Understanding the role of caregiver mental health in outcomes following childhood severe acute malnutrition

PROJECT SUMMARY/ABSTRACT Caregivers of children with serious illness experience high burdens of depression and anxiety, which impacts their own wellbeing and the wellbeing of those in their care. Severe acute malnutrition (SAM) is the most serious form of acute malnutrition. Affecting millions of children each year primarily in sub-Saharan Africa and South Asia, it typically involves cycles of acute illness, treatment, and often relapse. Children with SAM have 9 times the risk of mortality compared to their well-nourished peers, and families of children experiencing SAM typically are experiencing extreme poverty and food insecurity. While postnatal depression has been shown to increase the risk of infant undernutrition and affect breastfeeding practices, the impact of caregiver depression on child outcomes among children with SAM is not well characterized. Here, we propose to add an ancillary study to an ongoing randomized controlled trial evaluating treatment for SAM in Burkina Faso to longitudinally measure caregiver depression and anxiety over the treatment course and up to 1 year following treatment of a child’s SAM. By leveraging an existing trial collecting detailed data on child outcomes, we anticipate that this study will provide comprehensive evidence of the burden of caregiver mental distress and the relationship between caregiver depression and anxiety and recovery and relapse among children with SAM. This study will provide critical data needed to inform development of interventions, such as community-health worker led counseling programs or peer support groups, that may benefit caregivers of children with SAM and lead to improved outcomes for children who are recovering from an episode of SAM.