[pronut-hiv] Supplementation for moderately malnourished HIV-infected children in the ASIAN context!

[Naureen_Mushtaq_Butt@wvi.org]

Dear All,

I am talking from a very Asian perspective, I am working as an HIV/AIDS 
and Nutrition Technical Advisor in Pakistan and one of the biggest 
problems we are facing is exactly what all of you are talking about. We 
have not yet explored the idea of developing therapeutic foods for 
rehabilitating malnourished children and the one that we currently use is 
plumpy nut, which again is peanut based and there have been some cases of 
peanut allergies in Asian children. For my PhD research I am trying to 
look at various options of Ready to Use Therapeutic Foods for Asia by 
using locally available resources and knowledge to develop these. I would 
appreciate it if anyone knows of any RUTFs that may have been tested in 
the Asian contexts which can help my research!

Regards,

Naureen M Butt

 
------"Lungi Lumumba Okoko" wrote:



Dear all,

Why not not use local food and knowledge to rehabilitate moderately
malnourished children, instead of using food aid (in the form of PlumpyNut
and others)?

What happens when PlumpyNut or whey protein is no longer available to the
community? How will they rehabilitate malnourished children if they have
been taught to think that external food is the cure?

In my opinion, using behavior change approaches, such as the positive
deviance/hearth approach would be more sustainable. Even with HIV infected
children, some mothers (or caregivers) engage in behaviors and practices
that result in good nutritional outcome for child succeed. Why not use the
positively deviant caregivers as models to teach mothers of moderately
malnourished children new locally acceptable and affordable practices in
terms of feeding, care, and hygiene?

For more on positive deviance visit: http://www.positivedeviance.org/

-Lungi


------ George Carter  wrote:
>
> Geoffrey - wow!! The dreadful thing to many outside Africa is the
> notion that Plumpynut sounds like the better than abject starvation
> so many face--but you are absolutely correct. And a high fat
> intervention for people with HIV can be problematic with all the
> attendant gut problems (let alone high sugar feeding candida).
>
> Which brings me back to the notion of a fortified whey protein (or
> some such protein source). What I think we know is needed is high
> protein and micronutrient repletion. At least from a nutritional
> standpoint - let alone the need for things like gardens, fresh
> vegetables, reinvigoration of older farming techniques that use
> forests and don't burn them for corn for diesel.
>
> We need a lot in this world but we're not going to ever get it in
> Africa. What do African kids want? What do their (still living)
> parents and guardians need?
>
> I think Plumpynut does remain a bit better than nothing. Hey--in the 
West
> you can make garbage like that and sell it for an outrageous price--you
> don't get  shot. You get rewarded!
>
> George M. Carter
>