1. SITES & COORDINATING CENTRES
CHAIN
The Childhood Acute Illness & Nutrition Network
INTRODUCTION
SITES & COORDINATING CENTRES
COHORT DESIGN
Children admitted to hospital with undernutrition are at high risk of mortality as inpatients and after discharge despite current practice.
We need to better understand biomedical and social risks and barriers in order to develop better interventions for the most vulnerable children.
Admitted with acute illness (500 per site)
Spectrum of nutritional status (SAM, MAM, well-nourished)
1 to 23 months old
Follow up 6 months
Community controls
Young age
Acute illness (hospitalization)
Low anthropometry
Target population
Admission
Day 45
Day 90
Day 180
Day 5
Day 2
Household
Survey
Daily Review
2nd
DISCHARGE
POST-DISCHARGE FOLLOW –UP
ADMISSION
OBSERVATION & SAMPLE COLLECTION
Follow up
Discharge
1st
3rd
4th
5th
6th
7th
FOCUS AREAS
AIMS
Sub-Studies
Understand and reduce mortality risks associated with undernutrition:
In hospital
After discharge
Identify agency & vulnerability
Biomedical & Social factors
Ethical conduct of research in vulnerable groups
Design and conduct more effective trials
Social Science: Qualitative – rural/urban in Kenya/Bangladesh
Immunology – ability to respond in vitro to pathogen challenge
TB - enhanced screening, burden and mortality
Enteric function: inflammation & permeability
Microbiology: pathogens and antimicrobial resistance
Body composition: health growth & recovery
PARTNERS
CORE ACTIVITIES
Harmonized international prospective cohort of acutely-ill children across a spectrum of nutritional status
Demographic, clinical, laboratory and social phenotyping
Leverage existing clinical data and samples for comparative or pooled analyses
Identify potential interventional trial priorities