Is fat mass a better predictor of 6-month survival than muscle mass among African children aged 6–59 months with severe pneumonia?
| dc.contributor.author | Nalwanga, Damalie | |
| dc.contributor.author | Musiime, Victor | |
| dc.contributor.author | Kiguli, Sarah | |
| dc.contributor.author | Olupot-Olupot, Peter | |
| dc.contributor.author | Alaroker, Florence; | |
| dc.contributor.author | Opoka, Robert; | |
| dc.contributor.author | Tagoola, Abner | |
| dc.contributor.author | Mnjalla, Hellen | |
| dc.contributor.author | Mogaka, Christabel | |
| dc.contributor.author | Nabawanuka, Eva | |
| dc.contributor.author | Giallongo, Elisa | |
| dc.contributor.author | Karamagi, Charles | |
| dc.contributor.author | Briend, André | |
| dc.contributor.author | Maitland, Kathryn | |
| dc.date.accessioned | 2024-10-04T10:59:34Z | |
| dc.date.available | 2024-10-04T10:59:34Z | |
| dc.date.issued | 2024-09 | |
| dc.description.abstract | Pneumonia remains the leading cause of mortality among children under 5 years. Poor nutritional status increases pneumonia mortality. Nutritional status assessed by anthropometry alone does not provide information on which body composition element predicts survival. Body composition proxy measures including arm-fat-area (AFA), arm-muscle-area (AMA), and arm-muscle-circumference (AMC) could be useful predictors. To compare the ability of fat and muscle mass indices to predict 6-month survival among children with severe pneumonia. This prospective cohort study was nested in the COAST-Nutrition trial (ISRCTN10829073, 06/06/2018) conducted between June 2020 and October 2022 in Uganda and Kenya. We included children aged 6-59 months hospitalized for severe pneumonia with hypoxemia. Children with severe malnutrition, known chronic lung or cardiac diseases were excluded. Anthropometry and clinical status were assessed at enrolment and at follow-up to day 180. We examined Receiver Operator Characteristic (ROC) curves of fat and muscle mass indices with 6-month survival as the outcome, and compared the areas under the curve (AUCs) using chi-square tests. Cox survival analysis models assessed time-to-mortality. We included 369 participants. The median age was 15-months (IQR 9, 26), and 59.4% (219/369) of participants were male. The baseline measurements were: median MUAC 15.0 cm (IQR 14.0,16.0); arm-fat-area 5.6cm (IQR 4.7, 6.8); arm-muscle-area 11.4cm (IQR 10.0, 12.7); and arm-muscle-circumference 12.2 cm (IQR 11.5, 12.9). Sixteen (4.3%) participants died and 4 (1.1%) were lost-to-follow-up. The AUC for Arm-Fat-Area was not significantly higher than that for Arm-Muscle-Area and Arm-Muscle-Circumference [AUC 0.77 (95%CI 0.64-0.90) vs. 0.61 (95%CI 0.48-0.74), p = 0.09 and 0.63 (95%CI 0.51-0.75), p = 0.16 respectively], but was not statistically different from MUAC (AUC 0.73 (95%CI 0.62-0.85), p = 0.47). Increase in Arm-Fat-Area and Arm-Muscle-Circumference significantly improved survival [aHR 0.40 (95%CI 0.24-0.64), p = < 0.01 and 0.59 (95%CI 0.36-1.06), p = 0.03 respectively]. Survival prediction using Arm-Fat-Area was not statistically different from that of MUAC (p = 0.54). Muscle mass did not predict 6-month survival better than fat mass in children with severe pneumonia. Fat mass appears to be a better predictor. Effects of fat and muscle could be considered for prognosis and targeted interventions. PubMed | |
| dc.identifier.citation | Nalwanga, Damalie, Victor Musiime, Sarah Kiguli, et al. 'Is Fat Mass a Better Predictor of 6-Month Survival than Muscle Mass among African Children Aged 6-59 Months with Severe Pneumonia?', BMC Nutrition, vol. 10/no. 1, (2024), pp. 130. | |
| dc.identifier.issn | ISSN 2055-0928 | |
| dc.identifier.issn | EISSN 2055-0928 | |
| dc.identifier.uri | https://nru.uncst.go.ug/handle/123456789/9637 | |
| dc.language.iso | en | |
| dc.publisher | BioMed Central | |
| dc.title | Is fat mass a better predictor of 6-month survival than muscle mass among African children aged 6–59 months with severe pneumonia? | |
| dc.type | Article |