Table 1. Inclusion criteria and primary and secondary study outcomes for the cross-sectional and longitudinal studies.
| Cross-sectional study | Longitudinal study | |
|---|---|---|
| Inclusion criteria | At study enrollment: | |
| (1) being a singleton child 0–17.9 months (±1 week) of age | (1) being a singleton child 0–6 weeks of age | |
| (2) not having congenital malformations that hinder growth and/or anthropometric measurements | (2) not having congenital malformations that hinder growth and/or anthropometric measurements | |
| (3) child’s principal caregiver having lived in the study area since the child was born | (3) child’s principal caregiver planning to reside in the village for the next year | |
| (4) child not suffering from AM at enrollment, defined as WLZ < −2 at enrollment and the first follow-up (to avoid normal postnatal weight loss to result in exclusion for AM) | ||
| Primary study outcomes | (1) AM screening coverage (the number of children screened for AM in the past month over the total number of study children) | (1) AM screening coverage (the number of children screened for AM in the past month over the total number of study children considering all monthly visits over the 18-month follow-up)a |
| (2) AM treatment coverage (number of children with AM under appropriate treatment for their condition [SAM or MAM] in the past month over the total number of AM cases identified at the time of the survey in the study sample) | (2) AM treatment coverage in children enrolled in the CMAM program (the number of AM episodes for which MAM or SAM treatment was received until discharged or recovery over the total number of AM episodes enrolled in a CMAM program over the 18-month follow-up) | |
| (3) AM prevalence (the number of cases of AM at survey time over the total number of study children) | (3) incidence of the first AM episode over the 18-month follow-upb | |
| Secondary study outcomes | Program participation and coverage in the month preceding the survey: | Program participation and coverage over 18 months of follow-up: |
| CNS coverage in the month preceding the survey; | CNS coverage | |
| change in CNS coverage over time | ||
| AM screening coverage through CNS c | AM screening coverage through CNSc | |
| change in AM screening coverage over time; | ||
| BCC coverage (BCC delivered at CNS and through any channel)c | BCC coverage (BCC delivered at CNS and through any channel)c | |
| change in BCC coverage over time | ||
| total SQ-LNS coverage | total SQ-LNS coverage | |
| change in SQ-LNS coverage over time | ||
| AM: | AM: | |
| prevalence of MAM (−3 ≤ WLZ < −2 or 115 mm ≤ MUAC < 125 mm in children older than 6 months of age) | longitudinal prevalence of AM (defined as the total time the child was with AM over the total follow-up time) | |
| prevalence of SAM (WLZ < −3 or MUAC < 115 mm in children older than 6 months of age or presence of bilateral pitting edema) | longitudinal prevalence of MAM and SAM (total time the child was with MAM or SAM over the total follow-up time, respectively) | |
| AM status at the time of SQ-LNS distribution, as reported on the PROMIS beneficiary card or by the caregiver in the absence of PROMIS beneficiary card | change in AM prevalence over time | |
| mean WLZ | change in WLZ over time | |
| mean MUAC | change in MUAC over time | |
| Treatment enrollment and coverage: | ||
| AM treatment enrollment and coverage (the number of MAM and SAM episodes in children enrolled in the CMAM program for which MAM- or SAM-appropriate treatment was received); | ||
| MAM and SAM treatment enrollment and coverage (the number of MAM or SAM episodes in children enrolled in the CMAM program for which MAM- or SAM-appropriate treatment was received, respectively). | ||
| Recovery, relapse, and episode length: | ||
| recovery of AM, MAM, and SAM after treatment | ||
| relapse rates of AM, MAM, and SAM | ||
| mean AM, MAM, and SAM episode length |
aThe monthly measurements done by the research team included anthropometry. When children were identified by the research team as having AM, they were referred to the CMAM for ethical reasons. Our measure of screening coverage excludes these measurements, as they were not part of the program implementation activities
bWe limited the analysis of the incidence to the first episode of AM to assess the impact of the preventive components of the intervention without possible interference of treatment of a previous episode. However, to assess the robustness of our findings, we also carried out the analysis using all episodes as a secondary outcome.
cSince AM screening and BCC were offered by multiple actors, we assessed the impact of the intervention on total AM screening and BCC coverage and specifically through the monthly CNS.
Abbreviations: AM, acute malnutrition; BCC, behavior change communication; CMAM, community management of AM; CNS, well-baby consultation; MAM, moderate AM; MUAC, mid-upper arm circumference; SAM, severe AM; SQ-LNS, small-quantity lipid-based nutrition supplement; WLZ, weight-for-length z-score