21 results on '"Kounnavong, Sengchanh"'
Search Results
2. Health system quality and COVID-19 vaccination: a cross-sectional analysis in 14 countries
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Arsenault, Catherine, Lewis, Todd P, Kapoor, Neena R, Okiro, Emelda A, Leslie, Hannah H, Armeni, Patrizio, Jarhyan, Prashant, Doubova, Svetlana V, Wright, Katherine D, Aryal, Amit, Kounnavong, Sengchanh, Mohan, Sailesh, Odipo, Emily, Lee, Hwa-Young, Shin, Jeonghyun, Ayele, Wondimu, Medina-Ranilla, Jesús, Espinoza-Pajuelo, Laura, Mebratie, Anagaw Derseh, Elorrio, Ezequiel García, Mazzoni, Agustina, Oh, Juhwan, SteelFisher, Gillian K, Tarricone, Rosanna, and Kruk, Margaret E
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Health Services and Systems ,Public Health ,Health Sciences ,Emerging Infectious Diseases ,Clinical Research ,Health Services ,Prevention ,Immunization ,Vaccine Related ,Behavioral and Social Science ,3.4 Vaccines ,Prevention of disease and conditions ,and promotion of well-being ,Generic health relevance ,Good Health and Well Being ,Humans ,Cross-Sectional Studies ,COVID-19 Vaccines ,COVID-19 ,Vaccination ,Vaccines ,Microbiology ,Public Health and Health Services ,Epidemiology ,Health services and systems ,Public health - Abstract
The social and behavioural determinants of COVID-19 vaccination have been described previously. However, little is known about how vaccinated people use and rate their health system. We used surveys conducted in 14 countries to study the health system correlates of COVID-19 vaccination. Country-specific logistic regression models were adjusted for respondent age, education, income, chronic illness, history of COVID-19, urban residence, and minority ethnic, racial, or linguistic group. Estimates were summarised across countries using random effects meta-analysis. Vaccination coverage with at least two or three doses ranged from 29% in India to 85% in Peru. Greater health-care use, having a regular and high-quality provider, and receiving other preventive health services were positively associated with vaccination. Confidence in the health system and government also increased the odds of vaccination. By contrast, having unmet health-care needs or experiencing discrimination or a medical mistake decreased the odds of vaccination. Associations between health system predictors and vaccination tended to be stronger in high-income countries and in countries with the most COVID-19-related deaths. Access to quality health systems might affect vaccine decisions. Building strong primary care systems and ensuring a baseline level of quality that is affordable for all should be central to pandemic preparedness strategies.
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- 2024
3. Risk factors for anaemia among women and their young children hospitalised with suspected thiamine deficiency in northern Lao PDR.
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Hess, Sonja, Smith, Taryn, Sitthideth, Dalaphone, Tan, Xiuping, Jones, Kerry, Brown, Kenneth, Alayon, Silvia, Kounnavong, Sengchanh, and Arnold, Charles
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Laos ,anaemia ,iron deficiency ,riboflavin deficiency ,thiamine deficiency ,Adult ,Female ,Humans ,Male ,Pregnancy ,Young Adult ,Anemia ,Anemia ,Iron-Deficiency ,Ferritins ,Hemoglobins ,Laos ,Prevalence ,Risk Factors ,Thiamine Deficiency - 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 Peoples Democratic Republic and explores possible nutritional causes and risk factors for anaemia. Hospitalised children (ages 21 days to
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- 2024
4. Insulin-like Growth Factor 1 (IGF1), IGF Binding Protein-3 (IGFBP3) and Growth Response to Daily Zinc Supplementation: A Randomized Trial in Rural Laotian Children.
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Barffour, Maxwell A, Bernstein, Robin M, Hinnouho, Guy-Marino, Wessells, K Ryan, Arnold, Charles D, Kounnavong, Sengchanh, and Hess, Sonja Y
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Humans ,Zinc ,Micronutrients ,Insulin-Like Growth Factor I ,Insulin-Like Growth Factor Binding Protein 3 ,Dietary Supplements ,Child ,IGF1 ,IGFBP3 ,multiple micronutrient powder ,physical growth ,zinc supplementation ,Clinical Research ,Nutrition ,Prevention ,Clinical Trials and Supportive Activities ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Food Sciences ,Nutrition and Dietetics - Abstract
ObjectivesTo assess (a) the impact of daily preventive zinc tablets (7 mg; PZ), zinc-containing multiple micronutrient powder (10 mg zinc, and 13 other micronutrients; MNP) or placebo, delivered for 9 months, on Insulin-like Growth Factor 1 (IGF1) and IGF Binding Protein 3 (IGFBP3) among Laotian children 6-23 months, and (b) whether the effects of PZ and MNP on length-for-age z-scores (LAZ) and weight-for-age z-scores (WAZ) are modified by baseline IGF1 and IGFBP3.DesignA double-blind, placebo-controlled trial (N = 419).MethodsPlasma IGF1 and IGFBP3 concentrations at baseline and 36 weeks were analyzed by automated chemiluminescent assay. Anthropometry was assessed at baseline, at 18 and 36 weeks. Intervention effects were estimated using ANCOVA.ResultsAt 36 weeks, geometric mean IGF1 (~39.0-39.2 ng/mL; p = 0.99) and IGFBP3 (2038-2076 ng/mL; p = 0.83) did not differ by group. At 18 weeks (but not at 36 weeks), LAZ in the PZ group (-1.45) was higher than the MNP (-1.70) and control (-1.55) groups (p = 0.01) among children in the highest baseline IGF1 tertile (p for interaction = 0.006). At 36 weeks (but not at 18 weeks), WAZ in the PZ group (-1.55) was significantly higher than the MNP (-1.75) and control (-1.65) groups (p = 0.03), among children in the lowest baseline IGFBP3 tertile (p for interactions = 0.06).ConclusionsAlthough IGF1 and IGFBP3 did not respond to PZ and MNP, baseline IGF1 and IGFBP3 significantly modified the impact of PZ on linear and ponderal growth, suggesting that IGF1 bioavailability may drive catch-up growth in zinc-supplemented children.
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- 2023
5. Daily supplementation of a multiple micronutrient powder improves folate but not thiamine, riboflavin, or vitamin B12 status among young Laotian children: a randomized controlled trial.
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Hinnouho, Guy-Marino, Hampel, Daniela, Shahab-Ferdows, Setareh, Barffour, Maxwell A, McAnena, Liadhan, Arnold, Charles D, Ryan Wessells, K, Kounnavong, Sengchanh, Allen, Lindsay H, McNulty, Helene, and Hess, Sonja Y
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Humans ,Vitamin B 12 ,Folic Acid ,Micronutrients ,Riboflavin ,Vitamins ,Thiamine ,Powders ,Nutritional Status ,Dietary Supplements ,Child ,Laos ,Folate ,Lao PDR ,MNP ,Micronutrient powder ,Vitamin B12 ,Young children ,Pediatric ,Complementary and Integrative Health ,Clinical Trials and Supportive Activities ,Clinical Research ,Nutrition ,Prevention of disease and conditions ,and promotion of well-being ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,3.3 Nutrition and chemoprevention ,Vitamin B-12 ,Nutrition and Dietetics ,Nutrition & Dietetics - Abstract
PurposeTo assess the effects of intervention with a daily multiple micronutrient powder (MNP) on thiamine, riboflavin, folate, and B12 status among young Laotian children.MethodsChildren (n = 1704) aged 6-23 mo, participating in a double-blind placebo-controlled randomized trial were individually randomized to receive daily either MNP (containing 0.5 mg of thiamine, 0.5 mg riboflavin, 150 μg folic acid, and 0.9 μg vitamin B12 along with 11 other micronutrients) or placebo and followed for ~ 36 weeks. In a randomly selected sub-sample of 260 children, erythrocyte thiamine diphosphate (eThDP), plasma folate and B12 concentrations, and erythrocyte glutathione reductase activation coefficient (EGRac; riboflavin biomarker) were assessed at baseline and endline.ResultsThere was no treatment effect on endline eThDP concentrations (110.6 ± 8.9 nmol/L in MNP vs. 109.4 ± 8.9 nmol/L in placebo group; p = 0.924), EGRac (1.46 ± 0.3 vs. 1.49 ± 0.3; p = 0.184) and B12 concentrations (523.3 ± 24.6 pmol/L vs. 515.9 ± 24.8 pmol/L; p = 0.678). Likewise, the prevalence of thiamine, riboflavin, and B12 deficiencies did not differ significantly between the two groups. However, endline folate concentration was significantly higher in the MNP compared to the placebo group (28.2 ± 0.8 nmol/L vs 19.9 ± 0.8 nmol/L, respectively; p
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- 2022
6. Nutrition and health-seeking practices during pregnancy and lactation and potential strategies to increase micronutrient intakes among women in northern Lao PDR
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Smith, Taryn J, Sitthideth, Dalaphone, Tan, Xiuping, Arnold, Charles D, Kounnavong, Sengchanh, and Hess, Sonja Y
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Biomedical and Clinical Sciences ,Midwifery ,Public Health ,Health Sciences ,Nutrition and Dietetics ,Prevention ,Clinical Trials and Supportive Activities ,Nutrition ,Clinical Research ,Management of diseases and conditions ,7.1 Individual care needs ,Reproductive health and childbirth ,Zero Hunger ,Humans ,Animals ,Female ,Pregnancy ,Prospective Studies ,Ethnicity ,Laos ,Minority Groups ,Lactation ,Eating ,Antenatal care ,Breastfeeding ,Food fortification ,Iron-folic acid ,Supplementation ,Thiamine ,ANC ,access to and utilisation of antenatal care ,IFA ,iron–folic acid ,Iron–folic acid ,Lao PDR ,Lao People's Democratic Republic ,MUAC ,maternal height ,weight and left mid-upper arm circumference ,SES ,socioeconomic status ,TDD ,thiamine deficiency disorders ,WHO ,World Health Organization ,Nutrition and dietetics ,Epidemiology - Abstract
Access to and utilisation of antenatal care (ANC) is important for optimising health and nutrition during pregnancy. This study aimed to assess adherence to and factors associated with ANC and antenatal supplement use among Laotian women, and consider culturally appropriate strategies to increase micronutrient intakes. Mother-child (aged 21 d to
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- 2022
7. Traditional prenatal and postpartum food restrictions among women in northern Lao PDR
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Smith, Taryn J, Tan, Xiuping, Arnold, Charles D, Sitthideth, Dalaphone, Kounnavong, Sengchanh, and Hess, Sonja Y
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Reproductive Medicine ,Biomedical and Clinical Sciences ,Nutrition and Dietetics ,Nutrition ,Clinical Research ,Prevention ,Reproductive health and childbirth ,Zero Hunger ,Cohort Studies ,Diet ,Female ,Food Supply ,Humans ,Laos ,Micronutrients ,Postpartum Period ,Pregnancy ,diet ,dietary diversity ,food taboos ,Lao PDR ,maternal nutrition ,postpartum ,pregnancy ,Nutrition & Dietetics ,Nutrition and dietetics ,Midwifery - Abstract
Culturally determined food restrictions are common among pregnant and postpartum women in Asia. This study aimed to describe perinatal dietary restrictions, factors associated with food avoidances and attainment of minimum dietary diversity (MDD-W) among women in Lao PDR. Mother-child (aged 21 days to
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- 2022
8. Daily preventive zinc supplementation increases the antibody response against pathogenic Escherichia coli in children with zinc insufficiency: a randomised controlled trial
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Kewcharoenwong, Chidchamai, Sein, Myint Myint, Nithichanon, Arnone, Khongmee, Aranya, Wessells, K Ryan, Hinnouho, Guy-Marino, Barffour, Maxwell A, Kounnavong, Sengchanh, Hess, Sonja Y, Stephensen, Charles B, and Lertmemongkolchai, Ganjana
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Medical Microbiology ,Biomedical and Clinical Sciences ,Nutrition ,Clinical Research ,Clinical Trials and Supportive Activities ,Prevention ,Evaluation of treatments and therapeutic interventions ,3.3 Nutrition and chemoprevention ,Prevention of disease and conditions ,and promotion of well-being ,6.1 Pharmaceuticals ,Antibody Formation ,Child ,Dietary Supplements ,Escherichia coli ,Humans ,Immunoglobulin G ,Infant ,Micronutrients ,Powders ,Zinc - Abstract
Zinc deficiency impairs the antibody-mediated immune response and is common in children from lower-income countries. This study aimed to investigate the impact of different zinc supplementation regimens (7, 10 or 20 mg/day elemental zinc)-therapeutic dispersible zinc tablets (TZ), daily multiple micronutrient powder (MNP), daily preventive zinc tablets (PZ) and placebo powder (control)-and compare between baseline and endline antibody production against pathogenic Escherichia coli in Laotian children (aged 6-23 months). Fifty representative plasma samples of each treatment group were randomly selected from 512 children to determine anti-E. coli IgG antibody levels and avidity. Of the 200 children, 78.5% had zinc deficiency (plasma zinc concentration
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- 2022
9. Plasma and Nail Zinc Concentrations, But Not Hair Zinc, Respond Positively to Two Different Forms of Preventive Zinc Supplementation in Young Laotian Children: a Randomized Controlled Trial.
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Wessells, K Ryan, Brown, Kenneth H, Arnold, Charles D, Barffour, Maxwell A, Hinnouho, Guy-Marino, Killilea, David W, Kounnavong, Sengchanh, and Hess, Sonja Y
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Nails ,Humans ,Diarrhea ,Zinc ,Micronutrients ,Double-Blind Method ,Dietary Supplements ,Child ,Child ,Preschool ,Infant ,Biomarker ,Hair ,Nail ,Plasma ,Supplement ,Clinical Trials and Supportive Activities ,Clinical Research ,Complementary and Integrative Health ,Prevention ,Nutrition ,Pediatric ,3.3 Nutrition and chemoprevention ,6.1 Pharmaceuticals ,Prevention of disease and conditions ,and promotion of well-being ,Evaluation of treatments and therapeutic interventions ,Biochemistry and Cell Biology ,Medical Biochemistry and Metabolomics ,Toxicology - Abstract
Plasma zinc concentrations (PZC) have been shown to significantly increase during zinc supplementation. This study investigated the effects of daily preventive zinc supplementation on hair and nail zinc concentrations compared with a control group. In a randomized controlled trial, 6- to 23-month-old children (n = 3407) in Lao PDR were randomly assigned to one of four groups and followed for ~ 36 weeks: daily preventive zinc dispersible tablet (7 mg/d; PZ), daily micronutrient powder (10 mg zinc/d; MNP), therapeutic zinc supplements for diarrhea treatment (20 mg/d for 10 days; TZ), or daily placebo powder (Control). Plasma, hair, and nail zinc concentrations were assessed in a sub-sample of participants (n = 457) at baseline and endline. At baseline, 75% of children had low PZC (
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- 2021
10. Impact of Different Strategies for Delivering Supplemental Zinc on Selected Fecal Markers of Environmental Enteric Dysfunction among Young Laotian Children: A Randomized Controlled Trial
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Hinnouho, Guy-Marino, Wessells, K Ryan, Barffour, Maxwell A, Sayasone, Somphou, Arnold, Charles D, Kounnavong, Sengchanh, and Hess, Sonja Y
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Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Digestive Diseases ,Pediatric ,Clinical Trials and Supportive Activities ,Nutrition ,Biomarkers ,Child Development ,Child Health ,Diarrhea ,Dietary Supplements ,Double-Blind Method ,Feces ,Female ,Humans ,Infant ,Laos ,Leukocyte L1 Antigen Complex ,Male ,Micronutrients ,Neopterin ,Peroxidase ,Zinc ,Medical and Health Sciences ,Tropical Medicine ,Biomedical and clinical sciences ,Health sciences - Abstract
The objective of this study was to assess the impact of different strategies for delivering supplemental zinc on fecal myeloperoxidase (MPO), neopterin (NEO), and calprotectin (CAL) among young Laotian children. In a double-blind controlled trial, children aged 6-23 months were randomized to receive either daily preventive zinc (PZ) tablets (7 mg/day), daily micronutrient powder (MNP; containing 10 mg zinc and 14 other micronutrients), therapeutic zinc (TZ) supplements for diarrhea treatment (20 mg/day for 10 days), or daily placebo powder and followed for ∼36 weeks. Stool samples were collected at baseline and endline. Fecal MPO, NEO, and CAL concentrations were determined in a randomly selected subsample of 720 children using commercially available ELISA kits. At baseline, the mean age was 14.1 ± 4.9 months and prevalence of stunting was 39%. The endline prevalence of stunting was 43%; there was no overall treatment effect on physical growth in the parent trial. At endline, the mean (95% CI) MPO in the PZ group was 1,590 [1,396; 1,811] ng/mL and did not differ from that in the MNP (1,633 [1,434; 1,859] ng/mL), TZ (1,749 [1,535; 1,992] ng/mL), and control (1,612 [1,415; 1,836] ng/mL) groups (P = 0.749). Similarly, there was no overall treatment effect on NEO and CAL concentrations (P = 0.226 and 0.229, respectively). In this population, the provision of PZ or TZ supplements or MNP had no impact on growth or environmental enteric dysfunction (EED) as assessed by fecal MPO, NEO, and CAL. Additional research is needed to better understand the etiology and proposed mechanisms of EED pathogenesis.
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- 2020
11. Daily Preventive Zinc Supplementation Decreases Lymphocyte and Eosinophil Concentrations in Rural Laotian Children from Communities with a High Prevalence of Zinc Deficiency: Results of a Randomized Controlled Trial
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Kewcharoenwong, Chidchamai, Schuster, Gertrud U, Wessells, K Ryan, Hinnouho, Guy-Marino, Barffour, Maxwell A, Kounnavong, Sengchanh, Brown, Kenneth H, Hess, Sonja Y, Samer, Waraporn, Tussakhon, Inthira, Peerson, Janet M, Lertmemongkolchai, Ganjana, and Stephensen, Charles B
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Biomedical and Clinical Sciences ,Clinical Sciences ,Nutrition ,Clinical Trials and Supportive Activities ,Clinical Research ,Prevention ,Prevention of disease and conditions ,and promotion of well-being ,3.3 Nutrition and chemoprevention ,Deficiency Diseases ,Dietary Supplements ,Eosinophils ,Humans ,Infant ,Laos ,Lymphocytes ,Prevalence ,Rural Population ,Zinc ,zinc supplementation ,children ,cytokine production ,T-cell concentration ,complete blood count ,Animal Production ,Food Sciences ,Nutrition and Dietetics ,Nutrition & Dietetics ,Animal production ,Food sciences ,Nutrition and dietetics - Abstract
BackgroundZinc deficiency impairs immune function and is common among children in South-East Asia.ObjectivesThe effect of zinc supplementation on immune function in young Laotian children was investigated.MethodsChildren (n = 512) aged 6-23 mo received daily preventive zinc tablets (PZ; 7 mg Zn/d), daily multiple micronutrient powder (MNP; 10 mg Zn/d, 6 mg Fe/d, plus 13 other micronutrients), therapeutic dispersible zinc tablets only in association with diarrhea episodes (TZ; 20 mg Zn/d for 10 d after an episode), or daily placebo powder (control). These interventions continued for 9 mo. Cytokine production from whole blood cultures, the concentrations of T-cell populations, and a complete blood count with differential leukocyte count were measured at baseline and endline. Endline means were compared via ANCOVA, controlling for the baseline value of the outcome, child age and sex, district, month of enrollment, and baseline zinc status (below, or above or equal to, the median plasma zinc concentration).ResultsT-cell cytokines (IL-2, IFN-γ, IL-13, IL-17), LPS-stimulated cytokines (IL-1β, IL-6, TNF-α, and IL-10), and T-cell concentrations at endline did not differ between intervention groups, nor was there an interaction with baseline zinc status. However, mean ± SE endline lymphocyte concentrations were significantly lower in the PZ than in the control group (5018 ± 158 compared with 5640 ± 160 cells/μL, P = 0.032). Interactions with baseline zinc status were seen for eosinophils (Pixn = 0.0036), basophils (Pixn = 0.023), and monocytes (P = 0.086) but a significant subgroup difference was seen only for eosinophils, where concentrations were significantly lower in the PZ than in the control group among children with baseline plasma zinc concentrations below the overall median (524 ± 44 compared with 600 ± 41 cells/μL, P = 0.012).ConclusionsZinc supplementation of rural Laotian children had no effect on cytokines or T-cell concentrations, although zinc supplementation affected lymphocyte and eosinophil concentrations. These cell subsets may be useful as indicators of response to zinc supplementation.This trial was registered at clinicaltrials.gov as NCT02428647.
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- 2020
12. Effects of therapeutic zinc supplementation for diarrhea and two preventive zinc supplementation regimens on the incidence and duration of diarrhea and acute respiratory tract infections in rural Laotian children: A randomized controlled trial
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Barffour, Maxwell A, Hinnouho, Guy-Marino, Wessells, K Ryan, Kounnavong, Sengchanh, Ratsavong, Kethmany, Sitthideth, Dalaphone, Bounheuang, Bangone, Sengnam, Khanpaseuth, Chanhthavong, Bigphone, Arnold, Charles D, Brown, Kenneth H, Larson, Charles P, and Hess, Sonja Y
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Public Health ,Health Sciences ,Digestive Diseases ,Clinical Research ,Nutrition ,Prevention ,Infectious Diseases ,Clinical Trials and Supportive Activities ,Pediatric ,6.1 Pharmaceuticals ,Prevention of disease and conditions ,and promotion of well-being ,3.3 Nutrition and chemoprevention ,Evaluation of treatments and therapeutic interventions ,Good Health and Well Being ,Diarrhea ,Dietary Supplements ,Double-Blind Method ,Female ,Humans ,Incidence ,Infant ,Laos ,Male ,Respiratory Tract Infections ,Rural Population ,Treatment Outcome ,Zinc ,Public Health and Health Services ,Public health - Abstract
BackgroundDiarrhea and respiratory tract infections are leading causes of childhood morbidity and mortality. This individually randomized, double-blind placebo-controlled trial was designed to evaluate the effects of different zinc supplementation regimens on the incidence and duration of diarrhea and acute lower (ALRI) and upper (AURI) respiratory tract infections among rural Laotian children. The study included 3407 children, 6-23 months at enrollment.MethodsChildren were randomized to one of four study groups: therapeutic zinc supplements for diarrhea treatment (20 mg/d for 10 days with each episode; TZ), daily preventive zinc tablets (7 mg/d; PZ), daily multiple micronutrient powder (10 mg/d zinc, 6 mg/d iron and 13 other micronutrients; MNP), or daily placebo powder for 9 months. Incidence and duration of diarrhea (≥3 liquid stools/24 hours), ALRI (persistent cough with wheezing, stridor or chest in-drawing) and AURI (purulent nasal discharge with cough) were assessed by parental report during weekly home visits and analyzed using negative binomial models.ResultsBaseline mean age was 14.2 ± 5.1 months, and 71% had low plasma zinc (18 months, TZ reduced diarrhea incidence by 24% vs MNP (P = 0.035), and 36% vs Control (P = 0.004), but there was no difference with PZ. This patterned remained when analyses were restricted to diarrhea episode occurring after the first treatment with TZ. Also, in children >18 months, TZ reduced diarrhea duration by 15% vs PZ (P = 0.03), and 16% vs Control (P = 0.03), but there was no difference with MNP. There were no overall effects of study group on incidence of ALRI (overall mean 0.005 ± 0.001 episodes/100 days, P = 0.14) or AURI (overall mean 0.09 ± 0.01 episodes/100 days, P = 0.72).ConclusionsThere was no overall impact of TZ, PZ or MNP on diarrhea, ALRI and AURI. However, in children >18 months, TZ significantly reduced both the duration of diarrhea episodes and the incidence of future diarrhea episodes compared with placebo.Trial registrationClinicalTrials.gov: NCT02428647.
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- 2020
13. Establishing a case definition of thiamine responsive disorders among infants and young children in Lao PDR: protocol for a prospective cohort study.
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Hess, Sonja Y, Smith, Taryn J, Fischer, Philip R, Trehan, Indi, Hiffler, Laurent, Arnold, Charles D, Sitthideth, Dalaphone, Tancredi, Daniel J, Schick, Michael A, Yeh, Jay, Stein-Wexler, Rebecca, McBeth, Christine N, Tan, Xiuping, Nhiacha, Kouyang, and Kounnavong, Sengchanh
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Humans ,Thiamine Deficiency ,Thiamine ,Risk Factors ,Prospective Studies ,Research Design ,Infant ,Infant ,Newborn ,Laos ,Female ,Observational Studies as Topic ,echocardiography ,neuroradiology ,nutrition & dietetics ,paediatrics ,Clinical Sciences ,Public Health and Health Services ,Other Medical and Health Sciences - Abstract
IntroductionDiagnosis of infantile thiamine deficiency disorders (TDD) is challenging due to the non-specific, highly variable clinical presentation, often leading to misdiagnosis. Our primary objective is to develop a case definition for thiamine responsive disorders (TRD) to determine among hospitalised infants and young children, which clinical features and risk factors identify those who respond positively to thiamine administration.Methods and analysisThis prospective study will enrol 662 children (aged 21 days to
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- 2020
14. Impact of Daily Preventive Zinc or Therapeutic Zinc Supplementation for Diarrhea on Plasma Biomarkers of Environmental Enteric Dysfunction among Rural Laotian Children: A Randomized Controlled Trial
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Wessells, K Ryan, Hinnouho, Guy-Marino, Barffour, Maxwell A, Arnold, Charles D, Kounnavong, Sengchanh, Kewcharoenwong, Chidchamai, Lertmemongkolchai, Ganjana, Schuster, Gertrud U, Stephensen, Charles B, and Hess, Sonja Y
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Biomedical and Clinical Sciences ,Nutrition and Dietetics ,Clinical Trials and Supportive Activities ,Pediatric ,Digestive Diseases ,Prevention ,Clinical Research ,Nutrition ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Biomarkers ,Diarrhea ,Dietary Supplements ,Drug Administration Schedule ,Female ,Humans ,Infant ,Laos ,Male ,Rural Population ,Zinc ,Medical and Health Sciences ,Tropical Medicine ,Biomedical and clinical sciences ,Health sciences - Abstract
Environmental enteric dysfunction (EED) may be ameliorated by zinc supplementation. The objective of this study was to investigate the impact of different forms of zinc supplementation on biomarkers of EED (i.e., plasma citrulline, kynurenine, and tryptophan concentrations and the kynurenine:tryptophan [KT] ratio) among young Laotian children. In a double-blind randomized controlled trial, 3,407 children aged 6-23 months were randomized into one of four groups: daily preventive zinc dispersible tablets (PZ; 7 mg zinc), daily multiple micronutrient powders (MNP; 10 mg zinc, 6 mg iron, and 13 other micronutrients), therapeutic zinc supplements for diarrhea treatment (TZ; 20 mg/day for 10 days), or daily placebo powder, and followed up for ∼36 weeks. Plasma samples at baseline and endline for 359 children were analyzed for citrulline, kynurenine, and tryptophan concentrations. At baseline, the prevalence of stunting and zinc deficiency was 37% and 76.5%, respectively. The mean plasma citrulline, kynurenine, and tryptophan concentrations were 24.6 ± 5.4 µmol/L, 3.27 ± 0.83 µmol/L, and 72.3 ± 12.9 µmol/L, respectively; the mean KT ratio (×1,000) was 45.9 ± 12.0. At endline, neither plasma citrulline, kynurenine, or tryptophan concentrations, nor the KT ratio differed among intervention groups (P > 0.05). In this population, PZ, MNP, and TZ had no overall effect on plasma concentrations of citrulline, kynurenine, and tryptophan, or the KT ratio. The need remains to better understand the etiology of EED, and the development of biomarkers to diagnose EED and evaluate the impact of interventions.
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- 2020
15. Iron status and inherited haemoglobin disorders modify the effects of micronutrient powders on linear growth and morbidity among young Lao children in a double-blind randomised trial
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Hess, Sonja Y, Wessells, K Ryan, Hinnouho, Guy-Marino, Barffour, Maxwell A, Sanchaisuriya, Kanokwan, Arnold, Charles D, Brown, Kenneth H, Larson, Charles P, Fucharoen, Supan, and Kounnavong, Sengchanh
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Biomedical and Clinical Sciences ,Nutrition and Dietetics ,Pediatric ,Clinical Research ,Clinical Trials and Supportive Activities ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Anemia ,Child Development ,Diarrhea ,Dietary Supplements ,Double-Blind Method ,Female ,Hemoglobinopathies ,Hemoglobins ,Humans ,Infant ,Iron ,Laos ,Male ,Micronutrients ,Nutritional Status ,Powders ,Prevalence ,Micronutrient powder ,Young children ,Inherited Hb disorder ,Iron status ,Anaemia ,Growth ,Diarrhoea ,Animal Production ,Food Sciences ,Nutrition & Dietetics ,Animal production ,Food sciences ,Nutrition and dietetics - Abstract
Some studies found that providing micronutrient powder (MNP) causes adverse health outcomes, but modifying factors are unknown. We aimed to investigate whether Fe status and inherited Hb disorders (IHbD) modify the impact of MNP on growth and diarrhoea among young Lao children. In a double-blind controlled trial, 1704 children of age 6-23 months were randomised to daily MNP (with 6 mg Fe plus fourteen micronutrients) or placebo for about 36 weeks. IHbD, and baseline and final Hb, Fe status and anthropometrics were assessed. Caregivers provided weekly morbidity reports. At enrolment, 55·6 % were anaemic; only 39·3 % had no sign of clinically significant IHbD. MNP had no overall impact on growth and longitudinal diarrhoea prevalence. Baseline Hb modified the effect of MNP on length-for-age (LAZ) (P for interaction = 0·082). Among children who were initially non-anaemic, the final mean LAZ in the MNP group was slightly lower (-1·93 (95 % CI -1·88, -1·97)) v. placebo (-1·88 (95 % CI -1·83, -1·92)), and the opposite occurred among initially anaemic children (final mean LAZ -1·90 (95 % CI -1·86, -1·94) in MNP v. -1·92 (95 % CI -1·88, -1·96) in placebo). IHbD modified the effect on diarrhoea prevalence (P = 0·095). Among children with IHbD, the MNP group had higher diarrhoea prevalence (1·37 (95 % CI 1·17, 1·59) v. 1·21 (95 % CI 1·04, 1·41)), while it was lower among children without IHbD who received MNP (1·15 (95 % CI 0·95, 1·39) v. 1·37 (95 % CI 1·13, 1·64)). In conclusion, there was a small adverse effect of MNP on growth among non-anaemic children and on diarrhoea prevalence among children with IHbD.
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- 2019
16. 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.
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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
- Subjects
Humans ,Anemia ,Iron-Deficiency ,Growth Disorders ,Diarrhea ,Zinc ,Micronutrients ,Powders ,Double-Blind Method ,Dietary Supplements ,Infant ,Laos ,Pediatric ,Clinical Trials and Supportive Activities ,Prevention ,Clinical Research ,Nutrition ,Hematology ,Prevention of disease and conditions ,and promotion of well-being ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,3.3 Nutrition and chemoprevention ,Human Movement and Sports Sciences ,Paediatrics and Reproductive Medicine ,Pediatrics - Abstract
ObjectivesTo evaluate the optimal zinc supplementation strategy for improving growth and hematologic and micronutrient status in young Laotian children.Study designIn total, 3407 children aged 6-23 months were randomized to receive either daily preventive zinc tablets (7 mg/d), high-zinc, low-iron micronutrient powder (10 mg/d zinc, 6 mg/d iron, and 13 other micronutrients), therapeutic zinc supplementation for diarrhea (20 mg/d for 10 days per episode), or daily placebo powder; all were followed for ~9 months. Anthropometry, hemoglobin, zinc, and iron status were assessed at baseline and endline. Analyses were by intention-to-treat, using linear and modified Poisson regression.ResultsAt baseline, mean (±SD) age was 14.2 ± 5.1 months and stunting and anemia prevalence were 37.9% and 55.6%, respectively. At endline, zinc deficiency in the preventive zinc (50.7%) and micronutrient powder (59.1%) groups were significantly lower than in the therapeutic zinc (79.2%) and control groups (78.6%; P
- Published
- 2019
17. Impact of Two Forms of Daily Preventive Zinc or Therapeutic Zinc Supplementation for Diarrhea on Hair Cortisol Concentrations Among Rural Laotian Children: A Randomized Controlled Trial
- Author
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Hinnouho, Guy-Marino, Bernstein, Robin M, Barffour, Maxwell A, Arnold, Charles D, Wessells, K Ryan, Ratsavong, Kethmany, Bounheuang, Bangone, Kounnavong, Sengchanh, and Hess, Sonja Y
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Digestive Diseases ,Rare Diseases ,Nutrition ,Clinical Research ,Pediatric ,Prevention ,Cancer ,Clinical Trials and Supportive Activities ,Prevention of disease and conditions ,and promotion of well-being ,Evaluation of treatments and therapeutic interventions ,3.3 Nutrition and chemoprevention ,6.1 Pharmaceuticals ,Diarrhea ,Dietary Supplements ,Double-Blind Method ,Female ,Hair ,Humans ,Hydrocortisone ,Infant ,Laos ,Male ,Risk Factors ,Rural Population ,Stress ,Physiological ,Zinc ,zinc supplementation ,micronutrient powder ,MNP ,hair cortisol ,chronic stress ,young children ,Lao PDR ,Food Sciences ,Nutrition and Dietetics ,Clinical sciences ,Nutrition and dietetics ,Public health - Abstract
Zinc supplementation has been shown to reduce the morbidity burden among young children, and may reduce chronic stress. Hair cortisol has been promoted as an indicator of chronic stress. We assessed the impact of different strategies for delivering supplementary zinc on hair cortisol concentrations (HCC) in young Laotian children and examined risk factors associated with HCC. In a randomized double-blind controlled trial (NCT02428647), children aged 6⁻23 mo were randomized to one of four intervention groups and followed for ~36 weeks: daily preventive zinc (PZ) tablets (7 mg/day), daily multiple micronutrient powder (MNP) sachets (containing 10 mg zinc and 14 other micronutrients), therapeutic zinc (TZ) supplements for diarrhea treatment (20 mg/day for 10 days) or daily placebo powder. HCC of 512 children was assessed at baseline and endline. ANCOVA and linear regression models were used to assess group differences in HCC and to examine the risk factors associated with HCC, respectively. At enrollment, mean HCC was 28.8 ± 43.9 pg/mg. In models adjusted for age at enrollment, health district, and baseline HCC there was no overall effect of the interventions on endline HCC and change in HCC. When controlling for additional predetermined covariates, there was a marginally significant effect on change in HCC (p = 0.075) with a slightly lower reduction of HCC in TZ compared to PZ (mean change (95% CI): -4.6 (-7.0; -2.3) vs. -9.4 (-11.7; -7.0) pg/mg; p = 0.053). At baseline, consumption of iron rich foods was negatively associated with HCC, whereas AGP (α1-acid glycoprotein) levels, elevated AGP and C-reactive protein and high soluble transferrin receptor were positively associated with HCC. In young Laotian children, MNP, PZ and TZ had no impact on HCC. The marginal difference in change in HCC between the PZ and TZ groups was too small to be considered of health significance.
- Published
- 2019
18. Comparison of haemoglobin assessments by HemoCue and two automated haematology analysers in young Laotian children
- Author
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Hinnouho, Guy-Marino, Barffour, Maxwell A, Wessells, K Ryan, Brown, Kenneth H, Kounnavong, Sengchanh, Chanhthavong, Bigphone, Ratsavong, Kethmany, Kewcharoenwong, Chidchamai, and Hess, Sonja Y
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Pediatric ,Clinical Research ,Pediatric Research Initiative ,Age Factors ,Anemia ,Automation ,Laboratory ,Biomarkers ,Blood Chemical Analysis ,Hematology ,Hemoglobins ,Humans ,Infant ,Laos ,Predictive Value of Tests ,Prevalence ,Randomized Controlled Trials as Topic ,Reproducibility of Results ,Rural Health Services ,paediatric haematology ,diagnosis ,epidemiology ,evaluating instrument ,Medical Microbiology ,Pathology ,Clinical sciences ,Oncology and carcinogenesis - Abstract
BackgroundHaemoglobin (Hb) assessment by Hemocue is used widely for anaemia screening in both adults and children. However, few studies have compared the diagnostic accuracy of Hemocue with an automated haematology analyser in young children.AimTo compare Hb concentrations by Hemocue Hb301 and two automated haematology analysers in young children in rural communities of Lao PDR.MethodsCapillary blood was collected from 6-month-old to 23-month-old children (n=1487) for determination of Hb concentration by Hemocue Hb301. On the same day, venous blood was collected for complete blood count using one of two haematology analysers (XT-1800i, Sysmex, and BC-3000Plus, Mindray Medical International). In a subsample of children (n=129), venous Hb was also measured by HemoCue Hb301. Agreement between the two methods was estimated using Bland-Altman plots.ResultsMean capillary Hb by Hemocue was significantly higher than mean venous Hb by haematology analysers combined (108.4±10.3 g/L vs 102.3±13.1 g/L; P
- Published
- 2018
19. Thiamine deficiency disorders: diagnosis, prevalence, and a roadmap for global control programs
- Author
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Whitfield, Kyly C., Bourassa, Megan W., Adamolekun, Bola, Bergeron, Gilles, Bettendorff, Lucien, Brown, Kenneth H., Cox, Lorna, Fattal‐Valevski, Aviva, Fischer, Philip R., Frank, Elizabeth L., Hiffler, Laurent, Hlaing, Lwin Mar, Jefferds, Maria Elena, Kapner, Hallie, Kounnavong, Sengchanh, Mousavi, Maral P.S., Roth, Daniel E., Tsaloglou, Maria‐Nefeli, Wieringa, Frank, and Combs, Gerald F.
- Subjects
thiamine deficiency ,erythrocyte transketolase ,Technical Reports ,food and beverages ,beriberi ,Global Health ,LMIC ,Technical Report ,nutrition ,Risk Factors ,thiamine diphosphate ,Dietary Supplements ,Food, Fortified ,Prevalence ,Humans ,Public Health ,human activities - Abstract
Thiamine is an essential micronutrient that plays a key role in energy metabolism. Many populations worldwide may be at risk of clinical or subclinical thiamine deficiencies, due to famine, reliance on staple crops with low thiamine content, or food preparation practices, such as milling grains and washing milled rice. Clinical manifestations of thiamine deficiency are variable; this, along with the lack of a readily accessible and widely agreed upon biomarker of thiamine status, complicates efforts to diagnose thiamine deficiency and assess its global prevalence. Strategies to identify regions at risk of thiamine deficiency through proxy measures, such as analysis of food balance sheet data and month‐specific infant mortality rates, may be valuable for understanding the scope of thiamine deficiency. Urgent public health responses are warranted in high‐risk regions, considering the contribution of thiamine deficiency to infant mortality and research suggesting that even subclinical thiamine deficiency in childhood may have lifelong neurodevelopmental consequences. Food fortification and maternal and/or infant thiamine supplementation have proven effective in raising thiamine status and reducing the incidence of infantile beriberi in regions where thiamine deficiency is prevalent, but trial data are limited. Efforts to determine culturally and environmentally appropriate food vehicles for thiamine fortification are ongoing.
- Published
- 2018
20. Lao language version of the Revised Hasegawa’s Dementia Scale
- Author
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Kounnavong, Sengchanh, Soundavong, Khouanchay, Xayavong, Syda, Vongpraserth, Nialoun, Bounsavath, Phongsavang, Houatthongkham, Souphatsone, Phoummalaysith, Bounfeng, Mon Saw, Yu, Yamamoto, Eiko, Toba, Kenji, and Hamajima, Nobuyuki
- Subjects
Adult ,Aged, 80 and over ,Male ,China ,Middle Aged ,Note ,Revised Hasegawa’s Dementia Scale ,Lao PDR ,Cognition ,Japan ,Laos ,Surveys and Questionnaires ,Humans ,Dementia ,Female ,cognitive function ,Aged - Abstract
With the aging of society, the number of elderly with reduced cognitive function has been increasing worldwide. As a test to measure the cognitive function, the Revised Hasegawa’s Dementia Scale (HDS-R) has been used in Japan, Korea, and China. Since there was no HDS-R version for Laotians, the questionnaire and manual were developed through the cooperation of Lao and Japanese researchers. Back-translation was conducted to confirm the accuracy of the translation. The score on the 9-item HDS-R ranges 0 to 30 points, and reduced cognitive function is usually defined as a score of 20 points or lower. After receiving explanation regarding the use of the tool and practicing its implementation, 3 female doctors interviewed 30 superficially healthy volunteers aged 31 to 84 years (12 males and 18 females) who lived with his/her family in Vientiane Capital, Lao PDR. Their score distributed from 4 to 30 points, with an average of 24.7 (standard deviation 5.4) points. Six (20.0%) participants scored 20 points or lower. The discussion before and after the pilot interviews revealed that the following changes needed to be made in accordance to the culture of Lao people; 1) order of date in Question 2, 2) words to be memorized in Questions 4 and 7, 3) objects to be memorized using pictures, not actual objects, in Question 8. Additionally, we introduced new two rules; a clear time definition for no reply (10 seconds), and repetition of questions twice for those with ear problems. The revised version of the HDS-R was thought to be an appropriate standard questionnaire for use in studies on cognitive function among Laotians.
- Published
- 2017
21. Impact of Two Forms of Daily Preventive Zinc or Therapeutic Zinc Supplementation for Diarrhea on Hair Cortisol Concentrations Among Rural Laotian Children: A Randomized Controlled Trial
- Author
-
Hinnouho, Guy-Marino, Bernstein, Robin M., Barffour, Maxwell A., Arnold, Charles D., Wessells, K. Ryan, Ratsavong, Kethmany, Bounheuang, Bangone, Kounnavong, Sengchanh, and Hess, Sonja Y.
- Subjects
Diarrhea ,Rural Population ,Male ,and promotion of well-being ,MNP ,Hydrocortisone ,Physiological ,Clinical Trials and Supportive Activities ,lcsh:TX341-641 ,Stress ,Rare Diseases ,Food Sciences ,micronutrient powder ,Lao PDR ,Double-Blind Method ,Risk Factors ,Clinical Research ,hair cortisol ,Humans ,3.3 Nutrition and chemoprevention ,Nutrition ,Cancer ,chronic stress ,Pediatric ,young children ,Nutrition and Dietetics ,Prevention ,zinc supplementation ,Infant ,Evaluation of treatments and therapeutic interventions ,Prevention of disease and conditions ,digestive system diseases ,Zinc ,Laos ,6.1 Pharmaceuticals ,Dietary Supplements ,Female ,Digestive Diseases ,lcsh:Nutrition. Foods and food supply ,Hair - Abstract
Zinc supplementation has been shown to reduce the morbidity burden among young children, and may reduce chronic stress. Hair cortisol has been promoted as an indicator of chronic stress. We assessed the impact of different strategies for delivering supplementary zinc on hair cortisol concentrations (HCC) in young Laotian children and examined risk factors associated with HCC. In a randomized double-blind controlled trial (NCT02428647), children aged 6&ndash, 23 mo were randomized to one of four intervention groups and followed for ~36 weeks: daily preventive zinc (PZ) tablets (7 mg/day), daily multiple micronutrient powder (MNP) sachets (containing 10 mg zinc and 14 other micronutrients), therapeutic zinc (TZ) supplements for diarrhea treatment (20 mg/day for 10 days) or daily placebo powder. HCC of 512 children was assessed at baseline and endline. ANCOVA and linear regression models were used to assess group differences in HCC and to examine the risk factors associated with HCC, respectively. At enrollment, mean HCC was 28.8 ±, 43.9 pg/mg. In models adjusted for age at enrollment, health district, and baseline HCC there was no overall effect of the interventions on endline HCC and change in HCC. When controlling for additional predetermined covariates, there was a marginally significant effect on change in HCC (p = 0.075) with a slightly lower reduction of HCC in TZ compared to PZ (mean change (95% CI): &minus, 4.6 (&minus, 7.0, &minus, 2.3) vs. &minus, 9.4 (&minus, 11.7, 7.0) pg/mg, p = 0.053). At baseline, consumption of iron rich foods was negatively associated with HCC, whereas AGP (&alpha, 1-acid glycoprotein) levels, elevated AGP and C-reactive protein and high soluble transferrin receptor were positively associated with HCC. In young Laotian children, MNP, PZ and TZ had no impact on HCC. The marginal difference in change in HCC between the PZ and TZ groups was too small to be considered of health significance.
- Published
- 2018
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