Childhood Malnutrition: Toward an Understanding of Infections, Inflammation, and Antimicrobials

Jones, Kelsey; Thitiri, Johnstone; Ngari, Moses; Berkley, James A.

doi:10.1177/15648265140352s110

Cited by 104 publications

(109 citation statements)

References 28 publications

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“…Scrimshaw et al [9] first described a vicious cycle of infection and undernutrition, whereby infections predispose to malnutrition, through reduced intake and absorption and diversion of nutrients away from growth, while malnutrition reduces immune function and increases the risk and/or severity of infections. Various iterations of this cycle have been proposed over the years, with more recent versions recognizing that subclinical infection, enteropathy, changes in the composition and function of the gut microbiota and systemic inflammation are likely to be important in the pathogenesis of malnutrition, in addition to overt infections [10][11][12]. Children hospitalized for severe acute malnutrition are extremely sick, with physiological dysfunction such as reduced respiratory muscle mass, impaired cardiac function and electrolyte disturbance, in addition to micronutrient deficiencies, inflammation, clinical infection and mucosal barrier breakdown.…”

Section: The Immunology Of Malnutritionmentioning

confidence: 99%

Malnutrition and vaccination in developing countries

Prendergast

2015

Phil. Trans. R. Soc. B

119

103

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Malnutrition contributes to an estimated 45% of deaths among children under 5 years of age in developing countries, predominantly due to infections. Malnourished children therefore stand to benefit hugely from vaccination, but malnutrition has been described as the most common immunodeficiency globally, suggesting that they may not be able to respond effectively to vaccines. The immunology of malnutrition remains poorly characterized, but is associated with impairments in mucosal barrier integrity, and innate and adaptive immune dysfunction. Despite this, the majority of malnourished children can mount a protective immune response following vaccination, although the timing, quality and duration of responses may be impaired. This paper reviews the evidence for vaccine immunogenicity in malnourished children, discusses the importance of vaccination in prevention of malnutrition and highlights evidence gaps in our current knowledge.

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Section: The Immunology Of Malnutritionmentioning

confidence: 99%

Malnutrition and vaccination in developing countries

Prendergast

2015

Phil. Trans. R. Soc. B

119

103

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“…Some Authors have studied the correlation between malnutrition and diseases in children [7,21] while other Authors have considered the possible impact of the use of local resources to fight malnutrition in other low-income countries, such as Madagascar, however focusing on a survey and a consumer test [24].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, we obtained a list of local food resources in order to select and propose local recipes as a possible, innovative, simple and rapid approach to fight children malnutrition and infectious diseases in a lowincome country as Mozambique [7,21,23,24]. The research was made in cooperation with the Provincial Health Department of Sofala and the local association "Grupo das Mães Kuplumussana".…”

Section: Methodsmentioning

confidence: 99%

“…In fact, even if many Authors suggest that malnutrition and diseases are strongly related [7,21], worsening the prognosis of infectious diseases like tuberculosis, HIV and malaria, no study have yet been published concerning the power and the potential good effect of local food resources on these aspects. A major issue in countries with limited resources is the sustainability of the program itself.…”

Section: Introduction and Objectivementioning

confidence: 99%

“…In fact, an inadequate diet leads to weight loss, decrease of the immune response and damage of the mucosa, allowing invasion of pathogens, which finally worsens the overall nutritional status. In addition, these conditions lead to decreased efficacy of vaccines and increased exposure to infectious agents [7,8].…”

Section: Introduction and Objectivementioning

confidence: 99%

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Local Food Resources to Fight Children Malnutrition and Infectious Diseases in Mozambique

Pizzol¹,

Gennaro²

2016

J Emerg Infect Dis

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Objective: To develop sustainable recipes, using local food resources, as a possible solution to manage children malnutrition and nutritional lack in Mozambique, thus preventing infectious diseases. Methods:Our work was based on the Dietary Reference Intake (DRI) reports for children aged 4-8 years old. After having listed more than 60 commonly consumed local foods in Mozambique, we developed some recipes, indicating composition, energy and nutrients values. Information on nutrients concentrations was taken from the National Nutrient Database for Standard References, the Food Composition Tables for Mozambique and the Research Center for Aliments and Nutrition. In the recipes, the traditional way of listing ingredients was reported, which were then turned into international, standardized values. Results:We elaborated some different local food recipes, easy to prepare, at low cost and useful in a systematic approach in order to fight malnutrition in Sofala Province, Mozambique. Each recipe included functions and daily Recommended Dietary Allowance (RDA) of: water, proteins, lipids, carbohydrates, fibers, sodium, potassium, iron, calcium, phosphorus and vitamins. We suggested recipes richer in vitamins and micro/macro nutrients for breakfast, while those providing high caloric intake were more indicated for the main meal. The resulting recipes have been made understandable, for both local and international population, thanks to the coexistence of traditional and international description of ingredients. Conclusion:Local recipes approach is a possible promising tool among the most cost-effective/high impact interventions against child malnutrition and mortality from infectious diseases in Mozambique. a general improvement in food production and availability of food [16]. Different and various strategies have been adopted to fight the malnutrition problem and the food-based approach in prevention and control of micronutrient deficiencies as well as nutrition, is fully recognized by the Food and Agriculture Organization of the United Nations [10,17]. Local Food Resources to Fight Children Malnutrition and Infectious Diseases in Mozambique

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Analysis of Postdischarge Interventions for Children Treated for Moderate or Severe Wasting, Growth Faltering or Failure, or Edema

et al. 2023

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ImportanceChildren treated for acute malnutrition remain at increased risk of relapse, infection, and mortality after programmatic recovery. Global guidelines for the management of acute malnutrition currently provide no recommendations to sustain recovery following treatment discharge.ObjectiveTo inform guideline development by evaluating the evidence on postdischarge interventions to improve outcomes within 6 months after discharge.Evidence ReviewIn this systematic review, 8 databases were searched from inception through December 2021 and included randomized and quasi-experimental studies investigating interventions delivered after discharge from nutritional treatment for children aged 0 to 59 months. Outcomes were relapse, deterioration to severe wasting, readmission, sustained recovery, anthropometry, all-cause mortality, and morbidity within 6 months after discharge. The risk of bias was assessed using Cochrane tools, and the certainty of the evidence was evaluated with the GRADE approach.FindingsOf 7124 records identified, 8 studies, conducted in 7 countries between 2003 and 2019 with 5965 participants, were included. The study interventions included antibiotic prophylaxis (n = 1), zinc supplementation (n = 1), food supplementation (n = 2), psychosocial stimulation (n = 3), unconditional cash transfers (n = 1), and an integrated biomedical, food supplementation, and malaria prevention package (n = 1). Risk of bias was moderate or high for half the studies. Only unconditional cash transfers were associated with reduced relapse, while the integrated package was associated with improved sustained recovery. Zinc supplementation, food supplementation, psychosocial stimulation, and unconditional cash transfers were associated with improvements in postdischarge anthropometry, while zinc supplementation was associated with reductions in multiple postdischarge morbidities.Conclusions and RelevanceIn this systematic review of postdischarge interventions to reduce relapse and improve other postdischarge outcomes among children treated for acute malnutrition, evidence was limited. Biomedical, cash, and integrated interventions showed promise in improving certain postdischarge outcomes for children treated for moderate or severe acute malnutrition in single studies. Further evidence on the efficacy, effectiveness, and operational feasibility of postdischarge interventions in other contexts is needed to inform global guidance development.

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Childhood Malnutrition: Toward an Understanding of Infections, Inflammation, and Antimicrobials

Cited by 104 publications

References 28 publications

Malnutrition and vaccination in developing countries

Malnutrition and vaccination in developing countries

Local Food Resources to Fight Children Malnutrition and Infectious Diseases in Mozambique

Analysis of Postdischarge Interventions for Children Treated for Moderate or Severe Wasting, Growth Faltering or Failure, or Edema

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