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Any agreed on protocols for use of Plumpy Doz for treatment of moderate acute malnutrition?

This question was posted the Prevention and treatment of moderate acute malnutrition forum area and has 4 replies. You can also reply via email – be sure to leave the subject unchanged.

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Wendy Dyment

Health advisor/ Medair

Normal user

15 Mar 2010, 14:44

I was suprised to learn our agency might shortly be mostly receiving Plumpy Doz as GIK from a UN agency for the treatment of children with moderate acute malnutrition in an SFP. We have used it for prevention of malnutrition in another country but not for treatment. I know there have been a few studies done recently comparing it with standard treatment and a posting asking about this, but I have not seen much on preliminary or final results. Is Plumpy Doz now considered acceptable to use for treatment of MAM? and if so, what are the protocols being used for treatment in these trials?

Mark Manary

Washington University School of Medicine

Technical expert

26 May 2010, 15:50

Wendy;

Plumpy Doz is a good source of micronutrients. You will need to add an adequate source of macronturients to this to treat MAM. Since the micronutrients are provided throught the paste, a cereal-legume flour is probably an adequate source of macronutrients. Depending on where you are, other foods may be available too. Give 75 kcal/kg/d, remembering Plumpy Doz is 5 kcal/g. So if 20 g of Plumpy Doz were given, this is 80 kcal and more energy will be needed.

Mark Myatt

Consultant Epideomiologist

Frequent user

26 May 2010, 18:09

Mark,

If you were using an RUTF (e.g. Plumpy'Nut) to treat MAM what dose would you go for? I've just been looking at a protocol which proposed approximately 100 kcal/g/day and 2-2.5 g/kg/day protein (the "approximately" is down to packaging). Does that seem reasonable?

Pascale Delchevalerie

Nutrition Advisor MSF Belgium

Normal user

8 Jun 2010, 15:23

Hello,

In our programs were we used RUTF for treatment of MAM, we gave 1000 kcal / day (2 sachets).
For MAM according to new WHO standards, in Niger, where 90% of children included in the program are < 2 years old, while we were not in hunger gap season, I tried with 500 Kcal (1 sachet)/day: according to centres, the mean lenght of stay ranged from 38 to 55 days and mean weight gain from 2,5 to 3,9 g/kg/d.
During Hunger gap period, children received 2 PN/day and mean lenght of stay and mean weight gain ranged from 35 to 46 days and 2,9 to 3,6 g/kg/j respectively.

Santiago

Nutritionist Epidemiologist / FAO

Normal user

7 Sep 2010, 17:55

A question to Pascale:

Did you used Plumpy nut to recover children with MAM?... Is there any risk doing that?... what is the best daily dose?

Thanks a lot.

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