title: Gut Microbiota in Children Hospitalized with Oedematous and Non-Oedematous Severe Acute Malnutrition in Uganda.
abstract: BACKGROUND
  Severe acute malnutrition (SAM) among children remains a major health problem in many developing countries. SAM manifests in both an oedematous and a non-oedematous form, with oedematous malnutrition in its most severe form also known as kwashiorkor. The pathogenesis of both types of malnutrition in children remains largely unknown, but gut microbiota (GM) dysbiosis has recently been linked to oedematous malnutrition. In the present study we aimed to assess whether GM composition differed between Ugandan children suffering from either oedematous or non-oedematous malnutrition.
  
  
  RESULTS
  As part of an observational study among children hospitalized with SAM aged 6-24 months in Uganda, fecal samples were collected at admission. Total genomic DNA was extracted from fecal samples, and PCR amplification was performed followed by Denaturing Gradient Gel Electrophoresis (DGGE) and tag-encoded 16S rRNA gene-targeted high throughput amplicon sequencing. Alpha and beta diversity measures were determined along with ANOVA mean relative abundance and G-test of independence followed by comparisons between groups. Of the 87 SAM children included, 62% suffered from oedematous malnutrition, 66% were boys and the mean age was 16.1 months. GM composition was found to differ between the two groups of children as determined by DGGE (p = 0.0317) and by high-throughput sequencing, with non-oedematous children having lower GM alpha diversity (p = 0.036). However, beta diversity analysis did not reveal larger differences between the GM of children with oedematous and non-oedematous SAM (ANOSIM analysis, weighted UniFrac, R = -0.0085, p = 0.584; unweighted UniFrac, R = 0.0719, p = 0.011).
  
  
  CONCLUSIONS
  Our results indicate that non-oedematous SAM children have lower GM diversity compared to oedematous SAM children, however no clear compositional differences were identified.
authors.affiliation: Department of Nutrition, Exercise and Sports, Section of Child Nutrition and International Nutrition, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Kia Hee Schultz
authors.initials: KH
authors.lastname: Kristensen
authors.affiliation: Department of Food Science, Section of Food Microbiology, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Maria
authors.initials: M
authors.lastname: Wiese
authors.affiliation: Department of Nutrition, Exercise and Sports, Section of Child Nutrition and International Nutrition, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.|Department of Pediatrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Maren Johanne Heilskov
authors.initials: MJ
authors.lastname: Rytter
authors.affiliation: Department of Food Science, Section of Food Microbiology, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Özçam
authors.affiliation: Department of Environmental Science, Section of Environmental Microbiology and Biotechnology, University of Aarhus, Roskilde, Denmark.
authors.forename: Lars Hestbjerg
authors.initials: LH
authors.lastname: Hansen
authors.affiliation: Department of Pediatrics and Child Health, Mwanamugimu Nutrition Unit, Mulago Hospital, Kampala, Uganda.
authors.forename: Hanifa
authors.initials: H
authors.lastname: Namusoke
authors.affiliation: Department of Nutrition, Exercise and Sports, Section of Child Nutrition and International Nutrition, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Henrik
authors.initials: H
authors.lastname: Friis
authors.affiliation: Department of Food Science, Section of Food Microbiology, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Dennis Sandris
authors.initials: DS
authors.lastname: Nielsen
mesh_terms: D001419:Bacteria / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D044822:Biodiversity; D002648:Child; D002675:Child, Preschool; D005243:Feces / Q000382:microbiology; D005260:Female; D000069196:Gastrointestinal Microbiome; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D000067011:Severe Acute Malnutrition / Q000382:microbiology* / Q000628:therapy; D014454:Uganda