Effectiveness of an Alternative Protocol in the Management of Acute Malnutrition

This experimental study aims to test an alternative protocol for managing acute malnutrition in children aged 6-59 months in Burkina Faso. This alternative protocol consists of using RUTF instead of RUSF for the management of moderate acute malnutrition and reduced-dose RUTF instead of standard-dose RUTF for the treatment of severe acute malnutrition. The main questions are: 1. Does treating children with moderate acute malnutrition using RUTF lead to a non-inferior programmatic and sustained recovery rate compared to the standard care with RUSF? 2. Does treating children with uncomplicated severe acute malnutrition using a reduced dose of RUTF lead to a non-inferior programmatic and sustained recovery rate compared to the standard care with a standard dose of RUFT? Secondly, the study will investigate the effect of this alternative protocol compared to the standard protocol on cost-effectiveness, psychomotor development, weight and linear growth and incidence of relapses.

1. MAM Inclusion Criteria: * Anthropometric measures: * (115 mm ≤ MUAC\< 125 mm and -3 SDs ≤ WLZ \< -2 SDs) OR * (115 mm ≤ MUAC\< 125 mm and WLZ ≥ -2 SDs) OR * (MUAC ≥ 125 mm and -3 SDs ≤ WLZ \< -2 SDs). * Age: 6 to 59 months * Parents' acceptance of biweekly visits until programme discharge and monthly visits for the post-programme follow up Exclusion Criteria: * Failure of appetite test * Medical complications requiring hospital treatment * Presence of any congenital anomaly or underlying chronic disease that may affect growth or the risk of infection * Presence of bilateral oedema * History of allergies to peanuts, milk, or soya * Relapse from MAM treatment or transfer from SAM treatment * Children who have recently (\