Researchers study long-term outcomes of severe childhood malnutrition

New findings from one of the few studies reporting the long-term health outcomes of children with severe malnutrition were published February 15, 2024 in The Lancet on child and adolescent health. The article is titled “Long-term outcomes after severe adolescent childhood malnutrition in Malawi (LOSCM): a prospective observational cohort study.”

This prospective cohort study followed a group of children in Malawi for 15 years after their hospital treatment for severe childhood malnutrition. The study compares the health outcomes of this group (currently adolescents and young adults) to those of their siblings and same-age peers from their communities who did not suffer from severe malnutrition as children. Researchers call for action to save lives in the short term and ensure the long-term health, development and well-being of children who have survived episodes of early malnutrition.

Very few other studies have been able to follow a vulnerable group like this over such a long period of time. While malnutrition is currently in the news in many countries and the subject is the subject of particular attention following the publication in July 2023 of the new World Health Organization (WHO) guidelines on malnutrition. malnutrition, the project is particularly timely and important.

The researchers, led by the University of Liverpool and working in partnership with a number of collaborators including the London School of Hygiene & Tropical Medicine, the Malawi-Liverpool Wellcome Trust Clinical Research Program and the University of Health Sciences from Kamuzu, Malawi, tracked and studied the health outcomes of 168 adolescents with a history of severe childhood malnutrition, alongside 123 siblings and 89 community adolescents with no history of severe malnutrition.

Results

Overall, the researchers summarized that a very high number of people with severe childhood malnutrition died in the years after leaving care, and that survivors had persistent negative effects such as lower height and possibly lower strength compared to those who had never suffered from severe malnutrition. However, survivors showed “catch-up” growth during childhood and beyond, providing hope for continued recovery from height deficits after treatment.

The researchers suggest that these findings highlight the importance of supporting the nutrition, health and well-being of people with severe childhood malnutrition after discharge from care, as well as the need to cope with adverse life circumstances while throughout early childhood and adolescence.

Dr Marko Kerac from the London School of Hygiene & Tropical Medicine said: “While we are pleased to see that the health and growth of our survivors of 2006-2007 childhood malnutrition appears to be catching up with that of their siblings and from their peers in the community, it is vital to see these results in context.

“More than 1,000 children were initially admitted to our severe malnutrition treatment program. Many died during the program and in the months and years that followed. It is therefore particularly tragic that the world has not progressed much since the food crisis 15 years ago. crises and conflicts, millions of children still suffer from hunger and malnutrition today.

“Urgent action is needed, not only to save lives in the short term, but also to ensure the long-term health, development and well-being of all survivors. The prevention and treatment of child malnutrition should never be considered as a cost but as an investment. for the future of individuals, societies and entire countries. »

Lead researcher Dr Amir Kirolos from the University of Liverpool and the Malawi-Liverpool-Wellcome Trust said: “Prevention, early identification and treatment of severe childhood malnutrition saves lives. Our study shows the importance of addressing other adverse factors alongside treatment of severe malnutrition. malnutrition. Poverty, hunger and living with HIV were common in our study and affected too many children and adolescents in Malawi and around the world.

“We need further research and investment to combat these adverse factors and all forms of child malnutrition. This will enable affected children not only to survive, but also to thrive and reach their full potential in the long term.

Next steps

Although this cohort did not find strong evidence of cognitive alterations or higher risk of cardiometabolic disease, the group is still young and the researchers recommend that further research in Malawi and other settings be needed to better understand long-term health risks as they develop later. adulthood.

Further research and investments to improve the living and living conditions of people facing adversity are needed to improve the long-term health outcomes of millions of children around the world who are currently malnourished.