Suchergebnisse

OBJECTIVES: Evaluate infant young child feeding (IYCF) trends from 12 to 24 mo in four low middle-income countries: Democratic Republic of Congo (DRC); Guatemala; India; and Pakistan. METHODS: 2413 children (570 DRC, 614 Guatemala, 589 India, and 640 Pakistan) born to women from the Women First Trial enrolled. Trained research health workers visited households and assessed children's feeding practices from 12 to 24 mo. Child feeding indicators including the prevalence and longitudinal trends of meeting minimum diet diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) were analyzed using the 2018 IYCF definitions from 12 to 24 mo for all four sites individually and combined. RESULTS: MDD significantly increased from 16% at 12 mo to 29% at 24 mo for all sites combined (p < 0.001); by site: 3 to 10 for DRC (p < 0.001), 33 to 42 for Guatemala (p = 0.001), 28 to 63 for India (p < 0.001), and 1 to 2 for Pakistan (not significant). MMF significantly increased from 49% at 12 mo to 68% at 24 mo for all sites (p < 0.001); by site: 22 to 49 for DRC (p < 0.001), 89 to 92 for Guatemala (not significant), 66 to 73 for India (0.012), and 18 to 58 for Pakistan (p < 0.001). MAD significantly increased (p < 0.001) for all sites, and by site for DRC and India only. Food groups least consumed at 24 mo for all sites were nuts/pulses (prevalence 20%), meats/fish/insects (21%), and vitamin A rich fruits & vegetables (38%); compared to grains/roots/tubers which were consumed by 98% of participants. For all sites, milk & dairy and eggs consumption significantly increased from 50 to 60% (p < 0.001) and 26 to 50% (p < 0.001), respectively. Breastfeeding decreased from 94% at 12 mo to 49% at 24 mo for all sites with the lowest prevalence of breastfeeding in Pakistan (23%), whereas the other sites were ∼50%. CONCLUSIONS: For all sites, the prevalence of participants meeting IYCF recommendations for feeding indicators increased from 12 to 24 mo, but prevalence at 24 mo remained ...

Background: Up-to-date dietary data are required to understand the diverse nutritional challenges of pregnant women living in low-middle income countries (LMIC). To that end, dietary data were collected from 1st trimester pregnant women in rural areas of Guatemala, India, Pakistan, and Democratic Republic of the Congo (DRC) participating in a maternal lipid-based nutrient supplement (LNS) Randomized Controlled Trial to examine dietary diversity (DD), usual group energy and nutrient intakes, and prevalence of inadequate dietary intakes.Methods: Two 24-h dietary recalls were conducted in ~240 pregnant women/site (total n = 966) prior to 12-week gestation. Adequate DD was assessed, i.e., ≥5 major food groups consumed within the past 24 h. Median, Q1, Q3 intakes (without LNS) of energy, macronutrients, 12 micronutrients, and phytate were examined. The "at risk" prevalence of inadequate intakes were based on international guidelines for pregnant women.Results: Dietary patterns varied widely among sites, with adequate DD reported: 20% (Pakistan), 25% (DRC), 50% (Guatemala), and 70% (India). Significantly higher intakes of most key nutrients were observed in participants with adequate DD. More than 80% of women in all sites had inadequate intakes of folate, vitamin B12, and choline, and >80% of women in India and DRC also had inadequate intakes of calcium, thiamine, riboflavin, and vitamin B6.Conclusions: Our data highlight the likely need for micronutrient supplementation in pregnancy, specifically multi-micronutrient interventions, and support the value of increasing DD as part of sustainable long-term nutrition programs for women of reproductive age in these poor rural settings in LMIC.

Background: Up-to-date dietary data are required to understand the diverse nutritional challenges of pregnant women living in low-middle income countries (LMIC). To that end, dietary data were collected from 1st trimester pregnant women in rural areas of Guatemala, India, Pakistan, and Democratic Republic of the Congo (DRC) participating in a maternal lipid-based nutrient supplement (LNS) Randomized Controlled Trial to examine dietary diversity (DD), usual group energy and nutrient intakes, and prevalence of inadequate dietary intakes. Methods: Two 24-h dietary recalls were conducted in ~240 pregnant women/site (total n = 966) prior to 12-week gestation. Adequate DD was assessed, i.e., ≥5 major food groups consumed within the past 24 h. Median, Q1, Q3 intakes (without LNS) of energy, macronutrients, 12 micronutrients, and phytate were examined. The "at risk" prevalence of inadequate intakes were based on international guidelines for pregnant women. Results: Dietary patterns varied widely among sites, with adequate DD reported: 20% (Pakistan), 25% (DRC), 50% (Guatemala), and 70% (India). Significantly higher intakes of most key nutrients were observed in participants with adequate DD. More than 80% of women in all sites had inadequate intakes of folate, vitamin B12, and choline, and >80% of women in India and DRC also had inadequate intakes of calcium, thiamine, riboflavin, and vitamin B6. Conclusions: Our data highlight the likely need for micronutrient supplementation in pregnancy, specifically multi-micronutrient interventions, and support the value of increasing DD as part of sustainable long-term nutrition programs for women of reproductive age in these poor rural settings in LMIC.

BACKGROUND: To describe quantitative data quality monitoring and performance metrics adopted by the Global Network´s (GN) Maternal Newborn Health Registry (MNHR), a maternal and perinatal population-based registry (MPPBR) based in low and middle income countries (LMICs). METHODS: Ongoing prospective, population-based data on all pregnancy outcomes within defined geographical locations participating in the GN have been collected since 2008. Data quality metrics were defined and are implemented at the cluster, site and the central level to ensure data quality. Quantitative performance metrics are described for data collected between 2010 and 2013. RESULTS: Delivery outcome rates over 95% illustrate that all sites are successful in following patients from pregnancy through delivery. Examples of specific performance metric reports illustrate how both the metrics and reporting process are used to identify cluster-level and site-level quality issues and illustrate how those metrics track over time. Other summary reports (e.g. the increasing proportion of measured birth weight compared to estimated and missing birth weight) illustrate how a site has improved quality over time. CONCLUSION: High quality MPPBRs such as the MNHR provide key information on pregnancy outcomes to local and international health officials where civil registration systems are lacking. The MNHR has measures in place to monitor data collection procedures and improve the quality of data collected. Sites have increasingly achieved acceptable values of performance metrics over time, indicating improvements in data quality, but the quality control program must continue to evolve to optimize the use of the MNHR to assess the impact of community interventions in research protocols in pregnancy and perinatal health. ; Fil: Goudar, Shivaprasad S. KLE University. Jawaharlal Nehru Medical College; India ; Fil: Stolka, Kristen B. Research Triangle Institute International; Estados Unidos ; Fil: Koso Thomas, Marion. Eunice Kennedy Shriver National Institute of Child Health and Human Development; Estados Unidos ; Fil: Honnungar, Narayan V. KLE University. Jawaharlal Nehru Medical College; India ; Fil: Mastiholi, Shivanand C. KLE University. Jawaharlal Nehru Medical College; India ; Fil: Ramadurg, Umesh Y. S. Nijalingappa Medical College; India ; Fil: Dhaded, Sangappa M. KLE University. Jawaharlal Nehru Medical College; India ; Fil: Pasha, Omrana. Aga Khan University; Pakistán ; Fil: Patel, Archana. Indira Gandhi Government Medical College and Lata Medical Research Foundation; India ; Fil: Esamai, Fabian. University School of Medicine; Kenia ; Fil: Chomba, Elwyn. University of Zambia; Zambia ; Fil: Garces, Ana. Universidad de San Carlos; Guatemala ; Fil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina ; Fil: Carlo, Waldemar A. University of Alabama at Birmingahm; Estados Unidos ; Fil: Goldenberg, Robert L. Columbia University; Estados Unidos ; Fil: Hibberd, Patricia L. Massachusetts General Hospital for Children; Estados Unidos ; Fil: Liechty, Edward A. Indiana University; Estados Unidos ; Fil: Krebs, Nancy F. University of Colorado School of Medicine; Estados Unidos ; Fil: Hambidge, Michael K. University of Colorado School of Medicine; Estados Unidos ; Fil: Moore, Janet L. Research Triangle Institute International; Estados Unidos ; Fil: Wallace, Dennis D. Research Triangle Institute International; Estados Unidos ; Fil: Derman, Richard J. Christiana Care Health Services; Estados Unidos ; Fil: Bhalachandra, Kodkany S. KLE University. Jawaharlal Nehru Medical College; India ; Fil: Bose, Carl L. University of North Carolina; Estados Unidos