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1دورية أكاديمية
المؤلفون: Morgan Boncyk, Aloisia Shemdoe, Ramya Ambikapathi, Dominic Mosha, Savannah L. Froese, Cristiana K. Verissimo, Mary Mwanyika-Sando, Japhet Killewo, Germana H. Leyna, Nilupa S. Gunaratna, Crystal L. Patil
المصدر: BMC Public Health, Vol 22, Iss 1, Pp 1-12 (2022)
مصطلحات موضوعية: Food environment, Family perspective, Food choice, Chronic disease, Public aspects of medicine, RA1-1270
الوصف: Abstract Background A nutritious diet is critical to minimizing disease progression of human immunodeficiency virus (HIV) and maximizing treatment efficacy. In low resource settings, meeting the food preference needs of people living with the HIV (PLHIV) can be achieved with a supportive food environment when HIV status is disclosed. However, less is known about family-level strategies related to building a supportive food environment. The Diet, Environment, and Choices of positive living (DECIDE), a mixed-methods observational study conducted in peri-urban Dar es Salaam, Tanzania, explored food preferences as influenced by the personal, family, and external food domains. Methods We completed a qualitative analysis of data generated from 40 interviews (n = 20 PLHIV and n = 20 family members) aimed at exploring the dynamics of food choice for using a family perspective. We expanded on Turner’s food environment framework and drew on Giddens’ structuration theory to guide our data collection and analysis. Interviews were audio recorded, transcribed, translated from Kiswahili to English, coded, and organized into themes. Results We found PLHIV personal food preferences were influenced by organoleptic properties, medications, disease stage, and gender norms. Family members were knowledgeable about the importance of nutritious food for HIV treatment and prioritized these needs to avoid HIV-related stigma and fulfill family obligations. With high prices of nutritious foods (animal source foods, fruits), family members strategized to secure preferred foods for the PLHIV by, 1) forgoing their own food preferences; 2) reallocating food within the household; 3)making food substitutions; and 4) leveraging external networks. These strategies were increasingly employed as the disease progressed. Conclusion The use of this expanded framework that included a family perspective on PLHIV food choice illuminated the various households decision-making dynamics that took place in this low resource community. Family members of PLHIV tried to buffer the limitations imposed by the external food environment, especially as the disease progressed. In the context of HIV status disclosure, integrating a family perspective into HIV nutrition interventions and programs has the potential to influence health outcomes and slow disease progression.
وصف الملف: electronic resource
العلاقة: https://doaj.org/toc/1471-2458Test
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2دورية أكاديمية
المؤلفون: Simone Passarelli, Semira Abdelmenan, Dagmawit Tewahido, Yohannes Mulugeta Demmu, Helen Abreham, Ramya Ambikapathi, Nilupa S. Gunaratna, Yemane Berhane, Wafaie Fawzi
المصدر: Agriculture & Food Security, Vol 11, Iss 1, Pp 1-12 (2022)
مصطلحات موضوعية: Chicken, Poultry, Animal husbandry, Qualitative, Ethiopia, Child health, Agriculture, Nutrition. Foods and food supply, TX341-641
الوصف: Abstract Small-scale chicken production holds great potential as a nutrition-sensitive strategy in low-income settings, due to its potential for improving income, increasing the consumption of nutritious foods (including eggs and meat), and empowering women. This study sought to evaluate the impacts of and to identify challenges and solutions for a nutrition-sensitive chicken production intervention in rural Ethiopia. We conducted a qualitative study following the endline evaluation of the African Chicken Genetic Gains and Agriculture to Nutrition project in the Amhara and Oromia regions of Ethiopia. Using semi-structured interviews, we held twelve Focus Group Discussions with woman project participants and six Key Informant Interviews with project staff. Data were analyzed using thematic analysis. Six Focus Group Discussions were with participants in the African Chicken Genetic Gains intervention, through which women received 25 high-yielding chickens. The other six Focus Group Discussions were held with participants who (in addition to the African Chicken Genetic Gains intervention) also received the Agriculture to Nutrition intervention, which focused on nutrition-sensitive behavior change communication related to child feeding, water, sanitation and hygiene, and home gardening. The African Chicken Genetic Gains and the Agriculture to Nutrition interventions benefited participants through improved income, nutrition, and child caregiving knowledge. Nutrition and child feeding benefits were emphasized more in the nutrition-sensitive behavior change arm, while income benefits were emphasized more in the arm that did not receive behavior change. The primary challenges of the project included death and disease of chickens and implementation issues at both the project and household levels. Recommendations to address these challenges included improved chicken housing designs, access to inputs, access to veterinary care (including vaccines and medication), and project logistics. The nutrition-sensitive and chicken production interventions were largely well-received by participants. Most participants agreed that the benefits of the project outweighed the challenges. Future projects would benefit from logistical and infrastructural improvements to improve implementation and impacts on nutrition, health, and livelihoods.
وصف الملف: electronic resource
العلاقة: https://doaj.org/toc/2048-7010Test
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3دورية أكاديمية
المؤلفون: Eva Débora de Oliveira Andrade, Amanda de Sousa Rebouças, José Q. Filho, Ramya Ambikapathi, Laura E. Caulfield, Aldo Ângelo Moreira Lima, Bruna Leal Lima Maciel
المصدر: Maternal and Child Nutrition, Vol 18, Iss 4, Pp n/a-n/a (2022)
مصطلحات موضوعية: breastfeeding, children, complementary feeding, ultra‐processed food, Pediatrics, RJ1-570, Gynecology and obstetrics, RG1-991, Nutritional diseases. Deficiency diseases, RC620-627
الوصف: Abstract Infant feeding practices impact children's nutritional and health status, influencing growth and development. This study aimed to analyse the evolution of infant feeding practices from 9 to 24 months of age, considering infant and young child feeding (IYCF) indicators and food processing. The infant feeding practices in children from the Brazilian site of the MAL‐ED study were evaluated at 9 (n = 193), 15 (n = 182) and 24 months (n = 164) using 24‐h dietary recalls. IYCF indicators were evaluated, and the extent of food processing was evaluated, using the NOVA classification. Breastfeeding declined significantly over time, from 77.6% at 9 months to 45.1% at 24 months. Although dietary diversity did not significantly change during the study period (80.5% at 24 months), the minimum acceptable diet significantly increased from 67.9% to 76.1% at 24 months (p
وصف الملف: electronic resource
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4دورية أكاديمية
المؤلفون: Simone Passarelli, Ramya Ambikapathi, Nilupa S. Gunaratna, Isabel Madzorera, Chelsey R. Canavan, Ramadhani Abdallah Noor, Dagmawit Tewahido, Yemane Berhane, Simbarashe Sibanda, Lindiwe Majele Sibanda, Tshilidzi Madzivhandila, Bertha L. M. Munthali, Margaret McConnell, Christopher Sudfeld, Kirsten Davison, Wafaie Fawzi
المصدر: BMC Public Health, Vol 21, Iss 1, Pp 1-15 (2021)
مصطلحات موضوعية: Agriculture, Water, sanitation, and hygiene, Ethiopia, Child health, Nutrition, Public aspects of medicine, RA1-1270
الوصف: Abstract Background Household chicken production presents an opportunity to promote child nutrition, but the benefits might be offset by increased environmental contamination. Using household surveys, direct observations, and in-depth interviews with woman caregivers, we sought to describe the relationship between chicken management practices and household exposure to environmental contamination, and assess barriers to adopting improved husbandry practices. Methods First, we analyzed baseline data from 973 households raising chickens in the two interventions arms from the Agriculture-to-Nutrition (ATONU) study in Ethiopia to assess the relationship between animal management practices and environmental exposures. Second, we conducted six-hour direct observations of children’s environmental exposures in 18 households. Among these households, we analyzed in-depth interviews with child caregivers. Results Quantitative analyses showed that households raised approximately 11 chickens, had animal feces visible on the property 67% of the time, and children’s hands were visibly dirty 38% of the time. Households with more chickens had lower exposure to animal feces. Having a chicken coop increased the risk of observing animal feces on the property by 30%, but among those with a coop, having an enclosed coop reduced that risk by 83%. Coops that were enclosed, had fencing, and were located further from homes were associated with a reduced risk of observing animal feces and an increased likelihood of children having clean hands. Direct observations showed that chicken coops were often poorly designed or not used. On average, 3 to 5 chickens were inside homes at a time, and livestock and domestic animals were frequently inside of houses and interacting with young children. In-depth interviews revealed that protection of animals, maintenance of household cleanliness and health, type of chicken (local versus improved) and resource constraints influenced management decisions. Conclusions Improvements in chicken management practices could mitigate the exposure of household members to environmental contamination. Our findings highlight the need for training and resources to promote safe animal husbandry practices and optimal child health in nutrition-sensitive livestock projects. Trial registration Clinical trials number: NCT03152227 ; Retrospectively registered at ClinicalTrials.gov on May 12, 2012.
وصف الملف: electronic resource
العلاقة: https://doaj.org/toc/1471-2458Test
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5دورية أكاديمية
المؤلفون: Tjale Cloupas Mahopo, Cebisa Noxolo Nesamvuni, Azwihangwisi Edward Nesamvuni, Melanie de Bryun, Johan van Niekerk, Ramya Ambikapathi
المصدر: Frontiers in Public Health, Vol 10 (2022)
مصطلحات موضوعية: operational characteristics, street food enterprises, street vendors, South Africa, women's employment, Public aspects of medicine, RA1-1270
الوصف: ObjectiveTo characterize the operations of the street food enterprise in the Vhembe district, focusing on business profile, sold foods, inputs, pricing, record-keeping practices and total running cost.MethodsA descriptive cross-sectional face-to-face study of 511 vendors was done using a structured researcher-administered questionnaire comprising demographic and operational characteristics. Convenience sampling was used to choose the vending sites. Chi-square tests were conducted between four categorical variables (gender, age, marital status and citizenship) and operational characteristics. P-values were considered significant at p < 0.05. However, a Bonferroni adjustment decreased the significant value to p < 0.013.ResultsThe findings highlight the dominance of single middle-aged (35–44) women (63.1%) with some high school education. About 14% migrated from Zimbabwe. Most vendors were owners (86.1%), with 70.0% in business for at least 1–10 years. Food sold included mielie pap (stiff porridge) served with beef or chicken, sometimes with vegetables. Plate prices were R40.00 (2.6 USD) for a full plate and R30.00 (2 USD) for half a plate. The typical street food consumers were government officials, middlemen, and schoolchildren. Social media such as Whatsapp were used to communicate between the street food vendors and customers. The results highlight poor managerial skills as only 15.5% kept records, most of which were sales records (59.5%). On average, street vendors made a monthly profit of R3200.00 (213 USD) while spending R1800.00 (120 USD) on daily running expenses. There were statistically significant variations in some operational characteristics of vendor variables and gender, age, marital status, and citizenship.ConclusionsThere is a need for capital and management for small businesses and food training for rural street food vendors. Therefore, government officials, policymakers, and NGOs could target street vendors to offer training and microfinance to improve their business skills while promoting food safety and consumption of nutritious foods.
وصف الملف: electronic resource
العلاقة: https://www.frontiersin.org/articles/10.3389/fpubh.2022.849059/fullTest; https://doaj.org/toc/2296-2565Test
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6دورية أكاديمية
المؤلفون: Stephanie A. Richard, Benjamin J. J. McCormick, Laura E. Murray‐Kolb, Crystal L. Patil, Ram K. Chandyo, Cloupas Mahopo, Bruna L. Maciel, Anuradha Bose, Mustafa Mahfuz, Ramya Ambikapathi, Maribel Paredes Olortegui, Laura E. Caulfield, the MAL‐ED Network Investigators
المصدر: Maternal and Child Nutrition, Vol 17, Iss 3, Pp n/a-n/a (2021)
مصطلحات موضوعية: breastfeeding, food insecurity, infant feeding, infant growth, maternal depression, Pediatrics, RJ1-570, Gynecology and obstetrics, RG1-991, Nutritional diseases. Deficiency diseases, RC620-627
الوصف: Abstract The WHO recommends exclusive breastfeeding for the first 6 months of life. However, the transition of the infants' diet to partial breastfeeding with the addition of animal milks and/or solids typically occurs earlier than this. Here, we explored factors associated with the timing of an early transition to partial breastfeeding across seven sites of a birth cohort study in which twice weekly information on infant feeding practices was collected. Infant (size, sex, illness and temperament), maternal (age, education, parity and depressive symptoms), breastfeeding initiation practices (time of initiation, colostrum and pre‐lacteal feeding) and household factors (food security, crowding, assets, income and resources) were considered. Three consecutive caregiver reports of feeding animal milks and/or solids (over a 10‐day period) were characterized as a transition to partial breastfeeding, and Cox proportional hazard models with time (in days) to partial breastfeeding were used to evaluate associations with both fixed and time‐varying characteristics. Overall, 1470 infants were included in this analysis. Median age of transition to partial breastfeeding ranged from 59 days (South Africa and Tanzania) to 178 days (Bangladesh). Overall, higher weight‐for‐length z‐scores were associated with later transitions to partial breastfeeding, as were food insecurity, and infant cough in the past 30 days. Maternal depressive symptoms (evaluated amongst 1227 infants from six sites) were associated with an earlier transition to partial breastfeeding. Relative thinness or heaviness within each site was related to breastfeeding transitions, as opposed to absolute z‐scores. Further research is needed to understand relationships between local perceptions of infant body size and decisions about breastfeeding.
وصف الملف: electronic resource
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7دورية أكاديمية
المؤلفون: Gwenyth O. Lee, Pamela J. Surkan, Jon Zelner, Maribel Paredes Olórtegui, Pablo Peñataro Yori, Ramya Ambikapathi, Laura E. Caulfield, Robert H. Gilman, Margaret N. Kosek
المصدر: SSM: Population Health, Vol 4, Iss , Pp 254-262 (2018)
مصطلحات موضوعية: Public aspects of medicine, RA1-1270, Social sciences (General), H1-99
الوصف: Background: Food insecurity is a major global public health issue. Social capital has been identified as central to maintaining food security across a wide range of low- and middle-income country contexts, but few studies have examined this relationship through sociocentric network analysis. Objective: We investigated relationships between household- and community-level social connectedness, household food security, and household income; and tested the hypothesis that social connectedness modified the relationship between income and food security. Methods: A cross-sectional census with an embedded questionnaire to capture social relationships was conducted among eleven peri-urban communities. Community connectedness was related to study outcomes of food security and per-capita income through regression models. Results: Of 1520 households identified, 1383 were interviewed (91.0%) and 1272 (83.9%) provided complete data. Households in the youngest communities had the most total contacts, and the highest proportion of contacts outside of the community. Household income was also associated with more outside-community contacts (0.05 more contacts per standard deviation increase in income, p
وصف الملف: electronic resource
العلاقة: http://www.sciencedirect.com/science/article/pii/S2352827317302021Test; https://doaj.org/toc/2352-8273Test
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8دورية أكاديمية
المؤلفون: Margaret N. Kosek, Tahmeed Ahmed, Zulfiquar Bhutta, Laura Caulfield, Richard Guerrant, Eric Houpt, Gagandeep Kang, Margaret Kosek, Gwenyth Lee, Aldo Lima, Benjamin J.J. McCormick, James Platts-Mills, Jessica Seidman, Rebecca R. Blank, Michael Gottlieb, Stacey L. Knobler, Dennis R. Lang, Mark A. Miller, Karen H. Tountas, Zulfiqar A. Bhutta, William Checkley, Richard L. Guerrant, Carl J. Mason, Laura E. Murray-Kolb, William A. Petri, Jr., Jessica C. Seidman, Pascal Bessong, Rashidul Haque, Sushil John, Aldo A.M. Lima, Estomih R. Mduma, Reinaldo B. Oriá, Prakash Sunder Shrestha, Sanjaya Kumar Shrestha, Erling Svensen, Anita K.M. Zaidi, Cláudia B. Abreu, Angel Mendez Acosta, Imran Ahmed, A.M. Shamsir Ahmed, Asad Ali, Ramya Ambikapathi, Leah Barrett, Aubrey Bauck, Eliwaza Bayyo, Ladaporn Bodhidatta, Anuradha Bose, J. Daniel Carreon, Ram Krishna Chandyo, Vivek Charu, Hilda Costa, Rebecca Dillingham, Alessandra Di Moura, Viyada Doan, Jose Quirino Filho, Jhanelle Graham, Christel Hoest, Iqbal Hossain, Munirul Islam, M. Steffi Jennifer, Shiny Kaki, Beena Koshy, Álvaro M. Leite, Noélia L. Lima, Bruna L.L. Maciel, Mustafa Mahfuz, Cloupas Mahopo, Angelina Maphula, Monica McGrath, Archana Mohale, Milena Moraes, Francisco S. Mota, Jayaprakash Muliyil, Regisiana Mvungi, Gaurvika Nayyar, Emanuel Nyathi, Maribel Paredes Olortegui, Reinaldo Oria, Angel Orbe Vasquez, William K. Pan, John Pascal, Crystal L. Patil, Laura Pendergast, Silvia Rengifo Pinedo, Stephanie Psaki, Mohan Venkata Raghava, Karthikeyan Ramanujam, Muneera Rasheed, Zeba A. Rasmussen, Stephanie A. Richard, Anuradha Rose, Reeba Roshan, Barbara Schaefer, Rebecca Scharf, Srujan L. Sharma, Binob Shrestha, Rita Shrestha, Suzanne Simons, Alberto M. Soares, Rosa M.S. Mota, Sajid Soofi, Tor Strand, Fahmida Tofail, Rahul J. Thomas, Ali Turab, Manjeswori Ulak, Vivian Wang, Ladislaus Yarrot, Pablo Peñataro Yori, Didar Alam, Caroline Amour, Cesar Banda Chavez, Sudhir Babji, Rosa Rios de Burga, Julian Torres Flores, Jean Gratz, Ajila T. George, Dinesh Hariraju, Alexandre Havt, Priyadarshani Karunakaran, Robin P. Lazarus, Ila F. Lima, Dinesh Mondal, Pedro H.Q.S. Medeiros, Rosemary Nshama, Josiane Quetz, Shahida Qureshi, Sophy Raju, Anup Ramachandran, Rakhi Ramadas, A. Catharine Ross, Mery Siguas Salas, Amidou Samie, Kerry Schulze, E. Shanmuga Sundaram, Buliga Mujaga Swema, Dixner Rengifo Trigoso
المصدر: EBioMedicine, Vol 18, Iss C, Pp 109-117 (2017)
مصطلحات موضوعية: Enteropathy, Undernutrition, Stunting, Enteropathogen, Child growth, Child health, Medicine, Medicine (General), R5-920
الوصف: Background: Environmental enteropathy (EE), the adverse impact of frequent and numerous enteric infections on the gut resulting in a state of persistent immune activation and altered permeability, has been proposed as a key determinant of growth failure in children in low- and middle-income populations. A theory-driven systems model to critically evaluate pathways through which enteropathogens, gut permeability, and intestinal and systemic inflammation affect child growth was conducted within the framework of the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) birth cohort study that included children from eight countries. Methods: Non-diarrheal stool samples (N = 22,846) from 1253 children from multiple sites were evaluated for a panel of 40 enteropathogens and fecal concentrations of myeloperoxidase, alpha-1-antitrypsin, and neopterin. Among these same children, urinary lactulose:mannitol (L:M) (N = 6363) and plasma alpha-1-acid glycoprotein (AGP) (N = 2797) were also measured. The temporal sampling design was used to create a directed acyclic graph of proposed mechanistic pathways between enteropathogen detection in non-diarrheal stools, biomarkers of intestinal permeability and inflammation, systemic inflammation and change in length- and weight- for age in children 0–2 years of age. Findings: Children in these populations had frequent enteric infections and high levels of both intestinal and systemic inflammation. Higher burdens of enteropathogens, especially those categorized as being enteroinvasive or causing mucosal disruption, were associated with elevated biomarker concentrations of gut and systemic inflammation and, via these associations, indirectly associated with both reduced linear and ponderal growth. Evidence for the association with reduced linear growth was stronger for systemic inflammation than for gut inflammation; the opposite was true of reduced ponderal growth. Although Giardia was associated with reduced growth, the association was not mediated by any of the biomarkers evaluated. Interpretation: The large quantity of empirical evidence contributing to this analysis supports the conceptual model of EE. The effects of EE on growth faltering in young children were small, but multiple mechanistic pathways underlying the attribution of growth failure to asymptomatic enteric infections had statistical support in the analysis. The strongest evidence for EE was the association between enteropathogens and linear growth mediated through systemic inflammation. Funding: Bill & Melinda Gates Foundation.
وصف الملف: electronic resource
العلاقة: http://www.sciencedirect.com/science/article/pii/S235239641730083XTest; https://doaj.org/toc/2352-3964Test
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9دورية أكاديمية
المؤلفون: James A Platts-Mills, MD, Jie Liu, PhD, Elizabeth T Rogawski, PhD, Furqan Kabir, MSc, Paphavee Lertsethtakarn, PhD, Mery Siguas, BSc, Shaila S Khan, MSc, Ira Praharaj, MD, Arinao Murei, BSc, Rosemary Nshama, BSc, Buliga Mujaga, BSc, Alexandre Havt, PhD, Irene A Maciel, PhD, Timothy L McMurry, PhD, Darwin J Operario, PhD, Mami Taniuchi, PhD, Jean Gratz, MS, Suzanne E Stroup, MS, James H Roberts, Adil Kalam, MSc, Fatima Aziz, MSc, Shahida Qureshi, MSc, M Ohedul Islam, MSc, Pimmada Sakpaisal, MSc, Sasikorn Silapong, B BSc, Pablo P Yori, MPH, Revathi Rajendiran, MSc, Blossom Benny, MSc, Monica McGrath, ScD, Benjamin J J McCormick, DPhil, Jessica C Seidman, PhD, Dennis Lang, PhD, Michael Gottlieb, PhD, Richard L Guerrant, MD, Aldo A M Lima, ProfPhD, Jose Paulo Leite, PhD, Amidou Samie, PhD, Pascal O Bessong, ProfPhD, Nicola Page, PhD, Ladaporn Bodhidatta, MD, Carl Mason, MD, Sanjaya Shrestha, MD, Ireen Kiwelu, PhD, Estomih R Mduma, MPH, Najeeha T Iqbal, PhD, Zulfiqar A Bhutta, ProfPhD, Tahmeed Ahmed, ProfMBBS, Rashidul Haque, PhD, Gagandeep Kang, ProfMD, Margaret N Kosek, MD, Eric R Houpt, ProfMD, Angel Mendez Acosta, Rosa Rios de Burga, Cesar Banda Chavez, Julian Torres Flores, Maribel Paredes Olotegui, Silvia Rengifo Pinedo, Dixner Rengifo Trigoso, Angel Orbe Vasquez, Imran Ahmed, Didar Alam, Asad Ali, Muneera Rasheed, Sajid Soofi, Ali Turab, Aisha Yousafzai, Anita KM Zaidi, Binob Shrestha, Bishnu Bahadur Rayamajhi, Tor Strand, Geetha Ammu, Sudhir Babji, Anuradha Bose, Ajila T George, Dinesh Hariraju, M. Steffi Jennifer, Sushil John, Shiny Kaki, Priyadarshani Karunakaran, Beena Koshy, Robin P Lazarus, Jayaprakash Muliyil, Preethi Ragasudha, Mohan Venkata Raghava, Sophy Raju, Anup Ramachandran, Rakhi Ramadas, Karthikeyan Ramanujam, Anuradha Rose, Reeba Roshan, Srujan L Sharma, Shanmuga Sundaram, Rahul J Thomas, William K Pan, Ramya Ambikapathi, J Daniel Carreon, Viyada Doan, Christel Hoest, Stacey Knobler, Mark A Miller, Stephanie Psaki, Zeba Rasmussen, Stephanie A Richard, Karen H Tountas, Erling Svensen, Caroline Amour, Eliwaza Bayyo, Regisiana Mvungi, John Pascal, Ladislaus Yarrot, Leah Barrett, Rebecca Dillingham, William A Petri, Rebecca Scharf, AM Shamsir Ahmed, Md Ashraful Alam, Umma Haque, Md Iqbal Hossain, Munirul Islam, Mustafa Mahfuz, Dinesh Mondal, Baitun Nahar, Fahmida Tofail, Ram Krishna Chandyo, Prakash Sunder Shrestha, Rita Shrestha, Manjeswori Ulak, Aubrey Bauck, Robert Black, Laura Caulfield, William Checkley, Gwenyth Lee, Kerry Schulze, Samuel Scott, Laura E Murray-Kolb, A Catharine Ross, Barbara Schaefer, Suzanne Simons, Laura Pendergast, Cláudia B Abreu, Hilda Costa, Alessandra Di Moura, José Quirino Filho, Álvaro M Leite, Noélia L Lima, Ila F Lima, Bruna LL Maciel, Pedro HQS Medeiros, Milena Moraes, Francisco S Mota, Reinaldo B Oriá, Josiane Quetz, Alberto M Soares, Rosa MS Mota, Crystal L Patil, Cloupas Mahopo, Angelina Maphula, Emanuel Nyathi
المصدر: The Lancet Global Health, Vol 6, Iss 12, Pp e1309-e1318 (2018)
مصطلحات موضوعية: Public aspects of medicine, RA1-1270
الوصف: Summary: Background: Optimum management of childhood diarrhoea in low-resource settings has been hampered by insufficient data on aetiology, burden, and associated clinical characteristics. We used quantitative diagnostic methods to reassess and refine estimates of diarrhoea aetiology from the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) cohort study. Methods: We re-analysed stool specimens from the multisite MAL-ED cohort study of children aged 0–2 years done at eight locations (Dhaka, Bangladesh; Vellore, India; Bhaktapur, Nepal; Naushero Feroze, Pakistan; Venda, South Africa; Haydom, Tanzania; Fortaleza, Brazil; and Loreto, Peru), which included active surveillance for diarrhoea and routine non-diarrhoeal stool collection. We used quantitative PCR to test for 29 enteropathogens, calculated population-level pathogen-specific attributable burdens, derived stringent quantitative cutoffs to identify aetiology for individual episodes, and created aetiology prediction scores using clinical characteristics. Findings: We analysed 6625 diarrhoeal and 30 968 non-diarrhoeal surveillance stools from 1715 children. Overall, 64·9% of diarrhoea episodes (95% CI 62·6–71·2) could be attributed to an aetiology by quantitative PCR compared with 32·8% (30·8–38·7) using the original study microbiology. Viral diarrhoea (36·4% of overall incidence, 95% CI 33·6–39·5) was more common than bacterial (25·0%, 23·4–28·4) and parasitic diarrhoea (3·5%, 3·0–5·2). Ten pathogens accounted for 95·7% of attributable diarrhoea: Shigella (26·1 attributable episodes per 100 child-years, 95% CI 23·8–29·9), sapovirus (22·8, 18·9–27·5), rotavirus (20·7, 18·8–23·0), adenovirus 40/41 (19·0, 16·8–23·0), enterotoxigenic Escherichia coli (18·8, 16·5–23·8), norovirus (15·4, 13·5–20·1), astrovirus (15·0, 12·0–19·5), Campylobacter jejuni or C coli (12·1, 8·5–17·2), Cryptosporidium (5·8, 4·3–8·3), and typical enteropathogenic E coli (5·4, 2·8–9·3). 86·2% of the attributable incidence for Shigella was non-dysenteric. A prediction score for shigellosis was more accurate (sensitivity 50·4% [95% CI 46·7–54·1], specificity 84·0% [83·0–84·9]) than current guidelines, which recommend treatment only of bloody diarrhoea to cover Shigella (sensitivity 14·5% [95% CI 12·1–17·3], specificity 96·5% [96·0–97·0]). Interpretation: Quantitative molecular diagnostics improved estimates of pathogen-specific burdens of childhood diarrhoea in the community setting. Viral causes predominated, including a substantial burden of sapovirus; however, Shigella had the highest overall burden with a high incidence in the second year of life. These data could improve the management of diarrhoea in these low-resource settings. Funding: Bill & Melinda Gates Foundation.
وصف الملف: electronic resource
العلاقة: http://www.sciencedirect.com/science/article/pii/S2214109X18303498Test; https://doaj.org/toc/2214-109XTest
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10دورية أكاديمية
المؤلفون: Elizabeth T Rogawski, PhD, Jie Liu, PhD, James A Platts-Mills, MD, Furqan Kabir, MSc, Paphavee Lertsethtakarn, PhD, Mery Siguas, BSc, Shaila S Khan, MSc, Ira Praharaj, MD, Arinao Murei, BSc, Rosemary Nshama, BSc, Buliga Mujaga, BSc, Alexandre Havt, PhD, Irene A Maciel, PhD, Darwin J Operario, PhD, Mami Taniuchi, PhD, Jean Gratz, MS, Suzanne E Stroup, MS, James H Roberts, Adil Kalam, MSc, Fatima Aziz, MSc, Shahida Qureshi, MSc, M Ohedul Islam, MSc, Pimmada Sakpaisal, MSc, Sasikorn Silapong, MSc, Pablo P Yori, MPH, Revathi Rajendiran, MSc, Blossom Benny, MSc, Monica McGrath, ScD, Jessica C Seidman, PhD, Dennis Lang, PhD, Michael Gottlieb, PhD, Richard L Guerrant, MD, Aldo A M Lima, ProfPhD, Jose Paulo Leite, PhD, Amidou Samie, PhD, Pascal O Bessong, ProfPhD, Nicola Page, PhD, Ladaporn Bodhidatta, MD, Carl Mason, MD, Sanjaya Shrestha, MD, Ireen Kiwelu, PhD, Estomih R Mduma, MPH, Najeeha T Iqbal, PhD, Zulfiqar A Bhutta, ProfPhD, Tahmeed Ahmed, ProfMBBS, Rashidul Haque, PhD, Gagandeep Kang, ProfMD, Margaret N Kosek, MD, Eric R Houpt, ProfMD, Angel Mendez Acosta, Rosa Rios de Burga, Cesar Banda Chavez, Julian Torres Flores, Maribel Paredes Olotegui, Silvia Rengifo Pinedo, Dixner Rengifo Trigoso, Angel Orbe Vasquez, Imran Ahmed, Didar Alam, Asad Ali, Muneera Rasheed, Sajid Soofi, Ali Turab, Aisha Yousafzai, Anita KM Zaidi, Binob Shrestha, Bishnu Bahadur Rayamajhi, Tor Strand, Geetha Ammu, Sudhir Babji, Anuradha Bose, Ajila T George, Dinesh Hariraju, M. Steffi Jennifer, Sushil John, Shiny Kaki, Priyadarshani Karunakaran, Beena Koshy, Robin P Lazarus, Jayaprakash Muliyil, Preethi Ragasudha, Mohan Venkata Raghava, Sophy Raju, Anup Ramachandran, Rakhi Ramadas, Karthikeyan Ramanujam, Anuradha Rose, Reeba Roshan, Srujan L Sharma, Shanmuga Sundaram, Rahul J Thomas, William K Pan, Ramya Ambikapathi, J Daniel Carreon, Viyada Doan, Christel Hoest, Stacey Knobler, Mark A Miller, Stephanie Psaki, Zeba Rasmussen, Stephanie A Richard, Karen H Tountas, Erling Svensen, Caroline Amour, Eliwaza Bayyo, Regisiana Mvungi, John Pascal, Ladislaus Yarrot, Leah Barrett, Rebecca Dillingham, William A Petri, Rebecca Scharf, AM Shamsir Ahmed, Md Ashraful Alam, Umma Haque, Md Iqbal Hossain, Munirul Islam, Mustafa Mahfuz, Dinesh Mondal, Baitun Nahar, Fahmida Tofail, Ram Krishna Chandyo, Prakash Sunder Shrestha, Rita Shrestha, Manjeswori Ulak, Aubrey Bauck, Robert Black, Laura Caulfield, William Checkley, Gwenyth Lee, Kerry Schulze, Samuel Scott, Laura E Murray-Kolb, A Catharine Ross, Barbara Schaefer, Suzanne Simons, Laura Pendergast, Cláudia B Abreu, Hilda Costa, Alessandra Di Moura, José Quirino Filho, Álvaro M Leite, Noélia L Lima, Ila F Lima, Bruna LL Maciel, Pedro HQS Medeiros, Milena Moraes, Francisco S Mota, Reinaldo B Oriá, Josiane Quetz, Alberto M Soares, Rosa MS Mota, Crystal L Patil, Cloupas Mahopo, Angelina Maphula, Emanuel Nyathi
المصدر: The Lancet Global Health, Vol 6, Iss 12, Pp e1319-e1328 (2018)
مصطلحات موضوعية: Public aspects of medicine, RA1-1270
الوصف: Summary: Background: Enteropathogen infections in early childhood not only cause diarrhoea but contribute to poor growth. We used molecular diagnostics to assess whether particular enteropathogens were associated with linear growth across seven low-resource settings. Methods: We used quantitative PCR to detect 29 enteropathogens in diarrhoeal and non-diarrhoeal stools collected from children in the first 2 years of life obtained during the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) multisite cohort study. Length was measured monthly. We estimated associations between aetiology-specific diarrhoea and subclinical enteropathogen infection and quantity and attained length in 3 month intervals, at age 2 and 5 years, and used a longitudinal model to account for temporality and time-dependent confounding. Findings: Among 1469 children who completed 2 year follow-up, 35 622 stool samples were tested and yielded valid results. Diarrhoeal episodes attributed to bacteria and parasites, but not viruses, were associated with small decreases in length after 3 months and at age 2 years. Substantial decrements in length at 2 years were associated with subclinical, non-diarrhoeal, infection with Shigella (length-for-age Z score [LAZ] reduction −0·14, 95% CI −0·27 to −0·01), enteroaggregative Escherichia coli (−0·21, −0·37 to −0·05), Campylobacter (−0·17, −0·32 to −0·01), and Giardia (−0·17, −0·30 to −0·05). Norovirus, Cryptosporidium, typical enteropathogenic E coli, and Enterocytozoon bieneusi were also associated with small decrements in LAZ. Shigella and E bieneusi were associated with the largest decreases in LAZ per log increase in quantity per g of stool (−0·13 LAZ, 95% CI −0·22 to −0·03 for Shigella; −0·14, −0·26 to −0·02 for E bieneusi). Based on these models, interventions that successfully decrease exposure to Shigella, enteroaggregative E coli, Campylobacter, and Giardia could increase mean length of children by 0·12–0·37 LAZ (0·4–1·2 cm) at the MAL-ED sites. Interpretation: Subclinical infection and quantity of pathogens, particularly Shigella, enteroaggregative E coli, Campylobacter, and Giardia, had a substantial negative association with linear growth, which was sustained during the first 2 years of life, and in some cases, to 5 years. Successfully reducing exposure to certain pathogens might reduce global stunting. Funding: Bill & Melinda Gates Foundation.
وصف الملف: electronic resource
العلاقة: http://www.sciencedirect.com/science/article/pii/S2214109X18303516Test; https://doaj.org/toc/2214-109XTest
النص الكامل