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1. Association between prenatal provision of lipid‐based nutrient supplements and caesarean delivery: Findings from a randomised controlled trial in Malawi

Author

Salenius, Meeri, Pyykkö, Juha, Ashorn, Ulla, Dewey, Kathryn G, Gondwe, Austrida, Harjunmaa, Ulla, Maleta, Kenneth, Nkhoma, Minyanga, Vosti, Stephen A, Ashorn, Per, and Adubra, Laura

Subjects
Reproductive Medicine, Midwifery, Biomedical and Clinical Sciences, Health Sciences, Pediatric, Nutrition, Prevention, Clinical Research, Reproductive health and childbirth, Zero Hunger, Adolescent, Cesarean Section, Dietary Supplements, Female, Folic Acid, Humans, Iron, Lipids, Malawi, Micronutrients, Pregnancy, Vitamins, cesarian section, delivery complications, lipid-based nutrient supplements, Nutrition and Dietetics, Nutrition & Dietetics, Nutrition and dietetics
Abstract

In populations with a high prevalence of childhood and adolescent undernutrition, supplementation during pregnancy aiming at improving maternal nutritional status and preventing fetal growth restriction might theoretically lead to cephalopelvic disproportion and delivery complications. We investigated whether the prenatal provision of small-quantity lipid-based nutrient supplements (SQ-LNS) was associated with an increased risk of caesarean section (CS) or other delivery complications. Pregnant Malawian women were randomised to receive daily i) iron-folic acid (IFA) capsule (control), ii) multiple micronutrient (MMN) capsule of 18 micronutrients (second control), or iii) SQ-LNS with similar micronutrients as MMN, plus four minerals and macronutrients contributing 118 kcal. We analysed the associations of SQ-LNS, CS, and other delivery complications using log-binomial regressions. Among 1391 women enrolled, 1255 had delivery information available. The incidence of CS and delivery complications was 6.3% and 8.2%, respectively. The incidence of CS was 4.0%, 6.0%, and 8.9% (p = 0.017) in the IFA, MMN, and LNS groups, respectively. Compared to the IFA group, the relative risk (95% confidence interval) of CS was 2.2 (1.3-3.8) (p = 0.006) in the LNS group and 1.5 (0.8-2.7) (p = 0.200) in the MMN group. We found no significant differences for other delivery complications. Provision of SQ-LNS to pregnant women may have increased the incidence of CS. The baseline rate was, however, lower than recommended. It is unclear if the higher CS incidence in the SQ-LNS group resulted from increased obstetric needs or more active health seeking and a better supply of services. Trial registered at clinicaltrials.gov, NCT01239693.

Published
2022

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

Author

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

Published
2023
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3. Early Development of Visual Attention in Infants in Rural Malawi

Author

Pyykkö, Juha, Forssman, Linda, Maleta, Kenneth, Ashorn, Per, Ashorn, Ulla, and Leppänen, Jukka M.

Abstract

Eye tracking research has shown that infants develop a repertoire of attentional capacities during the first year. The majority of studies examining the early development of attention comes from Western, high-resource countries. We examined visual attention in a heterogeneous sample of infants in rural Malawi (N = 312-376, depending on analysis). Infants were assessed with eye-tracking-based tests that targeted visual orienting, anticipatory looking, and attention to faces at 7 and 9 months. Consistent with prior research, infants exhibited active visual search for salient visual targets, anticipatory saccades to predictable events, and a robust attentional bias for happy and fearful faces. Individual variations in these processes had low to moderate odd-even split-half and test-retest reliability. There were no consistent associations between attention measures and gestational age, nutritional status, or characteristics of the rearing environment (i.e., maternal cognition, psychosocial well-being, socioeconomic status, and care practices). The results replicate infants' early attentional biases in a large, unique sample, and suggest that some of these biases (e.g., bias for faces) are pronounced in low-resource settings. The results provided no evidence that the initial manifestation of infants' attentional capacities is associated with risk factors that are common in low-resource environments.

Published
2019
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4. A mixed method study exploring adherence to and acceptability of small quantity lipid-based nutrient supplements (SQ-LNS) among pregnant and lactating women in Ghana and Malawi

Author

Klevor, Moses K, Adu-Afarwuah, Seth, Ashorn, Per, Arimond, Mary, Dewey, Kathryn G, Lartey, Anna, Maleta, Kenneth, Phiri, Nozgechi, Pyykkö, Juha, Zeilani, Mamane, and Ashorn, Ulla

Subjects
Reproductive Medicine, Biomedical and Clinical Sciences, Nutrition and Dietetics, Clinical Research, Nutrition, Clinical Trials and Supportive Activities, Pediatric, Reproductive health and childbirth, Adult, Dietary Supplements, Female, Ghana, Humans, Lactation, Lipids, Malawi, Micronutrients, Patient Compliance, Pregnancy, Pregnant Women, Time Factors, Young Adult, Small-quantity lipid-based nutrient supplements, Adherence, Acceptability, Women, Nursing, Paediatrics and Reproductive Medicine, Public Health and Health Services, Obstetrics & Reproductive Medicine, Reproductive medicine, Midwifery
Abstract

BackgroundSupplementing pregnant and lactating mothers with small quantity lipid-based nutrient supplements (SQ-LNS) has resulted in improvements in birth outcomes in some low-income settings. In order to be effective, SQ-LNS must be consumed regularly over sustained periods.MethodsThe objective was to assess and compare acceptability of and adherence to SQ-LNS consumption among pregnant and lactating women in Ghana and Malawi throughout 12 months of supplementation. We enrolled women before 20 gestation weeks into randomized trials in Ghana (n = 1320) and Malawi (n = 869). In the SQ-LNS group participants received a 20 g sachet of supplement per day during pregnancy and the first 6 months of lactation. In the control groups participants received multiple micronutrients (MMN) during pregnancy and lactation or iron and folic acid (IFA) during pregnancy and calcium during lactation. We used questionnaires to collect data on self-reported adherence to daily use of supplements and conducted in-depth interviews with women in the SQ-LNS group to examine acceptability.ResultsThe mean self-reported adherence during the supplementation period was lower in Ghana (79.9 %) than in Malawi (91.7 %) for all supplements (difference 11.8 %, P

Published
2016

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

Author

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

Published
2023
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6. Small babies, big risks: global estimates of prevalence and mortality for vulnerable newborns to accelerate change and improve counting

Author

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

Published
2023
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7. Study Protocol: The Impact of Growth Charts and Nutritional Supplements on Child Growth in Zambia (ZamCharts): A Cluster Randomized Controlled Trial

Author

Fink, Günther, primary, Lauer, Jacqueline M., additional, Locks, Lindsey, additional, Chembe, Mpela, additional, Henderson, Savanna, additional, Kumwenda, Chiza, additional, Sikazwe, Dorothy, additional, Bague, Irene Falgas, additional, Bilima-Mulenga, Tamara, additional, Parkerson, Doug, additional, Rockers, Peter, additional, Leppänen, Jukka, additional, and Pyykkö, Juha, additional

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

Author

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

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

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

Published
2023

10. Associations between individual variations in visual attention at 9 months and behavioral competencies at 18 months in rural Malawi

Author

Chilora, Eletina, Ashorn, Per, Leppänen, Jukka, Ashorn, Ulla, Maleta, Kenneth, Pyykkö, Juha, Tampere University, Clinical Medicine, BioMediTech, and Department of Paediatrics

Subjects
PsyArXiv|Social and Behavioral Sciences, 3123 Gynaecology and paediatrics, Science, bepress|Social and Behavioral Sciences, PsyArXiv|Social and Behavioral Sciences|Developmental Psychology, Medicine, bepress|Social and Behavioral Sciences|Psychology|Child Psychology, bepress|Social and Behavioral Sciences|Psychology|Developmental Psychology, PsyArXiv|Social and Behavioral Sciences|Developmental Psychology|Early Childhood
Abstract

Theoretical and empirical considerations suggest that individual differences in infant visual attention correlate with variations in cognitive skills later in childhood. Here we tested this hypothesis in infants from rural Malawi (n = 198–377, depending on analysis), who were assessed with eye tracking tests of visual orienting, anticipatory looks, and attention to faces at 9 months, and more conventional tests of cognitive control (A-not-B), motor, language, and socioemotional development at 18 months. The results showed no associations between measures of infant attention at 9 months and cognitive skills at 18 months, either in analyses linking infant visual orienting with broad cognitive outcomes or analyses linking specific constructs between the two time points (i.e., switching of anticipatory looks and manual reaching responses), as correlations varied between -0.08 and 0.14. Measures of physical growth, and family socioeconomic characteristics were also not correlated with cognitive outcomes at 18 months in the current sample (correlations between -0.10 and 0.19). The results do not support the use of the current tests of infant visual attention as a predictive tool for 18-month-old infants’ cognitive skills in the Malawian setting. The results are discussed in light of the potential limitations of the employed infant tests as well as potentially unique characteristics of early cognitive development in low-resource settings. publishedVersion

Published
2020

13. A mixed method study exploring adherence to and acceptability of small quantity lipid-based nutrient supplements (SQ-LNS) among pregnant and lactating women in Ghana and Malawi

Author

Klevor, Moses K., Adu-Afarwuah, Seth, Ashorn, Per, Arimond, Mary, Dewey, Kathryn G., Lartey, Anna, Maleta, Kenneth, Phiri, Nozgechi, Pyykkö, Juha, Zeilani, Mamane, Ashorn, Ulla, Lääketieteen yksikkö - School of Medicine, and University of Tampere

Subjects
Adult, Malawi, Time Factors, Kansanterveystiede, ympäristö ja työterveys - Public health care science, environmental and occupational health, Clinical Trials and Supportive Activities, Reproductive health and childbirth, Nursing, Ghana, Paediatrics and Reproductive Medicine, Young Adult, Acceptability, Clinical Research, Pregnancy, Obstetrics and Gynaecology, parasitic diseases, Lactation, Humans, Small-quantity lipid-based nutrient supplements, Women, Micronutrients, Obstetrics & Reproductive Medicine, Nutrition, Pediatric, integumentary system, Naisten- ja lastentaudit - Gynaecology and paediatrics, Lipids, Adherence, Dietary Supplements, Public Health and Health Services, Patient Compliance, Female, Pregnant Women, Research Article
Abstract

Background Supplementing pregnant and lactating mothers with small quantity lipid-based nutrient supplements (SQ-LNS) has resulted in improvements in birth outcomes in some low-income settings. In order to be effective, SQ-LNS must be consumed regularly over sustained periods. Methods The objective was to assess and compare acceptability of and adherence to SQ-LNS consumption among pregnant and lactating women in Ghana and Malawi throughout 12 months of supplementation. We enrolled women before 20 gestation weeks into randomized trials in Ghana (n = 1320) and Malawi (n = 869). In the SQ-LNS group participants received a 20 g sachet of supplement per day during pregnancy and the first 6 months of lactation. In the control groups participants received multiple micronutrients (MMN) during pregnancy and lactation or iron and folic acid (IFA) during pregnancy and calcium during lactation. We used questionnaires to collect data on self-reported adherence to daily use of supplements and conducted in-depth interviews with women in the SQ-LNS group to examine acceptability. Results The mean self-reported adherence during the supplementation period was lower in Ghana (79.9 %) than in Malawi (91.7 %) for all supplements (difference 11.8 %, P

Published
2016

14. Malawilaisten lasten pituuskasvun mallintaminen sekamallein

Author

Pyykkö, Juha, Informaatiotieteiden yksikkö - School of Information Sciences, and University of Tampere

Subjects
pääkomponenttianalyysi, ryhmittelyanalyysi, lineaarinen sekamalli, Tilastotiede - Statistics
Abstract

Tutkielmassa lasten pituuskasvun mallintamiseen malawilaisesta populaatiosta käytetään pitkittäisaineistoa LAIS-tutkimuksesta, jossa yksilöistä otettujen mittausten määrä ja mittausajankohdat vaihtelevat. Tällaisen aineiston mallinnukseen käytetään lineaarista sekamallia, jonka avulla havaintoaineiston epätasapainoisuus ei häiritse analyysia. Huomiota kiinnitetään myös mallin satunnaisvirheiden kovarianssirakenteeseen, jonka huomioon ottamalla mallinnusta voidaan tarkentaa. Mallintamalla pituutta iän muunnoksilla lineaarinen sekamalli tuottaa yksilöille sopivat mallit. Lisäksi mallinnusta ja aineistoa tarkastellaan pääkomponentti- ja ryhmittelyanalyysin avulla. Näitä menetelmiä hyödyntäen erilaisia kasvukäyriä on mahdollista havainnollistaa.

Published
2014

15. Early development of visual attention in infants in rural Malawi.

Author

Pyykkö, Juha, Forssman, Linda, Maleta, Kenneth, Ashorn, Per, Ashorn, Ulla, and Leppänen, Jukka M.

Subjects
*INFANTS, *ATTENTIONAL bias, *EYE tracking, *GESTATIONAL age, *STATISTICAL reliability
Abstract

Eye tracking research has shown that infants develop a repertoire of attentional capacities during the first year. The majority of studies examining the early development of attention comes from Western, high‐resource countries. We examined visual attention in a heterogeneous sample of infants in rural Malawi (N = 312–376, depending on analysis). Infants were assessed with eye‐tracking‐based tests that targeted visual orienting, anticipatory looking, and attention to faces at 7 and 9 months. Consistent with prior research, infants exhibited active visual search for salient visual targets, anticipatory saccades to predictable events, and a robust attentional bias for happy and fearful faces. Individual variations in these processes had low to moderate odd‐even split‐half and test‐retest reliability. There were no consistent associations between attention measures and gestational age, nutritional status, or characteristics of the rearing environment (i.e., maternal cognition, psychosocial well‐being, socioeconomic status, and care practices). The results replicate infants' early attentional biases in a large, unique sample, and suggest that some of these biases (e.g., bias for faces) are pronounced in low‐resource settings. The results provided no evidence that the initial manifestation of infants' attentional capacities is associated with risk factors that are common in low‐resource environments. [ABSTRACT FROM AUTHOR]

Published
2019
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