Childhood Acute Illness and Nutrition (CHAIN) Network: A protocol for a multi-site prospective cohort study to identify modifiable risk factors for mortality among acutely ill children in Africa and Asia

J. A. Berkley, J. L. Walson, A. H. Diallo, J. Ki-Zerbo, A. S. M. S. B. Shahid, A. Gwela, A. Saleem, A. Asad, C. C. Tigoi, C. Bourdon, C. L. Lancioni, D. M. Denno, D. I. Mangale, E. Mupere, K. D. Tickell, M. K. Mwangome, M. J. Chisti, M. M. Ngari, N. M. Ngao, P. Sukhtankar & 5 others R. H. J. Bandsma, S. Molyneux, T. Ahmed, W. Voskuijl, The Childhood Acute Illness and Nutrition Network

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Introduction Children admitted to hospitals in resource-poor settings remain at risk of both inpatient and post-discharge mortality. While known risk factors such as young age and nutritional status can identify children at risk, they do not provide clear mechanistic targets for intervention. The Childhood Acute Illness and Nutrition (CHAIN) cohort study aims to characterise the biomedical and social risk factors for mortality in acutely ill children in hospitals and after discharge to identify targeted interventions to reduce mortality. Methods and analysis The CHAIN network is currently undertaking a multi-site, prospective, observational cohort study, enrolling children aged 1 week to 2 years at admission to hospitals at nine sites located in four African and two South Asian countries. The CHAIN Network supports the sites to provide care according to national and international guidelines. Enrolment is stratified by anthropometric status and children are followed throughout hospitalisation and for 6 months after discharge. Detailed clinical, demographic, anthropometric, laboratory and social exposures are assessed. Scheduled visits are conducted at 45, 90 and 180 days after discharge. Blood, stool and rectal swabs are collected at enrolment, hospital discharge and follow-up. The primary outcome is inpatient or post-discharge death. Secondary outcomes include readmission to hospital and nutritional status after discharge. Cohort analysis will identify modifiable risks, children with distinct phenotypes, relationships between factors and mechanisms underlying poor outcomes that may be targets for intervention. A nested case-control study examining infectious, immunological, metabolic, nutritional and other biological factors will be undertaken. Ethics and dissemination This study protocol was reviewed and approved primarily by the Oxford Tropical Research Ethics Committee, and the institutional review boards of all partner sites. The study is being externally monitored. Results will be published in open access peer-reviewed scientific journals and presented to academic and policy stakeholders.
Original languageEnglish
Article numbere028454
JournalBMJ Open
Volume9
Issue number5
DOIs
Publication statusPublished - 2019
Externally publishedYes

Cite this

Berkley, J. A., Walson, J. L., Diallo, A. H., Ki-Zerbo, J., Shahid, A. S. M. S. B., Gwela, A., ... The Childhood Acute Illness and Nutrition Network (2019). Childhood Acute Illness and Nutrition (CHAIN) Network: A protocol for a multi-site prospective cohort study to identify modifiable risk factors for mortality among acutely ill children in Africa and Asia. BMJ Open, 9(5), [e028454]. https://doi.org/10.1136/bmjopen-2018-028454
Berkley, J. A. ; Walson, J. L. ; Diallo, A. H. ; Ki-Zerbo, J. ; Shahid, A. S. M. S. B. ; Gwela, A. ; Saleem, A. ; Asad, A. ; Tigoi, C. C. ; Bourdon, C. ; Lancioni, C. L. ; Denno, D. M. ; Mangale, D. I. ; Mupere, E. ; Tickell, K. D. ; Mwangome, M. K. ; Chisti, M. J. ; Ngari, M. M. ; Ngao, N. M. ; Sukhtankar, P. ; Bandsma, R. H. J. ; Molyneux, S. ; Ahmed, T. ; Voskuijl, W. ; The Childhood Acute Illness and Nutrition Network. / Childhood Acute Illness and Nutrition (CHAIN) Network: A protocol for a multi-site prospective cohort study to identify modifiable risk factors for mortality among acutely ill children in Africa and Asia. In: BMJ Open. 2019 ; Vol. 9, No. 5.
@article{93441914f7494273b513a2c8812229d6,
title = "Childhood Acute Illness and Nutrition (CHAIN) Network: A protocol for a multi-site prospective cohort study to identify modifiable risk factors for mortality among acutely ill children in Africa and Asia",
abstract = "Introduction Children admitted to hospitals in resource-poor settings remain at risk of both inpatient and post-discharge mortality. While known risk factors such as young age and nutritional status can identify children at risk, they do not provide clear mechanistic targets for intervention. The Childhood Acute Illness and Nutrition (CHAIN) cohort study aims to characterise the biomedical and social risk factors for mortality in acutely ill children in hospitals and after discharge to identify targeted interventions to reduce mortality. Methods and analysis The CHAIN network is currently undertaking a multi-site, prospective, observational cohort study, enrolling children aged 1 week to 2 years at admission to hospitals at nine sites located in four African and two South Asian countries. The CHAIN Network supports the sites to provide care according to national and international guidelines. Enrolment is stratified by anthropometric status and children are followed throughout hospitalisation and for 6 months after discharge. Detailed clinical, demographic, anthropometric, laboratory and social exposures are assessed. Scheduled visits are conducted at 45, 90 and 180 days after discharge. Blood, stool and rectal swabs are collected at enrolment, hospital discharge and follow-up. The primary outcome is inpatient or post-discharge death. Secondary outcomes include readmission to hospital and nutritional status after discharge. Cohort analysis will identify modifiable risks, children with distinct phenotypes, relationships between factors and mechanisms underlying poor outcomes that may be targets for intervention. A nested case-control study examining infectious, immunological, metabolic, nutritional and other biological factors will be undertaken. Ethics and dissemination This study protocol was reviewed and approved primarily by the Oxford Tropical Research Ethics Committee, and the institutional review boards of all partner sites. The study is being externally monitored. Results will be published in open access peer-reviewed scientific journals and presented to academic and policy stakeholders.",
author = "Berkley, {J. A.} and Walson, {J. L.} and Diallo, {A. H.} and J. Ki-Zerbo and Shahid, {A. S. M. S. B.} and A. Gwela and A. Saleem and A. Asad and Tigoi, {C. C.} and C. Bourdon and Lancioni, {C. L.} and Denno, {D. M.} and Mangale, {D. I.} and E. Mupere and Tickell, {K. D.} and Mwangome, {M. K.} and Chisti, {M. J.} and Ngari, {M. M.} and Ngao, {N. M.} and P. Sukhtankar and Bandsma, {R. H. J.} and S. Molyneux and T. Ahmed and W. Voskuijl and {The Childhood Acute Illness and Nutrition Network} and Berkley, {J. A.} and Walson, {J. L.} and Diallo, {A. H.} and Asmsb Shahid and A. Gwela and A. Saleem and A. Asad and Tigoi, {C. C.} and C. Bourdon and Lancioni, {C. L.} and Denno, {D. M.} and Mangale, {D. I.} and E. Mupere and Tickell, {K. D.} and Mwangome, {M. K.} and Chisti, {M. J.} and Ngari, {M. M.} and Ngao, {N. M.} and P. Sukhtankar and Rhj Bandsma and S. Molyneux and T. Ahmed and W. Voskuijl",
year = "2019",
doi = "10.1136/bmjopen-2018-028454",
language = "English",
volume = "9",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "5",

}

Berkley, JA, Walson, JL, Diallo, AH, Ki-Zerbo, J, Shahid, ASMSB, Gwela, A, Saleem, A, Asad, A, Tigoi, CC, Bourdon, C, Lancioni, CL, Denno, DM, Mangale, DI, Mupere, E, Tickell, KD, Mwangome, MK, Chisti, MJ, Ngari, MM, Ngao, NM, Sukhtankar, P, Bandsma, RHJ, Molyneux, S, Ahmed, T, Voskuijl, W & The Childhood Acute Illness and Nutrition Network 2019, 'Childhood Acute Illness and Nutrition (CHAIN) Network: A protocol for a multi-site prospective cohort study to identify modifiable risk factors for mortality among acutely ill children in Africa and Asia' BMJ Open, vol. 9, no. 5, e028454. https://doi.org/10.1136/bmjopen-2018-028454

Childhood Acute Illness and Nutrition (CHAIN) Network: A protocol for a multi-site prospective cohort study to identify modifiable risk factors for mortality among acutely ill children in Africa and Asia. / Berkley, J. A.; Walson, J. L.; Diallo, A. H.; Ki-Zerbo, J.; Shahid, A. S. M. S. B.; Gwela, A.; Saleem, A.; Asad, A.; Tigoi, C. C.; Bourdon, C.; Lancioni, C. L.; Denno, D. M.; Mangale, D. I.; Mupere, E.; Tickell, K. D.; Mwangome, M. K.; Chisti, M. J.; Ngari, M. M.; Ngao, N. M.; Sukhtankar, P.; Bandsma, R. H. J.; Molyneux, S.; Ahmed, T.; Voskuijl, W.; The Childhood Acute Illness and Nutrition Network.

In: BMJ Open, Vol. 9, No. 5, e028454, 2019.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Childhood Acute Illness and Nutrition (CHAIN) Network: A protocol for a multi-site prospective cohort study to identify modifiable risk factors for mortality among acutely ill children in Africa and Asia

AU - Berkley, J. A.

AU - Walson, J. L.

AU - Diallo, A. H.

AU - Ki-Zerbo, J.

AU - Shahid, A. S. M. S. B.

AU - Gwela, A.

AU - Saleem, A.

AU - Asad, A.

AU - Tigoi, C. C.

AU - Bourdon, C.

AU - Lancioni, C. L.

AU - Denno, D. M.

AU - Mangale, D. I.

AU - Mupere, E.

AU - Tickell, K. D.

AU - Mwangome, M. K.

AU - Chisti, M. J.

AU - Ngari, M. M.

AU - Ngao, N. M.

AU - Sukhtankar, P.

AU - Bandsma, R. H. J.

AU - Molyneux, S.

AU - Ahmed, T.

AU - Voskuijl, W.

AU - The Childhood Acute Illness and Nutrition Network

AU - Berkley, J. A.

AU - Walson, J. L.

AU - Diallo, A. H.

AU - Shahid, Asmsb

AU - Gwela, A.

AU - Saleem, A.

AU - Asad, A.

AU - Tigoi, C. C.

AU - Bourdon, C.

AU - Lancioni, C. L.

AU - Denno, D. M.

AU - Mangale, D. I.

AU - Mupere, E.

AU - Tickell, K. D.

AU - Mwangome, M. K.

AU - Chisti, M. J.

AU - Ngari, M. M.

AU - Ngao, N. M.

AU - Sukhtankar, P.

AU - Bandsma, Rhj

AU - Molyneux, S.

AU - Ahmed, T.

AU - Voskuijl, W.

PY - 2019

Y1 - 2019

N2 - Introduction Children admitted to hospitals in resource-poor settings remain at risk of both inpatient and post-discharge mortality. While known risk factors such as young age and nutritional status can identify children at risk, they do not provide clear mechanistic targets for intervention. The Childhood Acute Illness and Nutrition (CHAIN) cohort study aims to characterise the biomedical and social risk factors for mortality in acutely ill children in hospitals and after discharge to identify targeted interventions to reduce mortality. Methods and analysis The CHAIN network is currently undertaking a multi-site, prospective, observational cohort study, enrolling children aged 1 week to 2 years at admission to hospitals at nine sites located in four African and two South Asian countries. The CHAIN Network supports the sites to provide care according to national and international guidelines. Enrolment is stratified by anthropometric status and children are followed throughout hospitalisation and for 6 months after discharge. Detailed clinical, demographic, anthropometric, laboratory and social exposures are assessed. Scheduled visits are conducted at 45, 90 and 180 days after discharge. Blood, stool and rectal swabs are collected at enrolment, hospital discharge and follow-up. The primary outcome is inpatient or post-discharge death. Secondary outcomes include readmission to hospital and nutritional status after discharge. Cohort analysis will identify modifiable risks, children with distinct phenotypes, relationships between factors and mechanisms underlying poor outcomes that may be targets for intervention. A nested case-control study examining infectious, immunological, metabolic, nutritional and other biological factors will be undertaken. Ethics and dissemination This study protocol was reviewed and approved primarily by the Oxford Tropical Research Ethics Committee, and the institutional review boards of all partner sites. The study is being externally monitored. Results will be published in open access peer-reviewed scientific journals and presented to academic and policy stakeholders.

AB - Introduction Children admitted to hospitals in resource-poor settings remain at risk of both inpatient and post-discharge mortality. While known risk factors such as young age and nutritional status can identify children at risk, they do not provide clear mechanistic targets for intervention. The Childhood Acute Illness and Nutrition (CHAIN) cohort study aims to characterise the biomedical and social risk factors for mortality in acutely ill children in hospitals and after discharge to identify targeted interventions to reduce mortality. Methods and analysis The CHAIN network is currently undertaking a multi-site, prospective, observational cohort study, enrolling children aged 1 week to 2 years at admission to hospitals at nine sites located in four African and two South Asian countries. The CHAIN Network supports the sites to provide care according to national and international guidelines. Enrolment is stratified by anthropometric status and children are followed throughout hospitalisation and for 6 months after discharge. Detailed clinical, demographic, anthropometric, laboratory and social exposures are assessed. Scheduled visits are conducted at 45, 90 and 180 days after discharge. Blood, stool and rectal swabs are collected at enrolment, hospital discharge and follow-up. The primary outcome is inpatient or post-discharge death. Secondary outcomes include readmission to hospital and nutritional status after discharge. Cohort analysis will identify modifiable risks, children with distinct phenotypes, relationships between factors and mechanisms underlying poor outcomes that may be targets for intervention. A nested case-control study examining infectious, immunological, metabolic, nutritional and other biological factors will be undertaken. Ethics and dissemination This study protocol was reviewed and approved primarily by the Oxford Tropical Research Ethics Committee, and the institutional review boards of all partner sites. The study is being externally monitored. Results will be published in open access peer-reviewed scientific journals and presented to academic and policy stakeholders.

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85065441969&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/31061058

U2 - 10.1136/bmjopen-2018-028454

DO - 10.1136/bmjopen-2018-028454

M3 - Article

VL - 9

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 5

M1 - e028454

ER -