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Glucose needs in children with acute febrile illness in Uganda- challenging the existing guidelines for improved survival

Mortality from pneumonia, malaria and other infections in young children remains high in sub-Saharan African hospitals, and most deaths occur within the first 24 hours of admission. Antimalarial and antimicrobial drugs constitute the routine treatment basis, but the role of supportive therapies, involving the maintenance of a normal glucose and electrolyte balance, has been given limited attention. While hyperglycemia is the most common blood glucose anomaly seen in infectious disease patients in high-income settings, hypoglycemia is not uncommon in low-income settings. 1.8-7.3% of children admitted with fever present with hypoglycemia, a known predictor of poor clinical outcome. A number of studies also indicate an increased mortality among children with blood glucose levels that are currently considered within the normal range, e.g. 2.5 - 5.0 mmol/l, compared to children with higher blood glucose levels (>5.0mmol/l). This randomized clinical trial will evaluate the benefit of glucose administration already ay blood glucose levels <5.0mmol/l in children presenting to a Ugandan hospital with an acute febrile illness. It will further explain the metabolic response, through the measurement of metabolic markers, in pediatric acute infections and how this influences the final outcome in children with hypo-, normo- and hyperglycemia. Our results will highlight the potential need to revise current hypoglycemia cut off values in order to increase child survival in acute infections.

Project ID

SE-0-SE-29-2014-2791-285-12182

Activity status

2 - Implementation

Aid type

D02 - Other technical assistance

% to Uganda

100.00

Organisations

Funding

Sweden

Extending

The Swedish Research Council

Implementing

Karolinska Institutet

CRS code	%
Medical research (12182)	100.0