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Войти в исследования Cureus · 2026
Impact of an Age-Stratified Augmented Take-Home Ration on Nutritional Recovery in Under-Five Children With Uncomplicated SAM: A Community-Based Prospective Study in Southern Jharkhand.
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Sundram Shalini, Kujur Anit, Kujur Manisha, Kiran Kumari Asha, Sagar Vidya, Birua Hirendra
Аннотация
BACKGROUND: Community-based management of acute malnutrition (CMAM) often lacks context-specific evidence regarding the scaling and age-stratification of Take-Home Rations (THR). This study evaluates the association of nutritional recovery at four-month follow-up with this age-appropriate augmented THR ("Shishu Shakti"), delivering 490 kcal and 17 g of protein per 100 g versus standard uniform THR, which yielded 432.27 kcal and 13.95 g of protein per 100 g among children with uncomplicated severe acute malnutrition (SAM) in Southern Jharkhand.
METHODS: A community-based prospective cohort study enrolled 205 children aged 6-59 months with uncomplicated SAM. Group A (n= 139) received the age-stratified augmented Shishu Shakti THR (90-160 g/day), while Group B (n = 66) received the uniform standard THR (180 g/day). Anthropometric parameters and nutritional classifications were tracked over a four-month longitudinal follow-up.
RESULTS: Significant baseline disparities existed between cohorts: Group A children were younger (26.85 ± 14.41 months vs. 35.48 ± 15.33 months; t = -3.924, p < 0.001) and presented with lower baseline weight (7.71 ± 2.03 kg vs. 9.26 ± 2.29 kg; t = -4.899, p < 0.001). At the four-month follow-up, Group A achieved a significantly higher nutritional recovery rate (75.5%, n = 105) compared to Group B (60.6%, n = 40) (χ2 = 11.15, p = 0.011). Persistent Moderate Acute Malnutrition (MAM) at discharge was lower in Group A (13.7%, n = 19) than in Group B (33.3%, n = 22). Age-stratified tracking confirmed superior normalization across all younger age tiers in the intervention cohort.
CONCLUSION: Children receiving the age-stratified augmented THR had a higher crude proportion of nutritional recovery at four months than children receiving the standard uniform THR.
METHODS: A community-based prospective cohort study enrolled 205 children aged 6-59 months with uncomplicated SAM. Group A (n= 139) received the age-stratified augmented Shishu Shakti THR (90-160 g/day), while Group B (n = 66) received the uniform standard THR (180 g/day). Anthropometric parameters and nutritional classifications were tracked over a four-month longitudinal follow-up.
RESULTS: Significant baseline disparities existed between cohorts: Group A children were younger (26.85 ± 14.41 months vs. 35.48 ± 15.33 months; t = -3.924, p < 0.001) and presented with lower baseline weight (7.71 ± 2.03 kg vs. 9.26 ± 2.29 kg; t = -4.899, p < 0.001). At the four-month follow-up, Group A achieved a significantly higher nutritional recovery rate (75.5%, n = 105) compared to Group B (60.6%, n = 40) (χ2 = 11.15, p = 0.011). Persistent Moderate Acute Malnutrition (MAM) at discharge was lower in Group A (13.7%, n = 19) than in Group B (33.3%, n = 22). Age-stratified tracking confirmed superior normalization across all younger age tiers in the intervention cohort.
CONCLUSION: Children receiving the age-stratified augmented THR had a higher crude proportion of nutritional recovery at four months than children receiving the standard uniform THR.