut de Recherche pour le Développementen_US
hal.identifierhal-04730193
hal.version1
hal.date.transferred2024-10-10T10:21:55Z
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exporttrue
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&amp;rft_val_fmt=info:ofi/fmt:kev:mtx:journal&amp;rft.jtitle=Frontiers%20in%20Public%20Health&amp;rft.date=2024-08-14&amp;rft.volume=12&amp;rft.spage=1357891&amp;rft.epage=1357891&amp;rft.eissn=2296-2565&amp;rft.issn=2296-2565&amp;rft.au=DAURES,%20Maguy&amp;HIEN,%20Jeremie&amp;CAZES,%20Cecile&amp;ALITANOU,%20Rodrigue&amp;SAILLET,%20Laure&amp;rft.genre=article


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