TY - JOUR
T1 - Health Outcomes, Pathogenesis and Epidemiology of Severe Acute Malnutrition (HOPE-SAM)
T2 - Rationale and methods of a longitudinal observational study
AU - Bwakura-Dangarembizi, Mutsa
AU - Amadi, Beatrice
AU - Bourke, Claire D.
AU - Robertson, Ruairi C.
AU - Mwapenya, Benjamin
AU - Chandwe, Kanta
AU - Kapoma, Chanda
AU - Chifunda, Kapula
AU - Majo, Florence
AU - Ngosa, Deophine
AU - Chakara, Pamela
AU - Chulu, Nivea
AU - Masimba, Faithfull
AU - Mapurisa, Idah
AU - Besa, Ellen
AU - Mutasa, Kuda
AU - Mwakamui, Simutanyi
AU - Runodamoto, Thompson
AU - Humphrey, Jean H.
AU - Ntozini, Robert
AU - Wells, Jonathan C.K.
AU - Manges, Amee R.
AU - Swann, Jonathan R.
AU - Walker, A. Sarah
AU - Nathoo, Kusum J.
AU - Kelly, Paul
AU - Prendergast, Andrew J.
N1 - Publisher Copyright:
© 2019 BMJ Publishing Group Limited.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Introduction Mortality 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 analysis The 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 dissemination The 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.
AB - Introduction Mortality 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 analysis The 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 dissemination The 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.
KW - Africa
KW - HIV
KW - enteropathy
KW - malnutrition
KW - microbiota
KW - mortality
UR - http://www.scopus.com/inward/record.url?scp=85061044701&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85061044701&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2018-023077
DO - 10.1136/bmjopen-2018-023077
M3 - Article
C2 - 30782694
AN - SCOPUS:85061044701
SN - 2044-6055
VL - 9
JO - BMJ open
JF - BMJ open
IS - 1
M1 - e023077
ER -