Can anthropometry measure gender discrimination? An analysis using WHO standards to assess the growth of Bangladeshi children

Abstract Objective To examine the potential of anthropometry as a tool to measure gender discrimination, with particular attention to the WHO growth standards. Design Surveillance data collected from 1990 to 1999 were analysed. Height-for-age Z-scores were calculated using three norms: the WHO standards, the 1978 National Center for Health Statistics (NCHS) reference and the 1990 British growth reference (UK90). Setting Bangladesh. Subjects Boys and girls aged 6-59 months (n 504 358). Results The three sets of growth curves provided conflicting pictures of the relative growth of girls and boys by age and over time. Conclusions on sex differences in growth depended also on the method used to analyse the curves, be it according to the shape or the relative position of the sex-specific curves. The shapes of the WHO-generated curves uniquely implied that Bangladeshi girls faltered faster or caught up slower than boys throughout their pre-school years, a finding consistent with the literature. In contrast, analysis of the relative position of the curves suggested that girls had higher WHO Z-scores than boys below 24 months of age. Conclusion Further research is needed to help establish whether and how the WHO international standards can measure gender discrimination in practice, which continues to be a serious problem in many parts of the worl

Adherence and acceptability of community-based distribution of micronutrient powders in Southern Mali.

Home fortification with micronutrient powders (MNP) has been shown to reduce anaemia, with high overall acceptability and adherence, but there is limited evidence from West Africa. Around 80% of children younger than 5 years are anaemic in Mali, and new interventions are needed. This paper reports on the adherence and acceptability of a community-led MNP intervention targeting children aged 6-59 months in Southern Mali. The MNP were delivered by a multidisciplinary group of community volunteers using community-based preschools, cooking demonstrations, and traditional communication networks to promote MNP, nutrition, hygiene, and child stimulation. The MNP were delivered alongside early childhood development interventions and seasonal malaria chemoprevention. Adherence and acceptability were evaluated through two cross-sectional surveys in 2014 and 2016 and a qualitative evaluation in 2015. Over 80% of parents reported ever having given MNP to their child, with 65% having given MNP for four or more days in the last week. Likely contributors to uptake include: perceived positive changes in the children following MNP use, the selection of a food vehicle that was already commonly given to children (morning porridge or bouillie) and the community driven, decentralized and integrated delivery approach. These findings support recommendations from recent reviews of MNP implementation to use community-based delivery approaches and behaviour change components

Learner Treatment Kit (school-based malaria diagnosis and treatment in southern Malawi): Study data and support materials

A set of data collection tools, STATA .do processing scripts, and resultant datasets produced as part of the Learner Treatment Kit (LTK) Project, a study funded to evaluate the impact of a school-based programme of malaria diagnosis and treatment (malaria case management) as part of a wider school first-aid kit exploring school attendance, health and education outcomes. The study conducted a cluster randomized controlled trial in 58 primary schools in TA Chikowi, Zomba district of southern Malawi. The intervention, implemented between 2013-2015 in 29 randomly selected schools from the total of 58 schools, comprised providing free-of-charge malaria rapid diagnostic tests (RDTs) and artemisinin-based combination therapy (ACT) to primary schools to be used by trained teachers to diagnose and treat uncomplicated malaria, as part of basic first aid kits known as "Learner Treatment Kits" (LTKs). The primary outcome was school attendance, assessed through teacher-recorded school attendance registers and periodic spot checks. Secondary outcomes included prevalence of Plasmodium spp. infection, anaemia, educational performance, self-reported child wellbeing, and health seeking behaviour. The trial is registered with ClinicalTrials.gov, NCT02213211

Learner Treatment Kit (school-based malaria diagnosis and treatment in southern Malawi): Study data and support materials

A set of data collection tools, STATA .do processing scripts, and resultant datasets produced as part of the Learner Treatment Kit (LTK) Project, a study funded to evaluate the impact of a school-based programme of malaria diagnosis and treatment (malaria case management) as part of a wider school first-aid kit exploring school attendance, health and education outcomes. The study conducted a cluster randomized controlled trial in 58 primary schools in TA Chikowi, Zomba district of southern Malawi. The intervention, implemented between 2013-2015 in 29 randomly selected schools from the total of 58 schools, comprised providing free-of-charge malaria rapid diagnostic tests (RDTs) and artemisinin-based combination therapy (ACT) to primary schools to be used by trained teachers to diagnose and treat uncomplicated malaria, as part of basic first aid kits known as "Learner Treatment Kits" (LTKs). The primary outcome was school attendance, assessed through teacher-recorded school attendance registers and periodic spot checks. Secondary outcomes included prevalence of Plasmodium spp. infection, anaemia, educational performance, self-reported child wellbeing, and health seeking behaviour. The trial is registered with ClinicalTrials.gov, NCT02213211

Impact of school-based malaria case management on school attendance, health and education outcomes: a cluster randomised trial in southern Malawi.

Introduction: Evidence indicates children who suffer from ill-health are less likely to attend or complete schooling. Malaria is an important cause of morbidity and mortality in school-age children. However, they are less likely to receive malaria treatment at health facilities and evidence for how to improve schoolchildren's access to care is limited. This study aimed to evaluate the impact of a programme of school-based malaria case management on schoolchildren's attendance, health and education. Methods: A cluster randomised controlled trial was conducted in 58 primary schools in Zomba District, Malawi, 2011-2015. The intervention, implemented in 29 randomly selected schools, provided malaria rapid diagnostic tests and artemisinin-based combination therapy to diagnose and treat uncomplicated malaria as part of basic first aid kits known as 'Learner Treatment Kits' (LTK). The primary outcome was school attendance, assessed through teacher-recorded daily attendance registers and independent periodic attendance spot checks. Secondary outcomes included prevalence of Plasmodium spp infection, anaemia, educational performance, self-reported child well-being and health-seeking behaviour. A total of 9571 children from standards 1-7 were randomly selected for assessment of school attendance, with subsamples assessed for the secondary outcomes. Results: Between November 2013 and March 2015, 97 trained teachers in 29 schools provided 32 685 unique consultations. Female schoolchildren were significantly more likely than male to seek a consultation (unadjusted OR=1.78 (95% CI 1.58 to 2.00). No significant intervention effect was observed on the proportion of child-days recorded as absent in teacher registers (n=9017 OR=0.90 (95% CI 0.77 to 1.05), p=0.173) or of children absent during random school visits-spot checks (n=5791 OR=1.09 (95% CI 0.87 to 1.36), p=0.474). There was no significant impact on child-reported well-being, prevalence of Plasmodium spp, anaemia or education scores. Conclusion: Despite high community demand, the LTK programme did not reduce schoolchildren's absenteeism or improve health or education outcomes in this study setting. Trial registration number: ClinicalTrials.gov NCT02213211

Metabolite profiling in retinoblastoma identifies novel clinicopathological subgroups

BACKGROUND: Tumour classification, based on histopathology or molecular pathology, is of value to predict tumour behaviour and to select appropriate treatment. In retinoblastoma, pathology information is not available at diagnosis and only exists for enucleated tumours. Alternative methods of tumour classification, using noninvasive techniques such as magnetic resonance spectroscopy, are urgently required to guide treatment decisions at the time of diagnosis. METHODS: High-resolution magic-angle spinning magnetic resonance spectroscopy (HR-MAS MRS) was undertaken on enucleated retinoblastomas. Principal component analysis and cluster analysis of the HR-MAS MRS data was used to identify tumour subgroups. Individual metabolite concentrations were determined and were correlated with histopathological risk factors for each group. RESULTS: Multivariate analysis identified three metabolic subgroups of retinoblastoma, with the most discriminatory metabolites being taurine, hypotaurine, total-choline and creatine. Metabolite concentrations correlated with specific histopathological features: taurine was correlated with differentiation, total-choline and phosphocholine with retrolaminar optic nerve invasion, and total lipids with necrosis. CONCLUSIONS: We have demonstrated that a metabolite-based classification of retinoblastoma can be obtained using ex vivo magnetic resonance spectroscopy, and that the subgroups identified correlate with histopathological features. This result justifies future studies to validate the clinical relevance of these subgroups and highlights the potential of in vivo MRS as a noninvasive diagnostic tool for retinoblastoma patient stratification

'The bigger the better'--mothers' social networks and child nutrition in Andhra Pradesh.

OBJECTIVE: It is hypothesised that mothers' social networks can positively affect child nutrition through the sharing of health knowledge and other resources. The present study describes the composition of mothers' networks, examines their association with child nutrition, and assesses whether health knowledge is shared within networks. DESIGN AND SETTING: Cross-sectional data for mothers of young children from Andhra Pradesh (south India) were combined with existing data from the Young Lives study, in which the mothers were participating (n = 282). RESULTS: The composition of social networks varied between urban and rural areas, with urban networks being larger, more female, more literate and with a greater proportion of members living outside the household and being non-family. There was a positive association between child's height-for-age Z-score and mother's network size and network literacy rate. The association with network literacy was stronger among the poorest households. Women commonly reported seeking or receiving health advice from network members. CONCLUSION: Big and literate social networks are associated with better child nutrition, especially among the poor. The dissemination of health knowledge between network members is a plausible way in which social networks benefit child nutrition in India. Further research into the underlying mechanisms is necessary to inform the development of interventions that channel health information through word of mouth to the most excluded and vulnerable families

Adult education and child nutrition in India and Vietnam : the role of family, neighbours and friends

EThOS - Electronic Theses Online ServiceGBUnited Kingdo