Trial reportBMC medicine2014
Mesalazine in the initial management of severely acutely malnourished children with environmental enteric dysfunction: a pilot randomized controlled trial.
Trial report in BMC medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 53 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.
Randomised Placebo-controlled Trial of a Gut Immunomodulatory Agent (Mesalamine) to Tackle Environmental Enteropathy in Acutely Malnourished Children: A Pilot Study.
Pharmacokinetics of Antimicrobials and Carriage of Antimicrobial Resistance Amongst Hospitalised Children With Severe Acute Malnutrition
First Line Antimicrobials in Children With Complicated Severe Acute Malnutrition
Who cites it
53 citing papers in PubMed, 4 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- Postdischarge interventions for children hospitalized with severe acute malnutrition: a systematic review and meta-analysis.The American journal of clinical nutrition · 2021Pooled it
- Predictors of inpatient mortality among children hospitalized for severe acute malnutrition: a systematic review and meta-analysis.The American journal of clinical nutrition · 2020Pooled it
- Guidelines for the treatment of severe acute malnutrition: a systematic review of the evidence for antimicrobial therapy.Paediatrics and international child health · 2018Pooled it
- Environmental enteric dysfunction pathways and child stunting: A systematic review.PLoS neglected tropical diseases · 2018Pooled it
- A Pilot Study of Enterade (VS001), an Oral Amino Acid Formulation, in Malnourished Bangladeshi Children with Environmental Enteric Dysfunction.The American journal of tropical medicine and hygiene · 2025Trial
- Malnutrition enteropathy in Zambian and Zimbabwean children with severe acute malnutrition: A multi-arm randomized phase II trial.Nature communications · 2024Trial
- Impact of Different Strategies for Delivering Supplemental Zinc on Selected Fecal Markers of Environmental Enteric Dysfunction among Young Laotian Children: A Randomized Controlled Trial.The American journal of tropical medicine and hygiene · 2020Trial
- Tryptophan, glutamine, leucine, and micronutrient supplementation improves environmental enteropathy in Zambian adults: a randomized controlled trial.The American journal of clinical nutrition · 2019Trial
- Soya, maize and sorghum ready-to-use therapeutic foods are more effective in correcting anaemia and iron deficiency than the standard ready-to-use therapeutic food: randomized controlled trial.BMC public health · 2019Trial
- Hypoallergenic and anti-inflammatory feeds in children with complicated severe acute malnutrition: an open randomised controlled 3-arm intervention trial in Malawi.Scientific reports · 2019Trial
- Trial
- Trial
- Intestinal Permeability Is Associated with Mortality and Readmission in Children Hospitalized with Severe Acute Malnutrition.The Journal of nutrition · 2026Observational
- Lactoferrin and lysozyme for Kenyan children presenting with wasting and diarrhea: A 2 × 2 factorial randomized controlled trial.medRxiv : the preprint server for health sciences · 2026Article
- Disrupting the vicious cycle of malnutrition and enteropathy: advancing strategies to improve child physical and neurocognitive outcomes.Frontiers in public health · 2026Review
- Enteric dysfunction and enteropathogens among hospitalized south Asian and sub-Saharan African children.PLOS global public health · 2026Article
- Cost analysis of probiotic/synbiotic supplementation in infants in rural Kenya: a study from the PROSYNK trial.BMJ paediatrics open · 2025Article
- Getting back on track to meet global anaemia reduction targets: a Lancet Haematology Commission.The Lancet. Haematology · 2025Review
- Host-microbiome determinants of ready-to-use supplemental food efficacy in acute childhood malnutrition.JCI insight · 2025Article
- Association between stunting and fecal calprotectin levels in breastfed infants living in a rural area of the Democratic Republic of the Congo: a cross sectional study.African health sciences · 2024Article
Corrections and comments
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Authors and funding
16 authors at 6 institutions in 2 countries.
Funding
Abstract
backgroundEnvironmental enteric dysfunction (EED) is an acquired syndrome of impaired gastrointestinal mucosal barrier function that is thought to play a key role in the pathogenesis of stunting in early life. It has been conceptualized as an adaptive response to excess environmental pathogen exposure. However, it is clinically similar to other inflammatory enteropathies, which result from both host and environmental triggers, and for which immunomodulation is a cornerstone of therapy.
methodsIn this pilot double-blind randomized placebo-controlled trial, 44 children with severe acute malnutrition and evidence of EED were assigned to treatment with mesalazine or placebo for 28 days during nutritional rehabilitation. Primary outcomes were safety and acceptability of the intervention.
resultsTreatment with mesalazine was safe: there was no excess of adverse events, evidence of deterioration in intestinal barrier integrity or impact on nutritional recovery. There were modest reductions in several inflammatory markers with mesalazine compared to placebo. Depression of the growth hormone--insulin-like growth factor-1 axis was evident at enrollment and associated with inflammatory activation. Increases in the former and decreases in the latter correlated with linear growth.
conclusionsIntestinal inflammation in EED is non-essential for mucosal homeostasis and is at least partly maladaptive. Further trials of gut-specific immunomodulatory therapies targeting host inflammatory activation in order to optimize the growth benefits of nutritional rehabilitation and to address stunting are warranted. Funded by The Wellcome Trust.
trial registrationRegistered at Clinicaltrials.gov NCT01841099.
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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.