scholarly journals Determinants of Childhood Anemia in India

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Nkechi G. Onyeneho ◽  
Benjamin C. Ozumba ◽  
S. V. Subramanian
Keyword(s):  
Vitamin A ◽  
Maternal Education ◽  
Multinomial Logistic Regression ◽  
Linear Regression Analysis ◽  
Daily Intake ◽  
Wealth Index ◽  
Nutritional Intake ◽  
Logistic Regression Models ◽  
Iron Deficient ◽  
Childhood Anemia

Abstract We analyzed a sample of 112714 children from the 2015–2016 Indian National Fertility and Health Survey with available data on hemoglobin. Multinomial logistic regression models were used to establish associations between parent anemia, household characteristics and nutritional intake of children. Linear regression analysis was also conducted to see the link between the household characteristic and childhood nutritional intake on one hand and hemoglobin levels on the other hand. A number of socio-demographic factors, namely maternal age, type of residence and maternal education, as well as wealth index, among others correlate with incidence of childhood anemia. For instance, whereas 52.9% of children in the richest households were anemic, 63.2% of children in the poorest household were anemic (p < 0.001). Mean Vitamin A intake in the last six months was 0.63 (0.626–0.634) which was 0.18% of the recommended intake. Mean iron intake, from sources other than breast milk, in the last 24 hours was 0.29 (0.286–0.294) and 2.42% of the recommended daily intake. Fifty-nine percent (58.5%) of the children surveyed were anemic (Hb level: 9.75 g/dL [9.59–9.91]). Children with anemia were more prone to being iron deficient (odds ratio [OR]: 0.981 (0.961–1.001), Vitamin A deficient (OR: 0.813 (0.794–0.833)), and have lower maternal hemoglobin level (OR: 1.992 (1.957–2.027)). Combining nutritional supplementation and food-fortification programmes with reduction in maternal anemia and family poverty may yield optimal improvement of childhood anemia in India.

ANALYSIS OF HEALTH SERVICES USE FOR RESPIRATORY ILLNESS IN INDONESIAN CHILDREN: IMPLICATIONS FOR POLICY

2004 ◽  
Vol 37 (2) ◽  
pp. 129-142 ◽  
Author(s):  
AMARDEEP THIND
Keyword(s):  
Managed Care ◽  
Health Services ◽  
Maternal Education ◽  
Multinomial Logistic Regression ◽  
Respiratory Illness ◽  
Health Services Use ◽  
Logistic Regression Models ◽  
Services Utilization ◽  
Indonesian Government ◽  
Care Plans

Respiratory illness continues to be a leading cause of paediatric morbidity and mortality in Indonesia. The Indonesian government is moving towards a more managed care-based approach as it reforms its health care system following the 1997 financial crisis. In order to better design contractual relationships between the payor and different providers, there needs to be a better understanding of the patterns and predictors of health services utilization for respiratory illness. This study uses the Indonesia Demographic and Health Survey to study the determinants of private, public and non-formal provider utilization for respiratory illness. Multinomial logistic regression models for predicting use were constructed using the Andersen Behavioural Model as the conceptual framework. The findings indicate that age, household size, maternal education, religion, the asset index, location and illness severity play a role in determining use of private, public or non-formal providers. The results indicate that from a policy perspective, the Indonesian government needs be inclusive rather than exclusive in the choice of providers that are contracted by the managed care plans, in order to safeguard the health of the under-five population.

scholarly journals Matched Case-Control Study of Beans Intakes and Breast Cancer Risk in Urbanized Nigerian Women

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 310-310
Author(s):  
Galya Bigman ◽  
Sally Adebamowo ◽  
Clement Adebamowo
Keyword(s):  
Breast Cancer ◽  
Contraceptive Use ◽  
Conditional Logistic Regression ◽  
Daily Intake ◽  
Wealth Index ◽  
P Value ◽  
Dietary Intakes ◽  
Nigerian Women ◽  
Logistic Regression Models ◽  
Funding Sources

Abstract Objectives To examine the association between dietary intake of beans and breast cancer in Nigerian women. Methods Overall 630 newly diagnosed patients with primary invasive breast cancer were age-matched (±5 years) with 630 controls from the Nigerian Integrative Epidemiology of Breast Cancer (NIBBLE) Study from 01/2014 to 07/2016. Dietary intakes were collected using a food frequency questionnaire (FFQ) to derive daily intake of beans. The daily bean intakes included intakes of beans alone, bean porridge, bean cake (akara), bean pudding (moinmoin), beans and corn (adalu) and bean soup (gbegiri). We categorized the daily bean intake into low, medium and high equally based on the distribution. Additional covariates included occupation, education, wealth index, contraceptive use, menopause status, number of pregnancies, breastfeeding,  Body Mass Index, Waist to Hip Ratio and physical activity. Conditional logistic regression models were utilized to estimate the crude and adjusted Odds Ratio (OR) of total beans intake per day and breast cancer. Results The mean (SD) age of the cases was 42.5 (10.1) and controls was 41.5 (9.2) years. Among controls, almost 36% consume a high intake of total bean compared to 30% among cases, whereas among the cases 37.3% consumed the low intake of total bean compared to 31.6% among controls. In the multivariable, we found a significant association between total beans intakes and breast cancer (OR = 0.85; 95% CI: 0.74–0.97, p-value = 0.02). Comparing the highest category (approximately two portions or more a day) with the lowest category (less than one portion a day), the adjusted OR was 0.72 (95% CI: 0.52–0.98, p-value for trend = 0.04). Conclusions We found a significant association between high intakes of beans and reduce risks for breast cancer. Future studies are needed to evaluate the causality of this relationship and the specific component of beans that is responsible for this reduction. Funding Sources National Human Genome Research Institute of the National Institutes of Health's African Collaborative Center for Microbiome and Genomics Research grant, Award Number U54HG006947; the Fogarty International Center of the National Institutes of Health's Training Program in Nigeria for Non-communicable Diseases Research (TRAPING NCD), Award Number D43TW009106, the Maryland Department of Health's Cigarette Restitution Fund Program.

scholarly journals Sex-Specific Association Between Socioeconomic Status, Lifestyle, and the Risk of Frailty Among the Elderly in China

2021 ◽  
Vol 8 ◽  
Author(s):  
Huai-yu Wang ◽  
Mufan Zhang ◽  
Xiaojing Sun
Keyword(s):  
Socioeconomic Status ◽  
Multinomial Logistic Regression ◽  
East Asian ◽  
Daily Intake ◽  
The Elderly ◽  
Protective Effects ◽  
Logistic Regression Models ◽  
Healthy Longevity ◽  
Increased Risk ◽  
Specific Association

Background: Lifestyle contributors to frailty among the elderly were previously reported in the developed Western countries, while evidence from the less developed East Asian regions was still lacking. Due to the well-acknowledged sex-based disparity of frailty and sex-difference of socioeconomic status and lifestyle, it is worth investigating the sex-specific association between the social and behavioral contributors and the risk of frailty among the East Asian longevous population.Methods: The present study was an observational study based on the four waves of interviews of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018. The participants aged ≥65 years and without frailty at baseline were included. Fried criteria (exhaustion, shrink, weakness, low mobility, and inactivity) were adopted to identify the incidence of frailty (≥3 domains) and pre-frailty (1–2 domains) during the follow-up. The sex-specific association between lifestyle (smoke status, drinking status, food intake, sleep, exercise, and physical activity) and the risk of incident pre-frailty and frailty was analyzed using the multinomial logistic regression models.Results: Altogether, 3,327 participants aged 81.2 ± 10.3 (range 65–116) years were included. In total, 964 (29.0%) and 1,249 (37.5%) participants were recognized as having incident pre-frailty and frailty, respectively. Older women were disproportionately uneducated, frequently did housework and labor work, but seldom did exercise. Men had diverse dietary and recreational activities but were frequently exposed to tobacco and alcohol. The protective effects of higher income, exercise, doing housework, and daily intake of fresh fruits/vegetables were found in both the sexes (P &lt; 0.05). Sleep disorders (odds ratio [OR] = 2.16, 95% CI: 1.28–3.62) and labor work (OR = 2.18, 95% CI: 1.42–3.33) were associated with the increased risk of frailty among women. For men, diverse dietary (four types of food added: OR = 0.21, 95% CI: 0.09–0.50) showed a protective effect on the risk of frailty, but daily intake of pickled vegetables showed the opposite effect (OR = 1.86, 95% CI: 1.12–3.07).Conclusion: Socioeconomic status, lifestyle, and the association with the risk of frailty showed substantial difference between the sexes among the longevous population in China. To establish the individualized strategy of behavioral improvement for the frailty prevention should consider the sex disparity.

scholarly journals Examining Associations of HIV and Iron Status with Nutritional and Inflammatory Status, Anemia and Dietary Intake in South African Schoolchildren

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 962
Author(s):  
Charlene Goosen ◽  
Jeannine Baumgartner ◽  
Nadja Mikulic ◽  
Shaun L. Barnabas ◽  
Mark F. Cotton ◽  
...  
Keyword(s):  
Vitamin A ◽  
Dietary Intake ◽  
South African ◽  
Serum Ferritin ◽  
Iron Status ◽  
Daily Intake ◽  
Subclinical Inflammation ◽  
Iron Stores ◽  
Inflammatory Status ◽  
Iron Deficient

The etiology of multifactorial morbidities such as undernutrition and anemia in children living with the human immunodeficiency virus (HIV) (HIV+) on antiretroviral therapy (ART) is poorly understood. Our objective was to examine associations of HIV and iron status with nutritional and inflammatory status, anemia, and dietary intake in school-aged South African children. Using a two-way factorial case-control design, we compared four groups of 8 to 13-year-old South African schoolchildren: (1) HIV+ and low iron stores (inflammation-unadjusted serum ferritin ≤40 µg/L), n = 43; (2) HIV+ and iron sufficient non-anemic (inflammation-unadjusted serum ferritin >40 µg/L, hemoglobin ≥115 g/L), n = 41; (3) children without HIV (HIV-ve) and low iron stores, n = 45; and (4) HIV-ve and iron sufficient non-anemic, n = 45. We assessed height, weight, plasma ferritin (PF), soluble transferrin receptor (sTfR), plasma retinol-binding protein, plasma zinc, C-reactive protein (CRP), α-1-acid glycoprotein (AGP), hemoglobin, mean corpuscular volume, and selected nutrient intakes. Both HIV and low iron stores were associated with lower height-for-age Z-scores (HAZ, p < 0.001 and p = 0.02, respectively), while both HIV and sufficient iron stores were associated with significantly higher CRP and AGP concentrations. HIV+ children with low iron stores had significantly lower HAZ, significantly higher sTfR concentrations, and significantly higher prevalence of subclinical inflammation (CRP 0.05 to 4.99 mg/L) (54%) than both HIV-ve groups. HIV was associated with 2.5-fold higher odds of iron deficient erythropoiesis (sTfR >8.3 mg/L) (95% CI: 1.03–5.8, p = 0.04), 2.7-fold higher odds of subclinical inflammation (95% CI: 1.4–5.3, p = 0.004), and 12-fold higher odds of macrocytosis (95% CI: 6–27, p < 0.001). Compared to HIV-ve counterparts, HIV+ children reported significantly lower daily intake of animal protein, muscle protein, heme iron, calcium, riboflavin, and vitamin B12, and significantly higher proportions of HIV+ children did not meet vitamin A and fiber requirements. Compared to iron sufficient non-anemic counterparts, children with low iron stores reported significantly higher daily intake of plant protein, lower daily intake of vitamin A, and lower proportions of inadequate fiber intake. Along with best treatment practices for HIV, optimizing dietary intake in HIV+ children could improve nutritional status and anemia in this vulnerable population. This study was registered at clinicaltrials.gov as NCT03572010.

scholarly journals Trends in Iron, Zinc, and Vitamin A Status Biomarkers Among Colombian Children: Results From 2 Nationally Representative Surveys

2017 ◽  
Vol 38 (2) ◽  
pp. 146-157 ◽  
Author(s):  
Wenchao Li ◽  
Oscar F. Herrán ◽  
Eduardo Villamor
Keyword(s):  
Vitamin A ◽  
Maternal Education ◽  
Nutrition Transition ◽  
Serum Zinc ◽  
Wealth Index ◽  
Micronutrient Deficiencies ◽  
Cross Sectional ◽  
Micronutrient Status ◽  
Region Of Residence ◽  
Nationally Representative

Background: Micronutrient deficiencies are still highly prevalent in countries undergoing the nutrition transition, but nationally representative data documenting their burden in children are exceedingly rare. Objective: To examine the distribution and recent trends in micronutrient status biomarkers of Colombian children. Methods: We compared the distributions of plasma ferritin, serum zinc, and vitamin A in Colombian children between 2005 and 2010 using 2 cross-sectional, nationally representative surveys overall and by categories of sociodemographic variables. Analysis for ferritin included boys and nonpregnant girls aged 1 to 17 years. Analyses for zinc and vitamin A included children aged 1 to 4 years. Results: The mean 2010 to 2005 differences in ferritin, zinc, and vitamin A were 2.5 µg/L (95% confidence interval [CI]: 1.3 to 3.7), −34.9 µg/dL (95% CI: −39.6 to −30.2), and −11.5 µg/dL (95% CI: −12.3 to −10.7), respectively, after adjusting for sociodemographic characteristics. These differences varied significantly by region of residence. In 2010, region of residence was a significant correlate for all 3 micronutrients. Other important correlates included age and maternal education for ferritin and body mass index-for-age Z score, maternal education, wealth index, food insecurity, and urbanicity for vitamin A. Conclusions: Plasma ferritin was slightly higher in 2010 than in 2005, whereas serum zinc and vitamin A were substantially lower in 2010. In the absence of obvious causal explanations, it is uncertain whether this decline represents a worsening of micronutrient status in Colombian children or an artifact due to systematic laboratory or data management errors incurred in the surveys.

scholarly journals Prevalence and determinants of diabetes and prediabetes in southwestern Iran: the Khuzestan comprehensive health study (KCHS)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sanam Hariri ◽  
Zahra Rahimi ◽  
Nahid Hashemi-Madani ◽  
Seyyed Ali Mard ◽  
Farnaz Hashemi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Waist Circumference ◽  
Multinomial Logistic Regression ◽  
Fasting Blood Glucose ◽  
Health Study ◽  
Khuzestan Province ◽  
Logistic Regression Models ◽  
Relative Risks ◽  
Southwestern Iran

Background The Middle East and North Africa (MENA) is postulated to have the highest increase in the prevalence of diabetes by 2030; however, studies on the epidemiology of diabetes are rather limited across the region, including in Iran. Methods This study was conducted between 2016 and 2018 among Iranian adults aged 20 to 65 years residing in Khuzestan province, southwestern Iran. Diabetes was defined as the fasting blood glucose (FBG) level of 126 mg/dl or higher, and/or taking antidiabetic medications, and/or self-declared diabetes. Prediabetes was defined as FBG 100 to 125 mg/dl. Multinomial logistic regression models were used to examine the association of multiple risk factors that attained significance on the outcome. Results Overall, 30,498 participants were recruited; the mean (±SD) age was 41.6 (±11.9) years. The prevalence of prediabetes and diabetes were 30.8 and 15.3%, respectively. We found a similar prevalence of diabetes in both sexes, although it was higher among illiterates, urban residents, married people, and smokers. Participants aged 50–65 and those with Body Mass Index (BMI) 30 kg/m2 or higher were more likely to be affected by diabetes [RR: 20.5 (18.1,23.3) and 3.2 (3.0,3.6)]. Hypertension [RR: 5.1 (4.7,5.5)], waist circumference (WC) equal or more than 90 cm [RR: 3.6 (3.3,3.9)], and family history [RR: 2.3 (2.2,2.5)] were also significantly associated with diabetes. For prediabetes, the main risk factors were age 50 to 65 years [RR: 2.6 (2.4,2.8)], BMI 30 kg/m2 or higher [RR: 1.9 (1.8,2.0)], hypertension and WC of 90 cm or higher [RR: 1.7 (1.6,1.8)]. The adjusted relative risks for all variables were higher in females than males, with the exception of family history for both conditions and waist circumference for prediabetes. Conclusions Prediabetes and diabetes are prevalent in southwestern Iran. The major determinants are older age, obesity, and the presence of hypertension. Further interventions are required to escalate diabetes prevention and diagnosis in high-risk areas across Iran.

scholarly journals Transitions in hookah (Waterpipe) smoking by U.S. sexual minority adults between 2013 and 2015: the population assessment of tobacco and health study wave 1 and wave 2

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mary Rezk-Hanna ◽  
Ian W. Holloway ◽  
Joy Toyama ◽  
Umme Shefa Warda ◽  
Lorree Catherine Berteau ◽  
...  
Keyword(s):  
Multinomial Logistic Regression ◽  
Health Study ◽  
Chi Square ◽  
Population Assessment ◽  
Logistic Regression Models ◽  
Global Epidemic ◽  
Product Use ◽  
Hookah Smoking ◽  
Nationally Representative ◽  
And Gender

Abstract Background Tobacco smoking using a hookah (i.e., waterpipe) is a global epidemic. While evidence suggests that sexual minorities (SM) have higher odds of hookah use compared to heterosexuals, little is known about their hookah use patterns and transitions. We sought to examine transitions between hookah smoking and use of other tobacco and electronic (e-) products among SM adults aged 18 years of age and older versus their heterosexual counterparts. Methods We analyzed nationally representative data of ever and current hookah smokers from Wave 1 (2013–2014; ever use n = 1014 SM and n = 9462 heterosexuals; current use n = 144 SM and n = 910 heterosexuals) and Wave 2 (2014–2015; ever use n = 901 SM and n = 8049 heterosexuals; current use n = 117 SM and n = 602 heterosexuals) of the Population Assessment of Tobacco and Health Study. Comparisons between groups and gender subgroups within SM identity groups were determined with Rao-Scott chi-square tests and multivariable survey-weighted multinomial logistic regression models were estimated for transition patterns and initiation of electronic product use in Wave 2. Results Ever and current hookah smoking among SM adults (ever use Wave 1: 29% and Wave 2: 31%; current use Wave 1: 4% and Wave 2: 3%) was higher than heterosexuals (ever use Wave 1: 16% and Wave 2: 16%; current use Wave 1: 1% and Wave 2: 1%; both p < 0.0001). Among SM adults who reported hookah use at Wave 1, 46% quit hookah use at Wave 2; 39% continued hookah use and did not transition to other products while 36% of heterosexual adults quit hookah use at Wave 2 and 36% continued hookah use and did not transition to other products. Compared with heterosexuals, SM adults reported higher use of hookah plus e-products (Wave 2 usage increased by 65 and 83%, respectively). Conclusions Compared to heterosexuals, in addition to higher rates of hookah smoking, higher percentages of SM adults transitioned to hookah plus e-product use between 2013 and 2015. Results have implications for stronger efforts to increase awareness of the harmful effects of hookah as well as vaping, specifically tailored among SM communities.

scholarly journals Food insecurity and its association with changes in nutritional habits among adults during the COVID-19 confinement measures in Belgium

2020 ◽  
pp. 1-7
Author(s):  
Stefanie Vandevijvere ◽  
Karin De Ridder ◽  
Sabine Drieskens ◽  
Rana Charafeddine ◽  
Finaba Berete ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Multinomial Logistic Regression ◽  
Soft Drink ◽  
Household Composition ◽  
Healthy Diet ◽  
Cross Sectional ◽  
Nutritional Habits ◽  
Logistic Regression Models ◽  
Soft Drink Consumption ◽  
Snack Consumption

Abstract Objective: To assess food insecurity and its association with changes in nutritional habits among Belgian adults during confinement due to COVID-19. Design: Three cross-sectional online health surveys were conducted during March–May 2020. Multinomial logistic regression models were used to determine associations between self-reported changes in fruit, vegetable, soft drink and sweet and salted snack consumption or weight as dependent variables and food insecurity indicators as independent variables, adjusted for gender, household composition, educational attainment and household income. Setting: Belgium. Participants: In total, 8640 adults recruited by convenience sampling. Results: About 10·4 % of Belgians often or sometimes feared food shortages, 5·0 % were often or sometimes short of food without money to buy more and 10·3 % often or sometimes could not afford to eat a healthy diet during confinement. These percentages were highest among single-parent families (26·7, 14·4 and 23·4 %, respectively). Adults who often or sometimes feared that food would run out during confinement had significantly higher odds of decreased v. unchanged fruits (3·53; 95 % CI = 2·06, 6·05) and vegetables (5·42; 95 % CI = 2·90, 10·11) consumption and significantly higher odds of increased v. unchanged soft drink consumption (3·79; 95 % CI = 2·20, 6·54). Similar results were found for adults who often or sometimes ran out of food and for adults who often or sometimes were not able to afford a healthy diet. Conclusion: Food insecurity during the COVID-19 confinement measures in Belgium was associated with adverse changes in most dietary behaviours. A strong government response is needed to tackle malnutrition and food insecurity to protect public health from ongoing and future pandemics.

scholarly journals Correlates of Transitions in Food Insecurity Status during the Early Stages of the COVID-19 Pandemic among Ethnically Diverse Households in Central Texas

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2597
Author(s):  
Kathryn M. Janda ◽  
Nalini Ranjit ◽  
Deborah Salvo ◽  
Aida Nielsen ◽  
Pablo Lemoine ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Food Availability ◽  
Low Income ◽  
Food Access ◽  
Multinomial Logistic Regression ◽  
Related Factors ◽  
Logistic Regression Models ◽  
Early Stages ◽  
Central Texas ◽  
June July

Food insecurity increased substantially in the USA during the early stages of the 2020 COVID-19 pandemic. The purpose of this study was to identify potential sociodemographic and food access-related factors that were associated with continuing or transitioning into food insecurity in a diverse population. An electronic survey was completed by 367 households living in low-income communities in Central Texas during June–July 2020. Multinomial logistic regression models were developed to examine the associations among food insecurity transitions during COVID-19 and various sociodemographic and food access-related factors, including race/ethnicity, children in the household, loss of employment/wages, language, and issues with food availability, accessibility, affordability, and stability during the pandemic. Sociodemographic and food access-related factors associated with staying or becoming newly food insecure were similar but not identical. Having children in the household, changes in employment/wages, changing shopping location due to food availability, accessibility and/or affordability issues, issues with food availability, and stability of food supply were associated with becoming newly food insecure and staying food insecure during the pandemic. Identifying as Latino and/or Black was associated with staying food insecure during COVID-19. These findings suggest that the COVID-19 pandemic did not create new food insecurity disparities. Rather, the pandemic exacerbated pre-existing disparities.

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