Related Experiment Video
Updated: Nov 19, 2025
Effect of Hyaluronic Acid 35 kDa on an In Vitro Model of Preterm Small Intestinal Injury and Healing Using Enteroid-Derived Monolayers
Published on: July 28, 2022
Postdischarge interventions for children hospitalized with severe acute malnutrition: a systematic review and
Christie C A Noble1,2, Jonathan P Sturgeon1,2, Mutsa Bwakura-Dangarembizi2,3
1Blizard Institute, Queen Mary University of London, London, United Kingdom.
Insights
Post-discharge interventions for severe acute malnutrition (SAM) show promise. Psychosocial stimulation and synbiotics may reduce mortality in children recovering from SAM, warranting further research in large trials.
Area of Science:
- Pediatrics
- Nutritional Science
- Public Health
Background:
- Children with severe acute malnutrition (SAM) face poor long-term outcomes post-hospitalization, including mortality, morbidity, and neurodevelopmental impairment.
- Limited guidance exists for supporting children with SAM after inpatient treatment.
- Effective post-discharge strategies are crucial for improving long-term health in these vulnerable children.
Purpose of the Study:
- To systematically review and meta-analyze the effectiveness of post-discharge interventions in improving outcomes for children recovering from complicated SAM.
- To identify specific interventions that can mitigate mortality, morbidity, and neurodevelopmental deficits.
- To synthesize evidence for future clinical practice guidelines and research.
Main Methods:
- Systematic searches of four databases were conducted to identify relevant studies.
- Interventions delivered fully or partially after hospital discharge in children aged 6-59 months with SAM were included.
- Random-effects meta-analysis was performed on studies with similar interventions and outcomes, with mortality as the primary outcome.
Main Results:
- Ten studies involving 39-1781 participants across 7 countries (1975-2015) were analyzed.
- Pancreatic enzyme supplementation reduced inpatient mortality (37.8% vs. 18.6%, P < 0.05).
- Evidence suggests prebiotics/synbiotics may reduce mortality (RR: 0.72; 95% CI: 0.51, 1.00), and psychosocial stimulation significantly reduced mortality (RR: 0.36; 95% CI: 0.15, 0.87) and improved neurodevelopmental scores.
Conclusions:
- Several biological and psychosocial interventions demonstrate potential for improving outcomes in children post-SAM hospitalization.
- Further large-scale randomized controlled trials are needed to confirm the efficacy of promising interventions.
- Findings support the exploration of interventions like synbiotics and psychosocial stimulation for children recovering from SAM.
Background:
Children hospitalized with severe acute malnutrition (SAM) have poor long-term outcomes following discharge, with high rates of mortality, morbidity, and impaired neurodevelopment. There is currently minimal guidance on how to support children with SAM following discharge from inpatient treatment.
Objectives:
This systematic review and meta-analysis aimed to examine whether postdischarge interventions can improve outcomes in children recovering from complicated SAM.
Methods:
Systematic searches of 4 databases were undertaken to identify studies of interventions delivered completely or partially after hospital discharge in children aged 6-59 mo, following inpatient treatment of SAM. The main outcome of interest was mortality. Random-effects meta-analysis was undertaken where ≥2 studies were sufficiently similar in intervention and outcome.
Results:
Ten studies fulfilled the inclusion criteria, recruiting 39-1781 participants in 7 countries between 1975 and 2015. Studies evaluated provision of zinc (2 studies), probiotics or synbiotics (2 studies), antibiotics (1 study), pancreatic enzymes (1 study), and psychosocial stimulation (4 studies). Six studies had unclear or high risk of bias in ≥2 domains. Compared with standard care, pancreatic enzyme supplementation reduced inpatient mortality (37.8% compared with 18.6%, P < 0.05). In meta-analysis there was some evidence that prebiotics or synbiotics reduced mortality (RR: 0.72; 95% CI: 0.51, 1.00; P = 0.049). Psychosocial stimulation reduced mortality in meta-analysis of the 2 trials reporting deaths (RR: 0.36; 95% CI: 0.15, 0.87), and improved neurodevelopmental scores in ≥1 domain in all studies. There was no evidence that zinc reduced mortality in the single study reporting deaths. Antibiotics reduced infectious morbidity but did not reduce mortality.
Conclusions:
Several biological and psychosocial interventions show promise in improving outcomes in children following hospitalization for SAM and require further exploration in larger randomized mortality trials. This study was registered with PROSPERO as CRD42018111342 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=111342).
More Related Videos
03:35Determining Gender-Based Differences in Retinal and Choroidal Thickness in Underweight Individuals via Swept-Source Optical Coherence Tomography
Published on: December 1, 2023
05:04A Common Marmoset Model of Mother-Infant Intervention for Breastfeeding Disorders in the Presence of Paternal Inhibition and Maternal Neglect
Published on: September 22, 2023
Related Concept Videos
01:15Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
01:20Acute Kidney Injury V: Interprofessional Care
01:22Acute Kidney Injury VI: Nursing Management
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:28Acute Coronary Syndrome IV: Interprofessional Care