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George PE, Gamble AV, Palzer EF, Brearley AM, Johnson DE, Eckerle JK. Health of Post-Institutionalized Haitian Children Adopted to the United States. Matern Child Health J 2023:10.1007/s10995-022-03574-4. [PMID: 36737526 PMCID: PMC9897990 DOI: 10.1007/s10995-022-03574-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 11/06/2022] [Accepted: 12/19/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Haiti remains a principal placement country for intercountry adoptees to the United States. This project reports the health status of children adopted from Haiti arriving to the U.S. and compares them to intercountry adoptees from other regions. METHODS A retrospective chart review was conducted of adoptees placed in the U.S. from Haiti (n=87), age and sex matched with intercountry adoptees placed in the U.S. from Asia (n=87) and Latin America (n=87) between January 2010 and November 2019. Data on immunization status, contagious diseases, and nutrition and growth were analyzed via linear, logistic, and multinomial regression. RESULTS After adjusting for age, sex, and standardized height, children adopted from Haiti, compared to adoptees from Latin America and Asia, demonstrated a lack of immunity to hepatitis B (OR=5.89;6.87), increased immunity to hepatitis A (OR=0.38;0.30), infection by two or more parasites (OR=8.43;38.48), high lead levels (OR=23.79;7.04), and anemia (OR=15.25;9.18). Unexpectedly, children adopted from Haiti had greater standardized height (-1.28 vs. -1.82 and -2.13) and standardized weight (-0.32 vs. -0.57 and -1.57) than their counterparts from Latin America and Asia. CONCLUSIONS Children adopted from Haiti face complex medical challenges undoubtedly related to the country's low socioeconomic status (SES) and the impact of recurrent natural disasters and governmental neglect on public health infrastructure. Appropriate care is critical in preventing and avoiding transmission of infectious diseases in adoptees and family members. The high incidence of anemia and elevated lead levels may further exacerbate the developmental effects of early institutional deprivation.
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Affiliation(s)
- Priya E. George
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, MN USA
| | - Anna V. Gamble
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, MN USA
| | - Elise F. Palzer
- Division of Biostatistics, School of Public Health and Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN USA
| | - Ann M. Brearley
- Division of Biostatistics, School of Public Health and Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN USA
| | - Dana E. Johnson
- Division of Neonatology, Department of Pediatrics, University of Minnesota, Minneapolis, MN USA
| | - Judith K. Eckerle
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, MN USA
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Fadl N, Ice GH, Haile ZT. Association between maternal high-risk factors and anemia among women in Ethiopia. Nutrition 2021; 91-92:111404. [PMID: 34388586 DOI: 10.1016/j.nut.2021.111404] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 06/10/2021] [Accepted: 06/20/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim of this study was to examine the association between maternal high-risk factors and anemia among reproductive-age women in Ethiopia. METHODS A cross-sectional study was conducted using data from the 2016 Ethiopia Demographic and Health Survey (N = 5282). Hemoglobin levels were used to determine anemia status. Maternal high-risk factors were measured using maternal age at delivery, birth order, and birth interval. We performed χ2 test and multivariable regression models. RESULTS There was a significant antagonistic interaction between maternal high-risk factors and place of residence on anemia (relative excess risk due to interaction, -1.79, synergy index, 0.48) with an attributable proportion due to interaction (AP) of -67% (AP = -0.67; 95% confidence interval [CI], -0.95 to -0.29). Multiplicative interaction was also significant (odds ratio for interaction, 0.38; P = 0.003). The odds of anemia were higher among women with any maternal high-risk factor than in those who did not experience any high-risk factors (adjusted odds ratio [AOR], 2.64; 95% CI, 1.24-5.63 for urban and AOR, 1.27; 95% CI, 1.01-1.61 for rural women). Exposure to a single maternal high-risk factor was significantly associated with increased odds of anemia among urban residents only (AOR, 2.61; 95% CI, 1.17-5.81). Exposure to multiple maternal high-risk factors significantly increased the odds of anemia (AOR, 2.82; 95% CI, 1.15-6.91) and (AOR, 1.55; 95% CI, 1.10-2.17) for urban and rural women, respectively. CONCLUSIONS Place of residence moderated the relationship between maternal high-risk factors and anemia. Context-specific strategies and interventions are needed to prevent anemia.
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Affiliation(s)
- Noha Fadl
- Department of Family Health, Alexandria University High Institute of Public Health, Alexandria, Egypt
| | - Gillian H Ice
- Department of Social Medicine, Ohio University Heritage College of Osteopathic Medicine. Ohio University, Athens, Ohio, USA
| | - Zelalem T Haile
- Department of Social Medicine, Ohio University Heritage College of Osteopathic Medicine. Ohio University, Dublin, Ohio, USA.
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Palacios AM, Freeland-Graves JH, Dulience SJL, Delnatus JR, Iannotti LL. Differences in factors associated with anemia in Haitian children from urban and rural areas. PLoS One 2021; 16:e0247975. [PMID: 33822795 PMCID: PMC8023464 DOI: 10.1371/journal.pone.0247975] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 02/16/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND In Haiti, differences in the prevalence of anemia between urban and rural areas have been observed. OBJECTIVE To identify moderating factors that may help explain the difference in the prevalence of anemia in children from poor urban vs. rural areas of Haiti. METHODS This cross-sectional study used secondary data from urban and rural school-based trials that assessed the effectiveness of a nutrition intervention. The study was registered at ClinicalTrials.gov as NCT02747524. A total of 300 rural- and 981 urban- children between 2.5-13 years of age were included in this analysis. Effect modification in a binary logistic generalized linear mixed model was conducted using sample weights in SPSS® version 26. Models were adjusted for age and income. School cluster was included as random effect. RESULTS In rural areas, stunting was more prevalent in children with anemia vs. no anemia, (16.6%, and 6.3%, P = 0.008), respectively. Also, rural children with anemia lived with fewer adults vs. rural children with no anemia, ([Formula: see text] = 2.83±1.29, and 3.30±1.54, P = 0.005), respectively. In poor urban areas, helminth morbidities were more frequent in children with anemia vs. no anemia, (21.9% vs. 13.9, P = 0.011), respectively. In the combined sample, stunting, [AOR = 2.05; 95%CI (1.32-3.18)], age [AOR = 0.89; 95%CI (0.85-0.93)], and households with more adults [AOR = 0.77; 95%CI (0.67-0.87)] were associated with anemia. Effect modification by place of residence was observed in households with more adults (t = 3.83, P<0.001). No other nutritional, dietary, sanitation or morbidity factors or effect modifiers were observed. CONCLUSIONS In this sample, factors associated with anemia differed in poor urban and rural children from Haiti including family structure and helminth morbidities. Stunting and lower age increased the odds of anemia in the combined sample. Family structure appears to have an important role in anemia, and further research understanding the influence of family structures in anemia is needed.
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Affiliation(s)
- Ana M. Palacios
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, United States of America
| | - Jeanne H. Freeland-Graves
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, United States of America
| | | | | | - Lora L. Iannotti
- Institute for Public Health, George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri, United States of America
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Muleta A, Hailu D, Belachew T. Camel milk consumption was associated with lower prevalence of anemia among preschool children in rural pastoral districts of Somali, eastern Ethiopia. Nutrition 2021; 86:111170. [PMID: 33601123 DOI: 10.1016/j.nut.2021.111170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 01/09/2021] [Accepted: 01/16/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study was to investigate association between consumption of camel milk (CaM) and childhood anemia. METHODS A community-based cross-sectional study was conducted with 388 preschool children (24-59 mo of age) in rural pastoral districts of Somali, eastern Ethiopia. We sampled 185 consumers of CaM and 203 who consumed bovine milk (BM). Children were selected from random households with lactating camels or cattle. Hemoglobin (Hb) was measured in the field using a HemoCue instrument. A multivariable logistic regressions model was used in SPSS version 20 to examine association between type of milk consumption and anemia. RESULTS Anemia (Hb <11 g/dL) was found in 59.8% of the overall sample, whereas it was 42.7% and 75.4% among CaM and BM consumers, respectively. The odds of anemia among BM consumers (adjusted odds ratio [aOR], 3.12; 95% confidence interval [CI], 1.27-7.66) and children with intestinal parasites (aOR: 3.32; 95% CI, 1.39-7.91) was compared with CaM consumers and children without intestinal parasites, respectively. Increasing age and height-for-age z-score of children were associated with decreased childhood anemia (P < 0.001). Children with anemia consumed a higher volume of BM compared with non-anemic and CaM consumers, too but the consumption was not statistically significant. CONCLUSION CaM consumption was associated with lower prevalence of anemia compared with consumption of BM. Promoting use of CaM as complementary food for preschool children in pastoralist areas might be considered an intervention toward reducing anemia.
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Affiliation(s)
- Anbissa Muleta
- Hawassa University, School of Nutrition, Food Science and Technology, Hawassa, Ethiopia; Jigjiga University, Department of Food Science and Nutrition, Jigjiga, Ethiopia.
| | - Dejene Hailu
- Hawassa University, Department of Public and Environmental Health, College of Health Sciences, Hawassa, Ethiopia
| | - Tefera Belachew
- Jimma University, Department of Nutrition and Dietetics, Jimma, Ethiopia
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Chronic inflammation was a major predictor and determinant factor of anemia in lactating women in Sidama zone southern Ethiopia: A cross-sectional study. PLoS One 2020; 15:e0240254. [PMID: 33017433 PMCID: PMC7535025 DOI: 10.1371/journal.pone.0240254] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 09/22/2020] [Indexed: 11/29/2022] Open
Abstract
Anemia in women of reproductive age is highly prevalent globally and remains a public health problem. In Ethiopia, despite efforts to minimize the burden of anemia, it is still a moderate public health problem. Anemia has various etiologies including nutritional deficiency, parasitic infection, and inflammation. The aim of this study was to examine contributing factors to anemia in lactating women. Following ethical approval, and six months after delivery, all lactating women (n = 150) were recruited to participate in this study from eight randomly selected rural villages. Anthropometric and socio-economic factors were assessed. From each, a blood sample was collected for measuring hemoglobin, iron biomarkers, zinc, selenium, and inflammation markers. The median (IQR) hemoglobin (Hb) was 132 (123, 139) g/L. Of the women, 19% were anemic and 7% had iron deficiency anemia; 31% were iron deficient and 2% had iron overload. Also, 8% had functional iron deficit, 6% had acute inflammation, 13% had chronic inflammation, and 16% had tissue iron deficiency. The majority (78%) of the women had low plasma zinc out of which more than 16% were anemic. Hb was positively associated with plasma iron and plasma zinc and negatively associated with transferrin receptor (TfR) and α-1-acid glycoprotein (AGP). Plasma iron, AGP, TfR, hepcidin and plasma zinc were significant predictors of maternal anemia. Additionally MUAC and level of education were associated positively with maternal hemoglobin. This study showed that maternal anemia was associated with multiple factors including nutritional deficiencies, inflammation and limited education.
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Baum A, Elize W, Jean-Louis F. Microfinance Institutions' Successful Delivery Of Micronutrient Powders: A Randomized Trial In Rural Haiti. Health Aff (Millwood) 2018; 36:1938-1946. [PMID: 29137512 DOI: 10.1377/hlthaff.2017.0281] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Globally, two-thirds of child deaths could be prevented by increased provision of health interventions such as vaccines, micronutrient supplements, and water purification tablets. We report the results from a randomized controlled trial in Haiti during 2012 that tested whether microfinance institutions-which reach 200 million households worldwide-can effectively deliver health products. These institutions provide loans to underserved entrepreneurs, primarily poor women in rural areas. In the intervention group, micronutrient powders to improve the nutrition of young children were distributed at regularly occurring microfinance meetings by a trained borrower. In both the control and the intervention groups, nurses led seminars on nutrition and extended breastfeeding during microfinance meetings. At three-month follow-up, the mean difference in hemoglobin concentration between children in the intervention group and those in the control group was 0.28 grams per deciliter (g/dL)-with a subsample of younger children (under two years of age) showing greater relative improvement (0.46 g/dL)-and the odds ratio for children in the intervention group meeting the diagnostic criteria for anemia was 0.64. The results are similar to those of previous studies that evaluated micronutrient powder distribution through dedicated health institutions. Our findings suggest that microfinance institutions are a promising platform for the large-scale delivery of health products in low-income countries.
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Affiliation(s)
- Aaron Baum
- Aaron Baum ( ) is an assistant professor of health system design and global health at the Icahn School of Medicine at Mount Sinai and an economist at the Arnhold Institute for Global Health, both in New York City
| | - Wesly Elize
- Wesly Elize is a physician and health project officer at Fonkoze, in Port-au-Prince, Haiti
| | - Florence Jean-Louis
- Florence Jean-Louis is a physician and human development director at Fonkoze
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Séraphin MN, Xinguang C, Ayoya MA, Ngnie-Teta I, Boldon E, Mamadoultaibou A, Saint-Fleur JE, Pierre I. Childhood anemia in Rural Haiti: the potential role of community health workers. Glob Health Res Policy 2017; 2:3. [PMID: 29202071 PMCID: PMC5683206 DOI: 10.1186/s41256-016-0022-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 12/12/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Childhood iron deficiency anemia (IDA) is an important contributor to under-five mortality in the developing world. There is evidence that Community Health Worker (CHW) delivered programs to increase maternal knowledge of child health practices may decrease childhood IDA. This study reports findings on the association between a long standing CHW intervention and childhood anemia status in rural Haiti. METHODS Using structural equations and mediation analyses on data from a household-based survey of 621 mother/child dyads, we tested the hypothesis that CHW would have a direct positive effect on maternal knowledge and an indirect effect on childhood anemia in rural Haiti. RESULTS CHW contact was significantly associated with maternal knowledge of key child health practices (β = 0.193, SE = 0.058, p = 0.001). However, knowledge was not associated with childhood anemia (β = -0.008, SE = 0.009, p = 0.382). Maternal knowledge categories significantly affected by CHW contact included diarrheal prevention knowledge (β = 0.111, SE = 0.045, p = 0.013) and signs of malnutrition (β = 0.217, SE = 0.071, p = 0.002). There was no significant association with knowledge of vitamin A and iron rich foods (β = 0.057, SE = 0.032, p = 0.074), which is the intervention most likely to impact childhood anemia. In all path models tested, we identified the control variables low household socio-economic status, mothers' anemia status, and child's age less than 24 months as significant predictors of childhood anemia. CONCLUSIONS CHWs delivered interventions are associated with improved maternal knowledge of child health practices in rural Haiti; however, this knowledge is not associated with improved childhood anemia. Concurrently with CHW-delivered programs, interventions household poverty are implied to impact childhood health outcomes in resource poor settings.
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Affiliation(s)
- Marie N. Séraphin
- Department of Medicine, Division of Infectious Diseases and Global Medicine, University of Florida, 2055 Mowry Road, Suite 250, PO Box 103600, Gainesville, FL 32610-3600 USA
- Department of Epidemiology, College of Public Health and Health Professions and the College of Medicine, University of Florida, Gainesville, FL USA
| | - Chen Xinguang
- Department of Epidemiology, College of Public Health and Health Professions and the College of Medicine, University of Florida, Gainesville, FL USA
| | - Mohamed Ag Ayoya
- UNICEF Country Office, 125 Rue Faubert, Petionville, Port-au-Prince Haiti
| | - Ismael Ngnie-Teta
- UNICEF Country Office, 125 Rue Faubert, Petionville, Port-au-Prince Haiti
| | - Ellen Boldon
- St. Boniface Haïti Foundation, 12 Rue E. Guello, Fond des Blancs, Haiti
| | | | | | - Inobert Pierre
- St. Boniface Haïti Foundation, 12 Rue E. Guello, Fond des Blancs, Haiti
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Weppelmann TA, von Fricken ME, Masse R, Gelin G, Morris JG, Okech BA, De Rochars VMB. Indicators of anemia and physical growth in schoolchildren from the Ouest and Sud-Est Departments of Haiti: a cross-sectional study. BMC Nutr 2016. [DOI: 10.1186/s40795-016-0107-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Iannotti LL, Delnatus JR, Odom AR, Eaton JC, Griggs JJ, Brown S, Wolff PB. Determinants of Anemia and Hemoglobin Concentration in Haitian School-Aged Children. Am J Trop Med Hyg 2015; 93:1092-8. [PMID: 26350448 PMCID: PMC4703262 DOI: 10.4269/ajtmh.15-0073] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 06/25/2015] [Indexed: 02/04/2023] Open
Abstract
Anemia diminishes oxygen transport in the body, resulting in potentially irreversible growth and developmental consequences for children. Limited evidence for determinants of anemia exists for school-aged children. We conducted a cluster randomized controlled trial in Haiti from 2012 to 2013 to test the efficacy of a fortified school snack. Children (N = 1,047) aged 3-13 years were followed longitudinally at three time points for hemoglobin (Hb) concentrations, anthropometry, and bioelectrical impedance measures. Dietary intakes, infectious disease morbidities, and socioeconomic and demographic factors were collected at baseline and endline. Longitudinal regression modeling with generalized least squares and logit models with random effects identified anemia risk factors beyond the intervention effect. At baseline, 70.6% of children were anemic and 2.6% were severely anemic. Stunting increased the odds of developing anemia (adjusted odds ratio [OR]: 1.48, 95% confidence interval [CI]: 1.05-2.08) and severe anemia (adjusted OR: 2.47, 95% CI: 1.30-4.71). Parent-reported vitamin A supplementation and deworming were positively associated with Hb concentrations, whereas fever and poultry ownership showed a negative relationship with Hb concentration and increased odds of severe anemia, respectively. Further research should explore the full spectrum of anemia etiologies in school children, including genetic causes.
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Affiliation(s)
- Lora L Iannotti
- Institute for Public Health, George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri; Meds and Food for Kids, Cap Haitien, Haiti; Department of Pediatrics Washington University School of Medicine, St. Louis, Missouri; Department of Medicine, University of Michigan, Ann Arbor, Michigan; Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri
| | - Jacques R Delnatus
- Institute for Public Health, George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri; Meds and Food for Kids, Cap Haitien, Haiti; Department of Pediatrics Washington University School of Medicine, St. Louis, Missouri; Department of Medicine, University of Michigan, Ann Arbor, Michigan; Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri
| | - Audrey R Odom
- Institute for Public Health, George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri; Meds and Food for Kids, Cap Haitien, Haiti; Department of Pediatrics Washington University School of Medicine, St. Louis, Missouri; Department of Medicine, University of Michigan, Ann Arbor, Michigan; Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri
| | - Jacob C Eaton
- Institute for Public Health, George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri; Meds and Food for Kids, Cap Haitien, Haiti; Department of Pediatrics Washington University School of Medicine, St. Louis, Missouri; Department of Medicine, University of Michigan, Ann Arbor, Michigan; Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri
| | - Jennifer J Griggs
- Institute for Public Health, George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri; Meds and Food for Kids, Cap Haitien, Haiti; Department of Pediatrics Washington University School of Medicine, St. Louis, Missouri; Department of Medicine, University of Michigan, Ann Arbor, Michigan; Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri
| | - Sarah Brown
- Institute for Public Health, George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri; Meds and Food for Kids, Cap Haitien, Haiti; Department of Pediatrics Washington University School of Medicine, St. Louis, Missouri; Department of Medicine, University of Michigan, Ann Arbor, Michigan; Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri
| | - Patricia B Wolff
- Institute for Public Health, George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri; Meds and Food for Kids, Cap Haitien, Haiti; Department of Pediatrics Washington University School of Medicine, St. Louis, Missouri; Department of Medicine, University of Michigan, Ann Arbor, Michigan; Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri
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Wang J, Wang H, Chang S, Zhao L, Fu P, Yu W, Man Q, Scherpbier R, Pan L, Duan Y, Yin SA. The Influence of Malnutrition and Micronutrient Status on Anemic Risk in Children under 3 Years Old in Poor Areas in China. PLoS One 2015; 10:e0140840. [PMID: 26488490 PMCID: PMC4619061 DOI: 10.1371/journal.pone.0140840] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 09/29/2015] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Malnutrition and anemia affect large numbers of young children living in poor areas of China. Multi-micronutrient deficiencies may be related to the prevalence of anemia in different populations, and identifying the risk factors that render children susceptible to anemia is the first step in combating anemia effectively. METHODS In this cross-sectional study, a total of 1370 children under 3 years old were selected based on probability proportional to size sampling principles from poor counties of China. Basic characteristics data were collected by questionnaire; then anthropometrics and hemoglobin were measured in the field and anemia prevalence evaluated. Venous blood was drawn from children aged 12-35 months (N = 553) to evaluate micronutrient status. Logistic regression was used to identify the risk factors for children's anemia. RESULTS Among children aged 0-35 months, the prevalence of stunting, low body weight and wasting was 17.5%, 8.6% and 5.1%, respectively, and 25.6% of the children were affected by anemia, with more anemic infants and younger children than older children (P <0.01). There were 26.5%, 12.8%, 14.1% and 20.0% of the children aged 12-35 months affected by iron deficiency, vitamin D deficiency, folic acid deficiency and vitamin B12 deficiency, respectively. For children aged 0-11 months who were breastfed, the mothers' anemic status was the only factor associated with the child's anemia (OR = 2.6; 95% CI: 1.2-5.4, P < 0.05). For children aged 12-35 months, multivariate logistic regression indicated that anemia was significantly associated with iron and vitamin B12 deficiency (OR = 5.3; 95% CI: 1.9-14.5, P < 0.01) and monotonous diet (OR = 2.3; 95% CI: 1.1-4.7, P < 0.05) after adjusting for age and gender. CONCLUSION The prevalence of anemia was higher in children under 2 years old and requires urgent intervention. An effective intervention strategy should include iron and vitamin B12 supplements, improving dietary diversity and controlling breastfeeding mothers' anemia.
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Affiliation(s)
- Jie Wang
- Department of Maternal and Child Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hui Wang
- Department of Population Research, China Population and Development Research Center, Beijing, China
| | - Suying Chang
- Section of Health and Nutrition and Water, Environment and Sanitation, United Nations Children’s Fund, Beijing, China
| | - Liyun Zhao
- Department of Nutrition Surveillance, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ping Fu
- Department of Nutrition on Aging, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wentao Yu
- Department of Nutrition Surveillance, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qingqing Man
- Department of Nutrition on Aging, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Robert Scherpbier
- Section of Health and Nutrition and Water, Environment and Sanitation, United Nations Children’s Fund, Beijing, China
| | - Lili Pan
- Department of Maternal and Child Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yifan Duan
- Department of Maternal and Child Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shi-an Yin
- Department of Maternal and Child Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
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Legha RK, Solages M. Child and Adolescent Mental Health in Haiti: Developing Long-Term Mental Health Services After the 2010 Earthquake. Child Adolesc Psychiatr Clin N Am 2015; 24:731-49. [PMID: 26346386 DOI: 10.1016/j.chc.2015.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article presents an overview of child and adolescent mental health in Haiti, emphasizing the role of structural violence and the factors shaping child protection. The 2010 Haiti earthquake is discussed as an acute on chronic event that highlighted the lack of pre-existing formal biomedical mental health services and worsened the impact of structural violence. Considerations for long-term, sustainable, culturally relevant child and adolescent mental health care in Haiti are also provided.
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Affiliation(s)
- Rupinder K Legha
- Dr. Mario Pagenel Fellow in Global Mental Health Service Delivery, Partners in Health, 888 Commonwealth Avenue, Boston, MA 02215, USA; Program in Global Mental Health and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA 02115, USA.
| | - Martine Solages
- Department of Psychiatry and Behavioral Sciences, Children's National Medical Center, 111 Michigan Avenue, Northwest, Washington, DC 20010, USA
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Prevalence and determinants of anaemia among children aged 0–59 months in a rural region of Armenia: a case–control study. Public Health Nutr 2015; 19:1260-9. [DOI: 10.1017/s1368980015002451] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveDespite the trend of increasing prevalence of childhood anaemia in Armenia, no studies exploring its risk factors have been conducted in the country. The present study aimed to investigate the prevalence and determinants of childhood anaemia in rural Armenia.DesignBlood Hb level was measured among a representative sample of children using the HemoCue Hb201+ analyser. The revealed cases with anaemia were compared with randomly selected non-anaemic controls. Mothers of cases and controls were interviewed. Logistic and linear regression models were fitted to identify the risk factors of anaemia and low Hb level, respectively.SettingTalin communities, Aragatsotn Province, Armenia.SubjectsChildren under 5 years of age in Talin region.ResultsOf the 729 studied children, 32·4 % were anaemic with 14·7 % having moderate/severe anaemia. Infants were the most affected group with 51·1 % being anaemic before 6 months and 67·9 % at 6–12 months of age. Fitted regression models identified the following predictors of anaemia: younger age, male gender, shorter birth length, anaemia during pregnancy, lower meal frequency per day, lack of meat in the diet, using dung cakes for heating and living in a community that received an incomplete set of nutrition interventions.ConclusionsThe study identified several modifiable risk factors that could be targeted to reduce childhood anaemia in rural Armenia and, possibly, in rural areas in other low-/middle-income countries. The suggested interventions include prevention and treatment of anaemia during pregnancy, provision of adequate complementary feeding to children with inclusion of meat in their daily diet and reduction of their exposure to biomass fuel smoke.
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Ayoya MA, Heidkamp R, Ngnie‐Teta I, Mamadoultaibou A, Daniel EF, Durandisse EB, Saint‐Fleur JE, Beaulière JM, Koita Y, M'Mbakwa BE, Stoltzfus RJ, Pierre JM. Précis of nutrition of children and women in Haiti: analyses of data from 1995 to 2012. Ann N Y Acad Sci 2014; 1309:37-62. [DOI: 10.1111/nyas.12373] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - Rebecca Heidkamp
- Division of Nutritional Sciences Cornell University Ithaca New York
| | | | | | | | | | | | | | - Youssouf Koita
- Nutrition Section UNICEF Country Office Port‐au‐Prince Haiti
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