Wednesday, February 13, 2013

Malnutrition and Disease: A Vicious Cycle


Malnutrition and infectious disease are severe problems for many people in disadvantaged areas of the world. While both challenges alone pose a significant obstacle to global health, new research suggests that they may comprise a vicious cycle. Malnourishment is known to be a significant risk factor in acquiring various infectious diseases such as malaria, HIV, and tuberculosis. However, infectious disease also appears to be a contributing cause in many cases of malnourishment. Infections that disturb the body’s normal bacterial composition in the digestive tract may prevent the proper absorption of nutrients. Also, when a person’s immune system is actively fighting an infection, a significant amount of their limited metabolic energy goes into fighting the infection. This can put substantial stress on an already energy deprived system.
Despite daunting challenges posed by malnourishment and infectious disease, new research has shown that targeting both problems simultaneously in patients can have promising results. A recent study in Malawai showed that malnourished children who were given an antibiotic along with a dietary supplement showed better recovery from malnutrition then patients on the dietary supplement alone. The study consisted of 2,767 malnourished children aged six months to five years. Of the subjects, 85.1% of the children on placebo recovered, compared with 88.7% and 90.9% on amoxicillin and cefdinir, respectively. This same study also looked at the gut microbial content of children with kwashikior, a disease that develops in some children with severe malnutrition. The hallmarks of this disease are bulging stomachs, thin and elongated limbs, skin disorders, and liver disease. The study looked at pairs of twins in which one child developed the disease and the other did not. The researchers found that the twin with kwashikior routinely had a less diverse microbiome in their digestive tract than the healthy twin. These results illustrate the importance of maintaining a balanced and diverse microbe content in order to digest food effectively.
Based on the results of this study, the World Health Organization is expected to recommend the use of antibiotic supplements in treating malnourishment. Many of these antibiotics cost only a few dollars for a week’s supply. Hopefully with prices as low as these, an international effort to get these drugs into the hands of those who need them will be successful.

Posted by Sean McDougall (2)

14 comments:

  1. This comment has been removed by the author.

    ReplyDelete
  2. The differences in the results between children who received placebo and those whom received antibiotics does not seem all that great. Do you feel that before recommending the use of the antibiotics there should be more testing done?
    Also I always was under the impression that antibiotics killed off normal flora, which is why doctors will sometimes prescribe pro-biotic now.
    Tonya Sulham

    ReplyDelete
  3. How does being malnourished increase the risk factor of contracting HIV? Is HIV sometimes effectively prevented from gaining a foothold by the immune system if introduced to a healthy person?

    Michael Ball (1)

    ReplyDelete
  4. How long were the children given the antibiotic and dietary supplement in order for the researchers to see progress?

    Kimberly Ty (3)

    ReplyDelete
  5. Since the placebo recovery rate and the antibiotic supplement rates are very similar, do you think that they should have more studies and run more tests to verify their hypothesis? Also, do you think that 2,767 patients, are enough evidence to support their claim? Or do you think that they should have a bigger sample group, seeing as the world's population is in the billions.

    Cynthia Bui (1)

    ReplyDelete
  6. Considering the small difference between the effects of the placebo and the antibiotic, do you think that this study supports the use of the antibiotic or not? Would using more studies that proved the effectiveness of the drug over the the absence of treatment be helpful in deciding if it were truly useful?

    Ashley Sterpka (1)

    ReplyDelete
    Replies
    1. This comment has been removed by the author.

      Delete
    2. From what I can tell of the study, the difference in recovery with antibiotics vs. placebo appears to be statistically significant, albeit small. However, I would still suppport more studies of this nature to confirm the effectiveness of antibiotics in treating malnutrition. This is especially important given the rise of antibiotic resistance in the parts of the world effected by malnutrition. It is neccesary to ensure that these antibiotics are still effective when they are really needed. This needs to be balanced against their use in treating malnutrition.

      Sean McDougall (2)

      Delete
  7. Its interesting that antibiotics help surpress malnourishment. I was always under the impression that antibiotics should only be taken when you're ill with a certain illness and that it helps fight off the virus. I don't know whether or not its such a good idea to have people taking antibiotics for malnourishment reasons because then it would most likely cause their body to become resistant to that particular antibiotic after some time and then would stop treating the malnourishment and then not help cure them of an illness in the future that would require that antibiotic. It just seems like a very risky option to help treat malnourishment, however, interesting nonetheless.

    Gabrielle Wertheim (3)

    ReplyDelete
  8. This is definitely a step in the right direction in preventing the spread of disease and infection. I did not know that being malnourished makes a person more susceptible to malaria, HIV, or tuberculosis. I wonder if this is a realistic solution for severely disadvantaged areas in economic dispair.

    Lindsey Dugas (1)

    ReplyDelete
    Replies
    1. I think it is definitely possible to use this type of combined antibiotic/nutrient treatment, even in severely economically depressed areas. These are broad spectrum, generic antibiotics being used. As a result, they are widely available and very cheap in comparison to more specialized antibiotics. As long as there is sufficient government, private, and public support for programs implementing these treatments, I see no reason why they shouldn’t be successful.

      Sean McDougall (2)

      Delete
  9. Cool study but the treatment vs placebo statistic is not very convincing. I think a lot of further study is needed to justify such broad use of antibiotics. The use of antibiotics in cattle feed is causing the emergence of increasingly resistant bacteria. I wonder if a similar thing could happen applying the same idea to humans?

    ReplyDelete
  10. I never really thought about treating malnurishment in this way, but I could see where they're going with it. I think the best way is to just gradually introduce food into the system otherwise the system will just get shocked. And a response to Joseph Starrett's comment, that would be one of my concerns because there is a risk of creating resistance. Over use and misuse of antibiotics is a real issue, but I suppose there would need to be more studies done on this to find out!

    ReplyDelete
  11. I mean I know that the US is pretty good with getting vaccines and other medical supplies to underdeveloped countries. I wish other countries would participate to achieve a cleaner and healthier goal standard of living.

    Nick Mulone (3)

    ReplyDelete