Changes in susceptibility to life-threatening infections after treatment for complicated severe malnutrition in Kenya
Changes in susceptibility to life-threatening infections after treatment for complicated severe malnutrition in Kenya
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DOI：
10.1093/ajcn/nqy007
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发表时间：
2018-04-01
影响因子：
7.1
通讯作者：
Berkley, James A.
中科院分区：
文献类型：
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作者：
Ngari, Moses M.;Mwalekwa, Laura;Berkley, James A.
治疗儿童严重急性营养不良（SAM）的目标，除了人体测量恢复和预防短期死亡外，还包括降低随后严重感染的风险。严重疾病的风险在康复过程中变化的速度和程度尚不清楚，但可以为改善干预措施的设计和范围提供信息。本研究的目的是调查与SAM人体测量恢复相关的危及生命事件（LTE）风险的变化。这是对一项临床试验的二次分析，该试验包括1778名年龄在2-59个月之间患有复杂SAM的未感染HIV的肯尼亚儿童，在治疗的住院稳定期后入组，并随访12个月。主要结局是LTE，定义为需要再次住院或导致死亡的感染。我们检查了在入组后1、3和6个月测量的人体测量变量与这些时间点后6个月内发生的LTE的关系。在12个月内，有823例LTE（257例死亡），主要是严重肺炎和腹泻。在第1、3和6个月，557（34%）、764（49%）和842（56%）名儿童的身高或身长体重评分（WHZ）分别为千分之二，与WHZ相比，
Goals of treating childhood severe acute malnutrition (SAM), in addition to anthropometric recovery and preventing short-term mortality, include reducing the risks of subsequent serious infections. How quickly and how much the risk of serious illness changes during rehabilitation are unknown but could inform improving the design and scope of interventions.The aim of this study was to investigate changes in the risk of life-threatening events (LTEs) in relation to anthropometric recovery from SAM.This was a secondary analysis of a clinical trial including 1778 HIV-uninfected Kenyan children aged 2-59 mo with complicated SAM, enrolled after the inpatient stabilization phase of treatment, and followed for 12 mo. The main outcome was LTEs, defined as infections requiring rehospitalization or causing death. We examined anthropometric variables measured at months 1, 3, and 6 after enrollment in relation to LTEs occurring during the 6 mo after each of these time points.Over 12 mo, there were 823 LTEs (257 fatal), predominantly severe pneumonia and diarrhea. At months 1, 3, and 6, 557 (34%), 764 (49%), and 842 (56%) children had a weight-for-height or -lengthz score (WHZ) a parts per thousand-2, respectively, which, compared with a WHZ