Health Outcomes, Pathogenesis and Epidemiology of Severe Acute Malnutrition (HOPE-SAM): rationale and methods of a longitudinal observational study

IntroductionMortality among children hospitalised for complicated severe acute malnutrition (SAM) remains high despite the implementation of WHO guidelines, particularly in settings of high HIV prevalence. Children continue to be at high risk of morbidity, mortality and relapse after discharge from...

Full description

Saved in:

Bibliographic Details
Published in:	BMJ open Vol. 9; no. 1; p. e023077
Main Authors:	Bwakura-Dangarembizi, Mutsa, Amadi, Beatrice, Bourke, Claire D, Robertson, Ruairi C, Mwapenya, Benjamin, Chandwe, Kanta, Kapoma, Chanda, Chifunda, Kapula, Majo, Florence, Ngosa, Deophine, Chakara, Pamela, Chulu, Nivea, Masimba, Faithfull, Mapurisa, Idah, Besa, Ellen, Mutasa, Kuda, Mwakamui, Simutanyi, Runodamoto, Thompson, Humphrey, Jean H, Ntozini, Robert, Wells, Jonathan C K, Manges, Amee R, Swann, Jonathan R, Walker, A Sarah, Nathoo, Kusum J, Kelly, Paul, Prendergast, Andrew J
Format:	Journal Article
Language:	English
Published:	England BMJ Publishing Group LTD 01-01-2019 BMJ Publishing Group
Subjects:	Age Body composition Cardiovascular disease Child Development Child, Preschool Clinical outcomes Cytokines Developing countries Drug therapy Edema Epidemiology Female Global Health HIV HIV Infections - complications Hospitals Human immunodeficiency virus Humans Infant Infant, Newborn Infections Kaplan-Meier Estimate LDCs Linear Models Longitudinal Studies Male Malnutrition Metabolism Morbidity Mortality Observational studies Pathogenesis Patient Discharge - statistics & numerical data Prevalence Recurrence Rehabilitation Risk Factors ROC Curve Severe Acute Malnutrition - mortality Severe Acute Malnutrition - therapy Systematic review Zambia - epidemiology Zimbabwe - epidemiology Zimbabwe Zambia Malawi Africa microbiota mortality malnutrition HIV Africa enteropathy
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	IntroductionMortality among children hospitalised for complicated severe acute malnutrition (SAM) remains high despite the implementation of WHO guidelines, particularly in settings of high HIV prevalence. Children continue to be at high risk of morbidity, mortality and relapse after discharge from hospital although long-term outcomes are not well documented. Better understanding the pathogenesis of SAM and the factors associated with poor outcomes may inform new therapeutic interventions.Methods and analysisThe Health Outcomes, Pathogenesis and Epidemiology of Severe Acute Malnutrition (HOPE-SAM) study is a longitudinal observational cohort that aims to evaluate the short-term and long-term clinical outcomes of HIV-positive and HIV-negative children with complicated SAM, and to identify the risk factors at admission and discharge from hospital that independently predict poor outcomes. Children aged 0–59 months hospitalised for SAM are being enrolled at three tertiary hospitals in Harare, Zimbabwe and Lusaka, Zambia. Longitudinal mortality, morbidity and nutritional data are being collected at admission, discharge and for 48 weeks post discharge. Nested laboratory substudies are exploring the role of enteropathy, gut microbiota, metabolomics and cellular immune function in the pathogenesis of SAM using stool, urine and blood collected from participants and from well-nourished controls.Ethics and disseminationThe study is approved by the local and international institutional review boards in the participating countries (the Joint Research Ethics Committee of the University of Zimbabwe, Medical Research Council of Zimbabwe and University of Zambia Biomedical Research Ethics Committee) and the study sponsor (Queen Mary University of London). Caregivers provide written informed consent for each participant. Findings will be disseminated through peer-reviewed journals, conference presentations and to caregivers at face-to-face meetings.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3
ISSN:	2044-6055 2044-6055
DOI:	10.1136/bmjopen-2018-023077