Benefits and harms

The GDG made the judgement that there are small desirable effects, and unknown undesirable effects, of an integrated package of care including medical care, food supplementation and malaria prevention and treatment. The GDG agreed on a judgement of “don’t know” in terms of the balance of effects of this intervention.

This judgement was based on evidence from one study in which the intervention arm received 40 g/d of a lipid-based nutrient supplement for eight weeks after exit, a single dose of albendazole for deworming at the time of exit, a 14-day course of 20 mg zinc sulphate (ZnSO4) at the time of exit, an insecticide-treated bed net at the time of exit, and sulfadoxine-pyrimethamine for malaria chemoprophylaxis (1).

There were some potential desirable effects on sustained recovery, but the evidence was of very low certainty. The evidence was also of very low certainty for relapse to moderate wasting. The intervention had no effect on mortality.

There was no evidence on anthropometric outcomes or readmission, which were pre-specified outcomes of interest.

Certainty of the evidence

The GDG agreed that the evidence was of very low certainty for this integrated package of care as a post-exit intervention.

Values and preferences

The GDG concluded there is probably no important uncertainty or variability in terms of the main outcomes, based on evidence from a qualitative evidence synthesis which included four relevant studies on growth and recovery, failure to respond or worsening condition after intervention and mortality.

Resources

In a systematic review of economic evidence there were no studies identified and therefore the GDG could not determine resources and cost-effectiveness of this integrated package of care.

Equity

In a qualitative evidence synthesis there were no studies identified related to the impacts of this integrated package of care on equity.

Acceptability

In a qualitative evidence synthesis there were no studies identified that indicated whether this post-exit intervention is acceptable.

Feasibility

In a qualitative evidence synthesis there were no studies identified about the feasibility of delivering this integrated package of care as a post-exit intervention.