The efficacy of a probiotic/prebiotic-enhanced Ready-to-Use Therapeutic Food in the treatment of severe acute malnutrition


The incidence of severe acute malnutrition in Africa remains a significant public health challenge. Evidence from studies in developed countries suggest that the inclusion of probiotic bacteria in therapeutic feeds may reduce the incidence and severity of diarrhoea and other infections, and improve the rate of recovery.

This study, involving members of the Nutrition in Crisis Research Group,  aimed to investigate the efficacy of a Ready-to-Use Therapeutic Food (RUTF), enhanced by the addition of a mixture of probiotic bacteria for severely malnourished children (including HIV positive children) admitted to ‘Moyo’ Therapeutic Feeding Programme (TFP) at Queen Elizabeth Central Hospital, Blantyre, Malawi.

As is typical for therapeutic feeding centres, malnutrition related mortality and morbidity is high in Moyo. Improving the food that is used for the therapeutic feeding is one factor that might have significant positive benefits. In this study, the therapeutic food was enhanced by the addition of a probiotics/prebiotic mixture called “Synbiotic” (Synbiotic 2000 forte® ~ Medipharm AB, Kågeröd, Sweden).

The study has now been completed and the main results have been published in the Lancet.  No positive impact of Synbiotic was observed in this study although a possible improvement in outpatient outcomes may deserve future study.

A follow-up study on children who took part in the trial is currently being analysed.

Read the abstract of the main trial paper