1.  Title: Diarrheal disease: solutions to defeat a global killer. Author: Program for Appropriate Technology in Health [PATH] Source: Washington, D.C., PATH, 2009. 38 p. Abstract: Today, the leading causes of death among children under the age of five, particularly in the developing world, are pneumonia and diarrhea. These illnesses are both preventable and treatable. The global health community possesses the interventions and knowledge to save millions of children's lives worldwide. We can do this by reprioritizing diarrheal disease on the global health agenda; educating, increasing awareness, and mobilizing health care providers, policymakers, and the larger global community around the burden of diarrheal disease and the lifesaving interventions that exist today; and by implementing these solutions with a coordinated approach. Proven, lifesaving, prevention and treatment methods [include]: safe water, improved sanitation and good hygiene; vaccines; exclusive breastfeeding and optimal complementary feeding; oral rehydration therapy (ORT) / oral rehydration solution (ORS); zinc treatment and other micronutrients. (Excerpts) Language: English Keywords: DEVELOPING COUNTRIES | SUMMARY REPORT | LOW INCOME POPULATION | CHILDREN | DIARRHEA | MALNUTRITION | CHILD MORTALITY | ZINC | WATER QUALITY | CAUSES OF DEATH | SANITATION | TREATMENT | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Nutrition Disorders | Mortality | Population Dynamics | Metals | Vitamins and Minerals | Physiology | Biology | Water | Natural Resources | Environment | Public Health | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 331382 |
2.  Peer Reviewed Title: Enhanced immunogenicity of an oral inactivated cholera vaccine in infants in Bangladesh obtained by zinc supplementation and by temporary withholding breast-feeding. Author: Ahmed T; Svennerholm AM; Al Tarique A; Sultana GN; Qadri F Source: Vaccine. 2009 Feb 25;27(9):1433-9. Abstract: The killed oral cholera vaccine Dukoral is recommended for adults and only children over 2 years of age, although cholera is seen frequently in younger children and there is an urgent need for a vaccine for them. Since decreased immunogenicity of oral vaccines in children in developing countries is a critical problem, we tested interventions to enhance responses to Dukoral. We evaluated the effect on the immune responses by temporarily withholding breast-feeding or by giving zinc supplementation. Two doses of Dukoral consisting of killed cholera vibrios and cholera B subunit were given to 6-18 months old Bangladeshi children (n=340) and safety and immunogenicity studied. Our results showed that two doses of the vaccine were safe and induced antibacterial (vibriocidal) antibody responses in 57% and antitoxin responses in 85% of the children. Immune responses were comparable after intake of one and two doses. Temporary withholding breast-feeding for 3 h before immunization or supplementation with 20 mg of zinc per day for 42 days resulted in increased magnitude of vibriocidal antibodies (77% and 79% responders, respectively). Administration of vaccines without buffer or in water did not result in reduction of vibriocidal responses. This study demonstrates that the vaccine is safe and immunogenic in children under 2 years of age and that simple interventions can enhance immune responses in young children. Language: English Keywords: BANGLADESH | RESEARCH REPORT | INFANT | CHOLERA | ZINC | HUMAN MILK | VACCINES | ADMINISTRATION AND DOSAGE | CONTRACEPTIVE USE-EFFECTIVENESS | AUTOIMMUNE RESPONSE | SAFETY | Developing Countries | Asia, Southern | Asia | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Bacterial and Fungal Diseases | Infections | Diseases | Metals | Vitamins and Minerals | Physiology | Biology | Lactation | Maternal Physiology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Treatment | Contraceptive Effectiveness | Contraception | Family Planning | Antibodies | Immunologic Factors | Immunity | Immune System | Public Health Document Number: 341051 |
| 3. Title: Effect of micronutrient supplementation on diarrhoeal disease among stunted children in rural South Africa. Author: Chhagan MK; Van den Broeck J; Luabeya KK; Mpontshane N; Tucker KL; Bennish ML Source: European Journal of Clinical Nutrition. 2009 Jul;63(7):850-7. Abstract: BACKGROUND/OBJECTIVE: The efficacy of zinc combined with vitamin A or multiple micronutrients in preventing diarrhoea is unclear in African countries with high prevalence of human immunodeficiency virus (HIV)-exposed children. Potential modifying factors, such as stunting, need to be addressed. The objective of this study was to determine whether adding zinc or zinc plus multiple micronutrients to vitamin A reduces diarrhoea incidence, and whether this differs between the strata of stunted or HIV-infected children. METHODS: We analyzed data from a randomized, controlled, double-blinded trial (ClinicalTrials.gov NCT00156832) of prophylactic micronutrient supplementation to children aged 6-24 months. Three cohorts of children: 32 HIV-infected children, 154 HIV-uninfected children born to HIV-infected mothers and 187 uninfected children born to HIV-uninfected mothers, received vitamin A, vitamin A plus zinc or multiple micronutrients, which included vitamin A and zinc. The main outcome was incidence of diarrhoea. Poisson regression was used in intent-to-treat analyses. Stratified analyses followed testing for statistical interaction between intervention and stunting. RESULTS: We observed no significant differences in overall diarrhoea incidence among treatment arms. Stunting modified this effect with stunted HIV-uninfected children having significantly lower diarrhoea incidence when supplemented with zinc or multiple micronutrients compared with vitamin A alone (2.04 and 2.23 vs 3.92 episodes/year, respectively, P=0.024). No meaningful subgroup analyses could be done in the cohort of HIV-infected children. CONCLUSIONS: Compared with vitamin A alone, supplementation with zinc and with zinc and multiple micronutrients, reduced diarrhoea morbidity in stunted rural South African children. Efficacy of zinc supplementation in HIV-infected children needs confirmation in studies that represent the spectrum of disease severity and age groups. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | DOUBLE-BLIND STUDIES | INFANT | DIARRHEA, INFANTILE | INCIDENCE | HIV INFECTIONS | FOOD SUPPLEMENTATION | ZINC | VITAMIN A | VITAMINS AND MINERALS | ANTHROPOMETRY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diarrhea | Diseases | Measurement | Viral Diseases | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Health | Metals | Physiology | Biology Document Number: 342462 |
| 4. Peer Reviewed Title: [Association between iron supplementation during pregnancy and prematurity, low birth weight, and very low birth weight] Associação entre o uso de sais de ferro durante a gestação e nascimento pré-termo, baixo peso ao nascer e muito baixo peso ao nascer. Author: Dal Pizzol TD; Giugliani ER; Mengue SS Source: Cadernos de Saude Publica. 2009 Jan;25(1):160-168. Abstract: The objective was to evaluate the association between prophylactic iron supplementation and prematurity and low birth weight. Pregnant women 20 years and older with 21 to 28 weeks of gestational age were enrolled consecutively in prenatal services in the Unified National Health System in six Brazilian State capitals between 1991 and 1995. Socio-demographic data and information on iron supplementation up until the 28th gestational week were obtained by means of an interview. Outcomes and other variables were collected from medical records. Anemia was present in 31.3% of the 3,865 women. Among anemic women (hemoglobin < 11.0g/dL), 29.8% were taking iron supplements, as compared to 16.7% among non-anemic women (hemoglobin > 11.0g/dL). After adjusting for potential confounders, iron was not associated with prematurity (OR = 0.88; 95%CI: 0.73-1.07), low birth weight (OR = 0.99; 95%CI: 0.75-1.31), or very low birth weight (OR = 0.58; 95%CI: 0.29-1.13). The results suggest that iron supplementation up to the 28th gestational week does not reduce the risk of prematurity, low birth weight, or very low birth weight. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | PREGNANCY | IRON | SERUM IRON LEVEL | VITAMINS AND MINERALS | LOW BIRTH WEIGHT | ANEMIA | TREATMENT | PREVENTION AND CONTROL | South America, Eastern | South America | Latin America | Americas | Developing Countries | Reproduction | Metals | Physiology | Biology | Hemic System | Birth Weight | Body Weight | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341872 |
| 5. Peer Reviewed Title: Effect of contraceptive pill on the selenium and zinc status of healthy subjects. Author: Fallah S; Sani FV; Firoozrai M Source: Contraception. 2009 Jul;80(1):40-3. Abstract: BACKGROUND: The study was conducted to ascertain the influence of oral contraceptive pill (OCP) uptake on serum zinc and selenium in contraceptive pill users. STUDY DESIGN: The concentration of zinc and selenium was determined by atomic absorption spectrophotometer in 50 healthy women with normal menstrual cycles as a control group and 50 women taking low-dose OCP. RESULTS: The control reference values were 81.61+/-9.44 and 70.35+/-25.57 mcg/dL, which were obtained for zinc and selenium, respectively. Use of OCP resulted in a significant decrease in serum zinc levels (pLanguage: English Keywords: IRAN | RESEARCH REPORT | WOMEN | ORAL CONTRACEPTIVES | ZINC | NUTRITION | Middle East | Developing Countries | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Metals | Vitamins and Minerals | Physiology | Biology | Health Document Number: 341583 |
| 6. Peer Reviewed Title: Micronutrient supplementation affects maternal-infant feeding interactions and maternal distress in Bangladesh. Author: Frith AL; Naved RT; Ekstrom EC; Rasmussen KM; Frongillo EA Source: American Journal of Clinical Nutrition. 2009 Jul;90(1):141-8. Abstract: BACKGROUND: Good maternal-infant interaction is essential for optimal infant growth, health, and development. Although micronutrient malnutrition has been associated with poorer interaction, the effects of maternal micronutrient supplementation on interaction are unknown. OBJECTIVES: We examined differences in maternal-infant feeding interaction between 3 maternal pre- and postpartum micronutrient supplementation groups that differed in iron dose and inclusion of multiple micronutrients and determined whether any differences observed were mediated by maternal distress. DESIGN: A cohort of 180 pregnant women was selected from 3300 women in the randomized controlled trial Maternal Infant Nutritional Interventions Matlab, which was conducted in Matlab, Bangladesh. At 8 wk of gestation, women were randomly assigned to 1 of 3 groups to receive a daily supplement of micronutrients (14 wk gestation to 12 wk postpartum): 60 or 30 mg Fe each with 400 microg folic acid or multiple micronutrients (MuMS; 30 mg Fe, 400 microg folic acid, and other micronutrients). A maternal-infant feeding interaction was observed in the home when infants were 3.4-4.0 mo of age, and maternal distress was assessed. RESULTS: Compared with 30 mg Fe, 60 mg Fe decreased the quality of maternal-infant feeding interaction by approximately 10%. Compared with 30 mg Fe, MuMS did not improve interaction but reduced maternal early postpartum distress. Distress did not mediate the effects of micronutrient supplementation on interaction. CONCLUSION: For pregnant and postpartum women, micronutrient supplementation should be based on both nutritional variables (eg, iron status) and functional outcomes (eg, maternal-infant interaction and maternal distress). Language: English Keywords: BANGLADESH | RESEARCH REPORT | DOUBLE-BLIND STUDIES | PREGNANT WOMEN | VITAMINS AND MINERALS | FOOD SUPPLEMENTATION | BONDING | MATERNAL HEALTH | DEFICIENCY DISEASES | IRON | FOLIC ACID | ANXIETY DISORDERS | DEPRESSION | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Physiology | Biology | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Health | Interpersonal Relations | Behavior | Nutrition Disorders | Diseases | Metals | Psychological Factors | Mental Disorders Document Number: 341995 |
| 7. Peer Reviewed Title: RNA viruses in community-acquired childhood pneumonia in semi-urban Nepal; a cross-sectional study. Author: Mathisen M; Strand TA; Sharma BN; Chandyo RK; Valentiner-Branth P; Basnet S; Adhikari RK; Hvidsten D; Shrestha PS; Sommerfelt H Source: BMC Medicine. 2009;7:35. Abstract: BACKGROUND: Pneumonia is among the main causes of illness and death in children <5 years of age. There is a need to better describe the epidemiology of viral community-acquired pneumonia (CAP) in developing countries. METHODS: From July 2004 to June 2007, we examined nasopharyngeal aspirates (NPA) from 2,230 cases of pneumonia (World Health Organization criteria) in children 2 to 35 months old recruited in a randomized trial of zinc supplementation at a field clinic in Bhaktapur, Nepal. The specimens were examined for respiratory syncytial virus (RSV), influenza virus type A (InfA) and B (InfB), parainfluenza virus types 1, 2 and 3 (PIV1, PIV2, and PIV3), and human metapneumovirus (hMPV) using a multiplex reverse transcriptase polymerase chain reaction (PCR) assay. RESULTS: We identified 919 virus isolates in 887 (40.0%) of the 2,219 NPA specimens with a valid PCR result, of which 334 (15.1%) yielded RSV, 164 (7.4%) InfA, 129 (5.8%) PIV3, 98 (4.4%) PIV1, 93 (4.2%) hMPV, 84 (3.8%) InfB, and 17 (0.8%) PIV2. CAP occurred in an epidemic pattern with substantial temporal variation during the three years of study. The largest peaks of pneumonia occurrence coincided with peaks of RSV infection, which occurred in epidemics during the rainy season and in winter. The monthly number of RSV infections was positively correlated with relative humidity (rs = 0.40, P = 0.01), but not with temperature or rainfall. An hMPV epidemic occurred during one of the three winter seasons and the monthly number of hMPV cases was also associated with relative humidity (rs = 0.55, P = 0.0005). CONCLUSION: Respiratory RNA viruses were detected from NPA in 40% of CAP cases in our study. The most commonly isolated viruses were RSV, InfA, and PIV3. RSV infections contributed substantially to the observed CAP epidemics. The occurrence of viral CAP in this community seemed to reflect more or less overlapping micro-epidemics with several respiratory viruses, highlighting the challenges of developing and implementing effective public health control measures. Language: English Keywords: NEPAL | RESEARCH REPORT | RANDOMIZED RESPONSE TECHNIC | CHILDREN | MORBIDITY | DEATH RATE | PNEUMONIA | VITAMINS AND MINERALS | ZINC | RESPIRATORY INFECTIONS | TREATMENT | Developing Countries | Asia, Southern | Asia | Questionnaire Design | Survey Methodology | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Mortality | Population Dynamics | Pulmonary Effects | Physiology | Biology | Metals | Infections | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342879 |
| 8. Title: Influence of inflammation as measured by alpha-1-acid glycoprotein on iron status indicators among HIV-positive postpartum Zimbabwean women. Author: Rawat R; Stoltzfus RJ; Ntozini R; Mutasa K; Iliff PJ; Humphrey JH Source: European Journal of Clinical Nutrition. 2009 Jun;63(6):787-93. Abstract: OBJECTIVES: The acute phase response (APR) influences indicators of iron status. A recent WHO/CDC consultation recommended concurrent measurement of alpha-1-acid-glycoprotein (AGP) in surveys to control for the APR, and aid in interpreting iron status. They proposed further exploratory analyses using AGP. We examined whether the APR (measured by AGP) influences the expected relationships between iron status indicators in an HIV-infected population. SUBJECTS: We measured hemoglobin (Hb), serum ferritin (SF), transferrin receptor (TfR), erythropoietin (EPO) and AGP in a cross-sectional survey of 643 HIV-positive Zimbabwean women. RESULTS: SF was significantly higher in APR-positive (AGP>1 g/l) women (P<0.001), in whom there was no association between SF and Hb. TfR was inversely associated with Hb, in both APR-positive and APR-negative women (P<0.001). However, among anemic women (Hb<110 g/l), APR-positive women had marginally lower TfR concentrations (P=0.053). There was no difference in EPO response to decreasing Hb among APR-positive and APR-negative women. CONCLUSIONS: AGP captured the influence of the APR on iron indicators and their relationships with each other. The APR influenced SF and its relationship with Hb as expected. TfR behaved unexpectedly. Although TfR has been promoted as an iron indicator that is uninfluenced by the APR, TfR concentrations were depressed among anemic APR-positive women. Because TfR reflects iron deficiency and erythropoietic activity, pro-inflammatory cytokines associated with the APR may be inhibiting erythropoiesis, which is reflected by lower TfR concentrations. We support the WHO/CDC recommendation that AGP is a useful indicator to assess the influence of the APR on iron status indicators. Language: English Keywords: ZIMBABWE | RESEARCH REPORT | POSTPARTUM WOMEN | PERSONS LIVING WITH HIV/AIDS | DEFICIENCY DISEASES | IRON | METABOLIC EFFECTS | ANEMIA | HIV INFECTIONS | HEMOGLOBIN LEVEL | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Puerperium | Reproduction | Viral Diseases | Diseases | Nutrition Disorders | Metals | Vitamins and Minerals | Physiology | Biology | Hemic System Document Number: 342647 |
| 9. Title: Nutrition intervention and adequate hygiene practices to improve iron status of vulnerable preschool Burkinabe children. Author: Sanou D; Turgeon-O'Brien H; Desrosiers T Source: Nutrition. 2009 Jul 21; Abstract: OBJECTIVE: To determine the impact of an intervention that combined an increase in dietary and bioavailable iron intakes and an improvement in hygiene behaviors on the iron status of preschool children from Burkina Faso. METHODS: Thirty-three orphans and vulnerable children from 11 families who were 1-6 y old, were non-anemic, or had mild to moderate anemia were enrolled in an 18-wk trial. Using the probability approach for planning diets in an assisted-living facility, bioavailable iron intake was increased from 0.4 to 0.9mg/d by increasing the amounts of meat and citrus fruits and by adding iron-rich condiments to the diet, for an estimated cost of U.S. $0.59/mo. Hygiene behaviors were modified by implementing hand-washing before meals and by the use of individual plates for meals. Iron status indicators were measured twice and means at enrollment and after intervention were compared. RESULTS: After intervention, hemoglobin concentration increased from 98.7 to 103.8g/L (P=0.006). There was a decrease in total iron binding capacity (107 to 91mumol/L, P=0.05) and a marginal increase in transferrin saturation (13% to 17%, P=0.06). Significant improvement was not observed for serum ferritin concentration or prevalence of depleted iron stores, likely due to the confounding effect of infection. Anemia and iron-deficiency anemia were decreased from 64% to 30% and from 61% to 30%, respectively. CONCLUSION: Dietary modification associated with adequate hygiene behaviors could be a relevant strategy to control iron deficiency and anemia in areas where infection is a major health problem. Language: English Keywords: BURKINA FASO | RESEARCH REPORT | SAMPLING STUDIES | ORPHANS AND VULNERABLE CHILDREN | CHILD NUTRITION | INTERVENTIONS | DIET | IRON | ANEMIA | PREVALENCE | HYGIENE | HEMOGLOBIN LEVEL | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Family and Household | Sociocultural Factors | Nutrition | Health | Programs | Organization and Administration | Metals | Vitamins and Minerals | Physiology | Biology | Diseases | Measurement | Public Health | Hemic System Document Number: 342282 |
| 10. Title: Cost-effectiveness of misoprostol and prenatal iron supplementation as maternal mortality interventions in home births in rural India. Author: Sutherland T; Bishai DM Source: International Journal of Gynaecology and Obstetrics. 2009 Mar;104(3):189-93. Abstract: OBJECTIVE: To determine the cost-effectiveness of prenatal iron supplementation and misoprostol use as interventions to prevent maternal mortality in home births in rural India. METHODS: A cost-effectiveness analysis depicted three hypothetical cohorts of 10,000 pregnant women delivering at home in rural India: one with no intervention, one receiving standard prenatal iron supplements, and 1 receiving 600 microg of misoprostol in the third stage of labor. RESULTS: Misoprostol used to prevent postpartum hemorrhage resulted in a 38% (95% CI, 5%-73%) decrease in maternal deaths, while prenatal iron supplementation resulted in a 5% (95% CI, 0%-47%) decrease. Misoprostol cost a median US $1401 (IQR US $1008-$1848) prenatal iron supplementation cost a median US $2241 (IQR No Lives Saved-$3882) per life saved compared with the standard care outcome. CONCLUSION: Misoprostol is a cost-effective maternal mortality intervention for home births. Iron supplementation may be worthwhile to improve women's health, but it is uncertain whether it can prevent mortality after hemorrhage. Language: English Keywords: INDIA | RURAL AREAS | RESEARCH REPORT | STATISTICAL STUDIES | PREGNANT WOMEN | MATERNAL MORTALITY | INTERVENTIONS | MISOPROSTOL | IRON | FOOD SUPPLEMENTATION | COST EFFECTIVENESS | ANEMIA | Asia, Southern | Asia | Developing Countries | Geographic Factors | Population | Studies | Research Methodology | Population Characteristics | Demographic Factors | Mortality | Population Dynamics | Programs | Organization and Administration | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Metals | Vitamins and Minerals | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Health | Evaluation Indexes | Quantitative Evaluation | Evaluation | Diseases Document Number: 341385 |
| 11. Peer Reviewed Title: Home fortification of complementary foods with micronutrient supplements is well accepted and has positive effects on infant iron status in Ghana. Author: Adu-Afarwuah S; Lartey A; Brown KH; Zlotkin S; Briend A Source: American Journal of Clinical Nutrition. 2008 Apr;87(4):929-938. Abstract: Micronutrient deficiencies are common during infancy, and optimal approaches for their prevention need to be identified. The objective was to compare the efficacy and acceptability of Sprinkles (SP), crushable Nutritabs (NT), and fat-based Nutributter (NB; 108 kcal/d), which provide 6, 16, and 19 vitamins and minerals, respectively, when used for home fortification of complementary foods. Ghanaian infants were randomly assigned to receive SP (n = 105),NT (n = 105), or NB (n = 103) daily from 6 to 12 mo of age. We assessed dietary intake, morbidity, and compliance weekly. Hemoglobin and plasma ferritin, TfR, C-reactive protein, and zinc were measured at 6 and 12 mo. We used an exit interview to assess acceptability. A randomly selected control group of infants who received no intervention (NI; n = 96) were assessed at 12 mo. All supplements were well accepted, and the mean percentage of days that supplements were consumed (87%) did not differ between groups. At 12 mo, all 3 intervention groups had significantly higher ferritin and lower TfR concentrations than did the NI control group. Mean (plus or minus SD) hemoglobin was significantly higher in NT (112 plus or minus 14 g/L) and NB (114 plus or minus 14 g/L) but not in SP (110 plus or minus 14 g/L) infants than in NI infants (106 plus or minus 14 g/L). The prevalence of iron deficiency anemia was 31% in the NI control group compared with 10% in the intervention groups combined (P less than 0.0001). All 3 options for home fortification of complementary foods are effective for reducing the prevalence of iron deficiency in such populations. (author's) Language: English Keywords: GHANA | RESEARCH REPORT | INFANT | VITAMINS AND MINERALS | IRON | DEFICIENCY DISEASES | INTERVENTIONS | PREVENTION AND CONTROL | TREATMENT | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Physiology | Biology | Metals | Nutrition Disorders | Diseases | Programs | Organization and Administration | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 325933 |
| 12. Peer Reviewed Title: Anaemia and iron deficiency anaemia among aboriginal schoolchildren in rural Peninsular Malaysia: An update on a continuing problem. Author: Al-Mekhlafi MH; Surin J; Atiya AS; Ariffin WA; Mahdy AK Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2008 Oct;102(10):1046-1052. Abstract: A cross-sectional study to determine the current prevalence of anaemia and iron deficiency anaemia (IDA) and to investigate the possible risk factors for IDA was carried out on 241 aboriginal schoolchildren (120 boys, 121 girls) aged 7-12 years and living in remote areas in Pos Betau, Pahang, Malaysia. Haemoglobin (Hb) level was measured and serum iron status was assessed by serum ferritin (SF), serum iron (SI) and total iron binding capacity measurements. Socioeconomic data were collected using pre-tested questionnaires. All children were screened for intestinal parasitic infections. Overall, 48.5% (95% CI 42.3-54.8) of children were anaemic (Hb < 12 g/dl). The prevalence of IDA was 34% (95% CI 28.3-40.2), which accounted for 70.1% of the anaemia cases. The prevalence of IDA was significantly higher in females than males. Low levels of mothers' education and low household income were identified as risk factors for IDA. Severe trichuriasis also found to be associated with low SF and SI. Logistic regression confirmed low levels of mothers' education and gender as significant risk factors for IDA. Improvement of socioeconomic status and health education together with periodic mass deworming should be included in public health strategies for the control and prevention of anaemia and IDA in this population. (author's) Language: English Keywords: MALAYSIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | ANEMIA | IRON | DEFICIENCY DISEASES | PARASITIC DISEASES | RISK FACTORS | SCHOOL AGE POPULATION | CHILDREN | RURAL AREAS | BODY HEIGHT | BODY WEIGHT | Developing Countries | Asia, Southeastern | Asia | Research Methodology | Diseases | Metals | Vitamins and Minerals | Physiology | Biology | Nutrition Disorders | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Geographic Factors Document Number: 328166 |
| 13. Peer Reviewed Title: Predictors of serum ferritin and haemoglobin during pregnancy, in a malaria-endemic area of western Kenya. Author: Alusala DN; Estambale BB; Magnussen P; Friis H; Luoba AI Source: Annals of Tropical Medicine and Parasitology. 2008 Jun;102(4):297-308. Abstract: Between 2000 and 2004, a cross-sectional survey was conducted, as part of a prospective cohort study, among the women attending antenatal-care clinics in Bondo district, a malaria-endemic area of western Kenya. The aim was to assess the prevalence of iron deficiency and determine the predictors of haemoglobin and serum ferritin concentrations in the women who had a gestational age between 14 and 24 weeks. A standardized questionnaire was used to collect and store the relevant bio-data for the study. Haemoglobin and ferritin concentrations were evaluated, sickle-cell status was determined, and malarial parasitaemias were detected and evaluated, using blood samples collected at enrolment. Multiple regression analysis was then used to test for significant predictors of the haemoglobin and serum ferritin concentrations. Although 842 women were enrolled in the prospective cohort study, haemoglobin concentrations were evaluated for only 828 of them, serum ferritin levels for 621, and levels of parasitaemia for 812. The mean haemoglobin concentration recorded was 10.9 g/dl. Although 37.9% of the subjects had mild-moderate anaemia (7.0-10.5 g haemoglobin/dl), only 0.5% were severely anaemic (less than 7.0 g haemoglobin/dl). The geometric mean serum ferritin concentration recorded was 18.9 mg/litre, and 32.3% of the subjects evaluated had low serum concentrations of ferritin (less than 12 microg/litre). Among the parasitaemic primigravidae (but not the parasitaemic multigravidae), those found positive for sickle-cell trait had significantly lower haemoglobin concentrations than those found negative in a sickling test (P = 0.01). Among the pregnant women of Bondo district, gravidity, malarial infection and sickle cell appear to be key predictors of haemoglobin concentration. (author's) Language: English Keywords: KENYA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | SURVEYS | PREGNANT WOMEN | GESTATIONAL AGE | IRON | DEFICIENCY DISEASES | PREVALENCE | HEMOGLOBIN LEVEL | MALARIA | TRANSMISSION | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Research Methodology | Sampling Studies | Studies | Population Characteristics | Demographic Factors | Population | Fetus | Pregnancy | Reproduction | Metals | Vitamins and Minerals | Physiology | Biology | Nutrition Disorders | Diseases | Measurement | Hemic System | Parasitic Diseases | Infections Document Number: 327216 |
| 14. Title: Additional zinc delivered in a liquid supplement, but not in a fortified porridge, increased fat-free mass accrual among young Peruvian children with mild-to-moderate stunting. Author: Arsenault JE; de Romana DL; Penny MH; Van Loan MD; Brown KH Source: Journal of Nutrition. 2008 Jan;138:108-114. Abstract: The exact mechanism whereby zinc influences growth is unknown, although it has been postulated that zinc may stimulate appetite and energy intake or enhance fat-free mass (FFM) accrual directly. We compared energy intake, reported appetite, and body composition of 6- to 8-mo-old Peruvian children with initial length-for-age Z-score (LAZ) < -0.5 SD who were randomly assigned to receive daily for 6 mo: 1) 3 mg/d zinc in a liquid supplement; 2) 3 mg/d zinc in a fortified porridge; or 3) no extra zinc in either the supplement or porridge. There were no group-wise differences in changes in dietary energy intakes or body composition or in the prevalence of reported poor appetite. However, among children with an initial LAZ less than the median (-1.1 SD), those who received zinc as a liquid supplement had a 0.41 kg greater increase in FFM than those who did not receive zinc (P < 0.05). We concluded that daily provision of 3 mg of supplemental zinc did not affect energy intake or reported appetite. Among children with initial mild-to-moderate stunting, those who received the zinc supplement had a greater increase in FFM than those who did not receive additional zinc. It is possible that the growth-restricted children were more likely to be zinc deficient and that FFM accrual may be an early growth response to supplemental zinc. Zinc supplements may be more efficacious than the same dose of zinc provided in fortified food; therefore, further research is needed on the optimal level of zinc fortification that will result in improved health outcomes in populations with high rates of zinc deficiency. (author's) Language: English Keywords: PERU | RESEARCH REPORT | COMPARATIVE STUDIES | CLINICAL RESEARCH | CHILDREN | ZINC | FOOD SUPPLEMENTATION | BODY WEIGHT | GROWTH | ADMINISTRATION AND DOSAGE | South America, Western | South America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Metals | Vitamins and Minerals | Physiology | Biology | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Health | Child Development | Drugs | Treatment | Medical Procedures | Medicine Document Number: 323233 |
| 15. Peer Reviewed Title: Effectiveness of zinc supplementation plus oral rehydration salts compared with oral rehydration salts alone as a treatment for acute diarrhea in a primary care setting: a cluster randomized trial. Author: Bhandari N; Mazumder S; Taneja S; Dube B; Agarwal RC; Mahalanabis D; Fontaine O; Black RE; Bhan MK Source: Pediatrics. 2008 May;121(5):e1279-85. Abstract: OBJECTIVE: The purpose of this work was to evaluate whether education about zinc supplements and provision of zinc supplements to caregivers is effective in the treatment of acute diarrhea and whether this strategy adversely affects the use of oral rehydration salts. PATIENTS AND METHODS: Six clusters of 30,000 people each in Haryana, India, were randomly assigned to intervention and control sites. Government and private providers and village health workers were trained to prescribe zinc and oral rehydration salts for use in diarrheal episodes in 1-month-old to 5-year-old children in intervention communities; in the control sites, oral rehydration salts alone was promoted. In 2 cross-sectional surveys commencing 3 months (survey 2) and 6 months (survey 3) after the start of the intervention, care-seeking behavior, drug therapy, and oral rehydration salts use during diarrhea, diarrheal and respiratory morbidity, and hospitalization rates were measured. RESULTS: In the 2 surveys, zinc was used in 36.5% (n = 1571) and 59.8% (n = 1649) and oral rehydration salts in 34.8% (n = 1571) and 59.2% (n = 1649) of diarrheal episodes occurring in the 4 weeks preceding interviews in the intervention areas. In control areas, oral rehydration salts were used in 7.8% (n = 2209) and 9.8% (n = 2609) of episodes. In the intervention communities, care seeking for diarrhea reduced by 34% (survey 3), as did the prescription of drugs of unknown identity (survey 3) and antibiotics (survey 3) for diarrhea. The 24-hour prevalences of diarrhea and acute lower respiratory infections were lower in the intervention communities (survey 3). All-cause, diarrhea, and pneumonia hospitalizations in the preceding 3 months were reduced in the intervention compared with control areas (survey 3). CONCLUSIONS: Diarrhea is more effectively treated when caregivers receive education on zinc supplementation and have ready access to supplies of oral rehydration salts and zinc, and this approach does not adversely affect the use of oral rehydration salts; in fact, it greatly increases use of the same. Language: English Keywords: INDIA | RESEARCH REPORT | CLINICAL TRIALS | COMPARATIVE STUDIES | CROSS SECTIONAL ANALYSIS | CHILDREN | HEALTH PERSONNEL | COMMUNITY WORKERS | ORAL REHYDRATION | ZINC | TRAINING PROGRAMS | FOOD SUPPLEMENTATION | DIARRHEA | ANTIBIOTICS | UTILIZATION OF HEALTH CARE | Developing Countries | Asia, Southern | Asia | Clinical Research | Research Methodology | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Health | Treatment | Medical Procedures | Medicine | Health Services | Metals | Vitamins and Minerals | Physiology | Biology | Education | Nutrition Programs | Primary Health Care | Diseases | Drugs Document Number: 328041 |
| 16. Peer Reviewed Title: Comparative efficacy and safety of intravenous ferric carboxymaltose in the treatment of postpartum iron deficiency anemia. Author: Breymann C; Gliga F; Bejenariu C; Strizhova N Source: International Journal of Gynecology and Obstetrics. 2008 Apr;101(1):67-73. Abstract: The objectives were to compare the safety and efficacy of iron carboxymaltose with ferrous sulfate to treat iron deficiency anemia in the post partum. Patients were randomized (2:1 ratio) to receive iron carboxymaltose (up to 3 weekly doses of 1000 mg maximum, applied in 15 min; n = 227) or ferrous sulfate (100 mg twice daily, 12 weeks; n = 117). Changes in hemoglobin and iron stores up to week 12 were analyzed. Iron carboxymaltose was as effective as oral iron sulfate in changing hemoglobin, despite the much shorter treatment period (2 weeks vs 12 weeks). Ferritin levels were significantly higher. Except for injection site burning, iron carboxymaltose was better tolerated than ferrous sulfate, mainly concerning gastrointestinal side effects. There were no safety concerns identified in breast-fed infants. Parenteral iron carboxymaltose is a safe and effective treatment option for postpartum anemia, with advantages of a shorter treatment period, better compliance, rapid normalization of iron storages, and lower incidence of gastrointestinal side effects. (author's) Language: English Keywords: SWITZERLAND | RESEARCH REPORT | COMPARATIVE STUDIES | POSTPARTUM WOMEN | ANEMIA | IRON | HUMAN MILK | BLOOD | TREATMENT | Europe, Central | Europe | Developed Countries | Studies | Research Methodology | Puerperium | Reproduction | Diseases | Metals | Vitamins and Minerals | Physiology | Biology | Lactation | Maternal Physiology | Hemic System | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 325542 |
| 17. Peer Reviewed Title: Effectiveness of weekly supplementation of iron to control anaemia among adolescent girls of Nashik, Maharashtra, India. Author: Deshmukh PR; Garg BS; Bharambe MS Source: Journal of Health, Population and Nutrition. 2008 Mar;26(1):74-78. Abstract: A national nutritional anaemia-control programme in India, focusing on supplementation of iron to pregnant women after the first trimester of pregnancy, failed to make an impact. It is prudent to recommend the correction of iron stores before the woman becomes pregnant. 'Efficacy' of weekly supplementation of iron has been proved to improve iron stores in adolescence in many studies abroad and in India. The objective was to study the 'effectiveness' of a weekly iron-supplementation regimen among urban-slum, rural, and tribal girls of Nashik district, Maharashtra, India. A baseline and the mid-term assessments were done using the cluster-sampling techniques. In each stratum, 30 clusters were identified. Twelve and 10 adolescent girls from each cluster were identified in the baseline and mid-term surveys respectively. The haemoglobin estimation was done using the HemoCue system. Data were analyzed using the Epi Info software (version 6.04). The overall prevalence of anaemia came down significantly to 54.3% from 65.3%. The decline was statistically significant (p less than 0.001) in tribal girls (48.6% from 68.9%) and among rural girls (51.6% from 62.8%). But the decline was not statistically significant among urban slum girls. Similarly, a significant rise in the mean haemoglobin levels was seen among tribal and rural girls. However, it did not increase significantly among urban slum girls. The programme had performed poorly in urban-slum areas, as the mean number of tablets consumed in urban-slum areas was only 5.6 plus or minus 3.3, as against 6.7 plus or minus 2.6 tablets in tribal girls and 7.2 plus or minus 2.2 tablets in rural girls. Considering the biological and operational feasibility and the effectiveness of the intervention, weekly supplementation of iron to adolescent girls should be universally started to correct the iron stores of a woman before she becomes pregnant. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | CLINICAL RESEARCH | ADOLESCENTS, FEMALE | ANEMIA | PREVENTION AND CONTROL | IRON | FOOD SUPPLEMENTATION | Developing Countries | Asia, Southern | Asia | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Metals | Vitamins and Minerals | Physiology | Biology | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Health Document Number: 327031 |
| 18. Peer Reviewed Title: [Effectiveness of weekly iron supplementation on hemoglobin concentration, nutritional status and development of infants of public daycare centers in Recife, Pernambuco State, Brazil] Efetividade da suplementacao semanal com ferro sobre a concentracao de Author: Eickmann SH; Brito CM; Lira PI; Lima MC Source: Cadernos de Saude Publica. 2008;24 Suppl 2:S303-11. Abstract: This study analyzed the effectiveness of weekly iron supplementation on hemoglobin concentration, nutritional status, and mental and motor development of infants at four public daycare centers in Recife, Pernambuco State, Brazil. This was a before-after intervention study conducted with weekly iron supplementation for six months in a sample of 76 infants in the 4 to 24 month age group, from February to December 2005. Mental and motor development was assessed through the Bayley Scale of Infant Development II. After supplementation, a significant increase was observed in hemoglobin concentration in the group of infants with initial hemoglobin level < or = 9.5g/dL (p = 0.001). There was also a significant increase in the mean weight-for-length z-score, but the opposite was found for length-for-age. No difference was observed in the developmental indices. We conclude that weekly iron supplementation was effective for increasing hemoglobin concentration in infants with lower initial levels, but no impact on infant development was observed. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | CONTRACEPTIVE USE-EFFECTIVENESS | NUTRITION INDEXES | INFANT | INFANT HEALTH | IRON | VITAMINS AND MINERALS | Developing Countries | South America, Eastern | South America | Latin America | Americas | Contraceptive Effectiveness | Contraception | Family Planning | Nutrition | Health | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Child Health | Metals | Physiology | Biology Document Number: 330118 |
| 19. Peer Reviewed Title: Anemia and iron deficiency in pregnant Ghanaian women from urban areas. Author: Engmann C; Adanu R; Lu TS; Bose C; Lozoff B Source: International Journal of Gynecology and Obstetrics. 2008 Apr;101(1):62-66. Abstract: The objectives were to determine the prevalence and identify risk factors for iron deficiency and anemia in pregnant Ghanaian women from urban areas. A cross-sectional study of 452 healthy pregnant women receiving prenatal care in Accra, Ghana, was conducted. A sociodemographic health questionnaire was performed and hematologic parameters were measured. Logistic regression methods were used to identify risk factors for anemia and iron status. Complete data were available for 428 women. Anemia (hemoglobin less than 11 g/dL) was present in 144 (34%), iron deficiency (ferritin less than or equal to 16 microg/L) in 69 (16%), and iron deficiency anemia in 32 (7.5%) women. The adjusted odds ratio (OR) for anemia was 3.4 and 9.8 if iron deficiency and malaria parasitemia were present, respectively; the OR was 0.6 if women were at greater than or equal to 36 weeks of pregnancy. The adjusted OR for iron deficiency was 2.7 if women were at greater than or equal to 36 weeks of pregnancy and 0.12 if they had sickle trait. Although anemia and iron deficiency remain substantial problems in pregnant Ghanaian women from urban areas, their prevalence is less than previously reported. (author's) Language: English Keywords: GHANA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PREGNANT WOMEN | ANEMIA | IRON | DEFICIENCY DISEASES | URBAN AREAS | RISK FACTORS | PREVALENCE | MALARIA | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Population Characteristics | Demographic Factors | Population | Diseases | Metals | Vitamins and Minerals | Physiology | Biology | Nutrition Disorders | Geographic Factors | Measurement | Parasitic Diseases Document Number: 325434 |
| 20. Peer Reviewed Title: Does age affect the response to zinc therapy for diarrhoea in Bangladeshi infants? Author: Fischer Walker CL; Black RE; Baqui AH Source: Journal of Health, Population and Nutrition. 2008 Mar;26(1):105-109. Abstract: The benefit of zinc for the treatment of diarrhoea in a cluster-randomized trial of children, aged 3-59 months, living in rural Bangladesh was previously reported. Here, the benefits of zinc stratified by age-3-5 months, 6-11 months, and 12-59 months-are reported. Although the sample sizes in the stratified groups were too small to detect statistical significance in the 3-5-month and 6-11-month age-groups, the trends suggest that there may be a benefit of zinc for the treatment of diarrhoea on the duration of diarrhoea and on subsequent morbidity and mortality. Additional research is needed to better understand the effect of zinc for the treatment of diarrhoea among infants aged less than six months. (author's) Language: English Keywords: BANGLADESH | RESEARCH REPORT | CLINICAL TRIALS | EPIDEMIOLOGIC METHODS | INFANT | AGE FACTORS | DIARRHEA, INFANTILE | ZINC | TREATMENT | TIME FACTORS | FOOD SUPPLEMENTATION | Developing Countries | Asia, Southern | Asia | Clinical Research | Research Methodology | Youth | Population Characteristics | Demographic Factors | Population | Diarrhea | Diseases | Metals | Vitamins and Minerals | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Dynamics | Nutrition Programs | Primary Health Care Document Number: 308654 |
| 21. Title: Micronutrient supplementation in pregnancy in developing countries [editorial] Author: Hiremath G Source: BMJ. 2008;337:a1942. Abstract: Micronutritional interventions clearly have a major role in improving women's health, pregnancy, birth outcomes, and child survival. Future endeavours must focus on carefully designed nutritional research that could help elucidate the mechanisms by which micronutrients exert beneficial effects and increase our understanding of the interactions between micronutrients that influence their bioavailability. Prospective high quality community trials should look at the influence of maternal nutritional status on pregnancy and perinatal outcomes. They should also focus on identifying the optimal micronutritional approach (supplementation with single or multiple micronutrients) in representative populations and inform local policies. In due course, the effectiveness of these approaches should be tested at the community level. Ultimately, long term efforts should involve a multidimensional approach to bring about a global improvement in women's health, precipitate social changes, and bridge cultural gaps. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | SUMMARY REPORT | PREGNANT WOMEN | MATERNAL NUTRITION | VITAMINS AND MINERALS | IRON | FOLIC ACID | WOMEN'S HEALTH | MATERNAL HEALTH | INTERVENTIONS | Population Characteristics | Demographic Factors | Population | Nutrition | Health | Physiology | Biology | Metals | Programs | Organization and Administration Document Number: 330122 |
| 22. Peer Reviewed Title: Maternal zinc supplementation and growth in Peruvian infants. Author: Iannotti LL; Zavaleta N; Leon Z; Shankar AH; Caulfield LE Source: American Journal of Clinical Nutrition. 2008 Jul;88(1):154-160. Abstract: Little is known about how maternal zinc intake influences growth in utero and in postnatal life in humans. The author's aimed to assess the effect of maternal zinc supplementation during pregnancy on infant growth through age 1 y. A double-blind, randomized controlled trial of prenatal zinc supplementation was conducted from 1995 to 1997 in Lima, Peru. Women (n = 1295) were enrolled at 15.6 +/- 4.6 wk gestation and assigned to receive daily supplements with zinc (15 mg Zn + 60 mg Fe + 250 microg folic acid) or without zinc (60 Fe + 250 microg folic acid) through pregnancy to 1 mo after delivery. At birth, 546 infants were followed for 12 mo to assess growth. Anthropometric measures of body size and composition were collected monthly, and morbidity and dietary intake surveillance was carried out weekly. No differences in maternal socioeconomic characteristics by treatment group or follow-up period were found. Infants born to mothers prenatally supplemented with zinc had significantly (P < 0.05) larger average growth measures beginning in month 4 and continuing through month 12. In longitudinal regression modeling, prenatal zinc was associated with greater weight (by 0.58 +/- 0.12 kg; P < 0.001), calf circumference (by 1.01 +/- 0.21 cm; P < 0.001), chest circumference (by 0.60 +/- 0.20 cm; P = 0.002), and calf muscle area (by 35.78 +/- 14.75 mm(2); P = 0.01) after adjustment for a range of covariates. No effect was observed for linear growth. Maternal zinc supplementation in this population was associated with offspring growth, which is suggestive of lean tissue mass accretion. (author's) Language: English Keywords: PERU | DOUBLE-BLIND STUDIES | ZINC | FOOD SUPPLEMENTATION | PREGNANT WOMEN | INFANT NUTRITION | MATERNAL NUTRITION | MUSCULAR EFFECTS | ANTENATAL CARE | South America, Western | South America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Metals | Vitamins and Minerals | Physiology | Biology | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Health | Population Characteristics | Demographic Factors | Population | Nutrition | Maternal Health Services | Maternal-Child Health Services Document Number: 327663 |
| 23. Peer Reviewed Title: Age patterns in undernutrition and helminth infection in a rural area of Brazil: Associations with ascariasis and hookworm. Author: Jardim-Botelho A; Brooker S; Geiger SM; Fleming F; Lopes AC Source: Tropical Medicine and International Health. 2008 Apr;13(4):458-467. Abstract: The objective was to investigate the nutritional status of individuals from a rural area of Brazil, and associations with helminth infections in an age-stratified sample. A total of 1113 individuals aged from 6 months to 83 years from the rural community of Americaninhas in Minas Gerais were investigated. Assessments comprised anthropometric measurements of weight, height and body composition, examining faecal samples for helminth eggs, and peripheral blood assays for albumin, haemoglobin and ferritin concentrations. Ten percent of the participants were underweight, 12.8% were overweight and 28.3% of the children and adolescents were stunted. 11.6% had low lean body mass and 28.8% had low fat body mass. Hypoalbuminaemia was seen in 5.5%, anaemia in 12.5% and iron deficiency in 13.1%, although the prevalence of these two indices increased with age. Multivariate analysis showed that, after controlling for age, sex and socio-economic status, stunting was significantly associated with Ascaris lumbricoides infection among children and adolescents, whereas low body mass was significantly associated with hookworm infection among adults and the elderly. Helminth infections are associated with undernutrition in endemic populations, with important differences between the effects of hookworm and A. lumbricoides on age-related nutritional status. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | INFANT | CHILD | ADULTS | RURAL AREAS | PARASITES | PARASITIC DISEASES | AGE FACTORS | MALNUTRITION | ANEMIA | IRON | South America, Eastern | South America | Latin America | Americas | Developing Countries | Youth | Population Characteristics | Demographic Factors | Population | Geographic Factors | Biology | Diseases | Nutrition Disorders | Metals | Vitamins and Minerals | Physiology Document Number: 325992 |
| 24. Peer Reviewed Title: Decreased susceptibility to Plasmodium falciparum infection in pregnant women with iron deficiency. Author: Kabyemela ER; Fried M; Kurtis JD; Mutabingwa TK; Duffy PE Source: Journal of Infectious Diseases. 2008 Jul 15;198:163-166. Abstract: Iron plus folate supplementation increases mortality and morbidity among children in areas of malaria endemicity in Africa, but the effects of supplementation on pregnant women in malaria-endemic areas remain unclear. In northeastern Tanzania, where malaria and iron deficiency are common, we found that placental malaria was less prevalent (8.5% vs. 47.3% of women; P<.0001) and less severe (median parasite density, 4.2% vs. 6.3% of placental red blood cells; P = .04) among women with iron deficiency than among women with sufficient iron stores, especially during the first pregnancy. Multivariate analysis revealed that iron deficiency (P<.0001) and multigravidity (P = .002) significantly decreased the risk of placental malaria. Interventional trials of iron and folate supplementation during pregnancy in malaria-endemic regions in Africa are urgently needed to ascertain the benefits and risks of this intervention. (author's) Language: English Keywords: TANZANIA | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | ANEMIA | SERUM IRON LEVEL | MALARIA | IRON | PREVALENCE | FOLIC ACID | FOOD SUPPLEMENTATION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Diseases | Hemic System | Physiology | Biology | Parasitic Diseases | Metals | Vitamins and Minerals | Measurement | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Health Document Number: 327787 |
| 25. Peer Reviewed Title: Zinc treatment to under-five children: applications to improve child survival and reduce burden of disease. Author: Larson CP; Roy SK; Khan AI; Rahman AS; Qadri F Source: Journal of Health, Population, and Nutrition. 2008 Sep;26(3):356-65. Abstract: Zinc is an essential micronutrient associated with over 300 biological functions. Marginal zinc deficiency states are common among children living in poverty and exposed to diets either low in zinc or high in phytates that compromise zinc uptake. These children are at increased risk of morbidity due to infectious diseases, including diarrhoea and respiratory infection. Children aged less than five years (under-five children) and those exposed to zinc-deficient diets will benefit from either daily supplementation of zinc or a 10 to 14-day course of zinc treatment for an episode of acute diarrhoea. This includes less severe illness and a reduced likelihood of repeat episodes of diarrhoea. Given these findings, the World Health Organization/United Nations Children's Fund now recommend that all children with an acute diarrhoeal illness be treated with zinc, regardless of aetiology. ICDDR.B scientists have led the way in identifying the benefits of zinc. Now, in partnership with the Ministry of Health and Family Welfare, Government of Bangladesh and the private sector, the first national scaling up of zinc treatment has been carried out. Important challenges remain in terms of reaching the poorest families and those living in remote areas of Bangladesh. Language: English Keywords: BANGLADESH | RESEARCH REPORT | CLINICAL RESEARCH | CHILDREN | CHILD NUTRITION | ZINC | FOOD SUPPLEMENTATION | CHILD SURVIVAL | POVERTY | DIET | WHO | DIARRHEA | DIARRHEA, INFANTILE | DEFICIENCY DISEASES | NUTRITION PROGRAMS | Developing Countries | Asia, Southern | Asia | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition | Health | Metals | Vitamins and Minerals | Physiology | Biology | Primary Health Care | Health Services | Delivery of Health Care | Survivorship | Length of Life | Mortality | Population Dynamics | Socioeconomic Factors | Economic Factors | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Diseases | Nutrition Disorders Document Number: 328886 |
| 26. Title: The association of maternal social factors and antenatal care with cord serum zinc in full-term neonates. Author: Lasisi AO; Kuti MO; Adekunle AO Source: African Journal of Biomedical Research. 2008 Sep;11(3):297-303. Abstract: Zinc is a crucial micronutrient in early childhood survival and the development of innate and acquired immunity. The objective is to determine the relationship between of maternal social class and antenatal care to serum zinc level in newborns in a tertiary and a rural hospital. It is prospective study using questionnaires on consecutive mothers with normal pregnancy(excluding sepsis and chronic illneses) and cord serum level of Zinc estimation in newborns using flame atomic absorption spectrophotometry. There were 106 mothers and neonates; were made up of 57 females and 49 males. The ages of the mother ranged between 21 years to 39 years, with a mean of 26 years; while the gestational age of the neonates ranged between 30 weeks and 45 weeks with a mean of 37.3. The range of the serum Zinc was 0.14µg/L – 0.92µg/L, with a mean of 0.64µg/L (SD=0.17) and median value of 0.63µg/L. The social classes of the mothers were low 66, middle 23 and high 17 with mean neonatal serum zinc of 0.62µg/L, 0.68µg/L and 0.72µg/L. The mean serum Zinc in 17/86 neonates of mothers with inadequate tetanus vaccination was 0.53µg/L, (below the median value) compared to 0.66µg/L in 89/106 neonates of mothers with complete vaccination. The serum zinc in the neonates of mothers <25 years of age was 0.68µg/L compared to 0.61µg/L in the neonates of mothers >25years. Fever in pregnancy was seen in 31/106; with mean neonatal serum Zinc of 0.63µg/L compared with those without fever 0.65µg/L. There were 94 neonates with normal weight (>2.5kg) and 12 low birth weight (<2.5kg) with mean serum Zinc of 0.69µg/L and 0.66µg/L respectively. Antenatal care was complete in 81 and incomplete in 25 with mean neonatal serum Zinc of 0.66µg/L and 0.56µg/L respectively. Univariate analysis revealed significant correlation between the mean serum Zinc and the socioeconomic class (P = 0.022), but there was no correlation with maternal age (P=0.327), sex (P=0.566), gestational age (P=0.100), birth weight (P=0.365), vaccination (P=0.954), malaria fever (P=0.875) and antenatal care (P=0.97), We concluded that low social status of the mothers and inadequate vaccination in pregnancy were major factors associated with low neonatal serum zinc. The control of these factors may impact on optimal neonatal nutrition. Language: English Keywords: NIGERIA | RESEARCH REPORT | INFANT | ANTENATAL CARE | ZINC | MATERNAL HEALTH | EDUCATION | MATERNAL NUTRITION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Metals | Vitamins and Minerals | Physiology | Biology | Nutrition Document Number: 340014 |
| 27. Peer Reviewed Title: Infectious diseases and vaccine sciences: strategic directions. Author: Luby SP; Brooks WA; Zaman K; Hossain S; Ahmed T Source: Journal of Health, Population, and Nutrition. 2008 Sep;26(3):295-310. Abstract: Despite substantial progress, infectious diseases remain important causes of ill-health and premature deaths in Bangladesh. Bangladesh has experienced a > 90% reduction in the incidence of deaths due to childhood diarrhoea over the last 25 years. Further reductions can be achieved through the introduction of effective vaccines against rotavirus and improvements in home hygiene, quality of drinking-water, and clinical case management, including appropriate use of oral rehydration solution and zinc. Pneumonia is now the leading cause of childhood deaths in Bangladesh, and the pneumonia-specific child mortality is largely unchanged over the last 25 years. Reductions in mortality due to pneumonia can be achieved through the introduction of protein conjugate vaccines against Haemophilus influenza type b and Streptococcus pneumoniae, improvements in case management, including efforts to prevent delays in providing appropriate treatment, and the wider use of zinc. Tuberculosis is responsible for an estimated 70,000 deaths each year in Bangladesh. Although services for directly-observed therapy have expanded markedly, improved case finding and involvement of private practitioners will be important to reduce the burden of disease. Language: English Keywords: BANGLADESH | RECOMMENDATIONS | PROGRESS REPORT | EPIDEMIOLOGIC METHODS | CHILDREN | COMMUNICABLE DISEASE CONTROL | INFECTION PREVENTION | IMMUNIZATION | CHILD SURVIVAL | ORAL REHYDRATION | DIARRHEA | ZINC | HYGIENE | PNEUMONIA | TUBERCULOSIS | Developing Countries | Asia, Southern | Asia | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health Services | Delivery of Health Care | Health | Infections | Diseases | Primary Health Care | Survivorship | Length of Life | Mortality | Population Dynamics | Treatment | Medical Procedures | Medicine | Metals | Vitamins and Minerals | Physiology | Biology | Public Health | Pulmonary Effects Document Number: 328889 |
| 28. Peer Reviewed Title: A meta-analysis of the effects of oral zinc in the treatment of acute and persistent diarrhea. Author: Lukacik M; Thomas RL; Aranda JV Source: Pediatrics. 2008 Feb;121(2):326-36. Abstract: OBJECTIVE: Children in developing countries are at a high risk for zinc deficiency. Supplemental zinc has previously been shown to provide therapeutic benefits in diarrhea. The objective of this study was to examine the efficacy and safety of supplemental oral zinc therapy during recovery from acute or persistent diarrhea. METHODS: We conducted a meta-analysis of randomized, controlled trials to compare the efficacy and safety of supplementary oral zinc with placebo in children with acute and persistent diarrhea. Results were reported using a pooled relative risk or a weighted mean difference. A total of 22 studies were identified for inclusion: 16 examined acute diarrhea (n = 15,231), and 6 examined persistent diarrhea (n = 2968). RESULTS: Mean duration of acute diarrhea and persistent diarrhea was significantly lower for zinc compared with placebo. Presence of diarrhea between zinc and placebo at day 1 was not significantly different in acute diarrhea or persistent diarrhea trials. At day 3, presence was significantly lower for zinc in persistent diarrhea trials (n = 221) but not in acute diarrhea trials. Vomiting after therapy was significantly higher for zinc in 11 acute diarrhea trials (n = 4438) and 4 persistent diarrhea trials (n = 2969). Those who received zinc gluconate in comparison with zinc sulfate/acetate vomited more frequently. Overall, children who received zinc reported an 18.8% and 12.5% reduction in average stool frequency, 15.0% and 15.5% shortening of diarrhea duration, and a 17.9% and 18.0% probability of reducing diarrhea over placebo in acute and persistent trials, respectively. CONCLUSIONS: Zinc supplementation reduces the duration and severity of acute and persistent diarrhea; however, the mechanisms by which zinc exerts its antidiarrheal effect have not been fully elucidated. Language: English Keywords: DEVELOPING COUNTRIES | LITERATURE REVIEW | CLINICAL TRIALS | CHILDREN | ZINC | DIARRHEA | FOOD SUPPLEMENTATION | TREATMENT | SAFETY | TIME FACTORS | VOMITING | SIDE EFFECTS | Clinical Research | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Metals | Vitamins and Minerals | Physiology | Biology | Diseases | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine | Public Health | Population Dynamics | Nausea | Signs and Symptoms Document Number: 328043 |
| 29. Peer Reviewed Title: Adequacy of prenatal care as a major determinant of folic acid, iron, and vitamin intake during pregnancy. Author: Lunet N; Rodrigues T; Correia S; Barros H Source: Cadernos de Saude Publica. 2008 May;24(5):1151-1157. Abstract: This study aimed to quantify the association between adequacy of prenatal care and prevalence of folic acid, iron, and multivitamin intake during pregnancy. Data were obtained on socio-demographics, prenatal care, pregnancy complications, and use of vitamin/mineral supplements for 836 women, using a postpartum interview. Associations with the use of vitamin/mineral supplements were quantified with risk ratios (RR), computed by generalized binomial regression. A high proportion of women reported the use of folic acid (81.9%), iron (55.4%), and multivitamins (76.2%) as supplements during pregnancy. Use of supplements was independently associated with adequacy of prenatal care (adequate vs. inadequate: folic acid, RR = 2.28; 95%CI: 1.58-3.29; iron, RR = 1.99; 95%CI: 1.57-2.52, multivitamins, RR = 1.97; 95%CI: 1.54-2.51). Higher schooling was also associated with increased use of folic acid (RR = 1.42; 95%CI: 1.18-1.70), but not multivitamins (RR = 0.87; 95%CI: 0.77-0.98). Use of folic acid was less prevalent in single women (RR = 0.67; 95%CI: 0.48-0.95) and during unplanned pregnancies (RR = 0.81; 95%CI: 0.71-0.92). Adequacy of prenatal care is a major determinant of vitamin/ mineral intake during pregnancy. (author's) Language: English Keywords: PORTUGAL | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PREGNANT WOMEN | ANTENATAL CARE | VITAMINS AND MINERALS | FOLIC ACID | IRON | FOOD SUPPLEMENTATION | PREVALENCE | EDUCATION | Developed Countries | Europe, Southwestern | Europe | Research Methodology | Population Characteristics | Demographic Factors | Population | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Physiology | Biology | Metals | Nutrition Programs | Measurement Document Number: 326501 |
| 30. Title: The burden of malaria and malnutrition among children less than 14 years of age in a rural village of Cameroon. Author: Nkuo-Akenji TK; Sumbele I; Mankah EN; Njunda AL; Samje M; Kamga L Source: African Journal of Food, Agriculture, Nutrition and Development. 2008 Sep;8(3):252-264. Abstract: Malaria and malnutrition are a major health burden in developing countries with infants and children being the most vulnerable groups. The extent of the burden of malaria and malnutrition was investigated in 339 children Keywords: CAMEROON | SUMMARY REPORT | RURAL AREAS | CHILD | MALARIA | MALNUTRITION | ANEMIA | IRON | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Geographic Factors | Population | Youth | Age Factors | Population Characteristics | Demographic Factors | Parasitic Diseases | Diseases | Nutrition Disorders | |