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 language | English (US) |
|---|---|
| Article number | e12702 |
| Journal | Maternal and Child Nutrition |
| DOIs | |
| State | Accepted/In press - Jan 1 2018 |
Fingerprint
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
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 journal › Article
}
TY - JOUR
T1 - Relapse after severe acute malnutrition
T2 - A systematic literature review and secondary data analysis
AU - Stobaugh, Heather C.
AU - Mayberry, Amy
AU - McGrath, Marie
AU - Bahwere, Paluku
AU - Zagre, Noël Marie
AU - Manary, Mark J.
AU - Black, Robert E
AU - Lelijveld, Natasha
PY - 2018/1/1
Y1 - 2018/1/1
N2 - 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.
AB - 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.
KW - community-based management of acute malnutrition
KW - outpatient therapeutic programme
KW - post-discharge outcomes
KW - relapse
KW - severe acute malnutrition
KW - wasting
UR - http://www.scopus.com/inward/record.url?scp=85055038289&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85055038289&partnerID=8YFLogxK
U2 - 10.1111/mcn.12702
DO - 10.1111/mcn.12702
M3 - Article
C2 - 30246929
AN - SCOPUS:85055038289
JO - Maternal and Child Nutrition
JF - Maternal and Child Nutrition
SN - 1740-8695
M1 - e12702
ER -