News / Health

Antibiotics Help Fight Severe Malnutrition

A starving child is covered with flies at the pediatric malnutrition ward at the Lilongwe Central Hospital, Malawi. (file photo)A starving child is covered with flies at the pediatric malnutrition ward at the Lilongwe Central Hospital, Malawi. (file photo)
x
A starving child is covered with flies at the pediatric malnutrition ward at the Lilongwe Central Hospital, Malawi. (file photo)
A starving child is covered with flies at the pediatric malnutrition ward at the Lilongwe Central Hospital, Malawi. (file photo)
Severely malnourished children are more likely to survive if they receive antibiotics in addition to therapeutic feeding, according to a new study.

In the study published in the New England Journal of Medicine, a week’s worth of common antibiotics reduced the death rate among severely malnourished children by 35 percent or more.

About 20 million children worldwide are severely malnourished, and malnutrition is a factor in the death of about 1 million every year. So the results are a big deal, says lead author Indi Trehan, a pediatrician at Washington University.

“If you can cut the death rate by 35 percent for any disease, that’s a huge finding," said Trehan. "And if you can do it with a $3 antibiotic, that’s an even bigger finding. And if you can do it with a $3 antibiotic and a disease that kills a million kids a year, 35 percent less deaths - that’s why we’re having this conversation today.”

Malnutrition stunts a child’s physical and mental development. It also affects their defense against diseases of all kinds, from pneumonia to malaria to measles. Trehan says that can be the difference between life and death.

“You can easily go into a village in the middle of a measles outbreak and hand-pick which ones are going to die," he said. "You can tell what’s going to happen based on how scrawny they are.”

Until a few years ago, those scrawny kids would have needed to be hospitalized to treat their malnutrition. And still, as many as half of them would die.

But with advances in ready-to-use therapeutic foods like Plumpy’Nut, a nutrient-fortified paste of peanuts and milk powder, these kids can be sent home and 85 to 90 percent of them recover fully. It’s a huge advance, Trehan says.

“But if 10 or 15 percent still don’t recover, and if 5 or 10 percent die, in a disease that hits 20 million kids a year, that 5 or 10 percent is still an outrageously large number that we can’t be happy with," said Trehan.

The Washington University pediatrician and his colleagues wondered if they could cut the number of deaths by sending malnourished kids home with antibiotics as well as nutrient-fortified therapeutic food.

Public health authorities have recommended antibiotic treatment for malnutrition for several years. But there has been no solid medical evidence for its benefits. And indiscriminate use of antibiotics carries a risk of side effects, including antibiotic resistance. Plus, there’s the added cost. So Indi Trehan’s group in Malawi had not prescribed them before.

But he says the new results quickly changed their minds.

“We were extremely shocked," he said. "I remember the night when we started looking at the data, and I had to call up the lead investigator, Mark Manary, and I said, ‘Can you believe this? This is actually happening.’”

“We were suspecting that this might be the case. However, we did not have any proof," said Myrto Schaefer.

Pediatrician Myrto Schaefer, with the relief organization Doctors Without Borders, says the group has been giving antibiotics to malnourished children anyway. But this is the first study to provide solid evidence for the practice.

“However, what we don’t know is whether the results of this study can be easily transferred to the areas where the majority of children with severe malnutrition live," said Schaefer.

Schaefer says severe malnutrition is most serious in the Sahel region of Africa. But malnourished kids there do not show the same symptoms as those in Malawi, where this study was done. That suggests the underlying causes are different, and go beyond just the lack of food.

In fact, Trehan is co-author on an accompanying study that suggests the types of microbes living in the Malawian children’s gastro-intestinal tracts may be contributing to their malnutrition.

“You could give them the right diet, but if the right bugs aren’t there to help liberate your zinc, or your vitamin A or your proteins, then you’re not going to really absorb them and use them for growth. And you’re going to get malnourished," he said.

Trehan acknowledges it's not really clear why the antibiotics are having the effect they are. He says that’s what he plans to spend the next several years studying.

You May Like

Video Drug Use Rises in Afghanistan

Ninety percent of world’s heroin comes from Afghanistan More

Here's Your Chance to Live in a Deserted Shopping Mall

About one-third of the 1200 enclosed malls in the US are dead or dying. Here's what's being done with them. More

Video NASA: Big Antarctica Ice Shelf Is Disintegrating

US space agency’s new study indicates Larsen B shelf could break up in just a few years More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Poverty, Ignorance Force Underage Girls Into Marriagei
X
May 21, 2015 4:14 AM
The recent marriage of a 17-year old Chechen girl to a local police chief who was 30 years older and already had a wife caused an outcry in Russia and beyond. The bride was reportedly forced to marry and her parents were intimidated into giving their consent. The union spotlighted yet again the plight of many underage girls in developing countries. Zlatica Hoke reports poverty, ignorance and fear are behind the practice, especially in Asia and Africa.
Video

Video Poverty, Ignorance Force Underage Girls Into Marriage

The recent marriage of a 17-year old Chechen girl to a local police chief who was 30 years older and already had a wife caused an outcry in Russia and beyond. The bride was reportedly forced to marry and her parents were intimidated into giving their consent. The union spotlighted yet again the plight of many underage girls in developing countries. Zlatica Hoke reports poverty, ignorance and fear are behind the practice, especially in Asia and Africa.
Video

Video South Korea Marks Gwangju Uprising Anniversary

South Korea this week marked the 35th anniversary of a protest that turned deadly. The Gwangju Uprising is credited with starting the country’s democratic revolution after it was violently quelled by South Korea’s former military rulers. But as Jason Strother reports, some observers worry that democracy has recently been eroded.
Video

Video California’s Water System Not Created To Handle Current Drought

The drought in California is moving into its fourth year. While the state's governor is mandating a reduction in urban water use, most of the water used in California is for agriculture. But both city dwellers and farmers are feeling the impact of the drought. Some experts say the state’s water system was not created to handle long periods of drought. Elizabeth Lee reports from Ventura County, an agricultural region just northwest of Los Angeles.
Video

Video How to Clone a Mammoth: The Science of De-Extinction

An international team of scientists has sequenced the complete genome of the woolly mammoth. Led by the Swedish Museum of Natural History in Stockholm, the work opens the door to recreate the huge herbivore, which last roamed the Earth 4,000 years ago. VOA’s Rosanne Skirble considers the science of de-extinction and its place on the planet
Video

Video Blind Boy Defines His Life with Music

Cole Moran was born blind. He also has cognitive delays and other birth defects. He has to learn everything by ear. Nevertheless, the 12-year-old has had an insatiable love for music since he was born. VOA’s June Soh introduces us to the young phenomenal harmonica player.
Video

Video Women to March for Peace Between Koreas

Prominent female activists from around the world plan to march through the demilitarized zone dividing North and South Korea to call for peace between the two neighbors, divided for more than 60 years. The event, taking place May 24, marks the International Women's Day for Peace and Disarmament and has been approved by both Koreas. Zlatica Hoke has more.
Video

Video Drug Use Rises in Afghanistan Following Record High Poppy Crops

Afghanistan has seen record high poppy crops during the last few years - and the result has been an alarming rise in illegal drug use and addiction in the war-torn country. VOA's Ayesha Tanzeem has this report from Kabul.
Video

Video America’s Front Lawn Gets Overhaul

America’s front yard is getting a much-needed overhaul. Almost two kilometers of lawn stretch from the U.S. Capitol to the Washington Monument. But the expanse of grass known as the National Mall has taken a beating over the years. Now workers are in the middle of restoring the lush, green carpet that fronts some of Washington’s best-known sights. VOA’s Steve Baragona took a look.

VOA Blogs