348 research outputs found
Does Age Affect the Response to Zinc Therapy for Diarrhoea in Bangladeshi Infants?
The benefit of zinc for the treatment of diarrhoea in a cluster-randomized trial of children, aged 3–59 months, living in rural Bangladesh was previously reported. Here, the benefits of zinc stratified by age—3–5 months, 6–11 months, and 12–59 months—are reported. Although the sample sizes in the stratified groups were too small to detect statistical significance in the 3–5-month and 6–11-month age-groups, the trends suggest that there may be a benefit of zinc for the treatment of diarrhoea on the duration of diarrhoea and on subsequent morbidity and mortality. Additional research is needed to better understand the effect of zinc for the treatment of diarrhoea among infants aged less than six months
Early-life Determinants of Stunted Adolescent Girls and Boys in Matlab, Bangladesh
This paper presents the results of a longitudinal study, conducted in Matlab, Bangladesh, that examined to what extent the level of stunting in adolescence can be predicted by nutritional status in early childhood and maternal height. A linked set of data collected from the same individuals at two moments in time, i.e. early childhood (1988–1989) and adolescence (2001), was analyzed. The study found that the odds of being stunted in adolescence could be explained by the combined effect of being stunted in childhood and having a mother whose height was less than 145 cm. Also, girls were more likely than boys to be stunted in childhood, whereas boys were more likely than girls to be stunted in adolescence. The latter is probably attributable to differences in the pace of maturation. In terms of policy and (reproductive health) programmes, it is important to recall that adolescent girls whose height and weight were subnormal (weight <45 kg and height <145 cm) might run an obstetric risk. Following these cut-off points, 83% and 23% of 16-year-old girls in this study would face obstetric risk, respectively, for weight and height if they marry and become pregnant soon
Recommended from our members
The effect of intrapartum antibiotics on early-onset neonatal sepsis in Dhaka, Bangladesh: a propensity score matched analysis
Background: We estimate the effect of antibiotics given in the intrapartum period on early-onset neonatal sepsis in Dhaka, Bangladesh using propensity score techniques. Methods: We followed 600 mother-newborn pairs as part of a cohort study at a maternity center in Dhaka. Some pregnant women received one dose of intravenous antibiotics during labor based on clinician discretion. Newborns were followed over the first seven days of life for early-onset neonatal sepsis defined by a modified version of the World Health Organization Young Infants Integrated Management of Childhood Illnesses criteria. Using propensity scores we matched women who received antibiotics with similar women who did not. A final logistic regression model predicting sepsis was run in the matched sample controlling for additional potential confounders. Results: Of the 600 mother-newborn pairs, 48 mothers (8.0%) received antibiotics during the intrapartum period. Seventy-seven newborns (12.8%) were classified with early-onset neonatal sepsis. Antibiotics appeared to be protective (odds ratio 0.381, 95% confidence interval 0.115–1.258), however this was not statistically significant. The results were similar after adjusting for prematurity, wealth status, and maternal colonization status (odds ratio 0.361, 95% confidence interval 0.106–1.225). Conclusions: Antibiotics administered during the intrapartum period may reduce the risk of early-onset neonatal sepsis in high neonatal mortality settings like Dhaka
Vitamin D Status of Infants in Northeastern Rural Bangladesh: Preliminary Observations and a Review of Potential Determinants
Vitamin D deficiency is a global public-health concern, even in tropical regions where the risk of deficiency was previously assumed to be low due to cutaneous vitamin D synthesis stimulated by exposure to sun. Poor vitamin D status, indicated by low serum concentrations of 25-hydroxyvitamin D [25(OH)D], has been observed in South Asian populations. However, limited information is available on the vitamin D status of young infants in this region. Therefore, to gain preliminary insights into the vitamin D status of infants in rural Bangladesh, 25(OH)D was assessed in a group of community-sampled control participants in a pneumonia case-control study in rural Sylhet, Bangladesh (25°N) during the winter dry season (January-February). Among 29 infants aged 1-6 months, the mean 25(OH)D was 36.7 nmol/L [95% confidence interval (CI) 30.2-43.2]. The proportion of infants with vitamin D deficiency defined by 25(OH)D <25 nmol/L was 28% (95% CI 10-45), 59% (95% CI 40-78) had 25(OH)D<40 nmol/L, and all were below 80 nmol/L. From one to six months, there was a positive correlation between age and 25(OH)D (Spearman=0.65; p=0.0001). Within a larger group of 74 infants and toddlers aged 1-17 months (cases and controls recruited for the pneumonia study), young age was the only significant risk factor for vitamin D deficiency [25(OH)D <25 nmol/L]. Since conservative maternal clothing practices (i.e. veiling) and low frequency of intake of foods from animal source (other than fish) were common among the mothers of the participants, determinants of low maternal-infant 25(OH)D in Bangladesh deserve more detailed consideration in future studies. In conclusion, the vitamin D status in young infants in rural Sylhet, Bangladesh, was poorer than might be expected based on geographic considerations. The causes and consequences of low 25(OH)D in infancy and early childhood in this setting remain to be established
Birth Preparedness and Complication Readiness among Slum Women in Indore City, India
Three hundred twelve mothers of infants aged 2-4 months in 11 slums of Indore, India, were interviewed to assess birth preparedness and complication readiness (BPACR) among them. The mothers were asked whether they followed the desired four steps while pregnant: identified a trained birth attendant, identified a health facility, arranged for transport, and saved money for emergency. Taking at least three steps was considered being well-prepared. Taking two or less steps was considered being less-prepared. One hundred forty-nine mothers (47.8%) were well-prepared. Factors associated with well-preparedness were assessed using adjusted multivariate models. Factors associated with well-preparedness were maternal literacy [odds ratio (OR)=1.9, (95%) confidence interval (CI) 1.1-3.4] and availing of antenatal services (OR=1.7, CI 1.05-2.8). Deliveries in the slum-home were high (56.4%). Among these, skilled attendance was low (7.4%); 77.3% of them were assisted by traditional birth attendants. Skilled attendance during delivery was three times higher in well-prepared mothers compared to less-prepared mothers (OR: 3.0, CI 1.6-5.4) Antenatal outreach sessions can be used for promoting BPACR. It will be important to increase the competency of slum-based traditional birth attendants, along with promoting institutional deliveries
Neonatal mortality within 24 hours of birth in six low- and lower-middle-income countries
OBJECTIVE: To assess the rates, timing and causes of neonatal deaths and the burden of stillbirths in rural Uttar Pradesh, India. We discuss the implications of our findings for neonatal interventions.
METHODS: We used verbal autopsy interviews to investigate 1048 neonatal deaths and stillbirths.
FINDINGS: There were 430 stillbirths reported, comprising 41% of all deaths in the sample. Of the 618 live births, 32% deaths were on the day of birth, 50% occurred during the first 3 days of life and 71% were during the first week. The primary causes of death on the first day of life (i.e. day 0) were birth asphyxia or injury (31%) and preterm birth (26%). During days 1–6, the most frequent causes of death were preterm birth (30%) and sepsis or pneumonia (25%). Half of all deaths caused by sepsis or pneumonia occurred during the first week of life. The proportion of deaths attributed to sepsis or pneumonia increased to 45% and 36% during days 7–13 and 14–27, respectively.
CONCLUSION: Stillbirths and deaths on the day of birth represent a large proportion of perinatal and neonatal deaths, highlighting an urgent need to improve coverage with skilled birth attendants and to ensure access to emergency obstetric care. Health interventions to improve essential neonatal care and care-seeking behavior are also needed, particularly for preterm neonates in the early postnatal period
Does Age Affect the Response to Zinc Therapy for Diarrhoea in Bangladeshi Infants?
The benefit of zinc for the treatment of diarrhoea in a
cluster-randomized trial of children, aged 3-59 months, living in rural
Bangladesh was previously reported. Here, the benefits of zinc
stratified by age-3-5 months, 6-11 months, and 12-59 months-are
reported. Although the sample sizes in the stratified groups were too
small to detect statistical significance in the 3-5-month and
6-11-month age-groups, the trends suggest that there may be a benefit
of zinc for the treatment of diarrhoea on the duration of diarrhoea and
on subsequent morbidity and mortality. Additional research is needed to
better understand the effect of zinc for the treatment of diarrhoea
among infants aged less than six months
Early-life Determinants of Stunted Adolescent Girls and Boys in Matlab, Bangladesh
This paper presents the results of a longitudinal study, conducted in
Matlab, Bangladesh, that examined to what extent the level of stunting
in adolescence can be predicted by nutritional status in early
childhood and maternal height. A linked set of data collected from the
same individuals at two moments in time, i.e. early childhood
(1988-1989) and adolescence (2001), was analyzed. The study found that
the odds of being stunted in adolescence could be explained by the
combined effect of being stunted in childhood and having a mother whose
height was less than 145 cm. Also, girls were more likely than boys to
be stunted in childhood, whereas boys were more likely than girls to be
stunted in adolescence. The latter is probably attributable to
differences in the pace of maturation. In terms of policy and
(reproductive health) programmes, it is important to recall that
adolescent girls whose height and weight were subnormal (weight <45
kg and height <145 cm) might run an obstetric risk. Following these
cut-off points, 83% and 23% of 16-year-old girls in this study would
face obstetric risk, respectively, for weight and height if they marry
and become pregnant soon
- …