1. Cotrimoxazole or multi-mineral multi-vitamins to improve post-discharge outcomes following severe anaemia in African children: a randomised controlled trial
- Author
-
Maitland, K, Olupot-Olupot, P, Kiguli, S, Chagaluka, G, Alaroker, F, Opoka, R, Mpoya, A, Walsh, K, Engoru, C, Nteziyaremye, J, Mallewa, M, Kennedy, N, Nakuya, M, Namayanja, C, Kayaga, J, Nabawanuka, E, Sennyondo, T, Aromut, D, Kumwenda, F, Williams Musika, C, Thomason, M, Bates, I, Boele Von Hensbroek, M, Evans, J, Uyoya, S, Williams, T, Frost, G, George, E, Gibb, D, Walker, A, Medical Research Council (MRC), Medical Research Council, Medical Research Council, UK, Imperial College Healthcare NHS Trust- BRC Funding, and Engineering & Physical Science Research Council (EPSRC)
- Subjects
SPRINKLES ,YOUNG-CHILDREN ,Malawi ,Science & Technology ,IRON FORTIFICATION ,MORTALITY ,Infant ,Anemia ,PROPHYLAXIS ,Patient Discharge ,TRACT trial group ,1117 Public Health and Health Services ,DEFICIENCY ,DOUBLE-BLIND ,MALARIA ,TRANSFUSION ,INFECTION ,Dietary Supplements ,Trimethoprim, Sulfamethoxazole Drug Combination ,Humans ,Uganda ,Child ,Life Sciences & Biomedicine ,Public, Environmental & Occupational Health ,0605 Microbiology - Abstract
Background: Severe anaemia (haemoglobin0.2). By day180, 489(24%) MVMM vs 509(26%) iron/folate had experienced one or more SAEs (HR=0.95 (0.84- 1.07), p=0.40) and 500(25%) cotrimoxazole vs 498(25%) no cotrimoxazole (HR=1.01 (0.89,1.15) p=0.85). Most SAEs were readmissions, occurring in 692(17%) children (175(4%) with ≥2 readmissions). Interpretation: Neither enhanced supplementation with MVMM versus iron/folate treatment or cotrimoxazole prophylaxis improved 6-month survival. High rates of hospital re-admission suggest that novel interventions are urgently required for severe anaemia, given the burden it places on overstretched health services in Africa.
- Published
- 2019