Kwashiorkor
Conditions
Keywords
sulfur amino acid
Brief summary
This observational cross-sectional study is investigating if young children in populations with higher prevalence of kwashiorkor malnutrition have lower dietary sulfur amino acid intake than populations with lower prevalence of kwashiorkor, controlling for multiple potential confounding factors. Intake is estimated through diet recalls during interviews with a child's caregiver, analysis of urine samples and analysis of food samples for their amino acid profiles.
Detailed description
Kwashiorkor is one of two categorizations of severe acute malnutrition, but its etiology remains unclear. Although kwashiorkor is found only where diets are low in quality protein, comparisons of total dietary protein of individual children with and without kwashiorkor has been inconclusive. This study aims to compare amino acid profiles of the diets, not just total protein. Evidence has shown that children with kwashiorkor consistently have very low circulating levels of sulfur amino acids (cysteine and methionine). Typical staple foods in regions with endemic kwashiorkor are generally poor in sulfur amino acids and the signs characterizing kwashiorkor can plausibly be explained by a shortage of sulfur amino acids. In eastern Democratic Republic of the Congo, certain populations have chronically higher prevalence of kwashiorkor than neighboring populations with similar livelihoods, religion, environment, language and ethnicity. This study will compare these two populations to understand what differences between them may explain the difference in prevalence.
Interventions
OTHERNo intervention
no intervention
Sponsors
World Concern
Action Contre la Faim
Rebuild Hope for Africa
Dignitas International
Tufts University
Study design
Observational model
OTHER
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
36 Months to 59 Months
Healthy volunteers
Yes
Inclusion criteria
* resident of the selected population * in the appropriate age range
Exclusion criteria
* caregiver reports the child has an illness that has required treatment for at least 6 months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Dietary sulfur amino acid | one measure at one time point within three weeks of registration | mg of sulfur amino acid in the diet per kg of body weight |
| dietary sulfur amino acid above or below WHO estimated average requirement (EAR) | one measure at one time point within three weeks of registration | the total sulfur amino acid in the diet will be calculated from a diet recall this will be a bivariate measure, 1 if the SAA in the diet is above or 0 if below the WHO/FAO requirement for sulfur amino acid intake of 17mg of sulfur amino acids per kg of body weight per day |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| calories and protein in diet per kg of body weight | one measure at one time point within three weeks of registration | intake of calories (kcal/kg body weight), digestibility adjusted protein - sum of (grams of protein per food item x digestibility of food item) per kg of body weight quality adjusted protein = digestibility adjusted protein in the diet x proportion of requirement of the limiting amino acid |
| urinary sulfate | one measure at one time point within three weeks of registration | sulfate excreted in the urine, normalized to creatinine |
Other
| Measure | Time frame | Description |
|---|---|---|
| socio-environmental factors (use of a latrine, shelter description, feeding habits, household demographics, health history) | one measure at one time point within three weeks of registration | sanitation - does the child use a latrine, defecate in the woods/fields, defecate around the home shelter - materials used for the roof and walls, size of the home in square meters feeding habits - number of hot meals per day, number of feeding episodes per day household demographics - age and sex of all people who eat and sleep regularly at that homestead health history - illnesses in the past 30 days, previous diagnoses of malnutrition and type of malnutrition |
| physical measurements of the subject's body size | one measure at one time point within three weeks of registration | height to the nearest mm, weight to the nearest 100g, middle-upper arm circumference to the nearest mm, visual signs of kwashiorkor (edema, rough or darkened skin, friable lightened hair, distended abdomen, lethargy or irritability) |
| urinary thiocyanate | one measure at one time point within three weeks of registration | thiocyanate excreted in the urine (ppm) |
Countries
Democratic Republic of the Congo
Outcome results
None listed