MEDI NEWS

ICDDR,B Team develops local solution for the treatment of Severe Acute Malnutrition

A team of Bangladeshi scientists of ICDDR,B have developed a modified ‘Ready-to-use Therapeutic Food’ (RuTF) using local food ingredients for the treatment of the children suffering from severe acute malnutrition – declared in a seminar held in Dhaka recently. State Minister for Health Zahed Malek, representatives from UNICEF, UKAID and some countries of SAARC and South-East Asian region were present at the seminar.
A group of scientists led by nutritionist Dr. Tahmeed Ahmed of the International Centre for Diarrhoeal Disease and Research, Bangladesh have revealed their research on two RuTFs named ‘Sharnali-1’ and ‘Sharnali-2’in the seminar. They say the effects of these two local RuTFs are as same as the ‘Plumpy Nut’. RuTF is referred to as ‘nutritional treatment’ in the national guideline on community-based management of acute malnutrition (CMAM) in Bangladesh. RuTF is an energy-dense, lipid-based paste enriched with vitamins and minerals, which is administered to children with severe acute malnutrition in a dose of 175 to 200 kcal/kg/day, once they demonstrate a reasonable appetite.  
Dr. Tahmeed in his presentation said that in Bangladesh around 600,000 children are suffering from severe acute malnutrition according to latest statistics. Among them death rates are high and those who survive have the chance to develop intellectual impairment in later life.  “Only a few can be admitted to a hospital for proper treatment. Even those admitted cannot stay there for the scheduled time for a host of reasons. So the best solution is to introduce local ingredient-based solution focused on frequent feeding of highly nutritious and energy diet” – he added.  
In international market ‘Plumpy Nut’ is available and is extensively used in Africa and other countries for the treatment of the same but in comparison of price and some controversies ‘Sharnali-1’ and ‘Sharnali-2’ perform better in local survey. Per pack of 100 gram each ‘Sharnali-1’ and ‘Sharnali-2’ contain 520-550 kcal.  The surveys objective was to compare the efficacy in terms of the rate of weight gain during treatment period. The average rate of weight gain is 7.5 gm/kg/day. During their survey period, there was no incidence in death. 80% of all patients who enrolled for this randomized controlled trial remained till the very end of the study.
The local RuTfs, one is based on rice and lentils while other on chickpeas both contain milk powder, sugar, soybean oil and micronutrients (1% soy lecithin). Dr. Tahmeed said that these two foods can be stored in room temperature for long because there is no water in the food and do not need any cooking or mixing with water.  “But the foods can be used only for therapeutic purpose” – he cautioned.
After the successful trial, the team has already set their future directions. These are: i) to go a bulk production at a lower cost so that it can be available to children suffering from severe acute malnutrition free of cost or a minimum, ii) to establish a pilot programme with National Nutrition Service (NNS), community clinics and other primary health care centres operated by NGOs, upazila health complex and hospitals throughout the country, iii) finally sharing experience to the SAARC and SEA region.
Stethocope desk

MEDI NEWS

ICDDR,B Team develops local solution for the treatment of Severe Acute Malnutrition A team of Bangladeshi scientists of ICDDR,B have developed a modified Ready-to-use Therapeutic Food (RuTF) using local food ingredients for the treatment of the children suffering from severe acute malnutrition declared in a seminar held in Dhaka recently. State Minister for Health Zahed Malek, representatives from UNICEF, UKAID and some countries of SAARC and South-East Asian region were present at the seminar. A group of scientists led by nutritionist Dr. Tahmeed Ahmed of the International Centre for Diarrhoeal Disease and Research, Bangladesh have revealed their research on two RuTFs named Sharnali-1 and Sharnali-2in the seminar. They say the effects of these two local RuTFs are as same as the Plumpy Nut. RuTF is referred to as nutritional treatment in the national guideline on community-based management of acute malnutrition (CMAM) in Bangladesh. RuTF is an energy-dense, lipid-based paste enriched with vitamins and minerals, which is administered to children with severe acute malnutrition in a dose of 175 to 200 kcal/kg/day, once they demonstrate a reasonable appetite. Dr. Tahmeed in his presentation said that in Bangladesh around 600,000 children are suffering from severe acute malnutrition according to latest statistics. Among them death rates are high and those who survive have the chance to develop intellectual impairment in later life. Only a few can be admitted to a hospital for proper treatment. Even those admitted cannot stay there for the scheduled time for a host of reasons. So the best solution is to introduce local ingredient-based solution focused on frequent feeding of highly nutritious and energy diet he added. In international market Plumpy Nut is available and is extensively used in Africa and other countries for the treatment of the same but in comparison of price and some controversies Sharnali-1 and Sharnali-2 perform better in local survey. Per pack of 100 gram each Sharnali-1 and Sharnali-2 contain 520-550 kcal. The surveys objective was to compare the efficacy in terms of the rate of weight gain during treatment period. The average rate of weight gain is 7.5 gm/kg/day. During their survey period, there was no incidence in death. 80% of all patients who enrolled for this randomized controlled trial remained till the very end of the study. The local RuTfs, one is based on rice and lentils while other on chickpeas both contain milk powder, sugar, soybean oil and micronutrients (1% soy lecithin). Dr. Tahmeed said that these two foods can be stored in room temperature for long because there is no water in the food and do not need any cooking or mixing with water. But the foods can be used only for therapeutic purpose he cautioned. After the successful trial, the team has already set their future directions. These are: i) to go a bulk production at a lower cost so that it can be available to children suffering from severe acute malnutrition free of cost or a minimum, ii) to establish a pilot programme with National Nutrition Service (NNS), community clinics and other primary health care centres operated by NGOs, upazila health complex and hospitals throughout the country, iii) finally sharing experience to the SAARC and SEA region. Stethocope desk