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Fernández-Gaxiola AC, Neufeld LM, García-Guerra A. Considerations for Correction of Micronutrient Deficiencies Through Supplementation in Pregnant Women and Children Under-5 in Latin America. Food Nutr Bull 2024:3795721231219824. [PMID: 38186006 DOI: 10.1177/03795721231219824] [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: 01/09/2024]
Abstract
BACKGROUND Micronutrient deficiencies in Latin America are a public health concern, nonetheless, lack of information still exists in many countries, so that the true magnitude of the problem remains uncertain. OBJECTIVE To summarise experiences that can inform the development of policies and programs to address micronutrient deficiencies throung supplementation in pregnant women and chlidren under five years of age in Latin American. METHODS Review of the most evidence on the effects of micronutrients supplementation, focusing on pregnant women and children under five years of age. RESULTS Certain population groups, as women of reproductive age and children under 2 years of age, are at increased risk for deficiency due to their high micronutrient requirements. This is compounded by the limited access to micronutrient-rich foods for many people living in vulnerable situations. Micronutrient supplementation is an effective intervention to prevent and treat deficiency and to mitigate its adverse effects on health, nutrition, and pregnancy outcomes in micronutrient-deficient populations. The potential benefits of supplementation programs, however, are realized only when they reach those who have the potential to benefit, that is, with inadequate intakes of micronutrients from dietary sources, and when the quality of design and delivery of the programs aresufficient to reach that population timely, regularly, and effectively to enable and motivate consumption. CONCLUSIONS Several resources and experiences exist that can help favor the development of programs that can realize this biological and programmatic potential. There is need for continuous efforts to augment coverage and achieve results that can translate into economic benefits for individuals, families, and nations.
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Niu X, Wang H, Zhao L, Lian P, Bai Y, Li J, Qiao J. All-trans retinoic acid increases the pathogenicity of the H9N2 influenza virus in mice. Virol J 2022; 19:113. [PMID: 35764970 PMCID: PMC9238145 DOI: 10.1186/s12985-022-01809-y] [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: 12/17/2021] [Accepted: 05/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The H9N2 virus can infect not only birds but also humans. The pathogenicity of H9N2 virus infection is determined by an excessive immune response in the lung. All-trans retinoic acid (ATRA), the active metabolite of vitamin A, plays an important regulatory role and has been widely used in the clinical practice. This study was aimed to investigate whether ATRA could regulate the immune response to H9N2 virus infection in the lungs of mice, thereby reducing the pathogenicity of the H9N2 virus in mice. METHODS Mice were infected intranasally with H9N2 virus, and injected intraperitoneally with 0.2 mL of ATRA at low (1 mg/kg), medium (5 or 10 mg/kg), or high therapeutic dose (20 mg/kg), and toxic dose (40, 60, or 80 mg/kg), once per day for 10 days. Clinical signs, survival rates, and lung gross pathology were compared between the ATRA-treated H9N2-infected group, the ATRA group, and the H9N2-infected group, to investigate the effect of different doses of ATRA on the pathogenicity of H9N2 virus. Additionally, the viral load and cytokine concentration of lungs were measured at 3, 5, 7, and 9 days after infection, to investigate the potential mechanism of ATRA in affecting the pathogenicity of the H9N2 virus. Expression levels of cellular retinoic acid-binding protein 1 (CRABP1), cellular retinoic acid-binding protein 2 (CRABP2), and Retinoic acid-inducible gene-I (RIG-I) were detected using Western blotting. RESULTS The ATRA-treated H9N2-infected mice showed more severe clinical signs compared with the H9N2-infected group. The medium and high therapeutic doses of ATRA reduced the survival rates, aggravated lung tissue damage, decreased the expression of interferon beta (IFN-β), and increased the concentrations of interleukin-1 beta (IL-1β), tumor necrosis factor alpha (TNF-α), and C-C motif chemokine ligand 2 (CCL2) in the lungs of the H9N2-infected mice. At the same time, the expression patterns of CRABP1, CRABP2, and RIG-I were changed in mice infected by H9N2 and treated with different concentrations of ATRA. CONCLUSIONS Our findings suggest that the therapeutic dose of ATRA can increase the pathogenicity of the H9N2 virus. Therefore, the consequences of those infected by influenza virus would be more severe after ATRA treatment.
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Affiliation(s)
- Xiaofei Niu
- Department of Pathophysiology, College of Veterinary Medicine, China Agricultural University, No. 2 Yuanmingyuan West Road, Haidian District, Beijing, 100193, People's Republic of China.,Department of Veterinary Medicine, College of Life Sciences and Food Engineering, Hebei University of Engineering, No. 19 Taiji Road, Economic and Technological Development Zone, Handan, 056038, People's Republic of China
| | - Hongyan Wang
- Department of Veterinary Medicine, College of Life Sciences and Food Engineering, Hebei University of Engineering, No. 19 Taiji Road, Economic and Technological Development Zone, Handan, 056038, People's Republic of China
| | - Lihong Zhao
- Department of Pathophysiology, College of Veterinary Medicine, China Agricultural University, No. 2 Yuanmingyuan West Road, Haidian District, Beijing, 100193, People's Republic of China
| | - Pengjing Lian
- Department of Pathophysiology, College of Veterinary Medicine, China Agricultural University, No. 2 Yuanmingyuan West Road, Haidian District, Beijing, 100193, People's Republic of China
| | - Yu Bai
- Department of Pathophysiology, College of Veterinary Medicine, China Agricultural University, No. 2 Yuanmingyuan West Road, Haidian District, Beijing, 100193, People's Republic of China
| | - Jingyun Li
- Department of Pathophysiology, College of Veterinary Medicine, China Agricultural University, No. 2 Yuanmingyuan West Road, Haidian District, Beijing, 100193, People's Republic of China
| | - Jian Qiao
- Department of Pathophysiology, College of Veterinary Medicine, China Agricultural University, No. 2 Yuanmingyuan West Road, Haidian District, Beijing, 100193, People's Republic of China.
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Deriba BS. Nutritional-Related Predictors of Preterm Birth in North Shewa Hospitals, Central Ethiopia: A Case-Control Study. PEDIATRIC HEALTH MEDICINE AND THERAPEUTICS 2021; 12:315-324. [PMID: 34262390 PMCID: PMC8275143 DOI: 10.2147/phmt.s319867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 06/27/2021] [Indexed: 11/23/2022]
Abstract
Background Preterm birth (PTB) is the leading cause of newborn death and the second cause of mortality among under-five children. Globally, about 15 million infants are born preterm every year. However, there is a lack of data on the nutritional-related predictors of preterm birth among Ethiopian women. The objective of the study was to identify nutritional-related predictors of preterm birth among women who gave birth at North Shewa public Hospitals in central Ethiopia. Methods A case–control study was undertaken in public hospitals in the North Shewa zone, central Ethiopia. Interviewer-administered questionnaire was used to gather data, which was then entered into EPI INFO version 7 and then exported to SPSS version 23 for analysis. Data were presented using texts, tables, and proportions. To find predictors of preterm birth, researcher used binary and multiple logistic regression models. The presence of a relationship between PTB and predictor factors was determined using the adjusted odds ratio (AOR), 95% confidence interval (CI), and p-value <0.05. Results A total of 161 cases and 322 controls participated in the study making a response rate of 97.6%. Unable to get iron folic acid (IFA) (AOR=2.26, 95% CI: 1.22, 4.18), not eating additional meals (AOR=2.63, 95% CI: 1.1, 4.62), restriction of foods (AOR=2.85, 95% CI: 1.58, 5.12), not taking dark green leafy vegetables (DGLV), (AOR=4.46, 95% CI: 1.72, 11.61), and mid upper arm circumference of mother (MUAC) <23 centimeters (AOR=3.7, 95% CI: 2.25, 6.11) had statistically significant association with premature birth. Conclusion IFA supplementation, additional meals, food taboo, frequency of DGLV, and MUAC were identified predictors of preterm birth. Encouraging such women to eat additional meals, varieties of diets like vegetables, and fruits during pregnancy, and adhering to culturally appropriate nutrition education to reverse food taboo is compulsory.
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Affiliation(s)
- Berhanu Senbeta Deriba
- Department of Public Health, Salale University College of Health Sciences, Fitche, Ethiopia
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Rhodes EC, Hennink M, Jefferds MED, Williams AM, Suchdev PS, Mapango C, Nyirenda E, Mshali G, Tripp K. Integrating micronutrient status assessment into the 2015-2016 Malawi Demographic and Health Survey: A qualitative evaluation. MATERNAL AND CHILD NUTRITION 2019; 15 Suppl 1:e12734. [PMID: 30748109 DOI: 10.1111/mcn.12734] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 10/06/2018] [Accepted: 10/08/2018] [Indexed: 12/14/2022]
Abstract
Demand for national-level micronutrient status data continues to grow, yet little is known about the implementation of different approaches for collecting these data. We conducted an evaluation of the process of linking the 2015-2016 Malawi Demographic and Health Survey (MDHS) and 2015-2016 Malawi Micronutrient Survey (MNS). We conducted 24 in-depth interviews with stakeholders from the Malawi government and international agencies and field staff. Interview questions explored perceptions of what worked and what was challenging during three phases of implementation: preparation; data collection; and data analysis, reporting, and dissemination. Data were analysed using thematic analysis. Results showed that there was strong government interest to integrate the MDHS and MNS. Perceived benefits included potential cost savings and lower respondent burden. However, government and international agency stakeholders did not view the linkage of the surveys to be a fully integrated approach. The lack of full integration produced challenges throughout implementation, such as complex field logistics and duplication in nutrition indicators assessed and reported. Some stakeholders believed integration was not attainable primarily due to timing. The MDHS and MNS were originally designed as stand-alone surveys, and planning for each survey was at an advanced stage once the government sought to integrate the surveys. Additionally, the MNS could not be incorporated as a module within the MDHS given the complexity of the MNS data collection and short timeframe for planning. These findings can inform decisions about implementing the next MNS and may be transferable to other countries that are conducting micronutrient surveys to address data gaps.
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Affiliation(s)
- Elizabeth C Rhodes
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, Georgia, USA
| | - Monique Hennink
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Maria Elena D Jefferds
- Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Anne M Williams
- Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Parminder S Suchdev
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, Georgia, USA.,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.,Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Department of Pediatrics, Emory University, Atlanta, Georgia, USA
| | - Carine Mapango
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Eunice Nyirenda
- Demography Section, National Statistical Office of Malawi, Zomba, Malawi
| | - Glory Mshali
- Demography Section, National Statistical Office of Malawi, Zomba, Malawi
| | - Katie Tripp
- Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Garcia-Casal MN, Estevez D, De-Regil LM. Multiple micronutrient supplements in pregnancy: Implementation considerations for integration as part of quality services in routine antenatal care. Objectives, results, and conclusions of the meeting. MATERNAL AND CHILD NUTRITION 2019; 14 Suppl 5:e12704. [PMID: 30585705 PMCID: PMC6866095 DOI: 10.1111/mcn.12704] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 09/12/2018] [Accepted: 09/15/2018] [Indexed: 02/06/2023]
Abstract
Health promotion, screening, diagnosis, and disease prevention are essential services of quality routine antenatal care for pregnant adult and adolescent women. Supplementation programmes in pregnancy, generally implemented in the context of antenatal care services, have had less than optimal results in many countries, generally attributed to limited access, low coverage, and reduced adherence to the recommended regimens and counselling. The World Health Organization Department of Nutrition for Health and Development, in collaboration with the United Nations Children's Fund and Nutrition International, convened the technical consultation "Multiple micronutrient supplements in pregnancy: Implementation considerations for successful incorporation into existing programmes." The objectives of the technical consultation were to (a) examine implementation experiences of micronutrient supplementation interventions in pregnant women, lessons learnt, and best practices; (b) discuss programmatic and technical considerations of interventions on multiple micronutrient supplementation in pregnant women in low-, middle-, and high-income countries; and (c) identify implementation considerations that can be useful to scaling up efforts by national policymaker and their advisors considering multiple micronutrient supplementation in pregnant women as part of existing antenatal care programmes as well as other delivery platforms. The consultation was based on presentations of background papers, case studies, and plenary discussions. Country representatives were asked to discuss the context of micronutrient supplementation for their countries and share implementation challenges they faced. This paper provides the background and rationale of the technical consultation, synopsises the presentations, and provides a summary of the main considerations and conclusions reached during plenary discussions.
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Affiliation(s)
- Maria Nieves Garcia-Casal
- Evidence and Programme Guidance Unit, Department of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland
| | - Diana Estevez
- Evidence and Programme Guidance Unit, Department of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland
| | - Luz Maria De-Regil
- Nutrition International, Division of Global Technical Services, Ottawa, Ontario, Canada
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Mei Z, Jefferds ME, Namaste S, Suchdev PS, Flores-Ayala RC. Monitoring and surveillance for multiple micronutrient supplements in pregnancy. MATERNAL AND CHILD NUTRITION 2017; 14 Suppl 5:e12501. [PMID: 29271064 PMCID: PMC6866115 DOI: 10.1111/mcn.12501] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 03/23/2017] [Accepted: 04/21/2017] [Indexed: 11/29/2022]
Abstract
The World Health Organization (WHO) recommends iron–folic acid (IFA) supplementation during pregnancy to improve maternal and infant health outcomes. Multiple micronutrient (MMN) supplementation in pregnancy has been implemented in select countries and emerging evidence suggests that MMN supplementation in pregnancy may provide additional benefits compared to IFA alone. In 2015, WHO, the United Nations Children's Fund (UNICEF), and the Micronutrient Initiative held a “Technical Consultation on MMN supplements in pregnancy: implementation considerations for successful incorporation into existing programmemes,” which included a call for indicators needed for monitoring, evaluation, and surveillance of MMN supplementation programmes. Currently, global surveillance and monitoring data show that overall IFA supplementation programmes suffer from low coverage and intake adherence, despite inclusion in national policies. Common barriers that limit the effectiveness of IFA—which also apply to MMN programmes—include weak supply chains, low access to antenatal care services, low‐quality behaviour change interventions to support and motivate women, and weak or non‐existent monitoring systems used for programme improvement. The causes of these barriers in a given country need careful review to resolve them. As countries heighten their focus on supplementation during pregnancy, or if they decide to initiate or transition into MMN supplementation, a priority is to identify key monitoring indicators to address these issues and support effective programmes. National and global monitoring and surveillance data on IFA supplementation during pregnancy are primarily derived from cross‐sectional surveys and, on a more routine basis, through health and logistics management information systems. Indicators for IFA supplementation exist; however, the new indicators for MMN supplementation need to be incorporated. We reviewed practice‐based evidence, guided by the WHO/Centers for Disease Control and Prevention logic model for vitamin and mineral interventions in public health programmes, and used existing manuals, published literature, country reports, and the opinion of experts, to identify monitoring, evaluation, and surveillance indicators for MMN supplementation programmes. We also considered cross‐cutting indicators that could be used across programme settings, as well as those specific to common delivery models, such as antenatal care services. We then described mechanisms for collecting these data, including integration within existing government monitoring systems, as well as other existing or proposed systems. Monitoring data needs at all stages of the programme lifecycle were considered, as well as the feasibility and cost of data collection. We also propose revisions to global‐, national‐, and subnational‐surveillance indicators based on these reviews.
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Affiliation(s)
- Zuguo Mei
- Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Maria Elena Jefferds
- Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Sorrel Namaste
- Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING), Arlington, VA, USA.,Helen Keller International, New York City, NY, USA
| | - Parminder S Suchdev
- Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Rafael C Flores-Ayala
- Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
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