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MannaPack™ Potato Clinical Trial

MannaPack™ Potato Clinical Trial. Wilna Oldewage-Theron PhD RD (SA) & Abdulkadir Egal PhD (PH) ‏. OUTLINE OF PRESENTATION. Introduction Background Stakeholders Methods Results Limitations Conclusions Recommendations. BACKGROUND: South Africa. 49.32 million (SSA 2009) ‏

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MannaPack™ Potato Clinical Trial

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  1. MannaPack™ Potato Clinical Trial Wilna Oldewage-Theron PhD RD (SA) & Abdulkadir Egal PhD (PH)‏

  2. OUTLINE OF PRESENTATION • Introduction • Background • Stakeholders • Methods • Results • Limitations • Conclusions • Recommendations

  3. BACKGROUND: South Africa • 49.32 million (SSA 2009)‏ • 40% live in poverty • (Cunnan & Maharaj, 2000:669, SA Govt, 2001)‏ • 2.5% hungry (1.23 million people household food insecurity) (SSA 2009)‏ • 20% of SA children stunted • 33.3% iron deficiency anaemia in children and women • 45.3% children at risk of zinc deficiency • 10% of children overweight (Labadarios et al., 2008) • 16.6% HIV and AIDS prevalence (WHO Stats, 2008)‏

  4. INTRODUCTION • Diarrhea = one of the top killers of • children around the world • Solution = medication or oral rehydration fluids

  5. INTRODUCTION • FMSC - new product, MannaPack™ Potato (MPP) to provide a “first food” in response to diarrhea • Dehydrated potato granules (resistant starches)‏ • Lecithinated soy flour (protein source)‏ • Gum arabic (soluble fiber)‏ • Vitamins and minerals • Mild sweet potato flavoring • Reduce the impact of diarrhea and maintain • the gut during diarrhea and recovery.

  6. MannaPack™

  7. MAIN AIM Overall purpose of the project was to document the actual impact and acceptability of MannaPack™ to reduce the impact and support resolution of the symptom of chronic and acute diarrhea.

  8. SPECIFIC OBJECTIVES • Assess the acceptability of • MannaPack™ in a setting that provides care and treatment for children with diarrhea. • Assess the impact of MannaPack™ on • the quality and quantity of acute and chronic diarrhea in a community setting.

  9. STAKEHOLDERS

  10. PROJECT METHODS • 1. Planning • Ethics approval (M080365) • Strategic participatory planning workshop with all stakeholders in South Africa (SA)‏ • Two crèches in the Vaal region identified (control group)‏ • SOS village for HIV/AIDS-affected orphans in Qwa-Qwa (experimental group). • Consent • Training of data enumerators and monitors

  11. PROJECT METHODS • 2. Measurements • Diarrhea questionnaire - baseline + 6 weekly • Sensory questionnaire – baseline and end

  12. PROJECT METHODS • 2. Measurements • Weight and height, handgrip, skin tenting • & nail blanching – baseline + 6 weeks

  13. PROJECT METHODS 3. Intervention

  14. QWA-QWA BACKGROUND • 5 people per household (hh)‏ • 89.9% of caregivers unemployed • 67.4% of partners unemployed • 59.1% of hh < R 1000 (US$133) pm • 51.0% hh food insecurity

  15. VAAL REGION BACKGROUND • 4.9 people per hh • 94.1% of caregivers unemployed • 80.1% of partners unemployed • 58.3% of hh < US$133 pm • 53.0% hh food insecurity

  16. LIMITATIONS • Questionnaires not tested for SA but for Zimbabwe only although in the same region • Diarrhea not a public health problem in • SA – small sample size • 2010 World Cup

  17. Beneficiary profile who completed the study • Children between the ages 2 to 13 years of age • Experimental group consisted of 29 girls and 32 boys with overall mean age of 6.2 years • Control group was 27 girls and 22 boys with overall mean age of 3.5 years • 2010 World Cup

  18. Variable Experimental group (n=63)‏ Control group (n=49)‏ Baseline Follow-up Significance of change between baseline and follow-up (p)‏ Baseline Follow-up Significance of change between baseline and follow-up (p)‏ Age 6.2±3.6 6.4±3.5 3.4±1.2 3.4±1.1 Weight (kg)‏ 21.9±8.8 22.2±9.1 0.002 15.07±2.54 15.06±2.56 0.444 Height (m)‏ 1.14±0.21 1.15±0.21 0.047 1.04±0.27 1.05±0.27 0.083 Skin tenting (seconds)‏ 1.0±0.0 1.0±0.0 0.145 3.0±0.6 3.2±0.6 0.133 Nail blanching (seconds)‏ 3.9±0.9 3.6±0.7 0.004 3.1±0.6 3.1±0.6 1.000 Handgrip right hand 7.5±4.2 7.4±4.1 0.400 - - Handgrip left hand 7.0±4.4 7.1±4.2 0.681 - - RESULTS

  19. Classification Girls n= (%)‏ Boys n= (%)‏ Total group n=61 (%)‏ Baseline Severely stunted 3.4 6.3 4.9 ≥-3<-2 SD Stunted 10.3 6.3 8.2 Girls n=25 (%)‏ Boys n=21 (%)‏ Total group n=46 (%)‏ At the end of the intervention (Follow-up)‏ <-3 SD Severely stunted 3.4 6.3 4.9 ≥-3<-2 SD Stunted 10.3 6.3 8.2 RESULTS: STUNTING (EXPERIMENTAL)‏

  20. Classification Girls n=27 (%)‏ Boys n=22 (%)‏ Total group n=49 (%)‏ Baseline <-3 SD Severely stunted 0 5.9 2.3 ≥-3<-2 SD Stunted 11.5 17.6 14.0 Girls n=25 (%)‏ Boys n=21 (%)‏ Total group n=46 (%)‏ At the end of the intervention (Follow-up)‏ <-3 SD Severely stunted 0 5.9 2.3 ≥-3<-2 SD Stunted 11.5 17.6 14.0 RESULTS: STUNTING (CONTROL)‏

  21. Classification Girls n=25 (%)‏ Boys n=23 (%)‏ Total group n=48 (%)‏ Baseline <-3 SD Severely underweight 0 4.5 2.1 ≥-3<-2 SD Underweight 11.5 4.5 8.3 Girls n=25 (%)‏ Boys n=21 (%)‏ Total group n=46 (%)‏ At the end of the intervention (Follow-up)‏ <-3 SD Severely underweight 0 0 0 ≥-3<-2 SD Underweight 7.7 0 4.2 RESULTS: UNDERWEIGHT (EXPERIMENTAL)‏

  22. Classification Girls n=25 (%)‏ Boys n=23 (%)‏ Total group n=48 (%)‏ Baseline <-3 SD Severely underweight 3.7 0 2.0 ≥-3<-2 SD Underweight 3.7 4.5 4.1 Girls n=25 (%)‏ Boys n=21 (%)‏ Total group n=46 (%)‏ At the end of the intervention (Follow-up)‏ <-3 SD Severely underweight 3.7 0 2.0 ≥-3<-2 SD Underweight 3.7 4.5 4.1 RESULTS: UNDERWEIGHT (CONTROL)‏

  23. DIARRHEA INCIDENCE RESULTS

  24. DIARRHEA RESULTS: NR OF STOOLS PER DAY

  25. PRODUCT ACCEPTABILITY RESULTS: APPEARANCE

  26. PRODUCT ACCEPTABILITY RESULTS: TEXTURE

  27. PRODUCT ACCEPTABILITY RESULTS: TASTE

  28. CONCLUSIONS • MannaPackT consumption results indicated a minority consuming the product for the whole week. • A significant improvement was observed for underweight after the intervention. • Impact of the MannaPackTMon the nutritional status of the experimental group very clear. • This was not observed in the control group.

  29. CONCLUSIONS • Incidence and severity of diarrhea significantly reduced in the experimental group as the study progressed. • Control group remained largely • unchanged. • MannaPackTM contributed to the • reduced incidence and prevalence of diarrhea in the experimental group.

  30. ACCEPTABILITY RESULTS • Mashed potatoes not commonly consumed by the low-income groups in South Africa. • MannaPackTM not very acceptable at baseline. • Liked the MannaPackTM towards the end of the study.

  31. RECOMMENDATIONS • MannaPackTM can be effectively used as a relief food in emergency situations where both diarrhea and/or acute food shortage exist. • Can complement the already successful commodities like CSB and WSB in the USAID title II programmes.

  32. afrika

  33. wilna@vut.ac.za abdul@vut.ac.za

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