Paediatric infections, especially malaria, sepsis (also referred to as blood poisoning) and tuberculosis pose a major health burden for children in Africa, accounting for millions of deaths every year.
Although some of these children would die at home, a proportion will make it to hospital for treatment but in a critically ill state. The mortality rates for children admitted to hospital with life-threatening infections in Africa, particularly sub-Saharan Africa, are still as high as 15-30%, and little progress has been made towards reducing them.
It is still not known how best to treat these children when they arrive in hospital, other than giving anti-malaria treatment and antibiotics as required. This question needs urgent attention, as 50% of those children who die do so in the first 24 hours after hospital admission. The other key question is what package of care is best to help prevent later re-admission and death after children have left hospital.
Through its work in this research area MRC CTU aims to improve outcomes for children with infectious diseases worldwide. We plan to do this by working with a committed network of paediatricians in Africa, and by looking at the whole scientific picture (for example using clinical trials to answer questions other than the main clinical trial question, or looking to use observational studies to address questions that clinical trials would not be able to answer). We are currently involved in one trial in this area - FEAST (Fluid Expansion as Supportive Therapy in critically ill African children). This trial is examining fluid resuscitation on admission to hospital, and aims to find out whether it is better to give fluid quickly (as a bolus) or slowly (the current standard of care) and which particular fluid it is best to give.
