scholarly journals Effect of Synthetic Vitamin A and Probiotics Supplementation for Prevention of Morbidity and Mortality during the Neonatal Period. A Systematic Review and Meta-Analysis of Studies from Low- and Middle-Income Countries

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 791
Author(s):  
Aamer Imdad ◽  
Faseeha Rehman ◽  
Evan Davis ◽  
Suzanna Attia ◽  
Deepika Ranjit ◽  
...  
Keyword(s):  
Vitamin A ◽  
Neonatal Period ◽  
Hospital Setting ◽  
Morbidity And Mortality ◽  
Probiotic Supplementation ◽  
Vitamin A Supplementation ◽  
Middle Income ◽  
Middle Income Countries ◽  
All Cause Mortality ◽  
Low And Middle Income

Background: Suboptimal nutritional status of a newborn is a risk factor for short- and long-term morbidity and mortality. The objectives of this review were to assess the efficacy and effectiveness of neonatal synthetic vitamin A supplementation, dextrose gel and probiotic supplementation for prevention of morbidity and mortality during infancy in low and middle-income countries. Methods: We included randomized trials. Primary outcome was all-cause mortality. We conducted electronic searches on multiple databases. Data were meta-analyzed to obtain relative risk (RR) and 95% confidence interval (CI). Studies for vitamin A and Probiotics were analyzed separately. No studies were found for dextrose gel supplementation during neonatal period. The overall rating of evidence was determined by Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results: Sixteen studies assessed the effect of vitamin A supplementation during the neonatal period. Based on pooled data from community-based studies only, there was no significant effect of vitamin A on all-cause mortality at age 1 month (RR 0.99, 95% CI 0.90, 1.08), 6 months (RR 0.98; 95% CI 0.89–1.08) and 12 months (RR 1.04, 95% CI 0.94, 1.14) but increased risk of bulging fontanelle (RR 1.53, 95% CI 1.12, 2.09). The overall quality of evidence was high for the above outcomes. Thirty-three studies assessed the effect of probiotic supplementation during the neonatal period and were mostly conducted in the hospital setting. Probiotics reduced the risk of all-cause mortality (RR 0.80, 95% CI 0.66, 0.96), necrotizing enterocolitis (RR 0.46, 95% CI 0.35, 0.59) and neonatal sepsis (RR 0.78, 95% CI 0.70, 0.86). The grade ratings for the above three outcomes were high. Conclusions: Vitamin A supplementation during the neonatal period does not reduce all-cause neonatal or infant mortality in low and middle-income countries in the community setting. Probiotic supplementation during the neonatal period seems to reduce all-cause mortality, NEC, and sepsis in babies born low birth weight and/or preterm in the hospital setting.

scholarly journals Consumption of Vitamin-A-Rich Foods and Vitamin A Supplementation for Children under Two Years Old in 51 Low- and Middle-Income Countries

Nutrients ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 188
Author(s):  
Omar Karlsson ◽  
Rockli Kim ◽  
Andreas Hasman ◽  
S. V. Subramanian
Keyword(s):  
Vitamin A ◽  
Dietary Diversity ◽  
Demographic And Health Surveys ◽  
Cross Sectional ◽  
Vitamin A Supplementation ◽  
Middle Income ◽  
Persistent Problem ◽  
Middle Income Countries ◽  
Minimum Dietary Diversity ◽  
Low And Middle Income

Vitamin A supplementation for children 6–59 months old is an important intervention that boosts immune function, especially where children do not consume enough vitamin-A-rich foods. However, the low coverage of vitamin A supplementation is a persistent problem in low- and middle-income countries. We first estimated the percentage of children 6–23 months old receiving the minimum dietary diversity, vitamin-A-rich foods, and vitamin A supplementation, and second, the difference in the percentage receiving vitamin A supplementation between children 6–23 months old and children 24–59 months old using nationally representative cross-sectional household surveys, namely, the Demographic and Health Surveys, conducted from 2010 to 2019 in 51 low- and middle-income countries. Overall, 22% (95% CI: 22, 23) of children received the minimum dietary diversity, 55% (95% CI: 54, 55) received vitamin-A-rich foods, 59% (95% CI: 58, 59) received vitamin A supplementation, and 78% (95% CI: 78, 79) received either vitamin-A-rich foods or supplementation. A wide variation across countries was observed; for example, the percentage of children that received either vitamin-A-rich foods or supplementation ranged from 53% (95% CI: 49, 57) in Guinea to 96% (95% CI: 95, 97) in Burundi. The coverage of vitamin A supplementation should be improved, especially for children 6–23 months old, in most countries, particularly where the consumption of vitamin-A-rich foods is inadequate.

scholarly journals Pneumococcal Vaccines: Challenges and Prospects

Vaccines ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 25
Author(s):  
Paul Licciardi ◽  
Ioanna Papadatou
Keyword(s):  
Streptococcus Pneumoniae ◽  
Morbidity And Mortality ◽  
Pneumococcal Vaccines ◽  
Middle Income ◽  
Middle Income Countries ◽  
Common Causes ◽  
Low And Middle Income

Infections with the bacterium Streptococcus pneumoniae are one of the most common causes of morbidity and mortality in children less than five years of age worldwide, mostly in low- and middle-income countries (LMICs) [...]

scholarly journals Maximising benefits and minimising adverse effects of micronutrient interventions in low- and middle-income countries

2019 ◽  
Vol 78 (4) ◽  
pp. 540-546 ◽  
Author(s):  
Kaleab Baye
Keyword(s):  
Adverse Effects ◽  
Vitamin A ◽  
Iron Concentration ◽  
Iodine Intake ◽  
Micronutrient Deficiencies ◽  
Nutrient Deficiencies ◽  
Middle Income ◽  
Middle Income Countries ◽  
Excessive Intake ◽  
Low And Middle Income

Micronutrient deficiencies are widespread and disproportionately affect women and children in low- and middle-income countries (LMIC). Among various interventions, food fortification and supplementation with micronutrients have been proven to be cost-effective. The aim of the present paper is to review existing literature to assess risks of excessive intake in LMIC to then highlight programmatic changes required to maximise benefits of micronutrient interventions while minimising risks of adverse effects. While very few LMIC have national food consumption surveys that can inform fortification programmes, many more are implementing mandatory fortification programmes. The risks of inadequate micronutrient intakes were common, but risks of excessive intakes were also present for iodine, vitamin A, folic acid and iron. Excessive salt consumption, high concentrations of iodine in ground-water and excessive levels of iodisation were linked with excessive iodine intake. For vitamin A, overlapping interventions were the main risk for excessive intake; whereas for iron, contamination with iron from soil and screw-wares of millers and high iron concentration in drinking-water increased the risk of excessive intake, which could be further exacerbated with fortification. Before implementing micronutrient interventions, adherence to the basic principles of documenting evidence confirming that the deficiency in question exists and that fortification will correct this deficiency is needed. This can be supported with dietary intake assessments and biochemical screening that help diagnose nutrient deficiencies. Targeting micronutrient interventions, although programmatically challenging, should be considered whenever possible. Moreover, closer monitoring of appropriate fortification of foods and overlapping interventions is needed.

scholarly journals Assessing the global burden of hemorrhage: The global blood supply, deficits, and potential solutions

2021 ◽  
Vol 9 ◽  
pp. 205031212110549
Author(s):  
Nakul P. Raykar ◽  
Jennifer Makin ◽  
Monty Khajanchi ◽  
Bernard Olayo ◽  
Alejandro Munoz Valencia ◽  
...  
Keyword(s):  
Blood Supply ◽  
Morbidity And Mortality ◽  
Global Burden ◽  
Obstetric Hemorrhage ◽  
Middle Income ◽  
Middle Income Countries ◽  
New Approaches ◽  
Blood Processing ◽  
Low And Middle Income

There is a critical shortage of blood available for transfusion in many low- and middle-income countries. The consequences of this scarcity are dire, resulting in uncounted morbidity and mortality from trauma, obstetric hemorrhage, and pediatric anemias, among numerous other conditions. The process of collecting blood from a donor to administering it to a patient involves many facets from donor availability to blood processing to blood delivery. Each step faces particular challenges in low- and middle-income countries. Optimizing existing strategies and introducing new approaches will be imperative to ensure a safe and sufficient blood supply worldwide.

scholarly journals Assessing the Burden ofClostridium difficileInfection in Low- and Middle-Income Countries

2018 ◽  
Vol 56 (3) ◽  
Author(s):  
G. A. Roldan ◽  
A. X. Cui ◽  
N. R. Pollock
Keyword(s):  
Clostridium Difficile ◽  
Antibiotic Stewardship ◽  
Morbidity And Mortality ◽  
Resource Limited Settings ◽  
Middle Income ◽  
Content Type ◽  
Middle Income Countries ◽  
Resource Limited ◽  
Hospital Acquired ◽  
Low And Middle Income

ABSTRACTIn contrast to the significant resources invested in the diagnosis and prevention ofClostridium difficileinfection (CDI) in resource-rich settings, in resource-limited settings patients with community- and hospital-acquired diarrhea may not routinely be tested for CDI. Is CDI actually less frequent or severe in resource-limited settings, or might we be missing an important opportunity to prevent CDI-related morbidity and mortality (and to promote antibiotic stewardship) in these settings? Here, we review the literature to assess the overall burden of CDI in low- and middle-income countries.

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