Childhood growth during recovery from acute illness in Africa and South Asia: a secondary analysis of the childhood acute illness and nutrition (CHAIN) prospective cohort.

Autor:	Bourdon C; Translational Medicine, Hospital for Sick Children, Toronto, ON, Canada., Diallo AH; Department of Public Health, University Joseph Ki-Zerbo, Ouagadougou, Burkina Faso.; Department of Public Health, Centre Muraz Research Institute, Bobo-Dioulasso, Burkina Faso., Mohammad Sayeem Bin Shahid AS; Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh., Khan MA; Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh., Saleem AF; Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan., Singa BO; Kenya Medical Research Institute, Nairobi, Kenya., Gnoumou BS; Department of Public Health, University Joseph Ki-Zerbo, Ouagadougou, Burkina Faso., Tigoi C; Clinical Research Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom., Otieno CA; Clinical Research Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya., Oduol CO; Clinical Research Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya., Lancioni CL; Department of Pediatrics, Oregon Health and Science University, Portland, OR, USA., Manyasi C; Department of Paediatrics, Mbagathi Hospital, Nairobi, Kenya., McGrath CJ; Department of Global Health, University of Washington, Seattle, WA, USA.; Department of Epidemiology, University of Washington, Seattle, WA, USA., Maronga C; Clinical Research Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya., Lwanga C; Uganda-Case Western Reserve University Research Collaboration, Kampala, Uganda., Brals D; Department of Global Health, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands., Ahmed D; Clinical Microbiology and Immunology Laboratory, Office of Executive Director, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh., Mondal D; Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh., Denno DM; Department of Global Health, University of Washington, Seattle, WA, USA.; Department of Pediatrics, University of Washington, Seattle, WA, USA., Mangale DI; Department of Global Health, University of Washington, Seattle, WA, USA., Chimwezi E; Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi., Mbale E; Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi., Mupere E; Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda., Salauddin Mamun GM; Infectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh., Ouédraogo I; Department of Pediatrics, Banfora Referral Regional Hospital, Banfora, Burkina Faso., Berkley JA; Clinical Research Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom., Njunge JM; Clinical Research Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya., Njirammadzi J; Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi., Mukisa J; Department of Immunology and Department of Molecular Biology Makerere University College of Health Sciences, Kampala, Uganda., Thitiri J; Clinical Research Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya., Walson JL; Departments of International Health and Medicine, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA., Jemutai J; Clinical Research Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya., Tickell KD; Department of Global Health, University of Washington, Seattle, WA, USA., Shahrin L; Hospitals, Office of Executive Director, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh., Mallewa M; Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi., Hossain MI; Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh., Chisti MJ; Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh., Timbwa M; Clinical Research Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya., Mburu M; Clinical Research Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya., Ngari MM; Clinical Research Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya., Ngao N; Clinical Research Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya., Aber P; Uganda-Case Western Reserve University Research Collaboration, Kampala, Uganda., Harawa PP; Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi., Sukhtankar P; Clinical Research Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom., Bandsma RHJ; Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada., Bamouni RM; Department of Public Health, University Joseph Ki-Zerbo, Ouagadougou, Burkina Faso., Molyneux S; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.; Health Systems and Research Ethics Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya., Mwaringa S; Clinical Research Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya., Shaima SN; Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh., Ali SA; Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan., Afsana SM; Clinical Biochemistry Laboratory, Office of Executive Director, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh., Banu S; Infectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh., Ahmed T; Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.; Office of Executive Director, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh., Voskuijl WP; Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi.; Amsterdam UMC, Location University of Amsterdam, Amsterdam Institute for Global Child Health, Emma Children's Hospital, Meibergdreef 9, Amsterdam, the Netherlands.; Amsterdam UMC, Location University of Amsterdam, Department of Global Health, Amsterdam Institute for Global Health and Development, Meibergdreef 9, Amsterdam, the Netherlands., Kazi Z; Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
Jazyk:	angličtina
Zdroj:	EClinicalMedicine [EClinicalMedicine] 2024 Mar 12; Vol. 70, pp. 102530. Date of Electronic Publication: 2024 Mar 12 (Print Publication: 2024).
DOI:	10.1016/j.eclinm.2024.102530
Abstrakt:	Background: Growth faltering is well-recognized during acute childhood illness and growth acceleration during convalescence, with or without nutritional therapy, may occur. However, there are limited recent data on growth after hospitalization in low- and middle-income countries. Methods: We evaluated growth following hospitalization among children aged 2-23 months in sub-Saharan Africa and South Asia. Between November 2016 and January 2019, children were recruited at hospital admission and classified as: not-wasted (NW), moderately-wasted (MW), severely-wasted (SW), or having nutritional oedema (NO). We describe earlier (discharge to 45-days) and later (45- to 180-days) changes in length-for-age [LAZ], weight-for-age [WAZ], mid-upper arm circumference [MUACZ], weight-for-length [WLZ] z-scores, and clinical, nutritional, and socioeconomic correlates. Findings: We included 2472 children who survived to 180-days post-discharge: NW, 960 (39%); MW, 572 (23%); SW, 682 (28%); and NO, 258 (10%). During 180-days, LAZ decreased in NW (-0.27 [-0.36, -0.19]) and MW (-0.23 [-0.34, -0.11]). However, all groups increased WAZ (NW, 0.21 [95% CI: 0.11, 0.32]; MW, 0.57 [0.44, 0.71]; SW, 1.0 [0.88, 1.1] and NO, 1.3 [1.1, 1.5]) with greatest gains in the first 45-days. Of children underweight (<-2 WAZ) at discharge, 66% remained underweight at 180-days. Lower WAZ post-discharge was associated with age-inappropriate nutrition, adverse caregiver characteristics, small size at birth, severe or moderate anaemia, and chronic conditions, while lower LAZ was additionally associated with household-level exposures but not with chronic medical conditions. Interpretation: Underweight and poor linear growth mostly persisted after an acute illness. Beyond short-term nutritional supplementation, improving linear growth post-discharge may require broader individual and family support. Funding: Bill & Melinda Gates FoundationOPP1131320; National Institute for Health ResearchNIHR201813. Competing Interests: Members of the writing group declare having received support from the Bill and Melinda Gates Foundation (BMGF) for staff and research activities directly linked to this project which was paid to their universities or institutions (JAB, JLW, RHJB). Reimbursement for travel directly related to this project was also provided by BMGF and paid through the universities (JLW, JAB). JAB participated in a leadership role for the Commonwealth Association for Paediatic Gastroenterology & Nutrition (CAPGAN) and on a Data Safety Monitoring Board (DSMB) for a study regarding vitamin D. (© 2024 The Authors.)
Databáze:	MEDLINE
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