DOI: 10.17037/data.00002657
title: CHANGE Cohort 2: Chronic disease outcomes after Severe Acute Malnutrition (ChroSAM). Malawi

description: A dataset containing information collected from a prospective cohort of children originally admitted for treatment of severe acute malnutrition (SAM) in Blantyre, Malawi during 2006 and 2007. It includes health and anthropometric data from admission to care, during treatment, at discharge, at 1 year post-discharge, and at 7-years post-discharge. During original admission to care, data was collected as part of a randomised controlled trial into the effects of pre- and probiotics on treatment recovery – findings were null (trial registry number ISRCTN19364765). At the most recent follow-up in 2013/14, data pertaining to NCD risk were also collected, and data on 1 sibling control and 1 community control (age and sex matched) was also added.
description: The data comes from a prospective cohort of children, recruited during a randomised controlled trial with null findings, while they were being treated for severe malnutrition (PRONUT study). They were then followed up at 1 year post-discharge (FuSAM). This was a secondary analysis of data collected from children treated for severe wasting and/or nutritional oedema in 2006/7 in Malawi, and followed up seven years later to assess risk of NCD. The objectives of the current analysis were to: (1) Explore rates of Post-malnutrition growth (PMGr) based on a variety of weight- and height-related definitions; (2) Explore different ways of categorising these PMGr definitions into fast and slow; and (3) Explore associations and patterns between the different definitions and categorisations of PMGr with indicators of NCD risk. The original data comes from a prospective cohort of children, recruited during a randomised controlled trial with null findings, while they were being treated for severe malnutrition (PRONUT study). They were then followed up at 1 year post-discharge (FuSAM study) and again at 7-years post-discharge (ChroSAM study), where the focus was more on indicators of NCD risk. Interviews were conducted face-to-face by trained nurses and data collectors, on the ward and then at the households of each participant, in the local language. Details of the data collection methods including anthropometry methods, lab tests, and questionnaires can be found in a number of publications (Kerac et al., 2009, Kerac et al., 2014, Lelijveld et al., 2016). Key features include: All children admitted for treatment during the recruitment period were eligible for inclusion. Admission criteria for treatment were weight-for-length z-score &lt;70% median (using NCHS reference) and/or MUAC&lt;110 mm and/or bilateral oedema. All patients were admitted for initial inpatient treatment, following the WHO 3-stage protocol at that time: stabilisation with F75 therapeutic milk, transition phase where RUTF was introduced to the diet alongside F75, and then rehabilitation phase where children were discharged with a 2-week ration of RUTF to continue their recovery at home and return to the ward for monitoring and to collect another ration every 2 weeks until recovery. Children were discharged from outpatient therapeutic care following 2 consecutive fortnightly visits at or above target weight of 80% median weight-for-height. Minimum time in outpatient care was therefore 4 weeks. Maximum time was 10 weeks. This analysis was coordinated with similar analyses of cohort data for children treated for severe malnutrition in Jamaica and Ethiopia – this had some bearing on the methodology.