MRC Keneba

West, Gambia

MRC Keneba

West, Gambia
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Courtiol A.,Leibniz Institute for Zoo and Wildlife Research | Rickard I.J.,Wissenschaftskolleg zu Berlin | Rickard I.J.,University of Sheffield | Rickard I.J.,Durham University | And 8 more authors.
Current Biology | Year: 2013

Recent human history is marked by demographic transitions characterized by declines in mortality and fertility [1]. By influencing the variance in those fitness components, demographic transitions can affect selection on other traits [2]. Parallel to changes in selection triggered by demography per se, relationships between fitness and anthropometric traits are also expected to change due to modification of the environment. Here we explore for the first time these two main evolutionary consequences of demographic transitions using a unique data set containing survival, fertility, and anthropometric data for thousands of women in rural Gambia from 1956-2010 [3]. We show how the demographic transition influenced directional selection on height and body mass index (BMI). We observed a change in selection for both traits mediated by variation in fertility: selection initially favored short females with high BMI values but shifted across the demographic transition to favor tall females with low BMI values. We demonstrate that these differences resulted both from changes in fitness variance that shape the strength of selection and from shifts in selective pressures triggered by environmental changes. These results suggest that demographic and environmental trends encountered by current human populations worldwide are likely to modify, but not stop, natural selection in humans. © 2013 Elsevier Ltd.


Braithwaite V.,MRC Human Nutrition Research | Jarjou L.M.A.,MRC Keneba | Goldberg G.R.,MRC Human Nutrition Research | Goldberg G.R.,University of Witwatersrand | And 3 more authors.
Bone | Year: 2012

We have previously reported on a case-series of children (n = 46) with suspected calcium-deficiency rickets who presented in The Gambia with rickets-like bone deformities. Biochemical analyses discounted vitamin D-deficiency as an aetiological factor but indicated a perturbation of Ca-P metabolism involving low plasma phosphate and high circulating fibroblast growth factor-23 (FGF23) concentrations.A follow-up study was conducted 5. years after presentation to investigate possible associated factors and characterise recovery. 35 children were investigated at follow-up (RFU). Clinical assessment of bone deformities, overnight fasted 2. h urine and blood samples, 2-day weighed dietary records and 24. h urine collections were obtained. Age- and season-matched data from children from the local community (LC) were used to calculate standard deviation scores (SDS) for RFU children.None of the RFU children had radiological signs of active rickets. However, over half had residual leg deformities consistent with rickets. Dietary Ca intake (SDS-Ca=-0.52 (0.98) p=0.04), dietary Ca/P ratio (SDS-Ca/P=-0.80 (0.82) p=0.0008) and TmP:GFR (SDS-TmP:GFR=-0.48 (0.81) p=0.04) were significantly lower in RFU children compared with LC children and circulating FGF23 concentration was elevated in 19% of RFU children. Furthermore an inverse relationship was seen between haemoglobin and FGF23 (R2=25.8, p=0.004).This study has shown differences in biochemical and dietary profiles between Gambian children with a history of rickets-like bone deformities and children from the local community. This study provided evidence in support of the calcium deficiency hypothesis leading to urinary phosphate wasting and rickets and identified glomerular filtration rate and iron status as possible modulators of FGF23 metabolic pathways. © 2011 Elsevier Inc.


Van Der Merwe L.F.,London School of Hygiene and Tropical Medicine | Moore S.E.,London School of Hygiene and Tropical Medicine | Fulford A.J.,London School of Hygiene and Tropical Medicine | Halliday K.E.,London School of Hygiene and Tropical Medicine | And 3 more authors.
American Journal of Clinical Nutrition | Year: 2013

Background: Intestinal damage and malabsorption caused by chronic environmental enteropathy are associated with growth faltering seen in infants in less-developed countries. Evidence has suggested that supplementary omega-3 (n-3) long-chain PUFAs (LC-PUFAs) might ameliorate this damage by reducing gastrointestinal inflammation. LC-PUFA supplementation may also benefit cognitive development. Objective: We tested whether early n-3 LC-PUFA supplementation improves infant intestinal integrity, growth, and cognitive function. Design: A randomized, double-blind, controlled trial [200 mg DHA and 300 mg EPA or 2 mL olive oil/d for 6 mo] was conducted in a population of 172 rural Gambian infants aged 3-9 mo. The primary endpoints were anthropometric measures and gut integrity [assessed by using urinary lactulose:mannitol ratios (LMRs)]. Plasma fatty acid status, intestinal mucosal inflammation (fecal calprotectin), daily morbidity, and cognitive development (2-step means-end test and an attention assessment) were secondary endpoints. Results: PUFA supplementation resulted in a significant increase in plasma n-3 LC-PUFA concentrations (P < 0.001 for both DHA and EPA) and midupper arm circumference (MUAC) (effect size: 0.31 z scores; 95% CI: 0.06, 0.56; P = 0.017) at 9 mo of age. At 12 mo, MUAC remained greater in the intervention group, and we observed significant increases in skinfold thicknesses (P ≤ 0.022 for all). No other significant differences between treatment groups were detected for growth or LMRs at 9 mo or for secondary outcomes. Conclusions: Fish-oil supplementation successfully increased plasma n-3 fatty acid status. However, in young, breastfed Gambian infants, the intervention failed to improve linear growth, intestinal integrity, morbidity, or selected measures of cognitive development. The trial was registered at www.isrctn.org as ISRCTN66645725. © 2013 American Society for Nutrition.


Prentice S.,MRC Human Nutrition Research | Fulford A.J.,London School of Hygiene and Tropical Medicine | Jarjou L.M.A.,MRC Keneba | Goldberg G.R.,MRC Human Nutrition Research | Prentice A.,MRC Human Nutrition Research
Annals of Human Biology | Year: 2010

Menarcheal age is a key indicator of female maturity and development. Studies in many countries have reported a downward secular trend in age of menarche over the past century. This study presents data gained using the 'status quo' method and interval regression to estimate median menarcheal age of girls in a rural Gambian community. Cross-sectional studies carried out in 1989, 2000 and 2008 revealed a median menarcheal age of 16.06 (95% CI 15.6716.45), 15.03 (95% CI 14.7615.30) and 14.90 (95% CI 14.5215.28), respectively. The average rate of decline of median age of menarche was amongst the most rapid yet reported, at 0.65 years of age per decade (p < 0.00001). There was no evidence for a change in the rate of decline over the two decades studied. These results probably reflect ongoing socio-economic development within the region. © 2010 Informa UK, Ltd.


PubMed | Ministry of Health & Social Welfare, University of Antwerp, London School of Hygiene and Tropical Medicine, MRC Keneba and Institserovarute of Tropical Medicine
Type: Journal Article | Journal: Transactions of the Royal Society of Tropical Medicine and Hygiene | Year: 2015

Ongoing surveillance of enteric pathogens of public health significance among casual food sellers is undertaken in many resource-limited countries. We report the results of a survey in Kiang West province, The Gambia, and provide an exemplar methodology for such surveys in resource-limited laboratories.Unpreserved, unrefrigerated stool samples were subjected to Salmonella, Shigella and agar plate culture for rhabditoid nematodes. Direct microscopy, formalin-ethyl acetate concentration and iron-hematoxylin staining was performed later, following preservation.Of 128 specimens received, no Shigella spp. was recovered, while four serovars of non-typhoidal Salmonella enterica, including Chandans, were isolated. Pathogenic parasitic infections were Necator americanus 10/128 (7.8%), Strongyloides stercoralis 3/128 (2.8%), Blastocystis species 45/128 (35.1%), Entamoeba histolytica complex 19/128 (14.8%) and Giardia intestinalis 4/128 (3.1%). A single case each of Hymenolepis diminuta and S. mansoni infection were detected. In one participant, myxozoan spores identical to those of Myxobolus species were found.Rare parasitoses and serovars of Salmonella enterica may occur relatively commonly in rural Africa. This paper describes intestinal pathogens found in a cohort of food sellers in such a setting. Furthermore, it describes two parasites rarely recovered from humans and demonstrates the need for methods other than microscopy to detect S. stercoralis infections.


Braithwaite V.,Medical Research Council MRC Human Nutrition Research | Jarjou L.M.A.,MRC Keneba | Goldberg G.R.,Medical Research Council MRC Human Nutrition Research | Prentice A.,Medical Research Council MRC Human Nutrition Research
Bone | Year: 2012

A relationship between iron and fibroblast growth factor-23 (FGF23) metabolic pathways has been proposed. Iron deficiency anaemia is prevalent in The Gambia and concentrations of fibroblast growth factor-23 FGF23 are elevated in a large percentage of Gambian children with rickets-like bone deformity.We speculate that low iron status may be involved in the aetiology of Gambian rickets. The aim of this study was to determine if there was a relationship between haemoglobin, as a marker of iron status, and FGF23 in samples from children with and without a history of rickets-like bone deformities in The Gambia. We conducted a retrospective analysis of studies carried out from 2006 to 2008 in children from a rural community in The Gambia where iron deficiency anaemia is endemic and where elevated circulating concentrations of FGF23 have been found. To investigate the relationship between circulating FGF23 and haemoglobin concentrations we used an age-adjusted linear regression model on data from children < 18. y of age with a family or personal history of rickets-like bone deformity (BD) (n= 108) and from the local community (LC) (n= 382).We found that circulating concentration of FGF23 was inversely correlated with haemoglobin concentration. This effect was more pronounced in BD children compared with LC children (interaction: P≤0.0001). Anaemia and elevated FGF23 were more prevalent in BD children compared to LC children (P=0.0003 and P=0.0001 respectively).In conclusion, there is a stronger relationship between FGF23 and haemoglobin in Gambian children with a history of rickets compared to local community children. This study provides support for the contention that iron may be involved in FGF23 metabolic pathways. © 2012 Elsevier Inc.


de Bono S.,MRC Human Nutrition Research | Schoenmakers I.,MRC Human Nutrition Research | Ceesay M.,MRC Keneba | Mendy M.,MRC Keneba | And 3 more authors.
Bone | Year: 2010

Fracture risk is determined by bone mass, size and architecture. Birth weight (Bwt) is reported to predict adult bone mass and density. Early life environment may therefore be a determinant of bone strength in later life. However such evidence was obtained using dual energy X-ray absorptiometry (DXA), which is known to be dependent on size.We used peripheral quantitative computed tomography (pQCT) and DXA to investigate Bwt as a determinant of bone size and cross section area (CSA), bone mineral content (BMC) and volumetric bone mineral density (vBMD) and areal BMD (aBMD) independent of current weight, height and age. The study population consisted of 68 males and 52 nulliparous females aged 17 to 21. years from Keneba, The Gambia. This population has a high prevalence of factors likely to influence skeletal development (poor nutrition, low calcium intake, late puberty and high physical activity).Measures of bone size and CSA, BMC and BMD were obtained using pQCT (Stratec 2000; at 4% and 66% radius; 4% and 50% tibia) and DXA (Lunar DPX; spine, hip, forearm and whole body). Sequential univariable (influence of Bwt on bone variables) and multivariable linear regression analyses (influence of Bwt on bone variables after adjusting for current height, weight and age) were used to investigate the independent effects of Bwt and attained size. Analyses were performed separately by sex.Bwt was a significant positive predictor of CSA at appendicular cortical sites in males and CSA and bone area at appendicular and most axial trabecular sites in females before and after adjustment for current height, weight and age. Bwt was not consistently related to BMC, vBMD or aBMD as measured by pQCT or DXA. Current weight was a positive predictor of aBMD and pQCT- and DXA-derived BMC in males and females. Height predicted aBMD and trabecular vBMD in males.In summary, Bwt significantly predicted attained CSA at cortical sites in males and at trabecular sites in females. Current weight was a positive predictor of BMC and aBMD in both sexes. This suggests that pre-natal factors affecting fetal growth may influence adult bone strength independently of post-natal factors. © 2010 Elsevier Inc.


Olausson H.,MRC Human Nutrition Research | Olausson H.,Gothenburg University | Goldberg G.R.,MRC Human Nutrition Research | Ann Laskey M.,MRC Human Nutrition Research | And 3 more authors.
Nutrition Research Reviews | Year: 2012

Pregnancy and lactation are times of additional demand for Ca. Ca is transferred across the placenta for fetal skeletal mineralisation, and supplied to the mammary gland for secretion into breast milk. In theory, these additional maternal requirements could be met through mobilisation of Ca from the skeleton, increased intestinal Ca absorption efficiency, enhanced renal Ca retention or greater dietary Ca intake. The extent to which any or all of these apply, the underpinning biological mechanisms and the possible consequences for maternal and infant bone health in the short and long term are the focus of the present review. The complexities in the methodological aspects of interpreting the literature in this area are highlighted and the inter-individual variation in the response to pregnancy and lactation is reviewed. In summary, human pregnancy and lactation are associated with changes in Ca and bone metabolism that support the transfer of Ca between mother and child. The changes generally appear to be independent of maternal Ca supply in populations where Ca intakes are close to current recommendations. Evidence suggests that the processes are physiological in humans and that they provide sufficient Ca for fetal growth and breast-milk production, without relying on an increase in dietary Ca intake or compromising long-term maternal bone health. Further research is needed to determine the limitations of the maternal response to the Ca demands of pregnancy and lactation, especially among mothers with marginal and low dietary Ca intake, and to define vitamin D adequacy for reproductive women. © 2012 The Author.


Jarjou L.M.A.,MRC Keneba | Goldberg G.R.,MRC Keneba | Goldberg G.R.,MRC Human Nutrition Research | Coward W.A.,MRC Human Nutrition Research | And 2 more authors.
European Journal of Clinical Nutrition | Year: 2012

BACKGROUND/OBJECTIVES: There is a paucity of information from developing countries on total calcium intake during infancy, and potential consequences for growth and bone development. DESIGN: Observational longitudinal study of rural Gambian infants (13 males and 17 females) at 3 and 12 months of age. SUBJECTS/METHODS: Breast-milk intake and calcium concentration, weighed dietary intake, anthropometry, midshaft radius bone mineral content (BMC) and bone width (BW). RESULTS: At 3 and 12 months (mean±s.d.) calcium intake from breast milk was 179±53 and 117±38, and from other foods 12±38 and 73±105 mg/day. There was no difference in total calcium intake; 94% and 62% of calcium came from breast milk. At 3 and 12 months, weight s.d.-scores were -0.441±1.07 and -1.967±1.06; length s.d.-scores were -0.511±1.04 and -1.469±1.13. Breast-milk calcium intake positively predicted weight (P=0.0002, P≤0.0001) and length (P=0.056, P=0.001). These relationships were not independent of breast-milk intake, which positively predicted weight (P≤0.002) and length (P=0.06, P=0.004). At 3, but not 12 months, weight and length correlated with total calcium intake. There were no relationships between total calcium intake and breast-milk intake with BW or BMC. CONCLUSION: The combination of low calcium intake from breast milk and complementary foods resulted in a low total calcium intake close to the estimated biological requirement for bone mineral accretion. Relationships between calcium intake and growth were largely accounted for by breast-milk intake, suggesting that low calcium intake per se was not the limiting factor in the poor growth. These findings have potential implications for deriving calcium requirements in developing countries. © 2012 Macmillan Publishers Limited All rights reserved.


Sawo Y.,MRC Keneba | Jarjou L.M.A.,MRC Keneba | Goldberg G.R.,MRC Keneba | Goldberg G.R.,MRC Human Nutrition Research | And 3 more authors.
European Journal of Clinical Nutrition | Year: 2013

Background/Objectives: Previous studies in Gambian women with a low calcium intake have described decreases in whole-body and regional bone mineral content (BMC) and areal bone mineral density (aBMD) during the first year of lactation. The aim of this study was to examine whether these effects are reversed after lactation. Subjects/Methods: Thirty-three Gambian women who had a previous dual-energy X-ray absorptiometry (DXA) scan at 52 weeks lactation (L52) were invited to participate in a follow-up study when neither pregnant nor lactating (NPNL) for ≥3 months and/or when 52 weeks postpartum in a subsequent lactation (F52). Whole body, lumbar spine and hip bone mineral were measured by DXA. Anthropometry and dietary assessments were also conducted. Repeated-measures analysis of covariance was used to determine differences from L52 at NPNL and F52. Results: Twenty-eight women were scanned at NPNL and 20 at F52. The mean±s.d. calcium intake of the 33 women at NPNL and F52 was 360±168 mg/day. BMC, aBMD and size-adjusted BMC (SA-BMC) at all sites were higher at NPNL than L52. Percent increases in SA-BMC (mean±s.e.m.) were significant (P<0.0001): whole body=2.7±0.4%; lumbar spine=4.9±1.0%; total hip=3.7±1.0%. There were no significant differences in any measurements between the two lactation time points (L52 and F52). Conclusions: This study of Gambian women with low calcium intakes demonstrates that bone mineral mobilised during lactation is recovered after lactation. Successive periods of long lactation are not associated with progressive skeletal depletion. Copyright © 2013 Macmillan Publishers Limited.

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