New approach to simplifying and optimising acute malnutrition treatment in children aged 6-59 months: the OptiMA single-arm proof-of-concept trial in Burkina Faso.

The Optimising treatment for acute MAlnutrition (OptiMA) strategy trains mothers to use mid upper arm circumference (MUAC) bracelets for screening and targets treatment to children with MUAC < 125 mm or oedema with one therapeutic food at a gradually reduced dose. This study seeks to determine whether OptiMA conforms to SPHERE standards (recovery rate > 75 %). A single-arm proof-of-concept trial was conducted in 2017 in Yako district, Burkina Faso including children aged 6-59 months in outpatient health centres with MUAC < 125 mm or oedema. Outcomes were stratified by MUAC category at admission. Multivariate survival analysis was carried out to identify variables predictive of recovery. Among 4958 children included, 824 (16·6 %) were admitted with MUAC < 115 mm or oedema, 1070 (21·6 %) with MUAC 115-119 mm and 3064 (61·8 %) with MUAC 120-124 mm. The new dosage was correctly implemented at all visits for 75·9 % of children. Global recovery was 86·3 (95 % CI 85·4, 87·2) % and 70·5 (95 % CI 67·5, 73·5) % for children admitted with MUAC < 115 mm or oedema. Average therapeutic food consumption was 60·8 sachets per child treated. Recovery was positively associated with mothers trained to use MUAC prior to child's admission (adjusted hazard ratio 1·09; 95 % CI 1·01, 1·19). OptiMA was successfully implemented at the scale of an entire district under 'real-life' conditions. Programme outcomes exceeded SPHERE standards, but further study is needed to determine if increasing therapeutic food dosages for the most severely malnourished will improve recovery.

Prevalence of wasting and associated factors among 6 to 23 months old children in the Sahel Region of Burkina Faso.

INTRODUCTION: Despite the efforts of nutrition stakeholders in Burkina Faso to improve infant and young child feeding (IYCF) practices, the country is still struggling to stem undernutrition. Wasting, or acute malnutrition, is the form of malnutrition that has the most harmful short-term consequences for children. The objective of our study was to estimate the prevalence of wasting in children aged 6-23 months in the Sahel region of Burkina Faso and to identify its associated factors. METHODS: We conducted a secondary analysis of data from the 2015 National Nutrition Survey. The factors associated with wasting in the studied population were identified using a logistic regression. RESULTS: A total of 956 children participated in the study. The prevalence of wasting was 25% (95% CI [22.28, 27.87]) in the Sahel region. Only 24.37% of children received a minimum meal frequency and 13.38% received a minimum dietary diversification the day before the survey. In the multivariate analysis, being male (aOR = 1.99; 95% CI [1.46, 2.72]), breastfeeding the day before the survey (aOR = 2.43; 95% CI [1.13, 5.22]), and having a history of illness (aOR = 2.32; 95% CI [1.67, 3.21]) significantly increased the risk of acute malnutrition. CONCLUSION: In 2015, the prevalence of wasting among children was high in the Sahel region and good IYCF practices were still inadequate. There is an urgent need to implement good IYCF practices and strengthen interventions to improve infant health in this region.

Mapping Nutrition Interventions, a Key Analytical Tool for Informing the Multisectoral Planning Process: Example From Burkina Faso.

BACKGROUND: The government of Burkina Faso, along with the United Nations Network for Nutrition (UNN), activity REACH (Renewed Efforts Against Child Hunger and undernutrition) partnership, conducted a mapping of nutrition interventions and stakeholders to identify the best approaches for scaling up priority nutrition interventions and to strengthen a multisectoral response to fight malnutrition. OBJECTIVE: The objectives include describing the process used to map a set of country-prioritized nutrition interventions and to describe how the results contributed to the multisectoral nutrition planning process in Burkina Faso. METHODS: The mapping exercise was designed as a cross-sectional study using the Excel-based Scaling Up Nutrition Planning and Monitoring Tool (SUN PMT) to collect, store, and analyze data. RESULTS: The results present different analyses produced by the SUN PMT for 29 prioritized nutrition interventions. The analyses include the distribution of nutrition stakeholders for each intervention, the calculation of geographic and population coverage for each intervention, and the utilization of delivery mechanisms to reach beneficiaries. CONCLUSIONS: The mapping of key nutrition interventions and stakeholders supporting those interventions in Burkina Faso was an important tool in the multisectoral planning process. The exercise made it possible to identify gaps and needs; launch a discussion on nutrition planning and the scaling up of interventions; and mobilize sectors and development partners around nutrition.

Comparative Validation of Five Quantitative Rapid Test Kits for the Analysis of Salt Iodine Content: Laboratory Performance, User- and Field-Friendliness.

BACKGROUND: Iodine deficiency has important health and development consequences and the introduction of iodized salt as national programs has been a great public health success in the past decades. To render national salt iodization programs sustainable and ensure adequate iodization levels, simple methods to quantitatively assess whether salt is adequately iodized are required. Several methods claim to be simple and reliable, and are available on the market or are in development. OBJECTIVE: This work has validated the currently available quantitative rapid test kits (quantRTK) in a comparative manner for both their laboratory performance and ease of use in field settings. METHODS: Laboratory performance parameters (linearity, detection and quantification limit, intra- and inter-assay imprecision) were conducted on 5 quantRTK. We assessed inter-operator imprecision using salt of different quality along with the comparison of 59 salt samples from across the globe; measurements were made both in a laboratory and a field setting by technicians and non-technicians. Results from the quantRTK were compared against iodometric titration for validity. An 'ease-of-use' rating system was developed to identify the most suitable quantRTK for a given task. RESULTS: Most of the devices showed acceptable laboratory performance, but for some of the devices, use by non-technicians revealed poorer performance when working in a routine manner. Of the quantRTK tested, the iCheck® and I-Reader® showed most consistent performance and ease of use, and a newly developed paper-based method (saltPAD) holds promise if further developed. CONCLUSIONS: User- and field-friendly devices are now available and the most appropriate quantRTK can be selected depending on the number of samples and the budget available.