Comparative weight gain with ready-to-use therapeutic food in stunted HIV-infected and -uninfected children in a Nigerian Hospital
Objective. To bridge the management gap between nutritional rehabilitation for severe acute malnutrition (SAM) and chronic malnutrition, this study investigated to what extent ready-to-use therapeutic food (RUTF) promotes growth in children with long-term nutrition deficit with superimposed SAM.
Methods. A total of 225 (164 HIV-negative and 61 HIV-positive) chronically malnourished children (aged 6 - 60 months) with superimposed SAM were enrolled. Children were provided 92 g packets of an RUTF, Plumpy’Nut, based on an estimated requirement of 200 kcal/kg body weight (BW)/day. Children were fed Plumpy’Nut over a 2-week period, and weight was assessed weekly. Weight gain was compared for HIV-positive children and HIV-negative children.
Results. On day 15, the HIV-positive group had a median weight gain of 645 g compared with 670 g in the HIV-negative group (difference 25 g, p=0.784). Similarly, rate of weight gain per kilogram BW per day was comparable for both groups of children (13.2 g/kg BW per day for HIV-negative children v. 11.9 g/kg BW per day for HIV-positive children, p=0.353). On day 15, the proportions of HIV-positive and HIV-negative children who had sustained weight gain were not significantly different.
Conclusion. Chronically malnourished children with superimposed SAM benefit from the use of RUTF as much as children without chronic nutritional deprivation, regardless of HIV status.