ComPAS: Combined Protocol for Severe and Moderate Acute Malnutrition Study

The primary objective of the Combined Protocol for Acute Malnutrition Study (or ComPAS) was to develop and test a simplified and combined protocol for the treatment of severe and moderate acute malnutrition that improves the coverage, quality, cost- effectiveness, and continuity of care. Although acute malnutrition is a continuum condition, severe and moderate acute malnutrition are treated separately with different protocols and therapeutic products managed by separate UN agencies. Due to logistical constraints, many CMAM programs only offer treatment of SAM despite the fact that children with MAM are also at high risk; they have a three-fold increased risk of death compared to well-nourished children. 

ComPAS has tested a new treatment protocol within the CMAM model that allows admission anywhere along the continuum of SAM and MAM, uses one therapeutic product at tapered doses as children progress through treatment, and discharges based on response to treatment. ComPAS Stage 1 (secondary analysis of 10,000 children from 5 countries) found that: two 92g sachets of RUTF (1,000 kcal) meet the total energy requirements for >95% of children with a MUAC<115mm, and one 92g sachet of RUTF (500 kcal) meets half the energy requirements for >95% of children with a MUAC of 115-<125mm, and serves to simplify and streamline the treatment to be tested in a combined protocol. Final results will be available in 2019.