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Post a reply: Simplified protocol - RUSF SAM treatment

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As per the MAM Decision Tool, there is a recommendation to use expanded admissions criteria to admit children 6-59 months classified with MAM into the OTP (MUAC <125mm), or SAM into SFP (<125mm without lower limit), as a temporary
measure in emergency situations when either SFP or OTP are not available. The aim is to avert deaths in SAM children by giving RUSF (when RUTF is not available); and treat MAM cases in OTP with RUTF (when RUSF is not available) so that malnutrition does not become lifethreatening. The dosage of RUTF/RUSF recommended is: MUAC <115mm 2 RUTF or RUSF/day; MUAC between 115mm - <125mm- 1 RUTF or RUSF/day.

Pilots studies/ operational experience has been documented using optimised dose of RUTF for SAM and MAM.

What are thoughts on conducting pilot studies using RUSF as the single product for SAM and MAM treatment?

- Aiming to 'Do No Harm' is there any potential risk that recovery, weight gain, linear growth... could be compromised in SAM children (MUAC<115mm) receiving RUSF compared to those who would have received RUTF?
- What are thoughts also in using RUSF vs RUTF for kwashiorkor +/++ children?
- How about RUSF vs RUTF in SAM children who are also stunted?

Or given that the nutrient content of RUTF is very similar to RUSF could it be considered that treatment outcomes in SAM children (MUAC<115mm or kwashiorkor +/++) will likely be the same regardless of whether they receive 2 sachets of RUSF or 2 sachets of RUTF?

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