Soya, maize and sorghum ready-to-use therapeutic foods are more effective in correcting anaemia and iron deficiency than the standard ready-to-use therapeutic food: randomized controlled trial
Soya, maize and sorghum ready-to-use therapeutic foods are more effective in correcting anaemia and iron deficiency than the standard ready-to-use therapeutic food: randomized controlled trial
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DOI：
10.1186/s12889-019-7170-x
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发表时间：
2019-06-24
影响因子：
4.5
通讯作者：
Collins, Steve
中科院分区：
文献类型：
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作者：
Akomo, Peter;Bahwere, Paluku;Collins, Steve
研究背景严重急性营养不良（SAM）儿童贫血和缺铁（ID）的患病率及其在营养康复过程中的纠正情况尚未得到很好的记录。本研究评估了SAM治疗开始时贫血和ID患病率及其预测因素，以及两种由大豆制备的新型即用型治疗性食品（RUTF）的治疗功效和对肠道健康的影响，玉米和高粱（SMS），（MSMS-RUTF）或不添加牛奶方法这是一个3臂平行组，简单随机，在6- 59个月大的马拉维中部SAM儿童中进行的对照非劣效性试验。贫血的定义使用海拔和种族调整血红蛋白。铁状态用可溶性转铁蛋白受体（sTfR）和身体铁储备（BIS）来定义。我们使用皮尔逊卡方检验，配对或非配对数据的t检验，克鲁斯卡尔-沃利斯检验臂间差异，适当的和逻辑回归，以确定独立的预测因子贫血或缺铁性贫血（IDA）。入院时，贫血患病率[%（95%CI）]为48.9（41.4-56.5）%，以sTfR为标准时，ID和IDA患病率分别为55.7（48.6-62.5）%和34.3（28.2-41.0）%，以BIS为标准时，ID和IDA患病率分别为29.1（24.4-34.4）%和28.9（23.7-34.9）%。出院时，采用SMS-RUTF的营养康复与贫血的最低患病率相关[12.0（6.9-20.3）% FSMS-RUTF，18.2（11.9-26.8）%，男、女同性恋者-RUTF和24.5（15.8-35.9）%; p=0.023]和IDA [FSMS-RUTF为7.9（3.4-17.3）%，MSMS-RUTF为10.9（4.8-22.6）%，PM-RUTF为20.5（10.7-35.5）%; p=0.028]。在入院时铁缺乏的患者中，SMS-RUTF也与BIS [BIS变化（95%CI）]的最高增幅相关[相同研究组为6.2（3.7; 8.6）、3.2（0.8; 5.6）、2.2（0.2; 4.3）; Anova p=0.045]。与P-Rutf相比，FSMS-Rutf具有最高的校正恢复率[OR（95%CI=0.3（0.2-0.5），p
BackgroundThe prevalence of anaemia and iron deficiency (ID) among children with severe acute malnutrition (SAM) and their correction during nutritional rehabilitation are not well documented. This study assessed anaemia and ID prevalence and their predictors at start of SAM treatment, and the efficacy of their treatment and effect on gut health of two novel Ready-To-Use Therapeutic foods (RUTF) prepared from soybean, maize and sorghum (SMS) with (MSMS-RUTF) or without added milk (FSMS-RUTF) compared to those of the standard formulation prepared from peanut and milk (PM-RUTF).MethodsThis was a 3-arms parallel groups, simple randomised, controlled non-inferiority trial in 6-59months old Central Malawian children with SAM. Anaemia was defined using altitude- and ethnicity-adjusted haemoglobin. Iron status was defined using soluble transferrin receptor (sTfR) and body iron stores (BIS). We used Pearson's chi-square test, t-test for paired or unpaired data, Kruskal-Wallis test for between-arm differences as appropriate and logistic regression to identify independent predictors of anaemia or iron deficiency anaemia (IDA).ResultsThe sample size was 389. At admission, the prevalence [%(95%CI)] of anaemia was 48.9(41.4-56.5)% while that of ID and IDA were 55.7(48.6-62.5)% and 34.3(28.2-41.0)% when using sTfR criterion and 29.1(24.4-34.4)% and 28.9(23.7-34.9)% when using BIS criterion, respectively. At discharge, nutrition rehabilitation with SMS-RUTF was associated with the lowest prevalence of anaemia [12.0(6.9-20.3)% for FSMS-RUTF, 18.2(11.9-26.8)% for MSMS-RUTF and 24.5(15.8-35.9)% for PM-RUTF; p=0.023] and IDA [7.9(3.4-17.3)% for FSMS-RUTF, 10.9(4.8-22.6)% for MSMS-RUTF and 20.5(10.7-35.5)% for PM-RUTF; p=0.028]. SMS-RUTF was also associated with the highest increase in BIS [Change in BIS (95%CI)] among the iron deplete at admission [6.2 (3.7; 8.6), 3.2 (0.8; 5.6), 2.2 (0.2; 4.3) for the same study arms; Anova p=0.045]. Compared to P-RUTF, FSMS-RUTF had the highest adjusted recovery rate [OR (95%CI=0.3 (0.2-0.5) with p