Gut function among children treated for severe acute malnutrition: A cohort study in Uganda

Area of Science:

• Pediatric Gastroenterology
• Nutritional Science
• Biomarker Research

Background:

• Severe acute malnutrition (SAM) in children is linked to impaired gut function and increased morbidity.
• Understanding gut health recovery during nutritional rehabilitation is crucial for improving outcomes in SAM patients.

Purpose of the Study:

• To evaluate changes in gut function biomarkers during nutritional rehabilitation for complicated severe acute malnutrition (SAM).
• To identify predictors of these gut function biomarker changes in SAM-affected children.

Main Methods:

• A cohort of 108 children (6-59 months) with complicated SAM were monitored during inpatient and outpatient therapeutic care.
• Key gut function biomarkers, including plasma citrulline and fecal markers of inflammation, were assessed at multiple time points.
• Biomarker levels were compared to healthy community reference children post-treatment.

Main Results:

• Plasma citrulline levels significantly increased during inpatient care, approaching normal values.
• Fecal markers indicated a decrease in myeloperoxidase but an increase in neopterin during inpatient treatment, with levels exceeding normal cut-offs.
• No significant differences in biomarkers were found between SAM children and controls after 8 weeks of outpatient care; probiotics showed no impact.

Conclusions:

• Inpatient nutritional rehabilitation can improve gut function in children with complicated SAM.
• Intestinal inflammation appears to be a persistent issue, remaining elevated even after 8 weeks of outpatient therapeutic care.
• Further interventions may be needed to fully resolve intestinal inflammation in children recovering from SAM.