1
|
Williams AM, Stewart CP, Shahab-Ferdows S, Hampel D, Kiprotich M, Achando B, Lin A, Null CA, Allen LH, Chantry CJ. Infant Serum and Maternal Milk Vitamin B-12 Are Positively Correlated in Kenyan Infant-Mother Dyads at 1-6 Months Postpartum, Irrespective of Infant Feeding Practice. J Nutr 2018; 148:86-93. [PMID: 29378045 PMCID: PMC5955065 DOI: 10.1093/jn/nxx009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 10/13/2017] [Indexed: 11/13/2022] Open
Abstract
Background Vitamin B-12 is an essential nutrient required for many functions including DNA synthesis, erythropoiesis, and brain development. If maternal milk vitamin B-12 concentrations are low, infants may face elevated risks of deficiency when exclusively breastfed. Objective We evaluated cross-sectional associations between infant serum vitamin B-12 concentrations and maternal milk vitamin B-12 concentrations at 1-6 mo postpartum among an unsupplemented population in rural western Kenya, and assessed biological demographic, and dietary characteristics associated with adequate infant serum vitamin B-12. Methods We modeled 1) infant serum vitamin B-12 using maternal milk vitamin B-12 concentration with linear regression; and 2) adequate (>220 pmol/L) infant serum vitamin B-12 using hypothesized biological, demographic, and dietary predictors with logistic regression. In both models, we used generalized estimating equations to account for correlated observations at the cluster-level. Results The median (quartile 1, quartile 3) infant serum vitamin B-12 concentration was 276 pmol/L (193, 399 pmol/L) and approximately one-third of infants had serum vitamin B-12 ≤220 pmol/L, indicating that they were vitamin B-12 depleted or deficient. There was a positive correlation between maternal milk and infant serum vitamin B-12 (r = 0.36, P < 0.001) and in multivariable analyses, maternal milk vitamin B-12 concentration was significantly associated with infant serum vitamin B-12 adequacy (P-trend = 0.03). Conclusions Despite a high prevalence (90%) of maternal milk vitamin B-12 concentrations below the level used to establish the Adequate Intake (<310 pmol/L), there was a low prevalence of infant vitamin B-12 deficiency. We found few factors that were associated with infant vitamin B-12 adequacy in this population, including infant feeding practices, although maternal vitamin B-12 status was not measured. The contribution of maternal milk to infant vitamin B-12 status remains important to quantify across populations, given that maternal milk vitamin B-12 concentration is modifiable with supplementation. This trial was registered at clinicaltrials.gov as NCT01704105.
Collapse
Affiliation(s)
- Anne M Williams
- Hubert Department of Global Health, Emory University, Atlanta, GA,Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA,Address correspondence to AMW (e-mail: )
| | - Christine P Stewart
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA
| | | | - Daniela Hampel
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA,USDA, ARS Western Human Nutrition Research Center, Davis, CA
| | - Marion Kiprotich
- Innovations for Poverty Action, New Haven, CT, USA and Kisumu, Kenya
| | - Beryl Achando
- Innovations for Poverty Action, New Haven, CT, USA and Kisumu, Kenya
| | - Audrie Lin
- School of Public Health, University of California Berkeley, Berkeley, CA
| | - Clair A Null
- Innovations for Poverty Action, New Haven, CT, USA and Kisumu, Kenya,Mathematica Policy Research, Washington DC
| | - Lindsay H Allen
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA,USDA, ARS Western Human Nutrition Research Center, Davis, CA
| | - Caroline J Chantry
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA,University of California Davis Medical Center, Sacramento, CA
| |
Collapse
|
2
|
Wolfe MK, Dentz HN, Achando B, Mureithi M, Wolfe T, Null C, Pickering AJ. Adapting and Evaluating a Rapid, Low-Cost Method to Enumerate Flies in the Household Setting. Am J Trop Med Hyg 2017; 96:449-456. [PMID: 27956654 PMCID: PMC5303052 DOI: 10.4269/ajtmh.16-0162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 08/12/2016] [Indexed: 11/30/2022] Open
Abstract
Diarrhea is a leading cause of death among children under 5 years of age worldwide. Flies are important vectors of diarrheal pathogens in settings lacking networked sanitation services. There is no standardized method for measuring fly density in households; many methods are cumbersome and unvalidated. We adapted a rapid, low-cost fly enumeration technique previously developed for industrial settings, the Scudder fly grill, for field use in household settings. We evaluated its performance in comparison to a sticky tape fly trapping method at latrine and food preparation areas among households in rural Kenya. The grill method was more sensitive; it detected the presence of any flies at 80% (433/543) of sampling locations versus 64% (348/543) of locations by the sticky tape. We found poor concordance between the two methods, suggesting that standardizing protocols is important for comparison of fly densities between studies. Fly species identification was feasible with both methods; however, the sticky tape trap allowed for more nuanced identification. Both methods detected a greater presence of bottle flies near latrines compared with food preparation areas (P < 0.01). The grill method detected more flies at the food preparation area compared with near the latrine (P = 0.014) while the sticky tape method detected no difference. We recommend the Scudder grill as a sensitive fly enumeration tool that is rapid and low cost to implement.
Collapse
Affiliation(s)
- Marlene K. Wolfe
- Tufts University, Medford, Massachusetts
- Innovations for Poverty Action, New Haven, Connecticut
| | - Holly N. Dentz
- Innovations for Poverty Action, New Haven, Connecticut
- University of California Davis, Davis, California
| | - Beryl Achando
- Innovations for Poverty Action, New Haven, Connecticut
| | | | - Tim Wolfe
- Innovations for Poverty Action, New Haven, Connecticut
| | - Clair Null
- Innovations for Poverty Action, New Haven, Connecticut
- Emory University, Atlanta, Georgia
- Mathematica Policy Research, Washington, District of Columbia
| | | |
Collapse
|