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Re-thinking "non-response" to wasting treatment: Exploratory analysis from 14 studies

dc.rights.licenseopenen_US
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorCAZES, Cecile
dc.contributor.authorSTOBAUGH, Heather
dc.contributor.authorBAHWERE, Paluku
dc.contributor.authorBINNS, Paul
dc.contributor.authorBLACK, Robert E
dc.contributor.authorBOYD, Erin
dc.contributor.authorBRIEND, André
dc.contributor.authorISANAKA, Sheila
dc.contributor.authorKANGAS, Suvi T
dc.contributor.authorKHARA, Tanya
dc.contributor.authorLELIJVELD, Natasha
dc.contributor.authorMWANGOME, Martha
dc.contributor.authorMYATT, Mark
dc.contributor.authorODEI OBENG-AMOAKO, Gloria
dc.contributor.authorTREHAN, Indi
dc.contributor.authorJAMES, Philip T
dc.date.accessioned2025-03-07T08:37:03Z
dc.date.available2025-03-07T08:37:03Z
dc.date.issued2025-01-01
dc.identifier.issn2767-3375en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/205424
dc.description.abstractEnChildren who receive therapeutic feeding for wasting treatment but do not reach the anthropometric definitions of recovery (usually within 12-16 weeks) are categorised as 'non-responders' and considered as treatment failures. We conducted a pooled analysis to explore the growth trajectories of non-responders and the appropriateness of the definition of 'non-response'. We pooled 14 studies of children aged 6-59 months receiving treatment for wasting. We included children classified by their studies as recovered or as non-responders. Observing the pooled data of non-responders' mid-upper arm circumference (MUAC), weight, weight-for-age z-score, weight-for-height z-score and daily weight gain rate, we found that the first quartile differentiated those who did not grow at all versus those that demonstrated some growth. We therefore defined 'low growth non-responders' as < 25th percentile anthropometric gain between admission and exit using the non-responders' pooled study data, and 'high growth non-responders' as ≥ 25th percentile gain. We plotted the growth trajectories of MUAC-, weight- and height-related indices of the recovered, high growth and low growth non-responder groups over time using mixed effects generalised additive models. We compared age, sex and anthropometric characteristics of the three groups and explored predictors of non-response category using a multivariate multinomial logistic regression model. For all outcomes, the high growth non-responders started with a worse anthropometric status compared to those who recovered, but then tracked along a near-parallel growth trajectory. The low growth non-responders showed limited growth throughout treatment. High growth non-responders are better viewed as 'delayed responders' and may need to be kept longer under treatment to recover and reduce the risks from early discharge. Low growth non-responders are the true treatment failures and should be referred for further investigations as quickly as possible. In conclusion, non-responders are not a homogenous group; ~75% of them respond well to treatment and ~25% are treatment failures.
dc.language.isoENen_US
dc.rightsAttribution 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/us/*
dc.title.enRe-thinking "non-response" to wasting treatment: Exploratory analysis from 14 studies
dc.title.alternativePLOS Glob Public Healthen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1371/journal.pgph.0003741en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed39937827en_US
bordeaux.journalPLOS Global Public Healthen_US
bordeaux.pagee0003741en_US
bordeaux.volume5en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.issue2en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamGHIGS_BPHen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
bordeaux.identifier.funderIDUnited States Agency for International Developmenten_US
bordeaux.identifier.funderIDInstitut de Recherche pour le Développementen_US
bordeaux.import.sourcepubmed
hal.identifierhal-04981326
hal.version1
hal.date.transferred2025-03-07T08:37:07Z
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exporttrue
workflow.import.sourcepubmed
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=PLOS%20Global%20Public%20Health&amp;rft.date=2025-01-01&amp;rft.volume=5&amp;rft.issue=2&amp;rft.spage=e0003741&amp;rft.epage=e0003741&amp;rft.eissn=2767-3375&amp;rft.issn=2767-3375&amp;rft.au=CAZES,%20Cecile&amp;STOBAUGH,%20Heather&amp;BAHWERE,%20Paluku&amp;BINNS,%20Paul&amp;BLACK,%20Robert%20E&amp;rft.genre=article


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