Health Outcomes, Pathogenesis and Epidemiology of Severe Acute Malnutrition (HOPE-SAM): rationale and methods of a longitudinal observational study. Issue 1 (1st February 2019)

• Record Type: Journal Article
• 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
• Other Names: author non-byline.; Sauramba Virginia author non-byline.; Dandadzi Adlight author non-byline.; Kureva Chipo author non-byline.; Mushonga Johnson author non-byline.; Mpofu Eddington author non-byline.; Dune Washington author non-byline.; Chidhanguro Tafadzwa author non-byline.; Nkiwane Sibongile author non-byline.; Rukobo Sandra author non-byline.; Govha Margaret author non-byline.; Mashayanembwa Patience author non-byline.; Chidamba Leah author non-byline.; Chasekwa Bernard author non-byline.; Tome Joice author non-byline.; Makasi Rachel author non-byline.; Murenjekekwa Wellington author non-byline.; Chidawanyika Theodore author non-byline.; Tsenesa Blessing author non-byline.; Moyo Stephen author non-byline.; Nyamwino Penias author non-byline.; Simango Pururudzai author non-byline.; Seremwe Shepherd author non-byline.; And sarudzai kasaru Lovemore Chingaoma author non-byline.; Tembo Andreck author non-byline.; Mpundu Mary author non-byline.; Nyendwa Evelyn author non-byline.; Nayame Gwendolyn author non-byline.; Tembo Dalitso author non-byline.; Mwaba Sophreen author non-byline.; Chilala Esther author non-byline.; Macwani Lucy author non-byline.; Dumba Tenzeni author non-byline.; Chipunza Miyoba author non-byline.; Kazhila Lydia author non-byline.; Gondwe Temwaninge author non-byline.; Phiri Dennis author non-byline.; Mwanza Mpala author non-byline.; Zyambo Kanekwa author non-byline.;
• Is Part Of: BMJ open. Volume 9:Issue 1(2019)
• Publication Date: 2019-02-01
• Subjects: malnutrition -- HIV -- Africa -- mortality -- microbiota -- enteropathy; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2018-023077
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : 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.