BACKGROUND/ OBJECTIVES:Young children with severe malnutrition usually have poor mental development. Psychosocial stimulation may reduce their cognitive deficit, but it is not usually provided. The aim of the study was to incorporate stimulation into the routine treatment of severely malnourished children in a nutrition unit and evaluate the impact on their growth and development. DESIGN: Time-lagged controlled study. SETTING:Nutritional Rehabilitation Unit (NRU) in ICDDR,B Dhaka Hospital. METHODS:Severely malnourished children, aged 6-24 months, admitted to the NRU were enrolled. All received standard nutritional care. A control group of 43 children was studied initially, followed by an intervention group of 54 children. The intervened mothers and children participated in daily group meetings and individual play sessions for 2 weeks in hospital and were visited at home for 6 months. Children's growth was measured and development assessed using the Bayley Scales of Infant Development. RESULTS:Twenty-seven children were lost to the study. In the remaining children, both groups had similar developmental scores and anthropometry initially. After 6 months, the intervention group had improved more than the controls did by a mean of 6.9 (P<0.001; 95% CI: 3.9, 10.0) mental and 3.1 (P=0.024; 95% CI: 0.4, 5.7) motor raw scores and a mean of 0.4 (P=0.029; 95% CI: 0.1, 0.8) weight-for-age z scores, controlling for background variables. CONCLUSION:Psychosocial stimulation integrated into treatment of severely malnourished children in hospital, followed by home visits for 6 months, was effective in improving children's growth and development and should be an integral part of their treatment.
RCT Entities:
BACKGROUND/ OBJECTIVES: Young children with severe malnutrition usually have poor mental development. Psychosocial stimulation may reduce their cognitive deficit, but it is not usually provided. The aim of the study was to incorporate stimulation into the routine treatment of severely malnourished children in a nutrition unit and evaluate the impact on their growth and development. DESIGN: Time-lagged controlled study. SETTING: Nutritional Rehabilitation Unit (NRU) in ICDDR,B Dhaka Hospital. METHODS: Severely malnourished children, aged 6-24 months, admitted to the NRU were enrolled. All received standard nutritional care. A control group of 43 children was studied initially, followed by an intervention group of 54 children. The intervened mothers and children participated in daily group meetings and individual play sessions for 2 weeks in hospital and were visited at home for 6 months. Children's growth was measured and development assessed using the Bayley Scales of Infant Development. RESULTS: Twenty-seven children were lost to the study. In the remaining children, both groups had similar developmental scores and anthropometry initially. After 6 months, the intervention group had improved more than the controls did by a mean of 6.9 (P<0.001; 95% CI: 3.9, 10.0) mental and 3.1 (P=0.024; 95% CI: 0.4, 5.7) motor raw scores and a mean of 0.4 (P=0.029; 95% CI: 0.1, 0.8) weight-for-age z scores, controlling for background variables. CONCLUSION: Psychosocial stimulation integrated into treatment of severely malnourished children in hospital, followed by home visits for 6 months, was effective in improving children's growth and development and should be an integral part of their treatment.
Authors: Allison I Daniel; Mike Bwanali; Josephine Chimoyo Tenthani; Melissa Gladstone; Wieger Voskuijl; Isabel Potani; Frank Ziwoya; Kate Chidzalo; Emmie Mbale; Anna Heath; Celine Bourdon; Jenala Njirammadzi; Meta van den Heuvel; Robert H J Bandsma Journal: Curr Dev Nutr Date: 2021-07-21
Authors: Jan L Wallander; Carla M Bann; Fred J Biasini; Shivaprasad S Goudar; Omrana Pasha; Elwyn Chomba; Elizabeth McClure; Waldemar A Carlo Journal: J Child Psychol Psychiatry Date: 2014-05-09 Impact factor: 8.982
Authors: Jan L Wallander; Elizabeth McClure; Fred Biasini; Shivaprasad S Goudar; Omrana Pasha; Elwyn Chomba; Darlene Shearer; Linda Wright; Vanessa Thorsten; Hrishikesh Chakraborty; Sangappa M Dhaded; Niranjana S Mahantshetti; Roopa M Bellad; Zahid Abbasi; Waldemar Carlo Journal: BMC Pediatr Date: 2010-04-30 Impact factor: 2.125
Authors: Zulfiqar A Bhutta; James A Berkley; Robert H J Bandsma; Marko Kerac; Indi Trehan; André Briend Journal: Nat Rev Dis Primers Date: 2017-09-21 Impact factor: 52.329