Relapse after severe acute malnutrition: A systematic literature review and secondary data analysis

Heather C. Stobaugh, Amy Mayberry, Marie McGrath, Paluku Bahwere, Noël Marie Zagre, Mark J. Manary, Robert E Black, Natasha Lelijveld

Research output: Contribution to journalArticle

Abstract

The objectives of most treatment programs for severe acute malnutrition (SAM) in children focus on initial recovery only, leaving post-discharge outcomes, such as relapse, poorly understood and undefined. This study aimed to systematically review current literature and conduct secondary data analyses of studies that captured relapse rates, up to 18-month post-discharge, in children following recovery from SAM treatment. The literature search (including PubMed and Google Scholar) built upon two recent reviews to identify a variety of up-to-date published studies and grey literature. This search yielded 26 articles and programme reports that provided information on relapse. The proportion of children who relapsed after SAM treatment varied greatly from 0% to 37% across varying lengths of time following discharge. The lack of a standard definition of relapse limited comparability even among the few studies that have quantified post-discharge relapse. Inconsistent treatment protocols and poor adherence to protocols likely add to the wide range of relapse reported. Secondary analysis of a database from Malawi found no significant association between potential individual risk factors at admission and discharge, except being an orphan, which resulted in five times greater odds of relapse at 6 months post-discharge (95% CI [1.7, 12.4], P = 0.003). The development of a standard definition of relapse is needed for programme implementers and researchers. This will allow for assessment of programme quality regarding sustained recovery and better understanding of the contribution of relapse to local and global burden of SAM.

Original languageEnglish (US)
Article numbere12702
JournalMaternal and Child Nutrition
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Recurrence
Child Nutrition Disorders
Literature
Severe Acute Malnutrition
Malawi
Clinical Protocols
PubMed
Therapeutics
Research Personnel
Databases

Keywords

  • community-based management of acute malnutrition
  • outpatient therapeutic programme
  • post-discharge outcomes
  • relapse
  • severe acute malnutrition
  • wasting

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology
  • Nutrition and Dietetics
  • Public Health, Environmental and Occupational Health

Cite this

Stobaugh, H. C., Mayberry, A., McGrath, M., Bahwere, P., Zagre, N. M., Manary, M. J., ... Lelijveld, N. (Accepted/In press). Relapse after severe acute malnutrition: A systematic literature review and secondary data analysis. Maternal and Child Nutrition, [e12702]. https://doi.org/10.1111/mcn.12702

Relapse after severe acute malnutrition : A systematic literature review and secondary data analysis. / Stobaugh, Heather C.; Mayberry, Amy; McGrath, Marie; Bahwere, Paluku; Zagre, Noël Marie; Manary, Mark J.; Black, Robert E; Lelijveld, Natasha.

In: Maternal and Child Nutrition, 01.01.2018.

Research output: Contribution to journalArticle

Stobaugh, Heather C. ; Mayberry, Amy ; McGrath, Marie ; Bahwere, Paluku ; Zagre, Noël Marie ; Manary, Mark J. ; Black, Robert E ; Lelijveld, Natasha. / Relapse after severe acute malnutrition : A systematic literature review and secondary data analysis. In: Maternal and Child Nutrition. 2018.
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