Evaluation of a community‐based early childhood caries (ECC) intervention in Cambodia

Objective: To critically evaluate an early childhood caries (ECC) intervention performed by non-dental primary healthcare providers. Methods: This mixed-methods investigation includes data from three sources: (a) a pilot non-randomized controlled trial to examine clinical outcomes at four health centres; (b) stakeholder focus group interviews; and (c) a survey of parents whose children were exposed to the intervention. The pilot study involved four Community Health Centres in rural Cambodia whereby mother-child (6-24 months of age)dyads received oral health education (OHE), toothbrushes, fluoride toothpaste and fluoride varnish on up to six occasions as part of the routine vaccination schedule. Outcomes were as follows: presence of ECC; impacts on oral health-related quality of life (OHRQoL); stakeholder perceptions of intervention delivery; and parental perceptions of fluoride varnish. Results: Participants in the intervention group had six times lower odds of developing ECC than those in the comparison group after controlling for socio-economic status (OR 0.13). Those in the intervention group also had a large reduction OHRQoL scale scores. Key knowledge and practice gaps were identified among stakeholders. Surveyed parents had favourable views of the fluoride varnish placement by medical professionals, and four out of five stated that they would recommend fluoride varnish for other children. Primary healthcare providers, commune council representatives and community health promoters supported oral health interventions being provided in CHCs. Conclusions: OHE and fluoride varnish interventions provided by non-dental primary health workers were feasible and acceptable for stakeholders in a Cambodian setting. The intervention group had lower ECC experience and better OHRQoL at 2 years of age

A qualitative assessment of barriers and facilitators to implementing recommended infant nutrition practices in Mumbai, India

Background: Childhood malnutrition has been a longstanding crisis in Mumbai, India. Despite national IYCF (Infant Young Child Feeding) guidelines to promote best practices for infant/toddler feeding, nearly one-third of children under age five are stunted or underweight. To improve child nutrition, interventions should address the cultural, social, and environmental influences on infant feeding practices. This study is an in-depth qualitative assessment of family barriers and facilitators to implementing recommended nutrition practices in two Mumbai slum communities, within the context of an existing nutrition education-based intervention by a local non-governmental non-profit organization. Methods: The population was purposively sampled to represent a variety of household demographics. Data were collected through 33 in-depth semi-structured interviews with caregivers (mothers and paternal grandmothers) of children age 0\u20132 years. Transcripts were translated and transcribed, and analyzed using qualitative analysis procedures and software. Results: A complex set of barriers and facilitators influence mothers\u2019/caregivers\u2019 infant-toddler feeding practices. Most infants were fed complementary foods and non-nutritious processed snacks, counter to IYCF recommendations. Key barriers included: lack of nutrition knowledge and experience, receiving conflicting messages from different sources, limited social support, and poor self-efficacy for maternal decision-making. Key facilitators included: professional nutrition guidance, personal self-efficacy and empowerment, and family support. Interventions to improve child nutrition should address mothers\u2019/caregivers\u2019 key barriers and facilitators to recommended infant-toddler feeding practices. Conclusions: Nutrition interventions should prioritize standard messaging across healthcare providers, engage all family members, target prevention of early introduction of sugary and non-nutritious processed foods, and strengthen maternal self-efficacy for following IYCF recommended guidelines

Obesity and Obesogenic Behaviors in Asian American Children with Immigrant and US-Born Mothers.

Child obesity is understudied in Asian Americans, which include a growing population of recent immigrants. We examined the relationship between maternal nativity and time in the US, and obesity and obesogenic behaviors among Asian American children. We analyzed public-use data from the 2013-2016 California Health Interview Survey for Asian American children ages 2 to 11 years. We used logistic regression to determine the odds of obesity and obesogenic behaviors associated with maternal nativity and time in the US. This study included n = 609 children. Children of US-born mothers had lower odds of obesity (adjusted odds ratio, AOR, 0.12; 95% CI 0.02 to 0.91) and lower fruit intake (AOR 0.15, 95% CI 0.03 to 0.81) than children of recent immigrants (< 5 years in the US). Asian American children with recent immigrant mothers are more likely to be obese and eat less fruit than children with US-born mothers. Efforts to prevent obesity and increase fruit consumption are particularly important for this vulnerable population of children of recent immigrants

Obesity and Obesogenic Behaviors in Asian American Children with Immigrant and US-Born Mothers

Child obesity is understudied in Asian Americans, which include a growing population of recent immigrants. We examined the relationship between maternal nativity and time in the US, and obesity and obesogenic behaviors among Asian American children. We analyzed public-use data from the 2013–2016 California Health Interview Survey for Asian American children ages 2 to 11 years. We used logistic regression to determine the odds of obesity and obesogenic behaviors associated with maternal nativity and time in the US. This study included n = 609 children. Children of US-born mothers had lower odds of obesity (adjusted odds ratio, AOR, 0.12; 95% CI 0.02 to 0.91) and lower fruit intake (AOR 0.15, 95% CI 0.03 to 0.81) than children of recent immigrants (< 5 years in the US). Asian American children with recent immigrant mothers are more likely to be obese and eat less fruit than children with US-born mothers. Efforts to prevent obesity and increase fruit consumption are particularly important for this vulnerable population of children of recent immigrants

Obesity and Obesogenic Behaviors in Asian American Children with Immigrant and US-Born Mothers.

Child obesity is understudied in Asian Americans, which include a growing population of recent immigrants. We examined the relationship between maternal nativity and time in the US, and obesity and obesogenic behaviors among Asian American children. We analyzed public-use data from the 2013-2016 California Health Interview Survey for Asian American children ages 2 to 11 years. We used logistic regression to determine the odds of obesity and obesogenic behaviors associated with maternal nativity and time in the US. This study included n = 609 children. Children of US-born mothers had lower odds of obesity (adjusted odds ratio, AOR, 0.12; 95% CI 0.02 to 0.91) and lower fruit intake (AOR 0.15, 95% CI 0.03 to 0.81) than children of recent immigrants (< 5 years in the US). Asian American children with recent immigrant mothers are more likely to be obese and eat less fruit than children with US-born mothers. Efforts to prevent obesity and increase fruit consumption are particularly important for this vulnerable population of children of recent immigrants

Association between satellite-detected tropospheric nitrogen dioxide and acute respiratory infections in children under age five in Senegal: spatio-temporal analysis.

BackgroundThere is growing evidence to suggest that exposure to a high concentration of nitrogen dioxide (NO2) can lead to a higher incidence of Acute Respiratory Infections (ARIs) in children; however, such an association remains understudied in Sub-Saharan Africa due to the limited availability of exposure data. This study explored this association by using the satellite-detected tropospheric NO2 concentrations measured by Sentinel-5 Precursor and ARI symptoms in children under age five collected in the Demographic and Health Survey (DHS) in Senegal.MethodsWe matched the daily tropospheric NO2 exposure with the individual ARI symptoms according to the DHS survey clusters spatially and temporally and conducted a logistic regression analysis to estimate the association of exposure to NO2 with ARI symptoms in two preceding weeks.ResultsWe observed a positive association between exposure to continuous levels of NO2 and ARI symptoms after adjusting for confounders (OR 1.27 per 10 mol/m2, 95% CI: 1.06 - 1.52). When the association was further examined by quartile exposure categories, the 4th quartile category was positively associated with symptoms of ARI after adjusting for confounders (OR 1.71, 95% CI: 1.08-2.69). This suggests that exposure to certain high levels of NO2 is associated with the increased risk of children having symptoms of ARI in Senegal.ConclusionsThis study highlights the need for increased research on the effects of ambient NO2 exposure in Africa as well as the need for more robust, ground-based air monitoring in the region. For a country like Senegal, where more than 90% of the population lives in areas that do not meet the national air quality standards, it is urgently required to implement air pollution prevention efforts to protect children from the health hazards of air pollution

Early childhood caries and malnutrition: baseline and two-year follow-up results of a community-based prevention intervention in Rural Ecuador

BACKGROUND: The global “nutrition transition” has increased children’s consumption of sugary snacks and beverages (junk food), compounding their risk for poor oral health and malnutrition. The purpose of this study was to examine the relationship between early childhood caries (ECC) and malnutrition in a community context. METHODS: This is a baseline and two-year follow-up analysis of a community-based preventive oral health and nutrition intervention for 1,575 children, from birth through age six, in an indigenous population in rural Ecuador. Trained community volunteers, preschool teachers and dentists provided children and families with nutrition and oral health education, toothbrushes and fluoride toothpaste, fluoride varnish, and referral for dental treatment, three times per year. Annual data collection included mother interviews, child dental examinations and measurements of height and weight. Descriptive and bivariate analyses were completed in SPSS. RESULTS: At baseline, nearly half of children consumed junk food daily. ECC began in infancy, increasing steadily thereafter. Among one-year-olds, 53.8% had caries with a mean of 2.1 decayed teeth; and among six-year-olds, 98.6% had caries with a mean of 10.5 decayed teeth, and half experienced mouth pain. At two-year follow-up, reported junk food consumption was cut in half; and the prevalence and severity of caries and mouth pain were reduced. Children who entered the intervention in their first year of life experienced the greatest dental improvements. Children who entered in their first two years and attended the entire two-year intervention experienced a one-third reduction in stunting malnutrition, with greatest improvement among those whose caries increment was controlled. CONCLUSIONS: ECC and caries-related malnutrition were reduced for children who participated in this prevention-oriented community oral health and nutrition intervention, especially those beginning in the first two years of life. Oral health and nutrition promotion should be incorporated into all maternal-child health programs, from pregnancy and birth onward

Maintaining Traditions: A Qualitative Study of Early Childhood Caries Risk and Protective Factors in an Indigenous Community

In lower middle-income economies (LMIE), the nutrition transition from traditional diets to sugary foods and beverages has contributed to widespread early childhood dental caries. This qualitative study explores perceived risk and protective factors, and overall experiences of early childhood nutrition and oral health in indigenous Ecuadorian families participating in a community-based oral health and nutrition intervention. Dental exams of 698 children age 6 months through 6 years determined each child’s caries burden. A convenience sample of 18 “outlier” families was identified: low-caries children with ≤2 carious teeth vs. high-caries children with ≥10 carious teeth. Semi-structured in-depth interviews with parents/caregivers explored the child’s diet, dental habits, and family factors related to nutrition and oral health. Interviews were transcribed and thematically analyzed using grounded theory. In the high-caries families, proximity to highway and stores, consumption of processed-food, and low parental monitoring of child behavior were identified as risk factors for ECC (early childhood caries). In the low-caries families, protective factors included harvesting and consuming food from the family farm, remote geography, and greater parental monitoring of child behavior. The study results suggest that maintaining traditional family farms and authoritative parenting to avoid processed foods/drinks and ensure tooth brushing could improve early childhood nutrition and oral health

Communityâ based assessment and intervention for early childhood caries in rural El Salvador

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/133584/1/idj12228.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/133584/2/idj12228_am.pd