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Davies-Kershaw H, Fahmida U, Htet MK, Kulkarni B, Faye B, Yanti D, Shinta D, Zahra NL, Angelin TC, Madhari R, Pullakhandam R, Palika R, Dasi T, Fernandez Rao S, Banjara SK, Selvaraj K, Palepu DP, Yadev D, Diouf S, Lopez-Sall P, Diallo B, Mouissi P, Fall S, Diallo I, Djigal A, Immerzeel TDV, Tairou F, Diop A, Pradeilles R, Strout S, Momo Kadia B, Tata DT, Jobarteh ML, Allen S, Walker A, Webster JP, Haggarty P, Heffernan C, Ferguson E. Anthropometric, biochemical, dietary, morbidity and well-being assessments in women and children in Indonesia, India and Senegal: a UKRI GCRF Action Against Stunting Hub protocol paper. BMJ Paediatr Open 2024; 8:e001683. [PMID: 38417920 PMCID: PMC10910654 DOI: 10.1136/bmjpo-2022-001683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 03/28/2023] [Indexed: 03/01/2024] Open
Abstract
INTRODUCTION Child stunting has a complex aetiology, especially in the first 1000 days of life. Nutrition interventions alone have not produced expected impacts in reducing/preventing child stunting, indicating the importance of understanding the complex interplay between environmental, physiological and psychological factors influencing child nutritional status. This study will investigate maternal and child nutrition, health and well-being status and associated factors through the assessment of: (1) anthropometry, (2) biomarkers of nutrition and health status, (3) dietary intakes, (4) fetal growth and development, (5) infant morbidity, (6) infant and young child feeding (IYCF) and (7) perinatal maternal stress, depression and social support. METHODS This study will be conducted in a prospective pregnancy cohort in India, Indonesia and Senegal. Pregnant women will be recruited in the second (Indonesia, Senegal) and third (India) trimester of pregnancy, and the mother and infant dyads followed until the infant is 24 months of age. During pregnancy, anthropometric measures will be taken, venous blood samples will be collected for biochemical assessment of nutrition and health status, dietary intakes will be assessed using a 4-pass-24-hour dietary recall method (MP24HR), fetal ultrasound for assessment of fetal growth. After birth, anthropometry measurements will be taken, venous blood samples will be collected, MP24HR will be conducted, infant morbidity and IYCF practices will be assessed and a sample of breastmilk will be collected for nutrient composition analyses. Perinatal maternal stress, depression, social support and hair cortisol levels (stress) will be measured. The results from this study will be integrated in an interdisciplinary analysis to examine factors influencing infant growth and inform global efforts in reducing child stunting. ETHICS AND DISSEMINATION Ethical approval was granted by the Ethics Committee of the London School of Hygiene and Tropical Medicine (17915/RR/17513); National Institute of Nutrition (ICMR)-Ministry of Health and Family Welfare, Government of India (CR/04/I/2021); Health Research Ethics Committee, University of Indonesia and Cipto Mangunkusumo Hospital (KET-887/UN2.F1/ETIK/PPM.00.02/2019); and the Comité National d'Ethique pour la Recherche en Santé, Senegal (Protocole SEN19/78); the Royal Veterinary College (URN SR2020-0197) and the International Livestock Research Institute Institutional Research Ethics Committee (ILRI-IREC2020-33). Results will be published in peer-reviewed journals and disseminated to policy-makers and participating communities.
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Affiliation(s)
- Hilary Davies-Kershaw
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Umi Fahmida
- Regional Centre for Food and Nutrition, SEAMEO, University of Indonesia, Jakarta, Indonesia
| | - Min Kyaw Htet
- Regional Centre for Food and Nutrition, SEAMEO, University of Indonesia, Jakarta, Indonesia
| | - Bharati Kulkarni
- Deparments of Maternal and Child Health and Dietetics Division, National Institute of Nutrition, Hyderabad, India
| | - Babacar Faye
- Service de Parasitologie-Mycologie- Pédiatrie, Faculté de médecine, UCAD, Dakar, Senegal
| | - Dwi Yanti
- Regional Centre for Food and Nutrition, SEAMEO, University of Indonesia, Jakarta, Indonesia
| | - Dewi Shinta
- Regional Centre for Food and Nutrition, SEAMEO, University of Indonesia, Jakarta, Indonesia
| | - Nur L Zahra
- Regional Centre for Food and Nutrition, SEAMEO, University of Indonesia, Jakarta, Indonesia
| | - Tiffany C Angelin
- Regional Centre for Food and Nutrition, SEAMEO, University of Indonesia, Jakarta, Indonesia
| | - Radhika Madhari
- Deparments of Maternal and Child Health and Dietetics Division, National Institute of Nutrition, Hyderabad, India
| | - Raghu Pullakhandam
- Deparments of Maternal and Child Health and Dietetics Division, National Institute of Nutrition, Hyderabad, India
| | - Ravindranadh Palika
- Deparments of Maternal and Child Health and Dietetics Division, National Institute of Nutrition, Hyderabad, India
| | - Teena Dasi
- Deparments of Maternal and Child Health and Dietetics Division, National Institute of Nutrition, Hyderabad, India
| | - Sylvia Fernandez Rao
- Deparments of Maternal and Child Health and Dietetics Division, National Institute of Nutrition, Hyderabad, India
| | - Santosh Kumar Banjara
- Deparments of Maternal and Child Health and Dietetics Division, National Institute of Nutrition, Hyderabad, India
| | - Kiruthika Selvaraj
- Deparments of Maternal and Child Health and Dietetics Division, National Institute of Nutrition, Hyderabad, India
| | - Dharani Pratyusha Palepu
- Deparments of Maternal and Child Health and Dietetics Division, National Institute of Nutrition, Hyderabad, India
| | - Dinesh Yadev
- Department of Public Health, London International Development Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Saliou Diouf
- Service de Parasitologie-Mycologie- Pédiatrie, Faculté de médecine, UCAD, Dakar, Senegal
| | - Philomene Lopez-Sall
- Service de Parasitologie-Mycologie- Pédiatrie, Faculté de médecine, UCAD, Dakar, Senegal
| | - Babacar Diallo
- Service de Parasitologie-Mycologie- Pédiatrie, Faculté de médecine, UCAD, Dakar, Senegal
| | - Princillia Mouissi
- Service de Parasitologie-Mycologie- Pédiatrie, Faculté de médecine, UCAD, Dakar, Senegal
| | - Sally Fall
- Service de Parasitologie-Mycologie- Pédiatrie, Faculté de médecine, UCAD, Dakar, Senegal
| | - Ibrahima Diallo
- Service de Parasitologie-Mycologie- Pédiatrie, Faculté de médecine, UCAD, Dakar, Senegal
| | - Aicha Djigal
- Service de Parasitologie-Mycologie- Pédiatrie, Faculté de médecine, UCAD, Dakar, Senegal
| | | | - Fassia Tairou
- Service de Parasitologie-Mycologie- Pédiatrie, Faculté de médecine, UCAD, Dakar, Senegal
| | - Assana Diop
- Service de Parasitologie-Mycologie- Pédiatrie, Faculté de médecine, UCAD, Dakar, Senegal
| | - Rebecca Pradeilles
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- UMR, MOISA, Montpellier, France
| | - Sara Strout
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Benjamin Momo Kadia
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Darius Tetsa Tata
- Department of Public Health, London International Development Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Modou Lamin Jobarteh
- Department of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Stephen Allen
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Alan Walker
- The Rowett Institute, University of Aberdeen, Aberdeen, UK
| | - Joanne P Webster
- Department of Pathobiology and Population Sciences, University of London, London, UK
| | - Paul Haggarty
- The Rowett Institute, University of Aberdeen, Aberdeen, UK
| | - Claire Heffernan
- Department of Public Health, London International Development Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Elaine Ferguson
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
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Bhaise S, Patel A, Dhurde V, Almeida M, Do T, Muthayya S, Dibley M. Development of mobile phone-based dietary data collection applications in pregnant women and infants for the M-SAKHI trial. J Nutr Sci 2023; 12:e124. [PMID: 38155806 PMCID: PMC10753473 DOI: 10.1017/jns.2023.95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 09/16/2023] [Accepted: 10/13/2023] [Indexed: 12/30/2023] Open
Abstract
In nutritional epidemiological studies, it is imperative to collect high-quality data to ensure accurate dietary assessment. However, dietary data collection using traditional paper forms has several limitations that may compromise data quality. The aim of this study was to propose novel methods to design and develop software applications (Apps) for dietary data collection to assess the nutritional status of pregnant women and infants. This study is part of the M-SAKHI (Mobile-Solutions for Aiding Knowledge for Health Improvement) cluster randomised controlled trial (cRCT) implemented in central India. Three tablet-based software Apps were developed in this study: the ACEC (Automated Coding and Energy Calculation) App to establish a generic cooked food recipe database, the FFQ (Food Frequency Questionnaire), and the IDR (24 h Infant Dietary Recall) Apps to collect dietary data from pregnant women and their infants from rural area of Bhandara and Nagpur districts. Regional food lists, recipes, and portion resource kits were developed to support the data collection using the Apps. In conclusion, the Apps were user-friendly, required minimal prior training, had built-in validation checks for erroneous data entry and provided automated calculations. The Apps were successfully deployed in low-resource rural settings to accurately collect high-quality regional cooked food data and individual-level dietary data of pregnant women and their infants.
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Affiliation(s)
- Shilpa Bhaise
- Lata Medical Research Foundation, Nagpur, Maharashtra, India
| | - Archana Patel
- Lata Medical Research Foundation, Nagpur, Maharashtra, India
- Datta Meghe Institute of Medical Sciences, Sawangi, Maharashtra, India
| | - Varsha Dhurde
- Lata Medical Research Foundation, Nagpur, Maharashtra, India
| | - Michelle Almeida
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Tran Do
- National Institute of Nutrition, Hanoi, Vietnam
| | | | - Michael Dibley
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
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The cost and cost efficiency of conducting a 24-h dietary recall using INDDEX24, a mobile dietary assessment platform, compared with pen-and-paper interview in Viet Nam and Burkina Faso. Br J Nutr 2023; 129:535-549. [PMID: 35508922 PMCID: PMC9876804 DOI: 10.1017/s0007114522001362] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The INDDEX24 Dietary Assessment Platform (INDDEX24) was developed to facilitate the collection of 24-h dietary recall (24HR) data. Alongside validation studies in Viet Nam and Burkina Faso in 2019-2020, we conducted activity-based costing studies to estimate the cost of conducting a 24HR among women of reproductive age using INDDEX24 compared with the pen-and-paper interview (PAPI) approach. We also modelled alternative scenarios in which: (1) 25-75 % of dietary reference data were borrowed from the INDDEX24 Global Food Matters Database (FMDB); (2) all study personnel were locally based and (3) national-scale surveys. In the primary analysis, in Viet Nam, the 24HR cost US $111 004 ($755/respondent, n 147) using INDDEX24 and $120 483 ($820/respondent, n 147) using PAPI. In Burkina Faso, the 24HR cost $78 105 ($539/respondent, n 145) using INDDEX24 and $79 465 ($544/respondent, n 146) using PAPI. In modelled scenarios, borrowing dietary reference data from the FMDB decreased the cost of INDDEX24 by 17-34 % (Viet Nam) and 5-15 % (Burkina Faso). With all locally based personnel, INDDEX24 cost more than PAPI ($498 v. $448 per respondent in Viet Nam and $456 v. $410 in Burkina Faso). However, at national scales (n 4376, Viet Nam; n 6500, Burkina Faso) using all locally based personnel, INDDEX24 was more cost-efficient ($109 v. $137 per respondent in Viet Nam and $123 v. $148 in Burkina Faso). In two countries and under most circumstances, INDDEX24 was less expensive than PAPI. Higher INDDEX24 survey preparation costs (including purchasing equipment) were more than offset by higher PAPI data entry, cleaning and processing costs. INDDEX24 may facilitate cost-efficient dietary data collection.
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Mata JDS, Freitas JV, Crispim SP, Interlenghi GS, Magno MB, Ferreira DMTP, Araujo MC. Technological tools for assessing children's food intake: a scoping review. J Nutr Sci 2023; 12:e43. [PMID: 37123397 PMCID: PMC10131056 DOI: 10.1017/jns.2023.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 05/02/2023] Open
Abstract
Technological innovations can standardise and minimise reporting errors in dietary assessment. This scoping review aimed to summarise the characteristics of technological tools used to assess children's food intake. The review followed the Joanna Briggs Institute's manual. The main inclusion criterion was studied that assessed the dietary intake of children 0-9 years of age using technology. We also considered articles on validation and calibration of technologies. We retrieved 15 119 studies and 279 articles were read in full, after which we selected 93 works that met the eligibility criteria. Forty-six technologies were identified, 37 % of which had been developed in Europe and 32⋅6 % in North America; 65⋅2 % were self-administered; 27 % were used exclusively at home; 37 % involved web-based software and more than 80 % were in children over 6 years of age. 24HR was the most widely used traditional method in the technologies (56⋅5 %), and 47⋅8 % of the tools were validated. The review summarised helpful information for studies on using existing tools or that intend to develop or validate tools with various innovations. It focused on places with a shortage of such technologies.
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Affiliation(s)
- Jonas de Souza Mata
- Emília de Jesus Ferreiro School of Nutrition, Federal Fluminense University, Niterói, RJ, Brazil
| | - Jade Veloso Freitas
- Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rua São Francisco Xavier, 524, 7° andar, bloco E, sala 6004, Maracanã, Rio de Janeiro, RJ CEP 20550-900, Brazil
- Corresponding author: Jade Veloso Freitas, Email
| | | | | | - Marcela Baraúna Magno
- Associate Professor of Graduate Studies in Dentistry, Veiga de Almeida University, Rio de Janeiro, RJ, Brazil
| | | | - Marina Campos Araujo
- Sérgio Arouca National School of Public Health, Oswaldo Cruz Foundation, Ministry of Health, Rio de Janeiro, RJ, Brazil
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Validation of the INDDEX24 mobile app v. a pen-and-paper 24-hour dietary recall using the weighed food record as a benchmark in Burkina Faso. Br J Nutr 2022; 128:1817-1831. [PMID: 34823617 PMCID: PMC9592947 DOI: 10.1017/s0007114521004700] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Effective nutrition policies require timely, accurate individual dietary consumption data; collection of such information has been hampered by cost and complexity of dietary surveys and lag in producing results. The objective of this work was to assess accuracy and cost-effectiveness of a streamlined, tablet-based dietary data collection platform for 24-hour individual dietary recalls (24HR) administered using INDDEX24 platform v. a pen-and-paper interview(PAPI) questionnaire, with weighed food record (WFR) as a benchmark. This cross-sectional comparative study included women 18-49 years old from rural Burkina Faso (n 116 INDDEX24; n 115 PAPI). A WFR was conducted; the following day, a 24HR was administered by different interviewers. Food consumption data were converted into nutrient intakes. Validity of 24HR estimates of nutrient and food group consumption was based on comparison with WFR using equivalence tests (group level) and percentages of participants within ranges of percentage error (individual level). Both modalities performed comparably estimating consumption of macro- and micronutrients, food groups and quantities (modalities' divergence from WFR not significantly different). Accuracy of both modalities was acceptable (equivalence to WFR significant at P < 0·05) at group level for macronutrients, less so for micronutrients and individual-level consumption (percentage within ±20 % for WFR, 17-45 % for macronutrients, 5-17 % for micronutrients). INDDEX24 was more cost-effective than PAPI based on superior accuracy of a composite nutrient intake measure (but not gram amount or item count) due to lower time and personnel costs. INDDEX24 for 24HR dietary surveys linked to dietary reference data shows comparable accuracy to PAPI at lower cost.
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Long Z, Huang S, Zhang J, Zhang D, Yin J, He C, Zhang Q, Xu H, He H, Sun HC, Xie K. A Digital Smartphone-Based Self-administered Tool (R+ Dietitian) for Nutritional Risk Screening and Dietary Assessment in Hospitalized Patients With Cancer: Evaluation and Diagnostic Accuracy Study. JMIR Form Res 2022; 6:e40316. [PMID: 36287601 PMCID: PMC9647468 DOI: 10.2196/40316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Malnutrition is a common and severe problem in patients with cancer that directly increases the incidence of complications and significantly deteriorates quality of life. Nutritional risk screening and dietary assessment are critical because they are the basis for providing personalized nutritional support. No digital smartphone-based self-administered tool for nutritional risk screening and dietary assessment among hospitalized patients with cancer has been developed and evaluated. OBJECTIVE This study aims to develop a digital smartphone-based self-administered mini program for nutritional risk screening and dietary assessment for hospitalized patients with cancer and to evaluate the validity of the mini program. METHODS We have developed the R+ Dietitian mini program, which consists of 3 parts: (1) collection of basic information of patients, (2) nutritional risk screening, and (3) dietary energy and protein assessment. The face-to-face paper-based Nutritional Risk Screening (NRS-2002), the Patient-Generated Subjective Global Assessment Short Form (PG-SGA-SF), and 3 days of 24-hour dietary recall (3d-24HRs) questionnaires were administered according to standard procedure by 2 trained dietitians as the reference methods. Sensitivity, specificity, positive predictive value, negative predictive value, κ value, and correlation coefficients (CCs) of nutritional risk screened in R+ Dietitian against the reference methods, as well as the difference and CCs of estimated dietary energy and protein intakes between R+ Dietitian and 3d-24HRs were calculated to evaluate the validity of R+ Dietitian. RESULTS A total of 244 hospitalized patients with cancer were recruited to evaluate the validity of R+ Dietitian. The NRS-2002 and PG-SGA-SF tools in R+ Dietitian showed high accuracy, sensitivity, and specificity (77.5%, 81.0%, and 76.7% and 69.3%, 84.5%, and 64.5%, respectively), and fair agreement (κ=0.42 and 0.37, respectively; CC 0.62 and 0.56, respectively) with the NRS-2002 and PG-SGA-SF tools administered by dietitians. The estimated intakes of dietary energy and protein were significantly higher (P<.001 for both) in R+ Dietitian (mean difference of energy intake: 144.2 kcal, SD 454.8; median difference of protein intake: 10.7 g, IQR 9.5-39.8), and showed fair agreement (CC 0.59 and 0.47, respectively), compared with 3d-24HRs performed by dietitians. CONCLUSIONS The identified nutritional risk and assessment of dietary intakes of energy and protein in R+ Dietitian displayed a fair agreement with the screening and assessment conducted by dietitians. R+ Dietitian has the potential to be a tool for nutritional risk screening and dietary intake assessment among hospitalized patients with cancer. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1900026324; https://www.chictr.org.cn/showprojen.aspx?proj=41528.
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Affiliation(s)
| | - Shan Huang
- Department of Oncology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Jie Zhang
- Department of Oncology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Deng Zhang
- Department of Oncology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
| | - Jun Yin
- Recovery Plus Clinic, Chengdu, China
| | | | - Qinqiu Zhang
- Recovery Plus Clinic, Chengdu, China
- College of Food Science, Sichuan Agricultural University, Ya'an, China
| | - Huilin Xu
- Recovery Plus Clinic, Chengdu, China
| | - Huimin He
- Recovery Plus Clinic, Chengdu, China
| | | | - Ke Xie
- Department of Oncology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
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Accuracy and cost-effectiveness of the INDDEX24 Dietary Assessment Platform in Viet Nam. Br J Nutr 2022; 129:1751-1764. [PMID: 35587720 PMCID: PMC10116183 DOI: 10.1017/s0007114522001507] [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: 01/20/2023]
Abstract
Technology-enabled approaches to conducting 24-h dietary recalls (24HR) may reduce dietary assessment bottlenecks in low-resource settings. However, few studies have assessed their performance relative to conventional pen-and-paper interview (PAPI) approaches and none have validated performance against a benchmark (e.g. weighed food record (WFR)) in a low- and middle-income country (LMIC). This study assessed relative accuracy and cost-effectiveness of INDDEX24, a technology-enabled approach to conducting 24HR, compared with a PAPI approach and against an observer WFR. Women aged 18-49 years from northern Viet Nam (n 234) were randomly assigned to be interviewed using INDDEX24 or PAPI 24HR following a WFR. The two one-sided t test approach assessed the equivalence of each recall modality to the benchmark. Difference-in-differences analysis compared the recall-benchmark results across modalities. Cost per percentage point of accuracy for INDDEX24 and PAPI was derived from accuracy results and the cost to conduct the 24HR. The PAPI and INDDEX24 24HR were statistically equivalent to the WFR for all nutrients except vitamin A. INDDEX24 diverged significantly less than PAPI from the WFR for Fe (0·9 v. -1·3 mg) and PAPI diverged less for protein (-3·7 v. 7·9 g). At the individual level, 26 % of PAPI and 32 % of INDDEX24 respondents had energy intakes within +/- 10 % of the WFR. INDDEX24 cost $111 004 and the PAPI cost $120 483 (USD 2019), making INDDEX24 more cost-effective across most indicators. INDDEX24 was an accurate and cost-effective method for assessing dietary intake in the study context and represents a preferred alternative to PAPI 24HR in Viet Nam and other LMIC.
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Ambikapathi R, Irema I, Lyatuu I, Caswell B, Mosha D, Nyamsangia S, Galvin L, Mangara A, Boncyk M, Froese SL, Verissimo CK, Itatiro J, Kariathi V, Kazonda P, Wandella M, Fawzi W, Killewo J, Mwanyika-Sando M, PrayGod G, Leyna G, Patil C, Gunaratna NS. Gender and Age Differences in Meal Structures, Food Away from Home, Chrono-Nutrition, and Nutrition Intakes among Adults and Children in Tanzania Using a Newly Developed Tablet-Based 24-Hour Recall Tool. Curr Dev Nutr 2022; 6:nzac015. [PMID: 35317413 PMCID: PMC8929990 DOI: 10.1093/cdn/nzac015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 01/18/2022] [Accepted: 01/26/2022] [Indexed: 12/04/2022] Open
Abstract
Background In many regions of the world, little is known about meal structures, meal patterns, and nutrient intake because the collection of quantitative dietary intake is expensive and labor-intensive. Objectives We describe the development and field feasibility of a tablet-based Tanzania 24-h recall tool (TZ-24hr-DR) and dietary intakes collected from adults and children in rural and urban settings. Methods Using the Tanzanian food-composition table, the TZ-24hr-DR tool was developed on an Android platform using the Open Data Kit. The module provides food lists, meal lists, ingredient lists, quantity and amount consumed, breastfeeding frequency, and a recipe feature. Similar to the USDA Automated Multiple Pass Method, this TZ-24hr-DR contains review features such as time in-between meals, a summary of meals, and portion sizes. Results Dietary intake using TZ-24hr-DR was collected among 1) 845 children 0-18 mo of age enrolled in the Engaging Fathers for Effective Child Nutrition and Development in Tanzania (EFFECTS) trial (ClinicalTrials.gov identifier: NCT03759821) in Mara, Tanzania, and 2) 312 adult families from the Diet, Environment, and Choices of positive living (DECIDE) observational study in peri-urban Dar es Salaam. Interviewers were trained on paper-based methods with food models and tablet-based collection. Conversion to nutrient intake was readily linked and accessible, enabling rapid review and analysis. Overall, 2158 and 8197 dietary meal records were collected from the DECIDE study and EFFECTS trial, respectively. Among adults, 63% of men and 92% of women reported eating at home, and there were differences in protein, fat, and zinc. Food consumed outside the home typically occurs for the first 2 meals. Children's intake of nutrients increased with age; however, median micronutrient intakes for calcium, iron, zinc, and vitamin A remained below recommended nutrient intakes. Conclusions The TZ-24hr-DR is a field- and user-friendly tool that can collect large samples of dietary intakes. Further validation is needed. The tool is available freely for research purposes and can be further adapted to other contexts in East Africa.
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Affiliation(s)
- Ramya Ambikapathi
- Departments of Public Health and Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Imani Irema
- Africa Academy of Public Health, Dar es Salaam, Tanzania
| | - Isaac Lyatuu
- Africa Academy of Public Health, Dar es Salaam, Tanzania
| | - Bess Caswell
- Western Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Davis, CA, USA
| | - Dominic Mosha
- Africa Academy of Public Health, Dar es Salaam, Tanzania
| | | | - Lauren Galvin
- Global Communities, Dar es Salaam, Tanzania and Silver Spring, MD, USA
| | - Ally Mangara
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Morgan Boncyk
- Departments of Public Health and Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Savannah L Froese
- Departments of Public Health and Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Cristiana K Verissimo
- Departments of Public Health and Nutrition Science, Purdue University, West Lafayette, IN, USA
| | | | | | - Patrick Kazonda
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Wafaie Fawzi
- Department of Global Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Japhet Killewo
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - George PrayGod
- National Institute for Medical Research, Mwanza, Tanzania
| | - Germana Leyna
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Tanzania Food and Nutrition Center, Dar es Salaam, Tanzania
| | - Crystal Patil
- Department of Women, Children and Family Health Science, University of Illinois Chicago, Chicago, IL, USA
| | - Nilupa S Gunaratna
- Departments of Public Health and Nutrition Science, Purdue University, West Lafayette, IN, USA
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Effect of an Integrated Package of Nutrition Behavior Change Interventions on Infant and Young Child Feeding Practices and Child Growth from Birth to 18 Months: Cohort Evaluation of the Baduta Cluster Randomized Controlled Trial in East Java, Indonesia. Nutrients 2020; 12:nu12123851. [PMID: 33339415 PMCID: PMC7767283 DOI: 10.3390/nu12123851] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 11/30/2022] Open
Abstract
The need for a multisectoral approach to tackle stunting has gained attention in recent years. Baduta project aims to address undernutrition among children during their first 1000 days of life using integrated nutrition-specific and nutrition-sensitive interventions. We undertook this cohort study to evaluate the Baduta project’s effectiveness on growth among children under 2 years of age in two districts (Sidoarjo and Malang Districts) in East Java. Six subdistricts were randomly selected, in which three were from the intervention areas, and three were from the control areas. We recruited 340 pregnant women per treatment group during the third trimester of pregnancy and followed up until 18 months postpartum. The assessment of breastfeeding and complementary feeding practices used standard infant and young child feeding (IYCF) indicators in a tablet-based application. We measured weight and length at birth and every three-months after that. The enumerators met precision and accuracy criteria following an anthropometry standardization procedure. Among the breastfed children, the percentage of children who achieved the minimum dietary diversity score (DDS) and minimum acceptable diet (MAD) was higher for the intervention group than the comparison group across all age groups. The odd ratios were 3.49 (95% CI: 2.2–5.5) and 2.79 (95% CI: 1.7–4.4) for DDS and 3.49 (95% CI: 2.2–5.5) and 2.74 (95% CI: 1.8–5.2) for MAD in the 9–11 month and 16–18-month age groups, respectively. However, there was no significant improvement in growth or reduction in the prevalence of anemia. The intervention was effective in improving the feeding practices of children although it failed to show significant improvement in linear growth of children at 18 months of age.
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