Trial reportPloS one2011
Timing of enteral feeding in cerebral malaria in resource-poor settings: a randomized trial.
Trial report in PloS one, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02427633 (A Randomised Controlled Study of the Use of Recovery Positions for Comatose Patients in a Resource Limited Setting), which is not on this map. Cited by 22 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomised Controlled Study of the Use of Recovery Positions for Comatose Patients in a Resource Limited Setting
Who cites it
22 citing papers in PubMed, 4 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Optimal timing of enteral nutrition initiation in critically ill patients: a network meta-analysis.Frontiers in nutrition · 2026Pooled it
- Outcomes reported in trials of treatments for severe malaria: The need for a core outcome set.Tropical medicine & international health : TM & IH · 2022Pooled it
- Early enteral nutrition (within 48 hours) versus delayed enteral nutrition (after 48 hours) with or without supplemental parenteral nutrition in critically ill adults.The Cochrane database of systematic reviews · 2019Pooled it
- Nutrition support in hospitalised adults at nutritional risk.The Cochrane database of systematic reviews · 2017Pooled it
- Early versus delayed enteral nutrition in critically ill children under 12 years of age: A systematic review and meta-analysis of randomised controlled trials.Clinical nutrition open science · 2025Article
- Article
- Investigating causal pathways in severe falciparum malaria: A pooled retrospective analysis of clinical studies.PLoS medicine · 2019Article
- The global burden of sepsis: barriers and potential solutions.Critical care (London, England) · 2018Review
- Increasing evidence-based interventions in patients with acute infections in a resource-limited setting: a before-and-after feasibility trial in Gitwe, Rwanda.Intensive care medicine · 2018Article
- The long sepsis journey in low- and middle-income countries begins with a first step...but on which road?Critical care (London, England) · 2018Article
- Pathophysiology, clinical presentation, and treatment of coma and acute kidney injury complicating falciparum malaria.Current opinion in infectious diseases · 2018Review
- Comparison of Quick Sequential Organ Failure Assessment and Modified Systemic Inflammatory Response Syndrome Criteria in a Lower Middle Income Setting.Journal of acute medicine · 2017Article
- Recommendations for the management of severe malaria and severe dengue in resource-limited settings.Intensive care medicine · 2017Article
- Article
- What's new in ARDS: ARDS also exists in resource-constrained settings.Intensive care medicine · 2016Article
- Parasitic diseases of the central nervous system: lessons for clinicians and policy makers.Expert review of neurotherapeutics · 2016Review
- Observational
- The clinical implications of thrombocytopenia in adults with severe falciparum malaria: a retrospective analysis.BMC medicine · 2015Article
- The prognostic utility of bedside assessment of adults hospitalized with malaria in Myanmar: a retrospective analysis.Malaria journal · 2015Article
- Managing malaria in the intensive care unit.British journal of anaesthesia · 2014Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
19 authors at 6 institutions in 3 countries.
Funding
Abstract
backgroundEarly start of enteral feeding is an established treatment strategy in intubated patients in intensive care since it reduces invasive bacterial infections and length of hospital stay. There is equipoise whether early enteral feeding is also beneficial in non-intubated patients with cerebral malaria in resource poor settings. We hypothesized that the risk of aspiration pneumonia might outweigh the potential benefits of earlier recovery and prevention of hypoglycaemia. METHOD AND
findingsA randomized trial of early (day of admission) versus late (after 60 hours in adults or 36 hours in children) start of enteral feeding was undertaken in patients with cerebral malaria in Chittagong, Bangladesh from May 2008 to August 2009. The primary outcome measures were incidence of aspiration pneumonia, hypoglycaemia and coma recovery time. The trial was terminated after inclusion of 56 patients because of a high incidence of aspiration pneumonia in the early feeding group (9/27 (33%)), compared to the late feeding group (0/29 (0%)), p = 0.001). One patient in the late feeding group, and none in the early group, had hypoglycaemia during admission. There was no significant difference in overall mortality (9/27 (33%) vs 6/29 (21%), p = 0.370), but mortality was 5/9 (56%) in patients with aspiration pneumonia.
conclusionsIn conclusion, early start of enteral feeding is detrimental in non-intubated patients with cerebral malaria in many resource-poor settings. Evidence gathered in resource rich settings is not necessarily transferable to resource-poor settings.
trial registrationControlled-Trials.com ISRCTN57488577.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.