1.  Title: The use of home-based therapy with ready-to-use therapeutic food to treat malnutrition in a rural area during a food crisis. Author: Amthor RE; Cole SM; Manary MJ Source: Journal of the American Dietetic Association. 2009 Mar;109(3):464-7. Abstract: When the international community declared a famine in Malawi in January of 2006, emergency food aid reached only populations with pre-existing health care services. To treat the widespread childhood malnutrition in Machinga district, a rural area lacking health care facilities, in February 2006 five outpatient therapeutic programs were implemented that utilized home-based therapy and ready-to-use therapeutic food. Children with severe malnutrition, defined as the presence of edema and/or a weight-for-height less than 70% of the reference standard, were enrolled in the program. Two senior clinical nurses trained village health aides in each of the five communities. Children visited the health aides biweekly. During the visits, health aides collected demographic and anthropometric information and distributed a 2-week supply of ready-to-use therapeutic food, providing 175 kcal/kg/d. Treatment continued for 8 weeks; children were discharged before 8 weeks if they reached a weight-for-height more than 100% of the reference standard, or required admission to the hospital due to systemic infection or recurrence of edema. Of the 826 children enrolled, 775 (93.7%) recovered, 13 (1.8%) remained malnourished, 30 (3.6%) defaulted, and 8 (0.9%) died. Mean weight gained was 2.7+/-3.7 g/kg/d, height gained 0.3+/-0.9 mm/d, and mid-upper arm circumference gained 0.2+/-0.3 mm/d. Home-based therapy with ready-to-use therapeutic food administered by village health aides is an effective approach to treating malnutrition during food crises in areas lacking health services. Language: English Keywords: DEVELOPING COUNTRIES | MALAWI | RESEARCH REPORT | RURAL AREAS | COMMUNITY | CHILDREN | FAMINE | FOOD SECURITY | NUTRITION DISORDERS | ANTHROPOMETRY | BODY WEIGHT | BODY HEIGHT | MALNUTRITION | HOME CARE | TREATMENT | Africa, Southern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Residence Characteristics | Population Distribution | Youth | Age Factors | Population Characteristics | Demographic Factors | Food Supply | Natural Resources | Environment | Diseases | Measurement | Research Methodology | Physiology | Biology | Care and Support | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine Document Number: 330803 |
| 2. Title: Evolution of the nourishing condition on children submitted to additional feeding program in county of state of Sao Paulo, Brazil. Evolucao do estado nutricional de criancas submetidas a um programa de suplementacao alimentar em municipio do estado de Sao Paulo. Author: Carvalho LG; Saldiva SR; da Costa Rosa TE; Lei DL Source: Revista de Nutricao / Brazilian Journal of Nutrition. 2009 Mar-Apr;22(2):207-217. Abstract: The objective of this study was to assess the impact of the Program Incentive to Fight Nutritional Deficiencies in the city of Assis, state of Sao Paulo. Methods A total of 132 children under 24 months who participated in the Program Incentive to Fight Nutritional Deficiencies for one year were followed. Their nutritional status was determined by comparing their weight-for-age in z-scores at baseline and after 2, 6, 9 and 12 months of follow-up to that of the reference population median given by the National Center for Health Statistics. Results Most (70%) of the children were classified as undernourished or at risk or malnutrition when they joined the Program Incentive to Fight Nutritional Deficiencies. After 12 months in the program, 64% of the children presented an increase in their weight-for-age z-score. Analysis of the mean weight-for-age z-score variation over time, according to age group and nutritional status at baseline, showed that children under 12 months of age had a significant increase in weight-for-age z-score. Conclusion Malnourished children under one year of age were the ones who benefited most from the Program Incentive to Fight Nutritional Deficiencies. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | DATA ANALYSIS | CHILDREN | DEFICIENCY DISEASES | NUTRITION DISORDERS | MALNUTRITION | NUTRITION INDEXES | INFANT NUTRITION | BODY WEIGHT | IMPACT | NUTRITION PROGRAMS | PROGRAM EVALUATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Nutrition | Health | Physiology | Biology | Communication | Primary Health Care | Health Services | Delivery of Health Care | Programs | Organization and Administration Document Number: 340199 |
| 3. Title: Zinc deficiency is common among healthy women of reproductive age in Bhaktapur, Nepal. Author: Chandyo RK; Strand TA; Mathisen M; Ulak M; Adhikari RK; Bolann BJ; Sommerfelt H Source: Journal of Nutrition. 2009 Mar;139(3):594-7. Abstract: Zinc deficiency is a major public health problem in many developing countries. However, its prevalence is still unknown in most populations. Women of reproductive age in developing countries are highly vulnerable to nutritional deficiencies, including that of zinc. To estimate the prevalence of zinc deficiency and to identify important dietary sources of zinc, we undertook a cross-sectional survey in 500 nonpregnant Nepalese women and measured their plasma zinc concentrations. We also examined the associations between plasma zinc and dietary intake of zinc or phytate, iron status, plasma concentrations of C-reactive protein, albumin, and hemoglobin. Food intake was estimated by 2 24-h dietary recalls and 1 FFQ for each woman. The plasma zinc concentration was (mean +/- SD) 8.5 +/- 2.4 micromol/L and more than three-quarters of the women were zinc deficient. Dietary zinc intake did not predict plasma zinc concentration, whereas phytate intake was negatively and significantly associated with plasma zinc. The other variables that were associated with plasma zinc were plasma albumin and hemoglobin concentration. Rice contributed 50% to the total estimated daily zinc intake and wheat and meat each contributed 15%. Rice also contributed 68% to the daily intake of phytate. In conclusion, we found that zinc deficiency was common in women of reproductive age and that the foods contributing substantial amounts of zinc also contributed importantly to the intake of phytate. Language: English Keywords: NEPAL | CROSS SECTIONAL ANALYSIS | WOMEN | NUTRITION DISORDERS | SERUM ZINC LEVEL | REPRODUCTIVE AGE | FOOD AND BEVERAGE | Developing Countries | Asia, Southern | Asia | Research Methodology | Demographic Factors | Population | Diseases | Hemic System | Physiology | Biology | Reproduction | Nutrition | Health Document Number: 330820 |
| 4. Title: [Nutritional situation for mothers and children in South Africa] Ernaeringssituasjonen for mor og barn i Sor-Afrika. Author: Iversen PO Source: Tidsskrift For Den Norske Laegeforening. 2009 Jun 25;129(13):1362-5. Abstract: BACKGROUND: Even 15 years after the downfall of the apartheid regime, there are significant inequalities regarding resources, welfare and social benefits among the people of South Africa. Poverty prevails and conditions are bad with respect to sanitation, health and living conditions; a situation which is likely to affect nutritional health. We have reviewed the nutritional status in South Africa. MATERIAL AND METHODS: This article is based on literature retrieved from non-systematic reviews of the databases PubMed and High Wire Press, in addition to information from official documents and African journals. The author's recent field work in South Africa was also a source of information. RESULTS: Nationwide surveys, as well as smaller studies have documented high rates of stunting, malnutrition and deficiency of micronutrients among South African children. Daily hunger is reported from more than half of South African households. There is also a rise in the number of overweight and obese children and mothers. HIV/aids is highly prevalent and often coexists with tuberculosis. Many of these patients have a poor nutritional status, which in turn reduces the effect of antiviral treatment. INTERPRETATION: The high rate of malnutrition and HIV/aids among mothers and children in South Africa will delay improvement of general health in this population with generations. Language: Norwegian Keywords: SOUTH AFRICA | RESEARCH REPORT | LITERATURE REVIEW | PERSONS LIVING WITH HIV/AIDS | MOTHERS | CHILDREN | INEQUALITIES | NUTRITION INDEXES | CHILD HEALTH | MALNUTRITION | NUTRITION DISORDERS | HIV INFECTIONS | TUBERCULOSIS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Viral Diseases | Diseases | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Socioeconomic Factors | Economic Factors | Nutrition | Health | Infections Document Number: 342051 |
| 5. Title: Causes for the decline in child under-nutrition in Brazil, 1996-2007. Author: Monteiro CA; Benicio MH; Konno SC; Silva AC; Lima AL; Conde WL Source: Revista De Saude Publica. 2009 Feb;43(1):35-43. Abstract: OBJECTIVE: To describe the evolution of prevalence of under-nutrition among Brazilian underfives between 1996 and 2007, and to identify major factors responsible for this evolution. METHODS: Data analyzed are from two Demographic Health Surveys carried out in Brazil in 1996 and 2006/7 based on probabilistic samples of roughly 4 thousand children under five years of age. Identification of factors responsible for temporal variation in prevalence of under-nutrition (height-for-age below -2 Z-scores; WHO 2006 standard) took into account changes in the distribution of four potential determinants of nutritional status. Statistical modeling of the independent association between these determinants and risk of under-nutrition, and calculation of 'partial attributable fractions' were used to determine the relative importance of each factor in the evolution of infant under-nutrition. RESULTS: Prevalence of under-nutrition fell by approximately 50%, from 13.5% (95%CI: 12.1%; 14.8%) in 1996 to 6.8% (5.4%; 8.3%) in 2006/7. Two-thirds of this reduction could be attributed to favorable evolution in the four factors studied: 25.7% to increased maternal schooling; 21.7% to increased purchasing power of families; 11.6% to expansion of healthcare; and 4.3%to improvements in sanitation. CONCLUSIONS: The 6.3% annual rate of decline in the proportion of children with height-for-age deficits indicates that, in another ten years, child malnutrition in Brazil may no longer be a public health issue. Achieving this will depend on the maintenance of economic and social policies that have favored an increase in purchasing power among the poor, and on public investments aimed at completing the universalization of access to essential services such as education, health, and sanitation among the Brazilian population. Language: EnglishPortuguese Keywords: BRAZIL | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | CHILD | MALNUTRITION | PREVALENCE | CHILD NUTRITION | NUTRITION DISORDERS | SOCIOECONOMIC FACTORS | EDUCATIONAL STATUS | HEALTH SERVICES | SANITATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Youth | Age Factors | Population Characteristics | Diseases | Measurement | Research Methodology | Nutrition | Health | Economic Factors | Socioeconomic Status | Delivery of Health Care | Public Health Document Number: 341847 |
6.  Title: Nutritional anaemia and malaria in pre-school and school age children. Author: Anumudu C; Afolami M; Igwe C; Nwagwu M; Keshinro O Source: Annals of African Medicine. 2008;7(1):11-17. Abstract: The most common cause of anemia is a deficiency of iron; but it may also be caused by deficiencies of folates, vitamin B12 and protein. Some anemias are not caused by nutritional factors, but by congenital factors and parasitic diseases such as malaria. This study attempted to estimate the prevalence of anemia among pre-school and school- aged children in two rural areas of Odogbolu Local government area, and to determine whether its cause was nutritional or could be attributed to malaria. A total of 177 children between the ages of 2 and 11 years were included in the study. Children were examined for malaria parasites by microscopy. The World Health Organization (WHO) age-adjusted cut-off for hemoglobin and hematocrit were used to classify anemia. An enzyme linked immunosorbent assay for serum ferritin was compared with standard methods of determining iron deficiency. Under- nutrition (stunting, wasting and underweight) was classified according to the National Centre for Health Statistics standards. Values below m - 2SD were defined as mild-moderate under-nutrition, and those below m -3SD as severe malnutrition. Most of the children were anemic, 87.1%, having PCV values below the 32% cut-off and 95% with hemoglobin levels lower than the 11g/dl, although parasite prevalence and density were low. Malnutrition was patent; 36% of the children were stunted, 18.3% wasted and 44.2% underweight. Serum ferritin was more sensitive than PCV in detecting anemic children. Although anemia was higher in boys and preschoolers compared to girls and school aged children, the difference was significant only in preschoolers (P = .004). Anaemia was also significantly higher in Irawo village school than in Iloti (P = .0001). The anemia detected in this population may be due more to under-nutrition than to malaria. (author's) Language: English Keywords: NIGERIA | RESEARCH REPORT | CLINICAL RESEARCH | CHILDREN | ANEMIA | PREVALENCE | MALARIA | PARASITES | NUTRITION DISORDERS | CHILD NUTRITION | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Measurement | Parasitic Diseases | Biology | Nutrition | Health Document Number: 327661 |
| 7. Title: Aetiological factors and perception of anaemia in Tunisian women of reproductive age. Author: El Ati J; Lefevre P; Beji C; Ben Rayana C; Gaigi S; Delpeuch F Source: Public Health Nutrition. 2008 Jul;11(7):729-36. Abstract: OBJECTIVES: To identify aetiological factors in anaemia and to explore knowledge, perceptions and attitudes towards anaemia. DESIGN: Two cross-sectional surveys and sixteen focus group discussions. SETTING: The two regions with the highest prevalence of anaemia in Tunisia, Greater Tunis (GT) and the South West (SW). SUBJECTS: Two representative samples of 687 (GT) and 729 (SW) women of reproductive age; 108 women were included in focus group discussions. RESULTS: Among anaemic women, 63.4% in the GT region and 80.2% in the SW displayed iron deficiency (ID). Genetic haemoglobinopathies accounted for 10.0% and 3.6% of the cases of anaemia in the two regions, respectively. After adjustment for confounders, the major factors for iron-deficiency anaemia were low dietary Fe intake (OR = 5.0, 95% CI 3.0, 8.4), drinking tea after eating (OR = 3.4, 95% CI 2.0, 5.7) and pica (OR = 2.1, 95% CI 1.1, 3.9). Most of the women related anaemia to the following causes: malnutrition, lack of hygiene, and their heavy workload and responsibilities in the household. Many women connected anaemia with hypotension. Few established a relationship between ID and anaemia. They had confidence in their doctor for treatment, but many complained they were not given sufficient information. Low dietary Fe intake, inappropriate food practices and inadequate perceptions contribute to the aetiology of anaemia in women. CONCLUSIONS: These results point out to the need for a strategy combining food fortification, Fe supplementation for pregnant women, nutritional education for the general public and at-risk specific target groups, and training of health professionals. Language: English Keywords: TUNISIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | FOCUS GROUPS | WOMEN | PERCEPTION | ATTITUDES | ANEMIA | NUTRITION DISORDERS | VITAMINS AND MINERALS | REPRODUCTIVE AGE | Developing Countries | Africa, North | Africa | Research Methodology | Data Collection | Demographic Factors | Population | Psychological Factors | Behavior | Diseases | Physiology | Biology | Reproduction Document Number: 328818 |
| 8. Peer Reviewed Title: Nutrition: basis for healthy children and mothers in Bangladesh. Author: Faruque AS; Ahmed AM; Ahmed T; Islam MM; Hossain MI; Roy SK; Alam N; Kabir I; Sack DA Source: Journal of Health, Population, and Nutrition. 2008 Sep;26(3):325-39. Abstract: Recent data from the World Health Organization showed that about 60% of all deaths, occurring among children aged less than five years (under-five children) in developing countries, could be attributed to malnutrition. It has been estimated that nearly 50.6 million under-five children are malnourished, and almost 90% of these children are from developing countries. Bangladesh is one of the countries with the highest rate of malnutrition. The recent baseline survey by the National Nutrition Programme (NNP) showed high rates of stunting, underweight, and wasting. However, data from the nutrition surveillance at the ICDDR,B hospital showed that the proportion of children with stunting, underweight, and wasting has actually reduced during 1984-2005. Inappropriate infant and young child-feeding practices (breastfeeding and complementary feeding) have been identified as a major cause of malnutrition. In Bangladesh, although the median duration of breastfeeding is about 30 months, the rate of exclusive breastfeeding until the first six months of life is low, and practice of appropriate complementary feeding is not satisfactory. Different surveys done by the Bangladesh Demographic and Health Survey, United Nations Children's Fund (UNICEF), and Bangladesh Breastfeeding Foundation (BBF) showed a rate of exclusive breastfeeding to be around 32-52%, which have actually remained same or declined over time. The NNP baseline survey using a strict definition of exclusive breastfeeding showed a rate of exclusive breastfeeding (12.8%) until six months of age. Another study from the Abhoynagar field site of ICDDR,B reported the prevalence of exclusive breastfeeding to be 15% only. Considerable efforts have been made to improve the rates of exclusive breastfeeding. Nationally, initiation of breastfeeding within one hour of birth, feeding colostrum, and exclusive breastfeeding have been promoted through the Baby-Friendly Hospital Initiative (BFHI) implemented and supported by BBF and UNICEF respectively. Since most (87-91%) deliveries take place in home, the BFHI has a limited impact on the breastfeeding practices. Results of a few studies done at ICDDR,B and elsewhere in developing countries showed that the breastfeeding peer-counselling method could substantially increase the rates of exclusive breastfeeding. Results of a study in urban Dhaka showed that the rate of exclusive breastfeeding was 70% among mothers who were counselled compared to only 6% who were not counselled. Results of another study in rural Bangladesh showed that peer-counselling given either individually or in a group improved the rate of exclusive breastfeeding from 89% to 81% compared to those mothers who received regular health messages only. This implies that scaling up peer-counselling methods and incorporation of breastfeeding counselling in the existing maternal and child heath programme is needed to achieve the Millennium Development Goal of improving child survival. The recent data showed that the prevalence of starting complementary food among infants aged 6-9 months had increased substantially with 76% in the current dataset. However, the adequacy, frequency, and energy density of the complementary food are in question. Remarkable advances have been made in the hospital management of severely-malnourished children. The protocolized management of severe protein-energy malnutrition at the Dhaka hospital of ICDDR,B has reduced the rate of hospital mortality by 50%. A recent study at ICDDR,B has also documented that home-based management of severe protein-energy malnutrition without follow-up was comparable with a hospital-based protocolized management. Although the community nutrition centres of the NNP have been providing food supplementation and performing growth monitoring of children with protein-energy malnutrition, the referral system and management of complicated severely-malnourished children are still not in place. Language: English Keywords: BANGLADESH | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CHILDREN | PREGNANT WOMEN | CHILD SURVIVAL | CHILD NUTRITION | MATERNAL NUTRITION | MALNUTRITION | BREASTFEEDING | BREASTFEEDING, EXCLUSIVE | PREVALENCE | COUNSELING | SUPPLEMENTARY FEEDING | NUTRITION DISORDERS | Developing Countries | Asia, Southern | Asia | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Survivorship | Length of Life | Mortality | Population Dynamics | Nutrition | Health | Diseases | Infant Nutrition | Measurement | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 328887 |
| 9. Title: Prevalence of antibodies to HAART agents among HIV patients in Benin city, Nigeria. Author: Omoregie R; Egbeobauwaye A; Ogefere H; Omokaro EU; Ekeh CC1 Source: African Journal of Biomedical Research. 2008 Jan;11(1):33-37. Abstract: Against the background that some human immunodeficiency virus (HIV)-infected patients on the highly active antiretroviral therapy (HAART) still experience anaemia, some possible reasons for this were investigated. Blood was collected from 50 newly diagnosed treatment naive HIV-infected patients, 100 HIV-infected patients on HAART and 30 apparently healthy HIV seronegative individuals that served as controls. Haemotocrit values, red blood cell distribution width (RDW) and the presence of antibodies to the drugs in the HAART regimen were determined. The mean +or- standard deviation of haematocrit values of HAART naive HIV patients (36.90 +or- 5.61%) and those on HAART (37.20 +or- 6.20%) were significantly lower compared to controls (41.50 +or- 5.88%) (p = 0.001), though the difference between HIV patients on HAART and those that were HAART naive was not significant (p = 0.836). Although, the RDW of HIV patients were lower than controls, the difference was only significant (p = 0.026) between controls (17.00 +or- 6.01%) and HAART naive HIV patients (15.00 +or- 1.87). A total of 81 (81%) out of the 100 HIV patients on HAART had antibodies to one or more of the HAART drugs. Antibodies to nevirapine (58%) was higher compared to stavudine (44.6) and zidovudine (42%) ( p = < 0.05). There was no significant improvement in haematocrit of HIV patients on HAART over HAART naive HIV patients. Use of zidovudine, nutritional deficiency and presence of antibodies to the HAART drugs may have been responsible. Language: English Keywords: NIGERIA | RESEARCH REPORT | PREVALENCE | PERSONS LIVING WITH HIV/AIDS | CLIENTS | ANTIBODIES | ANTIRETROVIRAL THERAPY | HIV INFECTIONS | NUTRITION DISORDERS | ANTIRETROVIRAL DRUGS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Measurement | Research Methodology | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | Immunologic Factors | Immunity | Immune System | Physiology | Biology | HIV | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 340141 |
| 10. Title: New challenges in studying nutrition-disease interactions in the developing world. Author: Prentice AM; Gershwin ME; Schaible UE; Keusch GT; Victora CG Source: Journal of Clinical Investigation. 2008 Apr;118(4):1322-1329. Abstract: Latest estimates indicate that nutritional deficiencies account for 3 million child deaths each year in less-developed countries. Targeted nutritional interventions could therefore save millions of lives. However, such interventions require careful optimization to maximize benefit and avoid harm. Progress toward designing effective life-saving interventions is currently hampered by some serious gaps in our understanding of nutrient metabolism in humans. In this Personal Perspective, we highlight some of these gaps and make some proposals as to how improved research methods and technologies can be brought to bear on the problems of undernourished children in the developing world. (author's) Language: English Keywords: DEVELOPING COUNTRIES | CRITIQUE | CASE STUDIES | RESEARCH AND DEVELOPMENT | NUTRITION DISORDERS | CHILD NUTRITION | INTERVENTIONS | NUTRITION INDEXES | OBSTACLES | IMMUNE SYSTEM | VITAMINS AND MINERALS | FOOD SUPPLEMENTATION | Studies | Research Methodology | Technology | Economic Factors | Diseases | Nutrition | Health | Programs | Organization and Administration | Physiology | Biology | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care Document Number: 326269 |
| 11. Title: Digestive, hepatic, and nutritional manifestations in Latin American children with HIV/AIDS. Author: Velasco-Benitez CA Source: Journal of Pediatric Gastroenterology and Nutrition. 2008 Aug;47 Suppl 1:S24-6. Abstract: The HIV/AIDS infection is increasing in Latin America and the Caribbean regions, according to the World Health Organization (WHO). In Latin America, most cases are in Brasil, Mexico, and Colombia. Some causes of the HIV/AIDS infection in Latin America are poverty, limitations on the access to antiretroviral drugs, poor response from governmental and health authorities, migration, and scantiness of research resources. In the pediatric population, perinatal transmission is the main contact mechanism. Several digestive, hepatic, and nutritional manifestations allow the classification of HIV infection in children, according to the Centers for Disease Control and Prevention. Improvement in knowledge of the epidemiology, pathogenesis, physiopathology; and management of HIV enteropathy and on nutritional care practices of infected HIV children is recommended. Language: English Keywords: LATIN AMERICA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLASSIFICATION | PERSONS LIVING WITH HIV/AIDS | CHILDREN | PREVALENCE | HIV INFECTIONS | COMPLICATIONS | HEPATIC EFFECTS | GASTROINTESTINAL EFFECTS | NUTRITION DISORDERS | CHILD NUTRITION | Americas | Developing Countries | Research Methodology | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Measurement | Physiology | Biology | Nutrition | Health Document Number: 329114 |
| 12. Peer Reviewed Title: A trail of the effect of micronutrient supplementation on treatment outcome, T cell counts, morbidity, and mortality in adults with pulmonary tuberculosis. Author: Villamor E; Mugusi F; Urassa W; Bosch RJ; Saathoff E Source: Journal of Infectious Diseases. 2008 Jun;197(11):1499-1505. Abstract: Tuberculosis (TB) often coincides with nutritional deficiencies. The effects of micronutrient supplementation on TB treatment outcomes, clinical complications, and mortality are uncertain. We conducted a randomized, double-blind, placebo-controlled trial of micronutrients (vitamins A, B complex, C, and E, as well as selenium) in Dar es Salaam, Tanzania. We enrolled 471 human immunodeficiency virus (HIV)-infected and 416 HIV-negative adults with pulmonary TB at the time of initiating chemotherapy and monitored them for a median of 43 months. Micronutrients decreased the risk of TB recurrence by 45% overall (95% confidence interval [CI], 7% to 67%; P = .02) and by 63%in HIV-infected patients (95% CI, 8% to 85%; P = .02). There were no significant effects on mortality overall; however, we noted a marginally significant 64% reduction of deaths in HIV-negative subjects (95% CI, -14% to 88%; P = .08). Supplementation increased CD3+ and CD4+ cell counts and decreased the incidence of extrapulmonary TB and genital ulcers in HIV-negative patients. Micronutrients reduced the incidence of peripheral neuropathy by 57% (95% CI, 41% to 69%; P less than .001), irrespective of HIV status. There were no significant effects on weight gain, body composition, anemia, or HIV load. Micronutrient supplementation could improve the outcome in patients undergoing TB chemotherapy in Tanzania. (author's) Language: English Keywords: TANZANIA | RESEARCH REPORT | CLINICAL TRIALS | CLIENTS | TUBERCULOSIS | VITAMINS AND MINERALS | HIV INFECTIONS | NUTRITION DISORDERS | TREATMENT | MORBIDITY | MORTALITY | PULMONARY EFFECTS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Clinical Research | Research Methodology | Program Activities | Programs | Organization and Administration | Infections | Diseases | Physiology | Biology | Viral Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Dynamics | Demographic Factors | Population Document Number: 326732 |
| 13. Title: Achieving the Millennium Development Goals for health: So far, progress is mixed -- Can we reach our targets? Author: World Bank. Disease Control Priorities Project Source: [Washington, D.C.], World Bank, Disease Control Priorities Project, 2007 Feb. [4] p. Abstract: The Millennium Development Goals (MDGs), adopted by 147 heads of state in 2001, address the world's most staggering health and poverty issues. Meeting the goals, or even substantial progress towards meeting them, would produce a healthier, more economically sound world. Some progress has been made, but it is lopsided -- both regionally and within countries. Sub-Saharan Africa lags behind the rest of the developing world on most of the MDGs. Within developing countries in all regions, the well-off are improving their health at a faster rate than the poor. Interventions known to help meet the goals are not being used effectively, nor are health systems always capable of implementing them on the appropriate scale. (excerpt) Language: English Keywords: AFRICA, SUB SAHARAN | SUMMARY REPORT | GOALS | HEALTH | POVERTY | HIV PREVENTION | AIDS PREVENTION | MALNUTRITION | MATERNAL HEALTH | CHILD MORTALITY | MATERNAL MORTALITY | NUTRITION DISORDERS | INTERVENTIONS | PROGRAM EFFECTIVENESS | Developing Countries | Africa | Planning | Organization and Administration | Socioeconomic Factors | Economic Factors | HIV Infections | Viral Diseases | Diseases | AIDS | Mortality | Population Dynamics | Demographic Factors | Population | Programs | Program Evaluation Document Number: 314866 |
| 14. Title: Maternal deaths: an unacceptable lack of progress. Author: World Bank. Disease Control Priorities Project Source: [Washington, D.C.], World Bank, Disease Control Priorities Project, 2007 Mar. [4] p. Abstract: Two of the eight Millennium Development Goals (MDGs) embraced by UN members in 2000 target the health of mothers and children, testifying to the vast inequities in maternal and child health within and between countries. In 2001, maternal and perinatal conditions represented the single largest contributor to the global burden of disease, at nearly 6 percent of total Disability Adjusted Life Years (DALYs).* About 500,000 women die as a result of pregnancy or childbirth, nearly all in developing countries. Maternal and newborn mortality are regarded as sensitive indicators of the entire health system, and can be used to monitor general health gains. However, these deaths also represent the most serious challenges to achieving the MDGs, particularly in South Asia and sub-Saharan Africa. Experts agree that nearly all maternal deaths could be prevented with proper prenatal and postnatal care, along with skilled attendance at childbirth and the availability of emergency care for serious complications. The clinical interventions needed to avert much of the disease burden from maternal deaths require a reasonably well-functioning health system. This fact sheet focuses on causes and management of conditions that arise during pregnancy and delivery resulting in the death of the mother. Maternal health is intricately linked with newborn health, which is discussed in detail in the "Newborn Health" fact sheet. (excerpt) Language: English Keywords: ASIA, SOUTHERN | AFRICA, SUB SAHARAN | SUMMARY REPORT | GOALS | MOTHERS | CHILD | MATERNAL MORTALITY | CHILD MORTALITY | CAUSES OF DEATH | NUTRITION DISORDERS | INTERVENTIONS | FEES | MATERNAL-CHILD HEALTH SERVICES | DELIVERY OF HEALTH CARE | ANTENATAL CARE | Asia | Developing Countries | Africa | Planning | Organization and Administration | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Diseases | Programs | Financial Activities | Economic Factors | Primary Health Care | Health Services | Health | Maternal Health Services Document Number: 314864 |
| 15. Peer Reviewed Title: Determinants of persistent underweight among children, aged 6 -- 35 months, after huge economic development and improvements in health services in Oman. Author: Alasfoor D; Traissac P; Gartner A; Delpeuch F Source: Journal of Health, Population and Nutrition. 2007 Sep;25(3):359-369. Abstract: Over the last decades, health indicators have witnessed major improvements in the Sultanate of Oman. This study was aimed at factors associated with underweight among children in four regions of Oman, as, in 1998, underweight was prevalent among 17.9% of children aged less than five years. A case-control study was conducted in 2002: 190 cases were 6-35-month old children with weight-for-age less than -2 z-scores. Controls were individually matched by village of residence, sex, and age. The questionnaire included anthropometry of children, child-feeding practices, morbidity, anthropometry of mothers, parity, birth-spacing, and socioeconomic characteristics. Conditional logistic regression was used for analyses. Birth-weight of less than 2,500 g was strongly associated with underweight and also were height of mother, low level of education of mother, bad quality of water in households, diarrhoea of children in the last two weeks, and regular use of infant formula. Factors, such as birth-weight, height of mother, supply of safe water in household, and care for mothers and children were the determinants of persistent underweight after huge economic development and improvements in health services. Further research is also needed to investigate further specific determinants of low birth-weight in the Omani context and try to disentangle emaciation and determinants of linear growth retardation. (author's) Language: English Keywords: OMAN | RESEARCH REPORT | CASE STUDIES | CHILD | CHILD HEALTH | CHILD NUTRITION | BIRTH WEIGHT | BODY WEIGHT | NUTRITION DISORDERS | LOW BIRTH WEIGHT | SOCIOECONOMIC FACTORS | Middle East | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Nutrition | Physiology | Biology | Diseases | Economic Factors Document Number: 323846 |
| 16. Peer Reviewed Title: Effects of zinc supplementation on child mortality. Author: Bhatnagar S Source: Lancet. 2007 Mar 17;369(9565):885-886. Abstract: More than 10 million children younger than 5 years die every year in the developing world, mostly from preventable infections. Malnutrition and micronutrient deficiencies are increasingly recognised as the main risk factor for childhood mortality in these countries. Micronutrients are important determinants of infection and their outcomes. Zinc is a crucial micronutrient because it affects various immune mechanisms and modulates host resistance to several pathogens. Zinc supplementation reduces morbidity from diarrhoea and pneumonia in high risk populations. A large body of evidence shows important therapeutic benefits with zinc administration during and after diarrhoea, and some studies also reported reduction in diarrhoea morbidity in the subsequent 2-3 months without further supplementation. Assessment of the effect of improved zinc intake on child mortality is important for the development of effective public-health policy. In today's Lancet, Sunil Sazawal and colleagues report an overall non-significant 7% reduction in mortality in a randomised trial of daily zinc supplementation in children aged 1-48 months residing in Pemba, Zanzibar. A significant reduction in mortality was noted in children aged 12-48 months which, although from a subgroup analysis, is plausible. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | SUMMARY REPORT | CHILD | LOW BIRTH WEIGHT | DIARRHEA | CHILD MORTALITY | PREVENTION AND CONTROL | NUTRITION DISORDERS | ZINC | TREATMENT | VITAMINS AND MINERALS | ADMINISTRATION AND DOSAGE | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Birth Weight | Body Weight | Physiology | Biology | Diseases | Mortality | Population Dynamics | Metals | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs Document Number: 314479 |
| 17. Peer Reviewed Title: Iron and zinc deficiency in children in developing countries. Author: Bhutta ZA Source: BMJ. British Medical Journal. 2007 Jan;334(7585):104-105. Abstract: In this week's BMJ Sazawal and colleagues report a trial of milk fortified with multiple micronutrients (as a strategy to deliver zinc and iron) in children in India. They found a significant reduction in severe illness and the incidence of acute respiratory infections and diarrhoea. Although data on the impact of the intervention on iron and zinc status are not presented, the functional benefits are consistent with the previously recognised benefits of zinc supplementation on the burden and severity of diarrhoeal diseases and respiratory infections. Iron deficiency ranked ninth among 26 risk factors included in the global burden of disease study, and accounted for 841 000 deaths and 35 057 000 disability adjusted life years lost. Large sections of populations in Africa and Asia are at risk of dietary zinc deficiency and resulting high rates of stunting. Correcting micronutrient deficiencies can help reduce child mortality, but it is unclear how these deficiencies can be dealt with at the population level. Although combinations of iron and zinc have been suggested as appropriate strategies for rectifying deficiencies of multiple micronutrients in children at risk, the benefits may not be additive because of potential interactions. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | SUMMARY REPORT | CHILD | CHILD NUTRITION | NUTRITION DISORDERS | IRON | ZINC | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition | Health | Diseases | Metals | Vitamins and Minerals | Physiology | Biology Document Number: 312017 |
| 18. Title: Maternal social capital and child nutritional status in four developing countries. Author: De Silva MJ; Harpham T Source: Health and Place. 2007;13(2):341-355. Abstract: Social capital has been shown to be positively associated with a range of health outcomes, yet no studies have explored the association between maternal social capital and child nutritional status. Using data from the Young Lives study comprising 7242 1-year-old children from Peru, Ethiopia, Vietnam and the state of Andhra Pradesh in India, we find significant differences in the levels of, in particular, structural social capital (group membership and citizenship) between countries. While few associations were found between structural measures of social capital, support from individuals and cognitive social capital (e.g. trust, social harmony) displayed fairly consistent positive associations with child nutritional status across countries. (author's) Language: English Keywords: ETHIOPIA | PERU | VIETNAM | INDIA | RESEARCH REPORT | COMPARATIVE STUDIES | CHILD | NUTRITION INDEXES | CHILD NUTRITION | MATERNAL HEALTH | SOCIAL NETWORKS | HOME ECONOMICS | NUTRITION DISORDERS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | South America, Western | South America | Latin America | Americas | Asia, Southeastern | Asia | Asia, Southern | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition | Health | Friends and Relatives | Family and Household | Sociocultural Factors | Microeconomic Factors | Economic Factors | Diseases Document Number: 311558 |
| 19. Peer Reviewed Title: Evaluating causes of acute renal failure in newborn infants. Author: Gharehbaghi MM; Peirovifar A Source: Pakistan Journal of Medical Sciences. 2007 Oct-Dec;23(6):877-880. Abstract: Acute renal failure (ARF) is a common problem in admitted neonates in intensive care units. In most patients ARF accompanies with a predisposing factor such as sepsis, heart failure, perinatal asphyxia or prematurity. The objective of this study was to determine the causes and outcome of ARF in hospitalized newborn infants. In a descriptive cross sectional study we evaluated neonates with ARF who had been hospitalized in Tabriz Children Hospital from March 2004 to September 2005. There were 85 cases with diagnosed ARF in 3000 hospitalized neonates (2.83%).The male to female ratio in patients with ARF was 2.03:1. Most of involved patients were term (70.6%). The prevalence of renal, pre renal and post renal causes of ARF was 49.4%, 43.5% and 7.1% respectively. The most common predisposing factors for ARF in our study were surgery (43.5%), perinatal asphyxia (36.5%), sepsis (32.9%), respiratory distress syndrome (25.9%), heart failure (20%) and feeding problems (20%). All patients had more than one predisposing factor. Among admitted neonates with ARF mortality rate was 20% and it was significantly higher in patients with assisted ventilation and sepsis (P<0.05). Early recognition of risk factors such as sepsis, perinatal asphyxia or, perioperative problems and rapid effective treatment of contributing conditions will reduce ARF in neonatal period. (author's) Language: English Keywords: IRAN | RESEARCH REPORT | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | EPIDEMIOLOGIC METHODS | INFANT | RENAL EFFECTS | NEONATAL DISEASES AND ABNORMALITIES | SURGERY | SEX FACTORS | PREVALENCE | RESPIRATORY INSUFFICIENCY | NUTRITION DISORDERS | HEART DISEASES | DEATH RATE | Developing Countries | Middle East | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Urogenital Effects | Urogenital System | Physiology | Biology | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Pulmonary Effects | Mortality | Population Dynamics Document Number: 323572 |
| 20. Title: [Iron deficiency anemia in first grade students from public schools in a region of Brasķlia, DF] Anemia ferropriva em escolares da primeira serie do ensino fundamental da rede publica de educacao de uma regiao de Brasilia, DF. Author: Heijblom GS; Santos LM Source: Revista Brasileira de Epidemiologia. 2007 Jun;10(2):258-266. Abstract: Iron deficiency anemia (IDA) is the most prevalent micronutrient deficiency in the world. In school age children, IDA is particularly deleterious: anemic children are sleepy and pay less attention. As a consequence, anemia can lead to high absenteeism and lower school performance. A cross-sectional survey was conducted in a representative sample of 424 randomly selected first graders (ages 6 to 11 years) from public schools located in the Northern Public Health Region of Brasķlia. The study objectives were to: (a) determine the prevalence of anemia; (b) compare the results obtained in 2004 to those of a similar survey conducted in the same area in 1998. Hemoglobin (Hb) was determined in finger- prick blood samples using Hemocue®. Two cut-off points were used to classify anemia, both established by the WHO: Hb<11.5g/dL and Hb<12.0g/dL. The height/age, weight/age and weight/height indicators below -2.0 standard deviations from the NCHS reference were used to indicate growth retardation. Prevalence of anemia was 12.5% and 11.9% (Hb<11.5g/ dL) and 26.9% and 21.5% (Hb<12.0g/dL) in 2004 and 1998 respectively. The prevalence of anemia increased between the surveys, but the difference was not significant. There was no statistically significant association between growth retardation and anemia. A high prevalence of anemia was observed, which justifies the implementation of public policies to fight the problem, such as the fortification of wheat and corn flours with iron, mandatory since 2004. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PREVALENCE | CHILDREN | CHILD NUTRITION | ANEMIA | IRON | DEFICIENCY DISEASES | NUTRITION DISORDERS | Developing Countries | South America, Eastern | South America | Latin America | Americas | Research Methodology | Measurement | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition | Health | Diseases | Metals | Vitamins and Minerals | Physiology | Biology Document Number: 324945 |
| 21. Peer Reviewed Title: Effect of the maternal betaE-globin gene on hematologic responses to iron supplementation during pregnancy. Author: Sanchaisuriya K; Fucharoen S; Ratanasiri T; Sanchaisuriya P; Fucharoen G Source: American Journal of Clinical Nutrition. 2007 Feb;85(2):474-479. Abstract: It is customary in Southeast Asia to treat pregnant anemic women with iron supplements, but anemia in this region may be complicated by thalassemia and hemoglobinopathies, which lead to an ineffective response. The aim was to determine whether routine iron supplementation during pregnancy in this area, which has a high prevalence of thalassemia and hemoglobinopathies, is an effective control strategy for iron deficiency anemia. A prospective study was conducted. Seventy-six pregnant women, including 43 who were heterozygous for the hemoglobin E (Hb E) gene, 20 who were heterozygous for Hb E and had a-thalassemia, and 13 who were homozygous Hb E, as well as 77 pregnant women who had no thalassemia gene, participated in this investigation. All pregnant women received a daily dose of 120 mg elemental Fe for an average of 133.5 d. Hematologic variables and serum ferritin concentrations were measured before supplementation and after supplementation at the gestational age of 28-32 wk. Differences in hematologic variables and serum ferritin were assessed. Significant differences in hemoglobin, mean corpuscular volume, and mean corpuscular hemoglobin responses were found between the nonthalassemia group and the 3 groups with the Hb E gene after adjustment for the following baseline values: age, body mass index, duration of iron supplementation, and ferritin concentration. Significant differences in the improvements in mean corpuscular volume and mean corpuscular hemoglobin values between the 3 groups indicate a poorer response at the cellular level in the pregnant women with the Hb E gene. Further analysis showed a significant difference in the hemoglobin response only for women who were homozygous for Hb E. Iron supplementation during pregnancy is not beneficial for pregnant women who are homozygous for Hb E, but a routine intervention should not cause iron overload, as judged from this short observation period. (author's) Language: English Keywords: ASIA, SOUTHEASTERN | RESEARCH REPORT | PROSPECTIVE STUDIES | PREGNANCY | ANEMIA | IRON | NUTRITION DISORDERS | HEMOGLOBIN LEVEL | VITAMINS AND MINERALS | TREATMENT | Asia | Developing Countries | Studies | Research Methodology | Reproduction | Diseases | Metals | Physiology | Biology | Hemic System | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 312066 |
| 22. Title: [Determinants of excessive weight gain during pregnancy in a public low risk antenatal care service] Determinantes do ganho ponderal excessivo durante a gestacao em servico publico de pre-natal de baixo risco. Author: Stulbach TE; Benicio MH; Andreazza R; Kono S Source: Revista Brasileira de Epidemiologia. 2007 Mar;10(1):99-108. Abstract: Introduction: Excessive weight gain during pregnancy tends to result in postpartum weight retention and contributes to obesity in women. Methods: This study evaluated the influence of socio-economic factors, obstetric history, smoking, having a job, and initial nutritional status on excessive weight gain (EWG). EWG was estimated according to IOM recommendations (weekly gain > 0.58g, >0.53g and >0.39g which correspond to an initial nutritional status of underweight, eutrophic, overweight/obesity, respectively). We studied a cohort of 141 healthy pregnant women enrolled in public health services, between March 1997 and March 1998. The influence of each study variable on EWG was checked separately for the 2nd and 3rd trimesters using the Poisson model for hierarchy multiple regression analysis. Results: Amongst the 237 eligible pregnant women, there were 37.8% of patient losses, but no statistical significance was detected for the main study variables. The incidence of EWG during the 2nd trimester was 38.6% (CI95% 30.5 -47.2) and during 3rd trimester it was 36.4% (CI95% 28.5 -45.0). During the 2nd trimester only schooling was associated with EWG. When comparing women who studied less than 5 years, with the ones who studied 5 to 8 years and those with more than 8 years of schooling, relative risks were 2.09 (CI95% 1.03 -4.25) and 2.62 (CI95% 1.32 -5.22), respectively. In the 3rd trimester the variables that resulted in statistical significance were: less than 8 years of schooling (RR= 1.91 [CI95% 1.22 -2.97], living without a partner (RR=1.66 [(CI95% 1.06 -2.59], primiparas (RR= 2.13 [CI95% 1.20 -3.85]; adequate initial nutritional status and overweight/obesity (RR= 1.53 [CI95% 0.82 -2.84] and RR=2.02 [IC95% 1.04 -3.92], respectively) in comparison to those who were underweight. Conclusion: Based on the high incidence of EWG, more attention should be given during antenatal care, particularly in women with more schooling, those living without partner, primiparas and those who have an initial adequate nutritional status or overweight/obesity during pregnancy, in order to prevent and control the problem. (author's) Language: Portuguese Keywords: RESEARCH REPORT | EVALUATION | COHORT ANALYSIS | INCIDENCE | PREGNANT WOMEN | SOCIOECONOMIC FACTORS | SUBSTANCE ADDICTION | EMPLOYMENT STATUS | NUTRITION DISORDERS | OBESITY | BODY WEIGHT | ANTENATAL CARE | PREVENTION AND CONTROL | Research Methodology | Measurement | Population Characteristics | Demographic Factors | Population | Economic Factors | Social Problems | Sociocultural Factors | Socioeconomic Status | Diseases | Physiology | Biology | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health Document Number: 324940 |
| 23. Peer Reviewed Title: Efficacy of daily and weekly multiple micronutrient food-like tabletsfor the correction of iodine deficiency in Indonesian males aged 6-12 months. Author: Wijaya-Erhardt M; Untoro J; Karyadi E; Wibowo L; Gross R Source: American Journal of Clinical Nutrition. 2007 Jan;85(1):137-143. Abstract: Infants are highly vulnerable to iodine deficiency, and little data exist on the effect of multiple micronutrient supplementation on their iodine status. We aimed to compare the efficacy of daily and weekly multiple micronutrient food-like tablets (foodLETs) on increasing iodine status among infants. In a double-blind, placebo-controlled trial, 133 Indonesian males aged 6-12 mo were randomly assigned to 1 of 4 groups: a daily multiple-micronutrient foodLET providing the Recommended Nutrient Intake (RNI)(DMM), a weekly multiple-micronutrient foodLET providing twice the RNI (WMM), a daily 10-mg Fe foodLET (DI), or placebo. Urinary iodine (UI) concentrations were measured at baseline and at 23 wk. At baseline, the average UI concentration (1.37micromol/L) was within the normal range, and 30.8% of subjects had iodine deficiency (UI_0.79micromol/L). At 23 wk, the DMM group had the highest increment in UI; however, after adjustment for initial UI, the changes in UI were not significantly different between the 4 groups (P = 0.39). Initial UI correlated inversely with the changes in UI (P < 0.001). The DMM group had the greatest reduction and increment in the proportion of iodine-deficient infants and in infants with iodine excess, respectively; however, no significant difference was found in these proportions (P = 0.13 and P = 0.42) between the 4 groups. Daily consumption of a multiple-micronutrient foodLET providing the RNI during infancy may be one strategy to improve iodine status. (author's) Language: English Keywords: INDONESIA | RESEARCH REPORT | CLINICAL TRIALS | INFANT | CHILD, MALE | INFANT NUTRITION | PROTEIN BOUND IODINE ALTERATIONS | NUTRITION DISORDERS | VITAMINS AND MINERALS | ADMINISTRATION AND DOSAGE | Asia, Southeastern | Asia | Developing Countries | Clinical Research | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Child | Nutrition | Health | Hematological Effects | Hemic System | Physiology | Biology | Diseases | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 312062 |
| 24. Title: Influence of parental and socioeconomic factors on stunting in children under 5 years in Egypt. Author: Zottarelli LK; Sunil TS; Rajaram S Source: Eastern Mediterranean Health Journal. 2007;13(6):1330-1342. Abstract: We assessed the relationship between parental and socioeconomic characteristics and nutritional status of children under 5 years in Egypt. Data from the 2000 Egypt Demographic and Health Survey were used. A logistic regression technique was used to estimate the odds of being malnourished. Children whose mothers had a higher level of education and were greater than 150 cm had a lower risk of stunting than those of mothers with no education and shorter height (less than 150 cm). Parental consanguinity, rural residence, higher birth order and short birth interval significantly increased the odds of stunting. Children aged greater than or equal to 12 months had greater odds of stunting than those less than 12 months. (author's) Language: English Keywords: EGYPT | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | RURAL AREAS | CHILD | PARENTS | CHILD NUTRITION | MALNUTRITION | NUTRITION DISORDERS | NUTRITION INDEXES | SOCIOECONOMIC FACTORS | EDUCATIONAL STATUS | Developing Countries | Africa, North | Africa | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Geographic Factors | Youth | Age Factors | Population Characteristics | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Nutrition | Health | Diseases | Economic Factors | Socioeconomic Status Document Number: 323875 |
| 25. Title: Community-based therapeutic care (CTC). A field manual. Author: Bahwere P; Binns P; Collins S; Dent N; Guerrero S Source: Oxford, England, Valid International, CTC Research and Development Program, 2006. [246] p. (USAID Cooperative Agreement No. HRN-A-00-98-00046-00) Abstract: Severe malnutrition has traditionally been managed in inpatient facilities. However, in several large-scale humanitarian crises in the 1990's, it became evident that the traditional therapeutic feeding centre (TFC) model of inpatient care was unable to provide an effective response. For example, during the famine in south Sudan in 1998, only a small proportion of acutely malnourished people were treated in NGO-run TFCs. Access was a considerable obstacle, and coverage was very limited. People who did reach a TFC were congregated together, exposing them to the risk of cross infection and to additional security risks. Furthermore, the opportunity costs to the family of having to stay in the centre were high. Carers, usually mothers, had to stay in centres for several weeks leaving their other children and family members at home and rendering them unable to engage in daily activities. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | MANUAL | WOMEN | CHILD | FAMINE | NUTRITION DISORDERS | RISK FACTORS | SOCIAL MOBILIZATION | METABOLIC EFFECTS | NUTRITION PROGRAMS | MALNUTRITION | TREATMENT | HOME CARE | SCREENING | DEATH RATE | PROGRAM DESIGN | Demographic Factors | Population | Youth | Age Factors | Population Characteristics | Food Supply | Natural Resources | Environment | Diseases | Biology | Social Change | Sociocultural Factors | Physiology | Primary Health Care | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine | Care and Support | Examinations and Diagnoses | Mortality | Population Dynamics | Programs | Organization and Administration Document Number: 310056 |
| 26. Peer Reviewed Title: Effect of wealth inequality on chronic under-nutrition in Cambodian children. Author: Hong R; Mishra V Source: Journal of Health, Population and Nutrition. 2006 Mar;24(1):89-99. Abstract: The problems of food insecurity and under-nutrition remain particularly severe in countries recovering from recent wars or civil unrest, where improvements in economic conditions have tended to benefit the advantaged groups and resulted in widespread inequalities in health. Using information on 3,235 children aged 0-59 month(s) included in the 2000 Cambodia Demographic and Health Survey, this study examined how economic inequality was associated with inequalities in chronic childhood under-nutrition. An under-nourished (stunted) child was defined as having his/her height-for-age more than two standard deviations below the reference median. Household wealth status was measured by an index based on household ownership of durable assets. Binary and multinomial logistic regressions were used for estimating the effects of household wealth status on moderate and severe stunting. The results indicated that children in the poorest 20% households were more than twice as likely to suffer from stunting as children in the richest 20% households (odds ratio [OR]=2.54; 95% confidence interval [CI] 1.91-3.39). Adjusting for child's age, sex, birth order, and duration of breastfeeding; age of mother at childbirth, body mass index, and education; and household access to safe drinking-water, hygienic toilet facility, residence, and geographic region made little difference to this effect (OR=2.05; 95% CI 1.28-3.28). The adjusted effect of wealth status was somewhat stronger on severe stunting (relative risk ratio [RRR]=2.26; 95% CI 1.22-4.18) than on moderate stunting (RRR=1.89; 95% CI 1.12-3.20). The study concludes that wealth inequality is strongly associated with chronic childhood under-nutrition and emphasizes that reducing poverty and making services more accessible to the poor will be key to improving the health and nutritional status of children in Cambodia. (author's) Language: English Keywords: CAMBODIA | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | CHILD | POVERTY | ECONOMIC CONDITIONS | INEQUALITIES | NUTRITION DISORDERS | CHRONIC DISEASES | ANTHROPOMETRY | CHILD DEVELOPMENT | Asia, Southeastern | Asia | Developing Countries | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Youth | Age Factors | Population Characteristics | Socioeconomic Factors | Economic Factors | Macroeconomic Factors | Diseases | Measurement | Research Methodology | Biology Document Number: 299528 |
| 27. Peer Reviewed Title: HIV incidence among post-partum women in Zimbabwe: risk factors and the effect of vitamin A supplementation. Author: Humphrey JH; Hargrove JW; Malaba LC; Iliff PJ; Moulton LH Source: AIDS. 2006 Jun;20(10):1437-1446. Abstract: The objective was to test whether post-partum vitamin A supplementation can reduce incident HIV among post-partum women and identify risk factors for HIV incidence. Design: Randomized, placebo-controlled trial Between November 1997 and January 2001, 14 110 women were randomly administered 400 000 I vitamin A or placebo within 96 h post-partum. HIV incidence was monitored among 9562 HIV-negative women. Cumulative incidence was 3.4% [95% confidence interval (CI), 3.0--3.8] and 6.5% (95% CI, 5.7--7.4) over 12 and 24 months post-partum, respectively. Vitamin A supplementation had no impact on incidence [hazard ratio (HR), 1.08; 95% CI, 0.85-- 1.38]. However, among 398 women for whom baseline serum retinol was measured, those with levels indicative of deficiency (< 0.7 µmol/l, 9.2% of those measured) were 10.4 (95% CI, 3.0--36.3) times more likely to seroconvert than women with higher concentrations. Furthermore, among women with low serum retinol, vitamin A supplementation tended to be protective against incidence (HR, 0.29; 95% CI, 0.03--2.60; P = 0.26), although not significantly so, perhaps due to limited statistical power. Severe anaemia (haemoglobin < 70 g/l) was associated with a 2.7-fold (95%CI, 1.2--6.1) greater incidence. Younger women were at higher risk of HIV infection: incidence declined by 5.7% (2.8--8.6) with each additional year of age. Among post-partum-women, a single large-dose vitamin A supplementation had no effect on incidence, although low serum retinol was a risk factor for seroconversion. Further investigation is required to determine whether vitamin A supplementation of vitamin-A-deficient women or treatment of anaemic women can reduce HIV incidence. (author's) Language: English Keywords: ZIMBABWE | RESEARCH REPORT | CONTROL GROUPS | INCIDENCE | POSTPARTUM WOMEN | HIV INFECTIONS | VITAMIN A | ANEMIA | NUTRITION DISORDERS | RISK FACTORS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Measurement | Puerperium | Reproduction | Viral Diseases | Diseases | Vitamins and Minerals | Physiology | Biology Document Number: 302679 |
| 28. Title: Status of iodine deficiency disorders in Uttaranchal. Author: Kandpal SD; Negi KS; Kansal A; Chandra R; Pradeep Source: Indian Journal of Preventive and Social Medicine. 2006 Jan-Jun;37(1-2):[5] p.. Abstract: Research Question: What is the status of Iodine Deficiency Disorders in various Districts of Uttaranchal State? Objectives: (a) To assess the magnitude of IDD in the rural population of various Districts Uttaranchal. (b) To find out the proportion of population consuming salt with adequate iodine content (= 15ppm). Study Design: Cross-Sectional. Setting Rural areas of the concerned districts of Uttaranchal. Participants: General population and school going children of the concerned districts. Statistical Analysis: Percentages, chi-square test. Results: Among the general population Goitre was detected in 1.85% individuals. 2.58% of the school going suffered from goitre. Majority of the general (89.7%) and school going children (96.26%) was in grade-I goitre. Among the general population as well as the school going population females were more affected with Goitre as compared to males. Iodine deficiency was found to be = 15ppm in 58.08% of the salt samples. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PREVALENCE | RURAL AREAS | CHILD | NUTRITION DISORDERS | PROTEIN BOUND IODINE ALTERATIONS | GOITER | THYROID EFFECTS | Asia, Southern | Asia | Developing Countries | Research Methodology | Measurement | Geographic Factors | Population | Youth | Age Factors | Population Characteristics | Demographic Factors | Diseases | Hematological Effects | Hemic System | Physiology | Biology | Endocrine Effects | Endocrine System Document Number: 314317 |
| 29. Peer Reviewed Title: Extended-interval gentamicin administration in malnourished children. Author: Khan AM; Ahmed T; Alam NH; Chowdhury AK; Fuchs GJ Source: Journal of Tropical Pediatrics. 2006 Jun;52(3):179-184. Abstract: Malnourished children have several physiologic abnormalities that can affect drug distribution and elimination. The aim of this study was to determine the efficacy, safety and pharmacokinetics of a once-daily dose of gentamicin compared with conventional thrice-daily dosing in malnourished children. To our knowledge, it has not been investigated in this population so far. A total of 310 malnourished children of either gender aged 6 months to 5 years with diarrhea and pneumonia were randomized to receive intramuscular gentamicin 5 mg/kg/day once-daily (OD) (n=148) or the same total daily amount given in three divided doses (TD) (n=162) in addition to ceftriaxone 75 mg/kg/day. After 48h at steady state, gentamicin pharmacokinetics was assessed by fluorescence polarization immunoassay in a subgroup of 59 children and 43 children in the OD and TD groups, respectively. The groups were equivalent in baseline demographic, clinical and laboratory characteristics. Good and partial clinical responses occurred in 64 per cent vs. 54 per cent and 25 per cent vs. 27 per cent in the OD and the TD children, respectively (p=NS for both comparisons). Five patients in each treatment group died. Renal toxicity defined by change in serum creatinine was not observed in any patient from either group. In the OD group, mean±SD serum gentamicin concentrations at 1 (peak), 3, 5, 8, 23, and 24 (trough value) hours after the dose were 11.7±4.1, 4.4±1.2, 2.08±0.9, 1.01±0.6, 0.31±0.09 and 0.29±0.07 mg/l respectively. In the TD group, mean±SD serum gentamicin concentration at 1 hour (peak) was 4.7±1.8 mg/l and the trough concentration was 0.48±0.21 mg/l. In OD group, the gentamicin trough concentration was significantly lower (p<0.001) and the peak concentration was significantly higher (p<0.001) compared to TD group. The results of this study indicate that once-daily gentamicin is effective and safe in malnourished children. Widespread implementation of once-daily dosing in malnourished children is appropriate and will reduce number of intramuscular injections and hospital costs. (author's) Language: English Keywords: BANGLADESH | RESEARCH REPORT | CONTROL GROUPS | CHILD | MALNUTRITION | NUTRITION DISORDERS | TREATMENT | DRUGS | SAFETY | CONTRACEPTIVE USE-EFFECTIVENESS | DIARRHEA | PNEUMONIA | Asia, Southern | Asia | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Public Health | Contraceptive Effectiveness | Contraception | Family Planning | Pulmonary Effects | Physiology | Biology Document Number: 302278 |
| 30. Title: Iodine deficiency disorders in India. Author: Laway BA; Zargar AH Source: JPMA. Journal of the Indian Medical Association. 2006 Oct;104(7):554-556. Abstract: Iodine deficiency disorders were widely prevalent in Indian subcontinent before the successful salt iodisation. There has been a remarkable decline in goitre prevalence and improvement of functional thyroid status and normalisation of iodine nutrition status in the community. Goitre endemicity of varying degree persists among school children even a decade after successful salt iodisation in India. Some other factors like high thiocyanate exposure or auto-immune thyroid disease could be responsible for such a phenomenon. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | CHILDREN | STUDENTS | PRIMARY SCHOOLS | DEFICIENCY DISEASES | NUTRITION DISORDERS | PROTEIN BOUND IODINE ALTERATIONS | GOITER | THYROID EFFECTS | Asia, Southern | Asia | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Schools | Diseases | Hematological Effects | Hemic System | Physiology | Biology | Endocrine Effects | Endocrine System Document Number: 314334 |
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