The Childhood Acute Illness & Nutrition (CHAIN) Network brings together a network of clinical scientists to build the evidence base to help undernourished children survive, thrive and grow during and after an acute illness. 


Russel Watkins/DFID CC LICENSE


The main Network activity is a harmonized cohort study of acutely ill hospitalized children who are followed for six months following discharge in Africa and Asia to better understand risk factors and mechanisms for both acute and post-discharge mortality. Small pilot studies and sub-studies will be undertaken within and alongside the cohort. Analyses using existing data and samples will be undertaken to provide early insights and guide later prospective analyses. The Network will also serve as a platform for clinical trials that are led within the group in order to inform policy. Further funding will be sought for interventional trials.



The principle behind the CHAIN Network is that an episode of illness occurs within the child’s ‘health trajectory’. Low birth weight, frequent infections with too little time been each episode to fully recover, suboptimal feeding and social constraints result in ongoing risks of mortality and poor growth despite treatment. To find out what aspects of these could be addressed to improve outcomes, CHAIN is initially conducting an observational study. This will lead on to clinical trials to test potential interventions that could be added to current treatment policies in hospitals, in communities and improve linkage between the two. 


CHAIN investigators are working in Kenya, Malawi, Uganda, Burkina Faso, Bangladesh and Pakistan. The project is coordinated from the KEMRI/Wellcome Trust Research Programme, Kenya, and the Department of Global Health, University of Washington, Seattle, USA. Collaborating centres are in the UK, USA, Canada and the Netherlands. The project is supported by the Bill & Melinda Gates Foundation as a grant to the Centre for Tropical Medicine & Global Health, University of Oxford, UK. The principal investigator is Professor James A Berkley.

You can have more information about the CHAIN Network here: