Risk Factors for Preterm Birth among HIV-Infected Tanzanian Women: A Prospective Study

Premature delivery, a significant cause of child mortality and morbidity worldwide, is particularly prevalent in the developing world. As HIV is highly prevalent in much of sub-Saharan Africa, it is important to determine risk factors for prematurity among HIV-positive pregnancies. The aims of this study were to identify risk factors of preterm (<37 weeks) and very preterm (<34 weeks) birth among a cohort of 927 HIV positive women living in Dar es Salaam, Tanzania, who enrolled in the Tanzania Vitamin and HIV Infection Trial between 1995 and 1997. Multivariable relative risk regression models were used to determine the association of potential maternal risk factors with premature and very premature delivery. High rates of preterm (24%) and very preterm birth (9%) were found. Risk factors (adjusted RR (95% CI)) for preterm birth were mother <20 years (1.46 (1.10, 1.95)), maternal illiteracy (1.54 (1.10, 2.16)), malaria (1.42 (1.11, 1.81)), Entamoeba coli (1.49 (1.04, 2.15)), no or low pregnancy weight gain, and HIV disease stage ≥2 (1.41 (1.12, 1.50)). Interventions to reduce pregnancies in women under 20, prevent and treat malaria, reduce Entamoeba coli infection, and promote weight gain in pregnant women may have a protective effect on prematurity

Source-specific pollution exposure and associations with pulmonary response in the Atlanta Commuters Exposure Studies

Concentrations of traffic-related air pollutants are frequently higher within commuting vehicles than in ambient air. Pollutants found within vehicles may include those generated by tailpipe exhaust, brake wear, and road dust sources, as well as pollutants from in-cabin sources. Sourcespecific pollution, compared to total pollution, may represent regulation targets that can better protect human health. We estimated source-specific pollution exposures and corresponding pulmonary response in a panel study of commuters. We used constrained positive matrix factorization to estimate source-specific pollution factors and, subsequently, mixed effects models to estimate associations between source-specific pollution and pulmonary response. We identified four pollution factors that we named: crustal, primary tailpipe traffic, non-tailpipe traffic, and secondary. Among asthmatic subjects (N=48), interquartile range increases in crustal and secondary pollution were associated with changes in lung function of −1.33% (95% confidence interval (CI): −2.45, −0.22) and −2.19% (95% CI: −3.46, −0.92) relative to baseline, respectively. Among non-asthmatic subjects (N=51), non-tailpipe pollution was associated with pulmonary response only at 2.5 hours post-commute. We found no significant associations between pulmonary response and primary tailpipe pollution. Health effects associated with traffic-related pollution may vary by source, and therefore some traffic pollution sources may require targeted interventions to protect healt

VALIDATION OF NOVEL TECHNIQUES TO EVALUATE NUTRITIONAL STATUS IN ADULT FEMALES IN RURAL, HIGHLAND ETHIOPIA

163 pagesAddressing malnutrition in Ethiopia is complex because the prevalence of underweight persists as overweight/obesity increases. A limitation in understanding and addressing malnutrition in adults is that body mass index (BMI) is frequently the only measure of nutritional status. Therefore, researchers need tools to assess body composition, measure physical activity, and understand the functional significance of malnutrition. However, a significant limitation to using these tools is that they have not been validated in many low- and middle-income settings. This research evaluated existing bioelectrical impedance analysis (BIA) and skinfold thickness (SFT) prediction equations that calculated fat mass (FM), fat-free mass (FFM), and percent body fat using air displacement plethysmography (ADP). The study participants consisted of 125 females and 129 males residing in Jimma City, Ethiopia. The second aim evaluated the Global Physical Activity Questionnaire (GPAQ) and a 24-hour recall of time use and perceived exertion in measuring the proportion of time spent at moderate and vigorous physical activity (MVPA) using accelerometry. The third aim evaluated the sit-to-stand test (STS), usual gait speed (UGS), and activities of daily living (ADLs) questionnaire as measures of physical function for feasibility, reliability, and validity. The second and third aims took place in rural Tigray, Ethiopia. The study population consisted of females between 18 and 45 years. One existing BIA prediction equation was validated for adult males. No BIA prediction equations were valid for females, and no SFT prediction equations were valid for males or females. New equations were created. The GPAQ was found to have low validity. The 24-hour recall had a fair agreement with accelerometry. The agreement improved by controlling for BMI. STS was a feasible, reliable, and valid measure of physical function. UGS lacked feasibility and reliability. The validity of the ADL questionnaires was inconclusive. This research will provide researchers with better tools to understand and address malnutrition in rural highland Ethiopia. The body composition equations will improve the identification of people who are malnourished. Quantifying physical activity and assessing physical function will enable researchers to understand the causes and consequences of malnutrition, guiding effective interventions to address malnutrition.2024-06-0

Feasibility, reliability, and validity of physical function tests and IADL survey questions in women living in rural, highland Ethiopia.

Physical function is the physical ability to fulfill one's daily roles and responsibilities. Poor physical function is detrimental to health and income-generating activities. Unfortunately, there is a lack of validated methods to measure physical function in adult women in low- and middle-income countries, including Ethiopia, the locus of this study. This study evaluated the feasibility, reliability, and validity of physical tests, including the sit-to-stand (STS) and usual gait speed (UGS) and a context-appropriate instrumental activities of daily living (IADL) survey. The results of the STS were used to calculate a muscle quality index (MQI, STS accounting for body mass and leg length). Feasibility was ascertained qualitatively based on reports from the enumerators on their ability to administer the tests. Reliability was assessed by comparing the results of the tests and questions between each visit using either Cohen's κ or Pearson's ρ. The validity of MQI was assessed using relevant participant characteristics such as age and self-reported disability. The validity of the IADL was assessed using MQI. Study participants comprised 316 women between the ages of 18 and 45 years, living in rural Tigray, Ethiopia, who had previously participated in an impact evaluation of a safety net program. Over a one-week period, participants completed the STS and UGS tests and responded to the IADL survey questions three times. MQI was determined to be a feasible, reliable, and valid physical function test for women in rural, highland Ethiopia. UGS lacked feasibility and reliability; validity was not ascertained. The IADL questions were feasible and reliable, but validity was inconclusive. In rural Ethiopia, the MQI will be a valuable tool to develop interventions for improving physical function, which will have positive impacts on health and quality of life

Changes in child undernutrition in Ethiopia (2000-2016)

PRIFPRI4; 2 Promoting Healthy Diets and Nutrition for allDSGD; PHN

Development and validation of skinfold-thickness equations for predicting body fatness in Ethiopian adults

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Symbiotic status alters fungal eco‐evolutionary offspring trajectories

International audienc