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Shibeshi AH, Mare KU, Kase BF, Wubshet BZ, Tebeje TM, Asgedom YS, Asmare ZA, Asebe HA, Lombebo AA, Sabo KG, Fente BM, Seifu BL. The effect of dietary diversity on anemia levels among children 6-23 months in sub-Saharan Africa: A multilevel ordinal logistic regression model. PLoS One 2024; 19:e0298647. [PMID: 38771790 PMCID: PMC11108208 DOI: 10.1371/journal.pone.0298647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 01/30/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Anemia is the most common hematologic disorder of children worldwide. Since dietary diversity is a main requirement of children is to get all the essential nutrients, it can thus use as one of the basic indicator when assessing the child's anemia. Although dietary diversity plays a major role in anemia among children in sub-Saharan Africa, there is little evidence of an association between the dietary diversity and anemia level to identified potential strategies for prevention of anemia level in sub-Saharan Africa. OBJECTIVE To examine the association between dietary diversity and anemia levels among children aged 6-23 months in sub-Saharan Africa. METHODS The most recent Demographic and Health Surveys from 32 countries in SSA were considered for this study, which used pooled data from those surveys. In this study, a total weighted sample of 52,180 children aged 6-23 months was included. The diversity of the diet given to children was assessed using the minimum dietary diversity (MDD), which considers only four of the seven food groups. A multilevel ordinal logistic regression model was applied due to the DHS data's hierarchical structure and the ordinal nature of anemia. With a p-value of 0.08, the Brant test found that the proportional odds assumption was satisfied. In addition, model comparisons were done using deviance. In the bi-variable analysis, variables having a p-value ≤0.2 were taken into account for multivariable analysis. The Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was presented for potential determinants of levels of anemia in the multivariable multilevel proportional odds model. RESULTS The overall prevalence of minimum dietary diversity and anemia among children aged 6-23 months were 43% [95% CI: 42.6%, 43.4%] and 72.0% [95% CI: 70.9%, 72.9%] respectively. Of which, 26.2% had mild anemia, 43.4% had moderate anemia, and 2.4% had severe anemia. MDD, being female child, being 18-23 months age, born from mothers aged ≥25, taking drugs for the intestinal parasite, higher level of maternal education, number of ANC visits, middle and richer household wealth status, distance of health facility and being born in Central and Southern Africa were significantly associated with the lower odds of levels of anemia. Contrarily, being 9-11- and 12-17-months age, size of child, having fever and diarrhea in the last two weeks, higher birth order, stunting, wasting, and underweight and being in West Africa were significantly associated with higher odds of levels of anemia. CONCLUSION Anemia was a significant public health issue among children aged 6-23 months in sub-Saharan Africa. Minimum dietary diversity intake is associated with reduced anemia in children aged 6 to 23 months in sub-Saharan Africa. Children should be fed a variety of foods to improve their anemia status. Reducing anemia in children aged 6-23 months can be achieved by raising mother education levels, treating febrile illnesses, and improve the family's financial situation. Finally, iron fortification or vitamin supplementation could help to better reduce the risk of anemia and raise children's hemoglobin levels in order to treat anemia.
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Affiliation(s)
- Abdu Hailu Shibeshi
- Department of Statistics, College of Natural and Computational Science, Samara University, Samara, Ethiopia
| | - Kusse Urmale Mare
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Bizunesh Fantahun Kase
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Betel Zelalem Wubshet
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Tsion Mulat Tebeje
- School of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Yordanos Sisay Asgedom
- Department of Epidemiology and Biostatics, College of Health Sciences and Medicine, Wolaita Sodo University, Soddo, Ethiopia
| | - Zufan Alamrie Asmare
- Department of Ophthalmology, School of Medicine and Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Hiwot Altaye Asebe
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Afework Alemu Lombebo
- School of Medicine, College of Health Science and Medicine, Wolaita Sodo University, Soddo, Ethiopia
| | - Kebede Gemeda Sabo
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Bezawit Melak Fente
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Beminate Lemma Seifu
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
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Seifu BL, Tesema GA. Individual-and community-level factors associated with anemia among children aged 6–23 months in sub-Saharan Africa: evidence from 32 sub-Saharan African countries. Arch Public Health 2022; 80:183. [PMID: 35933419 PMCID: PMC9357302 DOI: 10.1186/s13690-022-00950-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/03/2022] [Indexed: 11/17/2022] Open
Abstract
Background Anemia among children aged 6–23 months is a major public health problem worldwide specifically in sub-Saharan Africa (SSA). Anemia during the childhood period causes significant short-and long-term health consequences. However, there is a paucity of evidence on Anemia among children aged 6–23 months in SSA. Therefore, this study examined the individual- and community-level factors associated with anemia among children aged 6–23 months in sub-Saharan Africa. Methods A secondary data analysis was done based on the most recent Demographic and Health Survey (DHS) of 32 sub-Saharan African countries. A total weighted sample of 51,044 children aged 6–23 months was included for analysis. We have used a multilevel proportional odds model to identify predictors of severity levels of anemia. Variables with p < 0.2 in the bivariable analysis were considered for the multivariable analysis. In the multivariable multilevel proportional odds model, the Adjusted Odds Ratio (AOR) with the 95% Confidence Interval (CI) was reported to declare the statistical significance and strength of the association. Results In this study, about 76.6% (95% CI: 76.2%, 76.9%) of children aged 6–23 months in sub-Saharan Africa were anemic. In the multivariable multilevel proportional odds model, being female, being aged 18–23 months, higher level of maternal education, being larger size at birth, belonging to a wealthier household, getting four ANC visits and above, advanced maternal age, and belonging to a community with high maternal education were significantly associated with lower odds of higher levels of anemia. On the other hand, being twin birth, being smaller size at birth, being of a higher order of birth, having fever in the last two weeks, and distance to a health facility were significantly associated with higher odds of higher levels of anemia. Conclusion The study found that more than three-fourths of children aged 6–23 months in sub-Saharan Africa were anemic. This finding proved that the severity levels of anemia among children in sub-Saharan Africa remain a serious public health concern. Therefore, to curve this problem enhancing maternal education, promoting maternal health service utilization, and improving health care access is crucial. In addition, health care providers better give special emphasis to twin births, higher-order birth, and those belonging to poor households to reduce the incidence of anemia among children aged 6–23 months in SSA.
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Abstract
Inflammatory bowel disease (IBD) is a chronic relapsing remitting autoimmune disease including Crohn's disease and ulcerative colitis. IBD is associated with various extra-intestinal manifestations including oral manifestation. To date, only limited studies addressing the characteristics of the oral manifestations are available. The aim of the present review is to report the oral manifestations and their characteristics in IBD. A Medline/PubMed and Embase databases search were conducted and all relevant studies were extracted and analyzed. Overall, the oral manifestations in IBD were mostly associated with Crohn's disease rather than Ulcerative colitis where their prevalence ranged from 8 to 50%. Specific lesions for Crohn's disease include mucosal tags, cobblestoning and deep linear ulcerations with vertical fissures, while for ulcerative colitis, pyostomatisis vegetans was more disease specific. Notably, most of the oral manifestations were unrelated to disease activity, however more data are needed to accurately assess this correlation. Oral manifestations among IBD patients are not uncommon as Crohn's disease account for most of them. More data are warranted to precisely characterize their prevalence and association to intestinal activity.
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Naik SR, Gupta P, Khaitan T, Shukla AK. Reduced levels of serum vitamin B12 in symptomatic cases of oral lichen planus: A cross-sectional study. J Oral Biol Craniofac Res 2020; 10:578-582. [PMID: 32939337 DOI: 10.1016/j.jobcr.2020.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/14/2020] [Accepted: 07/19/2020] [Indexed: 12/31/2022] Open
Abstract
Objectives Oral Lichen Planus (OLP) is an immune mediated disease and causes oro-mucosal burning sensation that reduces food intake and hence resulting in nutritional deficiency. The present study was done to evaluate the serum levels of vitamin B12 in patients with symptomatic OLP and establish an association between reduced B12 levels and OLP. Materials and method Serum vitamin B12 was assessed in 60 symptomatic cases of oral lichen planus and 60 healthy age and gender matched controls. Results Serum vitamin B12 was significantly reduced (p value < 0) in patients with oral lichen planus when compared to healthy individuals. 43.33% of cases (26 out of 60) had B12 levels less than 187 pg/ml. Conclusion Oral lichen planus causes serum vitamin B12 deficiency. Vitamin B12 is linked with normal functioning of immune and neuropsychologic system which has a role to play in etiopathogenesis and malignant transformation of oral lichen planus.
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Affiliation(s)
- Shantala R Naik
- Dept of Oral Medicine and Radiology, Dental Institute - Rajendra Institute of Medical Sciences, Ranchi, 834001, India
| | - Prashant Gupta
- Dept of Oral Medicine and Radiology, Dental Institute - Rajendra Institute of Medical Sciences, Ranchi, 834001, India
| | - Tanya Khaitan
- Dept of Oral Medicine and Radiology, Dental Institute - Rajendra Institute of Medical Sciences, Ranchi, 834001, India
| | - Anjani Kumar Shukla
- Dept of Oral Medicine and Radiology, Dental Institute - Rajendra Institute of Medical Sciences, Ranchi, 834001, India
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Kandasamy M, Jaisanghar N, Austin RD, Srivastava KC, Anusuya GS, Anisa N. Comparative evaluation of serum and salivary immunoglobulin G and A levels with total serum protein in oral submucous fibrosis patients: A case control study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2016; 8:S126-S132. [PMID: 27829763 PMCID: PMC5074014 DOI: 10.4103/0975-7406.191941] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 04/28/2016] [Accepted: 05/06/2016] [Indexed: 11/04/2022] Open
Abstract
AIM AND OBJECTIVE The objective of this study is to estimate and compare the serum and salivary immunoglobulin G and A (IgG, IgA) levels in various stages of oral submucous fibrosis (OSMF) patients and relate it to total serum protein (TSP) and hemoglobin (Hb) levels. MATERIALS AND METHODS The sample for the present study comprised a total of 20 healthy controls, 20 OSMF patients. About 5 ml of blood and 2 ml of saliva were collected. Quantitative analysis of serum and salivary IgG, IgA was done by turbidometric immunoassay. TSP and Hb were estimated by Biuret and cyanmethemoglobin methods, respectively. RESULTS Serum and salivary IgA and IgG levels were statistically significantly increased (P < 0.001) in OSMF patients when compared to controls. Also serum and salivary IgG and IgA levels showed significantly increased (P < 0.01) in all the three staging of OSMF when compared to control group. Hb levels and TSP levels were significantly decreased (P < 0.001) in OSMF patients when compared to controls. One-way ANOVA, Pearson's correlation, and unpaired t-test were used for statistical analysis. CONCLUSION The elevated levels of IgG and IgA are also in favor of polygammapathy, which are nonspecific and nondiagnostic objective reflections of an underlying disease. Decreased TSP is a result of host response and Hb, acts as an indicator of nutritional status plays an important role. It is also observed from the present study that the severity of OSMF was directly proportional to the estimated elevated levels of the major IgG and IgA. A need is also felt for the knowledge of immunoprofile estimation in etiology and pathogenesis that would prove a great asset in the proper assessment of this condition.
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Affiliation(s)
- M. Kandasamy
- Department of Oral Medicine and Radiology, Rajas Dental College and Hospital, Tirunelveli, Tamil Nadu, India
| | - N. Jaisanghar
- Department of Oral Medicine and Radiology, Sree Anjaneya Institute of Dental Sciences, Modakkallur, Kerala, India
| | - Ravi David Austin
- Department of Oral Medicine and Radiology, Rajah Muthiah Dental College and Hospital, Annamalai University, Chidambaram, Tamil Nadu, India
| | - Kumar Chandan Srivastava
- Department of Oral Basic and Clinical Sciences, Division of Oral Medicine and Radiology, Qassim Private Colleges, Buraydah, Qassim Province, Kingdom of Saudi Arabia
| | - G. Sai Anusuya
- Department of Periodontics, Rajas Dental College and Hospital, Tirunelveli, Tamil Nadu, India
| | - N. Anisa
- Department of Oral Medicine and Radiology, Karpaga Vinayaga Institute of Dental Sciences, Kanchipuram, Tamil Nadu, India
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Muhvić-Urek M, Tomac-Stojmenović M, Mijandrušić-Sinčić B. Oral pathology in inflammatory bowel disease. World J Gastroenterol 2016; 22:5655-5667. [PMID: 27433081 PMCID: PMC4932203 DOI: 10.3748/wjg.v22.i25.5655] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 05/27/2016] [Accepted: 06/15/2016] [Indexed: 02/06/2023] Open
Abstract
The incidence of inflammatory bowel diseases (IBD) - Crohn’s disease (CD) and ulcerative colitis (UC) - has been increasing on a global scale, and progressively, more gastroenterologists will be included in the diagnosis and treatment of IBD. Although IBD primarily affects the intestinal tract, extraintestinal manifestations of the disease are often apparent, including in the oral cavity, especially in CD. Specific oral manifestations in patients with CD are as follows: indurate mucosal tags, cobblestoning and mucogingivitis, deep linear ulcerations and lip swelling with vertical fissures. The most common non-specific manifestations, such as aphthous stomatitis and angular cheilitis, occur in both diseases, while pyostomatitis vegetans is more pronounced in patients with UC. Non-specific lesions in the oral cavity can also be the result of malnutrition and drugs. Malnutrition, followed by anemia and mineral and vitamin deficiency, affects the oral cavity and teeth. Furthermore, all of the drug classes that are applied to the treatment of inflammatory bowel diseases can lead to alterations in the oral cavity due to the direct toxic effects of the drugs on oral tissues, as well as indirect immunosuppressive effects with a risk of developing opportunistic infections or bone marrow suppression. There is a higher occurrence of malignant diseases in patients with IBD, which is related to the disease itself and to the IBD-related therapy with a possible oral pathology. Treatment of oral lesions includes treatment of the alterations in the oral cavity according to the etiology together with treatment of the primary intestinal disease, which requires adequate knowledge and a strong cooperation between gastroenterologists and specialists in oral medicine.
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Kazancioglu HO, Cakir O, Koyuncuoglu G, Ciftci A, Ak G. Oral Findings and Health Status among Turkish Geriatric Patients with or without Dementia (Oral Lesions and Dementia Patients). INT J GERONTOL 2013. [DOI: 10.1016/j.ijge.2012.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Bascones-Martínez A, Muñoz-Corcuera M, Bascones-Ilundain C. [Clinical manifestations of hematological non-neoplastic diseases in Dentistry]. Med Clin (Barc) 2012; 139:18-24. [PMID: 22197599 DOI: 10.1016/j.medcli.2011.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Revised: 10/05/2011] [Accepted: 10/06/2011] [Indexed: 10/14/2022]
Abstract
Systemic disease can cause clinical manifestations in the oral and maxillofacial area, which is important to recognize because it could be the first symptom of an undiagnosed illness. There are different oral signs that could suggest the clinician a blood disorder, such as pallor, petechiae, ecchymosis, ulcerations, gingival hypertrophy or spontaneous gingival bleeding. In addition, blood disorders will determine the dental management of these patients and the protocol for limiting possible complications that may arise due to the treatment itself. This paper reviews the oral manifestations and dental management of non-neoplastic alterations of red cells, white cells and hemostasis, with emphasis on two-way relationship that must exist between the dentist and the patient's hematologist for making a treatment plan.
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Affiliation(s)
- Antonio Bascones-Martínez
- Departamento de Medicina y Cirugía Bucofacial, Facultad de Odontología, Universidad Complutense de Madrid, Madrid, España.
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Higham P, Alawi F, Stoopler ET. Medical management update: Peutz Jeghers syndrome. ACTA ACUST UNITED AC 2010; 109:5-11. [PMID: 20123375 DOI: 10.1016/j.tripleo.2009.08.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2009] [Revised: 07/16/2009] [Accepted: 08/11/2009] [Indexed: 12/12/2022]
Abstract
Peutz Jeghers syndrome (PJS) is an autosomal dominant disease characterized by hamartomatous polyposis and distinct mucocutaneous pigmentation. PJS is associated with an increased risk for several cancers and other complications such as small intestine intussusception, short bowel syndrome, and anemia. Medical management mainly consists of treatment of the polyps and surveillance. This medical management update will review clinical concepts, therapeutic advances, and emphasize features of PJS important to the oral health care provider.
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Affiliation(s)
- Paola Higham
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
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Stoopler ET, Vogl DT, Stadtmauer EA. Medical management update: Multiple myeloma. ACTA ACUST UNITED AC 2007; 103:599-609. [PMID: 17291793 DOI: 10.1016/j.tripleo.2006.10.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2006] [Revised: 10/20/2006] [Accepted: 10/23/2006] [Indexed: 02/08/2023]
Abstract
Multiple myeloma (MM) is a hematologic malignancy characterized by abnormal proliferation of immunoglobulin-secreting plasma cells. Manifestations of MM may include anemia, osteolytic lesions, and renal dysfunction. Treatment for this disease chiefly consists of corticosteroids, bisphosphonates, chemotherapy, and hematopoietic stem-cell transplantation. This medical management update will review recent clinical and therapeutic advances in the field of MM and highlight issues that are important to the oral health care provider.
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Affiliation(s)
- Eric T Stoopler
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, PA 19104, USA.
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Gorustovich AA, Steimetz T, Giglio MJ, Guglielmotti MB. A histomorphometric study of alveolar bone modeling and remodeling under experimental anaemia and polycythaemia in rats. Arch Oral Biol 2006; 51:246-51. [PMID: 16183035 DOI: 10.1016/j.archoralbio.2005.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2005] [Revised: 08/09/2005] [Accepted: 08/17/2005] [Indexed: 10/25/2022]
Abstract
UNLABELLED Alveolar bone is the least stable of the periodontal tissues, because it is subjected to continuous modeling and remodeling. OBJECTIVE To perform a histological and histomorphometric evaluation of bone modeling and remodeling of periodontal alveolar bone under experimental anaemia and polycythaemia. METHODS Thirty Wistar rats were divided into three groups: control (C), animals were i.p. injected with 0.5 mL of saline solution; anaemia (A), animals were injected with 6 mg/100 b.w. of phenylhydrazine every 48 h; polycythaemia (P), animals were transfused with 2.5 mL/100 b.w. of 80% suspension of homologous erythrocytes. All the animals were sacrificed 14 days after the onset of the experiment. The mandibles were resected, fixed in formalin, radiographed, processed and embedded in paraffin. Bucco-lingually oriented sections were obtained at the level of the mesial root of the first lower molar, and stained with hematoxylin-eosin. Histological and histomorphometric studies were performed on the buccal and lingual plates of periodontal alveolar bone. RESULTS Histological and histomorphometric studies showed a statistically significant decrease in bone formation both in buccal and lingual plates in group A (anaemia) as compared to group C (control). An increase in active bone formation was found in the lingual plate in group P (polycythaemia) as compared to group C (control). CONCLUSION The results obtained using this experimental model evidenced alterations in bone modeling and remodeling under conditions of anaemia and polycythaemia and/or associated factors.
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Affiliation(s)
- Alejandro A Gorustovich
- Department of Oral Pathology, School of Dentistry, University of Buenos Aires, M.T. de Alvear 2142-2A, C1122AAH, Buenos Aires, Argentina.
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