Carers' knowledge of treatment of severe acute malnutrition at Dadaab refugee complex, Kenya: A prospective cohort study.

Background. Severe acute malnutrition causes half of the deaths in children under the age of 5 years in refugee camps. Objective. To describe carers' knowledge of the treatment of severe acute malnutrition at Dadaab Refugee Complex in Garissa County, Kenya. Methods. A prospective cohort study of 128 children (6 - 59 months) and their carers was conducted at the Ifo I and Hagadera refugee camps, Kenya. Child-carer pairs from the stabilisation centre (SC) (n=22) and outpatient therapeutic feeding programme (OTFP) (n=42) at each camp were followed up until discharged. Data were collected using a structured questionnaire. Statistical analyses included 2 and independent-sample t-tests. Results. The mean (standard deviation) length of stay in the SC was 10.4 (6) days at Ifo and 9.5 (4) days at Hagadera (p=0.465), while 5.9 (1.5) days and 5.6 (2.1) days in the OTFPs at Ifo and Hagadera, respectively (p=0.125). There were no defaulters. More than a third of the carers in each OTFP did not know the duration of treatment (p=0.000) and less than half adhered strictly to the prescribed therapeutic feeding recommendations. Only 36% of carers in the SC at Ifo (n=8) and 27% (n=6) at Hagadera knew why malnourished children have to be kept warm during cold weather (p=0.003), compared with 48% (n=20) and 36% (n=15) of carers in the OTFPs (p=0.000). Conclusion. Carers have a critical role in managing acute malnutrition in a community-based model. This study provides invaluable insights regarding carers' knowledge on treatment of acute malnutrition and identifies areas of improvement. [ABSTRACT FROM AUTHOR]