Family MUAC supported by a two-way SMS platform for identifying children with wasting: the Mama Aweza randomised controlled trialResearch in context

Summary: Background: Effective methods of preventing and identifying childhood wasting are required to achieve global child health goals. Family mid-upper arm circumference (MUAC) programs train caregivers to screen their child for wasting with MUAC tapes. We assessed the effectiveness of a two-way short message service (SMS) platform (referred to as the Maternally Administered Malnutrition Monitoring System [MAMMS]) in western Kenya. Methods: In this individual-level randomised controlled trial in two rural countries in western Kenya, children (aged 5–12 months) were randomly allocated (1:1) to receive either standard care (SOC) or MAMMS. Randomisation method was permuted-block randomisation with a block size of 10. Eligible participants were children attending maternal child health clinics in the two counties whom had a MUAC between 12.5 and 14.0 cm. The MAMMS group received two MUAC tapes and weekly SMS reminders to screen their child's MUAC. The SOC group received routine community health volunteer services and additional quarterly visits from the study team. The primary analysis used a cox proportional hazards model to compare SOC and MAMMS time-to-diagnosis of wasting (MUAC <12.5 cm) confirmed by a health professional during 6-months follow-up. Secondary outcomes were days from enrolment to treatment initiation among children with wasting, proportion of all children with wasting who were identified by the two approaches (treatment coverage), mean MUAC at treatment initiation, and duration of wasting treatment. This trial was registered on ClinicalTrials.gov, NCT03967015. Findings: Between August 1, 2019 and January 31, 2022, 1200 children were enrolled, among whom the incidence of confirmed wasting was 37% lower in the MAMMS group (hazard ratio: 0.63, 95% CI: 0.42–0.94, p = 0.022). Among children with wasting, the median number of days-to-diagnosis was similar between study groups (MAMMS: 63 days [interquartile range (IQR): 23–92], SOC: 58 days [IQR: 22–94]). Treatment coverage in the MAMMS group was 83.3% (95% CI: 39.9–100.0) while coverage in the SOC group was 55.6% (95% CI: 22.3–88.9%, p = 0.300). Treatment duration and mean MUAC at treatment initiation were similar between groups. Interpretation: Family MUAC supported by SMS was associated with a 37% reduction in wasting among young children. Empowering caregivers to monitor their child's nutritional status at home may prevent a substantial proportion of moderate wasting. Funding: Thrasher Research Foundation and Pamela and Evan Fowler. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Kirkby D. Tickell [verfasserIn] Cathering Achieng [verfasserIn] Mary Masheti [verfasserIn] Maureen Anyango [verfasserIn] Agnes Ndirangu [verfasserIn] Mareme M. Diakhate [verfasserIn] Emily Yoshioka [verfasserIn] Carol Levin [verfasserIn] Arianna Rubin Means [verfasserIn] Esther M. Choo [verfasserIn] Keshet Ronen [verfasserIn] Jennifer A. Unger [verfasserIn] Barbra A. Richardson [verfasserIn] Benson O. Singa [verfasserIn] Christine J. McGrath [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	Family MUAC Childhood wasting Acute malnutrition

Übergeordnetes Werk:	In: EClinicalMedicine - Elsevier, 2018, 64(2023), Seite 102218-
Übergeordnetes Werk:	volume:64 ; year:2023 ; pages:102218-

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1016/j.eclinm.2023.102218

Katalog-ID:	DOAJ095066977

Internformat


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520			\|a Summary: Background: Effective methods of preventing and identifying childhood wasting are required to achieve global child health goals. Family mid-upper arm circumference (MUAC) programs train caregivers to screen their child for wasting with MUAC tapes. We assessed the effectiveness of a two-way short message service (SMS) platform (referred to as the Maternally Administered Malnutrition Monitoring System [MAMMS]) in western Kenya. Methods: In this individual-level randomised controlled trial in two rural countries in western Kenya, children (aged 5–12 months) were randomly allocated (1:1) to receive either standard care (SOC) or MAMMS. Randomisation method was permuted-block randomisation with a block size of 10. Eligible participants were children attending maternal child health clinics in the two counties whom had a MUAC between 12.5 and 14.0 cm. The MAMMS group received two MUAC tapes and weekly SMS reminders to screen their child's MUAC. The SOC group received routine community health volunteer services and additional quarterly visits from the study team. The primary analysis used a cox proportional hazards model to compare SOC and MAMMS time-to-diagnosis of wasting (MUAC <12.5 cm) confirmed by a health professional during 6-months follow-up. Secondary outcomes were days from enrolment to treatment initiation among children with wasting, proportion of all children with wasting who were identified by the two approaches (treatment coverage), mean MUAC at treatment initiation, and duration of wasting treatment. This trial was registered on ClinicalTrials.gov, NCT03967015. Findings: Between August 1, 2019 and January 31, 2022, 1200 children were enrolled, among whom the incidence of confirmed wasting was 37% lower in the MAMMS group (hazard ratio: 0.63, 95% CI: 0.42–0.94, p = 0.022). Among children with wasting, the median number of days-to-diagnosis was similar between study groups (MAMMS: 63 days [interquartile range (IQR): 23–92], SOC: 58 days [IQR: 22–94]). Treatment coverage in the MAMMS group was 83.3% (95% CI: 39.9–100.0) while coverage in the SOC group was 55.6% (95% CI: 22.3–88.9%, p = 0.300). Treatment duration and mean MUAC at treatment initiation were similar between groups. Interpretation: Family MUAC supported by SMS was associated with a 37% reduction in wasting among young children. Empowering caregivers to monitor their child's nutritional status at home may prevent a substantial proportion of moderate wasting. Funding: Thrasher Research Foundation and Pamela and Evan Fowler.
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700	0		\|a Mary Masheti \|e verfasserin \|4 aut
700	0		\|a Maureen Anyango \|e verfasserin \|4 aut
700	0		\|a Agnes Ndirangu \|e verfasserin \|4 aut
700	0		\|a Mareme M. Diakhate \|e verfasserin \|4 aut
700	0		\|a Emily Yoshioka \|e verfasserin \|4 aut
700	0		\|a Carol Levin \|e verfasserin \|4 aut
700	0		\|a Arianna Rubin Means \|e verfasserin \|4 aut
700	0		\|a Esther M. Choo \|e verfasserin \|4 aut
700	0		\|a Keshet Ronen \|e verfasserin \|4 aut
700	0		\|a Jennifer A. Unger \|e verfasserin \|4 aut
700	0		\|a Barbra A. Richardson \|e verfasserin \|4 aut
700	0		\|a Benson O. Singa \|e verfasserin \|4 aut
700	0		\|a Christine J. McGrath \|e verfasserin \|4 aut
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author_variant	k d t kdt c a ca m m mm m a ma a n an m m d mmd e y ey c l cl a r m arm e m c emc k r kr j a u jau b a r bar b o s bos c j m cjm
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allfields	10.1016/j.eclinm.2023.102218 doi (DE-627)DOAJ095066977 (DE-599)DOAJ697e240cb21d4c9482b39cdf5325318e DE-627 ger DE-627 rakwb eng R5-920 Kirkby D. Tickell verfasserin aut Family MUAC supported by a two-way SMS platform for identifying children with wasting: the Mama Aweza randomised controlled trialResearch in context 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Summary: Background: Effective methods of preventing and identifying childhood wasting are required to achieve global child health goals. Family mid-upper arm circumference (MUAC) programs train caregivers to screen their child for wasting with MUAC tapes. We assessed the effectiveness of a two-way short message service (SMS) platform (referred to as the Maternally Administered Malnutrition Monitoring System [MAMMS]) in western Kenya. Methods: In this individual-level randomised controlled trial in two rural countries in western Kenya, children (aged 5–12 months) were randomly allocated (1:1) to receive either standard care (SOC) or MAMMS. Randomisation method was permuted-block randomisation with a block size of 10. Eligible participants were children attending maternal child health clinics in the two counties whom had a MUAC between 12.5 and 14.0 cm. The MAMMS group received two MUAC tapes and weekly SMS reminders to screen their child's MUAC. The SOC group received routine community health volunteer services and additional quarterly visits from the study team. The primary analysis used a cox proportional hazards model to compare SOC and MAMMS time-to-diagnosis of wasting (MUAC <12.5 cm) confirmed by a health professional during 6-months follow-up. Secondary outcomes were days from enrolment to treatment initiation among children with wasting, proportion of all children with wasting who were identified by the two approaches (treatment coverage), mean MUAC at treatment initiation, and duration of wasting treatment. This trial was registered on ClinicalTrials.gov, NCT03967015. Findings: Between August 1, 2019 and January 31, 2022, 1200 children were enrolled, among whom the incidence of confirmed wasting was 37% lower in the MAMMS group (hazard ratio: 0.63, 95% CI: 0.42–0.94, p = 0.022). Among children with wasting, the median number of days-to-diagnosis was similar between study groups (MAMMS: 63 days [interquartile range (IQR): 23–92], SOC: 58 days [IQR: 22–94]). Treatment coverage in the MAMMS group was 83.3% (95% CI: 39.9–100.0) while coverage in the SOC group was 55.6% (95% CI: 22.3–88.9%, p = 0.300). Treatment duration and mean MUAC at treatment initiation were similar between groups. Interpretation: Family MUAC supported by SMS was associated with a 37% reduction in wasting among young children. Empowering caregivers to monitor their child's nutritional status at home may prevent a substantial proportion of moderate wasting. Funding: Thrasher Research Foundation and Pamela and Evan Fowler. Family MUAC Childhood wasting Acute malnutrition Medicine (General) Cathering Achieng verfasserin aut Mary Masheti verfasserin aut Maureen Anyango verfasserin aut Agnes Ndirangu verfasserin aut Mareme M. Diakhate verfasserin aut Emily Yoshioka verfasserin aut Carol Levin verfasserin aut Arianna Rubin Means verfasserin aut Esther M. Choo verfasserin aut Keshet Ronen verfasserin aut Jennifer A. Unger verfasserin aut Barbra A. Richardson verfasserin aut Benson O. Singa verfasserin aut Christine J. McGrath verfasserin aut In EClinicalMedicine Elsevier, 2018 64(2023), Seite 102218- (DE-627)1035271834 25895370 nnns volume:64 year:2023 pages:102218- https://doi.org/10.1016/j.eclinm.2023.102218 kostenfrei https://doaj.org/article/697e240cb21d4c9482b39cdf5325318e kostenfrei http://www.sciencedirect.com/science/article/pii/S2589537023003954 kostenfrei https://doaj.org/toc/2589-5370 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2110 GBV_ILN_2112 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 64 2023 102218-
spelling	10.1016/j.eclinm.2023.102218 doi (DE-627)DOAJ095066977 (DE-599)DOAJ697e240cb21d4c9482b39cdf5325318e DE-627 ger DE-627 rakwb eng R5-920 Kirkby D. Tickell verfasserin aut Family MUAC supported by a two-way SMS platform for identifying children with wasting: the Mama Aweza randomised controlled trialResearch in context 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Summary: Background: Effective methods of preventing and identifying childhood wasting are required to achieve global child health goals. Family mid-upper arm circumference (MUAC) programs train caregivers to screen their child for wasting with MUAC tapes. We assessed the effectiveness of a two-way short message service (SMS) platform (referred to as the Maternally Administered Malnutrition Monitoring System [MAMMS]) in western Kenya. Methods: In this individual-level randomised controlled trial in two rural countries in western Kenya, children (aged 5–12 months) were randomly allocated (1:1) to receive either standard care (SOC) or MAMMS. Randomisation method was permuted-block randomisation with a block size of 10. Eligible participants were children attending maternal child health clinics in the two counties whom had a MUAC between 12.5 and 14.0 cm. The MAMMS group received two MUAC tapes and weekly SMS reminders to screen their child's MUAC. The SOC group received routine community health volunteer services and additional quarterly visits from the study team. The primary analysis used a cox proportional hazards model to compare SOC and MAMMS time-to-diagnosis of wasting (MUAC <12.5 cm) confirmed by a health professional during 6-months follow-up. Secondary outcomes were days from enrolment to treatment initiation among children with wasting, proportion of all children with wasting who were identified by the two approaches (treatment coverage), mean MUAC at treatment initiation, and duration of wasting treatment. This trial was registered on ClinicalTrials.gov, NCT03967015. Findings: Between August 1, 2019 and January 31, 2022, 1200 children were enrolled, among whom the incidence of confirmed wasting was 37% lower in the MAMMS group (hazard ratio: 0.63, 95% CI: 0.42–0.94, p = 0.022). Among children with wasting, the median number of days-to-diagnosis was similar between study groups (MAMMS: 63 days [interquartile range (IQR): 23–92], SOC: 58 days [IQR: 22–94]). Treatment coverage in the MAMMS group was 83.3% (95% CI: 39.9–100.0) while coverage in the SOC group was 55.6% (95% CI: 22.3–88.9%, p = 0.300). Treatment duration and mean MUAC at treatment initiation were similar between groups. Interpretation: Family MUAC supported by SMS was associated with a 37% reduction in wasting among young children. Empowering caregivers to monitor their child's nutritional status at home may prevent a substantial proportion of moderate wasting. Funding: Thrasher Research Foundation and Pamela and Evan Fowler. Family MUAC Childhood wasting Acute malnutrition Medicine (General) Cathering Achieng verfasserin aut Mary Masheti verfasserin aut Maureen Anyango verfasserin aut Agnes Ndirangu verfasserin aut Mareme M. Diakhate verfasserin aut Emily Yoshioka verfasserin aut Carol Levin verfasserin aut Arianna Rubin Means verfasserin aut Esther M. Choo verfasserin aut Keshet Ronen verfasserin aut Jennifer A. Unger verfasserin aut Barbra A. Richardson verfasserin aut Benson O. Singa verfasserin aut Christine J. McGrath verfasserin aut In EClinicalMedicine Elsevier, 2018 64(2023), Seite 102218- (DE-627)1035271834 25895370 nnns volume:64 year:2023 pages:102218- https://doi.org/10.1016/j.eclinm.2023.102218 kostenfrei https://doaj.org/article/697e240cb21d4c9482b39cdf5325318e kostenfrei http://www.sciencedirect.com/science/article/pii/S2589537023003954 kostenfrei https://doaj.org/toc/2589-5370 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2110 GBV_ILN_2112 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 64 2023 102218-
allfields_unstemmed	10.1016/j.eclinm.2023.102218 doi (DE-627)DOAJ095066977 (DE-599)DOAJ697e240cb21d4c9482b39cdf5325318e DE-627 ger DE-627 rakwb eng R5-920 Kirkby D. Tickell verfasserin aut Family MUAC supported by a two-way SMS platform for identifying children with wasting: the Mama Aweza randomised controlled trialResearch in context 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Summary: Background: Effective methods of preventing and identifying childhood wasting are required to achieve global child health goals. Family mid-upper arm circumference (MUAC) programs train caregivers to screen their child for wasting with MUAC tapes. We assessed the effectiveness of a two-way short message service (SMS) platform (referred to as the Maternally Administered Malnutrition Monitoring System [MAMMS]) in western Kenya. Methods: In this individual-level randomised controlled trial in two rural countries in western Kenya, children (aged 5–12 months) were randomly allocated (1:1) to receive either standard care (SOC) or MAMMS. Randomisation method was permuted-block randomisation with a block size of 10. Eligible participants were children attending maternal child health clinics in the two counties whom had a MUAC between 12.5 and 14.0 cm. The MAMMS group received two MUAC tapes and weekly SMS reminders to screen their child's MUAC. The SOC group received routine community health volunteer services and additional quarterly visits from the study team. The primary analysis used a cox proportional hazards model to compare SOC and MAMMS time-to-diagnosis of wasting (MUAC <12.5 cm) confirmed by a health professional during 6-months follow-up. Secondary outcomes were days from enrolment to treatment initiation among children with wasting, proportion of all children with wasting who were identified by the two approaches (treatment coverage), mean MUAC at treatment initiation, and duration of wasting treatment. This trial was registered on ClinicalTrials.gov, NCT03967015. Findings: Between August 1, 2019 and January 31, 2022, 1200 children were enrolled, among whom the incidence of confirmed wasting was 37% lower in the MAMMS group (hazard ratio: 0.63, 95% CI: 0.42–0.94, p = 0.022). Among children with wasting, the median number of days-to-diagnosis was similar between study groups (MAMMS: 63 days [interquartile range (IQR): 23–92], SOC: 58 days [IQR: 22–94]). Treatment coverage in the MAMMS group was 83.3% (95% CI: 39.9–100.0) while coverage in the SOC group was 55.6% (95% CI: 22.3–88.9%, p = 0.300). Treatment duration and mean MUAC at treatment initiation were similar between groups. Interpretation: Family MUAC supported by SMS was associated with a 37% reduction in wasting among young children. Empowering caregivers to monitor their child's nutritional status at home may prevent a substantial proportion of moderate wasting. Funding: Thrasher Research Foundation and Pamela and Evan Fowler. Family MUAC Childhood wasting Acute malnutrition Medicine (General) Cathering Achieng verfasserin aut Mary Masheti verfasserin aut Maureen Anyango verfasserin aut Agnes Ndirangu verfasserin aut Mareme M. Diakhate verfasserin aut Emily Yoshioka verfasserin aut Carol Levin verfasserin aut Arianna Rubin Means verfasserin aut Esther M. Choo verfasserin aut Keshet Ronen verfasserin aut Jennifer A. Unger verfasserin aut Barbra A. Richardson verfasserin aut Benson O. Singa verfasserin aut Christine J. McGrath verfasserin aut In EClinicalMedicine Elsevier, 2018 64(2023), Seite 102218- (DE-627)1035271834 25895370 nnns volume:64 year:2023 pages:102218- https://doi.org/10.1016/j.eclinm.2023.102218 kostenfrei https://doaj.org/article/697e240cb21d4c9482b39cdf5325318e kostenfrei http://www.sciencedirect.com/science/article/pii/S2589537023003954 kostenfrei https://doaj.org/toc/2589-5370 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2110 GBV_ILN_2112 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 64 2023 102218-
allfieldsGer	10.1016/j.eclinm.2023.102218 doi (DE-627)DOAJ095066977 (DE-599)DOAJ697e240cb21d4c9482b39cdf5325318e DE-627 ger DE-627 rakwb eng R5-920 Kirkby D. Tickell verfasserin aut Family MUAC supported by a two-way SMS platform for identifying children with wasting: the Mama Aweza randomised controlled trialResearch in context 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Summary: Background: Effective methods of preventing and identifying childhood wasting are required to achieve global child health goals. Family mid-upper arm circumference (MUAC) programs train caregivers to screen their child for wasting with MUAC tapes. We assessed the effectiveness of a two-way short message service (SMS) platform (referred to as the Maternally Administered Malnutrition Monitoring System [MAMMS]) in western Kenya. Methods: In this individual-level randomised controlled trial in two rural countries in western Kenya, children (aged 5–12 months) were randomly allocated (1:1) to receive either standard care (SOC) or MAMMS. Randomisation method was permuted-block randomisation with a block size of 10. Eligible participants were children attending maternal child health clinics in the two counties whom had a MUAC between 12.5 and 14.0 cm. The MAMMS group received two MUAC tapes and weekly SMS reminders to screen their child's MUAC. The SOC group received routine community health volunteer services and additional quarterly visits from the study team. The primary analysis used a cox proportional hazards model to compare SOC and MAMMS time-to-diagnosis of wasting (MUAC <12.5 cm) confirmed by a health professional during 6-months follow-up. Secondary outcomes were days from enrolment to treatment initiation among children with wasting, proportion of all children with wasting who were identified by the two approaches (treatment coverage), mean MUAC at treatment initiation, and duration of wasting treatment. This trial was registered on ClinicalTrials.gov, NCT03967015. Findings: Between August 1, 2019 and January 31, 2022, 1200 children were enrolled, among whom the incidence of confirmed wasting was 37% lower in the MAMMS group (hazard ratio: 0.63, 95% CI: 0.42–0.94, p = 0.022). Among children with wasting, the median number of days-to-diagnosis was similar between study groups (MAMMS: 63 days [interquartile range (IQR): 23–92], SOC: 58 days [IQR: 22–94]). Treatment coverage in the MAMMS group was 83.3% (95% CI: 39.9–100.0) while coverage in the SOC group was 55.6% (95% CI: 22.3–88.9%, p = 0.300). Treatment duration and mean MUAC at treatment initiation were similar between groups. Interpretation: Family MUAC supported by SMS was associated with a 37% reduction in wasting among young children. Empowering caregivers to monitor their child's nutritional status at home may prevent a substantial proportion of moderate wasting. Funding: Thrasher Research Foundation and Pamela and Evan Fowler. Family MUAC Childhood wasting Acute malnutrition Medicine (General) Cathering Achieng verfasserin aut Mary Masheti verfasserin aut Maureen Anyango verfasserin aut Agnes Ndirangu verfasserin aut Mareme M. Diakhate verfasserin aut Emily Yoshioka verfasserin aut Carol Levin verfasserin aut Arianna Rubin Means verfasserin aut Esther M. Choo verfasserin aut Keshet Ronen verfasserin aut Jennifer A. Unger verfasserin aut Barbra A. Richardson verfasserin aut Benson O. Singa verfasserin aut Christine J. McGrath verfasserin aut In EClinicalMedicine Elsevier, 2018 64(2023), Seite 102218- (DE-627)1035271834 25895370 nnns volume:64 year:2023 pages:102218- https://doi.org/10.1016/j.eclinm.2023.102218 kostenfrei https://doaj.org/article/697e240cb21d4c9482b39cdf5325318e kostenfrei http://www.sciencedirect.com/science/article/pii/S2589537023003954 kostenfrei https://doaj.org/toc/2589-5370 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2110 GBV_ILN_2112 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 64 2023 102218-
allfieldsSound	10.1016/j.eclinm.2023.102218 doi (DE-627)DOAJ095066977 (DE-599)DOAJ697e240cb21d4c9482b39cdf5325318e DE-627 ger DE-627 rakwb eng R5-920 Kirkby D. Tickell verfasserin aut Family MUAC supported by a two-way SMS platform for identifying children with wasting: the Mama Aweza randomised controlled trialResearch in context 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Summary: Background: Effective methods of preventing and identifying childhood wasting are required to achieve global child health goals. Family mid-upper arm circumference (MUAC) programs train caregivers to screen their child for wasting with MUAC tapes. We assessed the effectiveness of a two-way short message service (SMS) platform (referred to as the Maternally Administered Malnutrition Monitoring System [MAMMS]) in western Kenya. Methods: In this individual-level randomised controlled trial in two rural countries in western Kenya, children (aged 5–12 months) were randomly allocated (1:1) to receive either standard care (SOC) or MAMMS. Randomisation method was permuted-block randomisation with a block size of 10. Eligible participants were children attending maternal child health clinics in the two counties whom had a MUAC between 12.5 and 14.0 cm. The MAMMS group received two MUAC tapes and weekly SMS reminders to screen their child's MUAC. The SOC group received routine community health volunteer services and additional quarterly visits from the study team. The primary analysis used a cox proportional hazards model to compare SOC and MAMMS time-to-diagnosis of wasting (MUAC <12.5 cm) confirmed by a health professional during 6-months follow-up. Secondary outcomes were days from enrolment to treatment initiation among children with wasting, proportion of all children with wasting who were identified by the two approaches (treatment coverage), mean MUAC at treatment initiation, and duration of wasting treatment. This trial was registered on ClinicalTrials.gov, NCT03967015. Findings: Between August 1, 2019 and January 31, 2022, 1200 children were enrolled, among whom the incidence of confirmed wasting was 37% lower in the MAMMS group (hazard ratio: 0.63, 95% CI: 0.42–0.94, p = 0.022). Among children with wasting, the median number of days-to-diagnosis was similar between study groups (MAMMS: 63 days [interquartile range (IQR): 23–92], SOC: 58 days [IQR: 22–94]). Treatment coverage in the MAMMS group was 83.3% (95% CI: 39.9–100.0) while coverage in the SOC group was 55.6% (95% CI: 22.3–88.9%, p = 0.300). Treatment duration and mean MUAC at treatment initiation were similar between groups. Interpretation: Family MUAC supported by SMS was associated with a 37% reduction in wasting among young children. Empowering caregivers to monitor their child's nutritional status at home may prevent a substantial proportion of moderate wasting. Funding: Thrasher Research Foundation and Pamela and Evan Fowler. Family MUAC Childhood wasting Acute malnutrition Medicine (General) Cathering Achieng verfasserin aut Mary Masheti verfasserin aut Maureen Anyango verfasserin aut Agnes Ndirangu verfasserin aut Mareme M. Diakhate verfasserin aut Emily Yoshioka verfasserin aut Carol Levin verfasserin aut Arianna Rubin Means verfasserin aut Esther M. Choo verfasserin aut Keshet Ronen verfasserin aut Jennifer A. Unger verfasserin aut Barbra A. Richardson verfasserin aut Benson O. Singa verfasserin aut Christine J. McGrath verfasserin aut In EClinicalMedicine Elsevier, 2018 64(2023), Seite 102218- (DE-627)1035271834 25895370 nnns volume:64 year:2023 pages:102218- https://doi.org/10.1016/j.eclinm.2023.102218 kostenfrei https://doaj.org/article/697e240cb21d4c9482b39cdf5325318e kostenfrei http://www.sciencedirect.com/science/article/pii/S2589537023003954 kostenfrei https://doaj.org/toc/2589-5370 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2110 GBV_ILN_2112 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 64 2023 102218-
language	English
source	In EClinicalMedicine 64(2023), Seite 102218- volume:64 year:2023 pages:102218-
sourceStr	In EClinicalMedicine 64(2023), Seite 102218- volume:64 year:2023 pages:102218-
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Family MUAC Childhood wasting Acute malnutrition Medicine (General)
isfreeaccess_bool	true
container_title	EClinicalMedicine
authorswithroles_txt_mv	Kirkby D. Tickell @@aut@@ Cathering Achieng @@aut@@ Mary Masheti @@aut@@ Maureen Anyango @@aut@@ Agnes Ndirangu @@aut@@ Mareme M. Diakhate @@aut@@ Emily Yoshioka @@aut@@ Carol Levin @@aut@@ Arianna Rubin Means @@aut@@ Esther M. Choo @@aut@@ Keshet Ronen @@aut@@ Jennifer A. Unger @@aut@@ Barbra A. Richardson @@aut@@ Benson O. Singa @@aut@@ Christine J. McGrath @@aut@@
publishDateDaySort_date	2023-01-01T00:00:00Z
hierarchy_top_id	1035271834
id	DOAJ095066977
language_de	englisch
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Tickell</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Family MUAC supported by a two-way SMS platform for identifying children with wasting: the Mama Aweza randomised controlled trialResearch in context</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2023</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Summary: Background: Effective methods of preventing and identifying childhood wasting are required to achieve global child health goals. Family mid-upper arm circumference (MUAC) programs train caregivers to screen their child for wasting with MUAC tapes. We assessed the effectiveness of a two-way short message service (SMS) platform (referred to as the Maternally Administered Malnutrition Monitoring System [MAMMS]) in western Kenya. Methods: In this individual-level randomised controlled trial in two rural countries in western Kenya, children (aged 5–12 months) were randomly allocated (1:1) to receive either standard care (SOC) or MAMMS. Randomisation method was permuted-block randomisation with a block size of 10. Eligible participants were children attending maternal child health clinics in the two counties whom had a MUAC between 12.5 and 14.0 cm. The MAMMS group received two MUAC tapes and weekly SMS reminders to screen their child's MUAC. The SOC group received routine community health volunteer services and additional quarterly visits from the study team. The primary analysis used a cox proportional hazards model to compare SOC and MAMMS time-to-diagnosis of wasting (MUAC <12.5 cm) confirmed by a health professional during 6-months follow-up. Secondary outcomes were days from enrolment to treatment initiation among children with wasting, proportion of all children with wasting who were identified by the two approaches (treatment coverage), mean MUAC at treatment initiation, and duration of wasting treatment. This trial was registered on ClinicalTrials.gov, NCT03967015. Findings: Between August 1, 2019 and January 31, 2022, 1200 children were enrolled, among whom the incidence of confirmed wasting was 37% lower in the MAMMS group (hazard ratio: 0.63, 95% CI: 0.42–0.94, p = 0.022). Among children with wasting, the median number of days-to-diagnosis was similar between study groups (MAMMS: 63 days [interquartile range (IQR): 23–92], SOC: 58 days [IQR: 22–94]). Treatment coverage in the MAMMS group was 83.3% (95% CI: 39.9–100.0) while coverage in the SOC group was 55.6% (95% CI: 22.3–88.9%, p = 0.300). Treatment duration and mean MUAC at treatment initiation were similar between groups. Interpretation: Family MUAC supported by SMS was associated with a 37% reduction in wasting among young children. Empowering caregivers to monitor their child's nutritional status at home may prevent a substantial proportion of moderate wasting. 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callnumber-first	R - Medicine
author	Kirkby D. Tickell
spellingShingle	Kirkby D. Tickell misc R5-920 misc Family MUAC misc Childhood wasting misc Acute malnutrition misc Medicine (General) Family MUAC supported by a two-way SMS platform for identifying children with wasting: the Mama Aweza randomised controlled trialResearch in context
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topic_title	R5-920 Family MUAC supported by a two-way SMS platform for identifying children with wasting: the Mama Aweza randomised controlled trialResearch in context Family MUAC Childhood wasting Acute malnutrition
topic	misc R5-920 misc Family MUAC misc Childhood wasting misc Acute malnutrition misc Medicine (General)
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title	Family MUAC supported by a two-way SMS platform for identifying children with wasting: the Mama Aweza randomised controlled trialResearch in context
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title_full	Family MUAC supported by a two-way SMS platform for identifying children with wasting: the Mama Aweza randomised controlled trialResearch in context
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author_browse	Kirkby D. Tickell Cathering Achieng Mary Masheti Maureen Anyango Agnes Ndirangu Mareme M. Diakhate Emily Yoshioka Carol Levin Arianna Rubin Means Esther M. Choo Keshet Ronen Jennifer A. Unger Barbra A. Richardson Benson O. Singa Christine J. McGrath
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title_sort	family muac supported by a two-way sms platform for identifying children with wasting: the mama aweza randomised controlled trialresearch in context
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title_auth	Family MUAC supported by a two-way SMS platform for identifying children with wasting: the Mama Aweza randomised controlled trialResearch in context
abstract	Summary: Background: Effective methods of preventing and identifying childhood wasting are required to achieve global child health goals. Family mid-upper arm circumference (MUAC) programs train caregivers to screen their child for wasting with MUAC tapes. We assessed the effectiveness of a two-way short message service (SMS) platform (referred to as the Maternally Administered Malnutrition Monitoring System [MAMMS]) in western Kenya. Methods: In this individual-level randomised controlled trial in two rural countries in western Kenya, children (aged 5–12 months) were randomly allocated (1:1) to receive either standard care (SOC) or MAMMS. Randomisation method was permuted-block randomisation with a block size of 10. Eligible participants were children attending maternal child health clinics in the two counties whom had a MUAC between 12.5 and 14.0 cm. The MAMMS group received two MUAC tapes and weekly SMS reminders to screen their child's MUAC. The SOC group received routine community health volunteer services and additional quarterly visits from the study team. The primary analysis used a cox proportional hazards model to compare SOC and MAMMS time-to-diagnosis of wasting (MUAC <12.5 cm) confirmed by a health professional during 6-months follow-up. Secondary outcomes were days from enrolment to treatment initiation among children with wasting, proportion of all children with wasting who were identified by the two approaches (treatment coverage), mean MUAC at treatment initiation, and duration of wasting treatment. This trial was registered on ClinicalTrials.gov, NCT03967015. Findings: Between August 1, 2019 and January 31, 2022, 1200 children were enrolled, among whom the incidence of confirmed wasting was 37% lower in the MAMMS group (hazard ratio: 0.63, 95% CI: 0.42–0.94, p = 0.022). Among children with wasting, the median number of days-to-diagnosis was similar between study groups (MAMMS: 63 days [interquartile range (IQR): 23–92], SOC: 58 days [IQR: 22–94]). Treatment coverage in the MAMMS group was 83.3% (95% CI: 39.9–100.0) while coverage in the SOC group was 55.6% (95% CI: 22.3–88.9%, p = 0.300). Treatment duration and mean MUAC at treatment initiation were similar between groups. Interpretation: Family MUAC supported by SMS was associated with a 37% reduction in wasting among young children. Empowering caregivers to monitor their child's nutritional status at home may prevent a substantial proportion of moderate wasting. Funding: Thrasher Research Foundation and Pamela and Evan Fowler.
abstractGer	Summary: Background: Effective methods of preventing and identifying childhood wasting are required to achieve global child health goals. Family mid-upper arm circumference (MUAC) programs train caregivers to screen their child for wasting with MUAC tapes. We assessed the effectiveness of a two-way short message service (SMS) platform (referred to as the Maternally Administered Malnutrition Monitoring System [MAMMS]) in western Kenya. Methods: In this individual-level randomised controlled trial in two rural countries in western Kenya, children (aged 5–12 months) were randomly allocated (1:1) to receive either standard care (SOC) or MAMMS. Randomisation method was permuted-block randomisation with a block size of 10. Eligible participants were children attending maternal child health clinics in the two counties whom had a MUAC between 12.5 and 14.0 cm. The MAMMS group received two MUAC tapes and weekly SMS reminders to screen their child's MUAC. The SOC group received routine community health volunteer services and additional quarterly visits from the study team. The primary analysis used a cox proportional hazards model to compare SOC and MAMMS time-to-diagnosis of wasting (MUAC <12.5 cm) confirmed by a health professional during 6-months follow-up. Secondary outcomes were days from enrolment to treatment initiation among children with wasting, proportion of all children with wasting who were identified by the two approaches (treatment coverage), mean MUAC at treatment initiation, and duration of wasting treatment. This trial was registered on ClinicalTrials.gov, NCT03967015. Findings: Between August 1, 2019 and January 31, 2022, 1200 children were enrolled, among whom the incidence of confirmed wasting was 37% lower in the MAMMS group (hazard ratio: 0.63, 95% CI: 0.42–0.94, p = 0.022). Among children with wasting, the median number of days-to-diagnosis was similar between study groups (MAMMS: 63 days [interquartile range (IQR): 23–92], SOC: 58 days [IQR: 22–94]). Treatment coverage in the MAMMS group was 83.3% (95% CI: 39.9–100.0) while coverage in the SOC group was 55.6% (95% CI: 22.3–88.9%, p = 0.300). Treatment duration and mean MUAC at treatment initiation were similar between groups. Interpretation: Family MUAC supported by SMS was associated with a 37% reduction in wasting among young children. Empowering caregivers to monitor their child's nutritional status at home may prevent a substantial proportion of moderate wasting. Funding: Thrasher Research Foundation and Pamela and Evan Fowler.
abstract_unstemmed	Summary: Background: Effective methods of preventing and identifying childhood wasting are required to achieve global child health goals. Family mid-upper arm circumference (MUAC) programs train caregivers to screen their child for wasting with MUAC tapes. We assessed the effectiveness of a two-way short message service (SMS) platform (referred to as the Maternally Administered Malnutrition Monitoring System [MAMMS]) in western Kenya. Methods: In this individual-level randomised controlled trial in two rural countries in western Kenya, children (aged 5–12 months) were randomly allocated (1:1) to receive either standard care (SOC) or MAMMS. Randomisation method was permuted-block randomisation with a block size of 10. Eligible participants were children attending maternal child health clinics in the two counties whom had a MUAC between 12.5 and 14.0 cm. The MAMMS group received two MUAC tapes and weekly SMS reminders to screen their child's MUAC. The SOC group received routine community health volunteer services and additional quarterly visits from the study team. The primary analysis used a cox proportional hazards model to compare SOC and MAMMS time-to-diagnosis of wasting (MUAC <12.5 cm) confirmed by a health professional during 6-months follow-up. Secondary outcomes were days from enrolment to treatment initiation among children with wasting, proportion of all children with wasting who were identified by the two approaches (treatment coverage), mean MUAC at treatment initiation, and duration of wasting treatment. This trial was registered on ClinicalTrials.gov, NCT03967015. Findings: Between August 1, 2019 and January 31, 2022, 1200 children were enrolled, among whom the incidence of confirmed wasting was 37% lower in the MAMMS group (hazard ratio: 0.63, 95% CI: 0.42–0.94, p = 0.022). Among children with wasting, the median number of days-to-diagnosis was similar between study groups (MAMMS: 63 days [interquartile range (IQR): 23–92], SOC: 58 days [IQR: 22–94]). Treatment coverage in the MAMMS group was 83.3% (95% CI: 39.9–100.0) while coverage in the SOC group was 55.6% (95% CI: 22.3–88.9%, p = 0.300). Treatment duration and mean MUAC at treatment initiation were similar between groups. Interpretation: Family MUAC supported by SMS was associated with a 37% reduction in wasting among young children. Empowering caregivers to monitor their child's nutritional status at home may prevent a substantial proportion of moderate wasting. Funding: Thrasher Research Foundation and Pamela and Evan Fowler.
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title_short	Family MUAC supported by a two-way SMS platform for identifying children with wasting: the Mama Aweza randomised controlled trialResearch in context
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Tickell</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Family MUAC supported by a two-way SMS platform for identifying children with wasting: the Mama Aweza randomised controlled trialResearch in context</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2023</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Summary: Background: Effective methods of preventing and identifying childhood wasting are required to achieve global child health goals. Family mid-upper arm circumference (MUAC) programs train caregivers to screen their child for wasting with MUAC tapes. We assessed the effectiveness of a two-way short message service (SMS) platform (referred to as the Maternally Administered Malnutrition Monitoring System [MAMMS]) in western Kenya. Methods: In this individual-level randomised controlled trial in two rural countries in western Kenya, children (aged 5–12 months) were randomly allocated (1:1) to receive either standard care (SOC) or MAMMS. Randomisation method was permuted-block randomisation with a block size of 10. Eligible participants were children attending maternal child health clinics in the two counties whom had a MUAC between 12.5 and 14.0 cm. The MAMMS group received two MUAC tapes and weekly SMS reminders to screen their child's MUAC. The SOC group received routine community health volunteer services and additional quarterly visits from the study team. The primary analysis used a cox proportional hazards model to compare SOC and MAMMS time-to-diagnosis of wasting (MUAC <12.5 cm) confirmed by a health professional during 6-months follow-up. Secondary outcomes were days from enrolment to treatment initiation among children with wasting, proportion of all children with wasting who were identified by the two approaches (treatment coverage), mean MUAC at treatment initiation, and duration of wasting treatment. This trial was registered on ClinicalTrials.gov, NCT03967015. Findings: Between August 1, 2019 and January 31, 2022, 1200 children were enrolled, among whom the incidence of confirmed wasting was 37% lower in the MAMMS group (hazard ratio: 0.63, 95% CI: 0.42–0.94, p = 0.022). Among children with wasting, the median number of days-to-diagnosis was similar between study groups (MAMMS: 63 days [interquartile range (IQR): 23–92], SOC: 58 days [IQR: 22–94]). Treatment coverage in the MAMMS group was 83.3% (95% CI: 39.9–100.0) while coverage in the SOC group was 55.6% (95% CI: 22.3–88.9%, p = 0.300). Treatment duration and mean MUAC at treatment initiation were similar between groups. Interpretation: Family MUAC supported by SMS was associated with a 37% reduction in wasting among young children. Empowering caregivers to monitor their child's nutritional status at home may prevent a substantial proportion of moderate wasting. 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Family MUAC supported by a two-way SMS platform for identifying children with wasting: the Mama Aweza randomised controlled trialResearch in context

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