Researchers in Niger tested two new ways to treat malnourished children that use less therapeutic food than the standard treatment. They studied 1,732 children aged 6 months to 5 years over 6 months. One new approach called ComPAS worked just as well as the standard treatment while using 50% less therapeutic food. The other approach, OptiMA, didn’t work quite as well but still helped children recover. For the most severely malnourished children, the standard treatment still worked better. This research could help make malnutrition treatment more affordable and easier to deliver in poor communities.

The Quick Take

  • What they studied: Whether two new treatment methods for malnourished children work as well as the current standard treatment while using less therapeutic food
  • Who participated: 1,732 malnourished children between 6 months and 5 years old living in rural Niger, Africa
  • Key finding: The ComPAS method worked just as well as standard treatment while using 50% less therapeutic food, but the OptiMA method was slightly less effective
  • What it means for you: If you work with malnourished children, the ComPAS approach could save money and resources while still helping kids recover effectively

The Research Details

This was a randomized controlled trial, which is considered the gold standard for medical research. The researchers randomly assigned children to one of three treatment groups: the standard Niger protocol, OptiMA, or ComPAS. They followed the children for 6 months to see how well each treatment worked. The study was designed as a ’noninferiority’ trial, meaning they wanted to prove the new treatments weren’t significantly worse than the standard treatment.

This type of study design is important because it directly compares treatments in real-world conditions. By randomly assigning children to different groups, the researchers could be confident that any differences in outcomes were due to the treatments themselves, not other factors.

This study was well-designed with a large sample size and was registered in advance (which prevents researchers from changing their methods after seeing results). The researchers used both intention-to-treat and per-protocol analyses, which gives a more complete picture of how the treatments work in both ideal and real-world conditions.

What the Results Show

Among all 1,732 children with acute malnutrition, the ComPAS treatment was just as effective as the standard treatment, with 51.9% of children achieving the primary outcome compared to 50.9% in the standard group. The OptiMA treatment was slightly less effective at 49.7%, but the difference wasn’t large enough to be considered significantly worse. Importantly, there were no differences in death rates between any of the three groups over the 6-month period. The ComPAS approach used 50% less ready-to-use therapeutic food (RUTF) than the standard treatment, while OptiMA used 32% less.

For the most severely malnourished children (those with very small arm measurements or swelling), the standard treatment worked better than both new approaches. Children in the OptiMA and ComPAS groups missed about 20% more clinic visits than those in the standard group. Growth patterns were similar between the standard and ComPAS groups, but children in the OptiMA group showed slightly slower growth.

This study builds on previous research suggesting that simplified treatment protocols could work for malnutrition. The results support the idea that using the same therapeutic food for both severe and moderate malnutrition cases could be effective, which would make treatment programs easier to manage.

The study was conducted only in Niger, so results might not apply to other countries or settings. The researchers aren’t sure why the OptiMA protocol didn’t work as well, despite using more therapeutic food than ComPAS. The higher rate of missed visits in the new treatment groups could affect how well they work in practice.

The Bottom Line

Based on this study, the ComPAS protocol appears to be a good alternative to standard treatment for most malnourished children, potentially saving resources while maintaining effectiveness. However, for the most severely malnourished children, the standard protocol may still be the best choice.

Healthcare workers, aid organizations, and policymakers working on malnutrition programs should pay attention to these findings. Parents of malnourished children should continue following their healthcare provider’s recommendations, as treatment decisions should always be individualized.

The study followed children for 6 months, which is a reasonable timeframe to see treatment effects. However, more research is needed to understand long-term outcomes and how these protocols work in different settings.

Want to Apply This Research?

  • Track mid-upper arm circumference measurements weekly using the app’s measurement tools, aiming for readings above 125mm
  • If working with malnourished children, consider discussing simplified treatment protocols with healthcare providers and track treatment adherence and clinic visit attendance
  • Monitor weight gain, arm circumference changes, and overall health status over 6-month periods, noting any missed appointments or treatment interruptions

This research was conducted in a specific population in Niger and may not apply to all settings. Treatment decisions for malnourished children should always be made by qualified healthcare professionals. Do not change existing treatment plans without consulting with a doctor or registered dietitian.