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

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

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anthropometry
  • Female
  • Food, Formulated* / statistics & numerical data
  • Humans
  • Infant
  • Infant Nutrition Disorders* / diet therapy
  • Male
  • Pakistan
  • Rural Population / statistics & numerical data
  • Severe Acute Malnutrition* / diet therapy
  • Treatment Outcome

Grants and funding

This work was supported by the Bill and Melinda Gates Foundation (grant number OPP1066200 and OPP1138727 to SAA and grant number OPP1144149 to SRM). The funders had no role in the design, data collection, analysis of the study, nor the decision to publish or the preparation of this manuscript.