Enteric function: An opportunity to promote survival among children recovering from hospitalization
BACKGROUND: Children being discharged from hospitals in low and middle income countries experience unacceptably high post-discharge mortality rates. Enteric dysfunction (ED) is characterized by malabsorption of nutrients and impaired enteric barrier function, and is likely to be a common condition among children recovering from acute illness. ED may be responsible for the increased morbidity and mortality experienced by children in the post-discharge period.
GAP: This study will establish the role of ED in post-discharge childhood mortality, identifying risk factors for poor enteric function, and the clinical utility of blood and stool ED biomarker among acutely unwell children.
HYPOTHESIS 1: Children with worse enteric function, as assessed by L:R, at hospital discharge will have a higher incidence of death or rehospitalization than those with better enteric function.
HYPOTHESIS 2: Potentially modifiable risk factors, including length of hospital stay, use of antibiotics, use of therapeutic foods and altered breastfeeding status will be associated with enteric function at hospital discharge.
METHODS: A prospective cohort of children being discharged from hospitals in Migori, Kenya and Karachi, Pakistan.
IMPACT: This study will inform large clinical trials of interventions aiming to improve enteric function at discharge and reduce post-discharge mortality.