Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

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 (CRP, CD14, TNFα, IL-6) and enterocyte damage (I-FABP) differed between the hospitalized and community groups. RESULTS: 137 hospitalized and 84 community participants were included. The hospitalized group had higher log-LRR (0.43, 95%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.

Original publication

DOI

10.1097/MPG.0000000000003619

Type

Journal article

Journal

J Pediatr Gastroenterol Nutr

Publication Date

20/09/2022