ArticleFrontiers in public health2026
Reducing relapses after acute malnutrition treatment: evidence from a simplified approach in emergency settings of Mali.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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12 authors.
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Abstract
Background: Acute malnutrition remains a critical public health issue, particularly in emergency settings. While simplified treatment protocols show promise in improving access and cost-effectiveness, evidence on their impact on relapse rates remains limited. This study aimed to compare relapse incidence among children treated for severe acute malnutrition (SAM) using a simplified protocol versus the standard Community Management of Acute Malnutrition (CMAM) protocol in the emergency context of Gao, Mali. Methods: This is a non-randomized controlled trial conducted between December 2022 and December 2023, involving 506 children aged 6-59 months discharged as cured from SAM. The intervention group ( Results: Relapse incidence was significantly lower in the simplified protocol group (5.6%) compared to the standard one (39.8%). The simplified protocol also had longer length of stay, used lower quantity of RUTF, and fewer comorbidities at discharge. We found similar results when analyzing the sub-sample with those children admitted with MUAC-only in the control group. Multivariate analysis identified treatment with the simplified protocol, older age at discharge, and greater MUAC gain as protective factors. Comorbidities during follow-up were the strongest predictor of relapse. Conclusion: Simplified protocols may reduce relapse rates after SAM treatment, even with reduced RUTF doses. Strengthening discharge procedures and post-discharge monitoring, particularly in emergency settings, is essential to sustain recovery and prevent relapse.
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