38 results on '"Kuong K"'
Search Results
2. Deoxyribonucleotide Pool Imbalances and Mitochondrial Mutagenesis.: P135
- Author
-
Kuong, K J and Loeb, L A
- Published
- 2012
3. High prevalence of thiamine (vitamin B1) deficiency in early childhood among a nationally representative sample of Cambodian women of childbearing age and their children
- Author
-
Whitfield, K. C., Smith, G., Chamnan, C., Karakochuk, C. D., Sophonneary, P., Kuong, K., Dijkhuizen, M. A., Hong, R., Berger, Jacques, Green, T. J., and Wieringa, Franck
- Abstract
Background Thiamine deficiency is thought to be an issue in Cambodia and throughout Southeast Asia due to frequent clinical reports of infantile beriberi. However the extent of this public health issue is currently unknown due to a lack of population-representative data. Therefore we assessed the thiamine status (measured as erythrocyte thiamine diphosphate concentrations; eThDP) among a representative sample of Cambodian women of childbearing age (15-49 y) and their young children (6-69 mo). Methodology/Principle findings Samples for this cross-sectional analysis were collected as part of a national micronutrient survey linked to the Cambodian Demographic and Health Survey (CDHS) 2014. One-sixth of households taking part in the CDHS were randomly selected and re-visited for additional blood sampling for eThDP analysis (719 women and 761 children). Thiamine status was assessed using different cut-offs from literature. Women were mean (SD) 30 (6) y, and children (46% girls) were 41 (17) mo. Women had lower mean (95% Cl) eThDP of 150 nmol/L (146-153) compared to children, 174 nmol/L (171-179; P < 0.001). Using the most conservative cut-off of eThDP < 120 nmol/ L, 27% of mothers and 15% of children were thiamine deficient, however prevalence rates of deficiency were as high as 78% for mothers and 58% for children using a cut-off of < 180 nmol/L. Thiamine deficiency was especially prevalent among infants aged 6-12 mo: 38% were deficient using the most conservative cut-off (< 120 nmol/L). Conclusions/Significance There is a lack of consensus on thiamine status cut-offs; more research is required to set clinically meaningful cut-offs. Despite this, there is strong evidence of suboptimal thiamine status among Cambodian mothers and their children, with infants
- Published
- 2017
4. SMILING Consortium Group. The SMILING project: a North-South-South collaborative action to prevent micronutrient deficiencies in women and young children in Southeast Asia
- Author
-
Berger, J., Blanchard, G., Maiza Campos Ponce, Chamnan, C., Chea, M., Dijkhuizen, M., Doak, C. M., Doets, E., Fahmida, U., Ferguson, E., Hulshof, P., Kameli, Y., Kuong, K., Akkhavong, K., Sengchanh, K., Le, B. M., Tran, T. L., Muslimatun, S., Roos, N., Sophonneary, P., Wieringa, F., Wasantwisut, E., Winichagoon, P., and Infectious Diseases
- Published
- 2013
5. Stability of vitamin A, iron and zinc in fortified rice during storage and its impact on future national standards and programs : case study in Cambodia
- Author
-
Kuong, K., Laillou, A., Chea, C., Chamnan, C., Berger, Jacques, and Wieringa, Franck
- Subjects
iron ,rice ,zinc ,fortification ,food and beverages ,stability ,Cambodia ,vitamin A - Abstract
Fortified rice holds great potential for bringing essential micronutrients to a large part of the world population. The present study quantified the losses of three different micronutrients (vitamin A, iron, zinc) in fortified rice that were produced using three different techniques (hot extrusion, cold extrusion, and coating) and stored at two different environments (25 +/- 5 degrees C at a humidity of 60% and 40 +/- 5 degrees C at a humidity of 75%) for up to one year. Fortified rice premix from the different techniques was mixed with normal rice in a 1:100 ratio. Each sample was analyzed in triplicate. The study confirmed the high stability of iron and zinc during storage while the retention of vitamin A was significantly affected by storage and the type of techniques used to make rice premix. Losses for iron and zinc were typically < 10% for any type of rice premix. After 12 months at mild conditions (25 degrees C and humidity of 60%), losses for vitamin A ranged from 20% for cold extrusion, 30% for hot extruded rice 77% for coated rice premix. At higher temperatures and humidity, losses of vitamin A were 40%-50% for extruded premix and 93% for coated premix after 6 months. We conclude that storage does lead to a major loss of vitamin A and question whether rice is a suitable food vehicle to fortify with vitamin A. For Cambodia, fortification of rice with iron and zinc could be an effective strategy to improve the micronutrient status of the population if no other food vehicles are available.
- Published
- 2016
6. Nutritional and micronutrient status of female workers in a garment factory in Cambodia
- Author
-
Makurat J, Friedrich H, Kuong K, Frank T Wieringa, Chamnan C, Mb, Krawinkel, and Institute of Nutritional Sciences
- Subjects
Iron ,Nutritional Status ,lcsh:TX341-641 ,malnutrition ,Article ,vitamin A ,Body Mass Index ,Clothing ,Hemoglobins ,Young Adult ,Sex Factors ,iron ,Manufacturing and Industrial Facilities ,Thinness ,underweight ,micronutrient deficiency ,Manufacturing Industry ,Prevalence ,Humans ,Micronutrients ,ddc:610 ,Occupational Health ,industry ,Anemia, Iron-Deficiency ,Age Factors ,nutritional and metabolic diseases ,Iron Deficiencies ,vitamin B12 ,Nutrition Surveys ,anemia ,Medical sciences Medicine ,garment factory ,Parity ,Cross-Sectional Studies ,Nutrition Assessment ,Female ,Cambodia ,lcsh:Nutrition. Foods and food supply ,Biomarkers - Abstract
Background: Concerns about the nutritional status of Cambodian garment workers were raised years ago but data are still scarce. The objectives of this study are to examine the nutritional, hemoglobin and micronutrient status of female workers in a garment factory in Phnom Penh, Cambodia, and to assess if body mass index is associated with hemoglobin and/or micronutrient status. Methods: A cross-sectional survey was conducted among 223 female workers (nulliparous, non-pregnant) at a garment factory in Phnom Penh. Anthropometric measurements were performed and blood samples were taken to obtain results on hemoglobin, iron, vitamin A, vitamin B12 and inflammation status (hemoglobinopathies not determined). Bivariate correlations were used to assess associations. Results: Overall, 31.4% of workers were underweight, 26.9% showed anemia, 22.1% showed iron deficiency, while 46.5% had marginal iron stores. No evidence of vitamin A or vitamin B12 deficiency was found. Body mass index was associated with serum ferritin (negative) and serum retinol-binding protein (positive) concentrations, but not strongly. A comparison between underweight and not underweight workers resulted in distinctions for iron deficiency and iron deficiency anemia, with a higher prevalence among not underweight. Conclusions: The prevalence of underweight, anemia and poor iron status was high. Young and nulliparous female garment workers in Cambodia might constitute a group with elevated risk for nutritional deficiencies. Strategies need to be developed for improving their nutritional, micronutrient and health status. The poor iron status seems to contribute to the overall prevalence of anemia. Low hemoglobin and iron deficiency affected both underweight and those not underweight. Despite the fact that body mass index was negatively associated with iron stores, true differences in iron status between underweight and not underweight participants cannot be confirmed.
- Published
- 2016
7. Progression of Aggressive Metastatic Carcinosarcoma After Treatment of Epithelioid Osteosarcoma
- Author
-
Robert M. Tamurian, Dariusz Borys, Kuong K. Ngann, and Derek F. Amanatullah
- Subjects
musculoskeletal diseases ,Pathology ,medicine.medical_specialty ,Biopsy ,CD99 ,Antineoplastic Agents ,Bone Neoplasms ,Diagnosis, Differential ,Fatal Outcome ,Carcinosarcoma ,medicine ,Humans ,Orthopedics and Sports Medicine ,Child ,neoplasms ,Survival rate ,Osteosarcoma ,Tibia ,medicine.diagnostic_test ,Osteoid ,business.industry ,medicine.disease ,Magnetic Resonance Imaging ,Conventional Osteosarcoma ,Chemotherapy, Adjuvant ,Disease Progression ,Female ,Surgery ,Tomography, X-Ray Computed ,business ,Epithelioid cell ,Follow-Up Studies - Abstract
Osteosarcoma is the most common primary malignant osseous neoplasm, constituting approximately 35% of skeletal malignancies. The different subtypes of osteosarcoma are differentiated based on clinical, histologic, and radiographic data, as well as the variable amount of osteoid produced by malignant cells. The epithelioid osteosarcoma subtype accounts for only 5.7% of all osteosarcomas and portends an extremely poor prognosis. The 5-year survival rate for patients with epithelioid osteosarcoma treated with surgery (with or without chemotherapy) is 13.5%. This is in direct contrast to the >70% ten-year survival rate of conventional osteosarcoma treated with surgery and chemotherapy. This article presents a fatal case of epithelioid osteosarcoma in an 11-year-old girl with right knee pain of 6 months' duration. Biopsy demonstrated morphologic findings consistent with high-grade osteosarcoma with epithelioid features. The epithelioid component was positive for vimentin and CD99; however, fluorescent in situ hybridization for the (11;22) translocation was negative. In this case, the epithelioid cells failed to respond to conventional or subsequent experimental chemotherapy for osteosarcoma and eventual metastasized to the lymph nodes and lungs despite multiple ablative surgeries. This case report supports the concept of carcinosarcoma with malignant cells lines arising from 2 different cellular lineages or a common cellular precursor. The epithelial component was more aggressive than the cells of mesenchymal origin, highlighting the need for continued research and a more favorable outcome for this rare subset of osteosarcoma.
- Published
- 2010
8. Progression of Aggressive Metastatic Carcinosarcoma After Treatment of Epithelioid Osteosarcoma
- Author
-
Amanatullah, Derek F., primary, Ngann, Kuong K., additional, Borys, Dariusz, additional, and Tamurian, Robert M., additional
- Published
- 2010
- Full Text
- View/download PDF
9. Height, Zinc and Soil-Transmitted Helminth Infections in Schoolchildren: A Study in Cuba and Cambodia
- Author
-
Brechje de Gier, Liliane Mpabanzi, Kim Vereecken, Suzanne D. van der Werff, Patrick C. D'Haese, Marion Fiorentino, Kuong Khov, Marlene Perignon, Chhoun Chamnan, Jacques Berger, Megan E. Parker, Raquel Junco Díaz, Fidel Angel Núñez, Lázara Rojas Rivero, Mariano Bonet Gorbea, Colleen M. Doak, Maiza Campos Ponce, Frank T. Wieringa, and Katja Polman
- Subjects
zinc ,soil-transmitted helminth infections ,child ,growth ,height ,Cambodia ,Cuba ,Nutrition. Foods and food supply ,TX341-641 - Abstract
Soil-transmitted helminth (STH) infections and zinc deficiency are often found in low- and middle-income countries and are both known to affect child growth. However, studies combining data on zinc and STH are lacking. In two studies in schoolchildren in Cuba and Cambodia, we collected data on height, STH infection and zinc concentration in either plasma (Cambodia) or hair (Cuba). We analyzed whether STH and/or zinc were associated with height for age z-scores and whether STH and zinc were associated. In Cuba, STH prevalence was 8.4%; these were mainly Ascaris lumbricoides and Trichuris trichiura infections. In Cambodia, STH prevalence was 16.8%, mostly caused by hookworm. In Cuban children, STH infection had a strong association with height for age (aB-0.438, p = 0.001), while hair zinc was significantly associated with height for age only in STH uninfected children. In Cambodian children, plasma zinc was associated with height for age (aB-0.033, p = 0.029), but STH infection was not. Only in Cambodia, STH infection showed an association with zinc concentration (aB-0.233, p = 0.051). Factors influencing child growth differ between populations and may depend on prevalences of STH species and zinc deficiency. Further research is needed to elucidate these relationships and their underlying mechanisms.
- Published
- 2015
- Full Text
- View/download PDF
10. Micronutrient-Fortified Rice Can Increase Hookworm Infection Risk: A Cluster Randomized Trial.
- Author
-
Brechje de Gier, Maiza Campos Ponce, Marlene Perignon, Marion Fiorentino, Kuong Khov, Chhoun Chamnan, Michiel R de Boer, Megan E Parker, Kurt Burja, Marjoleine A Dijkhuizen, Jacques Berger, Katja Polman, and Frank T Wieringa
- Subjects
Medicine ,Science - Abstract
Fortification of staple foods is considered an effective and safe strategy to combat micronutrient deficiencies, thereby improving health. While improving micronutrient status might be expected to have positive effects on immunity, some studies have reported increases in infections or inflammation after iron supplementation.To study effects of micronutrient-fortified rice on hookworm infection in Cambodian schoolchildren.A double-blinded, cluster-randomized trial was conducted in 16 Cambodian primary schools partaking in the World Food Program school meal program. Three types of multi-micronutrient fortified rice were tested against placebo rice within the school meal program: UltraRice_original, UltraRice_improved and NutriRice. Four schools were randomly assigned to each study group (placebo n = 492, UltraRice_original n = 479, UltraRice_improved n = 500, NutriRice n = 506). Intestinal parasite infection was measured in fecal samples by Kato-Katz method at baseline and after three and seven months. In a subgroup (N = 330), fecal calprotectin was measured by ELISA as a marker for intestinal inflammation.Baseline prevalence of hookworm infection was 18.6%, but differed considerably among schools (range 0%- 48.1%).Micronutrient-fortified rice significantly increased risk of new hookworm infection. This effect was modified by baseline hookworm prevalence at the school; hookworm infection risk was increased by all three types of fortified rice in schools where baseline prevalence was high (>15%), and only by UltraRice_original in schools with low baseline prevalence. Neither hookworm infection nor fortified rice was related to fecal calprotectin.Consumption of rice fortified with micronutrients can increase hookworm prevalence, especially in environments with high infection pressure. When considering fortification of staple foods, a careful risk-benefit analysis is warranted, taking into account severity of micronutrient deficiencies and local prevalence of parasitic infections.ClinicalTrials.gov NCT01706419.
- Published
- 2016
- Full Text
- View/download PDF
11. Faecal microbiota of schoolchildren is associated with nutritional status and markers of inflammation: a double-blinded cluster-randomized controlled trial using multi-micronutrient fortified rice.
- Author
-
Seyoum Y, Greffeuille V, Kouadio DKD, Kuong K, Turpin W, M'Rabt R, Chochois V, Fortin S, Perignon M, Fiorentino M, Berger J, Burja K, Ponce MC, Chamnan C, Wieringa FT, and Humblot C
- Subjects
- Humans, Female, Male, Double-Blind Method, Child, Gastrointestinal Microbiome drug effects, Biomarkers blood, Adolescent, Vitamin A administration & dosage, Vitamin A blood, Zinc deficiency, Oryza, Feces microbiology, Micronutrients, Nutritional Status, Food, Fortified, Inflammation
- Abstract
Faecal microbiota plays a critical role in human health, but its relationship with nutritional status among schoolchildren remains under-explored. Here, in a double-blinded cluster-randomized controlled trial on 380 Cambodian schoolchildren, we characterize the impact of six months consumption of two types of rice fortified with different levels of vitamins and minerals on pre-specified outcomes. We investigate the association between the faecal microbiota (16SrRNA sequencing) and age, sex, nutritional status (underweight, stunting), micronutrient status (iron, zinc and vitamin A deficiencies, anaemia, iron deficient anaemia, hemoglobinopathy), inflammation (systemic, gut), and parasitic infection. We show that the faecal microbiota is characterised by a surprisingly high proportion of Lactobacillaceae. We discover that deficiencies in specific micronutrients, such as iron and vitamin A, correlate with particular microbiota profiles, whereas zinc deficiency shows no such association. The nutritional intervention with the two rice treatments impacts both the composition and functions predicted from compositional analysis in different ways. (ClinicalTrials.gov (Identifier: NCT01706419))., (© 2024. The Author(s).)
- Published
- 2024
- Full Text
- View/download PDF
12. Multi-Micronutrient Fortified Rice Improved Serum Zinc and Folate Concentrations of Cambodian School Children. A Double-Blinded Cluster-Randomized Controlled Trial.
- Author
-
Kuong K, Tor P, Perignon M, Fiorentino M, Chamnan C, Berger J, Burja K, Dijkhuizen MA, Parker M, Roos N, and Wieringa FT
- Subjects
- Adolescent, Age Factors, Biomarkers blood, Cambodia, Child, Double-Blind Method, Female, Folic Acid Deficiency blood, Folic Acid Deficiency diagnosis, Folic Acid Deficiency physiopathology, Humans, Male, Recommended Dietary Allowances, Time Factors, Zinc deficiency, Adolescent Nutritional Physiological Phenomena, Child Nutritional Physiological Phenomena, Folic Acid blood, Folic Acid Deficiency diet therapy, Food, Fortified analysis, Nutritional Status, Nutritive Value, Oryza chemistry, Zinc blood
- Abstract
Background: Within Cambodia, micronutrient deficiencies continue to be prevalent in vulnerable groups, such as women and children. Fortification of staple foods such as rice could be a promising strategy for Cambodia to improve micronutrient status., Objective: Our objective was to investigate the impact of multiple-micronutrient fortified rice (MMFR), distributed through a World Food Program school-meals program (WFP-SMP) on serum zinc concentrations and folate status in a double-blind, cluster-randomized, placebo-controlled trial., Methods: Sixteen schools were randomly assigned to receive one of three different types of extruded-fortified rice (UltraRice Original (URO), UltraRice New (URN), or NutriRice) or unfortified rice (placebo) six days a week for six months. A total of 1950 schoolchildren (6-16 years old) participated in the study. Serum zinc (all groups) and folate (only in NutriRice and placebo group) concentrations were assessed from morning non-fasting antecubital blood samples and were measured at three time points (baseline and after three and six months)., Results: After six months of intervention, serum zinc concentrations were significantly increased in all fortified rice group compared to placebo and baseline (0.98, 0.85 and 1.40 µmol/L for URO, URN and NutriRice, respectively) (interaction effect: p < 0.001 for all). Children in the intervention groups had a risk of zinc deficiencies of around one third (0.35, 039, and 0.28 for URO, URN, and NutriRice, respectively) compared to the placebo ( p < 0.001 for all). The children receiving NutriRice had higher serum folate concentrations at endline compared to children receiving normal rice (+ 2.25 ng/mL, p = 0.007)., Conclusions: This study showed that the high prevalence of zinc and folate deficiency in Cambodia can be improved through the provision of MMFR. As rice is the staple diet for Cambodia, MMFR should be considered to be included in the school meal program and possibilities should be explored to introduce MMFR to the general population., Competing Interests: The authors declare no conflict of interest.
- Published
- 2019
- Full Text
- View/download PDF
13. High expression of IDO1 and TGF-β1 during recurrence and post infection clearance with Chlamydia trachomatis, are independent of host IFN-γ response.
- Author
-
Ziklo N, Huston WM, Taing K, and Timms P
- Subjects
- Adult, Anti-Bacterial Agents therapeutic use, Cell Line, Chlamydia Infections drug therapy, Chlamydia Infections microbiology, Chlamydia trachomatis pathogenicity, Coculture Techniques, Female, Forkhead Transcription Factors genetics, Forkhead Transcription Factors metabolism, Humans, Indoleamine-Pyrrole 2,3,-Dioxygenase genetics, Leukocytes, Mononuclear cytology, Leukocytes, Mononuclear metabolism, Recurrence, Transforming Growth Factor beta1 genetics, Up-Regulation, Vagina metabolism, Vagina microbiology, Young Adult, Chlamydia Infections diagnosis, Indoleamine-Pyrrole 2,3,-Dioxygenase metabolism, Interferon-gamma metabolism, Transforming Growth Factor beta1 metabolism
- Abstract
Background: Chlamydia trachomatis infections in women continue to be a major public health concern due to their high prevalence and consequent reproductive morbidities. While antibiotics are usually efficient to clear the Chlamydia, repeat infections are common and may contribute to pathological outcomes. Interferon-gamma (IFN-γ)-mediated immunity has been suggested to be protective against reinfection, and represent an important anti-chlamydial agent, primarily via the induction of indoleamine-2,3 dioxygenase 1 (IDO1) enzyme. IDO1 catalyzes the degradation of tryptophan, which can eliminate C. trachomatis infection in vitro. Here, we sought to measure IDO1 expression levels and related immune markers during different C. trachomatis infection statuses (repeated vs single infection vs post antibiotic treatment), in vitro and in vivo., Methods: In this study, we measured the expression levels of IDO1 and immune regulatory markers, transforming growth factor β1 (TGF-β1) and forkhead box P3 (FoxP3), in vaginal swab samples of C. trachomatis-infected women, with either single or repeated infection. In addition, we used an in vitro co-culture model of endometrial carcinoma cell-line and peripheral blood mononuclear cells (PBMCs) to measure the same immune markers., Results: We found that in women with repeated C. trachomatis infections vaginal IDO1 and TGF-β1 expression levels were significantly increased. Whereas, women who cleared their infection post antibiotic treatment, had increased levels of IDO1 and TGF-β1, as well as FoxP3. Similarly, using the in vitro model, we found significant upregulation of IDO1 and TGF-β1 levels in the co-culture infected with C. trachomatis. Furthermore, we found that in PBMCs infected with C. trachomatis there was a significant upregulation in IDO1 levels, which was independent of IFN-γ. In fact, C. trachomatis infection in PBMCs failed to induce IFN-γ levels in comparison to the uninfected culture., Conclusions: Our data provide evidence for a regulatory immune response comprised of IDO1, TGF-β1 and FoxP3 in women post antibiotic treatment. In this study, we demonstrated a significant increase in IDO1 expression levels in response to C. trachomatis infection, both in vivo and in vitro, without elevated IFN-γ levels. This study implicates IDO1 and TGF-β1 as part of the immune response to repeated C. trachomatis infections, independently of IFN-γ.
- Published
- 2019
- Full Text
- View/download PDF
14. Realistic Food-Based Approaches Alone May Not Ensure Dietary Adequacy for Women and Young Children in South-East Asia.
- Author
-
Ferguson EL, Watson L, Berger J, Chea M, Chittchang U, Fahmida U, Khov K, Kounnavong S, Le BM, Rojroongwasinkul N, Santika O, Sok S, Sok D, Do TT, Thi LT, Vonglokham M, Wieringa F, Wasantwisut E, and Winichagoon P
- Subjects
- Adult, Asia, Southeastern, Child, Female, Humans, Infant, Young Adult, Diet, Energy Intake, Food, Fortified, Micronutrients deficiency, Nutritional Status
- Abstract
Objectives Micronutrient deficiencies, in southeast Asia (SE Asia), remain a public health challenge. We evaluated whether promoting the consumption of locally available nutritious foods, which is a low-risk micronutrient intervention, alone can ensure dietary adequacy, for women of reproductive age and 6-23 m old children. Methods Representative dietary data from Cambodia, Indonesia, Lao PDR, Thailand and Vietnam were analysed using linear programming analysis to identify nutrients that are likely low in personal food environments (problem nutrients), and to formulate food-based recommendations (FBRs) for three to six target populations per country. Results The number of problem nutrients ranged from zero for 12-23 m olds in Indonesia, Thailand and Vietnam to six for pregnant women in Cambodia. The FBRs selected for each target population, if adopted, would ensure a low percentage of the population was at risk of inadequate intakes for five to ten micronutrients, depending on the country and target population. Of the 11 micronutrients modelled, requirements for iron, calcium and folate were most difficult to meet (≥ 10 of the 24 target populations), using FBRs alone. The number of individual FBRs selected per set, for each target population, ranged from three to eight; and often included meat, fish or eggs, liver/organ meats, vegetables and fruits. Conclusions for practice Intervention strategies need to increase access to nutritious foods, including products fortified with micronutrients, in SE Asia, when aiming to ensure dietary adequacy for most individuals in the population.
- Published
- 2019
- Full Text
- View/download PDF
15. Subclinical inflammation affects iron and vitamin A but not zinc status assessment in Senegalese children and Cambodian children and women - ERRATUM.
- Author
-
Fiorentino M, Perignon M, Kuong K, Chamnan C, Berger J, and Wieringa FT
- Published
- 2018
- Full Text
- View/download PDF
16. Soil-transmitted helminth infections and intestinal and systemic inflammation in schoolchildren.
- Author
-
de Gier B, Pita-Rodríguez GM, Campos-Ponce M, van de Bor M, Chamnan C, Junco-Díaz R, Doak CM, Fiorentino M, Kuong K, Angel-Núñez F, Parker ME, Perignon M, Rojas-Rivero L, Berger J, Polman K, and Wieringa FT
- Subjects
- C-Reactive Protein analysis, Cambodia epidemiology, Child, Cuba epidemiology, Gastroenteritis epidemiology, Helminthiasis blood, Helminthiasis epidemiology, Humans, Inflammation epidemiology, Leukocyte L1 Antigen Complex blood, Orosomucoid analysis, Prevalence, Gastroenteritis etiology, Helminthiasis etiology, Inflammation etiology, Soil parasitology
- Published
- 2018
- Full Text
- View/download PDF
17. Effect of multi-micronutrient-fortified rice on cognitive performance depends on premix composition and cognitive function tested: results of an effectiveness study in Cambodian schoolchildren.
- Author
-
Fiorentino M, Perignon M, Kuong K, de Groot R, Parker M, Burja K, Dijkhuizen MA, Sokhom S, Chamnan C, Berger J, and Wieringa FT
- Subjects
- Academic Success, Animals, Cambodia, Child, Double-Blind Method, Female, Humans, Male, Micronutrients administration & dosage, Parasites, Schools, Treatment Outcome, Child Health, Cognition drug effects, Diet, Food, Fortified, Micronutrients pharmacology, Nutritional Status, Oryza
- Abstract
Objective: Even though current policy is strongly focused on the crucial first '1000 days', it might be still possible to enhance cognitive function during the pre-adolescent and adolescent years by improving micronutrient status. In Cambodia, nutritional status is poor. Provision of rice fortified with micronutrients through a school meal programme (SMP) could be a cost-effective strategy to help improve health and school performance. The present study aimed to evaluate the effect of three different micronutrient-fortified rice formulations on cognitive function in Cambodian children., Setting: Sixteen Cambodian schools receiving SMP., Design: The FORISCA-UltraRice®+NutriRice® study was a randomized, double-blind, placebo-controlled trial. Four groups of four schools were randomly allocated to receive normal rice, UltraRice®Original, UltraRice®New or NutriRice®. Within each school, 132 children were randomly selected. Data on cognitive performance (picture completion, block design and Raven's coloured progressive matrices (RCPM)), anthropometry, parasite infestation and micronutrient status were collected before the intervention and after 6 months., Subjects: Cognitive data were available for 1796 children aged 6-16 years., Results: All cognitive scores improved after 6 months (P<0·001). Block design score improvement was significantly higher in children consuming UltraRice®Original (P=0·03) compared with the other fortified rice groups and placebo. No difference among groups was found on RCPM or picture completion scores. Stunting, parasite infestation and inflammation negatively affected the impact of the intervention., Conclusions: Combined with other interventions, using SMP to distribute fortified rice to schoolchildren may be a cost-effective way to increase cognitive performance and thereby improve school performance and educational achievements.
- Published
- 2018
- Full Text
- View/download PDF
18. Dysbiosis of the Vaginal Microbiota and Higher Vaginal Kynurenine/Tryptophan Ratio Reveals an Association with Chlamydia trachomatis Genital Infections.
- Author
-
Ziklo N, Vidgen ME, Taing K, Huston WM, and Timms P
- Subjects
- Cytokines metabolism, Female, Humans, Inflammation Mediators metabolism, Kynurenine metabolism, Metagenome, Metagenomics methods, Tryptophan metabolism, Chlamydia Infections metabolism, Chlamydia Infections microbiology, Chlamydia trachomatis physiology, Dysbiosis, Microbiota, Vagina metabolism, Vagina microbiology
- Abstract
The natural course of Chlamydia trachomatis urogenital tract infections varies between individuals. While protective immunity can occur, some women can become reinfected, contributing to the development of severe pathology. While the reasons for these differences are unknown, an individual's response to induced interferon-γ (IFN-γ) is suggested to be critical. IFN-γ induction of the enzyme indoleamine 2,3-dioxygenase, which depletes tryptophan, may be the key. One hypothesis suggests that indole-producing bacteria in the vaginal microbiota can provide a substrate for the Chlamydia to synthesize tryptophan, rescuing the Chlamydia from host IFN-γ attack. We studied a cohort of 25 women who were either, Chlamydia negative, Chlamydia positive with a single infection, or Chlamydia positive with repeated infection, to test our hypothesis. We characterized their vaginal microbiota, cytokine response, as well as their tryptophan, kynurenine and indole concentrations directly in vaginal secretions. We found that C. trachomatis urogenital tract infections either initial or repeat infections, were associated with elevated vaginal kynurenine/tryptophan ratios, primarily as a result of elevated kynurenine levels. In addition, vaginal microbiota of community state type (CST) IV showed significantly lower vaginal tryptophan levels compared to CST I and III, which might be related to a higher abundance of indole producers found within this group. Furthermore, we found a higher abundance of indole producers in women who cleared their Chlamydia infection post antibiotic treatment. This study demonstrates for the first time in vivo , the association between high vaginal kynurenine/tryptophan ratios and C. trachomatis infections. In addition, tryptophan depletion was associated with vaginal microbiota of CST IV.
- Published
- 2018
- Full Text
- View/download PDF
19. Preprocedural Fasting: Is it Time to Change Practice?
- Author
-
Vaughan JG, Nolan HR, Long A, Ngann K, Christie B, and Ashley D
- Subjects
- Enteral Nutrition adverse effects, Humans, Intensive Care Units, Preoperative Care adverse effects, Prospective Studies, Critical Illness therapy, Enteral Nutrition methods, Fasting adverse effects, Preoperative Care methods
- Published
- 2018
20. The aetiologies of central nervous system infections in hospitalised Cambodian children.
- Author
-
Turner P, Suy K, Tan LV, Sar P, Miliya T, Hong NTT, Hang VTT, Ny NTH, Soeng S, Day NPJ, van Doorn HR, and Turner C
- Subjects
- Adolescent, Anti-Bacterial Agents therapeutic use, Cambodia, Central Nervous System Infections cerebrospinal fluid, Child, Child, Hospitalized statistics & numerical data, Child, Preschool, Encephalitis Virus, Japanese genetics, Encephalitis Virus, Japanese pathogenicity, Enterovirus genetics, Enterovirus pathogenicity, Enterovirus Infections etiology, Female, Humans, Infant, Male, Multiplex Polymerase Chain Reaction, Prospective Studies, Streptococcus pneumoniae genetics, Streptococcus pneumoniae pathogenicity, Central Nervous System Infections etiology, Central Nervous System Infections therapy
- Abstract
Background: Central nervous system (CNS) infections are an important cause of childhood morbidity and mortality. The aetiologies of these potentially vaccine-preventable infections have not been well established in Cambodia., Methods: We did a one year prospective study of children hospitalised with suspected CNS infection at Angkor Hospital for Children, Siem Reap. Cerebrospinal fluid specimens (CSF) samples underwent culture, multiplex PCR and serological analysis to identify a range of bacterial and viral pathogens. Viral metagenomics was performed on a subset of pathogen negative specimens., Results: Between 1st October 2014 and 30th September 2015, 284 analysable patients were enrolled. The median patient age was 2.6 years; 62.0% were aged <5 years. CSF white blood cell count was ≥10 cells/μL in 116/272 (42.6%) cases. CNS infection was microbiologically confirmed in 55 children (19.3%). Enteroviruses (21/55), Japanese encephalitis virus (17/55), and Streptococcus pneumoniae (7/55) accounted for 45 (81.8%) of all pathogens identified. Of the pathogens detected, 74.5% (41/55) were viruses and 23.6% (13/55) were bacteria. The majority of patients were treated with ceftriaxone empirically. The case fatality rate was 2.5%., Conclusions: Enteroviruses, JEV and S. pneumoniae are the most frequently detected causes of CNS infection in hospitalised Cambodian children.
- Published
- 2017
- Full Text
- View/download PDF
21. High prevalence of thiamine (vitamin B1) deficiency in early childhood among a nationally representative sample of Cambodian women of childbearing age and their children.
- Author
-
Whitfield KC, Smith G, Chamnan C, Karakochuk CD, Sophonneary P, Kuong K, Dijkhuizen MA, Hong R, Berger J, Green TJ, and Wieringa FT
- Subjects
- Adolescent, Adult, Cambodia epidemiology, Child, Child, Preschool, Cross-Sectional Studies, Erythrocytes chemistry, Female, Humans, Infant, Male, Middle Aged, Prevalence, Random Allocation, Thiamine analysis, Young Adult, Thiamine Deficiency epidemiology
- Abstract
Background: Thiamine deficiency is thought to be an issue in Cambodia and throughout Southeast Asia due to frequent clinical reports of infantile beriberi. However the extent of this public health issue is currently unknown due to a lack of population-representative data. Therefore we assessed the thiamine status (measured as erythrocyte thiamine diphosphate concentrations; eThDP) among a representative sample of Cambodian women of childbearing age (15-49 y) and their young children (6-69 mo)., Methodology/principle Findings: Samples for this cross-sectional analysis were collected as part of a national micronutrient survey linked to the Cambodian Demographic and Health Survey (CDHS) 2014. One-sixth of households taking part in the CDHS were randomly selected and re-visited for additional blood sampling for eThDP analysis (719 women and 761 children). Thiamine status was assessed using different cut-offs from literature. Women were mean (SD) 30 (6) y, and children (46% girls) were 41 (17) mo. Women had lower mean (95% CI) eThDP of 150 nmol/L (146-153) compared to children, 174 nmol/L (171-179; P < 0.001). Using the most conservative cut-off of eThDP < 120 nmol/L, 27% of mothers and 15% of children were thiamine deficient, however prevalence rates of deficiency were as high as 78% for mothers and 58% for children using a cut-off of < 180 nmol/L. Thiamine deficiency was especially prevalent among infants aged 6-12 mo: 38% were deficient using the most conservative cut-off (< 120 nmol/L)., Conclusions/significance: There is a lack of consensus on thiamine status cut-offs; more research is required to set clinically meaningful cut-offs. Despite this, there is strong evidence of suboptimal thiamine status among Cambodian mothers and their children, with infants <12 mo at the highest risk. Based on eThDP from this nationally-representative sample, immediate action is required to address thiamine deficiency in Cambodia, and likely throughout Southeast Asia.
- Published
- 2017
- Full Text
- View/download PDF
22. In vitro rescue of genital strains of Chlamydia trachomatis from interferon-γ and tryptophan depletion with indole-positive, but not indole-negative Prevotella spp.
- Author
-
Ziklo N, Huston WM, Taing K, Katouli M, and Timms P
- Subjects
- Chlamydia Infections immunology, Chlamydia Infections metabolism, Chlamydia trachomatis genetics, Chlamydia trachomatis immunology, Epithelial Cells enzymology, Epithelial Cells immunology, Epithelial Cells metabolism, Epithelial Cells microbiology, Female, HeLa Cells, Hep G2 Cells, Humans, In Vitro Techniques, Indoleamine-Pyrrole 2,3,-Dioxygenase metabolism, Interferon-gamma immunology, Kynurenine analogs & derivatives, Kynurenine metabolism, Microbiota, Prevotella immunology, Prevotella physiology, RNA, Messenger genetics, RNA, Messenger metabolism, Tryptophan immunology, Tryptophan Synthase genetics, Tryptophan Synthase metabolism, Vaginal Diseases immunology, Vaginal Diseases metabolism, Chlamydia Infections microbiology, Chlamydia trachomatis metabolism, Indoles metabolism, Interferon-gamma deficiency, Prevotella metabolism, Tryptophan deficiency, Vaginal Diseases microbiology
- Abstract
Background: The natural course of sexually transmitted infections caused by Chlamydia trachomatis varies between individuals. In addition to parasite and host effects, the vaginal microbiota might play a key role in the outcome of C. trachomatis infections. Interferon-gamma (IFN-γ), known for its anti-chlamydial properties, activates the expression of indoleamine 2,3-dioxygenase (IDO1) in epithelial cells, an enzyme that catabolizes the amino acid L- tryptophan into N-formylkynurenine, depleting the host cell's pool of tryptophan. Although C. trachomatis is a tryptophan auxotroph, urogenital strains (but not ocular strains) have been shown in vitro to have the ability to produce tryptophan from indole using the tryptophan synthase (trpBA) gene. It has been suggested that indole producing bacteria from the vaginal microbiota could influence the outcome of Chlamydia infection., Results: We used two in vitro models (treatment with IFN-γ or direct limitation of tryptophan), to study the effects of direct rescue by the addition of exogenous indole, or by the addition of culture supernatant from indole-positive versus indole-negative Prevotella strains, on the growth and infectivity of C. trachomatis. We found that only supernatants from the indole-positive strains, P. intermedia and P. nigrescens, were able to rescue tryptophan-starved C. trachomatis. In addition, we analyzed vaginal secretion samples to determine physiological indole concentrations. In spite of the complexity of vaginal secretions, we demonstrated that for some vaginal specimens with higher indole levels, there was a link to higher recovery of the Chlamydia under tryptophan-starved conditions, lending preliminary support to the critical role of the IFN-γ-tryptophan-indole axis in vivo., Conclusions: Our data provide evidence for the ability of both exogenous indole as well as supernatant from indole producing bacteria such as Prevotella, to rescue genital C. trachomatis from tryptophan starvation. This adds weight to the hypothesis that the vaginal microbiota (particularly from women with lower levels of lactobacilli and higher levels of indole producing anaerobes) may be intrinsically linked to the outcome of chlamydial infections in some women.
- Published
- 2016
- Full Text
- View/download PDF
23. Cognitive Performance and Iron Status are Negatively Associated with Hookworm Infection in Cambodian Schoolchildren.
- Author
-
Kuong K, Fiorentino M, Perignon M, Chamnan C, Berger J, Sinuon M, Molyden V, Burja K, Parker M, Ly SC, Friis H, Roos N, and Wieringa FT
- Subjects
- Adolescent, Anemia, Iron-Deficiency complications, Anemia, Iron-Deficiency metabolism, Ascariasis complications, Ascariasis metabolism, Ascariasis psychology, Cambodia, Child, Cognitive Dysfunction complications, Cognitive Dysfunction metabolism, Coinfection, Female, Hemoglobins metabolism, Hookworm Infections complications, Hookworm Infections metabolism, Humans, Iron Deficiencies, Linear Models, Male, Severity of Illness Index, Social Class, Taeniasis complications, Taeniasis metabolism, Taeniasis psychology, Trichuriasis complications, Trichuriasis metabolism, Trichuriasis psychology, Vitamin A metabolism, Zinc metabolism, Anemia, Iron-Deficiency psychology, Cognition, Cognitive Dysfunction psychology, Ferritins metabolism, Hookworm Infections psychology, Iron metabolism, Receptors, Transferrin metabolism
- Abstract
Soil-transmitted helminth (STH) infection has been associated with lower cognitive performance of schoolchildren. To identify pathways through which STH infection might affect school performance, baseline data from a large rice-fortification trial in Cambodian schoolchildren were used to investigate associations between STH infection, micronutrient status, anemia, and cognitive performance. Complete data on anthropometry, cognitive performance, and micronutrient status were available for 1,760 schoolchildren, 6-16 years of age. STH infection was identified using Kato-Katz, whereas cognitive performance was assessed using Raven's Colored Progressive Matrices (RCPM), block design, and picture completion. STH infection was found in 18% of the children; almost exclusively hookwork infection. After adjusting for age and gender, raw cognitive test scores were significantly lower in hookworm-infected children (-0.65; -0.78; -2.03 points for picture completion, RCPM, and block design, respectively; P < 0.05 for all). Hookworm infection was associated with iron status (total body iron), but not with vitamin A and zinc status, nor with inflammation or anthropometry. Body iron was negatively associated with increased intensity of hookworm infection (R = 0.22, P < 0.001). Hookworm infection in Cambodian schoolchildren was associated with lower cognitive performance, an effect most likely mediated through lower body iron. Interventions that are more effective against hookworm infection are needed to contribute to better health and improvement of cognitive performance., (© The American Society of Tropical Medicine and Hygiene.)
- Published
- 2016
- Full Text
- View/download PDF
24. Lack of Utility of Nasopharyngeal Swabs for Diagnosis of Burkholderia pseudomallei Pneumonia in Paediatric Patients.
- Author
-
Hearn P, Turner C, Suy K, Soeng S, Day NP, and Turner P
- Subjects
- Anti-Bacterial Agents therapeutic use, Bacteremia diagnosis, Bacteremia drug therapy, Cambodia, Humans, Melioidosis drug therapy, Melioidosis microbiology, Pneumonia, Bacterial drug therapy, Pneumonia, Bacterial microbiology, Radiography, Thoracic, Bacteremia microbiology, Burkholderia pseudomallei isolation & purification, Melioidosis diagnosis, Pneumonia, Bacterial diagnostic imaging
- Abstract
Diagnosis of Burkholderia pseudomallei pneumonia in children is challenging. We investigated the utility of nasopharyngeal swabs taken from 194 paediatric patients on admission with radiologically proven pneumonia. Melioidosis was proven in 0.5% of samples tested and only in a third of those known to be bacteraemic with B. pseudomallei. It appears unlikely that culture of nasopharyngeal secretions is helpful to confirm B. pseudomallei pneumonia in paediatric patients., (© The Author [2016]. Published by Oxford University Press.)
- Published
- 2016
- Full Text
- View/download PDF
25. Molecular Characterization of Cryptosporidium Species and Giardia duodenalis from Symptomatic Cambodian Children.
- Author
-
Moore CE, Elwin K, Phot N, Seng C, Mao S, Suy K, Kumar V, Nader J, Bousfield R, Perera S, Bailey JW, Beeching NJ, Day NP, Parry CM, and Chalmers RM
- Subjects
- Adolescent, Animals, Cambodia epidemiology, Child, Child, Preschool, Cryptosporidiosis diagnosis, Cryptosporidiosis epidemiology, Cryptosporidium classification, Cryptosporidium genetics, Feces parasitology, Female, Giardia classification, Giardia genetics, Giardiasis diagnosis, Giardiasis epidemiology, Humans, Infant, Male, Prospective Studies, Cryptosporidiosis parasitology, Cryptosporidium isolation & purification, Giardia isolation & purification, Giardiasis parasitology
- Abstract
Background: In a prospective study, 498 single faecal samples from children aged under 16 years attending an outpatient clinic in the Angkor Hospital for Children, northwest Cambodia, were examined for Cryptosporidium oocysts and Giardia cysts using microscopy and molecular assays., Methodology/principal Findings: Cryptosporidium oocysts were detected in 2.2% (11/498) of samples using microscopy and in 7.7% (38/498) with molecular tests. Giardia duodenalis cysts were detected in 18.9% (94/498) by microscopy and 27.7% (138/498) by molecular tests; 82% of the positive samples (by either method) were from children aged 1-10 years. Cryptosporidium hominis was the most common species of Cryptosporidium, detected in 13 (34.2%) samples, followed by Cryptosporidium meleagridis in 9 (23.7%), Cryptosporidium parvum in 8 (21.1%), Cryptosporidium canis in 5 (13.2%), and Cryptosporidium suis and Cryptosporidium ubiquitum in one sample each. Cryptosporidium hominis and C. parvum positive samples were subtyped by sequencing the GP60 gene: C. hominis IaA16R6 and C. parvum IIeA7G1 were the most abundant subtypes. Giardia duodenalis was typed using a multiplex real-time PCR targeting assemblages A and B. Assemblage B (106; 76.8% of all Giardia positive samples) was most common followed by A (12.3%) and mixed infections (5.1%). Risk factors associated with Cryptosporidium were malnutrition (AOR 9.63, 95% CI 1.67-55.46), chronic medical diagnoses (AOR 4.51, 95% CI 1.79-11.34) and the presence of birds in the household (AOR 2.99, 95% CI 1.16-7.73); specifically C. hominis (p = 0.03) and C. meleagridis (p<0.001) were associated with the presence of birds. The use of soap was protective against Giardia infection (OR 0.74, 95% CI 0.58-0.95)., Conclusions/significance: This is the first report to describe the different Cryptosporidium species and subtypes and Giardia duodenalis assemblages in Cambodian children. The variety of Cryptosporidium species detected indicates both anthroponotic and zoonotic transmission in this population. Interventions to improve sanitation, increase hand washing after defecation and before preparing food and promote drinking boiled water may reduce the burden of these two parasites.
- Published
- 2016
- Full Text
- View/download PDF
26. The High Prevalence of Anemia in Cambodian Children and Women Cannot Be Satisfactorily Explained by Nutritional Deficiencies or Hemoglobin Disorders.
- Author
-
Wieringa FT, Dahl M, Chamnan C, Poirot E, Kuong K, Sophonneary P, Sinuon M, Greuffeille V, Hong R, Berger J, Dijkhuizen MA, and Laillou A
- Subjects
- Adult, Anemia epidemiology, Anemia genetics, Anemia metabolism, Cambodia epidemiology, Child, Preschool, Female, Folic Acid Deficiency complications, Hookworm Infections complications, Humans, Infant, Iron metabolism, Iron Deficiencies, Micronutrients metabolism, Odds Ratio, Prevalence, Risk Factors, Vitamin A Deficiency complications, Vitamin B 12 Deficiency complications, Zinc deficiency, Anemia etiology, Hemoglobins metabolism, Micronutrients deficiency
- Abstract
Background: Anemia is highly prevalent in Cambodian women and children, but data on causes of anemia are scarce. We performed a national micronutrient survey in children and women that was linked to the Cambodian Demographic Health Survey 2014 (CDHS-2014) to assess the prevalence of micronutrient deficiency, hemoglobin disorders and intestinal parasite infection., Methods: One-sixth of households from the CDHS-2014 were selected for a follow-up visit for the micronutrient survey. Households were visited from two weeks to two months after the CDHS-2014 visit. Data on micronutrient status were available for 1512 subjects (792 children and 720 women)., Results: Anemia was found in 43% of the women and 53% of the children. Hemoglobin disorders affected >50% of the population, with Hemoglobin-E the most prevalent disorder. Deficiencies of iron (ferritin < 15 g/L), vitamin A (retinol-binding-protein (RBP) < 0.70 mol/L) or vitamin B12 (<150 pmol/L) were not prevalent in the women (<5% for all), whereas 17.8% of the women had low concentrations of folic acid (<10 nmol/L). In the children, the prevalence of iron, vitamin A, vitamin B12 or folic acid deficiency was <10%. Zinc deficiency, hookworm infection and hemoglobinopathy were significantly associated with anemia in children, whereas in the women none of the factors was significantly associated with anemia. Iron deficiency anemia (IDA) was more prevalent in children <2 years, but in older children and women, the prevalence of IDA was <5%. The most prevalent, preventable causes of anemia were hookworm infection and zinc and folic acid deficiency. Over 40% of the anemia was not caused by nutritional factors., Conclusion: The very high prevalence of anemia in Cambodian women and children cannot be explained solely by micronutrient deficiencies and hemoglobin disorders. Micronutrient interventions to improve anemia prevalence are likely to have limited impact in the Cambodian setting. The focus of current interventions to reduce the high prevalence of anemia in children and women should be broadened to include zinc and folic acid as well as effective anti-hookworm measures.
- Published
- 2016
- Full Text
- View/download PDF
27. High Prevalence of Vitamin D Deficiency in Cambodian Women: A Common Deficiency in a Sunny Country.
- Author
-
Smith G, Wimalawansa SJ, Laillou A, Sophonneary P, Un S, Hong R, Poirot E, Kuong K, Chamnan C, De Los Reyes FN, and Wieringa FT
- Subjects
- Adolescent, Adult, Cambodia epidemiology, Demography, Female, Humans, Middle Aged, Prevalence, Risk Factors, Socioeconomic Factors, Vitamin D analogs & derivatives, Vitamin D blood, Sunlight, Vitamin D Deficiency epidemiology
- Abstract
Recent studies have shown that in spite of being generally close to the equator; vitamin D deficiency is common in South East Asian countries. In order to quantify micronutrient status for women and children in Cambodia; a nationally-representative survey was conducted in 2014 linked to the Cambodian Demographic Health Survey. The countrywide median of 25(OH)D was, respectively, 64.9 and 91.1 nmol/L for mothers and children. Based on The Endocrine Society cutoffs (>50<75 nmol/L = insufficiency; ≤50 nmol/L = deficiency); 64.6% of mothers and 34.8% of their children had plasma vitamin D concentrations indicating insufficiency or deficiency. For deficiency alone, 29% of the mothers were found to be vitamin D deficient, but only 13.4% of children. Children who live in urban areas had a 43% higher rate of vitamin D insufficiency versus those who live in rural areas (OR; 1.434; 95% CI: 1.007; 2.041). However, such differences were not observed in their mothers. The high prevalence of vitamin D deficiency is likely in part due to lifestyle choices, including sun avoidance, increasingly predominant indoor work, and covered transport. These survey findings support the need for a broader national Cambodian study incorporating testing of adult men, adolescents and the elderly, and encompassing other parameters such as skeletal health. However, the data presented in this study already show significant deficiencies which need to be addressed and we discuss the benefit of establishing nationally-mandated food fortification programs to enhance the intake of vitamin D.
- Published
- 2016
- Full Text
- View/download PDF
28. Low Urinary Iodine Concentration among Mothers and Children in Cambodia.
- Author
-
Laillou A, Sophonneary P, Kuong K, Hong R, Un S, Chamnan C, Poirot E, Berger J, and Wieringa F
- Subjects
- Adolescent, Adult, Cambodia epidemiology, Child, Preschool, Deficiency Diseases epidemiology, Deficiency Diseases urine, Female, Health Surveys, Humans, Infant, Infant, Newborn, Middle Aged, Sodium Chloride, Dietary administration & dosage, Young Adult, Iodine deficiency, Iodine urine
- Abstract
A 2014 national assessment of salt iodization coverage in Cambodia found that 62% of samples were non-iodized, suggesting a significant decline in daily iodine intakes. The Cambodian Micronutrient Survey conducted in 2014 (CMNS-2014) permitted obtaining national data on urinary iodine concentrations (UIC) to assess iodine status and whether iodized salt use had an impact. Urine samples were collected from mothers (n = 736) and children (n = 950). The median UIC was 63 µg/L and 72 µg/L in mothers and children respectively. More than 60% of mothers and their children had a UIC < 100 µg/L, thereby indicating a serious public health problem. Iodine status was significantly lower among mothers and children living in rural areas, belonging to the poorest socioeconomic category, or living in a household not using iodized salt. The limited enforcement of the legislation for iodized salt has resulted in a major decrease in the prevalence of iodized salt, which in turn has compromised iodine status in Cambodia. It is essential for the government to enhance enforcement of the iodized salt legislation, and implement short term strategies, such as iodine supplementation, to prevent an increase of severe complications due to iodine deficiency in the Cambodian population.
- Published
- 2016
- Full Text
- View/download PDF
29. Current MUAC Cut-Offs to Screen for Acute Malnutrition Need to Be Adapted to Gender and Age: The Example of Cambodia.
- Author
-
Fiorentino M, Sophonneary P, Laillou A, Whitney S, de Groot R, Perignon M, Kuong K, Berger J, and Wieringa FT
- Subjects
- Adolescent, Age Factors, Body Height, Body Weight, Cambodia, Child, Child, Preschool, Female, Humans, Infant, Male, Mass Screening methods, Nutrition Surveys, Reference Values, Sensitivity and Specificity, Sex Factors, Arm anatomy & histology, Child Nutrition Disorders diagnosis, Severe Acute Malnutrition diagnosis
- Abstract
Background: Early identification of children <5 yrs with acute malnutrition is a priority. Acute malnutrition is defined by the World Health Organization as a mid-upper-arm circumference (MUAC) <12.5 cm or a weight-for-height Z-score (WHZ) <-2. MUAC is a simple and low-cost indicator to screen for acute malnutrition in communities, but MUAC cut-offs currently recommended by WHO do not identify the majority of children with weight-for-height Z-score (<-2 (moderate malnourished) or r<-3 (severe malnourished). Also, no cut-offs for MUAC are established for children >5 yrs. Therefore, this study aimed at defining gender and age-specific cut-offs to improve sensitivity of MUAC as an indicator of acute malnutrition., Methods: To establish new age and gender-specific MUAC cut-offs, pooled data was obtained for 14,173 children from 5 surveys in Cambodia (2011-2013). Sensitivity, false positive rates, and areas under receiver-operator characteristic curves (AUC) were calculated using wasting for children <5yrs and thinness for children ≥5yrs as gold standards. Among the highest values of AUC, the cut-off with the highest sensitivity and a false positive rate ≤33% was selected as the optimal cut-off., Results: Optimal cut-off values increased with age. Boys had higher cut-offs than girls, except in the 8-10.9 yrs age range. In children <2yrs, the cut-off was lower for stunted children compared to non stunted children. Sensitivity of MUAC to identify WHZ<-2 and <-3 z-scores increased from 24.3% and 8.1% to >80% with the new cut-offs in comparison with the current WHO cut-offs., Conclusion: Gender and age specific MUAC cut-offs drastically increased sensitivity to identify children with WHZ-score <-2 z-scores. International reference of MUAC cut-offs by age group and gender should be established to screen for acute malnutrition at the community level.
- Published
- 2016
- Full Text
- View/download PDF
30. Stability of Vitamin A, Iron and Zinc in Fortified Rice during Storage and Its Impact on Future National Standards and Programs--Case Study in Cambodia.
- Author
-
Kuong K, Laillou A, Chea C, Chamnan C, Berger J, and Wieringa FT
- Subjects
- Cambodia, Food Storage standards, Food, Fortified standards, Humidity adverse effects, Iron standards, Micronutrients analysis, Micronutrients standards, National Health Programs standards, Temperature, Trace Elements analysis, Trace Elements standards, Vitamin A standards, Zinc standards, Food Storage methods, Food, Fortified analysis, Iron analysis, Oryza chemistry, Vitamin A analysis, Zinc analysis
- Abstract
Fortified rice holds great potential for bringing essential micronutrients to a large part of the world population. The present study quantified the losses of three different micronutrients (vitamin A, iron, zinc) in fortified rice that were produced using three different techniques (hot extrusion, cold extrusion, and coating) and stored at two different environments (25 ± 5 °C at a humidity of 60% and 40 ± 5 °C at a humidity of 75%) for up to one year. Fortified rice premix from the different techniques was mixed with normal rice in a 1:100 ratio. Each sample was analyzed in triplicate. The study confirmed the high stability of iron and zinc during storage while the retention of vitamin A was significantly affected by storage and the type of techniques used to make rice premix. Losses for iron and zinc were typically <10% for any type of rice premix. After 12 months at mild conditions (25 °C and humidity of 60%), losses for vitamin A ranged from 20% for cold extrusion, 30% for hot extruded rice 77% for coated rice premix. At higher temperatures and humidity, losses of vitamin A were 40%-50% for extruded premix and 93% for coated premix after 6 months. We conclude that storage does lead to a major loss of vitamin A and question whether rice is a suitable food vehicle to fortify with vitamin A. For Cambodia, fortification of rice with iron and zinc could be an effective strategy to improve the micronutrient status of the population if no other food vehicles are available.
- Published
- 2016
- Full Text
- View/download PDF
31. Impact of Multi-Micronutrient Fortified Rice on Hemoglobin, Iron and Vitamin A Status of Cambodian Schoolchildren: a Double-Blind Cluster-Randomized Controlled Trial.
- Author
-
Perignon M, Fiorentino M, Kuong K, Dijkhuizen MA, Burja K, Parker M, Chamnan C, Berger J, and Wieringa FT
- Subjects
- Adolescent, Anemia, Iron-Deficiency blood, Anemia, Iron-Deficiency diet therapy, Anemia, Iron-Deficiency epidemiology, Cambodia, Child, Diet methods, Double-Blind Method, Female, Ferritins blood, Hemoglobins analysis, Hemoglobins drug effects, Humans, Iron blood, Male, Prevalence, Retinol-Binding Proteins analysis, Schools, Vitamin A blood, Vitamin A Deficiency blood, Vitamin A Deficiency diet therapy, Vitamin A Deficiency epidemiology, Food, Fortified, Micronutrients administration & dosage, Nutritional Status drug effects, Oryza
- Abstract
In Cambodia, micronutrient deficiencies remain a critical public health problem. Our objective was to evaluate the impact of multi-micronutrient fortified rice (MMFR) formulations, distributed through a World Food Program school-meals program (WFP-SMP), on the hemoglobin concentrations and iron and vitamin A (VA) status of Cambodian schoolchildren. The FORISCA-UltraRice+NutriRice study was a double-blind, cluster-randomized, placebo-controlled trial. Sixteen schools participating in WFP-SMP were randomly assigned to receive extrusion-fortified rice (UltraRice Original, UltraRice New (URN), or NutriRice) or unfortified rice (placebo) six days a week for six months. Four additional schools not participating in WFP-SMP were randomly selected as controls. A total of 2440 schoolchildren (6-16 years old) participated in the biochemical study. Hemoglobin, iron status, estimated using inflammation-adjusted ferritin and transferrin receptors concentrations, and VA status, assessed using inflammation-adjusted retinol-binding protein concentration, were measured at the baseline, as well as at three and six months. Baseline prevalence of anemia, depleted iron stores, tissue iron deficiency, marginal VA status and VA deficiency were 15.6%, 1.4%, 51.0%, 7.9%, and 0.7%, respectively. The strongest risk factors for anemia were hemoglobinopathy, VA deficiency, and depleted iron stores (all p < 0.01). After six months, children receiving NutriRice and URN had 4 and 5 times less risk of low VA status, respectively, in comparison to the placebo group. Hemoglobin significantly increased (+0.8 g/L) after three months for the URN group in comparison to the placebo group; however, this difference was no longer significant after six months, except for children without inflammation. MMFR containing VA effectively improved the VA status of schoolchildren. The impact on hemoglobin and iron status was limited, partly by sub-clinical inflammation. MMFR combined with non-nutritional approaches addressing anemia and inflammation should be further investigated.
- Published
- 2016
- Full Text
- View/download PDF
32. Micronutrient-Fortified Rice Can Increase Hookworm Infection Risk: A Cluster Randomized Trial.
- Author
-
de Gier B, Campos Ponce M, Perignon M, Fiorentino M, Khov K, Chamnan C, de Boer MR, Parker ME, Burja K, Dijkhuizen MA, Berger J, Polman K, and Wieringa FT
- Subjects
- Animals, Child, Double-Blind Method, Enzyme-Linked Immunosorbent Assay, Feces parasitology, Female, Humans, Intestinal Diseases, Parasitic epidemiology, Iron, Dietary administration & dosage, Leukocyte L1 Antigen Complex analysis, Longitudinal Studies, Male, Micronutrients chemistry, Placebo Effect, Prevalence, Ancylostomatoidea physiology, Food, Fortified, Intestinal Diseases, Parasitic etiology, Micronutrients administration & dosage, Oryza chemistry
- Abstract
Background: Fortification of staple foods is considered an effective and safe strategy to combat micronutrient deficiencies, thereby improving health. While improving micronutrient status might be expected to have positive effects on immunity, some studies have reported increases in infections or inflammation after iron supplementation., Objective: To study effects of micronutrient-fortified rice on hookworm infection in Cambodian schoolchildren., Methods: A double-blinded, cluster-randomized trial was conducted in 16 Cambodian primary schools partaking in the World Food Program school meal program. Three types of multi-micronutrient fortified rice were tested against placebo rice within the school meal program: UltraRice_original, UltraRice_improved and NutriRice. Four schools were randomly assigned to each study group (placebo n = 492, UltraRice_original n = 479, UltraRice_improved n = 500, NutriRice n = 506). Intestinal parasite infection was measured in fecal samples by Kato-Katz method at baseline and after three and seven months. In a subgroup (N = 330), fecal calprotectin was measured by ELISA as a marker for intestinal inflammation., Results: Baseline prevalence of hookworm infection was 18.6%, but differed considerably among schools (range 0%- 48.1%).Micronutrient-fortified rice significantly increased risk of new hookworm infection. This effect was modified by baseline hookworm prevalence at the school; hookworm infection risk was increased by all three types of fortified rice in schools where baseline prevalence was high (>15%), and only by UltraRice_original in schools with low baseline prevalence. Neither hookworm infection nor fortified rice was related to fecal calprotectin., Conclusions: Consumption of rice fortified with micronutrients can increase hookworm prevalence, especially in environments with high infection pressure. When considering fortification of staple foods, a careful risk-benefit analysis is warranted, taking into account severity of micronutrient deficiencies and local prevalence of parasitic infections., Trial Registration: ClinicalTrials.gov NCT01706419.
- Published
- 2016
- Full Text
- View/download PDF
33. A survey for potentially zoonotic gastrointestinal parasites of dogs and pigs in Cambodia.
- Author
-
Inpankaew T, Murrell KD, Pinyopanuwat N, Chhoun C, Khov K, Sem T, Sorn S, Muth S, and Dalsgaard A
- Subjects
- Animals, Cambodia, Dog Diseases parasitology, Dogs, Helminthiasis epidemiology, Helminthiasis parasitology, Helminthiasis, Animal parasitology, Humans, Intestinal Diseases, Parasitic epidemiology, Intestinal Diseases, Parasitic parasitology, Parasitology methods, Prevalence, Swine, Swine Diseases parasitology, Dog Diseases epidemiology, Feces parasitology, Helminthiasis, Animal epidemiology, Helminths classification, Helminths isolation & purification, Intestinal Diseases, Parasitic veterinary, Swine Diseases epidemiology
- Abstract
There is little information available on parasites of zoonotic significance in Cambodia. In 2011, in an effort to obtain data on potentially zoonotic gastrointestinal parasites in domestic animals, 50 dogs and 30 pigs residing in 38 households located in Ang Svay Check village, Takeo province, Cambodia were examined for parasites from faecal samples. The samples were processed using the formalin-ethyl acetate concentration technique (FECT). Hookworms were the most common zoonotic parasite found in dogs (80.0%) followed by Echinostomes (18.0%). While, in pigs, Fasciolopsis buski was the most common zoonotic parasite (30.0%) followed by Ascaris suum (13.3%). This study provides baseline data on gastrointestinal parasites in dogs and pigs from Cambodia and underscores the importance of domestic animals as reservoir hosts for human parasites for Cambodian veterinary and public health agencies. Follow-up studies are required to further taxonomically characterize these dog and pig parasites and to determine their role in human parasites in this community.
- Published
- 2015
- Full Text
- View/download PDF
34. Pneumococcal Infection among Children before Introduction of 13-Valent Pneumococcal Conjugate Vaccine, Cambodia.
- Author
-
Turner P, Turner C, Suy K, Soeng S, Ly S, Miliya T, Goldblatt D, and Day NP
- Subjects
- Adolescent, Cambodia epidemiology, Child, Child, Preschool, Female, Humans, Infant, Male, Serogroup, Pneumococcal Vaccines therapeutic use, Pneumonia, Pneumococcal epidemiology, Streptococcus pneumoniae, Vaccines, Conjugate therapeutic use
- Abstract
Vaccination of children with pneumococcal conjugate vaccine (PCV13) was initiated in Cambodia in 2015. To determine baseline data, we collected samples from children in 2013 and 2014. PCV13 serotypes accounted for 62.7% of colonizing organisms in outpatients and 88.4% of invasive pneumococci overall; multidrug resistance was common. Thus, effectiveness of vaccination should be high.
- Published
- 2015
- Full Text
- View/download PDF
35. Height, zinc and soil-transmitted helminth infections in schoolchildren: a study in Cuba and Cambodia.
- Author
-
de Gier B, Mpabanzi L, Vereecken K, van der Werff SD, D'Haese PC, Fiorentino M, Khov K, Perignon M, Chamnan C, Berger J, Parker ME, Díaz RJ, Núñez FA, Rivero LR, Gorbea MB, Doak CM, Ponce MC, Wieringa FT, and Polman K
- Subjects
- Animals, Ascaris lumbricoides, Cambodia epidemiology, Child, Child Development, Cross-Sectional Studies, Cuba epidemiology, Developing Countries, Female, Hair chemistry, Helminthiasis transmission, Humans, Linear Models, Male, Prevalence, Trichuris, Zinc administration & dosage, Zinc deficiency, Body Height, Helminthiasis blood, Helminthiasis epidemiology, Soil parasitology, Zinc blood
- Abstract
Soil-transmitted helminth (STH) infections and zinc deficiency are often found in low- and middle-income countries and are both known to affect child growth. However, studies combining data on zinc and STH are lacking. In two studies in schoolchildren in Cuba and Cambodia, we collected data on height, STH infection and zinc concentration in either plasma (Cambodia) or hair (Cuba). We analyzed whether STH and/or zinc were associated with height for age z-scores and whether STH and zinc were associated. In Cuba, STH prevalence was 8.4%; these were mainly Ascaris lumbricoides and Trichuris trichiura infections. In Cambodia, STH prevalence was 16.8%, mostly caused by hookworm. In Cuban children, STH infection had a strong association with height for age (aB-0.438, p = 0.001), while hair zinc was significantly associated with height for age only in STH uninfected children. In Cambodian children, plasma zinc was associated with height for age (aB-0.033, p = 0.029), but STH infection was not. Only in Cambodia, STH infection showed an association with zinc concentration (aB-0.233, p = 0.051). Factors influencing child growth differ between populations and may depend on prevalences of STH species and zinc deficiency. Further research is needed to elucidate these relationships and their underlying mechanisms.
- Published
- 2015
- Full Text
- View/download PDF
36. Stunting, poor iron status and parasite infection are significant risk factors for lower cognitive performance in Cambodian school-aged children.
- Author
-
Perignon M, Fiorentino M, Kuong K, Burja K, Parker M, Sisokhom S, Chamnan C, Berger J, and Wieringa FT
- Subjects
- Adolescent, Anemia, Iron-Deficiency epidemiology, Cambodia, Child, Female, Humans, Intelligence Tests, Male, Nutritional Status, Parasitic Diseases epidemiology, Risk Factors, Anemia, Iron-Deficiency complications, Child Development, Cognition, Parasitic Diseases complications
- Abstract
Background: Nutrition is one of many factors affecting the cognitive development of children. In Cambodia, 55% of children <5 y were anemic and 40% stunted in 2010. Currently, no data exists on the nutritional status of Cambodian school-aged children, or on how malnutrition potentially affects their cognitive development., Objective: To assess the anthropometric and micronutrient status (iron, vitamin A, zinc, iodine) of Cambodian schoolchildren and their associations with cognitive performance., Methods: School children aged 6-16 y (n = 2443) from 20 primary schools in Cambodia were recruited. Anthropometry, hemoglobin, serum ferritin, transferrin receptors, retinol-binding protein and zinc concentrations, inflammation status, urinary iodine concentration and parasite infection were measured. Socio-economic data were collected in a sub-group of children (n = 616). Cognitive performance was assessed using Raven's Colored Progressive Matrices (RCPM) and block design and picture completion, two standardized tests from the Wechsler Intelligence Scale for Children (WISC-III)., Results: The prevalence of anemia, iron, zinc, iodine and vitamin A deficiency were 15.7%; 51.2%, 92.8%, 17.3% and 0.7% respectively. The prevalence of stunting was 40.0%, including 10.9% of severe stunting. Stunted children scored significantly lower than non-stunted children on all tests. In RCPM test, boys with iron-deficiency anemia had lower scores than boys with normal iron status (-1.46, p<0.05). In picture completion test, children with normal iron status tended to score higher than iron-deficient children with anemia (-0.81; p = 0.067) or without anemia (-0.49; p = 0.064). Parasite infection was associated with an increase in risk of scoring below the median value in block design test (OR = 1.62; p<0.05), and with lower scores in other tests, for girls only (both p<0.05)., Conclusion: Poor cognitive performance of Cambodian school-children was multifactorial and significantly associated with long-term (stunting) and current nutritional status indicators (iron status), as well as parasite infection. A life-cycle approach with programs to improve nutrition in early life and at school-age could contribute to optimal cognitive performance.
- Published
- 2014
- Full Text
- View/download PDF
37. The SMILING project: a North-South-South collaborative action to prevent micronutrient deficiencies in women and young children in Southeast Asia.
- Author
-
Berger J, Blanchard G, Ponce MC, Chamnan C, Chea M, Dijkhuizen M, Doak C, Doets E, Fahmida U, Ferguson E, Hulshof P, Kameli Y, Kuong K, Akkhavong K, Sengchanh K, Le BM, Tran TL, Muslimatun S, Roos N, Sophonneary P, Wieringa F, Wasantwisut E, and Winichagoon P
- Subjects
- Asia, Southeastern, Child, Preschool, Europe, Female, Health Priorities, Health Status, Humans, Infant, Infant, Newborn, Models, Theoretical, Nutrition Policy, Nutritional Status, International Cooperation, Malnutrition prevention & control, Micronutrients deficiency
- Abstract
Background: The "Sustainable Micronutrient Interventions to Control Deficiencies and Improve Nutritional Status and General Health in Asia" project (SMILING), funded by the European Commission, is a transnational collaboration of research institutions and implementation agencies in five Southeast Asian countries--Cambodia, Indonesia, Laos PDR, Thailand, and Vietnam--with European partners, to support the application of state-of-the art knowledge to alleviate micronutrient malnutrition in Southeast Asia., Objective: The major expected outcomes are to improve micronutrient status on a large scale, to identify priority interventions in each Southeast Asian country, and to develop a road map for decision makers and donors for inclusion of these priority interventions into the national policy., Methods: SMILING has been built around a strong project consortium that works on a constant and proactive exchange of data and analyses between partners and allows for the differences in contexts and development stages of the countries, as well as a strong North-South-South collaboration and colearning., Results: The selection of Southeast Asian countries considered the range of social and economic development, the extent of micronutrient malnutrition, and capacity and past success in nutrition improvement efforts. SMILING is applying innovative tools that support nutrition policy-making and programming. The mathematical modeling technique combined with linear programming will provide insight into which food-based strategies have the potential to provide essential (micro) nutrients for women and young children. Multicriteria mapping will offer a flexible decision-aiding tool taking into account the variability and uncertainty of opinions from key stakeholders. The lessons learned throughout the project will be widely disseminated.
- Published
- 2013
- Full Text
- View/download PDF
38. Moving from viral suppression to comprehensive patient-centered care: the high prevalence of comorbid conditions and health risk factors in HIV-1-infected patients in Australia.
- Author
-
Broom J, Sowden D, Williams M, Taing K, Morwood K, and McGill K
- Subjects
- Adult, Anxiety epidemiology, CD4 Lymphocyte Count, Comorbidity, Comprehensive Health Care, Depression epidemiology, Diabetes Mellitus diagnosis, Diabetes Mellitus epidemiology, Dyslipidemias drug therapy, Dyslipidemias epidemiology, Female, HIV Infections drug therapy, HIV Infections immunology, Hepatitis, Viral, Human diagnosis, Hepatitis, Viral, Human epidemiology, Humans, Hyperglycemia epidemiology, Hypertension drug therapy, Hypertension epidemiology, Latent Tuberculosis diagnosis, Male, Middle Aged, Osteoporosis epidemiology, Patient Compliance, Prevalence, Proteinuria epidemiology, Queensland epidemiology, Retrospective Studies, Risk Factors, Sexually Transmitted Diseases diagnosis, Sexually Transmitted Diseases epidemiology, Smoking epidemiology, Substance-Related Disorders epidemiology, HIV Infections epidemiology, HIV-1
- Abstract
HIV clinicians today need to move from focusing on viral suppression to a chronic disease model in which comorbid conditions and risk factors are comprehensively identified and addressed to reduce rates of serious non-AIDS-related morbidity and mortality. This study aimed to determine the prevalence of comorbid conditions in an Australian HIV-positive population. Of 180 patients included, there was a median CD4 count of 0.520 cells/mm(3). The majority (88%) of patients were currently receiving highly active antiretroviral therapy (HAART). There were high rates of failure to attend clinical appointments (30%), current smoking (42%), hypertension (16%), and dyslipidemia (17%). Significant rates of dipstick-positive proteinuria (16%) and elevated blood glucose (15%) were recorded. Risk factors were commonly not addressed by the treating clinician. There is an urgent need to systematize detection and management of high-prevalence comorbid conditions to prevent premature mortality associated with serious non-AIDS events.
- Published
- 2012
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.