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document
Long-stay versus short-stay hospital treatment of children suffering from severe protein-energy malnutrition . OBJECTIVE To contrast early discharge versus attempted full nutritional rehabilitation in hospital of children suffering from severe protein-energy malnutrition ( PEM ) . DESIGN Field experiment , two-way analysis of variance with one between group ( short- versus long-stay ) and one repeated measures factor ( admission , then 12 , 18 , 24 , 30 and 36 months post-admission ) . Covariates introduced . SETTING Primary health care , Kingston , Jamaica . SUBJECTS n = 81 ; mean age 11 months ; 79 contribute longitudinal data ; 44 every measurement . INTERVENTIONS When concurrent illnesses had been treated and normal feeding re-established ( weight gain 5 g/kg.day-1 ) , subjects were randomly allocated to short-stay ( SS ) or long-stay ( LS ) group . LS retained in hospital for full nutritional rehabilitation mean 40 days ) . SS discharged immediately ( mean 18 days ) for standard Health Service care at home for 6 months plus high-energy supplement ( 3.31 MJ with 20.6 g protein daily ) for first 3 months . After discharge LS received 6 months home care , but without supplementation . RESULTS Significant advantages for LS group on NCHS weight & length for age at discharge , and at 12 , 18 , 24 and for length also 30 months ( P < 0.05 to P < 0.001 ) . Weight advantage peaked at 12 and 18 months , length later at 18 and 24 months . CONCLUSIONS Contrary to earlier reports , full nutritional rehabilitation can be achieved in hospital for children suffering from PEM . Although in the long-term both groups move towards expected levels in their home community , a significant advantage maintained for approximately 2 years is developmentally advantageous during the critical time after weaning .
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Intervention_Other
Long-stay
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Intervention_Other
short-stay hospital treatment
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Intervention_Other
early discharge
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Intervention_Other
attempted full nutritional rehabilitation
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Intervention_Other
short-
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Intervention_Other
long-stay
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Intervention_Other
short-stay ( SS )
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Intervention_Other
long-stay ( LS )
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Intervention_Other
LS
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Intervention_Other
SS
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Intervention_Other
LS
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Outcome_Physical
NCHS weight & length for age at discharge
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Participant_Age
children
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Participant_Condition
suffering from severe protein-energy malnutrition .
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Participant_Condition
PEM
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Participant_Sample-size
81
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Participant_Age
11 months