(P24-043-24) Acceptability of a Microbiota-Directed Complementary Food for the Treatment of Uncomplicated Acute Malnutrition in Children 6–23 Mo in Burkina Faso

Objectives: To assess the acceptability of a microbiota-directed complementary food (MDCF) against standard supplementary and therapeutic foods for the treatment of uncomplicated acute malnutrition in children 6-23 mo in Burkina Faso.

Methods: A cross-over trial was conducted in July-August 2023 and December 2023- January 2024. Children 6-23 mo with uncomplicated MAM (n=42) and SAM (n=20) were enrolled for a 2-day feeding test followed by a 4-week home-use trial. To assess the acceptability, MDCF and the standard foods [Plumpy’Sup (PPS) for MAM and Plumpy’Nut (PPN) for SAM] were given separately to the children during two days of direct observation (50 g portion) and alternately during two weeks at-home consumption (1 sachet of 100 g/day for PPN and MDCF for MAM, and daily dose based on body weight for SAM). Quantitative and qualitative data were collected using questionnaires, observation forms, and focus group discussions at the enrollment, weekly and at the end of follow up.

Results: Mean age of children were 11.6 ± 5.0 mo for MAM and 12.2 ± 5.4 mo for MAS, respectively. On average, the weight-for-length z-score and MUAC were respectively – 2.0 ± 0.5 SD and 120.1 ± 3.3 mm for children with MAM, and – 2.9 ± 0.5 SD and with SAM. The majority of children were still breastfeeding and 70% or more were taking the family meal. Children with MAM consumed 26.0 ± 22.8% and 32.0 ±> 40.3%, respectively for PPS and MDCF, of the portion offered during the direct observation; for children with SAM, it was 33.2 ± 33.2% for PPS vs. 23.2 ± 20.0% for MDCF. The daily food and energy intake estimated from the at-home consumption was 90.9 ± 14 g and 69 ± 13.2 kcal/kg body weight for PPS vs. 79.9 ± 25.9 g and 57.4 ± 20.1 kcal/kg body weight for MDCF among children with MAM, and 188.9 ± 49.4 g and 145 ± 27 kcal/kg body weight for PPN vs. 158.8 ± 24.2 kcal/kg body weight for MDCF among children with SAM. Tested and standard foods were well appreciated by mothers/caregivers (hedonic scale score ≥ 4 for 95% or more of them). There was no difference in occurrence of diarrhea or vomiting between MDCF and standard foods in children with MAM and SAM.

Conclusions: The acceptability and tolerance of MDCF was similar to the standard foods used for the treatment of uncomplicated acute malnutrition in children 6-23 mo in routine. There is a need to assess the efficacy of MDCF.

Funding Sources: Bill and Melinda Gates Foundation