Send Orders for Reprints to [email protected] Childhood Cancer in the Republic of Suriname (1980 Through 2008)

Abstract: Childhood cancer incidence in Suriname (South-America) was estimated using secondary data from 1980 to 2008, and these findings were stratified according to gender; age groups < 1, 1-4, 5-14, and 15-19 years; and the largest ethnic groups (Hindustanis, Maroons, Creoles, and Javanese). Data were expressed as total numbers, proportions, average yearly numbers, and/or crude incidence rates per 1,000,000 population per year. There were 290 malignancies in the period covered, i.e., about 10 new cases per year or 24 per 1,000,000 per year. The average yearly number of overall cancer increased from approximately 1 every two years in newborns to 3-4 per year in adolescents and young adults. Thirty to 35% of patients were Hindustani or Creole; the proportions of Javanese and Maroons patients were about twice and five times, respectively, lower. Leukemias and lymphomas comprised almost half of cases, each occurring 2 to 3 times per year. Bone tumors, soft-tissue sarcomas, and carcinomas were the most common non-hematological malignancies, occurring once or twice per year. Central nervous system tumors, neuroblastoma, retinoblastoma, renal tumors, primary hepatic tumors, and germ cell tumors were exceedingly rare. In conclusion, childhood cancer incidence in Suriname was relatively low; the individual histiotypes displayed an unusual ranking; and there were differences in the sex, age, and ethnic distribution of overall cancer as well as certain histiotypes. However, these observations might be biased by the use of crude rates, and underdiagnosis and incomplete registration of cases due to the absence of specialized (pediatric) cancer facilities in the country

Adaptation of glucose metabolism to fasting in young children with infectious diseases: a perspective

Hypoglycemia is a frequently encountered complication in young children with infectious diseases and may result in permanent neurological damage or even death. Mortality rate in young children under 5 years of age is increased four- to six-fold when severe infectious disease is complicated by hypoglycemia. Young age, prolonged fasting and severity of disease are considered important risk factors. This perspective describes the combined results of recently conducted studies on the effect of these risk factors on glucose metabolism in children with different infectious diseases. The results of these studies have nutritional implications for the approach in clinical practice towards young children with infectious diseases and specific recommendations are made. A unique finding is the existence of infectious disease-related differences in the adaptation of glucose metabolism during fasting in young childre

Fasting Predisposes to Hypoglycemia in Surinamese Children with Severe Pneumonia, and Young Children are More at Risk

The objective of this study was to investigate glucose kinetics during controlled fasting in children with severe pneumonia. Plasma glucose concentration, endogenous glucose production and gluconeogenesis were measured in 12 Surinamese children (six young: 1-3 years, six older: 3-5 years) with severe pneumonia during a controlled 16 h fast using stable isotopes [6,6-H-2(2)]glucose and (H2O)-H-2 at a hospital-based research facility. On admission, the glucose concentrations were comparable in both groups: young children: 5.1 +/- 1.3 mmol/l, older children: 4.8 +/- 0.6 mmol/l, p = 0.685, with a decrease during the first 8 h of fasting in the young children only to 3.6 +/- 0.5, p = 0.04. Glucose production was comparable in both groups: young: 24.5 +/- 8.3, older: 24.9 +/- 5.9 mu mol/kg(center dot)min, p = 0.926. Between 8 and 16 h of fasting, the glucose concentration decreased comparably in both groups (young: - 0.9 +/- 0.7, p = 0.004; older: -1.0 +/- 0.4 mmol/l, p = 0.001), as did glucose production (young: -6.8 +/- 6.3, p = 0.003; older: -5.3 +/- 3.4 mu mol/kg(center dot)min, p = 0.001). Gluconeogenesis decreased in young children only: -5.0 +/- 7.4, p = 0.029. We conclude that fasting predisposes to hypoglycemia in children with severe pneumonia. Young children are more at risk than older children. Glucose production is an important determinant of the plasma glucose concentration in young children with pneumonia, indicating an inability to reduce glucose usage. Our results are largely in agreement with the literature on the adaptation of glucose metabolism in children with malaria, although there seem to be disease-specific differences in the regulation of gluconeogenesi

The Single and Combined Effects of Prenatal Nonchemical Stressors and Lead Exposure on Neurodevelopmental Outcomes in Toddlers: Results from the CCREOH Environmental Epidemiologic Study in Suriname

The primary aim of this prospective study was to examine the single and combined effect of prenatal exposure to perceived stress, probable depression, and lead on toddlers’ neurodevelopment using the Bayley Scales of Infant and Toddler Development, third edition. Data from 363 mother-toddler pairs enrolled in the Caribbean Consortium for Research in Environmental and Occupational Health prospective cohort study were analyzed. A prenatal lead exposure of ≥3.5 µg/dL was associated with significantly lower receptive (p = 0.008) and expressive (p = 0.006) communication scaled scores. Moderate and severe maternal prenatal probable depression scores were associated with significantly lower fine (p = 0.009) and gross (p = 0.009) motor scaled scores. However, a maternal report of prenatal stress was not associated with neurodevelopmental outcomes. After adjusting for maternal demographics, prenatal stress and lead exposure, prenatal probable depression remained predictive of the toddlers’ gross motor scaled scores (β −0.13, 95% CI [−0.24–−0.02]). Similarly, when adjusting for demographics, prenatal stress and probable depression, prenatal lead exposure remained a significant predictor of their receptive communication scaled scores (β −0.26, 95% CI [−0.49–−0.02]). An analysis testing combined exposure to perceived stress, probable depression, and lead exposure, measured using a cumulative risk index, significantly predicted the child fine motor scaled scores after adjusting for other covariates (β −0.74, 95% CI: [−1.41–−0.01])

The Single and Combined Effects of Prenatal Nonchemical Stressors and Lead Exposure on Neurodevelopmental Outcomes in Toddlers: Results from the CCREOH Environmental Epidemiologic Study in Suriname

The primary aim of this prospective study was to examine the single and combined effect of prenatal exposure to perceived stress, probable depression, and lead on toddlers’ neurodevelopment using the Bayley Scales of Infant and Toddler Development, third edition. Data from 363 mother-toddler pairs enrolled in the Caribbean Consortium for Research in Environmental and Occupational Health prospective cohort study were analyzed. A prenatal lead exposure of ≥3.5 µg/dL was associated with significantly lower receptive (p = 0.008) and expressive (p = 0.006) communication scaled scores. Moderate and severe maternal prenatal probable depression scores were associated with significantly lower fine (p = 0.009) and gross (p = 0.009) motor scaled scores. However, a maternal report of prenatal stress was not associated with neurodevelopmental outcomes. After adjusting for maternal demographics, prenatal stress and lead exposure, prenatal probable depression remained predictive of the toddlers’ gross motor scaled scores (β −0.13, 95% CI [−0.24–−0.02]). Similarly, when adjusting for demographics, prenatal stress and probable depression, prenatal lead exposure remained a significant predictor of their receptive communication scaled scores (β −0.26, 95% CI [−0.49–−0.02]). An analysis testing combined exposure to perceived stress, probable depression, and lead exposure, measured using a cumulative risk index, significantly predicted the child fine motor scaled scores after adjusting for other covariates (β −0.74, 95% CI: [−1.41–−0.01])

Influence of prenatal exposure to mercury, perceived stress, and depression on birth outcomes in suriname: Results from the mekitamara study

Prenatal exposure to mercury, stress, and depression may have adverse effects on birth outcomes. Little is known on the influence of chemical and non-chemical stressors on birth outcomes in the country of Suriname. We assessed the influence of prenatal exposure to mercury, perceived stress, and depression on adverse birth outcomes in 1143 pregnant Surinamese women who participated in the Caribbean Consortium for Research in Environmental and Occupational Health-MeKiTamara prospective cohort study. Associations between mercury (≥1.1 µg/g hair, USEPA action level/top versus bottom quartile), probable depression (Edinburgh Depression Scale ≥12), high perceived stress (Cohen’s Perceived Stress Scale ≥20), and adverse birth outcomes (low birthweight (<2500 g), preterm birth (<37 completed weeks of gestation), and low Apgar score (<7 at 5 min)) were assessed using bivariate and multivariate logistic regressions. Prevalence of elevated mercury levels, high perceived stress, and probable depression were 37.5%, 27.2%, and 22.4%, respectively. Mercury exposure was significantly associated with preterm birth in the overall study cohort (OR 2.47; 95% CI 1.05–5.83) and perceived stress with a low Apgar score (OR 9.73; 95% CI 2.03–46.70). Depression was not associated with any birth outcomes. These findings can inform policy-and practice-oriented solutions to improve maternal and child health in Suriname

Sociodemographic Influences on Perceived Stress during Pregnancy: Results from the CCREOH Environmental Epidemiologic Study, Suriname

Screening for prenatal stress is not routine in Suriname, despite its significant impact on maternal and newborn health. This study assessed the prevalence of high perceived prenatal stress and its sociodemographic predictors in three geographic areas in Suriname. In this cross-sectional study, data from 1190 participants of the Caribbean Consortium for Research in Environmental and Occupational Health cohort study were analyzed. Cohen&rsquo;s Perceived Stress Scale was completed during pregnancy to ascertain high perceived stress (cut-off score 20). The association between maternal sociodemographic factors and high perceived stress was examined using the chi-square test and logistic regression models; 27.5% of all participants had high perceived stress with statistically significant lower rates in Nickerie (18.8%) compared with Paramaribo (29.8%; p = 0.001) and the Interior (28.6%; p = 0.019). Maternal sociodemographic factors moderated the difference between the Interior and Nickerie. Participants from Paramaribo had statistically significant higher odds of high perceived stress compared to those from Nickerie, independent of their age and educational level (adjusted OR = 1.94; 95% confidence interval 1.32&ndash;2.86). Perceived stress during pregnancy is predicted by sociodemographic factors. These findings identified target groups for interventions in Suriname. Policy makers should consider integrating perceived stress assessment as a routine part of prenatal care