Inflammation impairs post-hospital discharge growth among children hospitalised with acute illness in sub-Saharan Africa and south Asia
Abstract
Abstract In resource-limited settings, children often experience poor growth following illness, but the mechanisms are poorly understood. This cohort study in six countries in sub-Saharan Africa and south Asia investigates pathways linking inflammation and post-discharge weight gain among children hospitalised with acute illness. We determine associations between inflammation, enteropathy, growth mediators and other exposures at hospital discharge and weight gain during 90 days and explain how these exposures influence growth. Here, we show that systemic inflammation impacts mediators of linear growth including the Growth hormone/Insulin-like growth factor 1 axis and bone metabolism to a larger extent and weight gain via enteroendocrine peptide YY and glucagon pathways to a lesser extent. Systemic inflammation negatively affects weight gain directly. Enteropathy impacts growth through systemic inflammation. Adverse household and chronic medical conditions predominantly influence weight gain through inflammation. It is critical to address inflammation, the intestinal mucosal barrier and other exposures driving inflammation to optimise recovery.
Article Details
Authors (35)
James M. Njunge
Evans O. Mudibo
Jasper Bogaert
Benedict Orindi
Charles J. Sande
Celine Bourdon
Caroline Tigoi
Moses M. Ngari
Narshion Ngao
Elisha Omer
Wilson Gumbi
Robert Musyimi
Molline Timbwa
Shalton Mwaringa
Agnes Gwela
Johnstone Thitiri
Ezekiel Mupere
Christina L. Lancioni
Gerard Bryan Gonzales
Benson O. Singa
Emmie Mbale
Wieger P. Voskuijl
Donna M. Denno
Abdoulaye Hama Diallo
Roseline Maϊmouna Bamouni
Mohammod Jobayer Chisti
Abu Sadat Mohammad Sayeem Bin Shahid
Tahmeed Ahmed
Ali Faisal Saleem
Syed Asad Ali
Holm H. Uhlig
Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
Kirkby D. Tickell
Robert H. J. Bandsma
Judd L. Walson
James A. Berkley
KEMRI–Wellcome Trust Research Programme, Center for Graphic Medicine Research, Kilifi, Kenya