The impact of rickets on growth and morbidity during recovery among children with complicated severe acute malnutrition in Kenya
A cohort study
Bibliographic Data
| ID | 15536210 |
|---|---|
| Authors | Moses M Ngari (0000-0001-7149-5491, Kenya Medical Research Institute, corresponding author), Johnstone Thitiri (0000-0002-5901-6651, Kenya Medical Research Institute), Laura Mwalekwa (0000-0001-8207-4967, Kenya Medical Research Institute), Molline Timbwa (0000-0002-1747-7943, Kenya Medical Research Institute), Per Ole Iversen (0000-0003-2977-9153), Greg Fegan (0000-0002-2663-2765, Kenya Medical Research Institute), James A Berkley (0000-0002-1236-849X, Kenya Medical Research Institute) |
| Year | 2017 |
| Volume | 14 |
| Issue | 2 |
| Pages | e12569-e12569 |
| Publication date | 2017-11-27 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Maternal and Child Nutrition (JOURNAL) |
| Journal identifiers | ISSN: 1740-8695 • E-ISSN: 1740-8709 |
| Publisher | Wiley (PUBLISHER • GB) |
| DOI | 10.1111/mcn.12569 |
| PMID | 29178404 |
| OpenAlex | W2770069268 |
| Language | EN |
| Citations received | 3 |
| References cited | 2 |
The effects of rickets on children recovery from severe acute malnutrition (SAM) are unknown. Rickets may affect both growth and susceptibility to infectious diseases. We investigated the associations of clinically diagnosed rickets with life-threatening events and anthropometric recovery during 1 year following inpatient treatment for complicated SAM. This was a secondary analysis of clinical trial data among non-human immunodeficiency virus-infected Kenyan children with complicated SAM (2-59 months) followed for 1 year posthospital discharge (ClinicalTrials.gov ID NCT00934492). The outcomes were mortality, hospital readmissions, and growth during 12 months. The main exposure was clinically diagnosed rickets at baseline. Of 1,778 children recruited, 230 (12.9%, 95% CI [11.4, 14 .6]) had clinical signs of rickets at baseline. Enrolment at an urban site, height-for-age and head circumference-for-age z scores were associated with rickets. Rickets at study enrolment was associated with increased mortality (adjusted Hazard Ratio [aHR] 1.61, 95% CI [1.14, 2.27]), any readmission (aHR 1.37, 95% CI [1.09, 1.72]), readmission for severe pneumonia (aHR 1.37, 95% CI [1.05, 1.79]), but not readmission with diarrhoea (aHR 1.05, 95% CI [0.73, 1.51]). Rickets was associated with increased height gain (centimetres), adjusted regression coefficient 0.19 (95% CI [0.10, 0.28]), but not changes in head circumference, mid-upper arm circumference, or weight. Rickets was common among children with SAM at urban sites and associated with increased risks of severe pneumonia and death. Increased height gain may have resulted from vitamin D and calcium treatment. Future work should explore possibility of other concurrent micronutrient deficiencies and optimal treatment of rickets in this high-risk population
Anthropometry · Cohort · Cohort study · Confidence interval · Hazard ratio · Malnutrition · Pneumonia · Rickets · Vitamin D and neurology · Child Nutrition and Feeding Issues · Child Nutrition and Water Access · Medicine · Poverty, Education, and Child Welfare · Internal Medicine · Pediatrics
| Unique citing works | 3 |
|---|---|
| Citations per year | 0,33 |
| Citation span | 2017 - 2021 (5) |
| Citation velocity | historical |
| Highly cited | No |
| Citation types | Neutral: 3 |