Effect of Moringa supplementation in the management of moderate malnutrition in children under 5 receiving ready-to-use supplementary foods in Niger: A randomized clinical trial

Authors

  • Mahamane Laouali MANZO Free University of Brussels, School of Public Health, Lennik road, N° 808, BP 598, CP 1070, PhD student, Brussels, Belgium.
  • Mahaman Elhadji HALLAROU Free University of Brussels, School of Public Health, Lennik road, N° 808, BP 598, CP 1070, PhD student, Brussels, Belgium.
  • Maimouna DOUDOU HALIDOU Free University of Brussels, School of Public Health, Member of the Centre for Research in Epidemiology and Biostatistics, Brussels, Belgium.
  • Daouda ALHOUSSEINI MAIGA National Hospital of Niamey, Laboratory of the National Hospital of Niamey, Head of laboratory, Niamey, Niger.
  • Paluku BAHWERE Free University of Brussels, School of Public Health, Member of the Centre for Research in Epidemiology and Biostatistics, Brussels, Belgium.
  • Salimata WADE Cheik Anta Diop University, Faculty of Science and Technology, Professor of Physiology and Nutrition, Dakar, Senegal.
  • Katia CASTETBON Free University of Brussels, School of Public Health, Professor, Department of Education, Brussels, Belgium.
  • Michèle WILMET-DRAMAIX Free University of Brussels, School of Public Health, Professor, Centre for Research in Epidemiology and Biostatistics, Brussels, Belgium, Brussels, Belgium.
  • Philippe DONNEN Free University of Brussels, School of Public Health, Professor, Department of Education, Brussels, Belgium.

DOI:

https://doi.org/10.30574/gscarr.2021.8.3.0189

Keywords:

Moringa oleifera, Powder, Malnutrition

Abstract

Each year in Niger, more than 40% of children under 5 years suffer from chronic malnutrition and more than 10% from acute malnutrition. The national nutrition rehabilitation protocol encourages the use of local foods. The objective of this work is to analyze the impact of supplementation in Moringa oleifera. We conducted a randomized double-blind clinical trial in 400 children with moderate acute malnutrition (MAM) aged 6 to 59 months admitted to outpatient nutritional recovery centers (CRENAM). The children were divided into two groups; one group received Ready-to-Use Supplemental Foods (RUSF) and dry leaf powder from Moringa oleifera and the other group received RUSF and placebo. We did not find any difference on average weight gain between the two groups or on mid-upper arm circumference and size. The median length of stay in CRENAM was 5 and 4 weeks for Moringa and placebo respectively, with no statistical difference (P=0.522). The cure rate was 82% (2.72) in the Moringa group with a RR of 1.03 (0.94 to 1.13) slightly in favor of Moringa. Renal and hepatic toxicity of Moringa was not observed. From this clinical trial, it could be held that Moringa supplementation, despite the presence of nutritional indices in favor of Moringa, does not have a significant effect on the nutritional recovery of MAM children but that Moringa has no renal or hepatic toxicity. Supplementation in subjects already on dietetic treatment, dose reduced to minimum and duration of supplementation seems to have played a role in this absence of effect of Moringa.

Metrics

Metrics Loading ...

References

National Institute of Statistics, National survey on household food insecurity vulnerability, Niger. 2013 ; 130.

National Institute of Statistics, Ministry of Economy and Finance of Niger and Macro International Inc. Calverton, Maryland, USA, Demographic and Health Survey and Multiple Indicators (EDSN-MICS III). 2006; 24-29.

National Institute of Statistics of Niger and UNDP, National Report on Progress towards the Achievement of the Millennium Development Goals, Niger. 2014 ; 5-13.

National Institute of Statistics and Nutrition Directorate of the Ministry of Public Health, Summary Report of National Nutrition Survey, Niger. 2012 ; 1-7.

National Institute of Statistics and Nutrition Directorate of the Ministry of Public Health, National Nutrition Survey Report, Niger. 2013; 39-52.

National Institute of Statistics and Nutrition Directorate of the Ministry of Public Health (2014), National Nutrition Survey Report, Niger. 2014 ; 36-54.

National Institute of Statistics, Nutrition Directorate of the Ministry of Public Health (2007), National Nutrition and Child Survival Survey Report, Niger. 2007 ; 17-37.

National Institute of Statistics, Nutrition Directorate of the Ministry of Public Health (2010), Report on the Nutrition Survey of Children 6-59 months, Niger. 2010 ; 27-47.

National Institute of Statistics, Nutrition Directorate of the Ministry of Public Health (2008), National Survey Report Nutrition and Child Survival, Niger. 2008 ; 27-47.

National Institute of Statistics and Nutrition Directorate of the Ministry of Public Health (2009), National Nutrition and Child Survival Survey Report, Niger. 2009 ; 34-49.

National Institute of Statistics and Nutrition Directorate of the Ministry of Public Health (2011), Summary Report of National Nutrition Survey, Niger. 2011 ; 1-5.

High Commission for the 3N Initiative, Performance of the Nigerien Health System. 2015 ; 5-6.

Ministry of Public Health and Directorate of Nutrition, National Protocol for the Integrated Management of Acute Malnutrition, Niger. 2012 ; 25-60.

C Tchiégang, Kitikil Aissatou, Ethnonutritional data and physico-chemical characteristics of leafy vegetables consumed in the Adamawa savannah (Cameroon), TROPICULTURA. 2004 ; 22(1): 11-18.

Armelle de Saint Sauveur, Mélanie Broin, Moringa and other plants with high nutritional potential: Strategies, standards and markets for a better impact on nutrition in Africa, Accra, Ghana, the use of Moringa oleifera leaves against dietary deficiencies: a potential still little valued, 16-18 November 2006; 8.

ECHO Development Notes (EDN), Martin Price, Dawn Berkelaar et al., October 2007; 97: 10.

Moussa Ndong, Salimata Wade, Nicole Dossou et al. nutritional value of Moringa oleifera, study of iron bioavailability, effect of enrichment of various traditional Senegalese dishes with leaf powder, African Journal of Food Agriculture Nutrition and Development (AJFAND). 2007 ; 7(3) : 17.

Urbain Zongo, Steve Léonce Zoungrana, Aly Savadogo, et al. Nutritional and Clinical Rehabilitation of Severely Malnourished Children with Moringa oleifera Lam. Leaf Powder in Ouagadougou (Burkina Faso), Food and Nutrition Sciences. 2013 ; 4: 991-997.

Bidossessi Victor Saturnin HOUNDJI et al., Improvement of the nutritional status of children aged 6 to 30 months in Lissèzoun (Centre-Benin) by Moringa oleifera (Lam.) leaf powder, Int. J. Biol. Chem. Sci. February 2013; 7(1): 225-235.

G Potier de Courcy et al. Nutritional needs and recommended intakes for the satisfaction of these needs, Medical-Surgical Encyclopedia 10-308-A-10.

UNICEF Niger, Training of Trainers Modules on Malnutrition. 2005.

David Moher, Sally Hopewell, Kenneth F Schulz, Victor Montori, Peter C Gøtzsche, P J Devereaux, Diana Elbourne, Matthias Egger,Douglas G Altman, CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials, Research methods & Reportin, BMJ. 2010; 340: c869

Nutriset, France, nutritional values plumpy SUP. June 2018.

WFP, Plumpy Sup, Procedure Manual. June 2018.

Workshop, Moringa and other highly nutritious plant resources: Strategies, standards and markets for a better impact on nutrition in Africa. Accra, Ghana, November 16-18, 2006, https://www. miracletrees.org, accessed on. March 25, 2015.

Manzo ML, Halidou DM, Hallarou M, Illo A, Rabani A, Donnen P, M Dramaix. Composition of the powder of the dry leaves of Moringa oleifera in three regions of Niger, Afric. J. of Food Agric. Nut. and Dev. 2016; 16(4): 11440.

Ministry of Public Health, Integrated Management of Childhood Illnesses, Assess and classify sick children aged 2 months to 5 years. 2002 ; 21-74.

Tété-Benissan Amivi et al., Nutritional recovery in HIV-positive and HIV-negative malnourished subjects after use of Moringa oleifera Lam leaves, Journal of Animal & Plant Sciences. 2012; 15(2): 2184-2199.

Tété-Benissan Amivi , Lawson-Evi KA, Kokou K et al., Effect of Moringa oleifera lam leaf powder. On the evolution of the hemogram profile of malnourished children in Togo: evaluation in HIV-positive subjects, African Journal of Food Agriculture Nutrition and Development (AJFAND). 2012; 12(2): 20.

Iqbal Hossain et al.,Acceptability and efficacy of ready-to-use therapeutic food using soy protein isolate in under-5 children suffering from severe acute malnutrition in Bangladesh: a double-blind randomized non-inferiority trial,European Journal of Nutrition,avril 2019; 1-13.

Félicitée Nguefack, David Chelo,Carine Nouboussi et al. Disturbances in liver function and morphology during severe acute malnutrition in children 6 to 59 months of age, MT pediatrics. 2017; 20(2): 78-85.

Abdulrahman K. A Review of Hepatoprotective Plants Used in Saudi Traditional Medicine, Hindawi Publishing Corporation Evidence-Based Complementary and Alternative Medicine. 2014; Article ID 890842, 22.

Hanachi M, et al. Hypertransaminasemia in severely malnourished adult anorexia nervosa patients:risk factors and evolution under nutrition,Clin Nutr. June 2013.

Vijay Lambole, Upendra Kumar, phytochemicals and acute toxicity of Moringa Oleifera barks in rats, International Journal of Biomedical Research. IJBR 2[10] [2011]548‐553.

OS Adeyemi, TC Elebiyo. Moringa oleifera Supplemented Diets Prevented Nickel-Induced Nephrotoxicity in Wistar Rats, Hindawi Publishing Corporation Journal of Nutrition and Metabolism. 2014; Article ID 958621, 8.

Downloads

Published

2021-09-30

How to Cite

MANZO, M. L. ., HALLAROU, M. E. ., HALIDOU, M. D. ., MAIGA, D. A. ., BAHWERE, P. ., WADE, S. ., CASTETBON, K. ., WILMET-DRAMAIX, M. ., & DONNEN, P. . (2021). Effect of Moringa supplementation in the management of moderate malnutrition in children under 5 receiving ready-to-use supplementary foods in Niger: A randomized clinical trial. GSC Advanced Research and Reviews, 8(3), 071–086. https://doi.org/10.30574/gscarr.2021.8.3.0189

Issue

Section

Original Article