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BackgroundVitamin A deficiency (VAD) impairs T-cell-mediated immunity. In regions where VAD is prevalent, vitamin A supplementation (VAS) reduces child mortality, perhaps by improving immune function.ObjectiveOur objective was to determine if neonatal VAS would improve thymic function in Bangladeshi infants, and to determine if such effects differed by sex or nutritional status (i.e., birth weight above/below the median).MethodsThree hundred and six infants were randomly assigned to 50,000 IU vitamin A (VA) or placebo (PL) within 48 h of birth. Primary outcomes were measured at multiple ages and included 1) thymic index (TI) at 1, 6, 10, and 15 wk; 2) T-cell receptor excision circles (TREC), an index of thymic output of naïve T cells; and 3) total/naïve T cells in peripheral blood at 6 wk, 15 wk, and 2 y. A mixed linear model for repeated measures was used to assess group differences at each age and identify interactions with sex and birth weight.ResultsVAS did not significantly (P = 0.21) affect TI overall (i.e., at all ages) but decreased TI by 7.8% (P = 0.029) at 6 wk: adjusted TI means for the PL and VA groups at 1, 6, 10, and 15 wk were 4.09 compared with 3.80 cm2, 7.78 compared with 7.18 cm2, 8.11 compared with 7.84 cm2, and 7.91 compared with 7.97 cm2, respectively. VAS did not significantly (P = 0.25) affect TREC overall but decreased TREC by 19% (P = 0.029) at 15 wk: adjusted TREC means for the PL and VA groups at 6 wk, 15 wk, and 2 y were 13.6 compared with 16.1 copies/pg DNA, 19.4 compared with 15.7 copies/pg DNA, and 11.8 compared with 10.0 copies/pg DNA, respectively. VAS did not significantly affect overall total (P = 0.10) or naïve (P = 0.092) T cells: adjusted naïve T-cell means for the PL and VA groups at 6 wk, 15 wk, and 2 y were 3259 compared with 3109 cells/µL, 3771 compared with 3487 cells/µL, and 1976 compared with 1898 cells/µL, respectively.ConclusionIn contrast to our hypothesis, VAS decreased thymic function early in infancy but health effects are presumably negligible owing to the transience and small magnitude of this effect. This trial was registered at clinicaltrials.gov as NCT01583972 and NCT02027610.

Background: This study investigates how lifestyle factors and westernization contribute to obesity and examines the influence of body mass index (BMI) changes and lifestyle factors on "lipitension," a significant risk factor for heart disease and metabolic syndrome. Methods: This prospective study focused on women aged 20–64 without pre-existing hypertension and dyslipidemia who underwent regular medical checkups between April 2016 and March 2022. Anthropometric measurements and blood pressure, along with low-density lipoprotein, high-density lipoprotein, and triglycerides levels, were assessed. Results: Over an average 46.5-month follow-up, 11.5% of initially healthy young and middle-aged women developed lipitension. Categorizing participants based on BMI changes revealed stable (63.8%), decreased (12.5%), and increased (23.8%) groups within this 11.5%. Increased BMI is linked with a heightened hazard risk for lipitension. Women with increased BMI who refrained from snacking (aHR [95% confidence interval (CI)] = 2.750 [1.433–5.279]), avoided late-night eating (aHR [95% CI] = 1.346 [1.032–1.754]), and engaged in alcohol consumption (aHR [95% CI] = 2.037 [1.138–3.646]) showed an elevated risk. Conversely, within the decreased BMI group, behaviors like skipping breakfast (aHR [95% CI] = 0.190 [0.047–0.764]), eating quickly (aHR [95% CI] = 0.457 [0.215–0.972]), and not eating late (aHR [95% CI] = 0.665 [0.467–0.948]) were associated to a reduced lipitension. Subgroup analysis for women with BMI <23 revealed specific behaviors influencing lipitension risk in both BMI-increased and BMI-stable groups. Conclusion: Customized interventions, including for women with BMI <23, enhance heart health, mitigating global lifestyle diseases and obesity. [ABSTRACT FROM AUTHOR]

Stress can impair T cell-mediated immunity. To determine if infants with high stress responses had deficits in T-cell mediated immunity, we examined the association of pain-induced cortisol responsiveness with thymic function and vaccine responses in infants. This study was performed among 306 (male = 153 and female = 153) participants of a randomized, controlled trial examining the effect of neonatal vitamin A supplementation on immune function in Bangladesh (NCT01583972). Salivary cortisol was measured before and 20 min after a needle stick (vaccination) at 6 weeks of age. The thymic index (TI) was determined by ultrasonography at 1, 6, 10 and 15 weeks. T-cell receptor excision circle and blood T-cell concentrations were measured at 6 and 15 weeks. Responses to Bacillus Calmette-Guérin (BCG), tetanus toxoid, hepatitis B virus and oral poliovirus vaccination were assayed at 6 and 15 weeks. Cortisol responsiveness was negatively associated with TI at all ages (p

Slum environment may pose risk to child health and nutrition. This study assessed the risks of anemia among under five-year-old children, five years after implementing a nutrition education and counseling intervention in two urban slums in Nairobi, Kenya. A cross-sectional study was conducted in May 2018 as a follow-up of a randomized controlled study carried out between 2012–2015. A trained nurse measured hemoglobin levels of 438 children from households which participated in the initial study. Multivariate logistic regression was conducted to identify risks of anemia. The mean (+ SD) age of the children was 55.9 (5.3) months and mean (+ SD) hemoglobin was 10.7 (1.5) g/dL. Anemia prevalence was 59.8%, 33.9% had mild, 24.7% moderate, and 1.2% severe anemia. Absence of home toilet (AOR = 3.31; 95% CI, 1.20–9.09), household which paid to use a toilet facility (AOR = 1.86; 95% CI, 1.12–3.08), child's frequency of eating colored fruits and vegetables (AOR = 0.28; 95% CI, 0.08–0.96), meat and meat products (AOR = 0.31; 95% CI, 0.23–6.01), number of meals a child aged <15years ate a day preceding the study (AOR = 1.49; 95% CI, 1.14–1.98), and a mother who had a history of anemia (AOR = 2.89; 95% CI, 1.22–12.01), were factors significantly associated with child's anemia status. The environment of urban informal settings influences child anemia status. Further studies with interventions are therefore required in order to improve sanitation facilities and access to meats, fruits, and vegetables in urban slums through innovative kitchen gardens and small animal husbandry. [ABSTRACT FROM AUTHOR]

Objective: Hearing loss is a major public health concern. Higher physical function may be related to the maintenance of hearing acuity. Therefore, this study examined the association between hearing loss and physical function in the general population. Methods: This cross-sectional study was conducted with health checkup participants who underwent pure-tone audiometry at a regional health care center in Japan. Information for physical function included handgrip strength, vital capacity (VC), and forced expiratory volume in one second (FEV1). A hearing threshold of >30 dB at 1 kHz and/or >40 dB at 4 kHz in either ear was identified as hearing loss. The characteristics of the subjects were examined with stratification by sex and age group. Multivariable logistic regression analysis was performed to examine the association between hearing loss and physical function with adjustments for age, body mass index and current smoking. Results: Among the 4766 study subjects, 56.5% were male. The mean age was 47.7 years (SD: 13.8 years; range: 20–86 years), and the prevalence of hearing loss was 12.8% based on the definition stated above. For females, handgrip strength, VC, and FEV1 showed significant negative associations with hearing loss (multivariable-adjusted OR [95% CI] = 0.691 [0.560–0.852], 0.542 [0.307–0.959], and 0.370 [0.183–0.747], respectively). These associations were not found in males. Conclusions: Higher physical function was associated with a lower prevalence of hearing loss among females. This study suggests that it is important to maintain physical function for hearing loss in females. Further studies are required to investigate sex differences in the relationship between physical function and hearing loss in the general population. [ABSTRACT FROM AUTHOR]

Since 1990, South Asia has experienced a resurgence of kala-azar (visceral leishmaniasis). To determine risk factors for kala-azar, we performed cross-sectional surveys over a 3-year period in a Bangladeshi community. [...]

An outbreak of dengue fever occurred among employees of a recreation club in Bangladesh. Occupational transmission was characterized by a 12% attack rate, no dengue among family contacts, and Aedes [...]

Little is known about the usefulness of biomarkers to study the influence of prenatal nutrition supplementation in improving child growth. Anthropometry is not always straightforward to understand how nutrition might impact growth, especially in settings with high rates of malnutrition and infections. We examined the effects of prenatal supplementation on growth and growth biomarkers and the relationship between anthropometric measures and growth biomarkers of children at 4.5 and 9 years of age. Children were enrolled from a longitudinal cohort, where mothers were randomized into daily supplementation with either early‐food (≤9 gestation week [GW]) or usual‐food (~20 GW) (608 kcal 6 days/week); they were further randomized to receive 30‐mg or 60‐mg iron with 400‐μg folic acid, or multiple micronutrients (MM) in rural Bangladesh. Anthropometric data were collected from mothers at GW8 and children at 4.5 (n = 640) and 9 years (n = 536). Fasting blood was collected from children at each age. Early‐food supplementation showed reduced stunting and underweight at 4.5 and 9 years age respectively compared to usual‐food. Prenatal supplementations did not have any effect on growth biomarkers except for STAT5b expression which was lower in the early‐food compared to the usual‐food group (β = −0.21; 95 CI% = −0.36, −0.07). Plasma concentrations of 25‐hydroxy vitamin D and calcium were both inversely associated with weight‐for‐age and body mass index‐for‐age Z‐scores at 9 years, particularly in early‐food and MM groups. Although there was minimal effect on child growth by prenatal supplementations, the associations of biomarkers with anthropometric indices were predominantly driven by timing of food or MM supplementations. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Handgrip strength, a simple measure of muscle strength, has been reported as a predictor of both prediabetes and type 2 diabetes mellitus (T2DM) and has been suggested for screening prediabetes and T2DM risk. This study examined the relationship of handgrip strength with prediabetes and T2DM among rural‐ and urban‐dwelling adults in Malawi. METHODS: This was a cross‐sectional study nested in a follow‐up study of prediabetic and prehypertensive individuals identified during an extensive noncommunicable disease survey in Malawi. A total of 261 participants (women: 64%) were recruited. Univariate and multivariate binary logistic regression analyses were performed to examine the association of prediabetes and T2DM with relative handgrip strength. RESULTS: The mean (SD) age of the participants was 49.7 (13.6) years, and 54.0% were between the ages of 40 and 59 years. The mean (SD) absolute handgrip strength and relative handgrip strength were 28.8 (7.3) kg and 1.16 (0.40) kg/BMI, respectively, and the mean relative handgrip strength differed significantly (p < 0.001) by T2DM status. In unadjusted model, the odds ratio (OR) of prediabetes and T2DM per unit increase in relative handgrip strength was 0.12 [95% CI; 0.04–0.33]. The result remained significant after adjusting for age (continuous), sex, place of study, hypertension, dyslipidaemia and level of education (aOR [95% CI]; 0.19 [0.03–0.95]). CONCLUSIONS: The findings suggest that handgrip strength could be a relatively inexpensive, noninvasive measure for contributing to risk scores to identify high‐risk individuals for screening diabetes in SSA. [ABSTRACT FROM AUTHOR]

Abstract Diagnosis of visceral leishmaniasis (VL) by demonstration of parasites in tissue smears obtained from bone marrow, spleen or lymph nodes is risky, painful, and difficult. The rK-39 strip test is widely used for the diagnosis of VL using blood/serum samples in endemic countries. The aim of the study was to evaluate the rK-39 strip test using urine sample as a non-invasive means for the diagnosis of VL. The rk-39 strip test was performed using urine from 100 suspected VL cases along with 25 disease control (malarial febrile cases) and 50 healthy control (from endemic and non-endemic areas). All the VL suspected cases were positive with the rK-39 strip test using serum. The sensitivity and specificity of the rK-39 strip test using urine samples was 95% and 93.3%, respectively, compared to serum based rK-39 test. The findings suggest that the urine based rK-39 test could be a practical and efficient tool for the diagnosis of VL patients in rural areas, particularly where resources are limited.

Abstract Background Malignant neoplasm of the pancreas has become one of the leading causes of death from malignant neoplasm in Japan (the 5th in 2003). Although smoking is believed to be a risk factor, other risk factors remain unclear. Mortality from malignant neoplasm of the pancreas tends to be higher in northern Japan and in northern European countries. A recent study reported that standardized mortality ratios (SMRs) for malignant neoplasm of the pancreas were negatively correlated to global solar radiation level. People residing in regions with lower solar radiation and lower temperatures may be at higher risk of development of malignant neoplasm of the pancreas. Therefore, this study aimed to examine the relationship between SMRs for malignant neoplasm of the pancreas and climatic factors, such as the amount of global solar radiation and the daily maximum temperature in Japan. Results The study used multiple linear regression models. Number of deaths and demographic data from 1998 to 2002 were used for the calculation of SMR. We employed mesh climatic data for Japan published in 2006 by the Japan Meteorological Agency. Regression coefficients for the amount of global solar radiation and the daily maximum temperature in males were -4.35 (p = 0.00034) and -2.81 (p < 0.0001) respectively, and those in females were -5.02 (p < 0.0001) and -1.87 (p < 0.0001) respectively. Increased amount of global solar radiation or daily maximum temperature was significantly related to the decreased SMRs for malignant neoplasm of the pancreas in both males and females. Conclusion This study suggested that low solar radiation and low temperature might relate to the increasing risk of malignant neoplasm of the pancreas. Use of group data has a limitation in the case of evaluating environmental factors affecting health, since the impact of climatic factors on the human body varies according to individual lifestyles and occupations. Use of geographical mesh climatic data, however, proved useful as an index of risk or beneficial factors in a small study area. Further research using individual data is necessary to elucidate the relationship between climatic factors and the development of malignant neoplasm of the pancreas.

Objective: Chronic undernutrition is a common phenomenon in Bangladesh. However, information is grossly lacking to report the correlation between chronic undernutrition trajectory and lung function in children. The aim of the current study was to understand the association between early-childhood chronic undernutrition trajectory and lung function at preadolescence.Design: The current study is a part of the 9-year follow-up of a large-scale cohort study called the Maternal and Infant Nutrition Interventions in Matlab.Settings: The current study was conducted in Matlab, a sub-district area of Bangladesh that is located 53 km south of the capital, Dhaka.Participants: A total of 517 children participated in lung function measured with a spirometer at the age of 9 years. Weight and height were measured at five intervals from birth till the age of 9 years.Results: Over half of the cohort have experienced a stunting undernutrition phenomenon up to 9 years of age. Children who were persistently or intermittently stunted showed lower forced expiratory volume (ml/s) than normal-stature children (P < 0·05). Children who exhibited catch-up growth throughout 4·5 years from the stunted group showed similar lung function with normal counterparts, and a better lung function than in children with the same growth velocity or who had faltering growth. In the multivariable models, similar associations were observed in children who experienced catch-up growth than their counterparts after adjusting for covariates.Conclusion: Our data suggest that catch-up growth in height during early childhood is associated with a better lung function at preadolescence. [ABSTRACT FROM AUTHOR]

BACKGROUND: Early-life arsenic exposure has been associated with reduced cell-mediated immunity, but little is known about its effects on humoral immunity. OBJECTIVE: We evaluated whether prenatal and childhood arsenic exposure was associated with humoral immune function in school-aged children. METHODS: Children born in a prospective mother-child cohort in rural Bangladesh were immunized with measles, mumps, and rubella (MMR) vaccines at 9 years of age (n = 525). Arsenic exposure was assessed in urine (U-As), from mothers during pregnancy and their children at 4.5 and 9 years of age. Total IgG (tIgG), tIgE, tIgA, and MMR-specific IgG concentrations were measured in plasma using immunoassays. RESULTS: Arsenic exposure was positively associated with child tIgG and tIgE, but not tIgA. The association with tIgG was mainly apparent in boys (p for interaction = 0.055), in whom each doubling of maternal U-As was related to an increase in tIgG by 28 mg/dL. The associations of U-As at 9 years with tIgG and tIgE were evident in underweight children (p for interaction CONCLUSIONS: Arsenic exposure increased tIgG and tIgE in plasma, and tended to decrease mumps-specific IgG in children at 9 years of age. https://doi.org/10.1289/EHP318., Introduction Exposure to inorganic arsenic through drinking water and certain food is a global public health concern. The arsenic problem is, perhaps, the most devastating in Bangladesh, where millions of [...]