ArticleJournal of tropical pediatrics2021
Safety and Ethics in Endoscopic Studies in Children: Evidence From the BEECH Study in Zambia.
Article in Journal of tropical pediatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 12 citations in OpenAlex.
- The Environmental Enteric Dysfunction Biopsy Initiative (EEDBI) Consortium: mucosal investigations of environmental enteric dysfunction.The American journal of clinical nutrition · 2024Article
- Duodenal quantitative mucosal morphometry in children with environmental enteric dysfunction: a cross-sectional multicountry analysis.The American journal of clinical nutrition · 2024Article
- Biomarker relationships with small bowel histopathology among malnourished children with environmental enteric dysfunction in a multicountry cohort study.The American journal of clinical nutrition · 2024Article
- Histopathology underlying environmental enteric dysfunction in a cohort study of undernourished children in Bangladesh, Pakistan, and Zambia compared with United States children.The American journal of clinical nutrition · 2024Article
- Enteric pathogens relationship with small bowel histologic features of environmental enteric dysfunction in a multicountry cohort study.The American journal of clinical nutrition · 2024Article
- Potential determinants of low circulating glucagon-like peptide 2 concentrations in Zambian children with non-responsive stunting.Experimental physiology · 2023Article
- Associations between Gut Microbiota and Intestinal Inflammation, Permeability and Damage in Young Malawian Children.Journal of tropical pediatrics · 2022Article
- Epithelial Abnormalities in the Small Intestine of Zambian Children With Stunting.Frontiers in medicine · 2022Article
- Helicobacter pylori infection and hypochlorhydria in Zambian adults and children: A secondary data analysis.PloS one · 2021Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEnvironmental enteropathy is an example of a poorly-understood intestinal disorder affecting millions of children worldwide, characterized by malabsorption and stunting. Although there is increasing interest in non-invasive means of assessing intestinal structure and function, the potential value of intestinal biopsy for histology, immunostaining, RNA sequencing and epigenetic work means that endoscopic biopsy remains extremely valuable. We here report our experience in the BEECH (Biomarkers of Environmental Enteropathy in CHildren) study of stunting in Zambia, in the belief that it may help address the knowledge gap regarding the safety of endoscopic biopsy in vulnerable young children.
methodsWe report our experience of safety in 119 children undergoing endoscopic biopsy in the BEECH study in Lusaka Children's Hospital, Lusaka, and discuss ethical considerations in this light.
resultsUpper gastrointestinal endoscopy was performed on children with stunting (length-for-age z score -2 or less) not responsive to nutritional interventions. Conscious sedation was provided by anaesthetists. Of 119 children, 5 (4%) developed transient desaturation, but no serious adverse events were experienced; no clinical, demographic or anaesthetic characteristics were identified as predictive of desaturation. Two children derived clinically useful information from the endoscopy, one life-saving. Of 105 lactase tests, 59 (54%) showed hypolactasia. DISCUSSION: Children with stunting underwent endoscopy safely, and some derived clinical benefit. Safety and the possibility of clinical benefit are usually felt to be preconditions for the ethical justification for endoscopy for research in children, and we believe that these conditions were met in this study.
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