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Phnom Penh, Cambodia

Knowles J.,Public Nutrition Solutions Ltd | Thurnham D.I.,University of Ulster | Phengdy B.,Ministry of Health | Houamboun K.,Institute of Public Health | And 3 more authors.
British Journal of Nutrition | Year: 2013

Anaemia is prevalent in South East Asia and Fe deficiency (ID) is considered to be the main cause, but the role of subclinical inflammation in the aetiology is uncertain. In the present study, we determined the influence of inflammation on the biomarkers of Fe status in women and children, and herein, we discuss the proportion of anaemia associated with ID. As part of the 2006 Lao People's Democratic Republic (The Lao PDR) National Nutrition Survey, blood collected from 482 young children and 816 non-pregnant women was analysed. Plasma ferritin, transferrin receptor (sTfR), Hb, C-reactive protein (CRP) and α-1-acid glycoprotein (AGP) concentrations were measured. ID was assessed using ferritin concentrations ( < 12 (children) or < 15 (adults) μg/l), sTfR concentrations (>8·3 mg/l) and body Fe stores (BIS < 0). Elevated CRP (>5 mg/l) and/or AGP (>1 g/l) concentrations were used to categorise inflammation status in order to correct the Fe biomarkers for inflammation. Inflammation was present in 14 % of adults and 43 % of children. Anaemia was present in 37·6 % of both women (Hb concentrations < 120 g/l) and children (Hb concentrations < 110 g/l). Correcting ferritin concentrations for inflammation increased the prevalence of ID from 24·3 to 26 % for women and from 18 to 21 % for children (P< 0·001 for both). Ferritin concentrations were more helpful in detecting ID than sTfR concentrations or BIS, but regression analysis found that sTfr concentrations explained more of the variance in Hb concentrations in both women (20 %) and children (17 %) than ferritin concentrations (5 and 1·4 %, respectively). Nevertheless, the total variance in Hb concentrations explained was only 26 and 18 % in women and children, respectively, and other factors may be more important than ID in contributing to anaemia in The Lao PDR. © The Authors 2013.

Hong R.,George Washington University | Chhea V.,Maternal and Child Health Center
Maternal and Child Health Journal | Year: 2010

This paper studies the trend of immunization dropout and its relationship with economic inequality among Cambodian children aged 12-59 months, using data from the 2000 and 2005 Cambodia Demographic and Health Surveys (CDHS). We define an 'immunization dropout' as a child who has received at least one dose of trivalent vaccine against diphtheria, pertussis, and tetanus (DPT), but failed to receive his or her third dose to complete the schedule before 12 months of age. Socioeconomic status is represented by household wealth index quintiles. The level of DPT dropouts from 1996 to 2004 decreased from 22% to 10%. The difference in DPT3 dropouts between children of the highest household wealth quintile and children of the lowest and lower wealth quintiles significantly improved over these years. In 2000, the children of the lowest wealth quintile were almost three times as likely as the children of the highest wealth quintile not to complete the third dose of DPT (Odds Ratios [OR] = 2.92, P = 0.001). In 2005, however, the difference was small and statistically insignificant (OR = 1.42, P = 0.290). These results demonstrated that the child immunization program in Cambodia improved significantly over the past years. The improvement was observed in children of all economic strata, especially among the children of the poorer households. © Springer Science+Business Media, LLC 2010.

Prak S.,Maternal and Child Health Center | Dahl M.I.,11 Health | Oeurn S.,11 Health | Conkle J.,11 Health | And 2 more authors.
Nutrients | Year: 2014

A cross-sectional analysis of the Cambodia Demographic Health Surveys from 2000, 2005 and 2010 was conducted to observe the national trends in infant and young child feeding practices. The results showed that rates of exclusive breastfeeding among infants aged 0-5.9 months have increased substantially since 2000, concurrent with an increase in the rates of early initiation of breastfeeding and a reduction in the giving of pre-lacteal feeds. However, the proportion of infants being fed with breast-milk substitutes (BMS) during 0-5.9 months doubled in 5 years (3.4% to 7.0%) from 2000 to 2005, but then did not increase from 2005, likely due to extensive public health campaigns on exclusive breastfeeding. BMS use increased among children aged 6-23.9 months from 2000 to 2010 (4.8% to 9.3%). 26.1% of women delivering in a private clinic provided their child with breast-milk substitute at 0-5.9 months, which is five times more than women delivering in the public sector(5.1%), and the greatest increase in bottle use happened among the urban poor (5.8% to 21.7%). These findings are discussed with reference to the increased supply and marketing of BMS that is occurring in Cambodia. © 2014 by the authors; licensee MDPI, Basel, Switzerland.

Phoutthakeo P.,University of Tokyo | Otsuka K.,University of Tokyo | Ito C.,International Organization for Migration | Sayamoungkhoun P.,Maternal and Child Health Center | And 2 more authors.
Journal of Paediatrics and Child Health | Year: 2014

Aim This study aims to examine the influence of formula milk promotion via the media from Thailand to Lao People's Democratic Republic (PDR), where a cultural and linguistic proximity are shared. Methods A cross-sectional study was conducted through a structured questionnaire survey and focus group discussion (FGD) with mothers who had children under 2 years of age and lived in Vientiane Capital, Lao PDR. Multivariate logistic regression models were constructed for quantitative data analysis. Content analysis was used for qualitative data analysis. Results Among infants aged 6-23 months, exclusive breastfeeding (EBF) rate for 6 months was 16.1% (n = 106/658). Among infants aged 0-5 months, 17.6% (n = 61/346) was exclusively breastfed at the time of survey (24 h recall). Of 1022 mothers, 89.9% reported frequent exposure to the Thai media's promotion of formula milk through TV commercials and 79.1% identified TV commercial as influential for them to develop a positive attitude towards the use of formula milk. In multivariate logistic regression analyses, mothers who reported a positive attitude towards Thai TV commercial on the formula use (n = 449) were approximately 75% less likely to practice EBF for 6 months than those who reported a negative attitude (n = 64). FGD further revealed that the participants tend to believe in the information in TV commercial for formula milk. Conclusion The promotion of formula milk via media from Thailand negatively affects breastfeeding mothers in Lao PDR. Cross-border impacts of promoting formula milk should be addressed globally. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Loke A.L.,Hong Kong Polytechnic University | Lam P.,Maternal and Child Health Center
BMC Pregnancy and Childbirth | Year: 2014

Background: Teenagers are unprepared to face or to deal with an unexpected pregnancy. Adolescents do not necessarily possess the cognitive ability needed to clearly evaluate such a situation or to determine how to resolve their pregnancy. This study seeks to shed light on what pregnant adolescents consider when coming to a decision about what to do about their pregnancy. Methods: In-depth interviews were conducted among a purposive sample of Hong Kong Chinese women recruited from a Maternal and Child Health Centre, who had a history of being pregnant in their teens and out of wedlock. Interviews were conducted to explore the considerations surrounding their decision on how to resolve their pregnancy. Results: A total of nine women were interviewed. An analysis of the interview transcripts revealed that to arrive at a decision on what to do about their pregnancy, pregnant teens took into consideration their relationship with their boyfriend, their family's advice or support, practical considerations, their personal values in life, and views on adoption. Conclusions: The results of this study results highlighted that during this life-altering event for adolescents, an open discussion should take place among all of the parties concerned. A better understanding of each party's perspective would allow for better decision making on the resolution of the pregnancy. Health professionals or social workers are there to help pregnant adolescents, romantic partners, and family members make informed choices on how to resolve the pregnancy. © Loke and Lam.

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