scholarly journals Nutritional Deficiencies and Maternal Depression: Associations and Interventions in Lower and Middle-Income Countries: a Systematic Review of Literature

Author(s):  
Beatrice A. Madeghe ◽  
Wambui Kogi-Makau ◽  
Sophia Ngala ◽  
Manasi Kumar

Abstract Background Nutrition deficiencies are common among pregnant and lactating women in middle- and low-income countries. At the same time, maternal mental disorders, mainly depression is highly prevalent during this period suggesting some connection between the two. The objective of this review is to determine the associations between nutritional deficiencies and maternal depression and identify the role of diet in depression to facilitate further research. Methods A literature search included PubMed databases and Google Scholar search engine published from June 2008 to June 2019 and published in English. Medical subject heading terms was used to identify all relevant studies. All titles and abstracts identified by the search were screened then reviewed the full-text articles which were potentially eligible for inclusion. Results The original search identified 1250 articles but with cascaded elimination, based on quality. Twenty five met the inclusion criteria, of which 13 were cross-sectional, eight were prospective cohort study, and four were intervention studies. Most (95%) of these studies reported positive associations between nutrition deficiencies, poor diet, and maternal depression; thus, only 5% did not show associations between nutrition and depression. Conclusion Our review findings suggest that nutritional interventions are some of the most promising intercessions for mental health illnesses. Not all studies consistently associate poor diet quality with poor maternal and offspring mental health outcomes, and the majority of those that show are cross-sectional. Considering that most of these associations are cross-sectional, studies devoid of exposing causal relationship; thus, longitudinal studies are needed to confirm the associations towards sufficing as a window of opportunity for reducing the risk of mental disorders in mothers and offspring alike.

2016 ◽  
Vol 68 (Suppl. 2) ◽  
pp. 29-31 ◽  
Author(s):  
John Feehally

The International Society of Nephrology's (ISN) 0by25 initiative aims to prevent avoidable deaths from acute kidney injury (AKI) by 2025, most of which occur in low and lower middle-income countries (LLMICs). To increase evidence about the epidemiology of AKI, especially in LLMICs, ISN conducted a ‘Global Snapshot', a multinational, cross-sectional study in which 322 physicians from 72 countries in 6 continents identified 3,664 adults and 354 children with AKI who were under their care of which 45% were from LLMICs, nevertheless low-income countries were under-represented. In LLMICs, patients with AKI were younger, and community acquired AKI was more common. Hypotension (40%) and dehydration (39%) were the most common causes of AKI. Dehydration was a more common cause in LLMIC, as were sepsis, pregnancy-related AKI and animal envenomation. Acute dialysis was performed in 23% of patients. Eight percent had a clinical indication for this but were not dialyzed. In LLMICs, lack of resources (16%) and inability to afford therapy (30%) accounted for almost half of these cases. Overall mortality at 7 days was 11% and was higher in LLMICs. Complete recovery from AKI occurred in 30% of patients and partial recovery 37%, and was more often complete in LLMICs. The 0by25 Global Snapshot provides new information about the worldwide epidemiology of AKI, helping to identify elements that would be amenable in intervention to reduce preventable deaths.


2020 ◽  
Vol 32 (1) ◽  
pp. 1-8
Author(s):  
Md Faruq Alam ◽  
Mekhala Sarkar ◽  
Mohammad Tariqul Alam ◽  
Helal Uddin Ahmed ◽  
Avra Das Bhowmik ◽  
...  

The prevalence of substance use is on rising trend in the country. This two-stage nationwide multicentric community based cross sectional study was conducted by National Institute of Mental Health (NIMH), Dhaka during the period of September 2017 to July 2018 to determine the prevalence of substance use as well as to identify the proportion of users used different substances and to find out socio-demographic correlates of substance use in Bangladesh. The sample were collected by cluster sampling technique. In the first stage data were collected from 19692 respondents aged between 7 years and above in 140 clusters through face-to-face interview using semi-structured questionnaires to collect information by trained data collector. Diagnoses of substance use were made in the second stage of interview by research psychiatrists following DSM-5 diagnostic criteria of mental disorders. Descriptive and inferential statistics of the collected data was done using standard statistical parameters. SPSS programme (Version 23) was used to summarize and to analyze the data. The results showed that, the prevalence of substance use was found as 3.3% among the population 18 years and above. Prevalence of substance use was 4.8% in male and 0.6% in female. Most frequently used substances include cannabis in (42.7%), alcohol in 27.5%, amphetamine (yaba) in 15.2%, opioid in 5.3% and sleeping pills in 3.4% users. Among professions of substance users 6.7% were labors, 5.7% unemployed, 4.3% business men, 3.8% farmers and 3.5% service holders. Extremes of social classes were found as increased users of substances such as people with low income 3.2% and people with high income 3.8% using as against 2.6% in middle income group. The data of this community survey will be used for planning of mental health services in Bangladesh. Bang J Psychiatry June 2018; 32(1): 1-8


2021 ◽  
Vol 35 ◽  
pp. 205873842110656
Author(s):  
Md. Rabiul Islam ◽  
Moynul Hasan ◽  
Waheeda Nasreen ◽  
Md. Ismail Tushar ◽  
Mohiuddin Ahmed Bhuiyan

Objectives Vaccination rollout against COVID-19 has started in developed countries in early December 2020. Mass immunization for poor or low-income countries is quite challenging before 2023. Being a lower–middle-income country, Bangladesh has begun a nationwide COVID-19 vaccination drive in early February 2021. Here, we aimed to assess the opinions, experiences, and adverse events of the COVID-19 vaccination in Bangladesh. Methods We conducted this online cross-sectional study from 10 February 2021, to 10 March 2021, in Bangladesh. A self-reported semi-structured survey questionnaire was used using Google forms. We recorded demographics, disease history, medication records, opinions and experiences of vaccination, and associated adverse events symptoms. Results We observed leading comorbid diseases were hypertension (25.9%), diabetes (21.1%), heart diseases (9.3%), and asthma (8.7%). The most frequently reported adverse events were injection site pain (34.3%), fever (32.6%), headache (20.2%), fatigue (16.6%), and cold feeling (15.4%). The chances of having adverse events were significantly higher in males than females ( p = 0.039). However, 36.4% of respondents reported no adverse events. Adverse events usually appeared after 12 h and went way within 48 h of vaccination. Besides, 85.5% were happy with the overall vaccination management, while 88.0% of the respondents recommended the COVID-19 vaccine for others for early immunization. Conclusion According to the present findings, reported adverse events after the doses of Covishield in Bangladesh were non-serious and temporary. In Bangladesh, the early vaccination against COVID-19 was possible due to its prudent vaccine deal, previous mass vaccination experience, and vaccine diplomacy.


2017 ◽  
Vol 41 (S1) ◽  
pp. S156-S157 ◽  
Author(s):  
R. Charara ◽  
A. Mokdad

The eastern Mediterranean region (EMR) is witnessing an increase in mental illness. With ongoing unrest, this is expected to rise. This is the first study to quantify the burden of mental disorders in the EMR. We used data from the global burden of disease study (GBD) 2013. DALYs (disability-adjusted life years) allow assessment of both premature mortality (years of life lost–YLLs) and nonfatal outcomes (years lived with disability–YLDs). DALYs are computed by adding YLLs and YLDs for each age-sex-country group. In 2013, mental disorders contributed to 5.6% of total disease burden in EMR (1894 DALYS/100,000 population): 2519 DALYS/100,000 (2590/100,000 males, 2426/100,000 females) in high-income countries, 1884 DALYS/100,000 (1618/100,000 males, 2157/100,000 females) in middle-income countries, 1607 DALYS/100,000 (1500/100,000 males, 1717/100,000 females) in low-income countries. Females had a greater proportion of burden due to mental disorders than did males of equivalent ages, except for those under 15 years. The highest proportion of DALYs occurred in the 25–49 age group. The burden of mental disorders in EMR increased from 1726 DALYs/100,000 in 1990 to 1912 DALYs/100,000 in 2013 (10.8% increase). Depressive disorders accounted for most DALYs, followed by anxiety disorders. Palestine had the largest burden of mental disorders. Nearly all EMR countries had a higher mental disorder burden compared to global level. Our findings call for EMR health ministries to increase provision of mental health services and to address stigma of mental illness. Our results showing the accelerating burden of mental health are alarming as the region is seeing an increased level of instability.


2021 ◽  
pp. 037957212110251
Author(s):  
Beatrice A. Madeghe ◽  
Wambui Kogi-Makau ◽  
Sophia Ngala ◽  
Manasi Kumar

Background: Nutritional deficiencies are common during pregnancy and a year after childbirth. At the same time, maternal depression affects many women during pregnancy up to 1 year after childbirth. The objectives of this study were to determine the associations between nutrition status, dietary intake, and maternal depression among pregnant women. Methods: This was a cross-sectional study that included 262 pregnant women aged 15 to 49 years attending the antenatal clinic in 2 public health facilities in urban-low income settlement Nairobi, Kenya. Maternal depression was assessed using Edinburgh Postnatal Depression Scale (EPDS). Mid-upper arm circumference (MUAC) was used to determine nutritional status. Dietary intake was assessed using the 24-hour recall, and brain essential nutrients were assessed through a questionnaire. Odds ratio was used to test the associations. All maternal characteristics with P <.001 in the univariable analysis were considered in the multivariable logistic regression, variables with P < .05 were considered significant. Results: Of the 262 pregnant women, 33.6% (95% CI: 27.9-40.7) had depressive illness as indicated by EPDS >13. About 9.9% of pregnant women had MUAC less than <23 cm. The study established statistically significant association between poor nutrition by MUAC and maternal depression ( P < .001). Maternal depression was statistically significantly associated with inadequate intake of brain food essential ( P = .002). Maternal depression was statistically significantly associated with lower income ( P < .001). In multivariable regression analysis, the main predictor of maternal depression was poor nutrition ( P < .004). Conclusion: The finding reveals an association between poor nutrition and maternal depression. These results suggest that nutritional deficiencies could be the contributing factor for maternal depression. Study recommends dietary interventions as cost-effective way to reduce deficiencies and improve mental health problems for pregnant women. Assessment of maternal depression and dietary intake be integrated as fundamental components of antenatal care.


BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Kefyalew Addis Alene ◽  
Kinley Wangdi ◽  
Samantha Colquhoun ◽  
Kudakwashe Chani ◽  
Tauhid Islam ◽  
...  

Abstract Background The sustainable development goals aim to improve health for all by 2030. They incorporate ambitious goals regarding tuberculosis (TB), which may be a significant cause of disability, yet to be quantified. Therefore, we aimed to quantify the prevalence and types of TB-related disabilities. Methods We performed a systematic review of TB-related disabilities. The pooled prevalence of disabilities was calculated using the inverse variance heterogeneity model. The maps of the proportions of common types of disabilities by country income level were created. Results We included a total of 131 studies (217,475 patients) that were conducted in 49 countries. The most common type of disabilities were mental health disorders (23.1%), respiratory impairment (20.7%), musculoskeletal impairment (17.1%), hearing impairment (14.5%), visual impairment (9.8%), renal impairment (5.7%), and neurological impairment (1.6%). The prevalence of respiratory impairment (61.2%) and mental health disorders (42.0%) was highest in low-income countries while neurological impairment was highest in lower middle-income countries (25.6%). Drug-resistant TB was associated with respiratory (58.7%), neurological (37.2%), and hearing impairments (25.0%) and mental health disorders (26.0%), respectively. Conclusions TB-related disabilities were frequently reported. More uniform reporting tools for TB-related disability and further research to better quantify and mitigate it are urgently needed. Prospero registration number CRD42019147488


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