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Tufts University (2021)

Individual, environmental, and programmatic determinants of effective severe wasting treatment among children 6-59 months old in Afghanistan and Mali

Boyd, Erin.

Titre : Individual, environmental, and programmatic determinants of effective severe wasting treatment among children 6-59 months old in Afghanistan and Mali

Auteur : Boyd, Erin.

Université de soutenance  : Tufts University,

Grade : Doctor of Philosophy (PhD) 2021

Résumé partiel
Severe wasting is a form of undernutrition associated with rapid weight loss linked to inadequate diet and exposure to disease and unsanitary living environments. A globally- accepted standard treatment protocol for severe wasting exists, which includes provision of essential medicines, routine medical assessments, and the provision of ready to use therapeutic foods (RUTFs). This protocol is primarily used in humanitarian settings, less so in chronic or protracted contexts where wasting incidence and prevalence rates can still be unacceptably high. While these treatments are very effective in terms of outcomes, there are still too many children who do not respond to treatment, respond poorly (take longer than required to be discharged from treatment), and/or relapse post-discharge. This suggests that there are additional factors at play (beyond diet and disease) that are still poorly understood or inadequately incorporated into prevailing programming approaches.

A major constraint to increasing effectiveness of treatment is weak evidence on how children progress through treatment, and a poor understanding of differences in response to treatment based on underlying individual risk factors at enrollment, environmental factors that impact the health and food situation, and health workers compliance to standard protocols. Consequently, standard protocols may miss opportunities to tailor treatment and address different individual, environmental, and programmatic risk factors during severe wasting treatment.

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Page publiée le 12 décembre 2022