Evaluation of three standard dietary regimes in the treatment of severe malnutrition

Conditions

Severe Acute Malnutrition Nutritional, Metabolic, Endocrine Unspecified protein-energy malnutrition

Allison I Daniel, Matilda E. Arvidsson Kvissberg, Edward Senga, Christian J. Versloot, Philliness Prisca Harawa et al. (10 authors)

Food and Nutrition Bulletin2019-07-14

10.1177/0379572119853930

Intestinal pathogen clearance in children with severe acute malnutrition is unrelated to inpatient morbidity.

Versloot CJ, Attia S, Bourdon C, Richardson SE, Potani I, Bandsma RHJ, Voskuijl W.

2018-02-0110 citations

10.1016/j.clnesp.2018.01.004

Effectiveness of three commonly used transition phase diets in the inpatient management of children with severe acute malnutrition: a pilot randomized controlled trial in Malawi.

Versloot CJ, Voskuijl W, van Vliet SJ, van den Heuvel M, Carter JC, Phiri A, Kerac M, Heikens GT, van Rheenen PF, Bandsma RHJ.

2017-04-2611 citations

10.1186/s12887-017-0860-6

Metabolomic Changes in Serum of Children with Different Clinical Diagnoses of Malnutrition.

Di Giovanni V, Bourdon C, Wang DX, Seshadri S, Senga E, Versloot CJ, Voskuijl W, Semba RD, Trehan I, Moaddel R, Ordiz MI, Zhang L, Parkinson J, Manary MJ, Bandsma RH.

2016-11-0260 citations

10.3945/jn.116.239145

Mortality in children with complicated severe acute malnutrition is related to intestinal and systemic inflammation: an observational cohort study.

Attia S, Versloot CJ, Voskuijl W, van Vliet SJ, Di Giovanni V, Zhang L, Richardson S, Bourdon C, Netea MG, Berkley JA, van Rheenen PF, Bandsma RH.

2016-09-21106 citations

10.3945/ajcn.116.130518

Interventions

Patients will begin the study once they achieve standardised criteria to move from stabilisation or phase 1 to the transition phase, according to the WHO current guidelines. The three therapeutic diet

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: 1. Children between 6-60 months with severe acute malnutrition (World Health Organisation [WHO] criteria: less than -3 Z-score and/or, Mid-Upper Arm Circumference (MUAC) less than 115mm and/or oedema) admitted to Malnutrition Ward, Queen Elizabeth Central Hospital, Blantyre, Malawi 2. Both Human immunodeficiency virus (HIV) positive and negative children will be included

Exclusion criteria

Exclusion criteria: 1. Severely malnourished Human immunodeficiency virus (HIV) infected children who are MOYO [(meaning 'life' in the local Chichewa language) is the name of the malnutrition ward where the study takes place] readmissions within the past year 2. HIV positive children already on anti-retroviral ?therapy 2. Children presenting with a packed cell volume (PCV) of less than 15% 3. Children with severe haemodynamic instability or severe neurological symptoms / disability 4.Children whose HIV status is unknown due to their carer declining the routinely offered test

Design outcomes

Primary

Measure	Time frame
1. Fecal pH 2. Electrolyte disturbances 3. Recovery rate expressed in incremental weight/kg body weight/per day Patients will be clinically assessed twice a day for the whole duration of the study (e.g. weight, clinical signs).	—

Secondary

Measure	Time frame
1. Morbidity (principally, the rate of carer-reported diarrhoea and severe diarrhoea) 2. Urinary and plasma 8-hydroxydeoxyguanosine 3. Plasma citrulline concentrations 4. Fecal excretion of elastase and alpha 1-antitrypsin 5. Analysis of fecal microbiota There are three sample moments (feaces, plasma, urine): on admission onto the ward (baseline), just before transition phase (2) and on the 3rd day in transition phase (3).	—

Measure

Time frame

1. Morbidity (principally, the rate of carer-reported diarrhoea and severe diarrhoea) 2. Urinary and plasma 8-hydroxydeoxyguanosine 3. Plasma citrulline concentrations 4. Fecal excretion of elastase and alpha 1-antitrypsin 5. Analysis of fecal microbiota There are three sample moments (feaces, plasma, urine): on admission onto the ward (baseline), just before transition phase (2) and on the 3rd day in transition phase (3).

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Countries

Malawi

Outcome results

None listed