The Saqmolo’ Project: Protocol for a Randomized Controlled Trial Examining the Impact of Daily Complementary Feeding of Eggs on Infant Development and Growth in Guatemala

Abstract Objectives Studies in Ecuador and Malawi have demonstrated mixed effects of interventions involving daily complementary feeding of eggs on child growth. For example, in Malawi, the egg intervention had no overall effect on child development. There is a need to test the effects of egg interventions on child growth and development in other settings with high prevalence of stunting and in the context of other nutritional interventions. The Saqmolo’ (i.e.,“egg” in the Mayan language, Kaqchiquel) study aims to evaluate the impact of adding 1 egg per day to local standard nutrition care (LSNC) on child development, in rural Maya infants from Guatemala. Methods In a community-based, individually randomized, controlled comparative effectiveness trial among rural indigenous Maya children (n = 1200), starting at 6–9 months at baseline, we will compare the impact of adding one egg per day to LSNC with LSNC alone. LSNC includes: growth monitoring, medical care, deworming medication, multiple micronutrient powders for point of use food fortification, and individualized complementary and responsive feeding education for caregivers. Intervention and control groups will be visited once per month during 6-months and adherence will be monitored during the visits and through phone calls for the first 2 months in both groups at the same frequency. The primary outcome is differences in child global development (measured by Caregiver Reported Child Development Instruments –CREDI-and the Guide for Monitoring Child Development GMCD); secondary outcomes include: growth (z-scores for weight for age, length for age, weight for length, and head circumference for age), and diet quality (using the World Health Organization's infant and young child feeding indicators). Results N/A (submitting study protocol abstract). Conclusions This study will provide new evidence on the potential effect of increased egg accessibility in high prevalence stunting areas along with integrated nutrition care on child development. The results may help to inform public health decision-making regarding resource allocation for effective nutrition interventions during the complementary feeding period in Guatemala. Funding Sources This work was supported by the Academy of Nutrition and Dietetics Foundation via an investigator-initiated research grant from the Egg Nutrition Center.

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Child Development and Nutritional Status in Ecuador

Global Pediatric Health ◽

10.1177/2333794x18821946 ◽

2019 ◽

Vol 6 ◽

pp. 2333794X1882194

Author(s):

Lourdes Huiracocha-Tutiven ◽

Adriana Orellana-Paucar ◽

Victoria Abril-Ulloa ◽

Mirian Huiracocha-Tutiven ◽

Gicela Palacios-Santana ◽

...

Keyword(s):

Child Development ◽

Nutritional Status ◽

Developmental Delay ◽

Complementary Feeding ◽

Dietary Diversity ◽

High Energy ◽

Child Growth ◽

World Health ◽

Nutrient Supplementation ◽

Nutrient Density

We assessed the development, nutritional status, and complementary feeding of 12- to 23-month-old children from Cuenca, Ecuador in 2013. Ecuador, an upper-middle-income country, developed a child policy in accordance with World Health Organization (WHO) guidelines. We collected cross-sectional survey data. Child development was assessed using the Integrated Management of Childhood Illness Guide–2011. The nutritional status was defined with WHO Child Growth Standards−2006. We investigated nutrient density, WHO Infant and Young Child Feeding Indicators, and nutrient supplementation intake of the complementary feeding. In all, 11.7% of children had “possible developmental delay,” stunting was identified in 29.4% of the children, and 25.3% faced overnutrition (overweight risk/overweight/obesity). The complementary feeding composition can be summarized as having adequate fat, high energy (MJ/day) and protein, and low iron and zinc. Children with “possible developmental delay” received less iron ( P < .05) than children with normal development. Overall, 30.4% of children had minimum dietary diversity. A total of 47.7% of children received nutrient supplementation. This epidemiological profile of infants remains a challenge for Ecuador’s health programs.

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Preconception Micronutrient Supplementation Positively Affects Child Development at 6 Years of Age: A Randomized Controlled Trial in Vietnam

Current Developments in Nutrition ◽

10.1093/cdn/nzaa053_081 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 876-876

Author(s):

Phuong Nguyen ◽

Melissa Young ◽

Long Khuong ◽

Thai Hong Duong ◽

Hoang Cong Nguyen ◽

...

Keyword(s):

Working Memory ◽

Randomized Controlled Trial ◽

Child Development ◽

Processing Speed ◽

Controlled Trial ◽

Intervention Group ◽

Child Growth ◽

Chi Square ◽

Randomized Controlled ◽

The Impact

Abstract Objectives While there is growing evidence on the role of preconception nutrition for birth outcomes, very few studies have evaluated the effects of nutrition interventions during the preconception period on child development. This study evaluates the impact of preconception weekly multiple micronutrients (MM) or iron and folic acid (IFA) supplementation compared to FA alone on child growth and development at age 6–7y. Methods We followed 1599 offspring born to women who participated in a randomized controlled trial of preconception supplementation in Vietnam. Women received weekly supplements containing either 2800 μg FA only, 60 mg iron and 2800 μg FA, or MM (15 micronutrients including IFA), from baseline until conception; followed by daily prenatal IFA supplements until delivery. Child anthropometry and development were measured at 6–7y. Child development was measured using the Wechsler Intelligence Scale for Children IV®. Group comparisons were done using ANOVA or chi-square tests for both intention-to-treat (ITT) and per-protocol analyses (PP, women consumed supplements ≥26 wk before conception). Results The groups were similar for baseline maternal and offspring birth characteristics and age at follow-up. We found significant differences (P < 0.05) by intervention group for processing speed index for both ITT (n = 1312) and PP analyses (n = 589), and for working memory index in PP analysis. Compared to the offspring in the FA group, those in the MM group had higher processing speed (β = 1.9 for ITT, and β = 3.4 for PP analysis) and working memory indices (β = 1.5 for ITT, and β = 2.2 for PP analysis). Similar trends were found for the offspring in the IFA group compared to the FA group for working memory index (β = 1.6 for ITT, and β = 3.5 for PP analyses). There were no significant differences by treatment group for measures of verbal comprehension, perceptual reasoning index, full-scale IQ or any of the child anthropometry measures. Conclusions Preconception supplementation with MM and IFA improved some components of child development but not child size at age 6–7 y when compared to FA. These findings suggest the potential for preconception micronutrient interventions to have long-term benefits for offspring development. Funding Sources The Nestle Foundation, the Mathile Institute, and the Micronutrient Initiative.

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NEW CORONOVIRUS INFECTION: CLINICAL AND PATHOGENETIC ASPECTS OF COVID-19 IN PREGNANT WOMEN

"Medical & pharmaceutical journal "Pulse" ◽

10.26787/nydha-2686-6838-2021-23-8-57-62 ◽

2021 ◽

pp. 57-62

Author(s):

Allakhyarov D.Z. ◽

Petrov Yu.A. ◽

Chernavsky V.V.

Keyword(s):

Pregnant Women ◽

The Body ◽

World Health ◽

Upper Respiratory Tract ◽

Global Pandemic ◽

High Prevalence ◽

Coronavirus Infection ◽

The Moment ◽

Health Organization ◽

The Impact

This article presents reviews of literature sources on the clinical and pathogenetic aspects of the course of a new coronovirus infection in pregnant women, in order to analyze the features of the course of COVID-19 in pregnant women and to assess the impact of infection on the body of a woman and a fetus. Pregnancy is a special physiological condition, during which a number of changes occur in the body, not only in the hormonal status, but also in the immune system. The urgency of this problem is due to the high prevalence of new coronavirus infection among the population. On March 12, 2020, the World Health Organization (WHO), as a result of the dynamic development of the epidemic in many countries and continents, declared a global pandemic of the contagious disease COVID-19 caused by the SARS-CoV-2 virus. According to available studies, pregnant women are more susceptible to a more severe course of infectious diseases affecting the upper respiratory tract. According to various studies, a new coronavirus infection can lead to premature birth, miscarriage, and preeclampsia. Separate studies show increased mortality in pregnant women diagnosed with COVID-19. The SARS-CoV-2 virus does not have a direct teratogenic effect on the fetus, but it can indirectly lead to harmful effects on the developing organism. Special attention should be paid to the issue of vaccination of pregnant women against a new coronavirus infection, at the moment there is no accurate data on the effect of the vaccine on the body of the pregnant woman and the fetus. In this regard, the question of the impact of a new coronavirus infection on the course of pregnancy has become relevant.

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Implications of violence experience in postpartum depression

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.953 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

D Fraga ◽

F Marabotti ◽

Costa Leite ◽

R de Cássia ◽

Duarte Lima ◽

...

Keyword(s):

Postpartum Depression ◽

Depression Scale ◽

Maternity Hospital ◽

Intimate Partner ◽

World Health ◽

Cross Sectional ◽

Female Population ◽

Symptoms Of Depression ◽

High Prevalence ◽

The Impact

Abstract Introduction The violence against women is an exacerbating factor in public health that affects a third of the world's female population, and the intimate partner is the main perpetrator. Researches show the impact of violence in the victims' health, such as: postpartum depression (PPD). In this context, considering the importance and magnitude of the experience of violence and its impact on health, as well as depression negatively impacted on the health of the mother and baby, justify it to carry out this study. Objective To identify the prevalence of symptoms of PPD among puerperal women and to examine the association with violence experience. Methods This is a cross-sectional study, performed with 330 puerperal women admitted to a municipal maternity hospital in Cariacica - State of Espírito Santo, Brazil. Data collection was conducted by duly trained interviewers, using a form containing data on socioeconomic, behavioral and clinical characterization. In order to track violence acts, in life and in pregnancy, practiced by the intimate partner, we applied the World Health Organization instrument, which enables the identification of psychological, physical and sexual violence acts. The identification of the outcome under study, postpartum depression, was obtained by means of the Edinburgh Postnatal Depression Scale. The data collected were analyzed through the Stata 13.0 program, where the following tests were performed: Pearson chi-squared test and Poisson regression. Results a rate of 36.7% of participants (95% CI: 31.6-42.0) showed symptoms of postpartum depression. Women who experienced violence from their partners throughout their lives had 1.9 times more prevalence of symptoms of depression. Those who experienced aggression during pregnancy showed an increase of 38.0% of this illness (p = 0.037). Conclusions The data presented reveal the high prevalence of women with symptoms of PPD and that violence experience was associated with higher frequencies of this event. Key messages Women who experienced violence from their partners throughout their lives had 1.9 times more prevalence of symptoms of depression. The data presented reveal the high prevalence of women with symptoms of postpartum depression and that violence experience was associated with higher frequencies of this event.

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Does a tailored intervention to promote adherence in patients with chronic lung disease affect exacerbations? A randomized controlled trial

Respiratory Research ◽

10.1186/s12931-019-1219-3 ◽

2019 ◽

Vol 20 (1) ◽

Author(s):

Claudia Gregoriano ◽

Thomas Dieterle ◽

Anna-Lisa Breitenstein ◽

Selina Dürr ◽

Amanda Baum ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Intervention Group ◽

Ambulatory Setting ◽

Randomized Controlled ◽

Phone Calls ◽

Copd Patients ◽

The Impact ◽

Inhaled Medication

Abstract Background Poor medication-adherence is common in chronic lung patients, resulting in reduced health-outcomes and increased healthcare-costs. This study aimed to investigate the impact of an acoustic reminder and support calls on adherence to inhaled therapy in asthma and COPD patients and to determine their effect on exacerbations. Methods This single-blinded randomized controlled trial investigated asthma and COPD patients during 6 months in an ambulatory setting. The intervention consisted of daily alarm clock and support phone calls, whenever use of rescue medication doubled or inhaled medication was not taken as prescribed. Primary outcome was time to next exacerbation. Frequency of exacerbations, adherence to inhaled medication and quality of life scores were secondary outcomes. Cox and Poisson regression were used to determine intervention effect on time to exacerbation and frequency of exacerbations, respectively. Results Seventy-five participants were assigned to the intervention group and 74 to usual follow-up care. During a median follow-up of 6.2 months, 22 and 28% in the intervention and control groups respectively, experienced at least one exacerbation. Intervention had no effect on time to first exacerbation (HR 0.65, 95% CI 0.21 to 2.07, P = .24), but showed a trend toward a 39% decreased frequency of exacerbations (RR = 0.61, 95% CI 0.35 to 1.03, P = .070) for the adjusted models, respectively. The intervention group had significantly more days with 80–100% taking adherence regarding puff inhalers (82 ± 14% vs. 60 ± 30%, P < .001) and dry powder capsules (90 ± .10% vs. 80 ± 21%, P = .01). Timing adherence in participants using puff inhalers was higher in the intervention group (69 ± 25% vs. 51 ± 33%, P < .001). No significant differences in QoL were found between the two groups. Conclusion Participants assigned to the intervention group had significantly better taking and timing adherence of inhaled medication resulting in a trend towards a decreased frequency of exacerbations. However, no effect on time to next exacerbation was observed. Trial registration ClinicalTrials.gov: NCT02386722, Registered 14 February 2014.

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Assessing the impact of the addition of pyriproxyfen on the durability of permethrin-treated bed nets in Burkina Faso: a compound-randomized controlled trial

Malaria Journal ◽

10.1186/s12936-019-3018-1 ◽

2019 ◽

Vol 18 (1) ◽

Cited By ~ 4

Author(s):

Kobié H. Toé ◽

Frank Mechan ◽

Julie-Anne A. Tangena ◽

Marion Morris ◽

Joanna Solino ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Burkina Faso ◽

Pyrethroid Resistance ◽

Controlled Trial ◽

Sub Saharan Africa ◽

World Health ◽

Target Range ◽

Bed Nets ◽

Randomized Controlled ◽

The Impact

Abstract Background Long-lasting insecticidal nets (LLINs) treated with pyrethroids are the foundation of malaria control in sub-Saharan Africa. Rising pyrethroid resistance in vectors, however, has driven the development of alternative net formulations. Here the durability of polyethylene nets with a novel combination of a pyrethroid, permethrin, and the insect juvenile hormone mimic, pyriproxyfen (PPF), compared to a standard permethrin LLIN, was assessed in rural Burkina Faso. Methods A compound-randomized controlled trial was completed in two villages. In one village 326 of the PPF-permethrin nets (Olyset Duo) and 327 standard LLINs (Olyset) were distributed to assess bioefficacy. In a second village, 170 PPF-permethrin nets and 376 LLINs were distributed to assess survivorship. Nets were followed at 6-monthly intervals for 3 years. Bioefficacy was assessed by exposing permethrin-susceptible and resistant Anopheles gambiae sensu lato mosquito strains to standard World Health Organization (WHO) cone and tunnel tests with impacts on fertility measured in the resistant strain. Insecticide content was measured using high-performance liquid chromatography. LLIN survivorship was recorded with a questionnaire and assessed by comparing the physical integrity using the proportionate hole index (pHI). Results The PPF-permethrin net met WHO bioefficacy criteria (≥ 80% mortality or ≥ 95% knockdown) for the first 18 months, compared to 6 months for the standard LLIN. Mean mosquito mortality for PPF-permethrin nets, across all time points, was 8.6% (CI 2.6–14.6%) higher than the standard LLIN. Fertility rates were reduced after PPF-permethrin net exposure at 1-month post distribution, but not later. Permethrin content of both types of nets remained within the target range of 20 g/kg ± 25% for 242/248 nets tested. The pyriproxyfen content of PPF-permethrin nets declined by 54%, from 10.4 g/kg (CI 10.2–10.6) to 4.7 g/kg (CI 3.5–6.0, p < 0.001) over 36 months. Net survivorship was poor, with only 13% of PPF-permethrin nets and 12% of LLINs still present in the original household after 36 months. There was no difference in the fabric integrity or survivorship between the two net types. Conclusion The PPF-permethrin net, Olyset Duo, met or exceeded the performance of the WHO-recommended standard LLIN (Olyset) in the current study but both net types failed the 3-year WHO bioefficacy criteria.

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PHARMACEUTICAL CARE OF ADOLESCENTS WITH DIABETES MELLITUS TYPE 1: THE DIADEMA STUDY, A RANDOMIZED CONTROLLED TRIAL

Archives of Disease in Childhood ◽

10.1136/archdischild-2015-310148.7 ◽

2015 ◽

Vol 101 (1) ◽

pp. e1.67-e1

Author(s):

Emina Obarčanin ◽

Manfred Krueger ◽

Petra Mueller ◽

Verena Nemitz ◽

Holger Schwender ◽

...

Keyword(s):

Diabetes Mellitus ◽

Pharmaceutical Care ◽

Intervention Group ◽

Well Being ◽

Diabetes Mellitus Type ◽

Control Group ◽

Randomized Controlled ◽

Phone Calls ◽

The Impact

BackgroundAdolescents with type 1 diabetes mellitus (T1DM) often show low adherence to complex insulin regimens, leading to poor glycemic control. The benefit of pharmaceutical care in adults with diabetes mellitus type 2 (T2DM) has been widely explored; however, evidence in adolescents with T1DM remains scarce.ObjectiveTo evaluate the impact of pharmaceutical care in adolescents with T1DM provided by a multidisciplinary team on multiple important clinical outcomes.SettingAt the outpatient Helios Paediatric Clinic and at the 12 regular community pharmacies of the study patients with 14 pharmacists in the Krefeld area, Germany, and at the University Pediatric Clinic with one pharmacist on-site in Sarajevo, Bosnia-Herzegovina.MethodsA randomized, controlled, prospective, multicenter study in 68 adolescents with T1DM. The intervention group received monthly structured pharmaceutical care delivered by pharmacists plus supplementary phone calls for 6 months. The control group received usual diabetic care. Data were collected at baseline and after 3 and 6 months. In addition, HbA1c was measured after 12 months.Main outcome measures The between-group difference in the change from baseline in glycosylated hemoglobin (HbA1c), the number of severe hypoglycemic events in both groups, and patient well-being in the intervention group.ResultsThe improvement from baseline in HbA1c was significantly greater in the intervention group than in the control group after 6 months (change from baseline −0.54 vs. +0.32%, p=0.0075), even after adjustment for country-specific variables (p=0.0078). However, the effect was more pronounced after only 3 months (−1.09 vs. +0.23%, p=0.00002). There was no significant between-group difference in the number of severe hypoglycemia events. After 6 months, the well-being according to the WHO-5 index in the intervention group increased significantly from 52.8% to 63.3%. After 12 months the mean total HbA1c remained significantly reduced in the intervention compared to the control group (8.6% vs. 9.5%, p=0.0184).ConclusionThe improved outcomes seen in this study provide new evidence that pharmaceutical care adds value to the management of T1DM in adolescents. However, the optimal methods of achieving sustained long-term improvements in this specific patient population require further study.

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Eggs in Early Complementary Feeding and Child Growth: A Randomized Controlled Trial

PEDIATRICS ◽

10.1542/peds.2016-3459 ◽

2017 ◽

Vol 140 (1) ◽

pp. e20163459 ◽

Cited By ~ 81

Author(s):

Lora L. Iannotti ◽

Chessa K. Lutter ◽

Christine P. Stewart ◽

Carlos Andres Gallegos Riofrío ◽

Carla Malo ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Complementary Feeding ◽

Controlled Trial ◽

Child Growth ◽

Randomized Controlled

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Program Keluarga Harapan dan Pemanfaatan Pelayanan Kesehatan Preventif

Kesmas National Public Health Journal ◽

10.21109/kesmas.v5i5.130 ◽

2011 ◽

Vol 5 (5) ◽

pp. 218

Author(s):

Budi Hidayat ◽

Hendratno Tuhiman ◽

Rudy Prawiradinata ◽

Pungky Sumadi

Keyword(s):

Intervention Program ◽

Preventive Health Care ◽

Child Growth ◽

Cash Transfers ◽

Conditional Cash Transfers ◽

Preventive Health ◽

Double Difference ◽

Growth Monitoring ◽

The Government ◽

The Impact

Program keluarga harapan (PKH) yang berbasis bantuan tunai bersyarat (conditional cash transfers, CCT) di bidang pendidikan dan kesehatan telah diluncurkan Pemerintah Indonesia sejak Juli 2007 di 348 kecamatan dari 48 kabupaten/kota di 7 provinsi, namun dampaknya dalam mengurangi angka kemiskinan dan meningkatkan kualitas sumber daya manusia warga miskin belum pernah dievaluasi. Studi ini mengevaluasi dampak awal PKH terhadap penggunaan layanan kesehatan preventif. Evaluasi ini menggunakan rancangan eksperimen, intervensi program PKH berbasis rumah tangga dengan pengukuran sebelum dan sesudah intervensi pada kelompok perlakuan dan kontrol yang sebelumnya dipilih acak pada tingkat kecamatan.Data diperoleh dari survei dasar CCT tahun 2007 dan survei lanjutan PKH tahun 2008 yang dikumpulkan di 6 provinsi. Hasil estimasi metode double-difference menunjukkan dampak program intervensi PKH pada kenaikan sejumlah indikator pelayanan kesehatan preventif seperti kunjungan posyandu, pemantauan tumbuh kembang anak, dan imunisasi. Temuan ini penting sebagai dasar pengambilan keputusan untuk melanjutkan program. Namun karena evaluasi awal ini memiliki sejumlah keterbatasan, hasil studi ini harus ditafsirkan hati-hati dan divalidasi lebih lanjut dengan data survei PKH tahun 2009 menggunakan berbagai metode analisisKata kunci: Evaluasi dampak, bantuan tunai bersyarat, program keluarga harapan, pelayanan kesehatan preventifAbstractFamily hope program (PKH), a conditional cash transfers (CCT)-based program in education and health, has been launched by the Government of Indonesia since 2007 in 348 sub-districts of 48 regencies/cities in 7 provinces, but its impact on the reduction of poverty and improvement of poor human resources has not been evaluated. This study valuates initial impact of the PKH on the utilization of preventive healthcare services. This evaluation applies experimental design, a household-based intervention program with measurements prior to and after-intervention in both treatment and control groups that previously were chosen randomly at the sub-district level. The data were obtained from CCT baseline surveys 2007 and PKH follow-up survey 2008 in 6 provinces. Double-difference estimates show the impact of PKH on the increase of preventive health care services indicators such as visit to posyandu, child growth monitoring, and immunization. These findings are important for decision making to continue the program. However, as this initial evaluation has a number of limitations, this study should be interpreted with caution and be validated further by PKH survey 2009 data using different methods of analysis.Key words: Impact evaluation, conditional cash transfers, family hope program, preventive health services

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Update on Technical issues concerning Complementary Feeding of Young Children in Developing Countries and Implications for Intervention Programs

Food and Nutrition Bulletin ◽

10.1177/156482650302400102 ◽

2003 ◽

Vol 24 (1) ◽

pp. 5-28 ◽

Cited By ~ 381

Author(s):

Kathryn G. Dewey ◽

Kenneth H. Brown

Keyword(s):

Young Children ◽

Complementary Feeding ◽

Child Growth ◽

Complementary Foods ◽

New Energy ◽

Research Findings ◽

Technical Issues ◽

New Research ◽

Comprehensive Programs ◽

The Impact

This paper provides an update to the 1998 WHO/UNICEF report on complementary feeding. New research findings are generally consistent with the guidelines in that report, but the adoption of new energy and micronutrient requirements for infants and young children will result in lower recommendations regarding minimum meal frequency and energy density of complementary foods, and will alter the list of “problem nutrients.” Without fortification, the densities of iron, zinc, and vitamin B6 in complementary foods are often inadequate, and the intake of other nutrients may also be low in some populations. Strategies for obtaining the needed amounts of problem nutrients, as well as optimizing breastmilk intake when other foods are added to the diet, are discussed. The impact of complementary feeding interventions on child growth has been variable, which calls attention to the need for more comprehensive programs. A six-step approach to planning, implementing, and evaluating such programs is recommended.

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