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Omary SA, Kalabamu FS, Fataki MR, Salum SS, Mohamed UH, Kimaro JG, Leshabari KM. Severity and Morphological Characteristics of Anaemia Among 6 to 59 Months Old Children in Temeke, Dar es Salaam-Tanzania: Clinics Based Cross Sectional Analysis. East Afr Health Res J 2024; 8:188-194. [PMID: 39296774 PMCID: PMC11407129 DOI: 10.24248/eahrj.v8i2.780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 03/13/2024] [Indexed: 09/21/2024] Open
Abstract
Background Anaemia is a global public health indicator of both poor nutrition and poor health. Besides, it stands as a silent signal of mal-aligned health system across the entire human lifespan. Globally, the importance of anaemia is most pronounced among children. This study was conceived to assess severity and morphological characteristics of anaemia among children aged from 6 to 59 months old in Temeke, Dar es Salaam, Tanzania. Methods We designed a cross sectional, clinics-based analytical study. Children aged 6 to 59 months with anaemia were the target population. Severity and morphological characteristics of anaemia were the main outcome variables. Data were collected using a pre-designed questionnaire. Data were summarised using median and inter-quartile range (continuous variables) or frequency and proportions (categorical variables). Chi-square tests were applied to assess association between categorical variables. Alpha level of 5% was used as a limit of type 1 error in findings. Written informed consent was sought from mother of each child prior to inclusion into the study. Results We successfully recruited and analysed 250 children. Participants median age was 17.5 (IQR: 9 - 34) months (females, n=112, 44.8%). Point prevalence of anaemia (Hb<12 g/dL) was 66.8%. Among anemic children (n=167), about 19%, 63% and 18% had mild, moderate and severe anaemia respectively. A direct linear association between MCV and MCHC was observed among anemic children (n=167, Spearman's rank ´Y= 0.86, P=.000). There was a significant association between prevalence and severity of anaemia among studied children (LR χ2 (corrected) = 229.5, df=3). Majority (n=121, 72%) of the studied children had normocytic normochromic anaemia. Conclusion Majority of under-fives in attendance at outpatient clinics in Temeke were anemic. Normochromic normocytic anaemia was the most prevalent variant of anaemia in this study population.
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Affiliation(s)
- Salha Ally Omary
- Department of Pediatrics/Child Health, Hubert Kairuki Memorial University, Dar es Salaam Tanzania
- Department of Pediatrics/Child Health, Temeke Regional Referral Hospital, Dar es Salaam Tanzania
- NUTritional REsearch iNTer-Collaboration (NUTRENT) Group, Registered Trustees of Ultimate Family Healthcare, Dar es Salaam, Tanzania
- Ageing Research Group, Registered Trustees of Ultimate Family Healthcare, Dar es Salaam Tanzania
| | | | - Maulidi Rashidi Fataki
- Department of Pediatrics/Child Health, Hubert Kairuki Memorial University, Dar es Salaam Tanzania
| | - Shani Shamsi Salum
- Department of Pediatrics/Child Health, Hubert Kairuki Memorial University, Dar es Salaam Tanzania
- NUTritional REsearch iNTer-Collaboration (NUTRENT) Group, Registered Trustees of Ultimate Family Healthcare, Dar es Salaam, Tanzania
- Ageing Research Group, Registered Trustees of Ultimate Family Healthcare, Dar es Salaam Tanzania
- Department of Pediatrics/Child Health, Muhimbili National Hospital (Mloganzila), Dar es Salaam Tanzania
| | - Ummulkheir Hamid Mohamed
- Department of Pediatrics/Child Health, Hubert Kairuki Memorial University, Dar es Salaam Tanzania
- NUTritional REsearch iNTer-Collaboration (NUTRENT) Group, Registered Trustees of Ultimate Family Healthcare, Dar es Salaam, Tanzania
- Ageing Research Group, Registered Trustees of Ultimate Family Healthcare, Dar es Salaam Tanzania
- Department of Pediatrics/Child Health, Msambweni County Referral Hospital, Kwale Kenya
| | - Joseph Gasper Kimaro
- Department of Pediatrics/Child Health, Temeke Regional Referral Hospital, Dar es Salaam Tanzania
| | - Kelvin Melkizedeck Leshabari
- NUTritional REsearch iNTer-Collaboration (NUTRENT) Group, Registered Trustees of Ultimate Family Healthcare, Dar es Salaam, Tanzania
- Ageing Research Group, Registered Trustees of Ultimate Family Healthcare, Dar es Salaam Tanzania
- H3 Clinical Research Unit, I-Katch Technology Ltd., Dar es Salaam Tanzania
- Department of Pediatrics/Child Health, Muhimbili National Hospital (Mloganzila), Dar es Salaam Tanzania
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Roy A, De A, Aftabuddin M, Bera AK, Bayen S, Ghosh A, Das BK. Analysis of Health Ailments and Associated Risk Factors in Small-Scale Fisherfolk Community of Indian Sundarbans: A Cross-Sectional Study. Indian J Community Med 2024; 49:360-366. [PMID: 38665455 PMCID: PMC11042129 DOI: 10.4103/ijcm.ijcm_906_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 10/31/2023] [Indexed: 04/28/2024] Open
Abstract
Background Small-scale fishers of Indian Sundarbans depend on open-water fisheries for their livelihoods. They often face health, occupational, and safety issues in their profession due to environmental, socio-economic, and policy changes. The morbidity pattern and related risk factors are important indicators of well-being for any community, hence applicable to small-scale fishers of Sundarbans. The present study was designed to assess patterns of morbidities, associated risk factors including occupational health hazards, and treatment-seeking behavior of small-scale fishers in the Indian Sundarbans. Material and Methods Household surveys, focused group discussions, and personal interviews were conducted through a predesigned pretested structured questionnaire. Associated risk factors and the nature of seeking treatment were considered during the data collection covering 650 individuals from 132 fishers' families. Results Morbidities were more frequent in males (39.33%) than in females (28.5%). The fever (31%) was the most dominant reason for morbidities followed by ocular ailments (23%), musculoskeletal disorder (20%), dermatological ailments (17%), and respiratory illness (9%). The highest morbidities (25%) were recorded in the age group of 21-30 years in males while that was 20% in the 11-20 years age group in the case of the females. Physical labor for fishing activities predisposes to health ailments of the studied population. Conclusions The prevalence of morbidity among the fishermen community was found to be 28.5%. The understanding of the morbidity profile of a population in general and specific age groups of both sexes in specific sheds light on the vulnerability of working groups that will help for effective healthcare planning and resource allocation.
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Affiliation(s)
- Aparna Roy
- Extension and Training Cell, ICAR-Central Inland Fisheries Research Institute, Barrackpore, Kolkata, West Bengal, India
| | - Angshuman De
- Laboratory Director, Consultant Clinical Biochemist and Quality Assurance Professional, Apollo Clinic Bansdroni, Kolkata, West Bengal, India
- Consultant Clinical Biochemist, Hindusthan Healthpoint Hospital, Garia, Kolkata, West Bengal, India
- Department of Biochemistrty, Murshidabad Medical College and Hospital, Berhampore, West Bengal, India
| | - Md. Aftabuddin
- Fisheries Resource Assessment and Informatics (FRAI) Division, ICAR-Central Inland Fisheries Research Institute, Barrackpore, Kolkata, West Bengal, India
| | - Asit K. Bera
- Fisheries Resource Assessment and Informatics (FRAI) Division, ICAR-Central Inland Fisheries Research Institute, Barrackpore, Kolkata, West Bengal, India
| | - Supriti Bayen
- Extension and Training Cell, ICAR-Central Inland Fisheries Research Institute, Barrackpore, Kolkata, West Bengal, India
| | - Abhishek Ghosh
- Department of Agricultural Extension, School of Agriculture and Allied Sciences, The Neotia University (TNU), Sarisa, West Bengal, India
| | - Basanta K. Das
- Extension and Training Cell, ICAR-Central Inland Fisheries Research Institute, Barrackpore, Kolkata, West Bengal, India
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Yao N, Kowalczyk M, Gregory L, Cheatham J, DeClemente T, Fox K, Ignoffo S, Volerman A. Community health workers' perspectives on integrating into school settings to support student health. Front Public Health 2023; 11:1187855. [PMID: 37415701 PMCID: PMC10320159 DOI: 10.3389/fpubh.2023.1187855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/23/2023] [Indexed: 07/08/2023] Open
Abstract
Introduction While schools represent key venues for supporting health, they continue to experience gaps in health resources. The integration of community health workers (CHWs) into schools has the potential to supplement these resources but has been underexplored. This study is the first to examine perspectives of experienced CHWs about how CHWs can be applied in school settings to support student health. Methods This qualitative study involved conducting semi-structured interviews focused on implementation of CHWs in schools with individuals who held positions aligned with the CHW scope of work. De-identified transcripts were analyzed, and codes were organized into domains and themes. Results Among 14 participants, seven domains emerged about the implementation of CHWs in schools: roles and responsibilities, collaborations, steps for integration, characteristics of successful CHWs, training, assessment, and potential challenges. Participants shared various potential responsibilities of school-based CHWs, including educating on health topics, addressing social determinants of health, and supporting chronic disease management. Participants emphasized the importance of CHWs building trusting relationships with the school community and identified internal and external collaborations integral to the success of CHWs. Specifically, participants indicated CHWs and schools should together determine CHWs' responsibilities, familiarize CHWs with the school population, introduce CHWs to the school community, and establish support systems for CHWs. Participants identified key characteristics of school-based CHWs, including having familiarity with the broader community, relevant work experience, essential professional skills, and specific personal qualities. Participants highlighted trainings relevant to school-based CHWs, including CHW core skills and health topics. To assess CHWs' impact, participants proposed utilizing evaluation tools, documenting interactions with students, and observing indicators of success within schools. Participants also identified challenges for school-based CHWs to overcome, including pushback from the school community and difficulties related to the scope of work. Discussion This study identified how CHWs can have a valuable role in supporting student health and the findings can help inform models to integrate CHWs to ensure healthy school environments.
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Affiliation(s)
- Nicole Yao
- Department of Medicine, University of Chicago, Chicago, IL, United States
| | - Monica Kowalczyk
- Department of Medicine, University of Chicago, Chicago, IL, United States
| | - LaToya Gregory
- Department of Medicine, University of Chicago, Chicago, IL, United States
| | - Jeannine Cheatham
- Department of Pediatrics, University of Chicago, Chicago, IL, United States
| | - Tarrah DeClemente
- Office of Student Health and Wellness, Chicago Public Schools, Chicago, IL, United States
| | - Kenneth Fox
- Office of Student Health and Wellness, Chicago Public Schools, Chicago, IL, United States
| | - Stacy Ignoffo
- Sinai Urban Health Institute, Chicago, IL, United States
| | - Anna Volerman
- Department of Medicine, University of Chicago, Chicago, IL, United States
- Department of Pediatrics, University of Chicago, Chicago, IL, United States
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Reyes-Ortiz CA, Lee T, Campo-Arias A, Ocampo-Chaparro JM, Luque JS. Racial Discrimination and Multimorbidity Among Older Adults in Colombia: A National Data Analysis. Prev Chronic Dis 2023; 20:E34. [PMID: 37141184 PMCID: PMC10159335 DOI: 10.5888/pcd20.220360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
INTRODUCTION Multimorbidity is a prevalent worldwide problem among older adults. Our objective was to assess the association between life-course racial discrimination and multimorbidity among older adults in Colombia. METHODS We used data from the SABE (Salud, Bienestar y Envejecimiento) Colombia Study in 2015 (N = 18,873), a national cross-sectional survey among adults aged 60 years or older. The outcome was multimorbidity, defined as having 2 or more chronic conditions. The main independent variables were 3 racial discrimination measures: 1) everyday racial discrimination (yes or no), 2) childhood racial discrimination score (scored from 0 [never] to 3 [many times]), and 3) situations of racial discrimination in the last 5 years (scored from 0 to 4 as a sum of the number of situations [group activities, public places, inside the family, health centers]). Other variables were sociodemographic characteristics, diseases, economic or health adversity during childhood, and functional status. We used weighted logistic regression analyses to adjust for differences between groups. RESULTS Multivariate logistic regression models showed that multimorbidity was significantly associated with experiencing everyday racial discrimination (OR, 2.21; 95% CI, 1.62-3.02), childhood racial discrimination (OR, 1.27; 95% CI, 1.10-1.47), and the number of situations of racial discrimination (OR= 1.56; 95% CI, 1.22-2.00). Multimorbidity was also independently associated with multimorbidity during childhood. CONCLUSION Racial discrimination experiences were associated with higher odds of multimorbidity among older adults in Colombia. Strategies to decrease life course experiences of racial discrimination may improve the health of older adults.
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Affiliation(s)
- Carlos A Reyes-Ortiz
- Institute of Public Health, College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, Florida
- Florida A&M University, 1515 South Martin Luther King Jr Blvd, Suite 209D, Tallahassee, FL 32307
| | - Torhonda Lee
- Institute of Public Health, College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, Florida
- Now with Department of Graduate Public Health, College of Veterinary Medicine, Tuskegee University, Tuskegee, Alabama
| | - Adalberto Campo-Arias
- Programa de Medicina, Facultad de Ciencias de la Salud, Universidad del Magdalena, Santa Marta, Colombia
| | - Jose Mauricio Ocampo-Chaparro
- Programa de Geriatría, Departamento de Medicina Familiar, Universidad del Valle, Cali, Colombia
- Grupo Interinstitucional de Medicina Interna, Departamento de Medicina Interna, Universidad Libre, Cali, Colombia
| | - John S Luque
- Institute of Public Health, College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, Florida
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Lockhart A, Mucida D, Parsa R. Immunity to enteric viruses. Immunity 2022; 55:800-818. [PMID: 35545029 PMCID: PMC9257994 DOI: 10.1016/j.immuni.2022.04.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/04/2022] [Accepted: 04/11/2022] [Indexed: 12/15/2022]
Abstract
Pathogenic enteric viruses are a major cause of morbidity and mortality, particularly among children in developing countries. The host response to enteric viruses occurs primarily within the mucosa, where the intestinal immune system must balance protection against pathogens with tissue protection and tolerance to harmless commensal bacteria and food. Here, we summarize current knowledge in natural immunity to enteric viruses, highlighting specialized features of the intestinal immune system. We further discuss how knowledge of intestinal anti-viral mechanisms can be translated into vaccine development with particular focus on immunization in the oral route. Research reveals that the intestine is a complex interface between enteric viruses and the host where environmental factors influence susceptibility and immunity to infection, while viral infections can have lasting implications for host health. A deeper mechanistic understanding of enteric anti-viral immunity with this broader context can ultimately lead to better vaccines for existing and emerging viruses.
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Affiliation(s)
- Ainsley Lockhart
- Laboratory of Mucosal Immunology, The Rockefeller University, New York, NY 10065, USA
| | - Daniel Mucida
- Laboratory of Mucosal Immunology, The Rockefeller University, New York, NY 10065, USA; Howard Hughes Medical Institute, The Rockefeller University, New York, NY, USA.
| | - Roham Parsa
- Laboratory of Mucosal Immunology, The Rockefeller University, New York, NY 10065, USA.
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Steinberg H. Distance and acceptance: Identity formation in young adults with chronic health conditions. ADVANCES IN LIFE COURSE RESEARCH 2020; 44:100325. [PMID: 36726244 DOI: 10.1016/j.alcr.2020.100325] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 02/14/2020] [Accepted: 02/14/2020] [Indexed: 06/18/2023]
Abstract
Health has long been a chief concern of life course researchers, especially in examining early life. Research on chronic conditions and their impact on individual identity often center on biographical disruption or the idea of a bifurcation of "before and after" identities. This research examines identity formation in young adults with chronic health conditions that began in childhood, a population that continues to grow. This study focuses on young adults' narrative identities, both regarding how young adults describe the transition to adulthood and how cultural ideals of young adulthood and actors from institutions influence how they describe themselves. This study uses 22 in-depth qualitative interviews to reveal how young adults distance themselves from their conditions or move to acceptance through the narratives they tell about their health, feelings, and behaviors. This research suggests that identity confirmation by others forms an integral part of the nexus of health and the life course, shaping how adolescents make the transition into young adulthood. Social support from actors in institutions gives room to some young adults with chronic conditions to integrate their conditions into their narrative identities. This study reveals the social nature of young adult identities, and how cultural ideals guide them, precisely because it uses cases of young adults who must transition to adulthood in alternative ways.
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Affiliation(s)
- Hillary Steinberg
- University of Colorado Boulder, UCB 327 Ketchum 195, Boulder, CO, 80309, United States.
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Peele ME. Domains of Childhood Disadvantage and Functional Limitation Trajectories Among Midlife Men and Women in China. J Aging Health 2019; 32:501-512. [PMID: 30845868 DOI: 10.1177/0898264319834813] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Objective: To examine the impacts of four childhood disadvantage domains-parental behavior, hunger, health, and socioeconomic status (SES)-on functional limitation trajectories among midlife adults in China. Method: Data (2011-2015) from the China Health and Retirement Longitudinal Study (N = 8,646) were used to examine the associations between different domains of childhood disadvantage and functional limitation trajectories among adults aged 45 to 64. Results: Adverse parental behavior was not associated with baseline functional limitation but was associated with steeper trajectories for men. Health, hunger, and SES were associated with more functional limitations at baseline, and SES with steeper trajectories for men and women. Adulthood SES largely accounted for the associations between childhood SES and functional limitations for men. Discussion: It is important to examine multiple domains of childhood conditions because the type and magnitude of disadvantage may influence functional limitations in different ways among men and women in China.
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Peele ME. Childhood Conditions Predict Chronic Diseases and Functional Limitations Among Older Adults: The Case of Indonesia. J Aging Health 2018; 31:1892-1916. [DOI: 10.1177/0898264318799550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: Limited knowledge exists about whether childhood health and socioeconomic status (SES) conditions influence health among older adults in Indonesia. Method: Data from Wave 5 (2014/2015) of the Indonesian Family Life Survey ( N = 6,530) was used to examine associations between childhood health and SES and hypertension, lung conditions, diabetes, lower body functional limitations (LBFL), and instrumental activities of daily living limitations (IADL). Results: Poor childhood health was associated with 34% higher odds of hypertension (odds ratio [OR] = 1.34, p < .05), 37% higher odds of diabetes (OR = 1.37, p < .05), and 32% higher odds of lung conditions (OR = 1.32, p < .05). Household overcrowding was associated with 22% higher odds of a LBFL (OR = 1.22, p < .05) and 24% higher odds of an IADL (OR = 1.24, p < .01). Lacking a household toilet was associated with 18% higher odds of a LBFL (OR = 1.18, p < .05). Adjusting for adult SES and current health did not account for these relationships. Discussion: Childhood conditions appear to shape older adult health in Indonesia.
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Wang Q, Zhang H, Rizzo JA, Fang H. The Effect of Childhood Health Status on Adult Health in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020212. [PMID: 29373554 PMCID: PMC5858281 DOI: 10.3390/ijerph15020212] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 01/20/2018] [Accepted: 01/22/2018] [Indexed: 01/08/2023]
Abstract
Childhood health in China was poor in the 1950s and 1960s because of limited nutrition. In the last three decades, China has distinguished itself through its tremendous economic growth and improvements in health and nutrition. However, prior to such growth, access to good nutrition was more variable, with potentially important implications, not only for childhood health, but also for adult health, because of its long-term effects lasting into adulthood. To shed light on these issues, this study examined the long-run association between childhood health and adult health outcomes among a middle-aged Chinese population and addresses the endogeneity of childhood health. A nationwide database from the 2011 China Health and Retirement Longitudinal Study (CHARLS) was employed. Three adult health outcomes variables were used: self-reported health status, cognition, and physical function. The local variation in grain production in the subjects’ fetal period and the first 24 months following birth was employed as an instrument for childhood health in order to correct for its endogeneity. Childhood health recalled by the respondents was positively and significantly associated with their adult health outcomes in terms of self-reported health status, cognition, and physical function in single-equation estimates that did not correct for the endogeneity of childhood health. A good childhood health status increased the probabilities of good adult health, good adult cognitive function, and good adult physical function by 16% (95% CI: 13–18%), 13% (95% CI: 10–15%), and 14% (95% CI: 12–17%), respectively. After correcting for endogeneity, the estimated effects of good childhood health were consistent but stronger. We also studied the male and female populations separately, finding that the positive effects of childhood health on adult health were larger for males. In China, childhood health significantly affects adult health. This suggests that early interventions to promote childhood health will have long-term benefits in China and that health-care policies should consider their long-term impacts over the life cycle in addition to their effects on specific age groups.
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Affiliation(s)
- Qing Wang
- School of Business, Dalian University of Technology, Panjin 124221, China.
| | - Huyang Zhang
- China Center for Health Development Studies, Peking University, Beijing 100083, China.
- Department of Health Policy and Administration, Peking University, Beijing 100083, China.
| | - John A Rizzo
- Department of Family, Population & Preventive Medicine, State University of New York at Stony Brook, Stony Brook, NY 11790, USA.
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing 100083, China.
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Nataro JP, Guerrant RL. Chronic consequences on human health induced by microbial pathogens: Growth faltering among children in developing countries. Vaccine 2017; 35:6807-6812. [DOI: 10.1016/j.vaccine.2017.05.035] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 03/28/2017] [Accepted: 05/10/2017] [Indexed: 02/07/2023]
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Puchner KP, Lopez-Ridaura R, Ortiz-Panozo E, Vieitez I, Lajous M. Stature is inversely associated with self-reported diabetes in middle-aged Mexican women. Rev Panam Salud Publica 2017; 41:e32. [PMID: 31363354 PMCID: PMC6612735 DOI: 10.26633/rpsp.2017.32] [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: 01/24/2016] [Accepted: 06/02/2016] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To investigate whether stature is associated with two highly prevalent cardiom- etabolic disorders-diabetes mellitus (DM) and high blood pressure (HBP) -in middle-aged Mexican women. METHODS We conducted a cross-sectional analysis of a sample of 93 481 middle-aged Mexican female teachers, all participating in the Mexican Teachers Cohort (MTC, or ESMaestras) study. We used a multivariable regression model to investigate the association of stature quintiles with the self-reported outcomes of DM and HBP. RESULTS After adjusting for birth cohort, ethnicity, family history, birthweight, occupation of household's head during participant's childhood, menopausal status, and geographical region of birthplace, stature was inversely associated with DM, with the odds for DM being 9% higher in the lowest stature quintile when compared to the highest stature quintile. Stratification for location of residence resulted in confirmation of the above-mentioned findings only in partici- pants living in urban environments. CONCLUSIONS We found an inverse association of stature with DM but not with HBP. Our data suggest that urban setting might be an important effect modifier of this association, which merits further investigation since it might provide valuable insights into the epidemiological transition occurring in developing countries.
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Affiliation(s)
- Karl P Puchner
- Center for Population Health ResearchNational Institute of Public HealthCuernavacaMorelosMexicoCenter for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
| | - Ruy Lopez-Ridaura
- Center for Population Health ResearchNational Institute of Public HealthCuernavacaMorelosMexicoCenter for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
| | - Eduardo Ortiz-Panozo
- Center for Population Health ResearchNational Institute of Public HealthCuernavacaMorelosMexicoCenter for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
| | - Isabel Vieitez
- Center for Population Health ResearchNational Institute of Public HealthCuernavacaMorelosMexicoCenter for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
| | - Martín Lajous
- Center for Population Health ResearchNational Institute of Public HealthCuernavacaMorelosMexicoCenter for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
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Wang Q, Shen JJ. Childhood Health Status and Adulthood Cardiovascular Disease Morbidity in Rural China: Are They Related? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E565. [PMID: 27275829 PMCID: PMC4924022 DOI: 10.3390/ijerph13060565] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 05/14/2016] [Accepted: 06/02/2016] [Indexed: 11/17/2022]
Abstract
Cardiovascular diseases (CVDs) are among the top health problems of the Chinese population. Although mounting evidence suggests that early childhood health status has an enduring effect on late life chronic morbidity, no study so far has analyzed the issue in China. Using nationally representative data from the 2013 China Health and Retirement Longitudinal Study (CHARLS), a Probit model and Two-Stage Residual Inclusion estimation estimator were applied to analyze the relationship between childhood health status and adulthood cardiovascular disease in rural China. Good childhood health was associated with reduced risk of adult CVDs. Given the long-term effects of childhood health on adulthood health later on, health policy and programs to improve the health status and well-being of Chinese populations over the entire life cycle, especially in persons' early life, are expected to be effective and successful.
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Affiliation(s)
- Qing Wang
- School of Business, Dalian University of Technology, Panjin 124221, China.
| | - Jay J Shen
- Department of Health Care Administration and Policy, School of Community Health Sciences, University of Nevada at Las Vegas, Las Vegas, NV 89103, USA.
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Missinne S, Neels K, Bracke P. Reconsidering inequalities in preventive health care: an application of cultural health capital theory and the life-course perspective to the take-up of mammography screening. SOCIOLOGY OF HEALTH & ILLNESS 2014; 36:1259-1275. [PMID: 25470325 DOI: 10.1111/1467-9566.12169] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
While there are abundant descriptions of socioeconomic inequalities in preventive health care, knowledge about the true mechanisms is still lacking. Recently, the role of cultural health capital in preventive health-care inequalities has been discussed theoretically. Given substantial analogies, we explore how our understanding of cultural health capital and preventive health-care inequalities can be advanced by applying the theoretical principles and methodology of the life-course perspective. By means of event history analysis and retrospective data from the Survey of Health Ageing and Retirement, we examine the role of cultural capital and cultural health capital during childhood on the timely initiation of mammography screening in Belgium (N = 1348). In line with cumulative disadvantage theory, the results show that childhood cultural conditions are independently associated with mammography screening, even after childhood and adulthood socioeconomic position and health are controlled for. Lingering effects from childhood are suggested by the accumulation of cultural health capital that starts early in life. Inequalities in the take-up of screening are manifested as a lower probability of ever having a mammogram, rather than in the late initiation of screening.
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Affiliation(s)
- Sarah Missinne
- Department of Sociology, Ghent University, Ghent, Belgium; Research Foundation (FWO), Flanders, Belgium
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Tzioumis E, Adair LS. Childhood dual burden of under- and overnutrition in low- and middle-income countries: a critical review. Food Nutr Bull 2014; 35:230-43. [PMID: 25076771 PMCID: PMC4313560 DOI: 10.1177/156482651403500210] [Citation(s) in RCA: 208] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND In low- and middle-income countries, the distribution of childhood nutritional diseases is shifting from a predominance of undernutrition to a dual burden of under- and overnutrition. This novel and complex problem challenges governments and health organizations to tackle opposite ends of the malnutrition spectrum. The dual burden may manifest within a community, household, or individual, but these different levels have not been addressed collectively. OBJECTIVE To critically review literature on the prevalence, trends, and predictors of the dual burden, with a focus on children from birth to 18 years of age. METHODS We reviewed literature since January 1, 1990, published in English, using the PubMed search terms nutrition transition, double burden, dual burden, nutrition status, obesity, overweight, underweight, stunting, body composition, and micronutrient deficiencies. The findings were classified and described according to dual burden level (community, household, or individual). RESULTS Global trends indicate decreases in diseases of undernutrition, while overnutrition is increasing. On the community level, economic status may influence the extent of the dual burden, with obesity increasingly affecting the already undernourished poor. In a household, shared determinants of poor nutritional status among members can result in disparate nutritional status across generations. Within an individual, obesity may co-occur with stunting or anemia due to shared underlying determinants or physiologic links. CONCLUSIONS The dual burden of malnutrition poses a threat to children's health in low- and middle-income countries. We must remain committed to reducing undernutrition while simultaneously preventing over-nutrition through integrated child health programs that incorporate prevention of infection, diet quality, and physical activity.
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Lourenço BH, Cardoso MA. C-reactive protein concentration predicts change in body mass index during childhood. PLoS One 2014; 9:e90357. [PMID: 24603645 PMCID: PMC3946086 DOI: 10.1371/journal.pone.0090357] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 01/28/2014] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Inflammation may constitute an underlying mechanism for increased risk of developing chronic diseases in later years, but few prospective studies have assessed the influence of low-grade inflammation on body weight gain, particularly among children in low- to middle-income settings with lower prevalence of overweight and obesity. We aimed to investigate whether C-reactive protein (CRP), as a biomarker of low-grade inflammation, predicts changes in body mass index-for-age z scores (BAZ) during childhood. METHODS A population-based longitudinal study was conducted in the Brazilian Amazon among children aged ≤10 years in 2007, with follow-up visits in 2009 and 2012. Outcome was annual change in BAZ. As the main exposure of interest, CRP concentrations were divided into four categories, with values <1 mg/L divided in tertiles plus a fourth category with values ranging from 1 to 10 mg/L. Children were simultaneously screened for iron and vitamin A deficiencies, diarrhea, and wheezing. We used mixed-effect linear regression models to measure the effect of CRP concentrations on annual BAZ change and linear regression models to explore CRP predictors at baseline. RESULTS At baseline, 1007 children had CRP and anthropometric data [mean (SD) age: 5.3 (2.9) years; 50.9% male, 84.5% mulatto/mixed-race, 14.0% at risk for overweight or obesity, 4.8% stunted]; 737 were successfully followed up. Morbidities and nutritional deficiencies were widespread. Among participants aged >5 years, children in the highest tertile of CRP <1 mg/L at baseline, regarded as an indicator of low-grade inflammation, had a 0.04 z/y higher gain in BAZ (95% CI: 0.01, 0.09 z/y) during follow-up. CRP was positively associated with household poverty and worse nutritional indicators. CONCLUSIONS We found evidence of a role for low-grade inflammation in predicting annual BAZ gain among children aged >5 years.
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Affiliation(s)
- Barbara H. Lourenço
- Public Health Nutrition Program, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Marly A. Cardoso
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- * E-mail:
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Potischman N, Linet MS. Invited commentary: are dietary intakes and other exposures in childhood and adolescence important for adult cancers? Am J Epidemiol 2013; 178:184-9. [PMID: 23792894 DOI: 10.1093/aje/kwt101] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
In this issue of the Journal, Nimptsch et al. (Am J Epidemiol. 2013;178(2):172-183) report significant associations between female adolescents' poultry consumption in high school and subsequent reduced risk of colorectal adenomas in adulthood. Consumption of red meat or fish was not related to risk, but replacement with poultry reduced the risk of later adenomas. Most epidemiologic studies of adult diseases lack exposure data from the distant past. By focusing on a cancer precursor lesion and using a variety of methods to assess data quality, the investigators address concerns about the quality of distant recall. These findings add to the growing evidence that links childhood and adolescent lifestyle and environmental exposures with subsequent risk of cancers arising in adulthood. Highlights of the literature on this topic and methodological challenges are summarized. Future studies would benefit from incorporating measures of lifestyle, diet, environmental exposures, and other risk factors from early in life and from validation and other data quality checks of such measurements. Sources of historical data on children's and adolescents' exposures should be sought and evaluated in conjunction with subsequent exposures in relationship to adult-onset cancers.
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Affiliation(s)
- Nancy Potischman
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892-9762, USA.
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Abstract
More than one-fifth of the world's population live in extreme poverty, where a lack of safe water and adequate sanitation enables high rates of enteric infections and diarrhoea to continue unabated. Although oral rehydration therapy has greatly reduced diarrhoea-associated mortality, enteric infections still persist, disrupting intestinal absorptive and barrier functions and resulting in up to 43% of stunted growth, affecting one-fifth of children worldwide and one-third of children in developing countries. Diarrhoea in children from impoverished areas during their first 2 years might cause, on average, an 8 cm growth shortfall and 10 IQ point decrement by the time they are 7-9 years old. A child's height at their second birthday is therefore the best predictor of cognitive development or 'human capital'. To this 'double burden' of diarrhoea and malnutrition, data now suggest that children with stunted growth and repeated gut infections are also at increased risk of developing obesity and its associated comorbidities, resulting in a 'triple burden' of the impoverished gut. Here, we Review the growing evidence for this triple burden and potential mechanisms and interventions that must be understood and applied to prevent the loss of human potential and unaffordable societal costs caused by these vicious cycles of poverty.
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DeBoer MD, Lima AAM, Oría RB, Scharf RJ, Moore SR, Luna MA, Guerrant RL. Early childhood growth failure and the developmental origins of adult disease: do enteric infections and malnutrition increase risk for the metabolic syndrome? Nutr Rev 2012; 70:642-53. [PMID: 23110643 DOI: 10.1111/j.1753-4887.2012.00543.x] [Citation(s) in RCA: 110] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Hypotheses regarding the developmental origins of health and disease postulate that developing fetuses - and potentially young children - undergo adaptive epigenetic changes that have longstanding effects on metabolism and other processes. Ongoing research explores whether these adaptations occur during early life following early childhood malnutrition. In the developing world, there remains a high degree of nutritional stunting, defined as linear growth failure caused by inadequate caloric intake, which may be exacerbated by inflammation from ongoing infections. In areas with poor sanitation, children experience vicious cycles of enteric infections and malnutrition, resulting in poor nutrient absorption as a result of changes in the intestinal mucosa, now termed "environmental enteropathy." Emerging evidence links early childhood diarrhea and/or growth failure with an increased occurrence of risk factors for cardiovascular disease in later life, including dyslipidemia, hypertension, and glucose intolerance. The mechanisms for these associations remain poorly understood and may relate to epigenetic responses to poor nutrition, increased inflammation, or both. Given the increased incidence of cardiovascular disease in developing areas of the world, associations between childhood malnutrition, early-life infections, and the increased occurrence of risk factors for cardiovascular disease underscore further reasons to improve nutrition and infection-related outcomes for young children worldwide.
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Affiliation(s)
- Mark D DeBoer
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Virginia, Charlottesville, VA, USA.
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Daily sugar-sweetened beverage consumption and insulin resistance in European adolescents: the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study. Public Health Nutr 2012; 16:479-86. [PMID: 23009737 DOI: 10.1017/s1368980012002613] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The present study aimed to evaluate the relationship between the consumption of selected food groups and insulin resistance, with an emphasis on sugar-sweetened beverages (SSB). DESIGN The present research is a large multicentre European study in adolescents, the HELENA-CSS (Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study). SETTING Homeostasis model assessment-insulin resistance index (HOMA-IR) was calculated. Several anthropometric and lifestyle characteristics were recorded. Dietary assessment was conducted by using a short FFQ. SUBJECTS The participants were a subset of the original sample (n 546) with complete data on glucose, insulin and FFQ. All participants were recruited at schools. RESULTS Median (25th, 75th percentile) HOMA-IR was 0.62 (0.44, 0.87). Mean HOMA-IR was significantly higher among adolescents consuming brown bread ≤1 time/week than among those consuming 2-6 times/week (P = 0·011). Mean values of HOMA-IR were also higher in adolescents consuming SSB >5 times/week compared with those consuming less frequently, although a statistically significant difference was detected between those consuming SSB 5-6 times/week and 2-4 times/week (P = 0.049). Multiple linear regression analysis showed that only the frequency of SSB consumption was significantly associated with HOMA-IR after controlling for potential confounders. In particular, it was found that HOMA-IR levels were higher among adolescents consuming SSB 5-6 times/week and ≥1 time/d compared with those consuming ≤1 time/week by 0.281 and 0.191 units, respectively (P = 0.009 and 0.046, respectively). CONCLUSIONS The present study revealed that daily consumption of SSB was related with increased HOMA-IR in adolescents.
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