Effectiveness of a locally produced RUTF for the treatment of Acute Malnutrition in Vietnam

Full text: Background and Objectives: After an assessment of peanut-based RUTF in Cambodia found low acceptability rates, the National Institute of Nutrition Vietnam, UNICEF and the Institut de Recherche pour le Developpement started in 2009 to work on a locally produced RUTF, adapted to local taste and preference for the treatment of severe acute malnutrition (SAM). In 2010, the newly developed product was found to be highly acceptable, but impact on weight gain needed to be proven. Therefore, this study was conducted to assess the effectiveness of the local RUTF on weight gain and recovery rate using the RUTF in a home based treatment of acute malnutrition. Methods and Design: The study was a randomized intervention trial in 150 children, aged 6-59 months, with SAM or moderate acute malnutrition (MAM) to test the effectiveness of the local RUTF (bar) against a standard RUTF (peanut-based paste). The study was done as a community-based intervention trial in Kon Tum province (Central Highlands region), Vietnam, where an Integrated Management of Acute Malnutrition programs (IMAM) program was just being introduced. Results: Children consumed 92% and 70% of the offered local RUTF and standard RUTF respectively, underlining the problems with a peanut-based RUTF in SE Asia. Nutritional status of the children was significantly improved after the 8 weeks intervention. Mean weight gain with the standard RUTF and the local RUTF was 2.97 (± 1.57) g/kg/d and 2.52 (± 1.23) g/kg/d respectively. Also, both RUTFs improved significantly height and HAZ-scores, with a mean height gain of 22.4 (±18.7) mm and 32.3 (±36.3) mm for respectively standard and local RUTF. The recovery rate from acute malnutrition with RUTFs as home treatment was 70.8%, and not different between the 2 interventions. Conclusions: The local RUTF was as effective as the standard RUTF on the treatment of acute malnutrition, whereas acceptability was higher. The local RUTF can be successfully used in the IMAM programs. The study supports the current efforts in Viet Nam to include IMAM and therapeutic foods into the National Targeted Programme and National Health Insurance scheme. Future: Currently the partners are working on the development of a RUSF specifically developed for moderate acute malnutrition, with an effectiveness study of the product alone or in combination with WASH just finishing. (author)