202445 Use of PlumpyNut to Improve Child Nutrition and Health: Experience in Central Mozambique

Wednesday, November 11, 2009

Jennifer Kasper, MD, MPH , Health Alliance International, Seattle, WA
Chiara Bussetti, MD , Health Alliance International, Seattle, WA, Mozambique
Clara Bowley, MPH , CUAMM, Beira, Mozambique
Alejandro Soto, MD, MPH , Health Alliance International, Seattle, WA
Tatiana Bocharnikova, MD , Health Alliance International, Seattle, WA
Vitoria Munhica , Health Alliance International, Seattle, WA
Etelvina Pedro , Sofala Provincial Department of Health, Beira, Mozambique
P. Canote , Manica Provincial Department of Health, Chimoio, Mozambique
Cesar Macome, MD , Hospital Central de Beira, Beira, Mozambique
Marina Karagianis, MD , Ministry of Health, Beira, Mozambique
F. Quinas, MD , Manica Provincial Department of Health, Chimoio, Mozambique
Pablo Montoya, MD, MPH , Beira office, Health Alliance International, Chimoio, Mozambique
Barrot Lambdin, MPH , Health Alliance International, Seattle, WA
Mark A. Micek, MD, MPH , Department of Global Health, University of Washington, Seattle, WA
HIV/AIDS prevalence in Central Mozambique is 25%; 25% of infected are children less than five years old. Childhood malnutrition and micronutrient deficiency are high: 24% underweight, 41% stunted, 75% iron-deficient and 69% vitamin A deficient. PlumpyNut® is RUTF that meets 100% of caloric and micronutrient needs for ages 6-12 months and 80% of nutritional needs for ages 12-18 months. Study purpose is to evaluate PlumpyNut program and recipients' anthropometrics.

Descriptive study of children less than two years of age attending child at risk clinics with PlumpyNut program in Central Mozambique. Criteria for PlumpyNut: HIV positive infants greater than six months of age with moderate malnutrition (weight for height 70-85%); infants, regardless of HIV status, with severe malnutrition (weight for height < 70%) without complications.

1511 children were enrolled at 19 sites; 67% were female. There was significant decrease in follow-up visits between 1st, 2nd and 3rd visits (one month's time). We will describe clinic information (site, date Child at Risk Clinic and PlumpyNut Program commenced, date of PlumpyNut training for clinic staff), patient information (age at enrollment, anthropometrics, number visits, date left program and reason) and program process and outcome measures (average age at enrollment, accuracy in recording anthropometrics and dispensing quantities of PlumpyNut based on child's weight, follow-up and graduation data).

PlumpyNut can be an effective, replicable, and potentially sustainable intervention to improve nutritional status of HIV exposed, HIV positive, and malnourished children. Challenges include on-site mentoring post-training, maximizing enrollment and strengthening follow-up.

Learning Objectives:
1. Describe benefits of PlumpyNut, a ready to use therapeutic food for infants and children 2. Evaluate the care, quality of nutritional monitoring, and follow-up of infants and children receiving PlumpyNut and the effectiveness of the PlumpyNut pilot program in enrolling eligible infants and children in Central Mozambique 3. Compare growth parameters of HIV-exposed, HIV positive, and malnourished infants and children in Central Mozambique who receive PlumpyNut

Keywords: Nutrition, Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the pediatrician and principal investigator who worked on this study in Mozambique and I have a background in child nutrition.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.