Inflammation impairs post-hospital discharge growth among children hospitalised with acute illness in sub-Saharan Africa and south Asia

In resource-limited settings, children often experience poor growth following illness, but the mechanisms are poorly understood. This cohort study in six countries in sub-Saharan Africa and south Asia investigates pathways linking inflammation and post-discharge weight gain among children hospitalised with acute illness. We determine associations between inflammation, enteropathy, growth mediators and other exposures at hospital discharge and weight gain during 90 days and explain how these exposures influence growth. Here, we show that systemic inflammation impacts mediators of linear growth including the Growth hormone/Insulin-like growth factor 1 axis and bone metabolism to a larger extent and weight gain via enteroendocrine peptide YY and glucagon pathways to a lesser extent. Systemic inflammation negatively affects weight gain directly. Enteropathy impacts growth through systemic inflammation. Adverse household and chronic medical conditions predominantly influence weight gain through inflammation. It is critical to address inflammation, the intestinal mucosal barrier and other exposures driving inflammation to optimise recovery.

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Publication Details

Journal
Nature Communications
Published
2025-11-28
DOI
https://doi.org/10.1038/s41467-025-66245-2
Primary Topic
Child Nutrition and Water Access
Type
article
Field-Weighted Citation Impact
0.00

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article

Inflammation impairs post-hospital discharge growth among children hospitalised with acute illness in sub-Saharan Africa and south Asia

Johnstone Thitiri, Charles Sande, Elisha Omer, Céline Bourdon et al.
Nature Communications
Child Nutrition and Water Access
article

Inflammation impairs post-hospital discharge growth among children hospitalised with acute illness in sub-Saharan Africa and south Asia

Johnstone Thitiri, Charles Sande, Elisha Omer, Céline Bourdon, Robert Musyimi, Abu Sadat Mohammad Sayeem Bin Shahid, Robert Bandsma, Christina Lancioni, Molline Timbwa, James Alexander Berkley, Roseline Maïmouna Bamouni, Caroline Tigoi, Judd L. Walson, Jasper Bogaert, James M. Njunge, Agnes Gwela, Benedict Orindi, Wieger P. Voskuijl, Ezekiel Mupere, Abdoulaye Hama Diallo, Emmie Mbale, Holm H. Uhlig, Moses M. Ngari, Narshion Ngao, Kirkby D. Tickell, Asad Ali, Shalton Mwaringa, Ali Faisal Saleem, Donna M. Denno, Tahmeed Ahmed, Benson O. Singa, Gerard Bryan Gonzales, Mohammod Jobayer Chisti, Evans O. Mudibo, Wilson Gumbi
article en

Abstract

In resource-limited settings, children often experience poor growth following illness, but the mechanisms are poorly understood. This cohort study in six countries in sub-Saharan Africa and south Asia investigates pathways linking inflammation and post-discharge weight gain among children hospitalised with acute illness. We determine associations between inflammation, enteropathy, growth mediators and other exposures at hospital discharge and weight gain during 90 days and explain how these exposures influence growth. Here, we show that systemic inflammation impacts mediators of linear growth including the Growth hormone/Insulin-like growth factor 1 axis and bone metabolism to a larger extent and weight gain via enteroendocrine peptide YY and glucagon pathways to a lesser extent. Systemic inflammation negatively affects weight gain directly. Enteropathy impacts growth through systemic inflammation. Adverse household and chronic medical conditions predominantly influence weight gain through inflammation. It is critical to address inflammation, the intestinal mucosal barrier and other exposures driving inflammation to optimise recovery.

Nature CommunicationsVol. 16(1)
Université Joseph Ki-Zerbo (BF), Centre for Human Genetics (GB), Johns Hopkins University (US), University of Malawi (MW), Oregon Health & Science University (US), University of Washington (US), International Centre for Diarrhoeal Disease Research (BD), Johns Hopkins Medicine (US), Kamuzu Central Hospital (MW), Hospital for Sick Children (CA), John Radcliffe Hospital (GB), Aga Khan University Hospital (PK), Kenya Medical Research Institute (KE), Ghent University (BE), University of Oxford (GB), Amsterdam Institute for Global Health and Development (NL), Oxford BioMedica (United Kingdom) (GB), The Childhood Acute Illness and Nutrition Network (KE), Amsterdam University Medical Centers (NL), Kamuzu University of Health Sciences (MW), Makerere University (UG), Wellcome Trust (GB), University of Amsterdam (NL), Wageningen University & Research (NL)
Bill and Melinda Gates Foundation, Wellcome, University of Washington, Johns Hopkins University, Wellcome Trust, Amsterdam University Medical Centers, University of Oxford, Universiteit van Amsterdam, Universiteit Gent, Hospital for Sick Children, International Centre for Diarrhoeal Disease Research, Bangladesh, Wageningen University and Research, Faculty of Medicine and Health, University of Sydney
Openalex Percentile: Top 56%
Child Nutrition and Water Access
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