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

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.