CATCH-UP GROWTH IN CHILDREN WITH SEVERE ACUTE MALNUTRITION: COMPARISON OF TWO THERAPEUTIC FEEDING APPROACHES AT A DISTRICT HOSPITAL, SOUTH AFRICA

Although the World Health Organisation (WHO) guidelines have proved to be effective in the treatment of severe acute malnutrition (SAM) in other countries, limited data is available in South Africa, especially in relation to HIV-infected children. This study aimed to describe the recovery of clinically stable children with SAM, 12–60 months of age, treated as in-patients at a specialised district hospital in KwaZulu-Natal, South Africa, using two WHO recommended treatment approaches. A prospective cohort with clinically stable SAM referred to Clairwood Hospital between August 2012 and September 2013 was followed from admission until discharge in this descriptive study. Children were nutritionally managed, after being stratified and randomly assigned to one of the two suggested nutritional treatment groups, F-100 or Ready-to-use Therapeutic Foods (RUTF). Of the total of 41 children admitted with SAM during the year, 35 children participated and 34 completed the study. About 56% were younger than 18 months and 73.5% HIV-infected. A mean growth velocity of 7.77g/kg/day (RUTF group) versus 6.11g/kg/day (F100 group) was observed (p  = 0.23). Recovery was achieved in 88.8% (n=15) of children on RUTF, and 64.7% (n=11) in the F-100 group, within 2.7 and 4.4 weeks, respectively. The RUTF group recovered significantly (p=0.02) faster. HIV-infection in this study did not affect growth velocity. RUTF can be used as effectively as F-100 in the rehabilitation of SAM to achieve catch-up growth and similar recovery rates are possible in HIV-infected children if managed according to WHO guidelines.