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1. Geographic pair matching in large-scale cluster randomized trials

Author

Arnold, Benjamin F., Rerolle, Francois, Tedijanto, Christine, Njenga, Sammy M., Rahman, Mahbubur, Ercumen, Ayse, Mertens, Andrew, Pickering, Amy J., Lin, Audrie, Arnold, Charles D., Das, Kishor, Stewart, Christine P., Null, Clair, Luby, Stephen P., Colford, Jr, John M., Hubbard, Alan E., and Benjamin-Chung, Jade

Published
2024
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2. Assessment of Erythrocyte Transketolase, Whole Blood Thiamine Diphosphate, and Human Milk Thiamine Concentrations to Identify Infants and Young Children Responding Favorably to Therapeutic Thiamine Administration: Findings from the Lao Thiamine Study, a Prospective Cohort Study

Author

Hess, Sonja Y, Smith, Taryn J, Arnold, Charles D, Jones, Kerry S, Hampel, Daniela, Hiffler, Laurent, Trehan, Indi, Fischer, Philip R, Meadows, Sarah R, Parkington, Damon A, Brown, Kenneth H, Sitthideth, Dalaphone, Tan, Xiuping, Koulman, Albert, Allen, Lindsay H, and Kounnavong, Sengchanh

Published
2024
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4. A Predictive Model for Thiamine Responsive Disorders Among Infants and Young Children: Results from a Prospective Cohort Study in Lao People's Democratic Republic

Author

Smith, Taryn J., Arnold, Charles D., Fischer, Philip R., Trehan, Indi, Hiffler, Laurent, Sitthideth, Dalaphone, Stein-Wexler, Rebecca, Yeh, Jay, Jones, Kerry S., Hampel, Daniela, Tancredi, Daniel J., Schick, Michael A., McBeth, Christine N., Tan, Xiuping, Allen, Lindsay H., Sayasone, Somphou, Kounnavong, Sengchanh, and Hess, Sonja Y.

Published
2024
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8. Effects of prenatal small-quantity lipid-based nutrient supplements on pregnancy, birth, and infant outcomes: a systematic review and meta-analysis of individual participant data from randomized controlled trials in low- and middle-income countries

Author

Dewey, Kathryn G, Wessells, K Ryan, Arnold, Charles D, Adu-Afarwuah, Seth, Arnold, Benjamin F, Ashorn, Per, Ashorn, Ulla, Garcés, Ana, Huybregts, Lieven, Krebs, Nancy F, Lartey, Anna, Leroy, Jef L, Maleta, Kenneth, Matias, Susana L, Moore, Sophie E, Mridha, Malay K, Okronipa, Harriet, and Stewart, Christine P

Published
2024
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15. Small babies, big risks: global estimates of prevalence and mortality for vulnerable newborns to accelerate change and improve counting

Author

Ashorn, Per, Black, Robert E, Lawn, Joy E, Ashorn, Ulla, Klein, Nigel, Hofmeyr, G Justus, Temmerman, Marleen, Askari, Sufia, Ohuma, Eric O, Moller, Ann-Beth, Bradley, Ellen, Chakwera, Samuel, Hussain-Alkhateeb, Laith, Lewin, Alexandra, Okwaraji, Yemisrach B, Retno Mahanani, Wahyu, White Johansson, Emily, Lavin, Tina, Estevez Fernandez, Diana, Gatica Domínguez, Giovanna, de Costa, Ayesha, Cresswell, Jenny A, Krasevec, Julia, Blencowe, Hannah, Requejo, Jennifer, Moran, Allisyn C, Pingray, Veronica, Cormick, Gabriela, Gibbons, Luz, Belizan, José, Guevel, Carlos, Warrilow, Kara, Gordon, Adrienne, Flenady, Vicki, Sexton, Jessica, Lawford, Harriet, Paixao, Enny S., Rocha Falcão, Ila, Lima Barreto, Mauricio, Lisonkova, Sarka, Wen, Qi, Mardones, Francisco, Caulier-Cisterna, Raúl, Acuña, José, Velebil, Petr, Jirova, Jitka, Horváth-Puhó, Erzsébet, Sørensen, Henrik Toft, Sakkeus, Luule, Abuladze, Liili, Gissler, Mika, Moradi-Lakeh, Maziar, Heidarzadeh, Mohammad, Khalili, Narjes, A. Yunis, Khalid, Al Bizri, Ayah, Nakad, Pascale, Devi Karalasingam, Shamala, R Jeganathan, J Ravichandran, binti Baharum, Nurakman, Suárez-Idueta, Lorena, Barranco Flores, Arturo, Gonzalez Roldan, Jesus F, Lopez Alvarez, Sonia, van Dijk, Aimée E., Broeders, Lisa, Huicho, Luis, Quezada Pinedo, Hugo G, Cajachagua-Torres, Kim N, Carrillo-Larco, Rodrigo M, Tarazona Meza, Carla Estefania, Guzman-Vilca, Wilmer Cristobal, Olukade, Tawa O., Ali, Hamdy A., Alyafei, Fawziya, AlQubaisi, Mai, Alturk, Mohamad R, Kim, Ho Yeon, Cho, Geum Joon, Razaz, Neda, Söderling, Jonas, Smith, Lucy K, Kurinczuk, Jennifer J, Matthews, Ruth J, Manktelow, Bradley N, Draper, Elizabeth S, Fenton, Alan C, Lowry, Estelle, Rowland, Neil, Wood, Rachael, Monteath, Kirsten, Pereyra, Isabel, Pravia, Gabriella, Davis, Celina, Clarke, Samantha, Wu, Lee S.F., Yoshida, Sachiyo, Bahl, Rajiv, Grandi, Carlos, Labrique, Alain B, Rashid, Mabhubur, Ahmed, Salahuddin, Roy, Arunangshu D., Haque, Rezwanul, Shaikh, Saijuddin, Baqui, Abdullah H., Saha, Samir K., Khanam, Rasheda, Rahman, Sayedur, Shapiro, Roger, Zash, Rebecca, Silveira, Mariângela F., Buffarini, Romina, Kolsteren, Patrick, Lachat, Carl, Huybregts, Lieven, Roberfroid, Dominique, Zeng, Lingxia, Zhu, Zhonghai, He, Jianrong, Qui, Xiu, Gebreyesus, Seifu H., Tesfamariam, Kokeb, Bekele, Delayehu, Chan, Grace, Baye, Estifanos, Workneh, Firehiwot, Asante, Kwaku P., Boanmah-Kaali, Ellen, Adu-Afarwuah, Seth, Dewey, Kathryn G., Gyaase, Stephaney, Wylie, Blair J., Kirkwood, Betty R., Manu, Alexander, Thulasiraj, Ravilla D, Tielsch, James, Chowdhury, Ranadip, Taneja, Sunita, Babu, Giridhara R, Shriyan, Prafulla, Maleta, Kenneth, Mangani, Charles, Acevedo-Gallegos, Sandra, Rodriguez-Sibaja, Maria J., Khatry, Subarna K., LeClerq, Steven C., Mullany, Luke C., Jehan, Fyezah, Ilyas, Muhammad, Rogerson, Stephen J., Unger, Holger W., Ghosh, Rakesh, Musange, Sabine, Ramokolo, Vundli, Zembe-Mkabile, Wanga, Lazzerini, Marzia, Mohamed, Rishard, Wang, Dongqing, Fawzi, Wafaie W., Minja, Daniel T.R., Schmiegelow, Christentze, Masanja, Honorati, Smith, Emily, Lusingu, John P.A., Msemo, Omari A., Kabole, Fathma M., Slim, Salim N., Keentupthai, Paniya, Mongkolchati, Aroonsri, Kajubi, Richard, Kakuru, Abel, Waiswa, Peter, Walker, Dilys, Hamer, Davidson H., Semrau, Katherine E.A., Chaponda, Enesia B., Chico, R. Matthew, Banda, Bowen, Musokotwane, Kebby, Manasyan, Albert, Pry, Jake M., Chasekwa, Bernard, Humphrey, Jean, Shamim, Abu Ahmed, Christian, Parul, Ali, Hasmot, Klemm, Rolf D.W., Massie, Alan B., Mitra, Maithili, Mehra, Sucheta, Schulze, Kerry J., Shamim, Abu Amed, Sommer, Alfred, Ullah, Barkat, West, Keith P., Jr, Begum, Nazma, Chowdhury, Nabidul Haque, Islam, Shafiqul, Mitra, Dipak Kumar, Quaiyum, Abdul, Diseko, Modiegi, Makhema, Joseph, Cheng, Yue, Guo, Yixin, Yuan, Shanshan, Roro, Meselech, Shikur, Bilal, Goddard, Frederick, Haneuse, Sebastien, Hunegnaw, Bezawit, Berhane, Yemane, Worku, Alemayehu, Kaali, Seyram, Arnold, Charles D., Jack, Darby, Amenga-Etego, Seeba, Hurt, Lisa, Shannon, Caitlin, Soremekun, Seyi, Bhandari, Nita, Martines, Jose, Mazumder, Sarmila, Ana, Yamuna, R, Deepa, Hallamaa, Lotta, Pyykkö, Juha, Lumbreras-Marquez, Mario I., Mendoza-Carrera, Claudia E., Hussain, Atiya, Karim, Muhammad, Kausar, Farzana, Mehmood, Usma, Nadeem, Naila, Nisar, Muhammad Imran, Sajid, Muhammad, Mueller, Ivo, Ome-Kaius, Maria, Butrick, Elizabeth, Sayinzoga, Felix, Mariani, Ilaria, Urassa, Willy, Theander, Thor, Deloron, Phillippe, Nielsen, Birgitte Bruun, Muhihi, Alfa, Noor, Ramadhani Abdallah, Bygbjerg, Ib, Moeller, Sofie Lykke, Aftab, Fahad, Ali, Said M., Dhingra, Pratibha, Dhingra, Usha, Dutta, Arup, Sazawal, Sunil, Suleiman, Atifa, Mohammed, Mohammed, Deb, Saikat, Kamya, Moses R., Nakalembe, Miriam, Mulowooz, Jude, Santos, Nicole, Biemba, Godfrey, Herlihy, Julie M., Mbewe, Reuben K., Mweena, Fern, Yeboah-Antwi, Kojo, Bruce, Jane, Chandramohan, Daniel, Prendergast, Andrew, Idueta, Lorena Suárez, Hazel, Elizabeth, Erchick, Daniel J, Yargawa, Judith, Katz, Joanne, Lee, Anne C C, Diaz, Mike, Salasibew, Mihretab, Hayashi, Chika, and Borghi, Elaine

Published
2023
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19. Preventive small-quantity lipid-based nutrient supplements reduce severe wasting and severe stunting among young children: an individual participant data meta-analysis of randomized controlled trials

Author

Dewey, Kathryn G, Arnold, Charles D, Wessells, K Ryan, Prado, Elizabeth L, Abbeddou, Souheila, Adu-Afarwuah, Seth, Ali, Hasmot, Arnold, Benjamin F, Ashorn, Per, Ashorn, Ulla, Ashraf, Sania, Becquey, Elodie, Brown, Kenneth H, Christian, Parul, Colford, Jr, John M, Dulience, Sherlie JL, Fernald, Lia CH, Galasso, Emanuela, Hallamaa, Lotta, Hess, Sonja Y, Humphrey, Jean H, Huybregts, Lieven, Iannotti, Lora L, Jannat, Kaniz, Lartey, Anna, Le Port, Agnes, Leroy, Jef L, Luby, Stephen P, Maleta, Kenneth, Matias, Susana L, Mbuya, Mduduzi NN, Mridha, Malay K, Nkhoma, Minyanga, Null, Clair, Paul, Rina R, Okronipa, Harriet, Ouédraogo, Jean-Bosco, Pickering, Amy J, Prendergast, Andrew J, Ruel, Marie, Shaikh, Saijuddin, Weber, Ann M, Wolff, Patricia, Zongrone, Amanda, and Stewart, Christine P

Published
2022
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21. Filipino Children with High Usual Vitamin A Intakes and Exposure to Multiple Sources of Vitamin A Have Elevated Total Body Stores of Vitamin A But Do Not Show Clear Evidence of Vitamin A Toxicity

Author

Engle-Stone, Reina, Miller, Jody C, Reario, Maria Fatima Dolly, Arnold, Charles D, Stormer, Ame, Lafuente, Eleanore, Oxley, Anthony, Capanzana, Mario V, Cabanilla, Carl Vincent D, Ford, Jennifer Lynn, Clark, Adam, Velavan, Thirumalaisamy P, Brown, Kenneth H, Lietz, Georg, and Haskell, Marjorie J

Published
2022
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23. Quintuply-fortified salt for the improvement of micronutrient status among women of reproductive age and preschool-aged children in Punjab, India: protocol for a randomized, controlled, community-based trial

Author

McDonald, Christine M., Brown, Kenneth H., Goh, Yvonne E., Manger, Mari S., Arnold, Charles D., Krebs, Nancy F., Westcott, Jamie, Long, Julie M., Gibson, Rosalind S., Jamwal, Manu, Singh, Bidhi L., Dahiya, Neha, Budhija, Deepmala, Das, Reena, and Duggal, Mona

Published
2022
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24. Provision of Small-Quantity Lipid-Based Nutrient Supplements Increases Plasma Selenium Concentration in Pregnant Women in Malawi: A Secondary Outcome of a Randomized Controlled Trial

Author

Haskell, Marjorie J, Maleta, Kenneth, Arnold, Charles D, Jorgensen, Josh M, Fan, Yue-Mei, Ashorn, Ulla, Matchado, Andrew, Monangi, Nagendra K, Zhang, Ge, Xu, Huan, Belling, Elizabeth, Landero, Julio, Chappell, Joanne, Muglia, Louis J, Hallman, Mikko, Ashorn, Per, and Dewey, Kathryn G

Published
2022
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27. Examining infants' visual paired comparison performance in the US and rural Malawi.

Author

Beckner, Aaron G., Arnold, Charles D., Bragg, Megan G., Caswell, Bess L., Chen, Zhijun, Cox, Katherine, DeBolt, Michaela C., George, Matthews, Maleta, Kenneth, Stewart, Christine, Oakes, Lisa M., and Prado, Elizabeth

Subjects
*RECOGNITION (Psychology), *EYE tracking, *VISUAL memory, *OPERATIONAL definitions, *INFANTS
Abstract

Measures of attention and memory were evaluated in 6‐ to 9‐month‐old infants from two diverse contexts. One sample consisted of African infants residing in rural Malawi (N = 228, 118 girls, 110 boys). The other sample consisted of racially diverse infants residing in suburban California (N = 48, 24 girls, 24 boys). Infants were tested in an eye‐tracking version of the visual paired comparison procedure and were shown racially familiar faces. The eye tracking data were parsed into individual looks, revealing that both groups of infants showed significant memory performance. However, how a look was operationally defined impacted some—but not other—measures of infant VPC performance. Research Highlights: In both the US and Malawi, 6‐ to 9‐month‐old infants showed evidence of memory for faces they had previously viewed during a familiarization period.Infant age was associated with peak look duration and memory performance in both contexts.Different operational definitions of a look yielded consistent findings for peak look duration and novelty preference scores—but not shift rate.Operationalization of look‐defined measures is an important consideration for studies of infants in different cultural contexts. [ABSTRACT FROM AUTHOR]

Published
2024
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28. Assessing Children's Autonomic Nervous System Activity During Structured Tasks: A Feasibility and Reliability Study in Ghana.

Author

Bentil, Helena J., Daang, Enya M., Guyer, Amanda E., Yuan, Haiying, Adu‐Afarwuah, Seth, Amponsah, Benjamin, Manu, Adom, Mensah, Mavis Osipi, Demuyakor, Maku E., Arnold, Charles D., Oaks, Brietta M., Prado, Elizabeth, and Hastings, Paul D.

Abstract

The significance of physiological regulation in relation to behavioral and emotional regulation is well documented, but primarily in economically advantaged contexts. Few studies have been conducted in low‐ and middle‐income countries. We investigated the feasibility and reliability of measuring autonomic nervous system (ANS) activity and behavior during challenge tasks in 30 children aged 8–10 years in Ghana during two visits, 1 week apart. Completeness of ANS data ranged from 80% to 100% across all tasks. There was low‐to‐moderate test–retest reliability of video mood induction (VMI) emotion ratings and balloon analog risk task (BART) pumps (r = 0.34–0.52). VMI elicited higher targeted emotion ratings in Visit 2 than Visit 1. Respiratory sinus arrhythmia (RSA) was higher, and pre‐ejection period (PEP) was longer at Visit 2 than Visit 1 for baseline and both tasks. RSA was higher at baseline than during the VMI anger scene at Visit 1, whereas PEP was shorter at baseline than during all VMI emotion scenes at Visit 2. RSA was higher at baseline than during BART at both visits. In conclusion, ANS data collection within evocative and arousing challenge tasks was feasible in Ghana, and the tasks were generally reliable and effective in eliciting target emotions and risk‐taking behavior in this sample. [ABSTRACT FROM AUTHOR]

Published
2024
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34. Effect of multiple micronutrient-fortified bouillon on micronutrient status among women and children in the Northern Region of Ghana: Protocol for the Condiment Micronutrient Innovation Trial (CoMIT), a community-based randomized controlled trial.

Author

Engle-Stone, Reina, Wessells, K Ryan, Haskell, Marjorie J., Kumordzie, Sika M., Arnold, Charles D., Davis, Jennie N., Becher, Emily R., Fuseini, Ahmed D., Nyaaba, Kania W., Tan, Xiuping, Adams, Katherine P., Lietz, Georg, Vosti, Stephen A., and Adu-Afarwuah, Seth

Subjects
MICRONUTRIENTS, RANDOMIZED controlled trials, GROWTH of children, CHILDBEARING age, VITAMIN A, DEFICIENCY diseases
Abstract

Introduction: Micronutrient deficiencies are prevalent in West Africa, particularly among women of reproductive age (WRA) and young children. Bouillon is a promising food fortification vehicle due to its widespread consumption. This study aims to evaluate the impact of multiple micronutrient-fortified bouillon cubes, compared to control bouillon cubes (fortified with iodine only), on micronutrient status and hemoglobin concentrations among lactating and non-lactating WRA and young children in northern Ghana. Methods: This randomized, controlled doubly-masked trial will be conducted in the Kumbungu and Tolon districts in the Northern Region of Ghana, where prior data indicate multiple micronutrient deficiencies are common. Participants will be: 1) non-pregnant non-lactating WRA (15–49 y), 2) children 2–5 y, and 3) non-pregnant lactating women 4–18 months postpartum. Eligible participants will be randomly assigned to receive household rations of one of two types of bouillon cubes: 1) a multiple micronutrient-fortified bouillon cube containing vitamin A, folic acid, vitamin B12, iron, zinc, and iodine, or 2) a control cube containing iodine only. Each participant's household will receive a ration of bouillon cubes every 2 weeks, and households will be advised to prepare meals as usual, using the study-provided cubes. The trial duration will be 9 months for non-pregnant non-lactating WRA and children, and 3 months for lactating women. The primary outcomes will be changes in biomarkers of micronutrient status and hemoglobin among WRA and children and milk micronutrient concentrations among lactating women. Secondary outcomes will include change in prevalence of micronutrient deficiency and anemia; dietary intake of bouillon and micronutrients; inflammation, malaria, and morbidity symptoms; and child growth and development. Discussion: Evidence from this study will inform discussions about bouillon fortification in Ghana and West Africa. Trial registration: The trial was registered on ClinicalTrials.gov (NCT05178407) and the Pan-African Clinical Trial Registry (PACTR202206868437931). This manuscript reflects protocol version 4 (August 29, 2022). [ABSTRACT FROM AUTHOR]

Published
2024
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35. Associations of fish and meat intake with iron and anaemia in Malawian children.

Author

Werner, E. Rochelle, Arnold, Charles D., Caswell, Bess L., Iannotti, Lora L., Maleta, Kenneth M., and Stewart, Christine P.

Subjects
*IRON deficiency anemia, *ANEMIA, *IRON, *IRON in the body, *INFANTS, *FOOD consumption, *EGGS, *FERRITIN, *RESEARCH funding, *IRON deficiency, *HEMOGLOBINS, *MEAT, *FISHES, *NUTRITIONAL requirements, *DESCRIPTIVE statistics, *INFANT nutrition, *NUTRITIONAL status, *BIOAVAILABILITY, *COMPARATIVE studies, *CONFIDENCE intervals, *CELL receptors, *TIME, *BIOMARKERS, *BLOOD, *CHILDREN
Abstract

Animal flesh foods are rich in bioavailable iron but infrequently consumed by young children. We aimed to determine whether flesh food intake was associated with iron and anaemia status among 585 Malawian infants enroled in a 6‐month egg‐feeding trial. The percentage of days of small fish, large fish and meat consumption were assessed through weekly 7‐day animal‐source food screeners. Grams of intake were assessed through 24‐h recalls conducted at 6–9, 9–12 and 12–15 months of age. Plasma ferritin, soluble transferrin receptor (sTfR) and haemoglobin concentrations were measured at 6–9 and 12–15 months of age. Iron biomarkers were adjusted for inflammation during analysis. At enrolment, each flesh food category was consumed by <5% of children in the past 24 h. Over the next 6 months, small fish, large fish and meat were consumed on 25%, 8% and 6% of days, respectively, with mean usual intakes of <5 g/day. More frequent small fish consumption was associated with lower sTfR (geometric mean ratio [95% CI]: 0.98 mg/L [0.96, 1.00] per 10 percentage point difference) but not ferritin (1.03 µg/L [0.98, 1.07]) or haemoglobin (1.01 g/dL [1.00, 1.01]). Large fish consumption was associated with higher anaemia (prevalence ratio [95% CI]: 1.09 [1.01, 1.19]) and lower iron deficiency (0.96 [0.93, 1.00]) prevalence. Gram intakes of flesh food categories were not associated with any iron or anaemia indicators. Small fish were a primary contributor to flesh food intake in this cohort of Malawian children, although usual portions were small. Fish was associated with modest improvements to iron status, but meat was too infrequent to be associated with anaemia and iron deficiency. Key messages: Small fish was the most frequently consumed flesh food among young children: 4% at enrolment and 40% at the 6‐month follow‐up. On average, children consumed small fish once every 4 days.Despite small usual portions of about 5 g/day, frequent consumption of small fish was associated with moderate improvements in iron status.Large fish consumption was associated with lower iron deficiency but not with mean plasma ferritin or sTfR. Meat was infrequently consumed and not associated with any iron or anaemia measures.Reducing the burden of iron deficiency among young Malawian children may require provision of supplemental dietary iron, improved complementary feeding practices, addressing underlying barriers to flesh food consumption and controlling inflammation and infectious diseases. [ABSTRACT FROM AUTHOR]

Published
2024
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38. Effects of Daily Zinc, Daily Multiple Micronutrient Powder, or Therapeutic Zinc Supplementation for Diarrhea Prevention on Physical Growth, Anemia, and Micronutrient Status in Rural Laotian Children: A Randomized Controlled Trial

Author

Barffour, Maxwell A., Hinnouho, Guy-Marino, Kounnavong, Sengchanh, Wessells, K. Ryan, Ratsavong, Kethmany, Bounheuang, Bangone, Chanhthavong, Bigphone, Sitthideth, Dalaphone, Sengnam, Khanpaseuth, Arnold, Charles D., Brown, Kenneth H., and Hess, Sonja Y.

Published
2019
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39. Effects of lipid-based nutrient supplements and infant and young child feeding counseling with or without improved water, sanitation, and hygiene (WASH) on anemia and micronutrient status: results from 2 cluster-randomized trials in Kenya and Bangladesh

Author

Stewart, Christine P, Dewey, Kathryn G, Lin, Audrie, Pickering, Amy J, Byrd, Kendra A, Jannat, Kaniz, Ali, Shahjahan, Rao, Gouthami, Dentz, Holly N, Kiprotich, Marion, Arnold, Charles D, Arnold, Benjamin F, Allen, Lindsay H, Shahab-Ferdows, Setareh, Ercumen, Ayse, Grembi, Jessica A, Naser, Abu Mohd, Rahman, Mahbubur, Unicomb, Leanne, Colford, John M, Jr, Luby, Stephen P, and Null, Clair

Published
2019
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40. Risk factors for anaemia among women and their young children hospitalised with suspected thiamine deficiency in northern Lao PDR.

Author

Hess, Sonja Y., Smith, Taryn J., Sitthideth, Dalaphone, Arnold, Charles D., Tan, Xiuping, Jones, Kerry S., Brown, Kenneth H., Alayon, Silvia, and Kounnavong, Sengchanh

Subjects
STATISTICS, HOSPITAL patients, HEMOGLOBINS, MULTIPLE regression analysis, FOOD security, DIET, RISK assessment, SOCIOECONOMIC factors, ANEMIA, VITAMIN B1 deficiency, DISEASE prevalence, DESCRIPTIVE statistics, RESEARCH funding, BODY mass index, PRENATAL care, IRON deficiency anemia, MICRONUTRIENTS, VITAMIN B2 deficiency, WOMEN'S health, NUTRITIONAL status, SECONDARY analysis, DISEASE risk factors, CHILDREN
Abstract

Anaemia among women and young children remains a major public health concern. This secondary study describes the anaemia prevalence among young hospitalised children and their mothers in northern Lao People's Democratic Republic and explores possible nutritional causes and risk factors for anaemia. Hospitalised children (ages 21 days to <18 months) with clinical symptoms suggestive of thiamine deficiency disorders were eligible along with their mothers. Venous blood was collected for determination of haemoglobin, ferritin, soluble transferrin receptor (sTfR), retinol‐binding protein (RBP), erythrocyte glutathione reductase activation coefficient (EGRac), thiamine diphosphate (ThDP) and acute phase proteins. Risk factors for anaemia were modelled using minimally adjusted logistic regression controlling for age. Haemoglobin results were available for 436 women (mean ± SD age 24.7 ± 6.4 years; 1.6% pregnant) and 427 children (4.3 ± 3.5 months; 60.3% male). Anaemia prevalence (Hb < 120 g/L for nonpregnant women and <110 g/L for pregnant women and children) was 30.7% among women and 55.2% among children. In bivariate analyses, biomarkers significantly associated with anaemia in women were ferritin, sTfR, RBP, EGRac and ThDP. Other risk factors for women were lower BMI, mid‐upper arm circumference < 23.5 cm, lower education, lower socioeconomic index, food insecurity, Hmong ethnicity, not/rarely having attended antenatal care, not having taken antenatal iron‐containing supplements and not meeting minimum dietary diversity. Risk factors for anaemia among children were older age, male sex, stunting, sTfR, ThDP and alpha‐1‐acid‐glycoprotein. Anaemia was common among women and their hospitalised children and was associated with micronutrient deficiencies and socioeconomic, dietary and health care‐seeking risk factors, suggesting that multiple strategies are required to prevent anaemia among women and children. Key messages: Anaemia is a public health concern among women and young children due to multiple causes and biological, socioeconomic and ecological risk factors.Anaemia was assessed among women and their young children hospitalised for clinical signs and symptoms suggestive of thiamine deficiency disorders. The risk of anaemia was significantly associated with multiple indicators of micronutrient status and factors related to poverty and health and dietary practices.The present study highlights that anaemia and iron, thiamine, riboflavin and vitamin A deficiencies are highly prevalent in the study population and that multiple strategies are required to prevent anaemia and the other consequences of these micronutrient deficiencies. [ABSTRACT FROM AUTHOR]

Published
2024
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41. Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Kenya: a cluster-randomised controlled trial

Author

Null, Clair, Stewart, Christine P, Pickering, Amy J, Dentz, Holly N, Arnold, Benjamin F, Arnold, Charles D, Benjamin-Chung, Jade, Clasen, Thomas, Dewey, Kathryn G, Fernald, Lia C H, Hubbard, Alan E, Kariger, Patricia, Lin, Audrie, Luby, Stephen P, Mertens, Andrew, Njenga, Sammy M, Nyambane, Geoffrey, Ram, Pavani K, and Colford, John M, Jr

Published
2018
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45. The cost-effectiveness of small-quantity lipid-based nutrient supplements for prevention of child death and malnutrition and promotion of healthy development: modelling results for Uganda.

Author

Adams, Katherine P, Vosti, Stephen A, Arnold, Charles D, Engle-Stone, Reina, Prado, Elizabeth L, Stewart, Christine P, Wessells, K Ryan, and Dewey, Kathryn G

Subjects
DIETARY supplements, CHILD death, COST effectiveness, CHILD mortality, RURAL children, IRON supplements, MALNUTRITION in children
Abstract

Objective: Recent meta-analyses demonstrate that small-quantity lipid-based nutrient supplements (SQ-LNS) for young children significantly reduce child mortality, stunting, wasting, anaemia and adverse developmental outcomes. Cost considerations should inform policy decisions. We developed a modelling framework to estimate the cost and cost-effectiveness of SQ-LNS and applied the framework in the context of rural Uganda. Design: We adapted costs from a costing study of micronutrient powder (MNP) in Uganda, and based effectiveness estimates on recent meta-analyses and Uganda-specific estimates of baseline mortality and the prevalence of stunting, wasting, anaemia and developmental disability. Setting: Rural Uganda. Participants: Not applicable. Results: Providing SQ-LNS daily to all children in rural Uganda (> 1 million) for 12 months (from 6 to 18 months of age) via the existing Village Health Team system would cost ∼$52 per child (2020 US dollars) or ∼$58·7 million annually. SQ-LNS could avert an average of > 242 000 disability-adjusted life years (DALYs) annually as a result of preventing 3689 deaths, > 160 000 cases of moderate or severe anaemia and ∼6000 cases of developmental disability. The estimated cost per DALY averted is $242. Conclusions: In this context, SQ-LNS may be more cost-effective than other options such as MNP or the provision of complementary food, although the total cost for a programme including all age-eligible children would be high. Strategies to reduce costs, such as targeting to the most vulnerable populations and the elimination of taxes on SQ-LNS, may enhance financial feasibility. [ABSTRACT FROM AUTHOR]

Published
2023
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46. Vulnerable newborn types : analysis of subnational, population‐based birth cohorts for 541 285 live births in 23 countries, 2000-2021

Author

Erchick, D. J., Hazel, E. A., Katz, J., Lee, A. C. C., Diaz, M., Wu, L. S. F., Yoshida, S., Bahl, R., Grandi, C., Labrique, A. B., Rashid, M., Ahmed, S., Roy, A. D., Haque, R., Shaikh, S., Baqui, A. H., Saha, S. K., Khanam, R., Rahman, S., Shapiro, R., Zash, R., Silveira, M. F., Buffarini, R., Kolsteren, Patrick, Lachat, Carl, Huybregts, Lieven, Roberfroid, D., Zeng, L., Zhu, Z., He, J., Qiu, X., Gebreyesus, S. H., Hadush, Kokeb Tesfamariam, Bekele, D., Chan, G., Baye, E., Workneh, F., Asante, K. P., Kaali, E. B., Adu‐Afarwuah, S., Dewey, K. G., Gyaase, S., Wylie, B. J., Kirkwood, B. R., Manu, A., Thulasiraj, R. D., Tielsch, J., Chowdhury, R., Taneja, S., Babu, G. R., Shriyan, P., Ashorn, P., Maleta, K., Ashorn, U., Mangani, C., Acevedo‐Gallegos, S., Rodriguez‐Sibaja, M. J., Khatry, S. K., LeClerq, S. C., Mullany, L. C., Jehan, F., Ilyas, M., Rogerson, S. J., Unger, H. W., Ghosh, R., Musange, S., Ramokolo, V., Zembe‐Mkabile, W., Lazzerini, M., Rishard, M., Wang, D., Fawzi, W. W., Minja, D. T. R., Schmiegelow, C., Masanja, H., Smith, E., Lusingu, J. P. A., Msemo, O. A., Kabole, F. M., Slim, S. N., Keentupthai, P., Mongkolchati, A., Kajubi, R., Kakuru, A., Waiswa, P., Walker, D., Hamer, D. H., Semrau, K. E. A., Chaponda, E. B., Chico, R. M., Banda, B., Musokotwane, K., Manasyan, A., Pry, J. M., Chasekwa, B., Humphrey, J., Black, R. E., Ali, Hasmot, Christian, Parul, Klemm, Rolf D. W., Massie, Alan B., Mitra, Maithili, Mehra, Sucheta, Schulze, Kerry J., Shamim, Abu Ahmed, Sommer, Alfred, Barkat Ullah, MD., West, Keith P., Begum, Nazma, Chowdhury, Nabidul Haque, Shafiqul Islam, Md., Mitra, Dipak Kumar, Quaiyum, Abdul, Diseko, Modiegi, Makhema, Joseph, Cheng, Yue, Guo, Yixin, Yuan, Shanshan, Roro, Meselech, Shikur, Bilal, Goddard, Frederick, Haneuse, Sebastien, Hunegnaw, Bezawit, Berhane, Yemane, Worku, Alemayehu, Kaali, Seyram, Arnold, Charles D., Jack, Darby, Amenga‐Etego, Seeba, Hurt, Lisa, Shannon, Caitlin, Soremekun, Seyi, Bhandari, Nita, Martines, Jose, Mazumder, Sarmila, Ana, Yamuna, Deepa, R, Hallamaa, Lotta, Pyykkö, Juha, Lumbreras‐Marquez, Mario I., Mendoza‐Carrera, Claudia E., Hussain, Atiya, Karim, Muhammad, Kausar, Farzana, Mehmood, Usma, Nadeem, Naila, Nisar, Muhammad Imran, Sajid, Muhammad, Mueller, Ivo, Ome‐Kaius, Maria, Butrick, Elizabeth, Sayinzoga, Felix, Mariani, Ilaria, Urassa, Willy, Theander, Thor, Deloron, Phillippe, Nielsen, Birgitte Bruun, Muhihi, Alfa, Noor, Ramadhani Abdallah, Bygbjerg, Ib, Moeller, Sofie Lykke, Aftab, Fahad, Ali, Said M., Dhingra, Pratibha, Dhingra, Usha, Dutta, Arup, Sazawal, Sunil, Suleiman, Atifa, Mohammed, Mohammed, Deb, Saikat, Kamya, Moses R., Nakalembe, Miriam, Mulowooz, Jude, Santos, Nicole, Biemba, Godfrey, Herlihy, Julie M., Mbewe, Reuben K., Mweena, Fern, Yeboah‐Antwi, Kojo, Bruce, Jane, Chandramohan, Daniel, Prendergast, Andrew, Lawn, Joy E., Blencowe, Hannah, Ohuma, Eric, Okwaraji, Yemi, Yargawa, Judith, Bradley, Ellen, Katz, Joanne, and the Subnational Vulnerable Newborn Prevalence Collaborative Group and Vulnerable Newborn Measurement Core Group, [missing]

Subjects
RISK, small for gestational age, PRETERM, newborn, MIDDLE-INCOME COUNTRIES, MORTALITY, FOR-GESTATIONAL-AGE, Medicine and Health Sciences, preterm birth, INFANTS, WEIGHT, TERM, low birthweight
Abstract

Setting: Subnational, population-based birth cohort studies (n = 45) in 23 low-and middle-income countries (LMICs) spanning 2000–2021. Population: Liveborn infants. Methods: Subnational, population-based studies with high-quality birth outcome data from LMICs were invited to join the Vulnerable Newborn Measurement Collaboration. We defined distinct newborn types using gestational age (preterm [PT], term [T]), birthweight for gestational age using INTERGROWTH-21st standards (small for gestational age [SGA], appropriate for gestational age [AGA] or large for gestational age [LGA]), and birthweight (low birthweight, LBW [

Published
2023

47. Neonatal mortality risk of vulnerable newborns : a descriptive analysis of subnational, population‐based birth cohorts for 238 143 live births in low‐ and middle‐income settings from 2000 to 2017

Author

Hazel, Elizabeth A., Erchick, Daniel J., Katz, Joanne, Lee, Anne C. C., Diaz, Michael, Wu, Lee S. F., West, Keith P., Shamim, Abu Ahmed, Christian, Parul, Ali, Hasmot, Baqui, Abdullah H., Saha, Samir K., Ahmed, Salahuddin, Roy, Arunangshu Dutta, Silveira, Mariângela F., Buffarini, Romina, Shapiro, Roger, Zash, Rebecca, Kolsteren, Patrick, Lachat, Carl, Huybregts, Lieven, Roberfroid, Dominique, Zhu, Zhonghai, Zeng, Lingxia, Gebreyesus, Seifu H., Hadush, Kokeb Tesfamariam, Adu‐Afarwuah, Seth, Dewey, Kathryn G., Gyaase, Stephaney, Poku‐Asante, Kwaku, Boamah Kaali, Ellen, Jack, Darby, Ravilla, Thulasiraj, Tielsch, James, Taneja, Sunita, Chowdhury, Ranadip, Ashorn, Per, Maleta, Kenneth, Ashorn, Ulla, Mangani, Charles, Mullany, Luke C., Khatry, Subarna K., Ramokolo, Vundli, Zembe‐Mkabile, Wanga, Fawzi, Wafaie W., Wang, Dongqing, Schmiegelow, Christentze, Minja, Daniel, Msemo, Omari Abdul, Lusingu, John P. A., Smith, Emily R., Masanja, Honorati, Mongkolchati, Aroonsri, Keentupthai, Paniya, Kakuru, Abel, Kajubi, Richard, Semrau, Katherine, Hamer, Davidson H., Manasyan, Albert, Pry, Jake M., Chasekwa, Bernard, Humphrey, Jean, Black, Robert E., Klemm, Rolf D. W., Massie, Allan B., Mitra, Maithilee, Mehra, Sucheta, Schulze, Kerry J., Sommer, Alfred, Ullah, Md. Barkat, Labrique, Alain B., Rashid, Mabhubur, Shaikh, Saijuddin, Begum, Nazma, Chowdhury, Nabidul Haque, Islam, Md. Shafiqul, Khanam, Rasheda, Mitra, Dipak Kumar, Quaiyum, Abdul, Diseko, Modiegi, Makhema, Joseph, Cheng, Yue, Roro, Meselech, Endris, Bilal Shikur, Arnold, Charles D., Bahl, Rajiv, Bhandari, Nita, Martines, Jose, Mazumder, Sarmila, Hallamaa, Lotta, Pyykkö, Juha, Urassa, Willy, Deloron, Phillippe, Bygbjerg, Ib Christian, Moeller, Sofie Lykke, Theander, Thor Grundtvig, Muhihi, Alfa, Noor, Ramadhani Abdallah, Kamya, Moses R., Nakalembe, Miriam, Biemba, Godfrey, Herlihy, Julie M., Mbewe, Reuben K., Mweena, Fern, Yeboah‐Antwi, Kojo, Prendergast, Andrew, Lawn, Joy E., Blencowe, Hannah, Ohuma, Eric, Okwaraji, Yemi, Yargawa, Judith, Bradley, Ellen, and Idueta, Lorena Suarez

Subjects
OUTCOMES, UMBILICAL-CORD, PRETERM, MATERNAL MULTIPLE MICRONUTRIENT, INFANT-MORTALITY, CHLORHEXIDINE, low-and middle-income countries, paediatrics, neonatal, obstetrics and gynaecology, FOR-GESTATIONAL-AGE, Medicine and Health Sciences, SOUTHERN NEPAL, small-for-gestational age, WEIGHT, PREGNANT-WOMEN
Abstract

Objective: We aimed to understand the mortality risks of vulnerable newborns (defined as preterm and/or born weighing smaller or larger compared to a standard population), in low-and middle-income countries (LMICs). Design: Descriptive multi-country, secondary analysis of individual-level study data of babies born since 2000. Setting: Sixteen subnational, population-based studies from nine LMICs in sub-Saharan Africa, Southern and Eastern Asia, and Latin America. Population: Live birth neonates. Methods: We categorically defined five vulnerable newborn types based on size (large-or appropriate-or small-for-gestational age [LGA, AGA, SGA]), and term (T) and preterm (PT): T + LGA, T + SGA, PT + LGA, PT + AGA, and PT + SGA, with T + AGA (reference). A 10-type definition included low birthweight (LBW) and non-LBW, and a four-type definition collapsed AGA/LGA into one category. We performed imputation for missing birthweights in 13 of the studies. Main Outcome Measures: Median and interquartile ranges by study for the prevalence, mortality rates and relative mortality risks for the four, six and ten type classification. Results: There were 238 143 live births with known neonatal status. Four of the six types had higher mortality risk: T + SGA (median relative risk [RR] 2.8, interquartile range [IQR] 2.0–3.2), PT + LGA (median RR 7.3, IQR 2.3–10.4), PT + AGA (median RR 6.0, IQR 4.4–13.2) and PT + SGA (median RR 10.4, IQR 8.6–13.9). T + SGA, PT + LGA and PT + AGA babies who were LBW, had higher risk compared with non-LBW babies. Conclusions: Small and/or preterm babies in LIMCs have a considerably increased mortality risk compared with babies born at term and larger. This classification system may advance the understanding of the social determinants and biomedical risk factors along with improved treatment that is critical for newborn health.

Published
2023

50. Assessing Repeated Urinary Proline Betaine Measures as a Biomarker of Usual Citrus Intake during Pregnancy: Sources of Within-Person Variation and Correlation with Reported Intake.

Author

French, Caitlin D., Arnold, Charles D., Taha, Ameer Y., Engle-Stone, Reina, Schmidt, Rebecca J., Hertz-Picciotto, Irva, and Slupsky, Carolyn M.

Subjects
BETAINE, CITRUS, PROLINE, CITRUS fruits, PEARSON correlation (Statistics), URINE, ORANGES, INGESTION
Abstract

Proline betaine (Pro-B) has been identified as a biomarker of dietary citrus intake, yet gaps remain in its validation as a quantitative predictor of intake during various physiological states. This study quantified sources of within-individual variation (WIV) in urinary Pro-B concentration during pregnancy and assessed its correlation with the reported usual intake of citrus fruit and juice. Pro-B concentrations were determined by 1H-NMR spectroscopy in spot and 24-h urine specimens (n = 255) collected throughout pregnancy from women participating in the MARBLES cohort study. Adjusted linear or log mixed effects models quantified WIV and tested potential temporal predictors of continuous or elevated Pro-B concentration. Pearson or Spearman correlations assessed the relationship between averaged repeated biomarker measures and usual citrus intake reported by food frequency questionnaires. The proportion of variance in urinary Pro-B attributable to WIV ranged from 0.69 to 0.74 in unadjusted and adjusted models. Citrus season was a significant predictor of Pro-B in most analyses (e.g., adjusted β [95% CI]: 0.52 [0.16, 0.88] for non-normalized Pro-B), while gestational age predicted only non-normalized Pro-B (adjusted β [95% CI]: −0.093 [−0.18, −0.0038]). Moderate correlations (rs of 0.40 to 0.42) were found between reported usual citrus intake and averaged repeated biomarker measurements, which were stronger compared to using a single measurement. Given the high degree of WIV observed in urinary Pro-B, multiple samples per participant are likely needed to assess associations between citrus consumption and health outcomes. [ABSTRACT FROM AUTHOR]

Published
2023
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