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Das G, Heredia JB, de Lourdes Pereira M, Coy-Barrera E, Rodrigues Oliveira SM, Gutiérrez-Grijalva EP, Cabanillas-Bojórquez LA, Shin HS, Patra JK. Korean traditional foods as antiviral and respiratory disease prevention and treatments: A detailed review. Trends Food Sci Technol 2021; 116:415-433. [PMID: 34345117 PMCID: PMC8321624 DOI: 10.1016/j.tifs.2021.07.037] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Korean traditional food (KTF), originated from ancestral agriculture and the nomadic traditions of the Korean peninsula and southern Manchuria, is based on healthy food that balances disease prevention and treatment. Fermented foods that include grains, herbs, fruits, and mushrooms are also an important practice in KTF, providing high levels of Lactobacilli, which confer relevant health benefits, including antiviral properties. Some of these probiotics may also protect against the Influenza virus through the modulation of innate immunity. SCOPE AND APPROACH The emerging of the COVID-19 pandemic, in addition to other diseases of viral origin, and the problems associated with other respiratory disorders, highlight how essential is a healthy eating pattern to strengthen our immune system.Key Findings and Conclusions: The present review covers the information available on edible plants, herbs, mushrooms, and preparations used in KTF to outline their multiple medicinal effects (e.g., antidiabetic, chemopreventive, antioxidative, anti-inflammatory, antibacterial), emphasizing their role and effects on the immune system with an emphasis on modulating properties of the gut microbiota that further support strong respiratory immunity. Potential functional foods commonly used in Korean cuisine such as Kimchi (a mixture of fermented vegetables), Meju, Doenjang, Jeotgal, and Mekgeolli and fermented sauces, among others, are highlighted for their great potential to improve gut-lung immunity. The traditional Korean diet and dietary mechanisms that may target viruses ACE-2 receptors or affect any step of a virus infection pathway that can determine a patient's prognosis are also highlighted. The regular oral intake of bioactive ingredients used in Korean foods can offer protection for some viral diseases, through protective and immunomodulatory effects, as evidenced in pre-clinical and clinical studies.
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Affiliation(s)
- Gitishree Das
- Research Institute of Biotechnology & Medical Converged Science, Dongguk University-Seoul, Goyangsi, South Korea
| | - J Basilio Heredia
- Centro de Investigación en Alimentación y Desarrollo, A.C., Carretera a Eldorado Km. 5.5, Col. Campo El Diez, CP. 80110, Culiacán, Sinaloa, Mexico
| | - Maria de Lourdes Pereira
- CICECO-Aveiro Institute of Materials, University of Aveiro, 3810-193 Aveiro, Portugal
- Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Ericsson Coy-Barrera
- Bioorganic Chemistry Laboratory, Facultad de Ciencias Básicas y Aplicadas, Universidad Militar Nueva Granada, Campus Nueva Granada, 250247, Cajicá, Colombia
| | - Sonia Marlene Rodrigues Oliveira
- CICECO-Aveiro Institute of Materials, University of Aveiro, 3810-193 Aveiro, Portugal
- HMRI and Hunter Cancer Research Alliance Centres, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Erick Paul Gutiérrez-Grijalva
- Catedras CONACYT-Centro de Investigación en Alimentación y Desarrollo, A.C., Carretera a Eldorado Km. 5.5, Col. Campo El Diez, CP. 80110 Culiacán, Sinaloa, Mexico
| | - Luis Angel Cabanillas-Bojórquez
- Centro de Investigación en Alimentación y Desarrollo, A.C., Carretera a Eldorado Km. 5.5, Col. Campo El Diez, CP. 80110, Culiacán, Sinaloa, Mexico
| | - Han-Seung Shin
- Department of Food Science & Biotechnology, Dongguk University-Seoul, Goyangsi, South Korea
| | - Jayanta Kumar Patra
- Research Institute of Biotechnology & Medical Converged Science, Dongguk University-Seoul, Goyangsi, South Korea
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Hermel M, Sweeney M, Ni YM, Bonakdar R, Triffon D, Suhar C, Mehta S, Dalhoumi S, Gray J. Natural Supplements for COVID19-Background, Rationale, and Clinical Trials. J Evid Based Integr Med 2021; 26:2515690X211036875. [PMID: 34384258 PMCID: PMC8369961 DOI: 10.1177/2515690x211036875] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Worldwide, the turmoil of the SARS-CoV-2 (COVID-19) pandemic has generated a burst of research efforts in search of effective prevention and treatment modalities. Current recommendations on natural supplements arise from mostly anecdotal evidence in other viral infections and expert opinion, and many clinical trials are ongoing. Here the authors review the evidence and rationale for the use of natural supplements for prevention and treatment of COVID-19, including those with potential benefit and those with potential harms. Specifically, the authors review probiotics, dietary patterns, micronutrients, antioxidants, polyphenols, melatonin, and cannabinoids. Authors critically evaluated and summarized the biomedical literature published in peer-reviewed journals, preprint servers, and current guidelines recommended by expert scientific governing bodies. Ongoing and future trials registered on clinicaltrials.gov were also recorded, appraised, and considered in conjunction with the literature findings. In light of the controversial issues surrounding the manufacturing and marketing of natural supplements and limited scientific evidence available, the authors assessed the available data and present this review to equip clinicians with the necessary information regarding the evidence for and potential harms of usage to promote open discussions with patients who are considering dietary supplements to prevent and treat COVID-19.
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Affiliation(s)
- Melody Hermel
- 2697Scripps Health, Cardiology, San Diego, CA, USA.,540266Scripps Center for Integrative Medicine, La Jolla, CA, USA
| | - Megan Sweeney
- 2697Scripps Health, Cardiology, San Diego, CA, USA.,540266Scripps Center for Integrative Medicine, La Jolla, CA, USA
| | - Yu-Ming Ni
- 2697Scripps Health, Cardiology, San Diego, CA, USA.,540266Scripps Center for Integrative Medicine, La Jolla, CA, USA
| | - Robert Bonakdar
- 540266Scripps Center for Integrative Medicine, La Jolla, CA, USA
| | - Douglas Triffon
- 2697Scripps Health, Cardiology, San Diego, CA, USA.,540266Scripps Center for Integrative Medicine, La Jolla, CA, USA
| | - Christopher Suhar
- 2697Scripps Health, Cardiology, San Diego, CA, USA.,540266Scripps Center for Integrative Medicine, La Jolla, CA, USA
| | - Sandeep Mehta
- 2697Scripps Health, Cardiology, San Diego, CA, USA.,540266Scripps Center for Integrative Medicine, La Jolla, CA, USA
| | - Sarah Dalhoumi
- 540266Scripps Center for Integrative Medicine, La Jolla, CA, USA
| | - James Gray
- 2697Scripps Health, Cardiology, San Diego, CA, USA.,540266Scripps Center for Integrative Medicine, La Jolla, CA, USA
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COŞKUN S, KIRKIL C, KİRKİL G. The change in the frequency of community acquired acute respiratory tract infections in weight loss period after bariatric surgery: An observational case-crossover study. Are those who have had bariatric surgery at risk? ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE 2021. [DOI: 10.25000/acem.938844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Lactobacillus rhamnosus postbiotic-induced immunomodulation as safer alternative to the use of live bacteria. Cytokine 2021; 146:155631. [PMID: 34252871 DOI: 10.1016/j.cyto.2021.155631] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 05/14/2021] [Accepted: 06/11/2021] [Indexed: 12/28/2022]
Abstract
Many attempts have been made to search for safer immunomodulatory agents that enhance the immune response and reduce the number and severity of infections in at-risk populations. The use of postbiotics, non-viable microbial cells or cell fractions that confer a health benefit to the consumer, represents a safe and attractive way to modulate and enhance the immune function in order to improve human health. Therefore, the aim of this work is to evaluate the immunoregulatory effect of Lactobacillus rhamnosus CRL1505 postbiotics in a complex culture system using human intestinal epithelial cells (IECs) and dendritic cells (DCs) differentiated from peripheral blood mononuclear cells. First, we demonstrated that L. rhamnosus CRL1505 differentially modulate human IECs and DCs after the challenge with the TLR4 agonist LPS. The CRL1505 strain down-regulated CD40, CD80 and CD86 expression in DCs, and increased their production of TNF-α, IL-1β, IL-6 and IL-10. Interestingly, the non-viable strain was able to modulate the immune response of both types of human cells. Then, we showed that cell wall (CW1505) and peptidoglycan (PG1505) from L. rhamnosus CRL1505 modulated TLR4-triggered immune response in IECs and DCs. Of interest, CW1505 showed a strong stimulatory effect while the PG1505 presented immune characteristics that were more similar to viable and non-viable CRL1505. To date, several molecules of immunobiotics were identified, that can be connected to specific host-responses. We hereby demonstrated that peptidoglycan of L. rhamnosus CRL1505 is a key molecule for the immunobiotic properties of this strain in human IECs and DCs. Likewise, the result of these studies could provide predictive tools for the in vivo efficacy of postbiotics and the scientific basis for their future applications in immunocompromised patients.
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Barbieri N, Salva S, Herrera M, Villena J, Alvarez S. Nasal Priming with Lactobacillus rhamnosus CRL1505 Stimulates Mononuclear Phagocytes of Immunocompromised Malnourished Mice: Improvement of Respiratory Immune Response. Probiotics Antimicrob Proteins 2021; 12:494-504. [PMID: 31030404 DOI: 10.1007/s12602-019-09551-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The effect of Lactobacillus rhamnosus CRL1505 (Lr) on macrophages (Ma) and dendritic cells (DC) in the orchestration of anti-pneumococcal immunity was studied using malnutrition and pneumococcal infection mouse models. Monocytes (Mo), Ma, and DC in two groups of malnourished mice fed with balanced diet (BCD) were studied through flow cytometry; one group was nasally administered with Lr (BCD+Lr group), and the other group was not (BCD group). Well-nourished (WNC) and malnourished (MNC) mice were used as controls.Malnutrition affected the number of respiratory and splenic mononuclear phagocytes. The BCD+Lr treatment, unlike BCD, was able to increase and normalize lung Mo and Ma. The BCD+Lr mice were also able to upregulate the expression of the activation marker MHC II in lung DC and to improve this population showing a more significant effect on CD11b+ DC subpopulation. At post-infection, lung Mo values were higher in BCD+Lr mice than in BCD mice and similar to those obtained in WNC group. Although both repletion treatments showed similar values of lung Ma post-infection, the Ma activation state in BCD+Lr mice was higher than that in BCD mice. Furthermore, BCD+Lr treatment was able to normalize the number and activation of splenic Ma and DC after the challenge.Lr administration stimulates respiratory and systemic mononuclear phagocytes. Stimulation of Ma and DC populations would increase the microbicide activity and improve the adaptive immunity through its antigen-presenting capacity. Thus, Lr contributes to improved outcomes of pneumococcal infection in immunocompromised hosts.
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Affiliation(s)
- Natalia Barbieri
- Laboratorio de Inmunobiotecnología, Centro de Referencia para Lactobacilos (CERELA-CONICET), Chacabuco 145, T4000ILC, San Miguel deTucumán, Tucumán, Argentina.,Departamento de Ciencias Básicas y Tecnológicas, Universidad Nacional de Chilecito (UNdeC), CONICET, 9 de Julio 22, F5360CKB, Chilecito, La Rioja, Argentina
| | - Susana Salva
- Laboratorio de Inmunobiotecnología, Centro de Referencia para Lactobacilos (CERELA-CONICET), Chacabuco 145, T4000ILC, San Miguel deTucumán, Tucumán, Argentina
| | - Matías Herrera
- Laboratorio de Inmunobiotecnología, Centro de Referencia para Lactobacilos (CERELA-CONICET), Chacabuco 145, T4000ILC, San Miguel deTucumán, Tucumán, Argentina.,Planta Piloto de Procesos Industriales Microbiológicos (PROIMI-CONICET), Av. Belgrano y Pje. Caseros, T4001MVB, San Miguel deTucumán, Tucumán, Argentina
| | - Julio Villena
- Laboratorio de Inmunobiotecnología, Centro de Referencia para Lactobacilos (CERELA-CONICET), Chacabuco 145, T4000ILC, San Miguel deTucumán, Tucumán, Argentina
| | - Susana Alvarez
- Laboratorio de Inmunobiotecnología, Centro de Referencia para Lactobacilos (CERELA-CONICET), Chacabuco 145, T4000ILC, San Miguel deTucumán, Tucumán, Argentina. .,Instituto de Bioquímica Aplicada, Facultad de Bioquímica, Química y Farmacia, Universidad Nacional de Tucumán, Balcarce 747, 4000, San Miguel deTucumán, Tucumán, Argentina.
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Gámez G, Rojas JP, Cardona S, Castillo Noreña JD, Palacio MA, Mejía LF, Torres JL, Contreras J, Muñoz LM, Criales J, Vélez LF, Forero AM, Zúñiga YA, Cuastumal ME, Acevedo LJ, Molina ÁDJ, Bolivar JA, Gómez-Mejia A, Morales JL, Hammerschmidt S. Factors Associated with Streptococcus pneumoniae Nasopharyngeal Carriage and Antimicrobial Susceptibility among Children Under the Age of 5 Years in the Southwestern Colombia. J PEDIAT INF DIS-GER 2021. [DOI: 10.1055/s-0041-1731343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Abstract
Objective This work aimed to evaluate the factors associated with Streptococcus pneumoniae nasopharyngeal colonization and antimicrobial susceptibility among pediatric outpatients in southwestern Colombia, 2019.
Methods A cross-sectional study was performed using survey-based interviews and the collection of nasopharyngeal-swab specimens for microbiological characterization and antimicrobial susceptibility testing. Logistic regression analyses were performed for factors associated with nasopharyngeal carriage.
Results A total of 452 children under the age of 5 years were examined in which 41.8% carried S. pneumoniae. Higher pneumococcal carriage frequencies were observed among participants aged <2 years and in individuals belonging to indigenous communities, which were lacking established pneumococcal-conjugated vaccine-10 immunization schemes. Additionally, children attending childcare institutions were also highly colonized by pneumococci. S. pneumoniae showed 57.7% nonsusceptibility to benzyl-penicillin (meningitis-cut); 45.5% intermediate-sensitivity to benzyl-penicillin (oral-cut) and 21.7% to cefotaxime; and resistance to erythromycin (40.7%), tetracycline (36.0%), trimethoprim/sulfamethoxazole (24.9%), clindamycin (24.3%), and ceftriaxone (27.0%).
Conclusion The 41.8% of participants carrying S. pneumoniae show a scenario with the presence of multidrug and extensively drug-resistant strains, which constitutes important reservoirs of bacterial transmission by children aged <5 years in Colombia, leading to an onset of pneumococcal diseases. Hence, there is an urgent need to expand conjugate pneumococcal immunization in the community and ensure compliance with established immunization schedules.
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Affiliation(s)
- Gustavo Gámez
- Basic and Applied Microbiology Research Group, School of Microbiology, University of Antioquia, UdeA, Medellín, Colombia
- Genetics, Regeneration and Cancer Research Group, University Research Center, University of Antioquia, UdeA, Medellín, Colombia
| | - Juan Pablo Rojas
- Club Noel Children's Clinical Foundation, Cali, Colombia
- Pediatrics Graduate Program, School of Medicine, University Libre Sectional Cali, Cali, Colombia
- School of Health, Valle University, Cali, Colombia
| | - Santiago Cardona
- Genetics, Regeneration and Cancer Research Group, University Research Center, University of Antioquia, UdeA, Medellín, Colombia
| | | | - María Alejandra Palacio
- Basic and Applied Microbiology Research Group, School of Microbiology, University of Antioquia, UdeA, Medellín, Colombia
| | - Luis Fernando Mejía
- Club Noel Children's Clinical Foundation, Cali, Colombia
- Pediatrics Graduate Program, School of Medicine, University Libre Sectional Cali, Cali, Colombia
| | - José Luis Torres
- Basic and Applied Microbiology Research Group, School of Microbiology, University of Antioquia, UdeA, Medellín, Colombia
| | | | - Laura Mery Muñoz
- Basic and Applied Microbiology Research Group, School of Microbiology, University of Antioquia, UdeA, Medellín, Colombia
| | - Javier Criales
- Club Noel Children's Clinical Foundation, Cali, Colombia
- Pediatrics Graduate Program, School of Medicine, University Libre Sectional Cali, Cali, Colombia
| | - Luis Felipe Vélez
- Genetics, Regeneration and Cancer Research Group, University Research Center, University of Antioquia, UdeA, Medellín, Colombia
| | - Angélica María Forero
- Club Noel Children's Clinical Foundation, Cali, Colombia
- Pediatrics Graduate Program, School of Medicine, University Libre Sectional Cali, Cali, Colombia
| | - Yulieth Alexandra Zúñiga
- Genetics, Regeneration and Cancer Research Group, University Research Center, University of Antioquia, UdeA, Medellín, Colombia
| | - María Eugenia Cuastumal
- Club Noel Children's Clinical Foundation, Cali, Colombia
- Pediatrics Graduate Program, School of Medicine, University Libre Sectional Cali, Cali, Colombia
| | - Leidy Johanna Acevedo
- Basic and Applied Microbiology Research Group, School of Microbiology, University of Antioquia, UdeA, Medellín, Colombia
| | - Álvaro de Jesús Molina
- Club Noel Children's Clinical Foundation, Cali, Colombia
- Pediatrics Graduate Program, School of Medicine, University Libre Sectional Cali, Cali, Colombia
| | - Johan Alexis Bolivar
- Genetics, Regeneration and Cancer Research Group, University Research Center, University of Antioquia, UdeA, Medellín, Colombia
| | - Alejandro Gómez-Mejia
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Molecular Genetics and Infection Biology, Center for Functional Genomics of Microbes, Interfaculty Institute for Genetics and Functional Genomics, University of Greifswald, Greifswald, Germany
| | - Jessica Lorena Morales
- Basic and Applied Microbiology Research Group, School of Microbiology, University of Antioquia, UdeA, Medellín, Colombia
- Genetics, Regeneration and Cancer Research Group, University Research Center, University of Antioquia, UdeA, Medellín, Colombia
| | - Sven Hammerschmidt
- Department of Molecular Genetics and Infection Biology, Center for Functional Genomics of Microbes, Interfaculty Institute for Genetics and Functional Genomics, University of Greifswald, Greifswald, Germany
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Franza L, Cianci R. Pollution, Inflammation, and Vaccines: A Complex Crosstalk. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126330. [PMID: 34208042 PMCID: PMC8296132 DOI: 10.3390/ijerph18126330] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/02/2021] [Accepted: 06/09/2021] [Indexed: 12/21/2022]
Abstract
The importance of pollution in determining human health is becoming increasingly clear, also given the dramatic consequences it has had on recent geopolitical events. Yet, the consequences of contamination are not always straightforward. In this paper, we will discuss the effects of different pollutants on different aspects of human health, in particular on the immune system and inflammation. Different environmental pollutants can have different effects on the immune system, which can then promote complex pathologies, such as autoimmune disorders and cancer. The interaction with the microbiota also further helps to determine the consequences of contamination on wellbeing. The pollution can affect vaccination efficacy, given the widespread effects of vaccination on immunity. At the same time, some vaccinations also can exert protective effects against some forms of pollution.
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Affiliation(s)
- Laura Franza
- Emergency Medicine, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8-00168 Rome, Italy;
| | - Rossella Cianci
- Dipartimento di Medicina e Chirurgia Traslazionale, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8-00168 Rome, Italy
- Correspondence: ; Tel.: +39-06-3015-7597; Fax: +39-06-3550-2775
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Zirinsky E, Paintsil E, Oliveira CR. The clinical epidemiology of coronavirus disease 2019 in children and adolescents mirrors the widening gap in healthcare disparities. Curr Opin Pediatr 2021; 33:281-285. [PMID: 33871422 PMCID: PMC8635086 DOI: 10.1097/mop.0000000000001018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has exacerbated the longstanding racial/ethnic health disparities in the USA, with a disproportionately negative effect on children of color. This review summarizes recently published studies that describe the clinical epidemiology and racial/ethnic disparities associated with SARS-CoV-2 in children. RECENT FINDINGS Children with SARS-CoV-2 infections manifest with a wide spectrum of disease. Most are either asymptomatic or mildly symptomatic with fever, gastrointestinal, and/or upper respiratory disease. Some children can progress to develop severe lower respiratory disease or a hyper-inflammatory, Kawasaki-like syndrome leading to cardiovascular shock. Although SARS-CoV-2-related deaths in children are rare, more children died within the first nine months of the pandemic than have died during any influenza season over the last decade.Black and Hispanic children represent less than 41% of the US population but account for three out of every four SARS-CoV-2-related hospitalizations and deaths in the USA. The drivers of these disparities in children are complex and likely a combination of societal, biological, and behavioral influences. SUMMARY This pandemic brought to light longstanding health disparities in historically marginalized populations, and minority children have suffered tremendously. It provides an opportunity to understand how a virus hijacked deep-rooted inequities, address these inequities, and work to prevent this outcome in future pandemics/epidemics.
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Affiliation(s)
- Elissa Zirinsky
- Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale University School of Medicine
| | - Elijah Paintsil
- Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale University School of Medicine
- Department of Pharmacology, Yale University School of Medicine
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Carlos R. Oliveira
- Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale University School of Medicine
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Chen Z, Wu H, Jiang J, Xu K, Gao S, Chen L, Wang H, Li X. Nutritional risk screening score as an independent predictor of nonventilator hospital-acquired pneumonia: a cohort study of 67,280 patients. BMC Infect Dis 2021; 21:313. [PMID: 33794788 PMCID: PMC8013169 DOI: 10.1186/s12879-021-06014-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/23/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Currently, the association of nutritional risk screening score with the development of nonventilator hospital-acquired pneumonia (NV-HAP) is unknown. This study investigated whether nutritional risk screening score is an independent predictor of NV-HAP. METHODS This retrospective cohort study was conducted between September 2017 and June 2020 in a tertiary hospital in China. The tool of Nutritional Risk Screening 2002 (NRS-2002) was used for nutritional risk screening. A total score of ≥3 indicated a patient was "at nutritional risk." Logistic regression was applied to explore the association between the NRS score and NV-HAP. RESULTS A total of 67,280 unique patients were included in the study. The incidence of NV-HAP in the cohort for the NRS < 3 and ≥ 3 NRS group was 0.4% (232/62702) and 2.6% (121/4578), respectively. In a multivariable logistic regression model adjusted for all of the covariates, per 1-point increase in the NRS score was associated with a 30% higher risk of NV-HAP (OR = 1.30; 95%CI:1.19-1.43). Similarly, patients with NRS score ≥ 3 had a higher risk of NV-HAP with an odds ratio (OR) of 2.06 (confidence interval (CI): 1.58-2.70) than those with NRS score < 3. Subgroup analyses indicated that the association between the NRS score and the risk of NV-HAP was similar for most strata. Furthermore, the interaction analyses revealed no interactive role in the association between NRS score and NV-HAP. CONCLUSION NRS score is an independent predictor of NV-HAP, irrespective of the patient's characteristics. NRS-2002 has the potential as a convenient tool for risk stratification of adult hospitalized patients with different NV-HAP risks.
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Affiliation(s)
- Zhihui Chen
- Department of Epidemiology and Biostatistics, and Centre for Clinical Big Data Statistics, Second Affiliated Hospital, Zhejiang University College of Medicine, 866 Yuhangtang Road, Hangzhou, 310058, China.,Department of Infection Control, Wenzhou people's Hospital, Wenzhou, China
| | - Hongmei Wu
- Department of Infection Control, Wenzhou people's Hospital, Wenzhou, China
| | - Jiehong Jiang
- XingLin Information Technology Company, Hangzhou, China
| | - Kun Xu
- XingLin Information Technology Company, Hangzhou, China
| | - Shengchun Gao
- Department of Infection Control, Wenzhou people's Hospital, Wenzhou, China
| | - Le Chen
- Department of Infection Control, Wenzhou people's Hospital, Wenzhou, China
| | - Haihong Wang
- Department of Infection Control, Wenzhou people's Hospital, Wenzhou, China
| | - Xiuyang Li
- Department of Epidemiology and Biostatistics, and Centre for Clinical Big Data Statistics, Second Affiliated Hospital, Zhejiang University College of Medicine, 866 Yuhangtang Road, Hangzhou, 310058, China.
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Chen O, Mah E, Dioum E, Marwaha A, Shanmugam S, Malleshi N, Sudha V, Gayathri R, Unnikrishnan R, Anjana RM, Krishnaswamy K, Mohan V, Chu Y. The Role of Oat Nutrients in the Immune System: A Narrative Review. Nutrients 2021; 13:nu13041048. [PMID: 33804909 PMCID: PMC8063794 DOI: 10.3390/nu13041048] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/18/2021] [Accepted: 03/19/2021] [Indexed: 12/19/2022] Open
Abstract
Optimal nutrition is the foundation for the development and maintenance of a healthy immune system. An optimal supply of nutrients is required for biosynthesis of immune factors and immune cell proliferation. Nutrient deficiency/inadequacy and hidden hunger, which manifests as depleted nutrients reserves, increase the risk of infectious diseases and aggravate disease severity. Therefore, an adequate and balanced diet containing an abundant diversity of foods, nutrients, and non-nutrient chemicals is paramount for an optimal immune defense against infectious diseases, including cold/flu and non-communicable diseases. Some nutrients and foods play a larger role than others in the support of the immune system. Oats are a nutritious whole grain and contain several immunomodulating nutrients. In this narrative review, we discuss the contribution of oat nutrients, including dietary fiber (β-glucans), copper, iron, selenium, and zinc, polyphenolics (ferulic acid and avenanthramides), and proteins (glutamine) in optimizing the innate and adaptive immune system's response to infections directly by modulating the innate and adaptive immunity and indirectly by eliciting changes in the gut microbiota and related metabolites.
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Affiliation(s)
- Oliver Chen
- Biofortis Research, Mérieux NutriSciences, Addison, IL 60101, USA;
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
- Correspondence: or
| | - Eunice Mah
- Biofortis Research, Mérieux NutriSciences, Addison, IL 60101, USA;
| | - ElHadji Dioum
- Quaker Oats Center of Excellence, PepsiCo Health & Nutrition Sciences, Barrington, IL 60010, USA; (E.D.); (Y.C.)
| | - Ankita Marwaha
- PepsiCo Health & Nutrition Sciences, AMESA, Gurgaon 122101, India;
| | - Shobana Shanmugam
- Madras Diabetes Research Foundation, Chennai, Tamil Nadu 600086, India; (S.S.); (N.M.); (V.S.); (R.G.); (R.U.); (R.M.A.); (K.K.); (V.M.)
| | - Nagappa Malleshi
- Madras Diabetes Research Foundation, Chennai, Tamil Nadu 600086, India; (S.S.); (N.M.); (V.S.); (R.G.); (R.U.); (R.M.A.); (K.K.); (V.M.)
| | - Vasudevan Sudha
- Madras Diabetes Research Foundation, Chennai, Tamil Nadu 600086, India; (S.S.); (N.M.); (V.S.); (R.G.); (R.U.); (R.M.A.); (K.K.); (V.M.)
| | - Rajagopal Gayathri
- Madras Diabetes Research Foundation, Chennai, Tamil Nadu 600086, India; (S.S.); (N.M.); (V.S.); (R.G.); (R.U.); (R.M.A.); (K.K.); (V.M.)
| | - Ranjit Unnikrishnan
- Madras Diabetes Research Foundation, Chennai, Tamil Nadu 600086, India; (S.S.); (N.M.); (V.S.); (R.G.); (R.U.); (R.M.A.); (K.K.); (V.M.)
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation, Chennai, Tamil Nadu 600086, India; (S.S.); (N.M.); (V.S.); (R.G.); (R.U.); (R.M.A.); (K.K.); (V.M.)
| | - Kamala Krishnaswamy
- Madras Diabetes Research Foundation, Chennai, Tamil Nadu 600086, India; (S.S.); (N.M.); (V.S.); (R.G.); (R.U.); (R.M.A.); (K.K.); (V.M.)
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation, Chennai, Tamil Nadu 600086, India; (S.S.); (N.M.); (V.S.); (R.G.); (R.U.); (R.M.A.); (K.K.); (V.M.)
| | - YiFang Chu
- Quaker Oats Center of Excellence, PepsiCo Health & Nutrition Sciences, Barrington, IL 60010, USA; (E.D.); (Y.C.)
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Qirani IAD, Ningsih WM, Sartika RAD. Consumption of milk and dairy products as dominant factor of underweight among children aged 24–59 months in Java Island, Indonesia (IFLS 2014). MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2021. [DOI: 10.3233/mnm-200482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION: Underweight is one of the most common forms of undernutrition suffered by children and has implications for both short and long term health problems. Characteristics of children, parents, and environment are factors affecting underweight in children, especially aged 24–59 months. OBJECTIVES: This study aimed to find out the dominant factors affecting underweight in children aged 24–59 months in Java Island. METHODS: This cross-sectional study used secondary data from Indonesia Family Life Survey (IFLS) 2014. There were 1,270 children aged 24–59 months who were involved in this study. We conducted univariate analysis, bivariate analysis using chi-square, and multivariate analysis using binary logistic regression. RESULTS: This study found that 20.2% of children in Java were underweight. Based on bivariate analysis, variables that significantly associated (p < 0.05) with underweight were low birth weight (LBW), acute respiratory infection (ARI), diarrhoea, frequency of eating milk and dairy products, parental education level, and underweight father. Furthermore, based on multivariate analysis, low consumption of milk and dairy products was the dominant factor in this study (OR = 1.80). CONCLUSION: Factors related to underweight can be used to determine appropriate prevention and treatment in community levels, such as by promoting a balanced nutrition program and healthy behaviour.
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Affiliation(s)
- Ida Ayu Devi Qirani
- Public Health Nutrition Programme, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | | | - Ratu Ayu Dewi Sartika
- Department of Public Health Nutrition, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
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Feddema JJ, van der Geest AM, Claassen E, van de Burgwal LHM. Lower Respiratory Tract Infection Trends in East and South-East Asia: In the Light of Economic and Health Care Development. Glob Pediatr Health 2021; 8:2333794X21989530. [PMID: 33614839 PMCID: PMC7841237 DOI: 10.1177/2333794x21989530] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 12/23/2020] [Accepted: 12/31/2020] [Indexed: 11/24/2022] Open
Abstract
This study explored to what degree economic development and improvement
of healthcare are associated with lower respiratory tract infection
(LRTI) mortality. A correlation analysis between LRTI mortality and
Gross Domestic Product (GDP) per capita, and the Health Access and
Quality Index (HAQI), respectively was conducted for 15 countries in
East and South-East Asia. The results revealed a dramatic decrease in
LRTI mortality in total populations for lower-middle income (LMI)
countries but at the same time an increase in upper-middle income
(UMI) and high-income (HI) countries. A highly significant
(P < .001) growth-dependent relationship
between LRTI mortality and economic growth was observed. Improvements
in HAQI were significantly associated with a decrease in LRTI
mortality in LMI countries, but an increase in UMI and HI countries.
The decline of LRTI mortality amongst children in LMI countries is an
encouraging trend and efforts against LRTI must be continued, though
not at the expense of preparing health systems for the growing
burden.
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Affiliation(s)
- Jelle J Feddema
- Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, The Netherlands
| | | | - Eric Claassen
- Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, The Netherlands
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Tahir ARM, Ee XW, Rashid AA, Yahaya AYB, Devaraj NK. The Proportion of Infectious Disease Cases, Its Associated Factors, and the Appropriateness of Antimicrobial Prescription Among Rohingya Refugee Pediatric Patients in IMARET Mobile Clinics. J Immigr Minor Health 2021; 23:1159-1169. [PMID: 33543426 DOI: 10.1007/s10903-021-01150-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2021] [Indexed: 11/29/2022]
Abstract
The Rohingyas fled from their home to escape ethnic persecution. Due to their status as refugees they have difficulties in accessing healthcare leading to avoidable mortality and morbidity. Infectious diseases are reported to be among the causes. To ease access to healthcare, IMAM Response and Relief Team (IMARET) provides a free monthly clinic for them. The objective of this study is to determine the proportion of infectious diseases and appropriateness of antimicrobial usage among its pediatrics patients. It was conducted in 2017, through universal sampling. Information retrieved were via interviews and medical records. The majority diagnosis were infectious diseases (57.1%), which include respiratory infections (77.3%), skin (13.6%), gastrointestinal (4.5%), eye and ear infection (both 1%). Albendazole (40.7%) was the most prescribed. Only 7.4% were appropriately prescribed antimicrobials. Age (p = 0.005) and BMI (p = 0.006) were significantly associated with infections.
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Affiliation(s)
- Ahmad Rashidi Mohamed Tahir
- Faculty of Pharmacy, University of Cyberjaya, 63000, Cyberjaya, Selangor, Malaysia.,Islamic Medical Association of Malaysia (IMAM) Response and Relief Team (IMARET), B G-39, Apartment Sri Penara, Jalan Sri Permaisuri 1, Bandar Sri Permaisuri, 56000, Cheras, Kuala Lumpur, Malaysia
| | - Xuan Wen Ee
- Faculty of Pharmacy, University of Cyberjaya, 63000, Cyberjaya, Selangor, Malaysia
| | - Aneesa Abdul Rashid
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, UPM Serdang, Selangor, Malaysia. .,Islamic Medical Association of Malaysia (IMAM) Response and Relief Team (IMARET), B G-39, Apartment Sri Penara, Jalan Sri Permaisuri 1, Bandar Sri Permaisuri, 56000, Cheras, Kuala Lumpur, Malaysia.
| | - Ahmad Yusuf Bin Yahaya
- Faculty of Medicine, SEGi University, 47810, Petaling Jaya, Selangor, Malaysia.,Islamic Medical Association of Malaysia (IMAM) Response and Relief Team (IMARET), B G-39, Apartment Sri Penara, Jalan Sri Permaisuri 1, Bandar Sri Permaisuri, 56000, Cheras, Kuala Lumpur, Malaysia
| | - Navin Kumar Devaraj
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, UPM Serdang, Selangor, Malaysia
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Birindwa AM, Manegabe JT, Mindja A, Nordén R, Andersson R, Skovbjerg S. Decreased number of hospitalized children with severe acute lower respiratory infection after introduction of the pneumococcal conjugate vaccine in the Eastern Democratic Republic of the Congo. Pan Afr Med J 2021; 37:211. [PMID: 33520050 PMCID: PMC7821803 DOI: 10.11604/pamj.2020.37.211.22589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 04/07/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction acute lower respiratory infections (ALRI) are a leading killer of children under five worldwide including the Democratic Republic of the Congo (DR Congo). We aimed to determine the morbidity and case fatality rate due to ALRI before and after introduction of the 13-valent pneumococcal conjugate vaccine (PVC13) in DR Congo 2013. Methods data were collected from medical records of children with a diagnosis of ALRI, aged from 2 to 59 months, treated at four hospitals in the Eastern DR Congo. Two study periods were defined; from 2010 to 2012 (before introduction of PCV13) and from 2014 to 2015 (after PCV13 introduction). Results out of 21,478 children admitted to the hospitals during 2010-2015, 2,007 were treated for ALRI. The case fatality rate among these children was 4.9%. Death was significantly and independently associated with malnutrition, severe ALRI, congenital disease and symptoms of fatigue. Among the ALRI hospitalised children severe ALRI decreased from 31% per year to 18% per year after vaccine introduction (p = 0.0002) while the fatality rate remained unchanged between the two study periods. Following introduction of PCV13, 63% of the children diagnosed with ALRI were treated with ampicillin combined with gentamicin while 33% received ceftriaxone and gentamicin. Conclusion three years after PCV13 introduction in the Eastern part of the DR Congo, we found a reduced risk of severe ALRI among children below five years. Broad-spectrum antibiotics were frequently used for the treatment of ALRI in the absence of any microbiological diagnostic support.
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Affiliation(s)
- Archippe Muhandule Birindwa
- Department of Infectious Disease, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden.,Panzi Hospital, Bukavu, Democratic Republic of Congo.,Université Évangélique en Afrique, Bukavu, Democratic Republic of Congo
| | | | - Aline Mindja
- Panzi Hospital, Bukavu, Democratic Republic of Congo
| | - Rickard Nordén
- Department of Infectious Disease, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden.,Department of Clinical Microbiology, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden
| | - Rune Andersson
- Department of Infectious Disease, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden.,Department of Clinical Microbiology, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden.,Centre for Antibiotic Resistance Research (CARe), Gothenburg University, Gothenburg, Sweden
| | - Susann Skovbjerg
- Department of Infectious Disease, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden.,Department of Clinical Microbiology, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden.,Centre for Antibiotic Resistance Research (CARe), Gothenburg University, Gothenburg, Sweden
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65
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Tahta A, Turgut YB, Sahin C. Malnutrition Essentials for Neurologists and Neurosurgeons: A Review of the Literature. JOURNAL OF PEDIATRIC NEUROLOGY 2021. [DOI: 10.1055/s-0040-1721852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractMalnutrition still causes deaths in the world today and protein energy malnutrition (PEM) is characterized by increased oxidative stress, immune deficiency, and development of various infections. Even today, however, it is an underrecognized and undertreated entity in neurology and neurosurgery. In this article, we therefore seek to review the available literature regarding various factors affecting surgical outcome of children with malnutrition undergoing some neurosurgical interventions including shunt surgery and traumatic brain injury in intensive care unit, in addition to its effects upon oxidative stress status and immunity. Furthermore, we attempt to provide essential knowledge of malnutrition affecting surgical outcome of patients with PEM. Based on available evidence in the published literature, it is concluded that it is a serious public health problem characterized by increased oxidative stress, immune deficiency, and development of various infections.
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Affiliation(s)
- Alican Tahta
- Department of Neurosurgery, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Yasar B. Turgut
- Department of Internal Medicine, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Cem Sahin
- Department of Internal Medicine, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
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Leader G, Molina Bonilla P, Naughton K, Maher L, Casburn M, Arndt S, Mannion A. Complex Comorbid Presentations are Associated with Harmful Behavior Problems among Children and Adolescents with Cerebral Palsy. Dev Neurorehabil 2021; 24:25-34. [PMID: 32508226 DOI: 10.1080/17518423.2020.1770353] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Aim: Frequency and relationship between gastrointestinal symptoms, sleep problems, internalizing and externalizing symptoms, behavior problems and autism spectrum disorder (ASD) symptoms, and predictors of behavior problems were examined in children and adolescents with Cerebral Palsy (CP). Method: Parents of 104 children and adolescents with CP completed the Gastrointestinal Symptom Inventory, Children's Sleep Habits Questionnaire, Child Behavior Checklist, Social Communication Questionnaire and the Behavior Problem Inventory-Short Form. Results: High frequency of behavior problems (88.5%), gastrointestinal symptoms (81.7%), sleep problems (81%) ASD symptoms (48%) and internalizing and externalizing symptoms (31.7%) were found. Relationships were found between gastrointestinal symptoms and sleep problems, and gastrointestinal symptoms and internalizing and externalizing symptoms. Relationships were found between sleep problems and behavior problems. Intellectual disability, sleep problems, internalizing and externalizing symptoms, and ASD symptoms predicted behavior problems. Conclusion: Findings highlights the frequency of comorbidities that exist in CP and how these comorbidities affect one another.
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Affiliation(s)
| | | | | | - Leanne Maher
- National University of Ireland , Galway, Ireland
| | - Mia Casburn
- National University of Ireland , Galway, Ireland
| | - Sophia Arndt
- National University of Ireland , Galway, Ireland
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67
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Zhu C, Wang X, Chen S, Yang X, Sun J, Pan B, Zhang W, Chen X, Huang Y. Efficacy of the Preoperative Albumin-Bilirubin Grade for Predicting Survival and Outcomes of Postoperative Chemotherapy for Advanced Gastric Cancer. Cancer Manag Res 2020; 12:11921-11932. [PMID: 33244269 PMCID: PMC7685381 DOI: 10.2147/cmar.s279782] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/06/2020] [Indexed: 01/27/2023] Open
Abstract
Purpose The liver function index can predict the prognosis of hepatocellular carcinoma and many other non-neoplastic diseases. We aimed to determine whether the preoperative albumin–bilirubin (ALBI) grade could predict the prognosis of patients with gastric cancer (GC). Patients and Methods Data of 243 patients with GC who underwent radical resection were collected retrospectively. Patients were divided into the high ALBI (>−2.34) and low ALBI (≤−2.34) grade groups. Overall survival was analyzed between the two groups using the Kaplan–Meier curves. Univariate and multivariate analyses identified the independent factors associated with postoperative complications and overall survival. Results The postoperative complication rates were higher in the high ALBI grade group than in the low ALBI grade group (P=0.005). The high ALBI grade group also had worse overall survival (P<0.001), especially TNM stage II–III patients (stage II, P=0.043; stage III, P<0.001). In the high ALBI grade group, patients with TNM stage III not undergoing chemotherapy had significantly worse survival times (P=0.001). High ALBI grade (P=0.032), Charlson score of 1–2 (P=0.007), and laparotomy surgery (P=0.045) were independent risk factors for postoperative complications. High ALBI grade (P=0.005), age ≥70 years (P=0.002), nutritional risk screening score 2002 score of 5–6 (P=0.019), tumor located in the cardia (P=0.020), diffuse tumor (P<0.001), and TNM stage III (P<0.001) were independent risk factors for overall survival. Conclusion Preoperative ALBI grade could predict postoperative complications and overall survival of patients with GC, especially those with TNM stages II–III. This grading method has the advantages of preoperative availability, simplicity, and objectivity and aids in improving preoperative prognosis prediction and in achieving better outcomes of postoperative chemotherapy.
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Affiliation(s)
- Ce Zhu
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Xiang Wang
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Sian Chen
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Xinxin Yang
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Jing Sun
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Bujian Pan
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Weiteng Zhang
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Xiaodong Chen
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Yingpeng Huang
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
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Manenzhe RI, Dube FS, Wright M, Lennard K, Mounaud S, Lo SW, Zar HJ, Nierman WC, Nicol MP, Moodley C. Characterization of Pneumococcal Colonization Dynamics and Antimicrobial Resistance Using Shotgun Metagenomic Sequencing in Intensively Sampled South African Infants. Front Public Health 2020; 8:543898. [PMID: 33072693 PMCID: PMC7536305 DOI: 10.3389/fpubh.2020.543898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 08/17/2020] [Indexed: 11/13/2022] Open
Abstract
Background: There remains a significant proportion of deaths due to pneumococcal pneumonia in infants from low- and middle-income countries despite the marginal global declines recorded in the past decade. Monitoring changes in pneumococcal carriage is key to understanding vaccination-induced shifts in the ecology of carriage, patterns of antimicrobial resistance, and impact on health. We longitudinally investigated pneumococcal carriage dynamics in PCV-13 vaccinated infants by collecting nasopharyngeal (NP) samples at 2-weekly intervals from birth through the first year of life from 137 infants. As a proof of concept, 196 NP samples were retrieved from a subset of 23 infants to explore strain-level pneumococcal colonization patterns and associated antimicrobial-resistance determinants. These were selected on the basis of changes in serotype and antibiogram over time. NP samples underwent short-term enrichment for streptococci prior to total nucleic acid extraction and whole metagenome shotgun sequencing (WMGS). Reads were assembled and aligned to pneumococcal reference genomes for the extraction of pneumococcal and non-pneumococcal bacterial reads. Pneumococcal contigs were aligned to the Antibiotic Resistance Gene-ANNOTation database of acquired AMR genes. In silico pneumococcal capsular and multilocus sequence typing were performed. Results: Of the 196 samples sequenced, 174 had corresponding positive cultures for pneumococci, of which, 152 were assigned an in silico serotype. Metagenomic sequencing detected a single pneumococcal serotype in 85% (129/152), and co-colonization in 15% (23/152) of the samples. Twenty-two different pneumococcal serotypes were identified, with 15B/15C and 16F being the most common non-PCV13 serotypes, while 23F and 19A were the most common PCV13 serotypes. Twenty-six different sequence types (STs), including four novel STs were identified in silico. Mutations in the folA and folP genes, associated with cotrimoxazole resistance, were detected in 89% (87/98) of cotrimoxazole-non-susceptible pneumococci, as well as in the pbp1a and pbp2x genes, in penicillin non-susceptible ST705215B/15C isolates. Conclusions: Metagenomic sequencing of NP samples is a valuable culture-independent technique for a detailed evaluation of the pneumococcal component and resistome of the NP microbiome. This method allowed for the detection of novel STs, as well as co-colonization, with a predominance of non-PCV13 serotypes in this cohort. Forty-eight resistance genes, as well as mutations associated with resistance were detected, but the correlation with phenotypic non-susceptibility was lower than expected.
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Affiliation(s)
- Rendani I Manenzhe
- Division of Medical Microbiology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Felix S Dube
- Division of Medical Microbiology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Department of Molecular and Cell Biology, Faculty of Science, University of Cape Town, Cape Town, South Africa
| | | | - Katie Lennard
- Division of Computational Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | | | - Stephanie W Lo
- Parasites and Microbes Program, The Wellcome Sanger Institute, Cambridge, United Kingdom
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and South African - Medical Research Council Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | | | - Mark P Nicol
- Division of Medical Microbiology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Division of Infection and Immunity, University of Western Australia, Perth, WA, Australia
| | - Clinton Moodley
- Division of Medical Microbiology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa
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Rakotomanana H, Komakech JJ, Walters CN, Stoecker BJ. The WHO and UNICEF Joint Monitoring Programme (JMP) Indicators for Water Supply, Sanitation and Hygiene and Their Association with Linear Growth in Children 6 to 23 Months in East Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176262. [PMID: 32872130 PMCID: PMC7503684 DOI: 10.3390/ijerph17176262] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 08/24/2020] [Accepted: 08/26/2020] [Indexed: 11/17/2022]
Abstract
The slow decrease in child stunting rates in East Africa warrants further research to identify the influence of contributing factors such as water, sanitation, and hygiene (WASH). This study investigated the association between child length and WASH conditions using the recently revised WHO and UNICEF (United Nations Children’s Fund) Joint Monitoring Programme (JMP) indicators. Data from households with infants and young children aged 6–23 months from the Demographic and Health Surveys in Burundi, Ethiopia, Kenya, Malawi, Rwanda, Tanzania, Uganda, and Zambia were used. Associations for each country between WASH conditions and length-for-age z-scores (LAZ) were analyzed using linear regression. Stunting rates were high (>20%) reaching 45% in Burundi. At the time of the most recent Demographic and Health Survey (DHS), more than half of the households in most countries did not have basic or safely managed WASH indicators. Models predicted significantly higher LAZ for children living in households with safely managed drinking water compared to those living in households drinking from surface water in Kenya (β = 0.13, p < 0.01) and Tanzania (β = 0.08, p < 0.05) after adjustment with child, maternal, and household covariates. Children living in households with improved sanitation facilities not shared with other households were also taller than children living in households practicing open defecation in Ethiopia (β = 0.07, p < 0.01) and Tanzania (β = 0.08, p < 0.01) in the adjusted models. All countries need improved WASH conditions to reduce pathogen and helminth contamination. Targeting adherence to the highest JMP indicators would support efforts to reduce child stunting in East Africa.
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70
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Alsayed A, Al-Doori A, Al-Dulaimi A, Alnaseri A, Abuhashish J, Aliasin K, Alfayoumi I. Influences of bovine colostrum on nasal swab microbiome and viral upper respiratory tract infections - A case report. Respir Med Case Rep 2020; 31:101189. [PMID: 32839688 PMCID: PMC7437540 DOI: 10.1016/j.rmcr.2020.101189] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/25/2020] [Accepted: 08/08/2020] [Indexed: 11/22/2022] Open
Abstract
Bovine colostrum has been advocated as a source of immunity against external environmental microorganisms. Recurrent upper respiratory tract infections present a critical public health concern in the developing countries. The present case report was performed to assess the influence of bovine colostrum in preventing recurrent upper respiratory tract infections caused by respiratory viruses in an adult in Jordan in addition to its effect on respiratory microbiome. In conclusion, bovine colostrum was successful in the prevention of upper respiratory tract infections and significantly affected the nasal swab microbiome. This is the first case report investigating the influence of bovine colostrum on the nasal swab microbiome.
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Affiliation(s)
- Ahmad Alsayed
- Department of Clinical Pharmacy and Therapeutics, Applied Science Private University, Amman, Jordan
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71
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Budhwar S, Sethi K, Chakraborty M. A Rapid Advice Guideline for the Prevention of Novel Coronavirus Through Nutritional Intervention. Curr Nutr Rep 2020; 9:119-128. [PMID: 32578027 PMCID: PMC7308604 DOI: 10.1007/s13668-020-00325-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Purpose of Review An unexpected and sudden outbreak of a novel infection known as a coronavirus (COVID-19) has imposed important problems to global well-being and economy. Based upon current researches, this virus is spreading from one human to another through respiratory droplets, i.e. cough and sneeze. Till now, there has not been any specific treatment found for this virus. Hence, there is a critical need to discover alternative techniques to cope with the current scenario. Recent Findings This review conducted an online search for prevention of coronavirus infection with the help of nutritional interventions. It has been observed that the effect of the virus is mostly on the individual with low immunity, individual affected with diseases like diabetes, and individual using any immune-suppressed drug or having past history of major surgeries or severe medical conditions. Summary Therefore, consuming foods which boost immunity helps in preventing respiratory-related disorder or suppressing diseases-related problems, which could be helpful in controlling the spread of this virus. In conclusion, it has been suggested that before the beginning of generalised treatments and interventions in each infected patient, nutritional status should be evaluated, as it can help in creating a specific nutrition intervention for the infected individual.
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Affiliation(s)
- Savita Budhwar
- Department of Nutrition Biology, School of Interdisciplinary and Applied Life Sciences, Central University of Haryana, Mahendragarh, Haryana, 123031, India.
| | - Kashika Sethi
- Department of Nutrition Biology, School of Interdisciplinary and Applied Life Sciences, Central University of Haryana, Mahendragarh, Haryana, 123031, India
| | - Manali Chakraborty
- Department of Nutrition Biology, School of Interdisciplinary and Applied Life Sciences, Central University of Haryana, Mahendragarh, Haryana, 123031, India
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Isah AUJ, Ekwunife OI, Ejie IL, Mandrik O. Effects of nutritional supplements on the re-infection rate of soil-transmitted helminths in school-age children: A systematic review and meta-analysis. PLoS One 2020; 15:e0237112. [PMID: 32790693 PMCID: PMC7425883 DOI: 10.1371/journal.pone.0237112] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 07/20/2020] [Indexed: 11/18/2022] Open
Abstract
Background The effect of nutritional supplements on the re-infection rate of species-specific soil-transmitted helminth infections in school-aged children remains complex and available evidence on the subject matter has not been synthesized. Methods The review included randomised controlled trials (RCTs) and cluster RCTs investigating food supplements on school-aged children between the age of 4–17 years. A search for RCTs was conducted on eight databases from inception to 12th June 2019. Cochrane Risk of Bias tool was used to assess the risk of bias in all included studies. Meta-analysis and narrative synthesis were conducted to describe and analyze the results of the review. Outcomes were summarized using the mean difference or standardized mean difference where appropriate. Results The search produced 1,816 records. Six studies met the inclusion criteria (five individually RCTs and one cluster RCT). Four studies reported data on all three STH species, while one study only reported data on Ascaris lumbricoides infections and the last study reported data on only hookworm infections. Overall, the risk of bias in four individual studies was low across most domains. Nutritional supplementation failed to statistically reduce the re-infection rates of the three STH species. The effect of nutritional supplements on measures of physical wellbeing in school-aged children could not be determined. Conclusions The findings from this systematic review suggest that nutritional supplements for treatment of STH in children should not be encouraged unless better evidence emerges. Conclusion of earlier reviews on general populations may not necessarily apply to children since children possibly have a higher re-infection rate.
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Affiliation(s)
- Aisha Ummi Jibrin Isah
- School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, United Kingdom
| | - Obinna Ikechukwu Ekwunife
- Department of Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe University, Awka, Nigeria
- * E-mail:
| | - Izuchukwu Loveth Ejie
- Department of Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe University, Awka, Nigeria
| | - Olena Mandrik
- School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, United Kingdom
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David SM, Pricilla RA, Paul SS, George K, Bose A, Prasad JH. Risk factors for severe acute malnutrition among children aged 6-59 months: A community-based case-control study from Vellore, Southern India. J Family Med Prim Care 2020; 9:2237-2243. [PMID: 32754480 PMCID: PMC7380755 DOI: 10.4103/jfmpc.jfmpc_211_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/13/2020] [Accepted: 03/30/2020] [Indexed: 11/29/2022] Open
Abstract
Background: Malnutrition plays an important role in the economic burden of society as well as the country. This study aimed to identify the various risk factors and determinants of severe acute malnutrition (SAM) as defined by WHO growth reference standards in children aged 6 months to 59 months living in Vellore. Methods: A community-based case-control study matched for age (±2months), gender and location was done among the children of the age group 6- 59 months residing in both rural and urban Vellore. Children of age group 6-59 months with SAM according to WHO definition, i.e., weight for height of less than -3SD with or without nutritional oedema were classified as cases. Children with weight-for-height z-score more than -1 SD and MUAC ≥13.5cms were classified as controls. With 2 controls per case, the required sample size was 54 cases and 108 controls. A questionnaire used to identify the risk factors including dietary intake. Uni-variate and multivariate analysis was done to generate an odds ratio and 95% confidence interval for the risk factors. Results: Majority of the cases 64.8% and 50% of the controls belonged to low SES. After adjusting all confounders, Severe Acute Malnutrition was significantly associated with birth weight <2.499kg [AOR- 8.95 (95% CI: 2.98-26.85)], not exclusively breastfed for 6 months [AOR 4.67 (95% CI: 1.72-12.65)], inadequate calorie intake [AOR 8.09 (95% CI: 3.15-20.82)] and mother being underweight [AOR 6.87 (95% CI: 1.92-24.55)]. Conclusion: Programs should be implemented to reduce the poor nutritional status of young girls and women in the reproductive age group. The importance of exclusive breastfeeding for the first six months, the time of weaning and appropriate feeding practice for the child should be emphasized to postnatal mothers during their hospital visits.
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Affiliation(s)
- Sam M David
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Ruby A Pricilla
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sherin S Paul
- Department of Community Medicine, Unit of Pain and Palliative Care, Pushpagiri Insitute of Medical Science and Research Institute, Thiruvalla, Kerala, India
| | - Kuryan George
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anuradha Bose
- Locum Consultant Paediatrician, Dr. Gray's Hospital, Elgin, United Kingdom
| | - Jasmin H Prasad
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
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Abateneh DD, Shano AK, Dedo TW. Nasopharyngeal Carriage of Streptococcus pneumoniae and Associated Factors among Children in Southwest Ethiopia. Open Microbiol J 2020. [DOI: 10.2174/1874285802014010171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
In Ethiopia, Streptococcus pneumoniae is the predominant causative agent of pneumonia. About, 95% of bacterial pneumonia cases in under five years of children are caused by pneumococci.
Objective:
To assess the nasopharyngeal carriage of Streptococcus pneumoniae, its antibiotic susceptibility pattern, and associated factors among children in Southwest Ethiopia.
Methods:
A cross-sectional study was conducted from October 01, 2018, to December 30, 2018. A total of 293 children aged ≤15 years were included in the study using a systematic random sampling technique. A nasopharyngeal swab was collected using a sterile cotton swab and cultured on blood agar supplemented with 5μg/ml gentamicin. The antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion technique.
Results:
The ages of participants ranged from 5 months to 14 years. The carriage rate of Streptococcus pneumoniae was 74/293 (25.3%). Being within the age group <3 years, the habit of sleeping with parent(s)/guardians and numbers of rooms per household were significantly associated with pneumococcal carriage. Streptococcus pneumoniae showed the highest resistance to Tetracycline, 36 (48.65%), and Trimethoprim/sulfamethoxazole, 29 (39.2%), and was found to be susceptible to Chloramphenicol, 54 (77%), and Erythromycin, 38 (51.4%).
Conclusion:
The nasopharyngeal carriage rate of Streptococcus pneumoniae is considerably high. High antimicrobial resistance of Streptococcus pneumoniae against Tetracycline and Trimethoprim/sulfamethoxazole was observed. Living in a house with a single room, children’s habit of sleeping with parents/guardians and age are associated factors of high pneumococcal carriage. Strategies need to be designed to address the modifiable associated factors and the bacterium antibiotic resistance pattern should be monitored regularly.
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Shokry E, Sadiq K, Soofi S, Habib A, Bhutto N, Rizvi A, Ahmad I, Demmelmair H, Uhl O, Bhutta ZA, Koletzko B. Impact of Treatment with RUTF on Plasma Lipid Profiles of Severely Malnourished Pakistani Children. Nutrients 2020; 12:nu12072163. [PMID: 32708260 PMCID: PMC7401247 DOI: 10.3390/nu12072163] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/10/2020] [Accepted: 07/16/2020] [Indexed: 12/22/2022] Open
Abstract
(1) Background: Little is known on impacts of ready-to-use therapeutic food (RUTF) treatment on lipid metabolism in children with severe acute malnutrition (SAM). (2) Methods: We analyzed glycerophospholipid fatty acids (FA) and polar lipids in plasma of 41 Pakistani children with SAM before and after 3 months of RUTF treatment using gas chromatography and flow-injection analysis tandem mass spectrometry, respectively. Statistical analysis was performed using univariate, multivariate tests and evaluated for the impact of age, sex, breastfeeding status, hemoglobin, and anthropometry. (3) Results: Essential fatty acid (EFA) depletion at baseline was corrected by RUTF treatment which increased EFA. In addition, long-chain polyunsaturated fatty acids (LC-PUFA) and the ratio of arachidonic acid (AA)/linoleic acid increased reflecting greater EFA conversion to LC-PUFA, whereas Mead acid/AA decreased. Among phospholipids, lysophosphatidylcholines (lyso.PC) were most impacted by treatment; in particular, saturated lyso.PC decreased. Higher child age and breastfeeding were associated with great decrease in total saturated FA (ΣSFA) and lesser decrease in monounsaturated FA and total phosphatidylcholines (ΣPC). Conclusions: RUTF treatment improves EFA deficiency in SAM, appears to enhance EFA conversion to biologically active LC-PUFA, and reduces lipolysis reflected in decreased ΣSFA and saturated lyso.PC. Child age and breastfeeding modify treatment-induced changes in ΣSFA and ΣPC.
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Affiliation(s)
- Engy Shokry
- Department of Pediatrics, Ludwig-Maximilians-University Paediatrics, Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, 80337 Munich, Germany; (E.S.); (H.D.); (O.U.)
| | - Kamran Sadiq
- Department of Pediatrics & Child Health, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan; (K.S.); (S.S.)
| | - Sajid Soofi
- Department of Pediatrics & Child Health, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan; (K.S.); (S.S.)
- Center of Excellence in Women & Child Health, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan; (A.H.); (N.B.); (A.R.); (I.A.)
| | - Atif Habib
- Center of Excellence in Women & Child Health, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan; (A.H.); (N.B.); (A.R.); (I.A.)
| | - Naveed Bhutto
- Center of Excellence in Women & Child Health, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan; (A.H.); (N.B.); (A.R.); (I.A.)
| | - Arjumand Rizvi
- Center of Excellence in Women & Child Health, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan; (A.H.); (N.B.); (A.R.); (I.A.)
| | - Imran Ahmad
- Center of Excellence in Women & Child Health, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan; (A.H.); (N.B.); (A.R.); (I.A.)
| | - Hans Demmelmair
- Department of Pediatrics, Ludwig-Maximilians-University Paediatrics, Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, 80337 Munich, Germany; (E.S.); (H.D.); (O.U.)
| | - Olaf Uhl
- Department of Pediatrics, Ludwig-Maximilians-University Paediatrics, Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, 80337 Munich, Germany; (E.S.); (H.D.); (O.U.)
| | - Zulfiqar A. Bhutta
- Center of Excellence in Women & Child Health, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan; (A.H.); (N.B.); (A.R.); (I.A.)
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
- Correspondence: (Z.A.B.); (B.K.); Tel.: +17-573248424 (Z.A.B.); +49-89-44005-2826 (B.K.); Fax: +49-89-44005-7742 (B.K.)
| | - Berthold Koletzko
- Department of Pediatrics, Ludwig-Maximilians-University Paediatrics, Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, 80337 Munich, Germany; (E.S.); (H.D.); (O.U.)
- Correspondence: (Z.A.B.); (B.K.); Tel.: +17-573248424 (Z.A.B.); +49-89-44005-2826 (B.K.); Fax: +49-89-44005-7742 (B.K.)
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Osama M, Khan AA, Syed SH, Mohiuddin O, Hassan A, Zaidi SR, Sami N. Non-Adherence to WHO Recommendations Regarding Infant Feeding Practices Results in Dilemma of Malnourishment: A Community-Based Prospective Cohort Study Conducted in Karachi, Pakistan. Cureus 2020; 12:e8507. [PMID: 32656023 PMCID: PMC7346294 DOI: 10.7759/cureus.8507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 06/08/2020] [Indexed: 11/05/2022] Open
Abstract
Background The prevalence of chronic malnutrition and its associated morbid outcomes has been a significant cause of health loss globally, affecting millions of children hampering their mental, physical, social, and immune system development. World Health Organization's (WHO) recommendations presenting infant feeding guidelines have largely controlled this burden. However, developing countries including Pakistan have failed to promote these guidelines and still succumb to a huge burden of morbidity and mortality secondary to malnourishment among infants. Methodology Our study is a prospective cohort including 300 infants without predisposing congenital anomaly, followed from 6 months to 18 months of age. The primary outcome involved was classifying patients as malnourished based on anthropometric measurements, assessing the prevalence of co-morbidities and comparison of results in compliance with WHO guidelines. Results A total of 276 infants were included and the rest were lost to follow-up. Stratification on socioeconomic status was done; 53% of infants were diagnosed as malnourished, either due to stunted growth, underweight, or both. The odds of development of malnourishment based on non-adherence to WHO guidelines on breastfeeding were 2.87 (p=0.001). The incidence of morbid complications was higher in the malnourished group, including gastrointestinal and respiratory tract infections. Conclusion The implementation of WHO recommendations on infant feeding techniques can prove to be a pivotal instrument to control the soaring index of morbidities and mortalities associated with malnourishment. A strong focus on parental education and awareness among masses is required for its promulgation and controlling the infant health burden linked to this preventable condition.
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Affiliation(s)
- Muhammad Osama
- General Surgery, Dow University of Health Sciences, Karachi, PAK
| | - Anosh Aslam Khan
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | | | - Osama Mohiuddin
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Ammar Hassan
- Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, PAK
| | | | - Neelofar Sami
- Community Medicine, Aga Khan University Hospital, Karachi, PAK
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77
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Strengthening the Immune System and Reducing Inflammation and Oxidative Stress through Diet and Nutrition: Considerations during the COVID-19 Crisis. Nutrients 2020; 12:nu12061562. [PMID: 32471251 PMCID: PMC7352291 DOI: 10.3390/nu12061562] [Citation(s) in RCA: 387] [Impact Index Per Article: 96.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/21/2020] [Accepted: 05/25/2020] [Indexed: 12/13/2022] Open
Abstract
The coronavirus-disease 2019 (COVID-19) was announced as a global pandemic by the World Health Organization. Challenges arise concerning how to optimally support the immune system in the general population, especially under self-confinement. An optimal immune response depends on an adequate diet and nutrition in order to keep infection at bay. For example, sufficient protein intake is crucial for optimal antibody production. Low micronutrient status, such as of vitamin A or zinc, has been associated with increased infection risk. Frequently, poor nutrient status is associated with inflammation and oxidative stress, which in turn can impact the immune system. Dietary constituents with especially high anti-inflammatory and antioxidant capacity include vitamin C, vitamin E, and phytochemicals such as carotenoids and polyphenols. Several of these can interact with transcription factors such as NF-kB and Nrf-2, related to anti-inflammatory and antioxidant effects, respectively. Vitamin D in particular may perturb viral cellular infection via interacting with cell entry receptors (angiotensin converting enzyme 2), ACE2. Dietary fiber, fermented by the gut microbiota into short-chain fatty acids, has also been shown to produce anti-inflammatory effects. In this review, we highlight the importance of an optimal status of relevant nutrients to effectively reduce inflammation and oxidative stress, thereby strengthening the immune system during the COVID-19 crisis.
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78
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Nuzhat S, Shahunja KM, Shahid ASMSB, Khan SH, Islam SB, Islam MR, Ahmed T, Chisti MJ, Hossain MI, Faruque ASG. Diarrhoeal children with concurrent severe wasting and stunting compared to severe wasting or severe stunting. Trop Med Int Health 2020; 25:928-935. [PMID: 32446268 DOI: 10.1111/tmi.13446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Children with both severe wasting and severe stunting (SWSS) represent an extreme form of malnutrition and are prone to develop severe infection. The study aims to demonstrate clinical features and aetiology of diarrhoea among children with SWSS compared to those with either severe wasting (SW) or severe stunting (SS), which may help in early identification of high-risk children. METHODS Data were extracted from the database of the diarrhoeal disease surveillance system (DDSS) of Dhaka Hospital, icddr,b from 2008 to 2017. Among 14 403 under-five diarrhoeal children, 149 had concurrent SWSS (WLZ/WHZ ˂-3 with LAZ/HAZ ˂-3), 795 had SW (WLZ/WHZ ˂-3 but LAZ/HAZ ≥-3) alone, and 1000 had only SS (LAZ/HAZ ˂-3 but WLZ/WHZ ≥-3). RESULTS In logistic regression analysis after adjusting for potential confounders, dehydrating diarrhoea and slum dwelling were independently associated with SWSS vs. SW (P < 0.05). When compared with SS, dehydration and maternal illiteracy were independently associated with SWSS (P < 0.05). In comparison with SW or SS, SWSS less often included infection with rotavirus (P < 0.05). Dehydration was independently associated with SW vs. SS after adjusting for potential confounders (P < 0.05). CONCLUSION Children with SWSS more often presented with dehydrating diarrhoea (69%) than children who had either SW (55%) or SS (43%). However, SWSS patients less frequently presented with rotavirus-associated diarrhoeal illnesses. This result underscores the importance of early detection and prompt management of dehydrating diarrhoea in children with concomitant severe wasting and severe stunting to reduce morbidity and mortality in these children, especially in poor settings.
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Affiliation(s)
- Sharika Nuzhat
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - K M Shahunja
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Abu S M S B Shahid
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Soroar Hossain Khan
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Shoeb Bin Islam
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Ridwan Islam
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mohammod Jobayer Chisti
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Iqbal Hossain
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - A S G Faruque
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
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Abstract
OBJECTIVE Chronic undernutrition is a common phenomenon in Bangladesh. However, information is grossly lacking to report the correlation between chronic undernutrition trajectory and lung function in children. The aim of the current study was to understand the association between early-childhood chronic undernutrition trajectory and lung function at preadolescence. DESIGN The current study is a part of the 9-year follow-up of a large-scale cohort study called the Maternal and Infant Nutrition Interventions in Matlab. SETTINGS The current study was conducted in Matlab, a sub-district area of Bangladesh that is located 53 km south of the capital, Dhaka. PARTICIPANTS A total of 517 children participated in lung function measured with a spirometer at the age of 9 years. Weight and height were measured at five intervals from birth till the age of 9 years. RESULTS Over half of the cohort have experienced a stunting undernutrition phenomenon up to 9 years of age. Children who were persistently or intermittently stunted showed lower forced expiratory volume (ml/s) than normal-stature children (P < 0·05). Children who exhibited catch-up growth throughout 4·5 years from the stunted group showed similar lung function with normal counterparts, and a better lung function than in children with the same growth velocity or who had faltering growth. In the multivariable models, similar associations were observed in children who experienced catch-up growth than their counterparts after adjusting for covariates. CONCLUSION Our data suggest that catch-up growth in height during early childhood is associated with a better lung function at preadolescence.
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80
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Rivadeneira MF, Moncayo AL, Tello B, Torres AL, Buitrón GJ, Astudillo F, Fredricks TR, Grijalva MJ. A Multi-causal Model for Chronic Malnutrition and Anemia in a Population of Rural Coastal Children in Ecuador. Matern Child Health J 2020; 24:472-482. [PMID: 31838668 PMCID: PMC7078138 DOI: 10.1007/s10995-019-02837-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Chronic malnutrition and anemia are prevalent in developing countries. This research aimed to determine the prevalence of chronic malnutrition and anemia and their associated factors in children under five using a multi-causal model in a rural community in the coast of Ecuador. METHODS The study included 314 children under 5 years old who were residents of San Isidro, Ecuador. Indicators of chronic malnutrition and anemia were identified. Mothers/caregivers were surveyed on socio-economic and environmental conditions, feeding and care practices, access to health services and biological characteristics. Bivariate and multivariable Poisson regression were performed. RESULTS The prevalence was 12.42% (n = 39) for chronic malnutrition and 16.98% (n = 54) for anemia. There was a significant and independent association between chronic malnutrition and family income less than $80 USD per month (Prevalence Ratio [PR] = 2.74, 95% CI 1.04, 7.20), maternal height less than 150 cm (PR 3.00, 95% CI 1.69, 5.32) and residence in a household with more than 4 children (PR 3.05, 95% CI 1.48, 6.29). Anemia was 2.57 times higher (95% CI 1.17, 5.65) in children with more than two episodes of diarrhea in the last 6 months. Prenatal care (5 to 8 visits) provided a protective effect for anemia (PR 0.48, 95% CI 0.27, 0.89). CONCLUSIONS FOR PRACTICE Findings support the need for comprehensive interventions targeted toward chronic malnutrition and anemia in children from rural coastal communities. Improvement of socioeconomic conditions, family planning, prenatal care and reduction of diarrheal diseases should be prioritized.
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Affiliation(s)
- María F Rivadeneira
- Instituto de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Apartado, 1701-2184, Quito, Ecuador
| | - Ana L Moncayo
- Centro de Investigación para la Salud en América Latina (CISeAL), Escuela de Ciencias Biológicas, Facultad de Ciencias Exactas y Naturales, Pontificia Universidad Católica del Ecuador, Apartado, 1701-2184, Quito, Ecuador.
| | - Betzabé Tello
- Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Apartado, 1701-2184, Quito, Ecuador
| | - Ana L Torres
- Instituto de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Apartado, 1701-2184, Quito, Ecuador
| | - Gladys J Buitrón
- Escuela de Ciencias Físicas y Matemática, Facultad de Ciencias Exactas y Naturales, Pontificia Universidad Católica del Ecuador, Apartado, 1701-2184, Quito, Ecuador
| | - Fabricio Astudillo
- Escuela de Geografía, Facultad de Ciencias Humanas, Pontificia Universidad Católica del Ecuador, Apartado, 1701-2184, Quito, Ecuador
| | - Todd R Fredricks
- Department of Family Medicine, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, 45701, USA
| | - Mario J Grijalva
- Centro de Investigación para la Salud en América Latina (CISeAL), Escuela de Ciencias Biológicas, Facultad de Ciencias Exactas y Naturales, Pontificia Universidad Católica del Ecuador, Apartado, 1701-2184, Quito, Ecuador
- Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, 45701, USA
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[Comments to the article "Overweight and clinical course in children younger than two years old hospitalized for lower respiratory tract infection"]. NUTR HOSP 2020; 37:228. [PMID: 31960701 DOI: 10.20960/nh.02955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction
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82
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Artificial Intelligence-Enabled Predictive Insights for Ameliorating Global Malnutrition: A Human-Centric AI-Thinking Approach. AI 2020. [DOI: 10.3390/ai1010004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
According to the World Health Organization (WHO) and the World Bank, malnutrition is one of the most serious but least-addressed development challenges in the world. Malnutrition refers to the malfunction or imbalance of nutrition, which could be influenced not only by under-nourishment, but also by over-nourishment. The significance of this paper is that it shows how artificial intelligence (AI) can be democratized to enable analysts who are not trained in computer science to also use human-centric explainable-AI to simulate the possible dynamics between malnutrition, health and population indicators in a dataset collected from 180 countries by the World Bank. This AI-based human-centric probabilistic reasoning approach can also be used as a cognitive scaffold to educe (draw out) AI-Thinking in analysts to ask further questions and gain deeper insights. In this study, a rudimentary beginner-friendly AI-based Bayesian predictive modeling approach was used to demonstrate how human-centric probabilistic reasoning could be utilized to analyze the dynamics of global malnutrition and optimize conditions for achieving the best-case scenario. Conditions of the worst-case “Black Swan” scenario were also simulated, and they could be used to inform stakeholders to prevent them from happening. Thus, the nutritional and health status of vulnerable populations could be ameliorated.
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83
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Arlinghaus KR, Truong C, Johnston CA, Hernandez DC. An Intergenerational Approach to Break the Cycle of Malnutrition. Curr Nutr Rep 2019; 7:259-267. [PMID: 30324333 DOI: 10.1007/s13668-018-0251-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW This article examines how nutritional status is treated throughout the lifecycle. In doing so, the review identifies promising life stages during which intervention may improve nutritional status of future generations. RECENT FINDINGS A life course perspective suggests that nutritional changes are most likely to be sustained when they occur during times of developmental transition, such as pregnancy or adolescence. Adolescence is a unique period in which malnutrition in future generations may be addressed because it is the first life stage at which pregnancy becomes feasible and individuals seek independence from parents. A need exists to begin investigating not just how nutrition changes are sustained throughout the lifespan, but how nutritional intervention in one generation impacts the next. This intergenerational approach should be undertaken with cross-discipline collaboration to have the best chance at impacting underlying determinants of malnutrition like poverty and women's education.
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Affiliation(s)
- Katherine R Arlinghaus
- Department of Health and Human Performance, University of Houston, 3875 Holman St. Rm 104 Garrison, Houston, TX, 77204-6015, USA.
| | - Chelsea Truong
- Department of Health and Human Performance, University of Houston, 3875 Holman St. Rm 104 Garrison, Houston, TX, 77204-6015, USA
| | - Craig A Johnston
- Department of Health and Human Performance, University of Houston, 3875 Holman St. Rm 104 Garrison, Houston, TX, 77204-6015, USA
| | - Daphne C Hernandez
- Department of Health and Human Performance, University of Houston, 3875 Holman St. Rm 104 Garrison, Houston, TX, 77204-6015, USA.,HEALTH Research Institute, University of Houston, 3875 Holman St. Rm 104 Garrison, Houston, TX, 77204-6015, USA
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Ghaffari M, Rakhshanderou S, Harooni J, Mehrabi Y, Ebrahimi A. Prenatal Interventional Program about Mothers' Behavior Related to Exclusive Breast Feeding: Findings of Planned Behavior Theory-Based Research. J Lifestyle Med 2019; 9:143-149. [PMID: 31828034 PMCID: PMC6894448 DOI: 10.15280/jlm.2019.9.2.143] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 07/17/2018] [Indexed: 11/26/2022] Open
Abstract
Background Promotion of exclusive breast feeding is known as a savior strategy, to reduce infantile mortality. The theory of planned behavior is an appropriate theory to explain the effect of psychosocial factors on infant feeding behavior. This study aimed to evaluate impact of planned behavior theory-based education on the behavior of pregnant women related to exclusive breast feeding in Arak city, 2016–17. Methods This study is an interventional study that was done on 101 pregnant women with gestational age of 32–28 weeks in health centers of Arak city. All individuals were divided into experimental and control groups randomly. Valid and reliable questionnaires were completed before, on and 3 months after intervention. Experimental group received educational intervention in 3 sessions. Date was analyzed using SPSS 16 software (Chi-square, T, R.M.ANOVA Tests). Results The results showed that, after implementation of the intervention, mean of scores for attitudes, subjective norms, Perceived behavioral control, intention and exclusive breast feeding behavior has increased significantly in the experimental group compared with the control group. Conclusion The findings of this study, showed the efficiency and effectiveness of educational intervention based on the theory of planned behavior on exclusive breast feeding behavior. Designing and implementing educational programs based on the theory of planned behavior is proposed to encourage women to breast-feed exclusively to encourage women to breast-feed exclusively.
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Affiliation(s)
- Mohtasham Ghaffari
- Health Education and Health Promotion, Environmental & Occupational Hazards Control Research Center, School of Public Health and safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sakineh Rakhshanderou
- Health Education and Health Promotion, Environmental & Occupational Hazards Control Research Center, School of Public Health and safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Javad Harooni
- Health Education & Health Promotion, Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Yadollah Mehrabi
- Biostatistics, Environmental & Occupational Hazards Control Research Center, Tehran, Iran
| | - Azar Ebrahimi
- Health Education, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Owino VO, Murphy‐Alford AJ, Kerac M, Bahwere P, Friis H, Berkley JA, Jackson AA. Measuring growth and medium- and longer-term outcomes in malnourished children. MATERNAL & CHILD NUTRITION 2019; 15:e12790. [PMID: 30690903 PMCID: PMC7199054 DOI: 10.1111/mcn.12790] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 11/13/2018] [Accepted: 12/12/2018] [Indexed: 12/26/2022]
Abstract
Severe and moderate acute malnutrition are among the leading causes of mortality among children in low- and middle-income countries. There is strong evidence that growth assessed anthropometrically from conception to 2 years of age marks later risk of ill health. This is central to the concept of the developmental origins of adult disease and is presumed to be related to modification of developmental processes during critical "window(s)" of vulnerability. Interventions to treat acute malnutrition have resulted in dramatic increase in the number of affected children surviving. Ensuring that these children thrive to fulfil their full physical and cognitive potential is a new challenge. Integral to this challenge is the need to be able to measure how earlier insults relate to the ability to survive and thrive to productive adulthood. Despite its obvious value, routine anthropometry does not adequately indicate how earlier adverse exposures affect more refined aspects of growth. Anthropometry is inadequate for predicting how disruption of healthy growth might modulate risk of disease or any subsequent interventions that correct this risk. A clear characterisation of healthy child growth is needed for determining which component best predicts later outcomes. The extent to which postnatal acute malnutrition is a consequence of maternal factors acting preconception or in utero and their relationship to postnatal health and long-term risk of non-communicable diseases is not clear. Body-composition measurement has significant untapped potential allowing us to translate and better understand the relationship between early insults and interventions on early growth in the short-term and long-term health outcomes.
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Affiliation(s)
- Victor O. Owino
- Nutritional and Health Related Environmental Studies Section, Division of HealthInternational Atomic Energy AgencyViennaAustria
| | - Alexia J. Murphy‐Alford
- Nutritional and Health Related Environmental Studies Section, Division of HealthInternational Atomic Energy AgencyViennaAustria
| | - Marko Kerac
- Department of Population HealthLondon School of Hygiene and Tropical MedicineLondonUK
| | - Paluku Bahwere
- Valid InternationalOxfordUK
- Research Centre in Epidemiology, Biostatistics and Clinical Research, School of Public HealthFree University of BrusselsBrusselsBelgium
| | - Henrik Friis
- Department of Nutrition, Exercise and SportsUniversity of CopenhagenFrederiksbergDenmark
| | - James A. Berkley
- DirectorThe Childhood Acute Illness & Nutrition (CHAIN) NetworkNairobiKenya
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global HealthUniversity of OxfordOxfordUK
| | - Alan A. Jackson
- Human Nutrition, International Malnutrition Task ForceSouthampton General HospitalSouthamptonUK
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86
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Re: "Investment Long Overdue in Primary Studies of HIV-exposed Uninfected Infant Infectious Morbidity". Pediatr Infect Dis J 2019; 38:e165. [PMID: 31192985 PMCID: PMC6578593 DOI: 10.1097/inf.0000000000002250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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87
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Mahumud RA, Alam K, Renzaho AMN, Sarker AR, Sultana M, Sheikh N, Rawal LB, Gow J. Changes in inequality of childhood morbidity in Bangladesh 1993-2014: A decomposition analysis. PLoS One 2019; 14:e0218515. [PMID: 31216352 PMCID: PMC6583970 DOI: 10.1371/journal.pone.0218515] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 06/04/2019] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Child health remains an important public health concern at the global level, with preventable diseases such as diarrheal disease, acute respiratory infection (ARI) and fever posing a large public health burden in low- and middle-income countries including Bangladesh. Improvements in socio-economic conditions have tended to benefit advantaged groups in societies, which has resulted in widespread inequalities in health outcomes. This study examined how socioeconomic inequality is associated with childhood morbidity in Bangladesh, and identified the factors affecting three illnesses: diarrhea, ARI and fever. MATERIALS AND METHODS A total of 43,860 sample observations from the Bangladesh Demographic and Health Survey, spanning a 22-year period (1993-2014), were analysed. Concentration curve and concentration index methods were used to evaluate changes in the degree of household wealth-related inequalities and related trends in childhood morbidity. Regression-based decomposition analyses were used to attribute the inequality disparities to individual determinants for the three selected causes of childhood morbidity. RESULTS The overall magnitude of inequality in relation to childhood morbidity has been declining slowly over the 22-year period. The magnitude of socio-economic inequality as a cause of childhood morbidity varied during the period. Decomposition analyses attributed the inequalities to poor maternal education attainment, inadequate pre-delivery care, adverse chronic undernutrition status and low immunisation coverage. CONCLUSIONS High rates of childhood morbidity were observed, although these have declined over time. Socio-economic inequality is strongly associated with childhood morbidity. Socio-economically disadvantaged communities need to be assisted and interventions should emphasise improvements of, and easier access to, health care services. These will be key to improving the health status of children in Bangladesh and should reduce economic inequality through improved health over time.
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Affiliation(s)
- Rashidul Alam Mahumud
- Health Economics and Policy Research, School of Commerce, Faculty of Business, Education, Law and Arts, Centre for Health, Informatics and Economic Research, University of Southern Queensland, Toowoomba, Queensland, Australia
- Health Economics and Financing Research, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Khorshed Alam
- Health Economics and Policy Research, School of Commerce, Faculty of Business, Education, Law and Arts, Centre for Health, Informatics and Economic Research, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Andre M. N. Renzaho
- School of Social Science and Psychology, Western Sydney University, Sydney Australia
| | - Abdur Razzaque Sarker
- Health Economics and Financing Research, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- Department of Management Science, University of Strathclyde Business School, Glasgow, United Kingdom
| | - Marufa Sultana
- Health Economics and Financing Research, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- School of Health & Social Development, Deakin University, Melbourne, Australia
| | - Nurnabi Sheikh
- Health Economics and Financing Research, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Lal B. Rawal
- School of Social Science and Psychology, Western Sydney University, Sydney Australia
| | - Jeff Gow
- Health Economics and Policy Research, School of Commerce, Faculty of Business, Education, Law and Arts, Centre for Health, Informatics and Economic Research, University of Southern Queensland, Toowoomba, Queensland, Australia
- School of Accounting, Economics and Finance, University of KwaZulu-Natal, Durban, South Africa
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88
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Agho KE, Akombi BJ, Ferdous AJ, Mbugua I, Kamara JK. Childhood undernutrition in three disadvantaged East African Districts: a multinomial analysis. BMC Pediatr 2019; 19:118. [PMID: 31014298 PMCID: PMC6477742 DOI: 10.1186/s12887-019-1482-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 04/01/2019] [Indexed: 11/10/2022] Open
Abstract
Background Undernutrition is an important public health indicator for monitoring nutritional status and survival. In spite of its importance, undernutrition is a significant problem health problem in many East African communities. The aim of this study was to identify factors associated with childhood undernutrition in three disadvantaged East African Districts. Methods We examined data for 9270 children aged 0–59 months using cross-sectional survey from Gicumbi District in Rwanda, Kitgum District in Uganda and Kilindi District in Tanzania. We considered the level of undernutrition (stunting, wasting and underweight) as the outcome variables with four ordinal categories (severely undernourished, moderately undernourished, mildly undernourished, and nourished). Generalized linear latent and mixed models (GLLAMM) with the mlogit link and binomial family that adjusted for clustering and sampling weights were used to identify factors associated with undernutrition among children aged 0–59 months in three disadvantaged East African Districts. Results After adjusting for potential confounding factors, the odds of a child being stunted were higher in Gicumbi District in Rwanda while the odds of a child being wasted and underweight were higher in Kitgum District in Uganda. Having diarrhoea two weeks prior to the survey was significantly associated with severe undernutrition. Wealth index (least poor household), increasing child’s age, sex of the child (male) and unavailability of water all year were reported to be associated with moderate or severe stunting/wasting. Children of women who did not attend monthly child growth monitoring sessions and children who had Acute Respiratory Infection (ARI) symptoms were significantly associated with moderate or severe underweight. Conclusions Findings from our study indicated that having diarrhoea, having ARI, not having water availability all year and not attending monthly child growth monitoring sessions were associated with undernutrition among children aged 0–59 months. Interventions aimed at improving undernutrition in these disadvantaged communities should target all children especially those children from households with poor sanitation practices. Electronic supplementary material The online version of this article (10.1186/s12887-019-1482-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kingsley E Agho
- School of Science and Health, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Blessing J Akombi
- School of Science and Health, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Akhi J Ferdous
- The International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Irene Mbugua
- World Vision International, Karen Road, Off Ngong Road, P.O. Box 133, Karen, Nairobi, 00502, Kenya
| | - Joseph K Kamara
- World Vision International, Southern Africa Regional Office, H100, Mbabane, Swaziland
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Khalil IA, Troeger C, Rao PC, Blacker BF, Brown A, Brewer TG, Colombara DV, De Hostos EL, Engmann C, Guerrant RL, Haque R, Houpt ER, Kang G, Korpe PS, Kotloff KL, Lima AAM, Petri WA, Platts-Mills JA, Shoultz DA, Forouzanfar MH, Hay SI, Reiner RC, Mokdad AH. Morbidity, mortality, and long-term consequences associated with diarrhoea from Cryptosporidium infection in children younger than 5 years: a meta-analyses study. LANCET GLOBAL HEALTH 2019; 6:e758-e768. [PMID: 29903377 PMCID: PMC6005120 DOI: 10.1016/s2214-109x(18)30283-3] [Citation(s) in RCA: 239] [Impact Index Per Article: 47.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 03/08/2018] [Accepted: 05/30/2018] [Indexed: 12/11/2022]
Abstract
Background The protozoan Cryptosporidium is a leading cause of diarrhoea morbidity and mortality in children younger than 5 years. However, the true global burden of Cryptosporidium infection in children younger than 5 years might have been underestimated in previous quantifications because it only took account of the acute effects of diarrhoea. We aimed to demonstrate whether there is a causal relation between Cryptosporidium and childhood growth and, if so, to quantify the associated additional burden. Methods The Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2016 was a systematic and scientific effort to quantify the morbidity and mortality associated with more than 300 causes of death and disability, including diarrhoea caused by Cryptosporidium infection. We supplemented estimates on the burden of Cryptosporidium in GBD 2016 with findings from a systematic review of published and unpublished cohort studies and a meta-analysis of the effect of childhood diarrhoea caused by Cryptosporidium infection on physical growth. Findings In 2016, Cryptosporidium infection was the fifth leading diarrhoeal aetiology in children younger than 5 years, and acute infection caused more than 48 000 deaths (95% uncertainty interval [UI] 24 600–81 900) and more than 4·2 million disability-adjusted life-years lost (95% UI 2·2 million–7·2 million). We identified seven data sources from the scientific literature and six individual-level data sources describing the relation between Cryptosporidium and childhood growth. Each episode of diarrhoea caused by Cryptosporidium infection was associated with a decrease in height-for-age Z score (0·049, 95% CI 0·014–0·080), weight-for-age Z score (0·095, 0·055–0·134), and weight-for-height Z score (0·126, 0·057–0·194). We estimated that diarrhoea from Cryptosporidium infection caused an additional 7·85 million disability-adjusted life-years (95% UI 5·42 million–10·11 million) after we accounted for its effect on growth faltering—153% more than that estimated from acute effects alone. Interpretation Our findings show that the substantial short-term burden of diarrhoea from Cryptosporidium infection on childhood growth and wellbeing is an underestimate of the true burden. Interventions designed to prevent and effectively treat infection in children younger than 5 years will have enormous public health and social development impacts. Funding The Bill & Melinda Gates Foundation.
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Affiliation(s)
- Ibrahim A Khalil
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Christopher Troeger
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Puja C Rao
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Brigette F Blacker
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Alexandria Brown
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Thomas G Brewer
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Danny V Colombara
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | - Cyril Engmann
- PATH, Seattle, WA, USA; School of Public Health, University of Washington, Seattle, WA, USA
| | - Richard L Guerrant
- Center for Global Health, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | | | - Eric R Houpt
- Center for Global Health, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - Gagandeep Kang
- Translational Health Science and Technology Institute, Faridabad, India
| | - Poonum S Korpe
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Karen L Kotloff
- Departments of Pediatrics and Medicine, Center for Vaccine Development, Institute for Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Aldo A M Lima
- Center for Global Health, Federal University of Ceara, Fortaleza, Ceara, Brazil
| | - William A Petri
- Center for Global Health, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - James A Platts-Mills
- Center for Global Health, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | | | | | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
| | - Robert C Reiner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
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90
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A review of GI conditions critical to oral drug absorption in malnourished children. Eur J Pharm Biopharm 2019; 137:9-22. [DOI: 10.1016/j.ejpb.2019.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 01/30/2019] [Accepted: 02/03/2019] [Indexed: 02/06/2023]
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91
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Ejaz H, Walicha N, Rizwan S, Javeria S, Iqbal S, Iqbal F, Ahmad H, Khan IA. DETERMINANTS OF NUTRITIONAL STATUS OF UNDER 5 YEARS CHILDREN. GOMAL JOURNAL OF MEDICAL SCIENCES 2019. [DOI: 10.46903/gjms/17.01.1681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Background: Malnutrition continues to be a major public health problem in developing and underdeveloped countries. The objectives of the study were to determine the determinants of nutritional status of under 5 years children in our population. Materials & Methods: This analytical cross sectional study was conducted by the Department of Public Health, Islamabad, Federal College, Islamabad, from November 2016 to March 2017. Sample size was 200 selected by convenient sampling. Demographic variables were sex, age-groups, socio-economics status, family structure. Research variable was nutritional status. The data collection was done in urban slums of Islamabad on a structured questionnaire. Statistical analysis was done by using SPSS software. Results: Out of 200 children, 117(58.5%) were boys and 83(41.5 %) were girls. One hundred (50%) children were of 6 to 24 months and 100(50%) were of 25 to 59 months of age. Eighty three (41.5%) were rich and 117(58.5%) were poor. One hundred and fifty eight (79%) children were from joint family system and 42(21%) were living in nuclear family system were children. One hundred and fifty one (75.50%) were normal, 39(19.50%) were mild and 10(5%) were having severe malnutrition. Conclusion: Except age all the other factors including sex, socio-economics status and family structure were associated with nutritional status of under 5 year children.
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92
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Tabi ESB, Cumber SN, Juma KO, Ngoh EA, Akum EA, Eyong EM. A cross-sectional survey on the prevalence of anaemia and malnutrition in primary school children in the Tiko Health District, Cameroon. Pan Afr Med J 2019; 32:111. [PMID: 31223401 PMCID: PMC6560948 DOI: 10.11604/pamj.2019.32.111.15728] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Accepted: 02/15/2019] [Indexed: 12/11/2022] Open
Abstract
Introduction Anaemia and malnutrition are common health problems in developing countries with children being the most vulnerable. They have negative impacts on human performance, growth and development, in children, both as cause and consequences of disease. Although annual mass deworming and nutrition supplement strategies have been implemented in the Tiko Health District (THD), no study has been carried out to determine the prevalence of anaemia and malnutrition. The aim of this study was therefore designed to determine the prevalence of anaemia and malnutrition among primary school children aged 5-15 years in the Tiko Health District. Methods A cross-sectional study was carried out in 10 randomly selected schools in the THD and a total of 400 school children were enrolled in the study. Body weight and height were measured using an electronic weighing scale and stadiometer respectively. Anthropometric indices: Height-for-Age Z scores (HAZ), Weight-for-Age Z scores (WAZ) and Body Mass Index-for-Age Z scores (BMIAZ) were analyzed and compared with WHO Growth Reference Standards using WHO Anthroplus software. Hemoglobin levels were determined using Urit-12 Haemoglobinometer and anaemia defined as Hemoglobin (Hb) < 11g/dl. Data analysis was done using the SPSS software. Results The overall prevalence of malnutrition was 9.25%, prevalence of stunting 7.5% with 0.8% being severely stunted. The prevalence of wasting was 1% and underweight 0.7%. The overall prevalence of anaemia was 5%. Parents occupation and the absence of toilet were statistically associated with anaemia (P = 0.04 and P = 0.003). Age, floor type, absence of toilet and BMI were significantly associated with malnutrition (P = 0.00, P = 0.01, P = 0.02 and P = 0.003). Conclusion This study revealed a low prevalence of malnutrition and anaemia which could be attributed to the deworming and nutrition supplement strategies which have been implemented.
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Affiliation(s)
- Egbe Sarah Balle Tabi
- Center for Research on filariasis and other Tropical Diseases (CRFilMT), Yaoundé, Cameroon.,Department of Microbiology and Parasitology, Faculty of Science, University of Buéa, Buéa, Cameroon
| | - Samuel Nambile Cumber
- Section for Epidemiology and Social Medicine, Department of Public Health, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.,School of Health Systems and Public Health Faculty of Health Sciences, University of Pretoria Private Bag X323, Gezina, Pretoria, 0001, Pretoria, South Africa
| | | | - Elvis Akwo Ngoh
- Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), Yaoundé, Cameroon
| | - Eric Achidi Akum
- Department of Biochemistry and Molecular Biology, Faculty of Science, University of Buéa, Buéa, Cameroon
| | - Esum Mathias Eyong
- Department of Microbiology and Parasitology, Faculty of Science, University of Buéa, Buéa, Cameroon
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Reiher A, Mohammadnezhad M. A qualitative exploration of behavioral factors affecting mothers of malnourished children under 5 years old in Kiribati. F1000Res 2019; 8:83. [PMID: 30863538 PMCID: PMC6402073 DOI: 10.12688/f1000research.17732.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/08/2019] [Indexed: 02/05/2023] Open
Abstract
Background: In Kiribati, malnutrition is the leading cause of death for children aged less than 5 years. The purpose of this study was to explore contributing behavioral factors among mothers of malnourished children under 5 years old in Kiribati. Methods: This qualitative study was conducted in an urban area of South Tarawa among mothers of malnourished children aged less than 5 years in 11 public health centers in 2016. The study included 9 focus group discussions, with a sub sample of 3 to 4 in each group, having a total of 35 participants. Using a semi-structured questionnaire, data was collected and thematic analysis was applied to analysis the data. Results: Seven main themes were identified including; knowledge, behaviors, perceived severity, perceived benefits to action, perceived barriers and cultural related issues. These encompassed a variety of reasons which could explain the malnutrition in children of those particular mothers. Conclusion: In order to tackle malnutrition in Kiribati, it is crucial to identify the main factors that are hindering this preventable disease. This study provides information essential to enhanced decision making, health care delivery planning and has policy implications for the improvement of quality of health care in Kiribati.
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Affiliation(s)
- Antje Reiher
- Department of Public Health, Ministry of Health and Medical Services, Nawerewere, Tarawa, Kiribati
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94
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Sultana M, Sarker AR, Sheikh N, Akram R, Ali N, Mahumud RA, Alam NH. Prevalence, determinants and health care-seeking behavior of childhood acute respiratory tract infections in Bangladesh. PLoS One 2019; 14:e0210433. [PMID: 30629689 PMCID: PMC6328134 DOI: 10.1371/journal.pone.0210433] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 12/22/2018] [Indexed: 11/18/2022] Open
Abstract
Background Acute respiratory infections (ARIs) are one of the leading causes of child mortality worldwide and contribute significant health burden for developing nations such as Bangladesh. Seeking care and prompt management is crucial to reduce disease severity and to prevent associated morbidity and mortality. Objective This study investigated the prevalence and care-seeking behaviors among under-five children in Bangladesh and identified factors associated with ARI prevalence and subsequent care-seeking behaviors. Method The present study analyzed cross-sectional data from the 2014 Bangladesh Demographic Health Survey. Bivariate analysis was performed to estimate the prevalence of ARIs and associated care-seeking. Logistic regression analysis was used to determine the influencing socio-economic and demographic predictors. A p-value of <0.05 was considered as the level of significance. Result Among 6,566 under-five children, 5.42% had experienced ARI symptoms, care being sought for 90% of affected children. Prevalence was significantly higher among children < 2 years old, and among males. Children from poorer and the poorest quintiles of households were 2.40 (95% CI = 1.12, 5.15) and 2.36 (95% CI = 1.06, 5.24) times more likely to suffer from ARIs compared to the wealthiest group. Seeking care was significantly higher among female children (AOR = 2.19, 95% CI = 0.94, 5.12). The likelihood of seeking care was less for children belonging to the poorest quintile compared to the richest (AOR = 0.03, 95% CI = 0.01, 0.55). Seeking care from untrained providers was 3.74 more likely among rural residents compared to urban (RRR = 3.74, 95% CI = 1.10, 12.77). Conclusion ARIs continue to contribute high disease burden among under-five children in Bangladesh lacking of appropriate care-seeking behavior. Various factors, such as age and sex of the children, wealth index, the education of the mother, and household lifestyle factors were significantly associated with ARI prevalence and care-seeking behaviors. In addition to public-private actions to increase service accessibility for poorer households, equitable and efficient service distribution and interventions targeting households with low socio-economic status and lower education level, are recommended.
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Affiliation(s)
- Marufa Sultana
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- School of Health and Social Development, Deakin University, Burwood, Melbourne, Australia
- * E-mail:
| | - Abdur Razzaque Sarker
- Health Systems and Population Studies Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- University of Strathclyde, Glasgow, United Kingdom
| | - Nurnabi Sheikh
- Health Systems and Population Studies Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Raisul Akram
- Health Systems and Population Studies Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Nausad Ali
- Health Systems and Population Studies Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Nur Haque Alam
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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Derseh B, Mruts K, Demie T, Gebremariam T. Co-morbidity, treatment outcomes and factors affecting the recovery rate of under -five children with severe acute malnutrition admitted in selected hospitals from Ethiopia: retrospective follow up study. Nutr J 2018; 17:116. [PMID: 30563516 PMCID: PMC6299567 DOI: 10.1186/s12937-018-0423-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 11/27/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In spite of the availability of guidelines for the management of severe acute malnutrition (SAM) in Ethiopia, high comorbidity and poor treatment outcomes are still observed in therapeutic feeding centers among under -five children with SAM. The aim of this study was to assess comorbidity, treatment outcomes and factors affecting the recovery rate of children aged 1-59 months with SAM admitted into Therapeutic Feeding Centers (TFCs). METHODS A total of 413 records of children with SAM admitted in three selected hospitals from July 2013 to July 2015 G.C were retrospectively reviewed. Descriptive analysis was used to compare performance indicator values with SPHERE project reference standards (the minimum standard to be attained during nutritional therapy). Cox-proportional hazard regression analysis was performed to estimate the predictors of recovery rate at p-value < 0.05. RESULT The mean age of children was 16 months (95% CI, 15.0, 17.0). Out of 413 children with SAM, 231 (55.9%) recovered, 24 (5.8%) died and 16.3% were defaulted from TFCs. The mean weight gain (in gram per weight of kilogram per day) for recovered children was 15.61 g/kg/day (95% CI, 14.15, 17.07). The overall median recovery time for these children was 12 days (95% CI, 11.22, 12.78). Moreover, most (77.5%) of children admitted with SAM were marasmic followed by Kwash (16%). Pneumonia (54.8%), diarrhea (41.8%) and rickets (21.4%) were co-morbidities which affected SAM children. A child being admitted at Mehal Meda Hospital (Adjusted Hazard Ratio (AHR) = 2.01; 95% CI: 1.34, 2.91), edematous form of malnutrition (AHR = 0.59; 95% CI: 0.39, 0.90) and being a child infected with pneumonia (AHR = 0.71; 95% CI: 0.51, 0.98) were predictors of nutritional recovery rate. CONCLUSION Under five pneumonia, diarrhea and rickets were co-morbidities that should be prevented. Recovery rate was poor when compared to SPHERE project reference value (which is > 75%). Predictors, namely presence of pneumonia and edematous form of malnutrition reduced nutritional recovery rate. Whereas, being admitted at Mehal Meda Hospital improved recovery rate. Therefore, hospitals should work in collaboration with health extension workers to prevent co-morbidities and strengthen screening and referral of malnutrition cases at community level. Moreover, Zonal Health Department and District Health Offices should facilitate experience sharing among health facilities.
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Affiliation(s)
- Behailu Derseh
- Department of Public Health, College of Health Sciences, Debre Berhan University, P.O. Box 445, Debre Berhan, Ethiopia
| | - Kalayu Mruts
- Department of Public Health, College of Health Sciences, Debre Berhan University, P.O. Box 445, Debre Berhan, Ethiopia
| | - Takele Demie
- Department of Public Health, College of Health Sciences, Debre Berhan University, P.O. Box 445, Debre Berhan, Ethiopia
| | - Tesfay Gebremariam
- Department of Public Health, College of Health Sciences, Debre Berhan University, P.O. Box 445, Debre Berhan, Ethiopia
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96
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Vubil D, Acácio S, Quintò L, Ballesté-Delpierre C, Nhampossa T, Kotloff K, Levine MM, Alonso P, Nataro JP, Farag TH, Vila J, Mandomando I. Clinical features, risk factors, and impact of antibiotic treatment of diarrhea caused by Shigella in children less than 5 years in Manhiça District, rural Mozambique. Infect Drug Resist 2018; 11:2095-2106. [PMID: 30464552 PMCID: PMC6219103 DOI: 10.2147/idr.s177579] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES During the period from December 2007 to November 2012, the epidemiology of diarrhea caused by Shigella was studied among children <5 years of age residing in Manhiça District, Southern Mozambique. MATERIALS AND METHODS Children from 0 to 5 years with moderate-to-severe diarrhea (MSD) and less severe diarrhea (LSD) were enrolled along with matched controls (by age, gender, and neighborhood). Age-stratified logistic regression analyses were conducted to identify clinical features and risk factors associated with Shigella positivity in cases of diarrhea. The impact of antibiotic treatment was assessed for patients with known outcome. RESULTS A total of 916 cases of MSD and 1979 matched controls, and 431 cases of LSD with equal number of controls were enrolled. Shigella was identified as significant pathogen in both cases of MSD and LSD compared to their respective controls. Shigella was detected in 3.9% (17/431) of LSD compared to 0.5% (2/431) in controls (P=0.001) and in 6.1% (56/916) of MSD cases compared to 0.2% (4/1979) in controls (P<0.0001), with an attributable fraction of 8.55% (95% CI: 7.86-9.24) among children aged 12-23 months. Clinical symptoms associated to Shigella among MSD cases included dysentery, fever, and rectal prolapse. Water availability, giving stored water to child, washing hands before preparing baby's food, and mother as caretaker were the protective factors against acquiring diarrhea caused by Shigella. Antibiotic treatment on admission was associated with a positive children outcome. CONCLUSION Shigella remains a common pathogen associated with childhood diarrhea in Mozambique, with dysentery being a significant clinical feature of shigellosis. Adherence to the basic hygiene rules and the use of antibiotic treatment could contribute to the prevention of most of diarrhea due to Shigella.
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Affiliation(s)
- Delfino Vubil
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique,
| | - Sozinho Acácio
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique,
- Instituto Nacional de Saúde (INS), Maputo, Mozambique,
| | - Llorenç Quintò
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | | | - Tacilta Nhampossa
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique,
- Instituto Nacional de Saúde (INS), Maputo, Mozambique,
| | - Karen Kotloff
- Center for Vaccine Development (CVD), University of Maryland, School of Medicine, Baltimore, MD, USA
| | - Myron M Levine
- Center for Vaccine Development (CVD), University of Maryland, School of Medicine, Baltimore, MD, USA
| | - Pedro Alonso
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique,
| | - James P Nataro
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Tamer H Farag
- Center for Vaccine Development (CVD), University of Maryland, School of Medicine, Baltimore, MD, USA
| | - Jordi Vila
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Department of Clinical Microbiology, Centre for Biomedical Diagnosis, Hospital Clinic, Barcelona, Spain
| | - Inacio Mandomando
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique,
- Instituto Nacional de Saúde (INS), Maputo, Mozambique,
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97
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Biomarkers of Systemic Inflammation and Growth in Early Infancy are Associated with Stunting in Young Tanzanian Children. Nutrients 2018; 10:nu10091158. [PMID: 30149537 PMCID: PMC6164697 DOI: 10.3390/nu10091158] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 08/15/2018] [Accepted: 08/22/2018] [Indexed: 01/08/2023] Open
Abstract
Stunting can afflict up to one-third of children in resource-constrained countries. We hypothesized that low-grade systemic inflammation (defined as elevations in serum C-reactive protein or alpha-1-acid glycoprotein) in infancy suppresses the growth hormone–insulin-like growth factor (IGF) axis and is associated with subsequent stunting. Blood samples of 590 children from periurban Dar es Salaam, Tanzania, were obtained at 6 weeks and 6 months of age as part of a randomized controlled trial. Primary outcomes were stunting, underweight, and wasting (defined as length-for-age, weight-for-age and weight-for-length z-scores < −2) between randomization and endline (18 months after randomization). Cox proportional hazards models were constructed to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) of time to first stunting, underweight, and wasting as outcomes, with measures of systemic inflammation, insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) as exposures, adjusting for numerous demographic and clinical variables. The incidences of subsequent stunting, underweight, and wasting were 26%, 20%, and 18%, respectively. In multivariate analyses, systemic inflammation at 6 weeks of age was significantly associated with stunting (HR: 2.14, 95% CI: 1.23, 3.72; p = 0.002). Children with higher levels of IGF-1 at 6 weeks were less likely to become stunted (HR: 0.58, 95% CI: 0.37, 0.93; p for trend = 0.019); a similar trend was noted in children with higher levels of IGF-1 at 6 months of age (HR: 0.50, 95% CI: 0.22, 1.12; p for trend = 0.07). Systemic inflammation occurs as early as 6 weeks of age and is associated with the risk of future stunting among Tanzanian children.
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98
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Ives R, Humphrey L. Endochondral growth disruption during vitamin D deficiency rickets in a mid-19th century series from Bethnal Green, London, UK. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2018; 167:585-601. [DOI: 10.1002/ajpa.23687] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 06/23/2018] [Accepted: 07/02/2018] [Indexed: 11/12/2022]
Affiliation(s)
- Rachel Ives
- Department of Earth Sciences; Natural History Museum; London The United Kingdom
- AOC Archaeology Group; Twickenham The United Kingdom
| | - Louise Humphrey
- Department of Earth Sciences; Natural History Museum; London The United Kingdom
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99
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Poda GG, Hsu CY, Chao JCJ. Factors associated with malnutrition among children <5 years old in Burkina Faso: evidence from the Demographic and Health Surveys IV 2010. Int J Qual Health Care 2018; 29:901-908. [PMID: 29045661 DOI: 10.1093/intqhc/mzx129] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 09/25/2017] [Indexed: 12/25/2022] Open
Abstract
Objective To assess the factors associated with malnutrition among children <5 years in Burkina Faso. Design This study was based on secondary analysis of cross-sectional population-based data from Burkina-Faso Demographic Health Surveys 2010. Setting This study was carried out in Burkina Faso, West Africa. Participants The participants were 6337 children <5 years and their mothers. Main outcome measures Demographic characteristics, child nutrition and health status, and maternal and household information were collected. Survey-specific SAS procedures for weighting, clustering and stratification in the survey design were used. The distribution of different nutritional status, such as underweight, stunting and wasting and the effects of risk factors on malnutrition was analyzed. Results Out of 6337 children <5 years, 51.0% of children were male and 57.8% of children had an average size at birth. There were 15.6, 21.5 and 10.6% of children who recently suffered from diarrhea, fever and acute respiratory infection, respectively. Child sex, age, size at birth, child morbidity, mother's education and body mass index and household wealth index were significantly associated with undernutrition among children <5 years in Burkina Faso. Conclusions In addition to the improvement of household wealth index, more health and nutritional education for mothers should be implemented by the government to improve health and nutritional status of children <5 years in Burkina Faso.
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Affiliation(s)
- Ghislain G Poda
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan.,Ministry of Health, Avenue of Burkina, Ouagadougou 7035, Burkina Faso
| | - Chien-Yeh Hsu
- Department of Information Management, National Taipei University of Nursing and Health Sciences, 365, Ming-Te Road, Taipei 112, Taiwan.,Master Program in Global Health and Development, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan
| | - Jane C-J Chao
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan.,Master Program in Global Health and Development, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan.,Nutrition Research Center, Taipei Medical University Hospital, 252 Wu-Hsing Street, Taipei 110, Taiwan
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100
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van Cooten MH, Bilal SM, Gebremedhin S, Spigt M. The association between acute malnutrition and water, sanitation, and hygiene among children aged 6-59 months in rural Ethiopia. MATERNAL AND CHILD NUTRITION 2018; 15:e12631. [PMID: 29961977 DOI: 10.1111/mcn.12631] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 05/18/2018] [Accepted: 05/21/2018] [Indexed: 01/22/2023]
Abstract
The causes of acute malnutrition-or "wasting"-are complex, and a better understanding of the underlying drivers is necessary in order to design effective interventions. Water, sanitation, and hygiene (WASH) practices may play a fundamental role in acute malnutrition, but more research is needed to confirm this relationship. We investigated the association between WASH practices and acute malnutrition among children 6 to 59 months of age in rural Ethiopia, making use of the Ethiopian Demographic and Health Survey. Descriptive statistics were used to assess the WASH status of all rural children. Bivariate logistic regression analyses were performed to assess associations between nutritional status and WASH. Multivariate logistic regression analyses were used to adjust for confounders. A total of 7,209 children were included in the analysis, of which 867 (12.0%) were acutely malnourished. Proper toilet facilities (AOR = 0.63, 95% CI [0.46, 0.86]) and a water source close to home (AOR = 0.71, 95% CI [0.61, 0.83]) were associated with a lower prevalence of wasting. A safe water source for drinking (COR = 1.03, 95% CI [0.89, 1.19]) and a safe disposal of the child's stool (AOR = 0.97, 95% CI [0.84, 1.13]) were not significantly associated with acute malnutrition. These results suggest that WASH practices are related to acute malnutrition. Future studies-in particular intervention studies-should investigate whether improving WASH practices is effective in reducing malnutrition in infants and young children.
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Affiliation(s)
- Merel H van Cooten
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Selamawit M Bilal
- School of Public and Environmental Health, Hawassa University, Hawassa, Ethiopia
| | - Samson Gebremedhin
- School of Public and Environmental Health, Hawassa University, Hawassa, Ethiopia
| | - Mark Spigt
- CAPHRI School for Public Health and Primary Care, Department of Family Medicine Maastricht University, Maastricht, The Netherlands
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