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Efficacy of outreach nutrition rehabilitation centres in reducing mortality and improving nutritional outcome of severely malnourished children in Guinea Bissau.
Eur J Clin Nutr. 1995 May; 49(5):353-9.EJ

Abstract

OBJECTIVE

There is still controversy about the efficacy and cost-effectiveness of outreach nutrition rehabilitation centres (NRCs) for severely malnourished children. We wanted to compare the mortality rates and nutritional status of severely malnourished children admitted to rural NRCs in Gabu region, Guinea Bissau, with other severely malnourished children who were not rehabilitated and stayed in their villages.

DESIGN

Retrospective cohort study over a 3-year period. Mortality rates and nutritional outcome compared for children who were admitted to rural NRCs and those who were not rehabilitated. Selection for admission to the NRCs was based on availability of places only.

SETTING

19 health areas of the Gabu region, Guinea Bissau, West Africa.

SUBJECTS

1038 severely malnourished children (< 60% weight-for-age using NCHS standards) aged 6 to 47 months. 354 were rehabilitated in NRCs and 684 received no rehabilitation.

RESULTS

Up to 36 months follow-up the relative risk of death in the rehabilitated group was 0.75 [95% confidence interval (c.i.) = 0.57-0.99], equivalent to a 25% reduction in mortality. The difference in mortality between the two groups was much higher during the first 3 months [P < 0.02, relative risk = 0.59 (95% c.i. = 0.39-0.91)]. Rehabilitated children had a higher mean weight gain in the first 3 months (1.63 compared to 0.56 weight-for-age standard deviation score, P < 0.001), and weight gain differences lasted up to 18 months (P < 0.01).

CONCLUSIONS

Low-cost, outreach NRCs are effective both in the short term and in the mid-term to improve the nutritional situation and reduce the mortality of severely malnourished children.

Authors+Show Affiliations

PC 215, Guinea Bissau, Gruppo di Volontariato Civile, Bologna, Italia.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

7664721

Citation

Perra, A, and A M. Costello. "Efficacy of Outreach Nutrition Rehabilitation Centres in Reducing Mortality and Improving Nutritional Outcome of Severely Malnourished Children in Guinea Bissau." European Journal of Clinical Nutrition, vol. 49, no. 5, 1995, pp. 353-9.
Perra A, Costello AM. Efficacy of outreach nutrition rehabilitation centres in reducing mortality and improving nutritional outcome of severely malnourished children in Guinea Bissau. Eur J Clin Nutr. 1995;49(5):353-9.
Perra, A., & Costello, A. M. (1995). Efficacy of outreach nutrition rehabilitation centres in reducing mortality and improving nutritional outcome of severely malnourished children in Guinea Bissau. European Journal of Clinical Nutrition, 49(5), 353-9.
Perra A, Costello AM. Efficacy of Outreach Nutrition Rehabilitation Centres in Reducing Mortality and Improving Nutritional Outcome of Severely Malnourished Children in Guinea Bissau. Eur J Clin Nutr. 1995;49(5):353-9. PubMed PMID: 7664721.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of outreach nutrition rehabilitation centres in reducing mortality and improving nutritional outcome of severely malnourished children in Guinea Bissau. AU - Perra,A, AU - Costello,A M, PY - 1995/5/1/pubmed PY - 1995/5/1/medline PY - 1995/5/1/entrez KW - Africa KW - Africa South Of The Sahara KW - Age Factors KW - Child KW - Child Mortality KW - Child Nutrition KW - Delivery Of Health Care KW - Demographic Factors KW - Developing Countries KW - Diseases KW - Guinea-bissau KW - Health KW - Health Services KW - Malnutrition KW - Mortality KW - Nutrition KW - Nutrition Disorders KW - Nutrition Programs KW - Population KW - Population Characteristics KW - Population Dynamics KW - Portuguese Speaking Africa KW - Primary Health Care KW - Research Report KW - Treatment KW - Western Africa KW - Youth SP - 353 EP - 9 JF - European journal of clinical nutrition JO - Eur J Clin Nutr VL - 49 IS - 5 N2 - OBJECTIVE: There is still controversy about the efficacy and cost-effectiveness of outreach nutrition rehabilitation centres (NRCs) for severely malnourished children. We wanted to compare the mortality rates and nutritional status of severely malnourished children admitted to rural NRCs in Gabu region, Guinea Bissau, with other severely malnourished children who were not rehabilitated and stayed in their villages. DESIGN: Retrospective cohort study over a 3-year period. Mortality rates and nutritional outcome compared for children who were admitted to rural NRCs and those who were not rehabilitated. Selection for admission to the NRCs was based on availability of places only. SETTING: 19 health areas of the Gabu region, Guinea Bissau, West Africa. SUBJECTS: 1038 severely malnourished children (< 60% weight-for-age using NCHS standards) aged 6 to 47 months. 354 were rehabilitated in NRCs and 684 received no rehabilitation. RESULTS: Up to 36 months follow-up the relative risk of death in the rehabilitated group was 0.75 [95% confidence interval (c.i.) = 0.57-0.99], equivalent to a 25% reduction in mortality. The difference in mortality between the two groups was much higher during the first 3 months [P < 0.02, relative risk = 0.59 (95% c.i. = 0.39-0.91)]. Rehabilitated children had a higher mean weight gain in the first 3 months (1.63 compared to 0.56 weight-for-age standard deviation score, P < 0.001), and weight gain differences lasted up to 18 months (P < 0.01). CONCLUSIONS: Low-cost, outreach NRCs are effective both in the short term and in the mid-term to improve the nutritional situation and reduce the mortality of severely malnourished children. SN - 0954-3007 UR - https://www.unboundmedicine.com/medline/citation/7664721/Efficacy_of_outreach_nutrition_rehabilitation_centres_in_reducing_mortality_and_improving_nutritional_outcome_of_severely_malnourished_children_in_Guinea_Bissau_ L2 - https://medlineplus.gov/ruralhealthconcerns.html DB - PRIME DP - Unbound Medicine ER -