BRIGHT-SAM: BRaIn development, Growth and HealTh in children with Severe Acute Malnutrition
Medical Research Council
National Institute for Medical Research
The use of ready-to-use therapeutic foods (RUTF) for community-based management of children with severe acute malnutrition (SAM) is well-established and saves lives. However, current RUTF formulations result in a low ratio of n3/n6 essential fatty acids (EFAs) and other data show that low levels of the n3 EFA, docosahexaenoic acid, are associated with impaired cognitive function. An RUTF has been developed with an EFA content which should improve n3/n6 EFA ratio. We will test this for acceptability among children with SAM and their caregivers and we will assess the EFA profile and variability before and after the interventions, and compare with that of control children. Current recommendations for SAM treatment include provision of psychosocial (PS) interventions to help caregivers improve cognitive function of their children. However, to date these have had little impact: interventions shown to be efficacious have been too intensive and costly for scale-up and those scaled-up widely for children without SAM had little benefit. A short intervention focussing on the most high-risk children may have greater benefit. We will work with caregivers, local health staff, and local organizations working to promote child development to design a short, focussed PS intervention which can be offered in parallel with RUTF for community-based SAM treatment. Our long-term plan is to conduct a well-powered 2X2 factorial clinical trial of the novel RUTF and the PS intervention to determine their individual and any synergistic effects on cognitive development of children with SAM. The development project will aid this by: finalising the interventions, determining contextual factors influencing intervention delivery and uptake, determining variability in EFA and development outcomes to aid sample size calculations; engagement with local health care staff managing SAM and providers of child development interventions to ensure that our interventions are appropriate and locally own
6.1 Pharmaceuticals / Research Grant