Jolly G K Kamugisha1,2, Betty Lanyero3, Nicolette Nabukeera-Barungi4, Harriet Nambuya-Lakor3,5, Christian Ritz6, Christian Mølgaard6, Kim F Michaelsen6, André Briend6,7, Ezekiel Mupere4, Henrik Friis6, Benedikte Grenov6. 1. Mwanamugimu Nutrition Unit, Department of Pediatrics, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda. jolly_kamugisha@yahoo.com. 2. Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958, Frederiksberg C, Denmark. jolly_kamugisha@yahoo.com. 3. Mwanamugimu Nutrition Unit, Department of Pediatrics, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda. 4. Department of Pediatrics and Child Health, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda. 5. Department of Pediatrics, Jinja Regional Referral Hospital, Jinja, Uganda. 6. Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958, Frederiksberg C, Denmark. 7. Center for Child Health Research, Faculty of Medicine and Health Technology, Tampere University, Arvo building, Arvo Ylpön katu 34, FIN-33014 Tampere University, Tampere, Finland.
Abstract
BACKGROUND:Weight gain is routinely monitored to assess hydration and growth during treatment of children with complicated severe acute malnutrition (SAM). However, changes in weight and mid-upper arm circumference (MUAC) gain velocities over time are scarcely described. We assessed weight and MUAC gain velocities in 6-59 mo-old children with complicated SAM by treatment phase and edema status. METHODS: This was a prospective study, nested in a randomized/probiotic trial ( ISRCTN16454889 ). Weight and MUAC gain velocities were assessed by treatment phase and edema at admission using linear mixed-effects models. RESULTS: Among 400 children enrolled, the median (IQR) age was 15.0 (11.2;19.2) months, 58% were males, and 65% presented with edema. During inpatient therapeutic care (ITC), children with edema vs no edema at admission had negative weight gain velocity in the stabilization phase [differences at day 3 and 4 were - 11.26 (95% CI: - 20.73; - 1.79) g/kg/d and - 13.09 (95% CI: - 23.15; - 3.02) g/kg/d, respectively]. This gradually changed into positive weight gain velocity in transition and eventually peaked at 12 g/kg/d early in the rehabilitation phase, with no difference by edema status (P > 0.9). During outpatient therapeutic care (OTC), overall, weight gain velocity showed a decreasing trend over time (from 5 to 2 g/kg/d), [difference between edema and non-edema groups at week 2 was 2.1 (95% CI: 1.0;3.2) g/kg/d]. MUAC gain velocity results mirrored those of weight gain velocity [differences were - 2.30 (95% CI: - 3.6; - 0.97) mm/week at week 1 in ITC and 0.65 (95% CI: - 0.07;1.37) mm/week at week 2 in OTC]. CONCLUSIONS:Weight and MUAC gain velocities among Ugandan children with complicated SAM showed an increasing trend during transition and early in the rehabilitation phase, and a decreasing trend thereafter, but, overall, catch-up growth was prolonged. Further research to establish specific cut-offs to assess weight and MUAC gain velocities during different periods of rehabilitation is needed.
RCT Entities:
BACKGROUND: Weight gain is routinely monitored to assess hydration and growth during treatment of children with complicated severe acute malnutrition (SAM). However, changes in weight and mid-upper arm circumference (MUAC) gain velocities over time are scarcely described. We assessed weight and MUAC gain velocities in 6-59 mo-old children with complicated SAM by treatment phase and edema status. METHODS: This was a prospective study, nested in a randomized/probiotic trial ( ISRCTN16454889 ). Weight and MUAC gain velocities were assessed by treatment phase and edema at admission using linear mixed-effects models. RESULTS: Among 400 children enrolled, the median (IQR) age was 15.0 (11.2;19.2) months, 58% were males, and 65% presented with edema. During inpatient therapeutic care (ITC), children with edema vs no edema at admission had negative weight gain velocity in the stabilization phase [differences at day 3 and 4 were - 11.26 (95% CI: - 20.73; - 1.79) g/kg/d and - 13.09 (95% CI: - 23.15; - 3.02) g/kg/d, respectively]. This gradually changed into positive weight gain velocity in transition and eventually peaked at 12 g/kg/d early in the rehabilitation phase, with no difference by edema status (P > 0.9). During outpatient therapeutic care (OTC), overall, weight gain velocity showed a decreasing trend over time (from 5 to 2 g/kg/d), [difference between edema and non-edema groups at week 2 was 2.1 (95% CI: 1.0;3.2) g/kg/d]. MUAC gain velocity results mirrored those of weight gain velocity [differences were - 2.30 (95% CI: - 3.6; - 0.97) mm/week at week 1 in ITC and 0.65 (95% CI: - 0.07;1.37) mm/week at week 2 in OTC]. CONCLUSIONS: Weight and MUAC gain velocities among Ugandan children with complicated SAM showed an increasing trend during transition and early in the rehabilitation phase, and a decreasing trend thereafter, but, overall, catch-up growth was prolonged. Further research to establish specific cut-offs to assess weight and MUAC gain velocities during different periods of rehabilitation is needed.
Entities:
Keywords:
Children; Edema; MUAC gain velocity; Severe acute malnutrition; Uganda; Weight gain velocity
Authors: Robert E Black; Cesar G Victora; Susan P Walker; Zulfiqar A Bhutta; Parul Christian; Mercedes de Onis; Majid Ezzati; Sally Grantham-McGregor; Joanne Katz; Reynaldo Martorell; Ricardo Uauy Journal: Lancet Date: 2013-06-06 Impact factor: 79.321
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Authors: Jolly G K Kamugisha; Betty Lanyero; Nicolette Nabukeera-Barungi; Christian Ritz; Christian Mølgaard; Kim F Michaelsen; André Briend; Ezekiel Mupere; Henrik Friis; Benedikte Grenov Journal: Curr Dev Nutr Date: 2021-09-25