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Sawalma M, Shalash A, Wahdan Y, Nemer M, Khalawi H, Hijazi B, Abu-Rmeileh N. Sexual and reproductive health interventions geared toward adolescent males: A scoping review. J Pediatr Nurs 2023; 73:e19-e26. [PMID: 37474422 DOI: 10.1016/j.pedn.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 07/05/2023] [Accepted: 07/05/2023] [Indexed: 07/22/2023]
Abstract
PROBLEM Male adolescent sexual and reproductive health (SRH) interventions are rare worldwide. The high prevalence of sexually transmitted infections and pregnancies among female and male adolescents worldwide highlights the need for comprehensive interventions that include both genders in the educational process. OBJECTIVE Our main focus is studying and analysing male-focused SRH interventions globally to include males in evidence-based interventions that improve SRH of adolescent males. ELIGIBILITY CRITERIA This Review was conducted using the PRISMA extension for scoping reviews. The following databases were searched: PubMed, Embase, Web of science, Scopus, CINAHL and PsycInfo. INCLUSION CRITERIA 1) No time or date limits; 2)all types of studies; 3)SRH campaign; 4)males; 5)10 to 19 years. SAMPLE Five thousand and sixty-eight articles were identified and 166 peer-reviewed articles met the inclusion criteria. RESULTS Family planning was identified as the primary domain covered for adolescents. While interactive activities was the most common method used to deliver information to adolescents about sexual health. SRH interventions for males were most prevalent in America. While in the Eastern Mediterranean region (EMR), no male interventions were found in our review. CONCLUSION This scoping review emphasizes the need to include adolescent males in sexual and reproductive health interventions, particularly in low- and middle-income countries (LMICs) and the EMR. Policymakers should develop comprehensive programs that address male-specific needs, improve training for intervention providers, and enhance reporting processes to identify gaps and barriers to male inclusion. IMPLICATION Future research should be directed toward the obstacles that prevent SRH interventions targeting males from being carried out.
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Affiliation(s)
- Mariam Sawalma
- Institute of Community and Public Health, Birzeit University, Palestine.
| | - Aisha Shalash
- Institute of Community and Public Health, Birzeit University, Palestine; School of Medicine, University of Limerick, Limerick, Ireland.
| | - Yasmeen Wahdan
- Institute of Community and Public Health, Birzeit University, Palestine
| | - Maysaa Nemer
- Institute of Community and Public Health, Birzeit University, Palestine.
| | - Hala Khalawi
- The Department of Social Sciences, Bethlehem University, Palestine
| | | | - Niveen Abu-Rmeileh
- Institute of Community and Public Health, Birzeit University, Palestine.
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Aurino E, Lleras-Muney A, Tarozzi A, Tinoco B. The rise and fall of SES gradients in heights around the world. JOURNAL OF HEALTH ECONOMICS 2023; 91:102797. [PMID: 37549519 PMCID: PMC11111217 DOI: 10.1016/j.jhealeco.2023.102797] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/02/2023] [Accepted: 07/11/2023] [Indexed: 08/09/2023]
Abstract
We use data from a large sample of low- and middle-income countries to study the association (or "gradient") between child height and maternal education. We show that the gap in height between high- and low-SES children is small at birth, rises throughout childhood, and declines in adolescence as girls and boys go through puberty. This inverted U-shaped pattern is consistent with a degree of catch-up in linear height among children of low- relative to high-SES families, in partial contrast to the argument that height deficits cannot be overcome after the early years of life. This finding appears to be explained by the association between SES and the timing of puberty and therefore of the adolescent growth spurt: low-SES children start their adolescent growth spurt later and stop growing at later ages as well.
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Affiliation(s)
- Elisabetta Aurino
- Universitat de Barcelona and Institut d'Economia de Barcelona, Spain.
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Matasariu DR, Dumitrascu I, Bujor IE, Cristofor AE, Boiculese LV, Mandici CE, Grigore M, Socolov D, Nechifor F, Ursache A. Mirroring Perinatal Outcomes in a Romanian Adolescent Cohort of Pregnant Women from 2015 to 2021. Diagnostics (Basel) 2023; 13:2186. [PMID: 37443580 DOI: 10.3390/diagnostics13132186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/10/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
Although the rates of adolescent pregnancies appear to have dropped according to the World Health Organization (WHO), the decrease in the age of the first menarche and better nutrition seems to contribute to the otherwise high rate of adolescent pregnancy worldwide, despite the efforts of different organizations to improve upon this trend. We conducted a population-based retrospective cohort study from January 2015 to December 2021 using our hospitals' database. We totaled 2.954 adolescent and 6.802 adult pregnancies. First, we compared younger adolescents' outcomes with those of older adolescents, as well as with adolescents aged between 18 and 19 years old; secondly, we compared adolescent pregnancies with adult ones. We detected higher percentages of cephalo-pelvic disproportion (43.2%), cervical dystocia (20.7%), and twin pregnancy (2.7%) in underage adolescents compared with 32%, 14.1%, and 1% in older underage adolescents, respectively, and 15.3%, 3.1%, and 0.6% in older ones. As teens became older, the likelihood of malpresentations and previous C-sections rose, whereas the likelihood of vaginal lacerations declined. When comparing adolescents with adult women, we found more cases that required episiotomy (48.1% compared with 34.6%), instrumental delivery (2.1% compared with 1%), and cervical laceration (10.7% compared with 8.4%) in the adolescent group, but the rates of malpresentation (11.4% compared with 13.5%), previous C-section (13.9% compared with 17.7%), and placenta and vasa praevia (4.5.6% compared with 14%) were higher in the adult women group. Adolescent pregnancy is prone to being associated with higher risks and complications and continues to represent a challenge for our medical system.
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Affiliation(s)
- Daniela Roxana Matasariu
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
- Department of Obstetrics and Gynecology, Cuza Vodă Hospital, 700038 Iasi, Romania
| | - Irina Dumitrascu
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
- Department of Obstetrics and Gynecology, Cuza Vodă Hospital, 700038 Iasi, Romania
| | - Iuliana Elena Bujor
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
| | - Alexandra Elena Cristofor
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
| | - Lucian Vasile Boiculese
- Biostatistics, Department of Preventive Medicine and Interdisciplinarity, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
| | - Cristina Elena Mandici
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
| | - Mihaela Grigore
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
- Department of Obstetrics and Gynecology, Cuza Vodă Hospital, 700038 Iasi, Romania
| | - Demetra Socolov
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
- Department of Obstetrics and Gynecology, Cuza Vodă Hospital, 700038 Iasi, Romania
| | - Florin Nechifor
- Department Clinics, Faculty of Veterinary Medicine, Iasi University of Life Sciences (IULS), 700489 Iasi, Romania
| | - Alexandra Ursache
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
- Department of Obstetrics and Gynecology, Cuza Vodă Hospital, 700038 Iasi, Romania
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4
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Nandi A, Zahra F, Austrian K, Haberland N, Ngô TD. Growth failure among children of adolescent mothers at ages 0-5 and 6-12 years in India. Ann N Y Acad Sci 2023; 1522:139-148. [PMID: 36924008 DOI: 10.1111/nyas.14984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
Adolescent motherhood has been linked with poor health outcomes at birth for children, including high neonatal mortality, low birthweight, and small-for-gestational-age rates. However, longer-term growth outcomes in the children of adolescent mothers in low-resource settings remain inadequately studied. We used longitudinal data from the India Human Development Surveys, 2004-2005 and 2011-2012 (n = 12,182) and employed regression and propensity score matching analysis to compare the following growth indicators of children born to adolescent mothers (ages 19 years or below) with those born to older mothers. Growth indicators included height and weight during ages 0-5 years and 6-12 years and change in height and weight between the two periods. In regression-based estimates, children born to adolescent mothers were 0.01 m shorter and weighed 0.2 kg less than children of older mothers at ages 0-5 years. At ages 6-12 years, those born to adolescent mothers were 0.02 m shorter and weighed 0.97 kg less. The height difference between the two groups increased by 0.01 m and the weight difference grew by 0.77 kg over time. Height and weight difference between the two groups worsened among boys over time, while for girls, only the weight gap worsened. The results were similar when using propensity score matching methods. Public policies for reducing child marriage, combined with targeted health, nutrition, and well-being programs for adolescent mothers, are essential for both preventing adolescent childbearing and reducing its impact on growth failure among children in India.
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Affiliation(s)
- Arindam Nandi
- The Population Council, New York City, New York, USA.,One Health Trust, Washington, DC, USA
| | - Fatima Zahra
- The Population Council, New York City, New York, USA
| | | | | | - Thoại D Ngô
- The Population Council, New York City, New York, USA
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Bol KN, Negera E, Gedefa AG. Pregnancy among adolescent girls in humanitarian settings: a case in refugee camp of Gambella regional state, community-based cross-sectional study, Southwest Ethiopia, 2021. BMJ Open 2022; 12:e064732. [PMID: 36396321 PMCID: PMC9677029 DOI: 10.1136/bmjopen-2022-064732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of this study was to assess the prevalence of pregnancy and associated factors among adolescent girls in Nguenyyiel Refugee Camp. DESIGN Cross-sectional study was employed to conduct this study. SETTING A community-based cross-sectional study was done in Nguenyyiel Refugee Camp. PARTICIPANTS Four hundred and fourteen adolescent girls participated in this study. The systematic random sampling technique was used to select respondents. Data were collected using a well-structured and pretested questionnaire. Pregnancy test was done using the human chorionic gonadotropin test. Bivariate and multivariate logistic regression analysis was run to identify factors associated with adolescent pregnancy. RESULTS The prevalence of pregnancy among adolescent girls in the Nguenyyiel Refugee Camp was 21.7% (95% CI: 17.6% to 25.6%). Factors associated with adolescent pregnancy were age (17-19 years) (AOR): 2.79; 95% CI: 1.55 to 5.05; educational status: primary education (AOR: 7.69; 95% CI: 3.55 to 16.68) and no formal education (AOR: 3.42; 95% CI: 1.59 to 7.36); and household living arrangement: living with none of the biological parents (AOR: 2.14; 95% CI: 1.02 to 4.49) and living with either of the biological parent (AOR: 3.71; 95% CI: 1.76 to 7.81). CONCLUSIONS AND RECOMMENDATIONS This study showed that there is a high prevalence of pregnancy among adolescent girls in the study setting. Age (17-19 years), educational status and household living arrangement (living with none of the biological parents and living with either of the biological parents) were among the factors significantly associated with adolescent pregnancy. Hence, health workers and other stakeholders in the camps should focus on strengthening adolescent sexual health education giving special attention to late adolescents, uneducated and living without biological family.
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Affiliation(s)
- Koang Nyak Bol
- Universal Health Coverage, Communicable, and Non-communicable Diseases (UCN) Cluster, Neglected Tropical Diseases (NTDs) Program, WHO, Gambella, Ethiopia
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Victora CG, Hartwig FP, Vidaletti LP, Martorell R, Osmond C, Richter LM, Stein AD, Barros AJD, Adair LS, Barros FC, Bhargava SK, Horta BL, Kroker-Lobos MF, Lee NR, Menezes AMB, Murray J, Norris SA, Sachdev HS, Stein A, Varghese JS, Bhutta ZA, Black RE. Effects of early-life poverty on health and human capital in children and adolescents: analyses of national surveys and birth cohort studies in LMICs. Lancet 2022; 399:1741-1752. [PMID: 35489358 PMCID: PMC9061872 DOI: 10.1016/s0140-6736(21)02716-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 09/14/2021] [Accepted: 11/23/2021] [Indexed: 12/11/2022]
Abstract
The survival and nutrition of children and, to a lesser extent, adolescents have improved substantially in the past two decades. Improvements have been linked to the delivery of effective biomedical, behavioural, and environmental interventions; however, large disparities exist between and within countries. Using data from 95 national surveys in low-income and middle-income countries (LMICs), we analyse how strongly the health, nutrition, and cognitive development of children and adolescents are related to early-life poverty. Additionally, using data from six large, long-running birth cohorts in LMICs, we show how early-life poverty can have a lasting effect on health and human capital throughout the life course. We emphasise the importance of implementing multisectoral anti-poverty policies and programmes to complement specific health and nutrition interventions delivered at an individual level, particularly at a time when COVID-19 continues to disrupt economic, health, and educational gains achieved in the recent past.
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Affiliation(s)
- Cesar G Victora
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil.
| | - Fernando P Hartwig
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Luis P Vidaletti
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Reynaldo Martorell
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Clive Osmond
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Linda M Richter
- Department of Science and Innovation, National Research Foundation Centre of Excellence in Human Development, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Aryeh D Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Psychiatry, University of Oxford, Oxford, UK
| | - Aluisio J D Barros
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Linda S Adair
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Fernando C Barros
- Post-Graduate Program of Health in the Life Cycle, Catholic University of Pelotas, Pelotas, Brazil
| | | | - Bernardo L Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Maria F Kroker-Lobos
- INCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
| | - Nanette R Lee
- USC Office of Population Studies Foundation, University of San Carlos, Cebu, Philippines
| | - Ana Maria B Menezes
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas, Brazil
| | - Shane A Norris
- SAMRC Pathways for Health Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Alan Stein
- MRC-Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; African Health Research Institute, Durban, South Africa
| | | | - Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada; Institute for Global Health and Development, The Aga Khan University, Karachi, Pakistan
| | - Robert E Black
- Institute for International Programs, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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Guure C, Afagbedzi S. Predicting the effect of sulfadoxine-pyrimethamine uptake by pregnant women on birth weight using a generalized ordered partial proportional odds model. BMC Pregnancy Childbirth 2022; 22:223. [PMID: 35305604 PMCID: PMC8933913 DOI: 10.1186/s12884-022-04565-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 03/10/2022] [Indexed: 11/10/2022] Open
Abstract
Background Low birth weight is a public health problem in Africa with the cause attributable to malaria in pregnancy. World Health Organization recommends the use of intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine to prevent malaria during pregnancy. The objective of this study was to evaluate the prevalence and trajectories of birth weight and the direct impact and relationship between sulfadoxine-pyrimethamine and birth weight in Ghana since 2003. Method This study used secondary data obtained from the Demographic and Health Survey conducted in Ghana since 2003. Low birth weight was defined as weight < 2500 g irrespective of the gestational age of the foetus, while normal birth weight was between 2500 g to < 4000 g and macrosomia was = > 4000 g. In all the analysis, we adjusted for clustering, stratification and weighting to reduce bias and improve precision of the estimates. Analysis was performed on each survey year as well as the pooled dataset. The generalized ordered partial proportional odds model was used due to violations of the parallel regression model assumptions. Efforts were made to identify all confounding variables and these were adjusted for. Predictive analysis was also executed. Results The overall prevalence of low birth weight was 9% while that of macrosomia was 13%. The low birth weight for 2003 was 12% while in 2008 it was 21% and then 68% in 2014. The mean birth weight of the children in 2014 was 3.16 (3.14, 3.19), 2008 was 3.37 (3.28, 3.45) and 2003 was 3.59 (3.49, 3.69) while that of the pooled data was 3.28 (3.25, 3.30). The adjusted model (taking into consideration all confounding variables) showed that non-uptake of SP could result in 51% odds of giving birth to a low-birth-weight compared with normal birth weight child. An insignificant result was observed between macrosomia and low birth weight. Conclusion There is higher probability that low birth weight could increase over the next couple of years if measures are not taking to reverse the current trajectories. The uptake of sulfadoxine-pyrimethamine should continue to be encouraged and recommended because it has a direct beneficial effect on the weight of the child.
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Rahman MM, Taniguchi H, Nsashiyi RS, Islam R, Mahmud SR, Rahman S, Jung J, Khan S. Trend and projection of skilled birth attendants and institutional delivery coverage for adolescents in 54 low- and middle-income countries, 2000-2030. BMC Med 2022; 20:46. [PMID: 35115000 PMCID: PMC8813474 DOI: 10.1186/s12916-022-02255-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 01/12/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Limitations to accessing delivery care services increase the risks of adverse outcomes during pregnancy and delivery for all pregnant women, particularly among adolescents in LMICs. In order to inform adolescent-specific delivery care initiatives and coverage, we conducted a comprehensive analysis of trends, projections and inequalities in coverage of delivery care services among adolescents at national, urban-rural and socio-economic levels in LMICs. METHODS Using 224 nationally representative cross-sectional survey data between 2000 and 2019, we estimated the coverage of institutional delivery (INSD) and skilled birth attendants (SBA). Bayesian hierarchical regression models were used to estimate trends, projections and determinants of INSD and SBA. RESULTS Coverage of delivery care services among adolescents increased substantially at the national level, as well as in both urban and rural areas in most countries between 2000 and 2018. Of the 54 LMICs, 24 countries reached 80% coverage of both INSD and SBA in 2018, and predictions for 40 countries are set to exceed 80% by 2030. The trends in coverage of INSD and SBA of adult mothers mostly align with those for adolescent mothers. Our findings show that urban-rural and wealth-based inequalities to delivery care remain persistent by 2030. In 2018, urban settings across 54 countries had higher rates of coverage exceeding 80% compared to rural for both INSD (45 urban, 16 rural) and SBA (50 urban, 19 rural). Several factors such as household head age ≥ 46 years, household head being female, access to mass media, lower parity, higher education, higher ANC visits and higher socio-economic status could increase the coverage of INSD and SBA among adolescents and adult women. CONCLUSIONS More than three-quarters of the LMICs are predicted to achieve 80% coverage of INSD and SBA among adolescent mothers in 2030, although with sustained inequalities.
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Affiliation(s)
- Md Mizanur Rahman
- Hitotsubashi Institute for Advanced Study, University of Hitotsubashi, 2-1 Naka, Kunitachi Tokyo, 186-8601, Japan.
| | - Hiroko Taniguchi
- Department of Global Health Policy, School of International Health, The University of Tokyo, Tokyo, Japan
| | - Raïssa Shiyghan Nsashiyi
- Department of Global Health Policy, School of International Health, The University of Tokyo, Tokyo, Japan.,Institute for Nature, Health, and Agricultural Research (INHAR), Yaoundé, Cameroon
| | - Rashedul Islam
- Department of Global Health Policy, School of International Health, The University of Tokyo, Tokyo, Japan
| | | | - Shafiur Rahman
- Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Jenny Jung
- Global Public Health Research Foundation, Dhaka, Bangladesh
| | - Shahjahan Khan
- School of Sciences, Centre for Health Research, University of Southern Queensland, Toowoomba, Australia
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Xie Y, Wang X, Mu Y, Liu Z, Wang Y, Li X, Dai L, Li Q, Li M, Chen P, Zhu J, Liang J. Characteristics and adverse outcomes of Chinese adolescent pregnancies between 2012 and 2019. Sci Rep 2021; 11:12508. [PMID: 34131205 PMCID: PMC8206124 DOI: 10.1038/s41598-021-92037-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/27/2021] [Indexed: 11/09/2022] Open
Abstract
We aimed to describe the characteristics of adolescent pregnancy, determine its effect on adverse maternal and perinatal outcomes and explore whether that association varies with gestational age with the goal of proposing specific recommendations for adolescent health in China. This study included 2,366,559 women aged 10–24 years who had singleton pregnancies between 2012 and 2019 at 438 hospitals. Adolescent pregnancy was defined as younger than 20 years of age. We used multivariable logistic regression to estimate the effects. Women aged 20–24 years served as the reference group in all analyses. The proportion of rural girls with adolescent pregnancies rebounded after 2015 even though common-law marriage in rural areas decreased. Higher risks of eclampsia (adjusted odds ratio (aOR) 1.87, 95% confidence interval (CI) 1.57 ~ 2.23), severe anaemia (aOR 1.18, 95% CI 1.09 ~ 1.28), maternal near miss (MNM; aOR 1.24, 95% CI 1.12 ~ 1.37), and small for gestational age (SGA; aOR 1.30, 95% CI 1.28 ~ 1.33) were observed when gestational age was > 37 weeks. Adolescent pregnancy was independently associated with increased risks of other perinatal outcomes. Further implementation of pregnancy prevention strategies and improved health care interventions are needed to reduce adolescent pregnancies and prevent adverse fertility outcomes among adolescent women in China at a time when adolescent fertility rate is rebounding.
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Affiliation(s)
- Yanxia Xie
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu, Sichuan, China
| | - Xiaodong Wang
- Department of Obstetrics, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu, Sichuan, China
| | - Yi Mu
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu, Sichuan, China
| | - Zheng Liu
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu, Sichuan, China
| | - Yanping Wang
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu, Sichuan, China
| | - Xiaohong Li
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu, Sichuan, China
| | - Li Dai
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu, Sichuan, China.,Medical Big Data Center, Sichuan University, Chengdu, Sichuan, China
| | - Qi Li
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu, Sichuan, China
| | - Mingrong Li
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu, Sichuan, China
| | - Peiran Chen
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu, Sichuan, China
| | - Jun Zhu
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu, Sichuan, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
| | - Juan Liang
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu, Sichuan, China. .,Department of Obstetrics, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu, Sichuan, China.
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10
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Chacón V, Liu Q, Park Y, Rohloff P, Barnoya J. Diet quality, school attendance, and body weight status in adolescent girls in rural Guatemala. Ann N Y Acad Sci 2021; 1494:59-69. [PMID: 33502805 DOI: 10.1111/nyas.14558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/31/2020] [Accepted: 12/10/2020] [Indexed: 11/28/2022]
Abstract
A cluster of factors affects nutritional status among adolescent girls in low- and middle-income countries (LMICs). We investigated the association between school attendance and diet quality among 498 rural adolescent girls (352 attending and 146 not attending school) in Tecpán, Guatemala. In a cross-sectional study, we collected sociodemographic and anthropometric data and characterized the dietary intake using a Food Frequency Questionnaire. We then calculated diet quality using the Healthy Eating Score (HES). Multiple linear regression models were conducted to evaluate the effects of school attendance on diet quality. We found that the overall diet quality among the study participants was poor, according to the HES. However, those who attended school had significantly higher intakes of vitamin A-rich fruits and vegetables (P = 0.04), other fruits (P = 0.01), and milk and milk products (P = 0.004), but a higher intake of fast foods, chips, and saturated fatty acids (P < 0.001). Furthermore, the effects of school attendance on diet quality were significant after adjusting for sociodemographic and lifestyle factors (β coefficient = -1.70, 95% CI: -3.30 to -0.11) but was attenuated when further adjusted for weight status (β coefficient = -1.58, 95% CI: -3.17 to 0.02). Our findings suggest that diet quality among girls in rural Guatemala is poor, particularly among those who do not attend school. To advance our understanding of adolescent diet in LMICs, future studies should include adolescents who are out of school.
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Affiliation(s)
- Violeta Chacón
- Unidad de Cirugía Cardiovascular de Guatemala and Fundación Aldo Castañeda, Guatemala City, Guatemala.,Friedman School of Nutrition Science and Policy at Tufts University, Boston, Massachusetts
| | - Qinran Liu
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Yikyung Park
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Peter Rohloff
- Center for Indigenous Health Research, Wuqu' Kawoq
- Maya Health Alliance, Tecpán, Chimaltenango, Guatemala
| | - Joaquin Barnoya
- Unidad de Cirugía Cardiovascular de Guatemala and Fundación Aldo Castañeda, Guatemala City, Guatemala.,Instituto de Investigación y Estudios Superiores en Salud, Universidad Rafael Landivar, Guatemala City, Guatemala
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11
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Kinshella MLW, Moore SE, Elango R. Beyond Reproduction: The "First 1,000 Days" Approach to Nutrition through a Gendered Rights-Based Lens. Health Hum Rights 2020; 22:113-123. [PMID: 33390701 PMCID: PMC7762907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The First 1,000 Days approach highlights the importance of adequate nutrition in early life-from conception to a child's second birthday-for good development and growth throughout the child's life and potentially onto their own offspring. The approach has been highly influential in mobilizing policy attention and resources to improve maternal and infant nutrition in global health and development. This paper undertakes a critical review of this approach from a gendered human rights lens, finding that the theoretical underpinnings implicitly reflect and reproduce gender biases by conceptualizing women within a limited scope of reproduction and child care. We explore the processes of systemic neglect through Pierre Bourdieu's theories on how social structures are reproduced. Understanding theory is important to the governance of global health, how we frame priorities, and how we act on them. Revisiting influential theories is a means of accountability to ensure inclusiveness and to reduce gender and health inequities in research. We argue that a greater focus on women could increase the potential impact of nutrition interventions.
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Affiliation(s)
- Mai-Lei Woo Kinshella
- PhD student at the Department of Obstetrics and Gynecology, BC Children’s and Women’s Hospital and University of British Columbia, and Global Health Research Coordinator at the University of British Columbia’s PRE-EMPT, Vancouver, Canada
| | - Sophie E. Moore
- Reader in Global Women and Children’s Health at King’s College London and an Honorary Senior Research Fellow at the MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, UK
| | - Rajavel Elango
- Associate Professor at the School of Population and Public Health, Department of Pediatrics, BC Children’s and Women’s Hospital and University of British Columbia, Vancouver, Canada
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12
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Birhanie MW, Adekunle AO, Arowojolu AO, Dugul TT, Mebiratie AL. Micronutrients Deficiency and Their Associations with Pregnancy Outcomes: A Review . NUTRITION AND DIETARY SUPPLEMENTS 2020. [DOI: 10.2147/nds.s274646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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13
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Ashcraft AM, Farjo S, Ponte CD, Dotson S, Sambamoorthi U, Murray PJ. Harder to get than you think: Levonorgestrel emergency contraception access in West Virginia community pharmacies. J Am Pharm Assoc (2003) 2020; 60:969-977. [PMID: 32830066 DOI: 10.1016/j.japh.2020.07.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/22/2020] [Accepted: 07/25/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Emergency contraception (EC) is the only noninvasive form of contraception available after risk exposure and is an important tool for preventing unintended pregnancy resulting from unprotected sex, sexual assault, or contraceptive failure. The U.S. Food and Drug Administration (FDA) removed age restrictions on levonorgestrel EC and made it available over-the-counter to everyone in 2013. Despite improved availability and accessibility since the change in FDA regulations, community pharmacies have not uniformly embraced the policy. West Virginia is a rural state with high rates of poverty and teen pregnancy. DESIGN The investigators called community pharmacies in West Virginia to assess the availability and accessibility of levonorgestrel EC in addition to the pharmacy staff's knowledge of effectiveness for this cross-sectional study. SETTING AND PARTICIPANTS The study sample consisted of 509 community pharmacies throughout the state. OUTCOME MEASURES A structured script was employed to conduct phone calls to community pharmacies with items assessing availability, accessibility, and knowledge of effectiveness. RESULTS At the time of the phone calls, levonorgestrel EC was reported to be available in 48.9% of the community pharmacies in West Virginia. Chain pharmacies were more likely to report EC as being in stock (0.76) than independent pharmacies (0.15.). Other measures of accessibility also favored chain pharmacies versus independent pharmacies. The overall accessibility of EC at West Virginia community pharmacies was derived from a binary composite variable of "completely accessible" or "not completely accessible" by combining 5 predetermined items. Overall, EC was completely accessible to callers in 0.27 of all pharmacies with significant differences by pharmacy type (0.47 of chain pharmacies as compared with 0.03 of independent pharmacies). CONCLUSION Accessible EC could reduce unintended pregnancy and help break the state's generational cycle of poverty and poor educational, social, and health outcomes. Pharmacists will be instrumental in expanding access to EC.
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14
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Dewey KG, Matias SL, Mridha MK, Arnold CD. Nutrient supplementation during the first 1000 days and growth of infants born to pregnant adolescents. Ann N Y Acad Sci 2019; 1468:25-34. [PMID: 31378980 PMCID: PMC7317730 DOI: 10.1111/nyas.14191] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 05/30/2019] [Accepted: 06/13/2019] [Indexed: 01/14/2023]
Abstract
Few studies have evaluated the impact of nutritional supplementation among pregnant adolescents. We examined the effects of the Rang Din Nutrition Study (RDNS) interventions on children born to mothers <20 years of age. The RDNS was a cluster‐randomized effectiveness trial with four arms: (1) women and children both received small‐quantity lipid‐based nutrient supplements (LNS‐LNS), (2) women received iron and folic acid (IFA) and children received LNS (IFA‐LNS), (3) women received IFA and children received micronutrient powder (MNP) (IFA‐MNP), and (4) women received IFA and children received no supplements (IFA‐Control). We enrolled 4011 women at <20 weeks gestation; 1552 were adolescents. Among adolescents, prenatal LNS reduced newborn stunting by 25% and small head size by 28% and had a marginally significant effect on newborn wasting, compared with IFA. Low birth weight and preterm birth were reduced only among adolescents with lower food security. Effects on subsequent growth status were observed only among female children in the LNS‐LNS group: less stunting at 18 months (versus IFA‐MNP) and lower prevalence of small head circumference and wasting at 24 months (versus IFA‐Control). Initiatives targeting pregnant adolescents in similar settings should consider inclusion of small‐quantity LNS, particularly for adolescents living in food‐insecure households.
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Affiliation(s)
- Kathryn G Dewey
- Department of Nutrition, University of California, Davis, California
| | - Susana L Matias
- Department of Nutrition, University of California, Davis, California
| | - Malay K Mridha
- Department of Nutrition, University of California, Davis, California.,BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Charles D Arnold
- Department of Nutrition, University of California, Davis, California
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15
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Mohammed S, Bonsing I, Yakubu I, Wondong WP. Maternal obstetric and socio-demographic determinants of low birth weight: a retrospective cross-sectional study in Ghana. Reprod Health 2019; 16:70. [PMID: 31142327 PMCID: PMC6542076 DOI: 10.1186/s12978-019-0742-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 05/21/2019] [Indexed: 11/27/2022] Open
Abstract
Background Birth weight is an important predictor of early neonatal mortality, morbidity, and long-term health outcomes. Annually, approximately 20 million babies are born globally with weights less than 2.5kg. In sub-Saharan Africa, the prevalence of LBW is around 13 to 15 percent. In Ghana, 10% of babies born in 2014 were with LBW. The aim of this study was to identify maternal socio-demographic and obstetric risk factors associated with the birth weight of newborns in the Sunyani Municipality of Ghana. Methods This retrospective cross-sectional study analysed data from 931 birth records of all deliveries between January 1 and December 31, 2017, at the Sunyani Municipal Hospital in the Brong-Ahafo Region of Ghana. Univariate and multivariable logistic regression models were fitted to estimate the effect of maternal factors on low birth weight. Results We found that the mean age of the participants and the mean gestational age at birth were 27.21(SD = 5.50) years and 37.95(SD = 1.85) weeks respectively. Nearly 10% of the infants born within the study period had birth weights below 2.5kg. The findings revealed that the odds of delivering LBW baby were significantly high (OR 1.77, 95%CI 1.14-2.76) among urban dwellers. However, mothers who attended or completed secondary or higher education were 63% (95% CI 0.20–0.78) less likely to give birth to a LBW baby when compared with uneducated mothers. We found that the odds of LBW significantly decreased with every one-week increase in gestational age (OR 0.67 95%CI 0.59-0.76) and significantly increased with increasing parity (OR 1.43 95%CI 1.21-1.70). Further, the likelihood of delivering LBW baby decreased with every additional ANC visit (OR 0.78 95%CI 0.67-0.90) and with every additional gram of haemoglobin (OR 0.78 95%CI 0.63-0.95). Conclusion The evidence from this study suggests that maternal educational level, residence, haemoglobin level, parity, number of ANC visits, and gestational age are independent predictors of low birth weight. The current findings add substantially to the growing literature on the influence of maternal socio-demographic and obstetric factors on LBW in resource-constrained settings and provide empirical data for clinical and public health interventions aimed at reducing low birth weight and its associated complications.
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Affiliation(s)
- Shamsudeen Mohammed
- Department of Nursing, College of Nursing and Midwifery, P. O. Box 10, Nalerigu, Ghana.
| | - Irene Bonsing
- Emergency Unit, Sunyani Municipal Hospital, Sunyani, Ghana
| | - Ibrahim Yakubu
- Department of Nursing, Nursing and Midwifery Training College, Gushegu, Ghana
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16
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Abstract
OBJECTIVE Pregnancy in adolescence is a global health issue, especially in developing countries. Additionally, the recommended gestational weight gain (GWG) is usually based on pre-pregnancy BMI and that might be complex for pregnant teens. The study objective was to compare three different methods of BMI classification and suggest the best way of determining pre-pregnancy BMI and monitoring GWG among pregnant adolescents. DESIGN Pre-pregnancy weight, weight at first prenatal visit, height, sociodemographic, reproductive and perinatal data were collected. Weighted kappa and McNemar statistics were used to assess agreement between the classification methods. SETTING Prof. Dr Jose Aristodemo Pinotti Women's Hospital, University of Campinas, Brazil.ParticipantsPrimiparas younger than 19 years of age and with less than 20 weeks of gestational age (n 150). RESULTS BMI of the primiparas was determined according to the WHO recommendation for adult women, the Child Growth Standards (CGS) and their gynaecological age (GA). The WHO and GA measurements presented a strong agreement with each other (κ w=0·99; 95 % CI 0·97, 1·00), but did not agree with the CGS classification (κ w=0·62; 95 % CI 0·50, 0·74 by WHO; κ w=0·62; 95 % CI 0·51, 0·74 by GA). Also, inadequate GWG was observed in 72·2 % of cases and was correlated with a higher rate of caesarean birth. CONCLUSIONS BMI classification according to the CGS differed from WHO and GA. However, CGS and WHO agreed on perinatal outcomes. We recommend using BMI classification by WHO to assess pregnant adolescents, since it is easily applied and better known among health professionals.
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17
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Flood D, Chary A, Colom A, Rohloff P. Adolescent Rights and the "First 1,000 days" Global Nutrition Movement: A View from Guatemala. Health Hum Rights 2018; 20:295-301. [PMID: 30008571 PMCID: PMC6039738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- David Flood
- Resident physician and health services researcher at Wuqu’ Kawoq’ in Santiago Sacatépquez, Guatemala, and at the University of Minnesota, Minneapolis, Minnesota, USA
| | - Anita Chary
- Resident physician and medical anthropologist at Wuqu’ Kawoq’ in Santiago Sacatépquez, Guatemala, and at Harvard Medical School, Boston, MA, USA
| | - Alejandra Colom
- Associate professor of anthropology at the University del Valle of Guatemala and country director of the Population Council in Gueatemala City, Guatemala
| | - Peter Rohloff
- Practicing internist and pediatrician, assistant professor of medicine at Brigham and Women’s Hospital, Boston, MA, USA, and founder of Wuqu’ Kawoq in Santiago Sacatépquez, Guatemala
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18
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Compaoré A, Gies S, Brabin B, Tinto H, Brabin L. Community approval required for periconceptional adolescent adherence to weekly iron and/or folic acid supplementation: a qualitative study in rural Burkina Faso. Reprod Health 2018. [PMID: 29540225 PMCID: PMC5852966 DOI: 10.1186/s12978-018-0490-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Iron deficiency remains a prevalent adolescent health problem in low income countries. Iron supplementation is recommended but improvement of iron status requires good adherence. Objectives We explored factors affecting adolescent adherence to weekly iron and/or folic acid supplements in a setting of low secondary school attendance. Methods Taped in-depth interviews were conducted with participants in a randomised, controlled, periconceptional iron supplementation trial for young nulliparous women living in a rural, malaria endemic region of Burkina Faso. Participants with good, medium or poor adherence were selected. Interviews were transcribed and analysed thematically. Results Thirty-nine interviews were conducted. The community initially thought supplements were contraceptives. The potential benefits of giving iron supplementation to unmarried “girls” ahead of pregnancy were not recognised. Trial participation, which required parental consent, remained high but was not openly admitted because iron supplements were thought to be contraceptives. Unmarried non-school attenders, being mobile, were often sent to provide domestic labour in varied locations. This interrupted adherence - as did movement of school girls during vacations and at marriage. Field workers tracked participants and trial provision of free treatment encouraged adherence. Most interviewees did not identify health benefits from taking supplements. Conclusions For success, communities must be convinced of the value of an adolescent intervention. During this safety trial, benefits not routinely available in iron supplementation programmes were important to this low income community, ensuring adolescent participation. Nevertheless, adolescents were obliged to fulfil cultural duties and roles that interfered with regular adherence to the iron supplementation regime. Trial Registration Trial Registration at clinicaltrials.gov: NCT01210040. Electronic supplementary material The online version of this article (10.1186/s12978-018-0490-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Adélaïde Compaoré
- Clinical Research Unit Nanoro, Institut de Recherche en Sciences de la, Santé, Direction Régionale du Centre-Ouest, Nanoro, Burkina Faso
| | - Sabine Gies
- Department of Biomedical Sciences, Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium.,Present address: Medical Mission Institute, Würzburg, Germany
| | - Bernard Brabin
- Liverpool School of Tropical Medicine and Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom; Global Child Health Group, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Halidou Tinto
- Clinical Research Unit Nanoro, Institut de Recherche en Sciences de la, Santé, Direction Régionale du Centre-Ouest, Nanoro, Burkina Faso
| | - Loretta Brabin
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
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19
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Schoenbuchner SM, Moore SE, Johnson W, Ngum M, Sonko B, Prentice A, Prentice AM, Ward KA. In rural Gambia, do adolescents have increased nutritional vulnerability compared with adults? Ann N Y Acad Sci 2018. [PMCID: PMC5901020 DOI: 10.1111/nyas.13587] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Adolescents may be particularly susceptible to malnutrition owing to the energy and nutrient costs of the pubertal growth spurt. Here, our aim is to compare differences in selected markers of nutritional status between adolescents and adults in rural Gambia. The Keneba Biobank collects cross‐sectional data and samples for all consenting individuals resident in the West Kiang region of the Gambia. For this study, participants between the ages of 10 and 40 years were selected (n = 4201, females 2447). Height, body mass index, body composition, hemoglobin concentration, fasting glucose concentration, and blood pressure were compared using linear regression models adjusting for age, parity, season of measurement, and residence, across three age groups: early adolescent (10–14.9 years), late adolescent (15–19.9 years), and adult (20–39.9 years). Adolescents, particularly early‐adolescent girls and boys, were shorter, lighter, and leaner than adults. By late adolescence, differences were smaller, particularly in girls where, notably, the prevalence of overweight, hypertension, and impaired fasting glucose was low. Given the importance of maternal health for reproductive outcomes and intergenerational health, the results of the study, albeit with limited biomarkers available, indicate that adolescent girls are no more compromised than adult women or males from the same population.
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Affiliation(s)
| | | | - William Johnson
- School of Sport, Exercise and Health Sciences; Loughborough University; Loughborough UK
| | | | | | - Ann Prentice
- MRC Elsie Widdowson Laboratory; Cambridge UK
- MRC Unit The Gambia; Banjul The Gambia
| | | | - Kate A. Ward
- MRC Elsie Widdowson Laboratory; Cambridge UK
- MRC Lifecourse Epidemiology Unit; University of Southampton, Southampton General Hospital; Southampton UK
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20
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Friebert A, Callaghan-Gillespie M, Papathakis PC, Manary MJ. Adolescent pregnancy and nutrition: a subgroup analysis from the Mamachiponde study in Malawi. Ann N Y Acad Sci 2017; 1416:140-146. [PMID: 29044558 DOI: 10.1111/nyas.13465] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 08/01/2017] [Accepted: 08/10/2017] [Indexed: 11/26/2022]
Abstract
Young age at childbearing (≤19 years) is common and associated with poor birth outcomes. A trial among Malawian pregnant women with moderate malnutrition was used to determine outcomes of young adolescents (≤18 years), older adolescents (18-20 years), and adults (>20 years). Women received one of three supplementary foods that provided ∼900 kcal/day and 33-36 g protein/day and returned every 2 weeks. Newborn/maternal measurements were taken at delivery and after 6 and 12 weeks. Upon enrollment, adolescents had greater body mass index than adults (19.9 ± 1.3 versus 19.5 ± 1.4 kg/m2 , P < 0.001). Young adolescents received more rations of food and enrolled and delivered with a lower fundal height than adults (21.7 ± 5.2 versus 23.0 ± 5.6, P = 0.00 enrollment; 30.2 ± 3.1 versus 31.0 ± 2.8, P < 0.001 delivery). Among newborns, length for age was lowest in young adolescents, greater in older adolescents, and greatest in adults (Z-scores -1.7 ± 1.2, -1.4 ± 1.2, and -1.1 ± 1.1, respectively; P < 0.001). These differences persisted in length for age at 6 and 12 weeks of age for infants. Adolescents enrolled earlier in pregnancy and appeared more nutritionally adequate than adults; adolescent outcomes were inferior to those of adults, suggesting that they were subject to more physiologic stressors and/or different nutritional needs.
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Affiliation(s)
- Alyssa Friebert
- Department of Nutrition and Food Science, California Polytechnic State University, San Luis Obispo, California
| | | | - Peggy C Papathakis
- Department of Nutrition and Food Science, California Polytechnic State University, San Luis Obispo, California
| | - Mark J Manary
- Department of Pediatrics, Washington University, St. Louis, Missouri
- School of Public Health and Family Medicine, College of Medicine, Blantyre, Malawi
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21
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Bhutta ZA, Lassi ZS, Bergeron G, Koletzko B, Salam R, Diaz A, McLean M, Black RE, De-Regil LM, Christian P, Prentice AM, Klein JD, Keenan W, Hanson M. Delivering an action agenda for nutrition interventions addressing adolescent girls and young women: priorities for implementation and research. Ann N Y Acad Sci 2017; 1393:61-71. [PMID: 28436103 DOI: 10.1111/nyas.13352] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 03/17/2017] [Indexed: 12/29/2022]
Abstract
Adolescent nutritional behaviors are assuming considerable importance in nutrition interventions given their important relationships with medium- and long-term outcomes. This is the period when young people undergo major anatomical and physiological maturational changes in preparation for adulthood. Nutritional requirements during puberty are higher during adolescence than during the prepubertal stage and during adulthood. A significant proportion of adolescents also become parents, and hence the importance of their health and nutritional status before as well as during pregnancy has its impact on their own health, fetal well-being, and newborn health. In this paper, we describe the evidence-based nutrition recommendations and the current global guidance for nutrition actions for adolescents. Despite the limitations of available information, we believe that a range of interventions are feasible to address outcomes in this age group, although some would need to start earlier in childhood. We propose packages of preventive care and management comprising nutrition-specific and nutrition-sensitive interventions to address adolescent undernutrition, overnutrition, and micronutrient deficiencies. We discuss potential delivery platforms and strategies relevant to low- and middle-income countries. Beyond the evidence synthesis, there is a clear need to translate evidence into policy and for implementation of key recommendations and addressing knowledge gaps through prioritized research.
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Affiliation(s)
- Zulfiqar A Bhutta
- Centre for Global Child Health, the Hospital for Sick Children, Toronto, Canada.,Center of Excellence in Women and Child Health, the Aga Khan University, Karachi, Pakistan
| | - Zohra S Lassi
- Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Gilles Bergeron
- The Sackler Institute for Nutrition Science, New York, New York
| | | | - Rehana Salam
- Division of Women and Child Health, the Aga Khan University, Karachi, Pakistan
| | - Angela Diaz
- Departments of Pediatrics and Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Robert E Black
- Global Disease Epidemiology and Control, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | | | - Parul Christian
- Women's Nutrition, Bill & Melinda Gates Foundation, Seattle, Washington
| | - Andrew M Prentice
- MRC Unit, Serrekunda, the Gambia.,MRC International Nutrition Group, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jonathan D Klein
- Global Health, Research and Policy, American Academy of Pediatrics, Washington, DC
| | - William Keenan
- Division of Neonatal-Perinatal Medicine, Saint Louis University, St. Louis, Missouri
| | - Mark Hanson
- Institute of Developmental Sciences and NIHR Biomedical Research Centre, University of Southampton and Southampton University Hospital, Southampton, United Kingdom
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22
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Wise NJ, Cantrell MA, Hadley F, Joyce K. Development of an Interactive Pregnant Adolescent Nutrition Education Workshop. J Perinat Educ 2017; 26:154-164. [PMID: 30723379 DOI: 10.1891/1058-1243.26.3.154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The health of pregnant adolescents affects the well-being of future generations. Modifying unhealthy eating patterns among pregnant adolescents is critical because of their association with risk of poor pregnancy and birth outcomes. Therefore, it is important to provide age- and developmentally appropriate nutrition education during this time. To sustain healthy behavior changes, nutrition interventions must be grounded in theory and reflect both motivating factors and barriers to healthy eating. Factors such as taste preferences, personal self-efficacy, developmentally appropriate nutrition education, and hands-on meal preparation have been identified as influences on dietary patterns in this population. The purpose of this article is to describe the development of an evidence-based nutrition education program for pregnant adolescents based on Pender's health promotion model.
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23
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Johnson W, Moore SE. Adolescent pregnancy, nutrition, and health outcomes in low- and middle-income countries: what we know and what we don't know. BJOG 2016; 123:1589-92. [PMID: 26629786 PMCID: PMC4996336 DOI: 10.1111/1471-0528.13782] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2015] [Indexed: 11/28/2022]
Affiliation(s)
- W Johnson
- Elsie Widdowson LaboratoryMedical Research Council (MRC) Human Nutrition ResearchCambridgeUK
| | - SE Moore
- Elsie Widdowson LaboratoryMedical Research Council (MRC) Human Nutrition ResearchCambridgeUK
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