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Faruque A.S.,Center for Nutrition and Food Security
BMC infectious diseases | Year: 2014

The study aimed to compare the socio-demographic, host and clinical characteristics, seasonality and antimicrobial susceptibility of Typhoidal Salmonella (Salmonella enterica serovar Typhi and Paratyphi) (TS) with diarrhea between urban and rural Bangladesh. Relevant information of 77/25,767 (0.30%) and 290/17,622 (1.65%) patients positive with TS (in stool) were extracted from the data archive of Diarrheal Disease Surveillance System of icddr,b (urban Dhaka and rural Matlab Hospitals respectively) during 2000-2012. Comparison group (diarrhea patients negative for TS) was randomly selected from the database (1:3 ratio). Two poisson regression models were investigated for modelling seasonal effects on the number of cases. Salmonella Typhi was more frequently isolated in Dhaka than Matlab (57% vs. 5%, p < 0.001); while Salmonella Paratyphi was more frequent in Matlab than Dhaka (96% vs. 43%; p < 0.001). Fever [adj. OR-5.86 (95% CI: 2.16, 15.94)], antimicrobial use at home [5.08 (2.60, 9.90)], and fecal red blood cells [2.53 (1.38, 4.64)] were significantly associated with detection of TS in stool of patient from Dhaka. For Matlab, the correlates were, vomiting [1.88 (1.35, 2.64)], fecal macrophage [1.89 (1.29, 2.74)] in addition to fever and duration of diarrhea and antimicrobial use. At Dhaka, all Salmonella Typhi isolates were susceptible to ceftriaxone; while in Dhaka and Matlab however, for ciprofloxacin it was 45% and 91%, respectively. Susceptibility to chloramphenicol, ampicillin, trimethoprim-sulphamethoxazole and nalidixic acid ranged from 12%-58%. Salmonella Paratyphi were susceptible to ceftriaxone (99%). A significant seasonal trend and year difference (before and after 2007) for Matlab was observed (p < 0.001 for all effects). Dhaka does not show significant year or seasonal effects (p = 0.07 for years and p = 0.81 and p = 0.18 for the cos and sin components, respectively). While not significant, two seasonal peaks were observed in Dhaka (January-February and September-November); while a single peak (August-November) was observed in Matlab. Proportion of serovar distribution of TS and their clinical characteristics, antimicrobial susceptibility and seasonal pattern were different among diarrhea patients in urban Dhaka and rural Matlab of Bangladesh. Source


Islam M.M.,Center for Nutrition and Food Security | Brown K.H.,University of California at Davis
Journal of Nutrition | Year: 2014

Information is needed on breast milk zinc concentration and amount of zinc transferred to the infant in relation to the time since birth for both appropriate-for-gestational-age (AGA) and small-for-gestational-age (SGA) infants. Breast milk zinc concentration and total milk volume were measured among mothers of AGA and SGA infants, using deuterium oxide ''dose-to-mother'' tracer technique and plasma zinc concentrations of mothers and infants. Forty-six mother-infant pairs (20 AGA and 26 SGA infants) were recruited from a low-income community in Bangladesh. Each mother-infant pair was studied 3 times: at 4, 12, and 24 wk postpartum. During each round, 2-wk studies of breast milk transfer were performed, using deuterium oxide dose-to-mother tracer technique. Breast milk samples were collected on days 1 and 5 of each round to determinemilk zinc concentration. Mean6 SD birth weight and lengthwere 3.02 ± 0.2 kg and 0.482 ± 0.012m, respectively, for AGA and 2.34 ± 0.20 kg and 0.462 ± 0.011 m, respectively, for SGA infants, and both variables were different between groups (birth weight, P < 0.001; length, P < 0.001). Breast milk intake increased gradually with time postpartum in both groups. Breast milk zinc concentration decreased with increasing infant age (P < 0.001) but did not differ for mothers of AGA and SGA infants. Breast milk zinc transfer decreased significantly with age in both groups (P < 0.001) but did not differ by birth-weight category. Breast milk zinc concentration among Bangladeshi mothers and patterns of change at 24 wk were similar to those of wealthier countries, and there was no relation between infant birth-weight category and milk zinc concentration or transfer. © 2014 American Society for Nutrition. Source


Khan J.R.,Center for Nutrition and Food Security | Awan N.,University of Dhaka | Misu F.,Bangladesh Agricultural University
BMC Pediatrics | Year: 2016

Background: Anemia is a global public health problem but the burden of anemia is disproportionately borne among children in developing countries. Anemia in early stages of life has serious consequences on the growth and development of the children. We examine the prevalence of anemia, possible association between anemia and different socio-economic, demographic, health and other factors among children with ages from 6 to 59 months from the nationally representative 2011 Bangladesh Demographic and Health Survey (BDHS). Methods: Data on hemoglobin (Hb) concentration among the children aged 6-59 months from the most recent BDHS (2011) were used. This nationally representative survey allowed a multistage stratified cluster sampling design and provided data on a wide range of indicators such as fertility, mortality, women and child health, nutrition and other background characteristics. Anemia status was determined using hemoglobin level (<11.0 g/dl), and weighted prevalence of childhood anemia along with 95 % confidence intervals were provided. We also examined the distribution of weighted anemia prevalence across different groups and performed logistic regression to assess the association of anemia with different factors. Results: A total of 2171 children aged 6-59 months were identified for this analysis, with weighted prevalence of anemia being 51.9 % overall- 47.4 % in urban and 53.1 % in rural regions. Results of a multivariable logistic regression analysis showed that, children below 24 months of age (odds ratio, [OR] 3.01; 95 % confidence interval [CI] 2.38-3.81), and those from an anemic mother (OR 1.80; 95 % CI 1.49-2.18) were at higher risk of anemia. Childhood anemia was significantly associated with chronic malnutrition of child, source of drinking water, household wealth and geographical location (defined by division). Conclusions: A high prevalence of anemia among 6-59 months aged children was observed in Bangladesh. Given the negative impact of anemia on the development of children in future, there is an urgent need for effective and efficient remedial public health interventions. © 2016 Khan et al. Source


Bhuiyan M.U.,Center for Communicable Diseases | Zaman S.,Northumbria University | Ahmed T.,Center for Nutrition and Food Security
BMC Pediatrics | Year: 2013

Background: Childhood obesity has become an emerging urban health problem in urban cities in Bangladesh, particularly in affluent families. Risk factors for obesity in this context have not been explored yet. The objective of this study was to identify the risk factors associated with overweight and obesity among school children and adolescents in Dhaka, Bangladesh.Methods: From October through November 2007, we conducted a case-control study among children aged 10-15 years in seven schools in Dhaka. We assessed body mass index (weight in kg/height in sq. meter) to identify the cases (overweight/obese) and controls (healthy/normal weight) following the Centers for Disease Control and Prevention age and sex specific growth chart. We used a structured questionnaire to collect demographic information and respondent's exposure to several risk factors such as daily physical activity at home and in school, hours spent on computer games and television watching, maternal education level and parents' weight and height.Results: We enrolled 198 children: 99 cases, 99 controls. Multiple logistic regression analysis revealed that having at least one overweight parent (OR = 2.8, p = 0.001) and engaging in sedentary activities for >4 hours a day (OR = 2.0, p = 0.02) were independent risk factors for childhood overweight and/or obesity while exercising ≥ 30 minutes a day at home was a protective factor (OR = 0.4, p = 0.02). There were no significant associations between childhood overweight and sex, maternal education or physical activity at school.Conclusion: Having overweight parents along with limited exercise and high levels of sedentary activities lead to obesity among school children in urban cities in Bangladesh. Public health programs are needed to increase awareness on risk factors for overweight and obesity among children and adolescents in order to reduce the future burden of obesity-associated chronic diseases. © 2013 Bhuiyan et al.; licensee BioMed Central Ltd. Source


Lenters L.M.,Center for Global Child Health | Wazny K.,Center for Global Child Health | Webb P.,Tufts University | Ahmed T.,Center for Nutrition and Food Security | And 2 more authors.
BMC Public Health | Year: 2013

Background: Globally, moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) affect approximately 52 million children under five. This systematic review evaluates the effectiveness of interventions for SAM including the World Health Organization (WHO) protocol for inpatient management and community-based management with ready-to-use-therapeutic food (RUTF), as well as interventions for MAM in children under five years in low- and middle-income countries. Methods. We systematically searched the literature and included 14 studies in the meta-analysis. Study quality was assessed using CHERG adaptation of GRADE criteria. A Delphi process was undertaken to complement the systematic review in estimating case fatality and recovery rates that were necessary for modelling in the Lives Saved Tool (LiST). Results: Case fatality rates for inpatient treatment of SAM using the WHO protocol ranged from 3.4% to 35%. For community-based treatment of SAM, children given RUTF were 51% more likely to achieve nutritional recovery than the standard care group. For the treatment of MAM, children in the RUSF group were significantly more likely to recover and less likely to be non-responders than in the CSB group. In both meta-analyses, weight gain in the intervention group was higher, and although statistically significant, these differences were small. Overall limitations in our analysis include considerable heterogeneity in many outcomes and an inability to evaluate intervention effects separate from commodity effect. The Delphi process indicated that adherence to standardized protocols for the treatment of SAM and MAM should have a marked positive impact on mortality and recovery rates; yet, true consensus was not achieved. Conclusions: Gaps in our ability to estimate effectiveness of overall treatment approaches for SAM and MAM persist. In addition to further impact studies conducted in a wider range of settings, more high quality program evaluations need to be conducted and the results disseminated. © 2013Lenters et al; licensee BioMed Central Ltd. Source

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