Efficacy of Striatin in Malnourished Children

• Children aged 12-59 months diagnosed with SAM based on weight-for-height Z score (WHZ) and/or mid-upper arm circumference (MUAC) will be included in the study.
• Informed consents will be given and drawn from mother or legal caregiver.
• Blood and stool samples will be taken before and after intervention in all participants. Markers which will be checked are: prealbumin, hsCRP, and brain-derived neurotropic factor (BDNF), from blood. Moreover, short-chain fatty acid (SCFA) and Bacteroides/Firmiculates ratio will be analyzed from stool.
• Block randomization will be conducted to allocate participants into two groups: intervention group who receive Striatin supplementation, and control group who receive placebo.
• The intervention will be given for 14 days. Neither researchers nor participants aware of the type of intervention (Striatin or placebo).
• Both groups will receive standard F-100 formula or oral nutrition therapy (ONS) as nutritional treatment for SAM, vitamin C, vitamin B complex, and folic acid.
• Intervention group will receive 1 sachet of Striatin and control group will receive 1 sachet of Placebo every 24 hours. Both Striatin and placebo will be dissolved in 10 ml of solvent syrup. The route of administration can be oral or via nasogastric tube.
• Weight will be measured every three days, and any complaint or side effect that appeared will be recorded every day.

Inclusion criteria

• Severe acute malnutrition (SAM) children based on WHZ and/or MUAC
• Consents are given by parents/caregivers.

Exclusion criteria

• SAM children with malignancy, liver cirrhosis, acute liver failure, severe kidney disorders, acute and chronic infections that attack the liver or other severe infections that require special treatment.
• Subjects who require special anthropometric examinations (condition such as edema, organomegaly, amputation, cerebral palsy GMFCS > 2)
• Children who have history of severe hypersensitivity to snakehead fish and/or cow's milk.