TY - JOUR
T1 - Point-of-use water treatment improves recovery rates among children with severe acute malnutrition in Pakistan
T2 - Results from a site-randomized trial
AU - Doocy, Shannon
AU - Tappis, Hannah
AU - Villeminot, Nicolas
AU - Suk, Ann
AU - Kumar, Deepak
AU - Fazal, Shahid
AU - Grant, Angeline
AU - Pietzsch, Silke
N1 - Publisher Copyright:
© The Authors 2018 This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike licence (.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Objective To evaluate effectiveness of point-of-use water treatment in improving treatment of children affected by severe acute malnutrition (SAM).Design Programme sites were randomized to one of four intervention arms: (i) standard SAM treatment; (ii) SAM treatment plus flocculent/disinfectant water treatment; (iii) SAM treatment plus chlorine disinfectant; or (iv) SAM treatment plus ceramic water filter. Outcome measures were calculated based on participant status upon exit or after 120d of enrolment, whichever came first. Child anthropometric data were collected during weekly monitoring at programme sites. Child caregivers were interviewed at enrolment and exit. Use of water treatment products was assessed in a home visit 4-6 weeks after enrolment.Setting Dadu District, Sindh Province, Pakistan.Subjects Children (n 901) aged 6-59 months with SAM and no medical complications.Results Recovery rates were 16·7-22·2 % higher among children receiving water treatment compared with the control group. The adjusted odds of recovery were approximately twice as high for those receiving water treatment compared with controls. Mean length of stay until recovery was 73 (sd 24·6) d and mean rate of weight gain was 4·7 (sd 3·0) g/kg per d. Differences in recovery rate, length of stay and rate of weight gain between intervention groups were not statistically significant.Conclusions Incorporating point-of-use water treatment into outpatient treatment programmes for children with SAM increased nutritional recovery rates. No significant differences in recovery rates were observed between the different intervention groups, indicating that different water treatment approaches were equally effective in improving recovery.
AB - Objective To evaluate effectiveness of point-of-use water treatment in improving treatment of children affected by severe acute malnutrition (SAM).Design Programme sites were randomized to one of four intervention arms: (i) standard SAM treatment; (ii) SAM treatment plus flocculent/disinfectant water treatment; (iii) SAM treatment plus chlorine disinfectant; or (iv) SAM treatment plus ceramic water filter. Outcome measures were calculated based on participant status upon exit or after 120d of enrolment, whichever came first. Child anthropometric data were collected during weekly monitoring at programme sites. Child caregivers were interviewed at enrolment and exit. Use of water treatment products was assessed in a home visit 4-6 weeks after enrolment.Setting Dadu District, Sindh Province, Pakistan.Subjects Children (n 901) aged 6-59 months with SAM and no medical complications.Results Recovery rates were 16·7-22·2 % higher among children receiving water treatment compared with the control group. The adjusted odds of recovery were approximately twice as high for those receiving water treatment compared with controls. Mean length of stay until recovery was 73 (sd 24·6) d and mean rate of weight gain was 4·7 (sd 3·0) g/kg per d. Differences in recovery rate, length of stay and rate of weight gain between intervention groups were not statistically significant.Conclusions Incorporating point-of-use water treatment into outpatient treatment programmes for children with SAM increased nutritional recovery rates. No significant differences in recovery rates were observed between the different intervention groups, indicating that different water treatment approaches were equally effective in improving recovery.
KW - Community management of acute malnutrition
KW - Pakistan
KW - Point-of-use water treatment
KW - Severe acute malnutrition
KW - Therapeutic feeding programmes
KW - Water treatment
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U2 - 10.1017/S1368980018001647
DO - 10.1017/S1368980018001647
M3 - Article
C2 - 30132426
AN - SCOPUS:85052732308
SN - 1368-9800
VL - 21
SP - 3080
EP - 3090
JO - Public health nutrition
JF - Public health nutrition
IS - 16
ER -