Ready-to-use therapeutic food (RUTF) for home-basednutritional rehabilitation of severe acute malnutrition inchildren from six months to five years of age

Background Management of severe acute malnutrition (SAM) in children comprises two potential phases: stabilisation and rehabilitation. During the initial stabilisation phase, children receive treatment for dehydration, electrolyte imbalances, intercurrent infections and other complications. In the rehabilitation phase (applicable to children presenting with uncomplicated SAM or those with complicated SAM after complications have been resolved), catch‐up growth is the main focus and the recommended energy and protein requirements are much higher. In‐hospital rehabilitation of children with SAM is not always desirable or practical ‐ especially in rural settings ‐ and home‐based care can offer a better solution. Ready‐to‐use therapeutic food (RUTF) is a widely used option for home‐based rehabilitation, but the findings of our previous review were inconclusive. Objectives To assess the effects of home‐based RUTF used during the rehabilitation phase of SAM in children aged between six months and five years on recovery, relapse, mortality and rate of weight gain. Search methods We searched the following databases in October 2018: CENTRAL, MEDLINE, Embase, six other databases and three trials registers. We ran separate searches for cost‐effectiveness studies, contacted researchers and healthcare professionals in the field, and checked bibliographies of included studies and relevant reviews. Selection criteria Randomised controlled trials (RCTs) and quasi‐RCTs, where children aged between six months and five years with SAM were, during the rehabilitation phase, treated at home with RUTF compared to an alternative dietary approach, or with different regimens and formulations of RUTF compared to each other. We assessed recovery, deterioration or relapse and mortality as primary outcomes; and rate of weight gain, time to recovery, anthropometrical changes, cognitive development and function, adverse outcomes and acceptability as secondary outcomes. Data collection and analysis