The edition · Paediatrics
A MUAC referral alone did not change outcomes for malnourished children
What happened at the 11.5 cm cut-off in Burkina Faso, problematic social media use and depression in early adolescence, what ten days of azithromycin did to the preterm gut, and two years of injectable HIV treatment in adolescents.
The edition in brief
In a regression discontinuity analysis of 65,554 children screened twice yearly in Burkina Faso, being just below the 11.5 cm mid-upper arm circumference cut-off, and so eligible for referral to a nutrition programme, made no detectable difference to arm circumference at the next census or to mortality; uptake of treatment was not measured, and the authors suggest stronger mechanisms to complete referral. In 11,279 US adolescents followed for five years, problematic social media use and depressive symptoms predicted each other in some years, more strongly in girls, but no such link was seen for anxiety. A microbiome analysis from the AZTEC trial in 693 infants born before 30 weeks found ten days of prophylactic intravenous azithromycin reduced gut diversity and Bifidobacterium, increased Staphylococcus and Enterobacter/Klebsiella, and raised macrolide resistance genes that persisted. The MOCHA trial in 144 suppressed adolescents with HIV found two-monthly injectable cabotegravir plus rilpivirine maintained suppression with no virological failures through 96 weeks, and at least 97% preferred injections to daily tablets.
Problematic social media use and depression fed each other in early adolescence
Ask about compulsive social media use and depressive symptoms together in young adolescents, especially girls.
Ten days of azithromycin left lasting resistance genes in the preterm gut
A short prophylactic antibiotic course reshaped the preterm gut and left resistance genes behind; weigh that cost before using one.
Two-monthly HIV injections kept adolescents suppressed through 96 weeks
Long-acting cabotegravir plus rilpivirine kept suppressed adolescents suppressed through 96 weeks, and nearly all preferred it.
Measure MUAC on the left arm, at the midpoint, without squeezing
Take MUAC at the true midpoint with a relaxed arm and a snug, not tight, tape, and always check for oedema.
Eligibility for referral at MUAC below 11.5 cm made no measurable difference on its own
A referral slip does not treat malnutrition; make sure the child actually reaches care.
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