BACKGROUND/ OBJECTIVE:Psychosocial stimulation (PS) and food supplementation (FS) improve development of malnourished children. This study evaluates the effects of a community-based approach of PS and FS on growth and development of severely malnourished children. SUBJECTS/ METHODS:Severely underweight hospitalised children aged 6-24 months (n = 507) were randomly allocated on discharge to five groups: (i) PS, (ii) FS, (iii) PS+FS, (iv) clinic-control and (v) hospital-control. PS included play sessions and parental counselling on child development. This was done at each fortnightly follow-up visit, that is, every second week, for 6 months at community clinics. FS included distribution of cereal-based food packets (150-300 kcal/day) for 3 months. All groups received medical care, micronutrient supplementation, health-education and growth monitoring. Children's development was assessed using revised version of Bayley Scales of Infant Development at baseline and after 3 and 6 months of intervention. Anthropometry was measured using standard procedure. RESULTS: Comparing groups with any stimulation with those with no stimulation there was a significant effect of stimulation on children's mental development index (group*session interaction P = 0.037, effect size = 0.37 s.d.) and weight-for-age Z-score (group*session interaction P = 0.02, effect size=0.26 s.d.). Poor levels of development and nutritional status were sustained, however, due to their initial very severe malnutrition. There was no effect on motor development and linear growth. CONCLUSION: Children receiving any stimulation showed a significant benefit to mental development and growth in weight. More intensive intervention with longer duration is needed to correct their poor developmental levels and nutritional status.
RCT Entities:
BACKGROUND/ OBJECTIVE: Psychosocial stimulation (PS) and food supplementation (FS) improve development of malnourished children. This study evaluates the effects of a community-based approach of PS and FS on growth and development of severely malnourished children. SUBJECTS/ METHODS: Severely underweight hospitalised children aged 6-24 months (n = 507) were randomly allocated on discharge to five groups: (i) PS, (ii) FS, (iii) PS+FS, (iv) clinic-control and (v) hospital-control. PS included play sessions and parental counselling on child development. This was done at each fortnightly follow-up visit, that is, every second week, for 6 months at community clinics. FS included distribution of cereal-based food packets (150-300 kcal/day) for 3 months. All groups received medical care, micronutrient supplementation, health-education and growth monitoring. Children's development was assessed using revised version of Bayley Scales of Infant Development at baseline and after 3 and 6 months of intervention. Anthropometry was measured using standard procedure. RESULTS: Comparing groups with any stimulation with those with no stimulation there was a significant effect of stimulation on children's mental development index (group*session interaction P = 0.037, effect size = 0.37 s.d.) and weight-for-age Z-score (group*session interaction P = 0.02, effect size=0.26 s.d.). Poor levels of development and nutritional status were sustained, however, due to their initial very severe malnutrition. There was no effect on motor development and linear growth. CONCLUSION:Children receiving any stimulation showed a significant benefit to mental development and growth in weight. More intensive intervention with longer duration is needed to correct their poor developmental levels and nutritional status.
Authors: Margaret E Kruk; Todd P Lewis; Catherine Arsenault; Zulfiqar A Bhutta; Grace Irimu; Joshua Jeong; Zohra S Lassi; Susan M Sawyer; Tyler Vaivada; Peter Waiswa; Aisha K Yousafzai Journal: Lancet Date: 2022-04-27 Impact factor: 202.731
Authors: Sathish Subramanian; Sayeeda Huq; Tanya Yatsunenko; Rashidul Haque; Mustafa Mahfuz; Mohammed A Alam; Amber Benezra; Joseph DeStefano; Martin F Meier; Brian D Muegge; Michael J Barratt; Laura G VanArendonk; Qunyuan Zhang; Michael A Province; William A Petri; Tahmeed Ahmed; Jeffrey I Gordon Journal: Nature Date: 2014-06-04 Impact factor: 49.962
Authors: John P Elder; Willo Pequegnat; Saifuddin Ahmed; Gretchen Bachman; Merry Bullock; Waldemar A Carlo; Venkatraman Chandra-Mouli; Nathan A Fox; Sara Harkness; Gillian Huebner; Joan Lombardi; Velma McBride Murry; Allisyn Moran; Maureen Norton; Jennifer Mulik; Will Parks; Helen H Raikes; Joseph Smyser; Caroline Sugg; Michael Sweat; Nurper Ulkuer Journal: J Health Commun Date: 2014
Authors: Orazio P Attanasio; Camila Fernández; Emla O A Fitzsimons; Sally M Grantham-McGregor; Costas Meghir; Marta Rubio-Codina Journal: BMJ Date: 2014-09-29