scholarly journals The Dietary Intake and Practices of Adolescent Girls in Low- and Middle-Income Countries: A Systematic Review

Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1978 ◽  
Author(s):  
Emily Keats ◽  
Aviva Rappaport ◽  
Shailja Shah ◽  
Christina Oh ◽  
Reena Jain ◽  
...  

In many low- and middle-income countries (LMICs) the double burden of malnutrition is high among adolescent girls, leading to poor health outcomes for the adolescent herself and sustained intergenerational effects. This underpins the importance of adequate dietary intake during this period of rapid biological development. The aim of this systematic review was to summarize the current dietary intake and practices among adolescent girls (10–19 years) in LMICs. We searched relevant databases and grey literature using MeSH terms and keywords. After applying specified inclusion and exclusion criteria, 227 articles were selected for data extraction, synthesis, and quality assessment. Of the included studies, 59% were conducted in urban populations, 78% in school settings, and dietary measures and indicators were inconsistent. Mean energy intake was lower in rural settings (1621 ± 312 kcal/day) compared to urban settings (1906 ± 507 kcal/day). Self-reported daily consumption of nutritious foods was low; on average, 16% of girls consumed dairy, 46% consumed meats, 44% consumed fruits, and 37% consumed vegetables. In contrast, energy-dense and nutrient-poor foods, like sweet snacks, salty snacks, fast foods, and sugar-sweetened beverages, were consumed four to six times per week by an average of 63%, 78%, 23%, and 49% of adolescent girls, respectively. 40% of adolescent girls reported skipping breakfast. Along with highlighting the poor dietary habits of adolescent girls in LMIC, this review emphasizes the need for consistently measured and standardized indicators, and dietary intake data that are nationally representative.

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 491 ◽  
Author(s):  
Christina Oh ◽  
Emily C. Keats ◽  
Zulfiqar A. Bhutta

Almost two billion people are deficient in key vitamins and minerals, mostly women and children in low- and middle-income countries (LMICs). Deficiencies worsen during pregnancy due to increased energy and nutritional demands, causing adverse outcomes in mother and child, but could be mitigated by interventions like micronutrient supplementation. To our knowledge, this is the first systematic review that aimed to compile evidence from both efficacy and effectiveness trials, evaluating different supplementation interventions on maternal, birth, child health, and developmental outcomes. We evaluated randomized controlled trials and quasi-experimental studies published since 1995 in peer-reviewed and grey literature that assessed the effects of calcium, vitamin A, iron, vitamin D, and zinc supplementation compared to placebo/no treatment; iron-folic (IFA) supplementation compared to folic acid only; multiple micronutrient (MMN) supplementation compared to IFA; and lipid-based nutrient supplementation (LNS) compared to MMN supplementation. Seventy-two studies, which collectively involved 314 papers (451,723 women), were included. Meta-analyses showed improvement in several key birth outcomes, such as preterm birth, small-for-gestational age (SGA) and low birthweight with MMN supplementation, compared to IFA. MMN also improved child outcomes, including diarrhea incidence and retinol concentration, which are findings not previously reported. Across all comparisons, micronutrient supplementation had little to no effect on mortality (maternal, neonatal, perinatal, and infant) outcomes, which is consistent with other systematic reviews. IFA supplementation showed notable improvement in maternal anemia and the reduction in low birthweight, whereas LNS supplementation had no apparent effect on outcomes; further research that compares LNS and MMN supplementation could help understand differences with these commodities. For single micronutrient supplementation, improvements were noted in only a few outcomes, mainly pre-eclampsia/eclampsia (calcium), maternal anemia (iron), preterm births (vitamin D), and maternal serum zinc concentration (zinc). These findings highlight that micronutrient-specific supplementation should be tailored to specific groups or needs for maximum benefit. In addition, they further contribute to the ongoing discourse of choosing antenatal MMN over IFA as the standard of care in LMICs.


Nature Food ◽  
2020 ◽  
Vol 1 (10) ◽  
pp. 605-619 ◽  
Author(s):  
W. H. Eugenie Maïga ◽  
Mohamed Porgo ◽  
Pam Zahonogo ◽  
Cocou Jaurès Amegnaglo ◽  
Doubahan Adeline Coulibaly ◽  
...  

Abstract Engagement of youth in agriculture in low- and middle-income countries may offer opportunities to curb underemployment, urban migration, disillusionment of youth and social unrest, as well as to lift individuals and communities from poverty and hunger. Lack of education or skills training has been cited as a challenge to engage youth in the sector. Here we systematically interrogate the literature for the evaluation of skills training programmes for youth in low- and middle-income countries. Sixteen studies—nine quantitative, four qualitative and three mixed methods—from the research and grey literature documented the effects of programmes on outcomes relating to youth engagement, including job creation, income, productivity and entrepreneurship in agriculture. Although we find that skills training programmes report positive effects on our chosen outcomes, like previous systematic reviews we find the topic to chronically lack evaluation. Given the interest that donors and policymakers have in youth engagement in agriculture, our systematic review uncovers a gap in the knowledge of their effectiveness.


2021 ◽  
Vol 5 (2) ◽  
pp. 129-136
Author(s):  
Irene Kida Minja ◽  
Edda Tandi Lwoga

Purpose of this systematic review was to bring together studies of evidence-based practice among dentists in low- and middle-income countries, where its use has been reported to be limited. The protocol was registered in PROSPERO. Methodology: We searched the evidence (in English only) from medical databases including PubMed, EBSCO, The Cochrane Library, CINAHL, ScienceDirect, HINARI summon, and SCOPUS and Web of Science via Research4Life, grey literature, hand search from relevant articles, and augmented results on Google scholar.Published reports were retrieved from relevant websites and organizations. Studies included those that looked at key factors that facilitate or hinder Evidence Based Dentistry (EBD), as well as outcomes in terms of: knowledge, attitudes and skills of EB practice among dentists; and the methodology used and their relevance in future EBD strategies.Main focus was on dentists, as practitioners and faculty members. Studies on students and non-dental personnel were excluded.Findings:A total of 4568 records were retrieved and five potentially relevant articles were selected after title/abstract screening. Two articles were excluded after full text screening, and therefore Three papers were included in this review. The studies report limited knowledge,unsatisfactory attitude towards EBD and lowpractice of EBD and use of scientific evidence databases. None of the studies reported implementation of EBD nor evaluation thereof. The main barriers that constrained application of EBD ranged from lack of interest to infrastructural limitations. Originality: The current review showed that there is a need to strategised implementation of EBD in this region.


BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e042788
Author(s):  
Chukwudi Arnest Nnaji ◽  
Paul Kuodi ◽  
Fiona M Walter ◽  
Jennifer Moodley

IntroductionBreast and cervical cancers pose a major public health burden globally, with disproportionately high incidence, morbidity and mortality in low- and middle-income countries (LMICs). The majority of women diagnosed with cancer in LMICs present with late-stage disease, the treatment of which is often costlier and less effective. While interventions to improve the timely diagnosis of these cancers are increasingly being implemented in LMICs, there is uncertainty about their role and effectiveness. The aim of this review is to systematically synthesise available evidence on the nature and effectiveness of interventions for improving timely diagnosis of breast and cervical cancers in LMICs.Methods and analysisA comprehensive search of published and relevant grey literature will be conducted. The following electronic databases will be searched: MEDLINE (via PubMed), Cochrane Library, Scopus, CINAHL, Web of Science and the International Clinical Trials Registry Platform (ICTRP). Evidence will be synthesised in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). Two reviewers will independently screen the search outputs, select studies using predefined inclusion criteria and assess each included study for risk of bias. If sufficient data are available and studies are comparable in terms of interventions and outcomes, a meta-analysis will be conducted. Where studies are not comparable and a meta-analysis is not appropriate, a narrative synthesis of findings will be reported.Ethics and disseminationAs this will be a systematic review of publicly available data, with no primary data collection, it will not require ethical approval. Findings will be disseminated widely through a peer-reviewed publication and forums such as conferences, workshops and community engagement sessions. This review will provide a user-friendly evidence summary for informing further efforts at developing and implementing interventions for addressing delays in breast and cervical cancer diagnosis in LMICs.PROSPERO registration numberCRD42020177232.


2021 ◽  
Author(s):  
Moses Ocan ◽  
Brenda Allen Kawala ◽  
Ephraim Kisangala ◽  
Regina Ndagire ◽  
Rachel Nante Wangi ◽  
...  

Abstract Background: Globally, health care workers continue to be infected, fall ill and die at the frontline of the Coronavirus disease 2019 (COVID-19) fight, an indicator of inadequate safety in health facilities. This rapid evidence synthesis aims to highlight the impacts of COVID-19 on healthcare workers in low-and middle-income countries (LMICs) in terms of infections, illnesses and deaths. Methods: A systematic review will be done. Article search will be performed by an experienced librarian in PubMed, MEDLINE Ovid, Google Scholar, COVID-END, Cochrane library and targeted search from other relevant sources. MeSH terms and Boolean operators “AND” and “OR” will be used in the article search. Independent reviewers will screen the retrieved articles using a priori criteria. Data abstraction will be done using an excel based abstraction tool and synthesized using structured narratives and summary of findings tables. Discussion and anticipated use of results: This evidence synthesis seeks to analyze the impact of COVID-19 on the healthcare systems of low- and middle-income countries. Information on healthcare worker infections, illness, and deaths due to COVID-19, will be collated from published research articles. This will help guide decision makers in establishing low- cost high impact interventions to mitigate the effects of COVID-19 in the health work force.Protocol registration: PROSPERO CRD 42020204174


2019 ◽  
Vol 10 (5) ◽  
pp. 827-847 ◽  
Author(s):  
Myra J Shapiro ◽  
Shauna M Downs ◽  
Haley J Swartz ◽  
Megan Parker ◽  
Diana Quelhas ◽  
...  

Abstract Animal-source foods (ASFs) are a food group of interest for interventions aimed at reducing stunting and other inadequate growth measures in early childhood. The aim of this systematic review was to examine the relation between ASF consumption and stunting in children aged 6–60 mo in low- and middle-income countries (LMICs). The secondary aim was to examine the relation between ASF consumption and other indicators of growth and development (length/height, weight, head circumference, and anemia). A search of the peer-reviewed and grey literature published from January 1980 to June 2017 was conducted. Databases searched included CINAHL, Embase, Global Index Medicus, PubMed, and Web of Science. There were 14,783 records and 116 full text articles dual screened; 21 studies were included in the review and were dual evaluated for risk of bias (RoB). The relation between ASF and stunting (length- or height-for-age z-score←2) was examined in randomized-controlled trials [(RCTs), n = 3] and cross-sectional studies (n = 4) only; ASF reduced stunting in 1 RCT and was associated with reduced stunting in 1 cross-sectional study. We did not identify any longitudinal cohorts that examined this relation. The relation between ASF and secondary indicators length/height, weight, head circumference, and anemia were largely nonsignificant across study designs. The intervention/exposure, comparator, outcome measures, methods, and analyses were highly heterogeneous. Although we did not find a consistent relation between ASF consumption and our primary and secondary outcomes, this may have been a function of inconsistencies in study design. Foods in the whole diet, particularly combination dishes, are inherently difficult to assess. To quantitatively assess the relation between ASF and stunting and other indicators of growth and iron status in early childhood, future research should provide consistency in the definition and quantification of the exposure and outcomes allowing for interstudy quantitative comparisons.


2021 ◽  
Author(s):  
Moses Ocan ◽  
Brenda Allen Kawala ◽  
Ephraim Kisangala ◽  
Regina Ndagire ◽  
Rachel Nante Nante Wangi ◽  
...  

Abstract Background: Globally, health care workers continue to be infected, fall ill and die at the frontline of the Coronavirus Disease 2019 (COVID-19) fight, an indicator of inadequate safety in health facilities. This rapid evidence synthesis aims to highlight the impacts of COVID-19 on healthcare workers in low-and middle-income countries (LMICs) in terms of infections, illnesses and deaths. Methods: A systematic review will be done. Article search will be performed by an experienced librarian in PubMed, MEDLINE Ovid, Google Scholar, COVID-END, Cochrane library and targeted search from other relevant sources. MeSH terms and Boolean operators “AND” and “OR” will be used in the article search. Independent reviewers will screen the retrieved articles using a priori criteria. Data abstraction will be done using an excel based abstraction tool and synthesized using structured narratives and summary of findings tables. Discussion: This evidence synthesis seeks to analyze the impact of COVID-19 on the healthcare systems of low- and middle-income countries. Information on healthcare worker infections, illness, and deaths due to COVID-19, will be collated from published research articles. This will help guide decision makers in establishing low- cost high impact interventions to mitigate the effects of COVID-19 in the health work force.Protocol registration: PROSPERO CRD 42020204174 [1] [1] This protocol registration can be found at; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020204174


2020 ◽  
Vol 11 (4) ◽  
pp. 951-959 ◽  
Author(s):  
Jenna L Moodie ◽  
Susan C Campisi ◽  
Kristen Salena ◽  
Megan Wheatley ◽  
Ashley Vandermorris ◽  
...  

ABSTRACT Despite increasing global attention to adolescent health in low- and middle-income countries (LMICs), limited literature exists on the timing of pubertal development in these settings. This study aimed to determine the age at menarche (AAM) and age of puberty onset [female Tanner Stage Breast 2 (B2) and male Tanner Stage Genital 2 (G2)] among healthy adolescents living in LMICs. It also aimed to explore the impact of nutritional status on pubertal timing in this population. MEDLINE, Embase, Cochrane CENTRAL, Web of Science, Scopus, and grey literature databases were searched. Observational studies and control arms of randomized controlled trials (RCTs) with healthy participants from LMICs born in or after 1998 were included. Pooled estimates with 95% CIs were calculated by random-effects meta-analyses using the DerSimonian and Laird inverse variance method for each pubertal milestone and by BMI category subgroups. Twenty-seven studies were included in the meta-analysis, representing 90,188 adolescents (78.3% female). Pooled mean estimates for AAM for normal, thin, and overweight BMI groupings were 12.3 y (95% CI: 12.1, 12.5), 12.4 y (95% CI: 12.2, 12.6), and 12.1 y (95% CI: 11.7, 12.5), respectively. For Tanner Stage B2, pooled mean age estimates for normal, thin, and overweight BMI groupings were 10.4 y (95% CI: 9.2, 11.6), 10.2 y (95% CI: 9.3, 11.4), and 8.4 y (95% CI: 6.8, 10.0), respectively. Finally, for Tanner Stage G2, pooled mean estimates for normal, thin, and overweight BMI groupings were 11.0 y (95% CI: 10.3, 11.7), 11.3 y (95% CI: 9.8, 12.9), and 10.3 y (95% CI: 10.0, 10.6), respectively. Data on the timing of pubertal milestones has traditionally come from high-income settings. In this systematic review of contemporary data from adolescents in LMICs, AAM, as well as age at pubertal onset, were similar to those reported from high-income settings.


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