Publications by authors named "K Nathoo"
Severe acute malnutrition (SAM) is the most high-risk form of undernutrition, particularly when children require hospitalization for complications. Complicated SAM is a multisystem disease with high inpatient and postdischarge mortality, especially in children with comorbidities such as HIV; however, the underlying pathogenesis of complicated SAM is poorly understood. Targeted multiplex biomarker analysis in children hospitalized with SAM ( = 264) was conducted on plasma samples, and inflammatory markers were assessed on stool samples taken at recruitment, discharge, and 12 to 24 and 48 weeks after discharge from three hospitals in Zimbabwe and Zambia.
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- * Severe wasting in SAM patients negatively impacts cytokine secretion, and children with HIV exhibit even lower monocyte activation rates, particularly among younger children.
- * The altered immune function observed in SAM patients may prioritize bacterial containment over proinflammatory responses, leading to ongoing health risks and increased mortality after discharge.
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- Optimal antituberculosis therapy is crucial for achieving good health outcomes in patients.
- Research shows that infants with HIV receiving standard doses of first-line TB drugs have significantly lower peak plasma concentrations than adults.
- This suggests that increasing the dosage of these TB drugs in infants may be necessary for better treatment effectiveness.
Article Synopsis
- Malnutrition causes 45% of deaths in children under 5 annually, and this study focused on identifying risk factors for inpatient mortality among children hospitalized with severe acute malnutrition (SAM) in Zimbabwe/Zambia.
- An observational study of 745 children revealed that factors such as age, mid-upper arm circumference, presence of oedema, shock, sepsis, persistent diarrhoea, lack of sanitation, and the hospital site were independently associated with higher mortality rates.
- The findings suggest that children exhibiting high-risk features at the time of admission require increased medical attention and highlight the need for further research into the causes and treatments for SAM.
Article Synopsis
- Super-boosted lopinavir/ritonavir (LPV/r) dosing strategies vary among infants with HIV due to limited access to pediatric ritonavir formulations, impacting treatment effectiveness.
- A pharmacokinetic study involved infants aged 1-12 months in sub-Saharan Africa receiving LPV/r in conjunction with or without rifampicin-based TB treatment, assessing drug levels through blood samples.
- Results indicated that infants on rifampicin often had subtherapeutic LPV levels, highlighting the need for alternative antiretroviral options for those with co-infection, such as dolutegravir.