RANDOMIZED CLINICAL-TRIAL COMPARING HOSPITAL TO AMBULATORY REHABILITATION OF MALNOURISHED CHILDREN IN NIGER

This study compared hospital to ambulatory nutritional rehabilitation outcomes and costs. Following a hospital stay to resolve initial acute medical conditions, 100 malnourished children (54 per cent male, ages 5 to 28 months) in Niger were randomly assigned to either hospital or ambulatory nutritional rehabilitation. Anthropometric measures were a ssessed at 15, 30, 60, 90 and 180 days post-randomization. Following r andomization, the hospital group received a mean of 12.9 days of hospi tal rehabilitation and 5.6 days of ambulatory rehabilitation, while th e ambulatory group received 2.2 days of hospital rehabilitation and 11 .9 days of ambulatory rehabilitation. No significant differences betwe en the two study groups in mortality rates or weight gain were found. The mean cost for hospital rehabilitation was 120 per cent higher (P < 0.001) than ambulatory rehabilitation. This study was the first rando mized clinical trial directly comparing hospital to ambulatory nutriti onal rehabilitation and suggests that ambulatory rehabilitation is mor e cost-effective.