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. 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 |
| 4. Title: Determinants of low birth weight in urban Pakistan. Author: Janjua NZ; Delzell E; Larson RR; Meleth S; Kristensen S; Kabagambe E; Sathiakumar N Source: Public Health Nutrition. 2009 Jun;12(6):789-98. Abstract: OBJECTIVE: To identify determinants of low birth weight (LBW) in Karachi, Pakistan, including environmental exposures and nutritional status of the mother during pregnancy. DESIGN: Cross-sectional study.ParticipantsFive hundred and forty mother-infant pairs. We interviewed mothers about obstetric history, diet and exposure to Pb. We measured birth weight and blood lead level (BLL). We performed multiple log binomial regression analysis to identify factors related to LBW. RESULTS: Of 540 infants, 100 (18.5 %) weighed Keywords: PAKISTAN | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | URBAN POPULATION | PREGNANCY | LOW BIRTH WEIGHT | ASCORBIC ACID | NUTRITION INDEXES | Developing Countries | Asia, Southern | Asia | Research Methodology | Population Characteristics | Demographic Factors | Population | Reproduction | Birth Weight | Body Weight | Physiology | Biology | Vitamins and Minerals | Nutrition | Health Document Number: 342264 |
| 5. Title: A systematic review of randomized controlled trials of prenatal and postnatal vitamin A supplementation of HIV-infected women. Author: Kongnyuy EJ; Wiysonge CS; Shey MS Source: International Journal of Gynaecology and Obstetrics. 2009 Jan;104(1):5-8. Abstract: We searched the Cochrane Library, MEDLINE, EMBASE, AIDSearch, and Gateway to assess the effect of prenatal and/or postnatal vitamin A supplementation on the risk of mother-to-child transmission (MTCT) of HIV and other pregnancy outcomes. We included 5 trials totaling 7528 women (4 trials of prenatal and 1 trial of postnatal supplementation). Overall, there was no evidence of an effect of prenatal and/or postnatal vitamin A supplementation on the risk of MTCT of HIV (Relative Risk [RR] 1.06, 95% Confidence Interval [CI] 0.89-1.26). However, prenatal vitamin A supplementation significantly improved birth weight (weighted mean difference 89.78; 95% CI, 84.73-94.83), but there was no evidence of an effect on stillbirths (RR 0.99; 95% CI, 0.68-1.43), preterm births (RR 0.88; 95% CI, 0.65-1.19), death before 24 months among live births (RR 1.08; 95% CI, 0.91-1.29), and maternal death (RR 0.83; 95% CI, 0.59-1.17). The available evidence does not support vitamin A supplementation of HIV-infected pregnant and lactating women, despite improvement in birth weight. Language: English Keywords: AFRICA | RESEARCH REPORT | CLINICAL TRIALS | PREGNANT WOMEN | PERSONS LIVING WITH HIV/AIDS | VITAMIN A | FOOD SUPPLEMENTATION | MOTHER-TO-CHILD TRANSMISSION | RISK FACTORS | BIRTH WEIGHT | Developing Countries | Clinical Research | Research Methodology | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Vitamins and Minerals | Physiology | Biology | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Health | Transmission | Infections | Body Weight Document Number: 341390 |
| 6. Title: The effect of fish and omega-3 LCPUFA intake on low birth weight in Indian pregnant women. Author: Muthayya S; Dwarkanath P; Thomas T; Ramprakash S; Mehra R; Mhaskar A; Mhaskar R; Thomas A; Bhat S; Vaz M; Kurpad AV Source: European Journal of Clinical Nutrition. 2009 Mar;63(3):340-6. Abstract: BACKGROUND: Inadequate consumption of fish could be a risk factor for low birth weight (LBW). This study assessed fish intake and omega-3 LCPUFA intake and status for their association with LBW in a cohort of urban, south Indian pregnant women. SUBJECTS/METHODS: In a prospective cohort study, data on maternal fish intake and omega-3 LCPUFA intake and status of 676 women were obtained at baseline (first trimester), the second and third trimesters of pregnancy. Infant birth weight was measured immediately following hospital delivery. The dropout rate was 7.6%. RESULTS: Fifty-six percent of the study women consumed fish with low daily median intakes (3.4, 4.1 and 3.8 g day(-1) at the three trimesters, respectively). Consequently, the median intakes of EPA and DHA during pregnancy were also low at 2.1 and 10.1 mg day(-1), respectively. EPA and DHA intakes were associated with their status in erythrocyte membrane phospholipids during pregnancy (r=0.40 and 0.36, r=0.34 and 0.32 and r=0.37 and 0.41, at the three trimesters, respectively, all P<0.001). Women who did not eat fish during the third trimester had a significantly higher risk of LBW (OR: 2.49, P=0.019). Similarly, low EPA intake during the third trimester had an association with a higher risk of LBW (OR: 2.75, P=0.011). CONCLUSIONS: Among low fish-eating pregnant women, fish intake in the third trimester was closely associated with birth weight. Supplementation with omega-3 LCPUFA during pregnancy may have important implications for fetal development in India. Language: English Keywords: INDIA | RESEARCH REPORT | COHORT ANALYSIS | URBAN AREAS | PREGNANT WOMEN | PREGNANCY | DIET | LOW BIRTH WEIGHT | LIPID METABOLIC EFFECTS | VITAMIN D | Asia, Southern | Asia | Developing Countries | Research Methodology | Geographic Factors | Population | Population Characteristics | Demographic Factors | Reproduction | Nutrition | Health | Birth Weight | Body Weight | Physiology | Biology | Lipids | Vitamins and Minerals Document Number: 341042 |
| 7. 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 |
| 8. Title: Effect of combined maternal and infant vitamin D supplementation on vitamin D status of exclusively breastfed infants. Author: Saadi HF; Dawodu A; Afandi B; Zayed R; Benedict S; Nagelkerke N; Hollis BW Source: Maternal and Child Nutrition. 2009 Jan;5(1):25-32. Abstract: Severe vitamin D deficiency in mothers and their breastfed infants is a significant health problem in the Middle East. Supplementation of the breastfed infant alone with the recommended dose of vitamin D may be insufficient in high-risk population. We investigated the effect of combined maternal and infant vitamin D supplementation on vitamin D status of the breastfed infant. We examined also the effect of supplementation on vitamin D antirachitic activity of breast milk in a subset of mothers. Healthy breastfeeding mothers (n = 90) were randomly assigned to 2000 IU daily (group 1) or 60,000 IU monthly (group 2) of vitamin D(2), and all their infants (n = 92) received 400 IU daily of vitamin D(2) for 3 months. Most infants had vitamin D deficiency - 25-hydroxyvitamin D [25(OH)D] Keywords: MIDDLE EAST | RESEARCH REPORT | PREVALENCE | MOTHERS | BREASTFEEDING | INFANT NUTRITION | VITAMIN D | DEFICIENCY DISEASES | Measurement | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Nutrition | Health | Vitamins and Minerals | Physiology | Biology | Nutrition Disorders | Diseases Document Number: 330819 |
| 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: Vitamin D nutritional status of exclusively breast fed infants and their mothers. Author: Seth A; Marwaha RK; Singla B; Aneja S; Mehrotra P; Sastry A; Khurana ML; Mani K; Sharma B; Tandon N Source: Journal of Pediatric Endocrinology and Metabolism. 2009 Mar;22(3):241-6. Abstract: BACKGROUND: Vitamin D nutrition has a profound effect on the development of an infant. Vitamin D status of mothers and their infants are closely correlated. While hypovitaminosis D has emerged as a significant public health problem across all age groups, there is limited information of this condition in lactating mothers and their breast fed infants. AIM: To evaluate the vitamin D status of lactating mothers and their breast fed infants. SUBJECTS AND METHODS: 180 healthy lactating mothers and exclusively breast fed infants, 2-24 weeks old, were recruited for the study. The mother-infant pairs underwent concurrent clinical, biochemical and hormonal evaluation for calcium-vitamin D-PTH axis. RESULTS: The mean serum 25(OH)D values in lactating mothers was 27.2 +/- 14.6 nmol/l (10.9 +/- 5.8 ng/ml), while that of their infants was 28.9 +/- 20.8 nmol/l (11.6 +/- 8.3 ng/ml). Serum 25(OH)D levels <25 nmol/l (10 ng/ml) were found in 47.8% of the mothers and 43.2% of the infants. Among these, elevated PTH levels (>54 pg/ml) were seen in 59.3% of the mothers and 69.6% of the infants. A highly significant negative correlation was found between serum 25(OH)D and PTH in mothers (r = -0.480, p = 0.01) and their infants (r = -0.431, p = 0.01). A strong positive correlation was seen of 25(OH)D levels in mother-infant pairs (r = 0.324, p = 0.001). CONCLUSIONS: A high prevalence of vitamin D deficiency was found in lactating mothers and their exclusively breast fed infants. Infants born to mothers with hypovitaminosis D had 3.8 times higher risk of developing hypovitaminosis D as compared to those born to mothers with normal vitamin D levels. Language: English Keywords: INDIA | RESEARCH REPORT | MOTHERS | INFANT | BREASTFEEDING | VITAMIN D | DEFICIENCY DISEASES | LACTATION | Asia, Southern | Asia | Developing Countries | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Vitamins and Minerals | Physiology | Biology | Nutrition Disorders | Diseases | Maternal Physiology Document Number: 341670 |
| 11. 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 |
| 12. Peer Reviewed Title: Integration of immunization services with other health interventions in the developing world: what works and why? Systematic literature review. Author: Wallace A; Dietz V; Cairns KL Source: Tropical Medicine and International Health. 2009 Jan;14(1):11-9. Abstract: OBJECTIVE: To assess benefits, challenges and characteristics of integrating child and maternal health services with immunization programmes. METHODS: Literature review using journal databases and grey literature. Papers meeting the inclusion criteria were rated for the quality of methodology and relevant information was systematically abstracted. RESULTS: Integrated services were vitamin A supplementation, bednet distribution, deworming tablet distribution, Intermittent Preventive Therapy for infants and referrals for family planning services. Two key characteristics of success were compatibility between interventions and presence of a strong immunization service prior to integration. Overburdened staff, unequal resource allocation and logistical difficulties were mentioned as risks of integration, whereas rapid uptake of the linked intervention and less competition for resources were listed as two key benefits of integration. CONCLUSION: The theoretical strengths of integrating other health services with immunization services remain to be rigorously proved in practice. When additional interventions are carefully selected for compatibility and when they receive adequate support, coverage of these interventions may improve, provided immunization coverage is already high. Evidence for the effectiveness of integration in increasing efficiency of resource use was insufficient and most benefits and challenges were not statistically quantified. More substantive information about the costs of integrated vs. vertical programmes and full documentation of the impacts of integration on immunization services should be published. Language: English Keywords: DEVELOPING COUNTRIES | LITERATURE REVIEW | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | CHILDREN | INTEGRATED PROGRAMS | IMMUNIZATION | MATERNAL-CHILD HEALTH SERVICES | VITAMIN A | FOOD SUPPLEMENTATION | BED NETS | DISTRIBUTIONAL ACTIVITIES | PARASITE CONTROL | PREVENTIVE HEALTH CARE | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Programs | Organization and Administration | Primary Health Care | Health Services | Delivery of Health Care | Health | Vitamins and Minerals | Physiology | Biology | Nutrition Programs | Public Health | Program Activities Document Number: 330264 |
| 13. Peer Reviewed Title: Postnatal vitamin A supplementation in developing countries: an intervention whose time has come? Author: Abrams SA; Hilmers DC Source: Pediatrics. 2008 Jul;122(1):180-1. Abstract: It is clear that we have much to understand about neonatal VAS. In southern Asia, which has a relatively low overall rate of HIV infection compared with sub-Saharan Africa, there is a mortality benefit. It seems appropriate to move ahead with implementation of neonatal VAS as a public health policy in regions where it has been shown to have a survival benefit. However, implementation of programs should not proceed in any specific geographic area until controlled trials have shown a benefit in that region. Research that elucidates the underlying mechanisms of VAS and individual factors that may modify its benefit, such as gender, interaction with immunizations, coinfections, or exposure to diseases such as HIV and genetic and maternal factors, needs to continue. The goal should be to understand the effects and mechanisms of VAS adequately so that infants can be chosen for or excluded from supplementation on the basis of a defined set of criteria. Neonatal VAS seems to be an intervention that holds promise in accomplishing a step-wise reduction in infant mortality in some resource-poor regions of the world, where successes have been difficult to achieve. However, we agree with others that caution and additional trials are needed before global use of such a program is undertaken. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | CRITIQUE | LOW INCOME POPULATION | INFANT MORTALITY | INFANT HEALTH | VITAMIN A | INTERVENTIONS | PREVENTION AND CONTROL | PROGRAM EVALUATION | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Mortality | Population Dynamics | Demographic Factors | Population | Child Health | Health | Vitamins and Minerals | Physiology | Biology | Programs | Organization and Administration | Diseases Document Number: 328444 |
| 14. 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 |
| 15. Peer Reviewed Title: Potential impact of nanotechnology on the control of infectious diseases. Author: Allaker RP; Ren G Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2008 Jan;102(1):1-2. Abstract: Nanotechnology encompasses those technologies used to fabricate materials, including sphere, cubic and needle-like nanoscaled particles (approximately 5-100 nm), and near-nanoscaled devices (up to micrometres). In comparison, mycoplasma are approximately 200nm in length, and a nanometre is 10-9 of a metre. The field of nanotechnology is experiencing rapid growth, with many and diverse potential applications being explored in the biomedical field, including the control of infectious diseases. Nanotechnology not only has the potential to offer improvements to current approaches for immunisation, drug design and delivery, diagnostics and cross-infection control, but is also unexpectedly delivering many new tools and capabilities. (author's) Language: English Keywords: UNITED KINGDOM | CRITIQUE | TECHNOLOGY | COMMUNICABLE DISEASE CONTROL | EXAMINATIONS AND DIAGNOSES | IMMUNIZATION | VACCINES | LABORATORY PROCEDURES | ANTIBIOTICS | ADMINISTRATION AND DOSAGE | METALS | Developed Countries | Europe, Western | Europe | Economic Factors | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine | Primary Health Care | Laboratory Examinations and Diagnoses | Drugs | Treatment | Vitamins and Minerals | Physiology | Biology Document Number: 322620 |
| 16. 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 |
| 17. 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 |
| 18. Peer Reviewed Title: Effect of 50,000 IU vitamin A given with BCG vaccine on mortality in infants in Guinea-Bissau: Randomised placebo controlled trial. Author: Benn CS; Diness BR; Roth A; Nante E; Fisker AB Source: BMJ. British Medical Journal. 2008 Jun 21;336(7658):1416-1420. Abstract: The objective of this study was to investigate the effect of high dose vitamin A supplementation given with BCG vaccine at birth in an African setting with high infant mortality. The study design was a randomised placebo controlled trial in Bandim Health Project's demographic surveillance system in Guinea-Bissau, covering approximately 90 000 inhabitants. Participants were 4345 infants due to receive BCG. Infants were randomised to 50 000 IU vitamin A or placebo and followed until age 12 months. The main outcome measure was mortality rate ratios. 174 children died during follow-up (mortality= 47/1000person-years). Vitamin A supplementation was not significantly associated with mortality; the mortality rate ratio was 1.07 (95% confidence interval 0.79 to 1.44). The effect was 1.00 (0.65 to 1.56) during the first four months and 1.13 (0.75 to 1.68) from 4 to 12 months of age. The mortality rate ratio in boyswas0.84 (0.55 to 1.27) compared with 1.39 (0.90 to 2.14) in girls (P for interaction=0.10). An explorative analysis revealed a strong interaction between vitamin A and season of administration. Vitamin A supplementation given with BCG vaccine at birth had no significant benefit in this African setting. Although little doubt exists that vitamin A supplementation reduces mortality in older children, a global recommendation of supplementation for all newborn infants may not contribute to better survival. (author's) Language: English Keywords: GUINEA-BISSAU | RESEARCH REPORT | CLINICAL TRIALS | INFANT | INFANT NUTRITION | INFANT MORTALITY | INFANT NUTRITION DISORDERS | VITAMIN A | VACCINES | FOOD SUPPLEMENTATION | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Clinical Research | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition | Health | Mortality | Population Dynamics | Nutrition Disorders | Diseases | Vitamins and Minerals | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Nutrition Programs | Primary Health Care Document Number: 327079 |
| 19. Peer Reviewed Title: Malnutrition and morbidity among children not reached by the national vitamin A capsule programme in urban slum areas of Indonesia. Author: Berger SG; de Pee S; Bloem MW; Halati S; Semba RD Source: Public Health. 2008 Apr;122(4):371-378. Abstract: The objective was to determine whether vitamin A capsule programmes fail to reach children who are at higher risk of malnutrition and morbidity. Although it has been suggested that there are health disparities between children who are reached or not reached by these programmes, little quantitative work has been undertaken to characterize this relationship. As part of a national surveillance system, nutritional status and other factors were compared in 138,956 children, aged 12-59 months, who had and had not received vitamin A supplementation in urban slum areas in Indonesia. In total, 63.1% of children had received a vitamin A capsule within the previous 6 months. Among children who had and had not received vitamin A supplementation, respectively, the proportion with weight-for-age and height-forage Z scores less than -3 were 7.8% vs 8.6% (P less than 0.0001) and 9.4% vs 10.7% (P less than 0.0001), and with a history of diarrhoea in the previous week was 8.1% vs 10.7% (P less than 0.0001). In families where a child had or had not received vitamin A supplementation, the proportion with a history of infant death less than 12 months was 5.2% vs 7.2% (P less than 0.0001) and child death less than 5 years was 6.7% vs 9.2%, respectively (P less than 0.0001). Children who had not received vitamin A supplementation were also significantly more likely to be anaemic and have diarrhoea or fever on the survey day compared with children who had received supplementation. In the urban slums of Indonesia, children who do not receive vitamin A supplementation tend to be slightly more malnourished and ill, and are more likely to come from families with higher child mortality than children who receive vitamin A. Higher rates of child mortality in non-participating households suggest that reaching preschoolers could yield a disproportionate survival benefit. Importantly, children who are not reached by the vitamin A programme are also unlikely to be reached by vaccination and other services, emphasizing the need to identify and extend efforts to reach non-participants. (author's) Language: English Keywords: INDONESIA | SLUMS | RESEARCH REPORT | NUTRITION SURVEYS | CHILDREN | MALNUTRITION | MORBIDITY | VITAMIN A | ANEMIA | DIARRHEA | IMMUNIZATION | FOOD SUPPLEMENTATION | Developing Countries | Asia, Southeastern | Asia | Urbanization | Urban Population Distribution | Population Distribution | Geographic Factors | Population | Nutrition | Health | Youth | Age Factors | Population Characteristics | Demographic Factors | Nutrition Disorders | Diseases | Vitamins and Minerals | Physiology | Biology | Primary Health Care | Health Services | Delivery of Health Care | Nutrition Programs Document Number: 325094 |
| 20. 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 |
| 21. 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 |
| 22. Peer Reviewed Title: Severe anemia in Malawian children. Author: Calis JC; Phiri KS; Faragher EB; Brabin BJ; Bates I Source: New England Journal of Medicine. 2008 Feb 28;358(9):888-899. Abstract: Severe anemia is a major cause of sickness and death in African children, yet the causes of anemia in this population have been inadequately studied. We conducted a case-control study of 381 preschool children with severe anemia (hemoglobin concentration, less than 5.0 g per deciliter) and 757 preschool children without severe anemia in urban and rural settings in Malawi. Causal factors previously associated with severe anemia were studied. The data were examined by multivariate analysis and structural equation modeling. Bacteremia (adjusted odds ratio, 5.3; 95% confidence interval [CI], 2.6 to 10.9), malaria (adjusted odds ratio, 2.3; 95% CI, 1.6 to 3.3), hookworm (adjusted odds ratio, 4.8; 95% CI, 2.0 to 11.8), human immunodeficiency virus infection (adjusted odds ratio, 2.0; 95% CI, 1.0 to 3.8), the G6PD/-202/-376 genetic disorder (adjusted odds ratio, 2.4; 95% CI, 1.3 to 4.4), vitamin A deficiency (adjusted odds ratio, 2.8; 95% CI, 1.3 to 5.8), and vitamin B/12 deficiency (adjusted odds ratio,2.2; 95% CI, 1.4 to 3.6) were associated with severe anemia. Folate deficiency, sickle cell disease, and laboratory signs of an abnormal inflammatory response were uncommon. Iron deficiency was not prevalent in case patients (adjusted odds ratio, 0.37; 95% CI, 0.22 to 0.60) and was negatively associated with bacteremia. Malaria was associated with severe anemia in the urban site (with seasonal transmission) but not in the rural site (where malaria was holoendemic). Seventy-six percent of hookworm infections were found in children under 2 years of age. There are multiple causes of severe anemia in Malawian preschool children, but folate and iron deficiencies are not prominent among them. Even in the presence of malaria parasites, additional or alternative causes of severe anemia should be considered. (author's) Language: English Keywords: MALAWI | RESEARCH REPORT | CLINICAL RESEARCH | CASE CONTROL STUDIES | EPIDEMIOLOGIC METHODS | CHILDREN | ANEMIA | RISK FACTORS | HIV INFECTIONS | PREVALENCE | DEFICIENCY DISEASES | VITAMIN A | HEREDITARY DISEASES | VITAMIN B COMPLEX | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Biology | Viral Diseases | Measurement | Nutrition Disorders | Vitamins and Minerals | Physiology Document Number: 324974 |
| 23. 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 |
| 24. Title: Associations of oral contraceptive use and dietary restraint with bone speed of sound and bone turnover in university-aged women. Author: Di Giovanni G; Roy BD; Gammage KL; Mack D; Klentrou P Source: Applied Physiology, Nutrition, and Metabolism. 2008 Aug;33(4):696-705. Abstract: The associations of oral contraceptive use and cognitive dietary restraint with bone speed of sound (SOS) and bone turnover were investigated in 100 Canadian university-aged women (18-25 years old). Dietary restraint was assessed using the Dutch Eating Behavior Questionnaire (DEBQ) and daily calcium intake (Ca++) was assessed by the rapid assessment method. Quantitative ultrasound was used to measure SOS at the tibia and radius. Bone formation was estimated from plasma osteocalcin (OC), 25-OH vitamin D, and serum bone-specific alkaline phosphatase (BAP). Bone resorption was determined from serum cross-linked N-teleopeptide of type I collagen (NTx) and plasma C-terminal telopeptide of type I collagen (CTx). Weekly physical activity energy expenditure (WAeq) was assessed using a standardized questionnaire, and height, body mass, relative body fat (%BF), and chest, waist, and hip circumferences were also measured. Participants were divided into low and moderate to high dietary restrainers (LDRs and MDRs, respectively). These groups were further sub-divided into users and non-users of oral contraceptives. All groups had similar age at menarche, body composition, WAeq, and equally low levels of Ca++ and vitamin D. Within the non-users of oral contraceptives, MDR exhibited a lower tibial SOS (p Keywords: CANADA | RESEARCH REPORT | QUANTITATIVE RESEARCH | STUDENTS | WOMEN | UNIVERSITIES | DIET | VITAMIN D | SKELETAL EFFECTS | CALORIC INTAKE | Developed Countries | North America, Northern | Americas | Research Methodology | Education | Demographic Factors | Population | Schools | Nutrition | Health | Vitamins and Minerals | Physiology | Biology Document Number: 329296 |
| 25. 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 |
| 26. Peer Reviewed Title: The cost of Child Health Days: a case study of Ethiopia's Enhanced Outreach Strategy (EOS). Author: Fiedler JL; Chuko T Source: Health Policy and Planning. 2008 Jul;23(4):222-33. Abstract: Child Health Days (CHDs) are twice-annual campaign-style events designed to increase the coverage of vitamin A and one or more other child health services. Although more than two dozen countries have had a CHD, little has been published about them. This paper presents an activity-based costing study of Ethiopia's version of CHDs, the Enhanced Outreach Strategy (EOS). The December 2006 round reached more than 10 million beneficiaries at an average cost per beneficiary of US$0.56. When measles is added, the cost of the package doubles. Given the way the distribution day delivery system and the service package are structured, there are economies of scope. Because most of the costs are determined by the number of delivery sites and are independent of the number of beneficiaries, other things equal, increasing the beneficiaries would reduce the average cost per beneficiary. Taking into account only the mortality impact of vitamin A, EOS saved 20,200 lives and averted 230,000 DALYs of children 6-59 months. The average cost per life saved was US$228 and the cost per DALY averted was equivalent to 6% of per capita GDP (US$9), making the EOS cost-effective, according to WHO criteria. While CHDs are generally construed as a temporary strategy for improving coverage of supply-constrained systems, inadequate attention has been paid to demand-side considerations that suggest CHDs have an important role to play in changing care-seeking behaviour, in increasing community organization and participation, and in promoting district autonomy and capacity. Recognition of these effects suggests the need for decisions about where and when to introduce, and when to end, a CHD to take into account more than 'just' health sector considerations: they are more broadly about community development. UNICEF played a key role in initiating the EOS and finances 68% of costs, raising concern about the programme's long-term sustainability. Language: English Keywords: ETHIOPIA | RESEARCH REPORT | CASE STUDIES | COST BENEFIT ANALYSIS | CHILDREN | CAMPAIGNS | VITAMIN A | PREVENTIVE HEALTH CARE | COST EFFECTIVENESS | MEASLES | DELIVERY OF HEALTH CARE | UTILIZATION OF HEALTH CARE | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Quantitative Evaluation | Evaluation | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Communication Programs | Communication | Vitamins and Minerals | Physiology | Biology | Health Services | Health | Evaluation Indexes | Viral Diseases | Diseases Document Number: 328447 |
| 27. 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 |
| 28. Title: Host-pathogen evolution: Implications for the prevention and treatment of malaria, myocardial infarction and AIDS. Author: Foster HD Source: Medical Hypotheses. 2008;70(1):21-25. Abstract: Humans have evolved complex immune systems to protect against infection by pathogens. However, pathogens possess a remarkable genetic versatility that allows them to gain new vigour and so escape such population immunity. Conflicting pathogen-host objectives, therefore, lead to the evolutionary equivalent of an "arms race". Typically, in this struggle, pathogens attempt to deplete their host of specific nutrients that are essential for immune system function. After infection, the resulting deficiency of nutrient(s) may cause many of the disease symptoms and sequela. In malaria, Plasmodium falciparum, for example, depletes its host of Vitamin A, possibly resulting in blindness in some cases. However, 200,000 International Units of Vitamin A, given to children every three months can reduce significantly their susceptibility to malaria. This would seem to be a minimum child dosage for the treatment of the disease. In contrast, the Coxsackie B virus causes a selenium deficiency that may result in myocardial infarction or Keshan disease. However, table salt fortified with 15 ppm anhydrous sodium selenite can cause dramatic drops in the incidence of Keshan disease, while selenium supplementation also reduces re-infarction rates. HIV-1 depletes its host of four nutrients: selenium, cysteine, glutamine and tryptophan, resulting in symptoms known as AIDS. Open and closed clinical trials in South Africa, Zambia and Uganda, involving daily adult doses of 600 mcg L-selenomethione, and some 500 mg L-glutamine, hydroxytryptophan and N-acetyl cysteine, however, have shown that such supplementation can reverse the symptoms of AIDS and prevent HIV-1 infected patients declining into this disease. It is obvious, therefore, that supplementation of diet with specific nutrients can reduce infection by particular pathogens. In addition, if infection still occurs, their use as a treatment may prevent many of the symptoms and sequela commonly associated with diseases such as malaria, myocardial infarction and AIDS. (author's) Language: English Keywords: AFRICA, SUB SAHARAN | LITERATURE REVIEW | CLINICAL TRIALS | PERSONS LIVING WITH HIV/AIDS | PARASITES | VITAMIN A | ADMINISTRATION AND DOSAGE | PARASITE CONTROL | MALARIA PREVENTION | MALARIA | TREATMENT | HIV INFECTIONS | HEART DISEASES | Developing Countries | Africa | Clinical Research | Research Methodology | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Biology | Vitamins and Minerals | Physiology | Drugs | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Public Health | Parasitic Diseases Document Number: 325622 |
| 29. Peer Reviewed Title: Vitamin D deficiency is associated with tuberculosis and latent tuberculosis infection in immigrants from sub-Saharan Africa. Author: Gibney KB; MacGregor L; Leder K; Torresi J; Marshall C Source: Clinical Infectious Diseases. 2008 Feb;46(3):443-447. Abstract: Among African immigrants in Melbourne, Victoria, Australia, we demonstrated lower geometric mean vitamin D levels in immigrants with latent tuberculosis infection than in those with no Mycobacterium tuberculosis infection (P = .007); such levels were also lower in immigrants with tuberculosis or past tuberculosis than in those with latent tuberculosis infection (P < .001). Higher vitamin D levels were associated with lower probability of any M. tuberculosis infection (P < .001) and lower probability of tuberculosis or past tuberculosis (compared with latent tuberculosis infection; P = .001). (author's) Language: English Keywords: AUSTRALIA | AFRICA, SUB SAHARAN | RESEARCH REPORT | RETROSPECTIVE STUDIES | IMMIGRANTS | CLIENTS | TUBERCULOSIS | PREVALENCE | VITAMIN D | DEFICIENCY DISEASES | PROBABILITY | Developed Countries | Oceania | Developing Countries | Africa | Studies | Research Methodology | Migrants | Migration | Population Dynamics | Demographic Factors | Population | Program Activities | Programs | Organization and Administration | Infections | Diseases | Measurement | Vitamins and Minerals | Physiology | Biology | Nutrition Disorders | Statistical Studies Document Number: 323514 |
| 30. Title: Vitamin A supplementation in Cambodia: program coverage and association with greater maternal formal education. Author: Grover DS; Pee S; Sun K; Raju VK; Bloem MW; Semba RD Source: Asia Pacific Journal of Clinical Nutrition. 2008;17(3):446-50. Abstract: Vitamin A supplementation reduces morbidity, mortality, and blindness among children in developing countries. The objective of this study is to characterize the coverage of the Cambodian national vitamin A program among preschool children and to identify risk factors for not receiving vitamin A supplementation. The study subjects were preschool children and their families who participated in the 2005 Cambodian Demographic and Health Survey (CDHS), a nationally representative survey. Of 1,547 preschool children, aged 12-59 months, 42.8% received a vitamin A capsule within the last six months. There were no significant differences in paternal education, child age, fever within the last 2 weeks, stunting, underweight, or wasting between children who did or did not receive a vitamin A capsule. Maternal education of > or =10 years (Odds Ratio [OR] 2.09, 95% Confidence Interval [CI] 1.02-4.29), 7-9 years (OR 1.46, 95% CI 0.99-2.15), 4-6 years (OR 1.71, 95% CI 1.26-2.32), and 1-3 years (OR 1.50, 95% CI 1.10-2.06) was associated with the child receiving a vitamin A capsule compared to no formal education in multivariate analyses adjusting for other potential confounders. The national vitamin A supplementation program in Cambodia did not reach over one-half of preschool children in 2005. Greater maternal formal education appears to be an important determinant for receipt of a vitamin A capsule by preschool children. Language: English Keywords: CAMBODIA | RESEARCH REPORT | CHILDREN | BLINDNESS | VITAMIN A | MORTALITY | DEFICIENCY DISEASES | MORBIDITY | Developing Countries | Asia, Southeastern | Asia | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Ophthalmological Effects | Physiology | Biology | Vitamins and Minerals | Population Dynamics | Nutrition Disorders | Diseases Document Number: 330114 |
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