Malnutrition

Malnutrition

Undernutrition underlies 45% of child mortality globally. Most of these deaths are from infections such as pneumonia and diarrhoea, but we have little information regarding the underlying mechanisms of susceptibility to infection.  Furthermore infection may itself alter nutrient intake, absorption, diversion, and expenditure, and thereby affect growth and nutrition.

Research themes include understanding the roles of infection, inflammation & immunity and testing novel intervention strategies. Clinical trials include new ways to use nutrients, antimicrobials and immunomodulatory agents aimed at reducing susceptibility to life-threatening infection (LINK: http://www.clinicaltrials.gov/ct2/show/NCT00934492  For children admitted to hospital with severe acute malnutrition, we are conducting trials of empiric antimicrobials, modified formulations of therapeutic feeds (LINKS: http://www.clinicaltrials.gov/ct2/show/NCT02246296 ; www.clinicaltrials.gov/ct2/show/NCT01593969 , studies identify the best way to treat malnutrition in early infancy, and observational studies of cardiac and metabolic dysfunction, and infections.  We also study mechanisms in the laboratory, currently with a focus on the effects of malnutrition on innate immune function and susceptibility to infections.

Malnutrition may result from infection and chronic immune activation rather than food insecurity alone. Environmental enteric dysfunction (EED) is emerging as a widespread and important cause of chronic inflammation in the developing world that contributes to this cycle (LINK Rosie Crane, Musa, Kelsey Jones). We are undertaking a birth cohort to characterise infectious exposures in relation to the onset of EED and have recently completed a novel trial of gut-specific anti-inflammatory treatment. Article: http://www.biomedcentral.com/1741-7015/12/133  and featured news item here: http://www.biomedcentral.com/biome/tackling-acute-childhood-malnutrition-needs-more-than-nutritional-rehab/ We were recently awarded a ‘Sustaining Health’ grant by the Wellcome Trust to undertaking a nationwide study together with UNICEF of the distribution and determinants of malnutrition using Bayesian geostatistical modelling methods developed for infectious diseases such as malaria (LINKS Jay, Noor). We are combining data from national surveys with remote sensing data, and targeted survey data from a wide range of ecological settings including an urban slums, rural arid land zones. http://www.wellcome.ac.uk/Funding/Sustaining-health/Funded-projects/WTS058409.htm

 

Investigators : Investigators: Jay Berkley, Kath Maitland, Martha Mwangome, Kelsey Jones