scholarly journals Unsafe Drinking Water Is Associated with Environmental Enteric Dysfunction and Poor Growth Outcomes in Young Children in Rural Southwestern Uganda

2018 ◽  
Vol 99 (6) ◽  
pp. 1606-1612 ◽  
Author(s):  
Jacqueline M. Lauer ◽  
Christopher P. Duggan ◽  
Lynne M. Ausman ◽  
Jeffrey K. Griffiths ◽  
Patrick Webb ◽  
...  
Keyword(s):  
Drinking Water ◽  
Young Children ◽  
Poor Growth ◽  
Growth Outcomes ◽  
Environmental Enteric Dysfunction ◽  
Southwestern Uganda

scholarly journals Effect of maternal aflatoxin exposure through diet on growth of infants 0 - 3 months in Kisumu county, Kenya

2021 ◽  
Vol 21 (04) ◽  
pp. 17907-17930
Author(s):  
MI Obade ◽  
◽  
P Andang’o ◽  
C Obonyo ◽  
F Lusweti ◽  
...  
Keyword(s):  
Young Children ◽  
Cox Regression ◽  
Infant Growth ◽  
Enzyme Linked Immunosorbent Assay ◽  
Poor Growth ◽  
Birth Prevalence ◽  
Infant Exposure ◽  
Regression Effect ◽  
Growth Outcomes ◽  
Baseline Characteristics

Aflatoxins are naturally occurring carcinogenic toxins associated with poor growth outcomes in young children. Although evidence supports mother-to-infant exposure during pregnancy and breastfeeding, evidence of its effect on growth is limited to the period after introduction of complementary foods. It is, therefore, unclear whether early maternal exposure to aflatoxins affects infant growth right from birth. Prevalence of aflatoxin levels of 40% has been observed in Nyanza region, Kenya, and 22.7% of children under 5 years are stunted. The purpose of this study was to determine the effect of maternal aflatoxin exposure on growth of infants 0-3 months old in Kisumu County, Kenya. Specific objectives were to: establish association between maternal baseline characteristics and aflatoxin exposure; establish association between infant baseline characteristics at birth and maternal aflatoxin exposure; determine effect of maternal aflatoxin exposure on infant growth indicators at 3 months of age. Out of 553 pregnant women who were screened for aflatoxin exposure, 137 exposed and 137 non-exposed women, matched for age and household income, participated in an 8-month cohort study. The women were followed up to delivery and their infants up to 3 months after delivery. Infant length and weight data was collected monthly. Length-for-age (LAZ), weight-for-length (WLZ)) and weight-for-age (WAZ) z-scores were generated. Aflatoxin levels were analyzed using Enzyme Linked Immunosorbent Assay (ELISA) in parts per billion (ppb). Effects of aflatoxin on infant growth outcomes were assessed using multi-variate linear and logistic regression. Effect of maternal aflatoxin exposure on infant length, weight, LAZ, WLZ, WAZ was determined using Cox regression with constant time at risk. Infants of exposed women had lower weight (95% CI:-0.85,-0.53), length (95% CI: -4.08, -3.36), LAZ (95% CI: -1.93, -1.16) and WAZ (95% CI:-1.03, -0.54) at 3 months of age, but there was no difference in WLZ (95% CI:-0.03, 0.74). Risk for stunting was higher in infants of exposed women (RR=4.08; 95% CI: 1.35, 12.29). There was no difference in the risk for underweight (RR=6.61; 95% CI: 0.80-54.33) and wasting (RR=0.37; 95% CI: 0.40, 3.39, P=0.38).These results underpin the need to reduce aflatoxin exposure in infants and young children who are very vulnerable.

scholarly journals The association between WASH, nutrition, and early childhood growth faltering in rural Cambodia: a cross-sectional risk factor analysis

2021 ◽  
Author(s):  
Amanda Justine Lai ◽  
Ramya Ambikapathi ◽  
Oliver Cumming ◽  
Krisna Seng ◽  
Irene Velez ◽  
...  
Keyword(s):  
Drinking Water ◽  
Regression Models ◽  
Water Source ◽  
Community Level ◽  
Standard Errors ◽  
Drinking Water Source ◽  
Household Level ◽  
Growth Outcomes ◽  
Growth Faltering ◽  
Robust Standard Errors

Background Inadequate nutrition in early life and exposure to sanitation-related enteric pathogens have been linked to poor growth outcomes in children. Despite rapid development in Cambodia, high prevalence of growth faltering and stunting persist among children. This study aimed to assess nutrition and WASH variables and their association with nutritional status of children under 24 months in rural Cambodia. Methods We conducted surveys in 491 villages across 55 rural communes in Cambodia in September 2016 to measure associations between child, household, and community-level risk factors for stunting and length-for-age z-score (LAZ). A primary survey measured child-level variables, including anthropometric measures and risk factors for growth faltering and stunting, for 4,036 children under 24 months of age from 3,877 households (approximately 8 households per village). A secondary survey of 5,341 households, including the same households from the primary survey and an additional 1,464 households (approximately 3 additional household per village) from the same villages, assessed village-level WASH variables to understand community water, sanitation, and hygiene (WASH) conditions that may influence child growth outcomes. For LAZ, we calculated bivariate and adjusted associations (as mean differences) with 95% confidence intervals using generalized estimating equations (GEEs) to fit linear regression models with robust standard errors. For stunting, we calculated unadjusted and adjusted prevalence ratios (PRs) with 95% confidence intervals using GEEs to fit Poisson regression models with robust standard errors. For all models assessing effects of household-level variables, we used GEEs to account for clustering at the village level. Findings After adjustment for potential confounders, presence of water and soap at a household's handwashing station was found to be significantly associated (p<0.05) with increased LAZ (adjusted mean difference in LAZ +0.10, 95% CI 0.03 to 0.16), and household use of an improved drinking water source was associated with less stunting in children compared to households that did not use an improved source of drinking water (aPR 0.81, 95% CI 0.66 to 0.98); breastfeeding and community-level access to an improved drinking water source were associated with a lower LAZ score (-0.16, 95% CI -0.27 to -0.05; -0.13, 95% CI -0.26 to 0.00). No other nutrition (i.e., dietary diversity, meal frequency) or sanitation variables (i.e., household's safe disposal of child stools, household-level sanitation, community-level sanitation) were measured to be associated with LAZ scores or stunting in children under 24 months of age.

Higher prevalence of stunting and poor growth outcomes in HIV-exposed uninfected than HIV-unexposed infants in Kenya

AIDS ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jillian Neary ◽  
Agnes Langat ◽  
Benson Singa ◽  
John Kinuthia ◽  
Janet Itindi ◽  
...  
Keyword(s):  
Poor Growth ◽  
Growth Outcomes ◽  
Hiv Exposed ◽  
Exposed Uninfected

Fecal Contamination on the Household Compound and in Water Sources are Associated with Subsequent Diarrhea in Young Children in Urban Bangladesh (CHoBI7 Program)

2021 ◽  
Author(s):  
Tahmina Parvin ◽  
Elizabeth D. Thomas ◽  
Md. Sazzadul Islam Bhuyian ◽  
Ismat Minhaj Uddin ◽  
Md. Tasdik Hasan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Drinking Water ◽  
Young Children ◽  
Diarrheal Disease ◽  
Fecal Contamination ◽  
Significant Risk ◽  
Sociodemographic Factors ◽  
Individual Level ◽  
Colony Forming Units ◽  
Slum Areas

We investigated the environmental and individual-level risk factors for diarrheal disease among young children in slum areas of Dhaka, Bangladesh. A prospective cohort study was conducted among 884 children under 5 years of age. Caregiver reports were collected on sociodemographic factors and hygiene behaviors. Diarrhea surveillance data was collected monthly based on caregiver-reported diarrhea for children in the past 2 weeks during the 12-month study period. Unannounced spot checks of the household compound were performed at 1, 3, 6, 9, and 12 months after enrollment to check for the presence of feces (animal or human) and the presence of animals in the child’s sleeping space, to assess child and caregiver hands for the presence of dirt, and to collect samples of the household’s source and stored drinking water. Children with feces found on the household compound during spot checks had a significantly higher odds of diarrhea (odds ratio: 1.71; 95% confidence interval: 1.23–2.38). Children residing in households with > 100 colony forming units/100 mL Escherichia coli in source drinking water had a significantly higher odds of diarrhea (OR: 1.43; 95% CI: 1.06–1.92). The presence of feces on the household compound and source drinking water with > 100 colony forming units/100 mL E. coli were significant risk factors for diarrheal disease for children < 5 years of age in slum areas of Dhaka, Bangladesh. These findings demonstrate the urgent need for comprehensive interventions to reduce fecal contamination on the household compound to protect the health of susceptible pediatric populations.

Forging Partnerships to Provide Computer Literacy in Swaziland

2008 ◽  
pp. 2394-2400
Author(s):  
C. M. Magagula
Keyword(s):  
Developing Countries ◽  
Drinking Water ◽  
Young Children ◽  
United Nations ◽  
Computer Literacy ◽  
Development Programme ◽  
Access To Education ◽  
The World ◽  
Nations Development ◽  
Global Population

The challenges facing the world, especially developing countries like Swaziland, are many and varied. The United Nations Development Programme (UNDP) estimates that over two billion people, out of a global population of six billion, do not have access to education. The majority of these people are found in developing countries. As many as 113 million children do not attend school. More than one billion people still live on less than US$1 a day and lack access to safe drinking water. More than two billion people in the world in developing countries in particular, lack sanitation. Every year, nearly 11 million young children die before their fifth birthday, mainly from preventable illnesses. The risk of dying in childbirth in developing countries is one in 48 (UNDP, 2003). In most developing countries, especially in remote areas, the situation is exacerbated by lack of electricity.

scholarly journals Maternal HIV infection and other factors associated with growth outcomes of HIV-uninfected infants in Entebbe, Uganda

2013 ◽  
Vol 16 (9) ◽  
pp. 1548-1557 ◽  
Author(s):  
Lawrence Muhangi ◽  
Swaib A Lule ◽  
Harriet Mpairwe ◽  
Juliet Ndibazza ◽  
Moses Kizza ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Maternal Education ◽  
Hiv Transmission ◽  
Growth Data ◽  
Poor Growth ◽  
Growth Outcomes ◽  
Maternal Hiv ◽  
Maternal Hiv Infection ◽  
Hiv Exposed ◽  
Living Children

AbstractObjectiveTo assess the associations between maternal HIV infection and growth outcomes of HIV-exposed but uninfected infants and to identify other predictors for poor growth among this population.DesignWithin a trial of de-worming during pregnancy, the cohort of offspring was followed from birth. HIV status of the mothers and their children was investigated and growth data for children were obtained at age 1 year. Length-for-age, weight-for-age and weight-for-length Z-scores were calculated for each child; Z-scores <−2 were defined as stunting, underweight and wasting, respectively.SettingThe study was conducted in Entebbe municipality and Katabi sub-county, Uganda.SubjectsThe sample consisted of 1502 children aged 1 year: HIV-unexposed (n 1380) and HIV-exposed not infected (n 122).ResultsPrevalence of stunting, underweight and wasting was 14·2 %, 8·0 % and 3·9 %, respectively. There was evidence for an association between maternal HIV infection and odds of being underweight (adjusted OR = 2·32; 95 % CI 1·32, 4·09; P = 0·006) but no evidence for an association with stunting or with wasting. Young maternal age, low maternal education, low birth weight, early weaning and experiencing a higher number of episodes of malaria during infancy were independent predictors for stunting and underweight. A higher number of living children in the family was associated with wasting.ConclusionsMaternal HIV infection was associated with being underweight in HIV-exposed uninfected infants. The success of programmes for prevention of mother-to-child HIV transmission means that an increasing number of infants will be born to HIV-infected women without acquiring HIV. Therefore, viable nutritional interventions need to be identified for this population.

Use of Cyproheptadine in Young Children With Feeding Difficulties and Poor Growth in a Pediatric Feeding Program

2014 ◽  
Vol 59 (5) ◽  
pp. 674-678 ◽  
Author(s):  
Ana M.G.A. Sant’Anna ◽  
Patricia S. Hammes ◽  
Mafalda Porporino ◽  
Chantal Martel ◽  
Catherine Zygmuntowicz ◽  
...  
Keyword(s):  
Young Children ◽  
Poor Growth ◽  
Feeding Difficulties ◽  
Feeding Program ◽  
Pediatric Feeding

scholarly journals Zinc Absorption from Micronutrient Powders Is Low in Bangladeshi Toddlers at Risk of Environmental Enteric Dysfunction and May Increase Dietary Zinc Requirements

2019 ◽  
Vol 149 (1) ◽  
pp. 98-105 ◽  
Author(s):  
Julie M Long ◽  
Prasenjit Mondal ◽  
Jamie E Westcott ◽  
Leland V Miller ◽  
M Munirul Islam ◽  
...  
Keyword(s):  
Young Children ◽  
Intestinal Inflammation ◽  
Nonlinear Models ◽  
Published Data ◽  
Inflammatory Disorder ◽  
Zinc Absorption ◽  
Chronic Inflammatory Disorder ◽  
Isotope Tracers ◽  
Micronutrient Powder ◽  
Environmental Enteric Dysfunction

ABSTRACT Background Environmental enteric dysfunction (EED), a chronic inflammatory disorder of the small bowel, is suspected to impair absorption of micronutrients, including zinc. Objective The objective of this study was to compare zinc absorption from micronutrient powder (MNP) over a range of zinc doses in young children screened for EED with use of the lactulose:mannitol ratio (L:M). Methods Bangladeshi children aged 18–24 mo, grouped according to high and low L:M (≥0.09 and <0.09, respectively), were randomly assigned to MNP with 0, 5, 10, or 15 mg Zn/sachet (10 subjects per dose per L:M group). Over a day, fractional absorption of zinc was measured from an MNP-fortified meal and from unfortified meals with stable isotope tracers; total daily absorbed zinc (TAZ, milligrams per day) was determined as the primary outcome. Secondary outcomes included investigation of relations of TAZ to intake, to physiologic requirement, and to other variables, including biomarkers of systemic and intestinal inflammation, using nonlinear models. TAZ was also compared with published data on child zinc absorption. Results In 74 subjects who completed the study, zinc absorption did not differ by L:M grouping. Most biomarkers of intestinal inflammation were elevated in both L:M groups. For combined L:M groups, mean ± SD TAZ for each MNP dose (0, 5, 10, and 15 mg/sachet) was 0.57 ± 0.30, 0.68 ± 0.31, 0.90 ± 0.43, and 1.0 ± 0.39 mg/d, respectively (P = 0.002), and exceeded the estimated physiologic requirement only for the 10- and 15-mg MNP doses. Zinc absorption was notably lower at all intake levels compared with published data (P < 0.0001) and was inversely related to serum α-1 acid glycoprotein and to fecal Entamoeba histolytica (P = 0.02). Conclusion Results indicate impaired absorption of zinc, which may predispose to zinc deficiency in young children with evidence of enteropathy. These findings suggest that current doses of zinc in MNP may be insufficient to yield zinc-related preventative benefits in similar settings. This study is registered at clinicaltrials.gov as NCT02758444.

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