Two research papers published today identify mechanisms that contribute to the long-term impacts of malnutrition and HIV infection on children.
The two research papers published today in Nature Communications build on Queen Mary’s long-standing partnership with research institutes in Zambia and Zimbabwe, led by Paul Kelly, Professor of Tropical Gastroenterology, and Andrew Prendergast, Wellcome Trust Senior Clinical Fellow and Professor of Paediatric Infection and Immunology - both from the Blizard Institute.
Central to these research relationships is a major drive to understand childhood malnutrition, and to find ways to treat it effectively, including in the context of maternal HIV infection. Childhood malnutrition in Africa takes several forms including wasting, oedematous malnutrition, stunting (impaired linear growth) and micronutrient deficiencies. Children with malnutrition usually live in severely disadvantaged circumstances, including being born into families affected by HIV, and psychosocial and economic determinants are often prominent, but once established derangements of gut and many other organ systems become critical to survival and recovery.
The Tropical Gastroenterology and Nutrition Group (TROPGAN) in Lusaka and the Zvitambo Institute for Maternal and Child Health Research in Harare work towards untangling these complex co-morbidities and developing therapies to counter them, at the same time building research capacity in both countries.
The two papers are:
First new analysis in three decades identifies which treatments for the long-term effects of malnutrition could help reduce mortality and poor health outcomes for children
A comparison of treatments for malnutrition enteropathy, caused by severe acute malnutrition (SAM), has found evidence supporting the use of treatments to enhance the healing of mucosal membranes and reduce inflammation in the gut to improve the outcomes of children affected by long-team health consequences of a period of malnutrition.
The Therapeutic Approaches to Malnutrition Enteropathy (TAME), led by Professor Paul Kelly and funded by the Medical Research Council, evaluated four interventions for malnutrition enteropathy in a multi-centre phase II multi-arm trial in Zambia and Zimbabwe. No interventions for malnutrition enteropathy are currently available. The research gathered the first evidence in three decades which confirmed that treating malnutrition enteropathy can reduce intestinal damage amongst children experiencing the effects of complicated SAM.
Read the full paper on the Nature Communications website.
New study uncovers why boys born to mothers with HIV are at greater risk of health problems and death in infancy.
Researchers have found that children of women with HIV infection have an increased risk of immune abnormalities following exposure to maternal HIV viraemia, immune dysfunction, and co-infections during pregnancy.
The study, led by Dr Ceri Evans while at Queen Mary University of London, compared clinical outcomes between infants who were HIV-exposed and HIV-unexposed in the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial in rural Zimbabwe.
Analysis of blood samples from both mothers and children in the trial showed evidence of several biological pathways that contributed to the increased mortality seen in this cohort of infants. Systemic inflammation among women with HIV, as measured by C-reactive protein (CRP), was strongly associated with infant mortality, suggesting that interventions targeting maternal inflammation and its causes during pregnancy might reduce infant mortality. Researchers also found that the immune development of HIV-exposed babies – and especially boys – was different to those who had not been exposed to HIV, making it less effective in dealing with future infections.
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