In sub Saharan Africa, up to one-in-five children die in hospital, despite the best available treatment, and almost a similar die in the year after discharge. Acutely ill children, especially those that are undernourished, also have long-term effects on learning, growth and risk of heart disease as adults. While anthropometry is a strong marker of mortality risk, little is known about the biological mechanisms that link poor anthropometry including common clinical characteristics to the risk of death. Little is also known about mechanisms regulating childhood growth after acute illness. We are working to better understand the aetiology and mechanisms of disease due to pathogens and their interplay with severe malnutrition using molecular approaches such as proteomics and next generation sequencing. The main aim is to identify intervenable mechanisms and targets and also to develop better diagnostic and early prognostic tools that will aid in clinical management.