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. 2023 Jul 12;18(7):e0287962.
doi: 10.1371/journal.pone.0287962. eCollection 2023.

Standard RUTF vs. locally-made RUSF for acutely malnourished children: A quasi-experimental comparison of the impact on growth and compliance in a rural community of Pakistan

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Standard RUTF vs. locally-made RUSF for acutely malnourished children: A quasi-experimental comparison of the impact on growth and compliance in a rural community of Pakistan

Azza Sarfraz et al. PLoS One. .

Abstract

Background: The reduction in severe and moderate acute malnutrition (SAM and MAM) rates in Pakistan has been sub-optimal compared to other low-and middle-income countries (LMICs). Specially-formulated products have been designed globally to manage SAM and MAM, such as ready-to-use therapeutic food (RUTF) and ready-to-use supplementary food (RUSF), with variable efficacies. RUTF is primarily produced and patented in industrialized countries, raising supply challenges in resource-constrained regions with a high burden of acute malnutrition. RUSF minimizes costs by using locally-available ingredients while providing similar nutritional value. In this study, we compared the efficacy, side effects, and compliance of two months of supplementation with either RUTF or RUSF.

Methods: Children aged nine months in the rural district of Matiari, Pakistan, with a weight-for-height z-score (WHZ) <-2 received either RUTF (500 kcal sachet) for two months in 2015 or RUSF (520 kcal sachet) for two months in 2018.

Results: The RUSF group had a higher height gain and mid-upper arm circumferences (MUAC) score. Higher compliance was noted with lower side effects in the RUSF group. A higher compliance rate did correlate with the growth parameters in respective groups.

Conclusion: Our study found that both RUTF and RUSF partially improve the anthropometric status of acutely malnourished children, with neither being superior to the other.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1
a. Front side of AchaMum ready-to-use supplementary food (RUSF). b. Back side of AchaMum ready-to-use supplementary food (RUSF).
Fig 2
Fig 2
The trajectory of a) WAZ, b) WHZ, and c) HAZ from birth until 1 year of age in both cohorts. There is a significant difference in the WAZ and WHZ scores between RUTF and RUSF cohorts from 0–6 months.
Fig 3
Fig 3
The trajectory of a) weight (kgs) and b) height (cms) from birth until 1 year of age in both cohorts.

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