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Enteric permeability, systemic inflammation and post-discharge growth among a cohort of hospitalized children in Kenya and Pakistan.

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dc.contributor.author Tickell, KD
dc.contributor.author Denno, DM
dc.contributor.author Saleem, A
dc.contributor.author Ali, A
dc.contributor.author Kazi, Z
dc.contributor.author Singa, BO
dc.contributor.author Otieno, C
dc.contributor.author Mutinda, C
dc.contributor.author Ochuodho, V
dc.contributor.author Richardson, BA
dc.contributor.author Ásbjörnsdóttir, KH
dc.contributor.author Hawes, SE
dc.contributor.author Berkley, JA
dc.contributor.author Walson, JL
dc.date.accessioned 2023-01-21T01:06:26Z
dc.date.available 2023-01-21T01:06:26Z
dc.date.issued 2022-09-20
dc.identifier.citation Tickell , KD , Denno , DM , Saleem , A , Ali , A , Kazi , Z , Singa , BO , Otieno , C , Mutinda , C , Ochuodho , V , Richardson , BA , Ásbjörnsdóttir , KH , Hawes , SE , Berkley , JA & Walson , JL 2022 , ' Enteric permeability, systemic inflammation and post-discharge growth among a cohort of hospitalized children in Kenya and Pakistan. ' , Journal of Pediatric Gastroenterology and Nutrition , vol. 75 , no. 6 , pp. 768-774 . https://doi.org/10.1097/mpg.0000000000003619
dc.identifier.issn 0277-2116
dc.identifier.other 72655639
dc.identifier.other 4d1fe237-a187-487b-b44d-ff3c843ef250
dc.identifier.other ORCID: /0000-0002-3263-3457/work/119418480
dc.identifier.other 36123771
dc.identifier.other unpaywall: 10.1097/mpg.0000000000003619
dc.identifier.other 85142403120
dc.identifier.uri https://hdl.handle.net/20.500.11815/3871
dc.description Funding Information: Sources of Funding: The CHAIN Network is supported by the Bill & Melinda Gates Foundation [OPP1131320]. For the purpose of Open Access, the authors have applied a CC-BY public copyright license to any author accepted manuscript version arising from this submission. The lactulose-rhamnose testing was funded by an Early Career Award from the Thrasher Research Foundation. The funders had no role in conduct of the study, interpretation, writing the manuscript or decision to submit. No authors were paid to write this article by any company, organization or agency. Publisher Copyright: © 2022 Lippincott Williams and Wilkins. All rights reserved.
dc.description.abstract Objectives: To determine whether gut permeability is associated with post-discharge growth and systemic inflammation among hospitalized children in low- and middle-income countries. Methods: Children aged 2-23 months being discharged from Civil Hospital Karachi (Pakistan) and Migori County Referral Hospital (Kenya) underwent lactulose-rhamnose ratio (LRR) permeability testing and were compared to age-matched children from their home communities. Linear mixed effect models estimated the associations between LRR among discharged children with change in length-for-age (LAZ) and weight-for-age z score (WAZ) at 45, 90, and 180 days after discharge. Linear regression tested if relationships between LRR, systemic inflammation [C-reative protein (CRP), Cluster of Differentiation 14 (CD14), Tumour Necrosis Factor Alpha (TNFα), Interleukin-6 (IL-6)], and enterocyte damage [Intestinal Fatty-Acid Binding protein (I-FABP)] differed between the hospitalized and community groups. Results: One hundred thirty-seven hospitalized and 84 community participants were included. The hospitalized group had higher log-LRR [0.43, 95% confidence interval (CI): 0.15-0.71, P = 0.003] than the community children. Adjustment for weight-for-length z score at discharge attenuated this association (0.31, 95% CI: 0.00-0.62, P = 0.049). LRR was not associated with changes in WAZ or LAZ in the post-discharge period. Associations between LRR and CRP (interaction P = 0.036), TNFα (P = 0.017), CD14 (P = 0.078), and IL-6 (P = 0.243) differed between community and hospitalized groups. LRR was associated with TNFα (P = 0.004) and approached significance with CD14 (P = 0.078) and IL-6 (P = 0.062) in community children, but there was no evidence of these associations among hospitalized children. Conclusions: Although increased enteric permeability is more prevalent among children being discharged from hospital compared to children in the community, it does not appear to be an important determinant of systemic inflammation or post-discharge growth among hospitalized children.
dc.format.extent 7
dc.format.extent 435113
dc.format.extent 435113
dc.format.extent 768-774
dc.language.iso en
dc.relation.ispartofseries Journal of Pediatric Gastroenterology and Nutrition; 75(6)
dc.rights info:eu-repo/semantics/openAccess
dc.subject childhood growth
dc.subject environmental enteric function
dc.subject systemic inflammation
dc.subject Pediatrics, Perinatology and Child Health
dc.subject Gastroenterology
dc.title Enteric permeability, systemic inflammation and post-discharge growth among a cohort of hospitalized children in Kenya and Pakistan.
dc.type /dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article
dc.description.version Peer reviewed
dc.identifier.doi 10.1097/mpg.0000000000003619
dc.relation.url http://europepmc.org/abstract/med/36123771
dc.relation.url http://www.scopus.com/inward/record.url?scp=85142403120&partnerID=8YFLogxK
dc.contributor.department Faculty of Physical Sciences
dc.contributor.department Faculty of Medicine

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