1
|
Okwaraji YB, Krasevec J, Bradley E, Conkle J, Stevens GA, Gatica-Domínguez G, Ohuma EO, Coffey C, Estevez Fernandez DG, Blencowe H, Kimathi B, Moller AB, Lewin A, Hussain-Alkhateeb L, Dalmiya N, Lawn JE, Borghi E, Hayashi C. National, regional, and global estimates of low birthweight in 2020, with trends from 2000: a systematic analysis. Lancet 2024; 403:1071-1080. [PMID: 38430921 DOI: 10.1016/s0140-6736(23)01198-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/31/2023] [Accepted: 06/07/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND Low birthweight (LBW; <2500 g) is an important predictor of health outcomes throughout the life course. We aimed to update country, regional, and global estimates of LBW prevalence for 2020, with trends from 2000, to assess progress towards global targets to reduce LBW by 30% by 2030. METHODS For this systematic analysis, we searched population-based, nationally representative data on LBW from Jan 1, 2000, to Dec 31, 2020. Using 2042 administrative and survey datapoints from 158 countries and areas, we developed a Bayesian hierarchical regression model incorporating country-specific intercepts, time-varying covariates, non-linear time trends, and bias adjustments based on data quality. We also provided novel estimates by birthweight subgroups. FINDINGS An estimated 19·8 million (95% credible interval 18·4-21·7 million) or 14·7% (13·7-16·1) of liveborn newborns were LBW worldwide in 2020, compared with 22·1 million (20·7-23·9 million) and 16·6% (15·5-17·9) in 2000-an absolute reduction of 1·9 percentage points between 2000 and 2020. Using 2012 as the baseline, as this is when the Global Nutrition Target began, the estimated average annual rate of reduction from 2012 to 2020 was 0·3% worldwide, 0·85% in southern Asia, and 0·59% in sub-Saharan Africa. Nearly three-quarters of LBW births in 2020 occurred in these two regions: of 19 833 900 estimated LBW births worldwide, 8 817 000 (44·5%) were in southern Asia and 5 381 300 (27·1%) were in sub-Saharan Africa. Of 945 300 estimated LBW births in northern America, Australia and New Zealand, central Asia, and Europe, approximately 35·0% (323 700) weighed less than 2000 g: 5·8% (95% CI 5·2-6·4; 54 800 [95% CI 49 400-60 800]) weighed less than 1000 g, 9·0% (8·7-9·4; 85 400 [82 000-88 900]) weighed between 1000 g and 1499 g, and 19·4% (19·0-19·8; 183 500 [180 000-187 000]) weighed between 1500 g and 1999 g. INTERPRETATION Insufficient progress has occurred over the past two decades to meet the Global Nutrition Target of a 30% reduction in LBW between 2012 and 2030. Accelerating progress requires investments throughout the lifecycle focused on primary prevention, especially for adolescent girls and women living in the most affected countries. With increasing numbers of births in facilities and advancing electronic information systems, improvements in the quality and availability of administrative LBW data are also achievable. FUNDING The Children's Investment Fund Foundation; the UNDP-UNFPA-UNICEF-WHO World Bank Special Programme of Research, Development and Research Training in Human Reproduction; and the Bill & Melinda Gates Foundation.
Collapse
Affiliation(s)
- Yemisrach B Okwaraji
- Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Julia Krasevec
- Division of Data, Analytics, Planning and Monitoring, United Nations Children's Fund, New York, NY, USA
| | - Ellen Bradley
- Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Joel Conkle
- Division of Data, Analytics, Planning and Monitoring, United Nations Children's Fund, New York, NY, USA
| | - Gretchen A Stevens
- Department of Nutrition and Food Safety, World Health Organization, Geneva, Switzerland
| | | | - Eric O Ohuma
- Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Christopher Coffey
- Division of Data, Analytics, Planning and Monitoring, United Nations Children's Fund, New York, NY, USA
| | | | - Hannah Blencowe
- Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Ben Kimathi
- Division of Data, Analytics, Planning and Monitoring, United Nations Children's Fund, New York, NY, USA
| | - Ann-Beth Moller
- Department of Sexual and Reproductive Health and Research World Health Organization includes the UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Geneva, Switzerland
| | - Alexandra Lewin
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - Laith Hussain-Alkhateeb
- Global Health Research Group, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Population Health Research Section, King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Nita Dalmiya
- Programme Group, Nutrition and Child Development Section, United Nations Children's Fund, New York, NY, USA
| | - Joy E Lawn
- Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK.
| | - Elaine Borghi
- Department of Nutrition and Food Safety, World Health Organization, Geneva, Switzerland
| | - Chika Hayashi
- Division of Data, Analytics, Planning and Monitoring, United Nations Children's Fund, New York, NY, USA
| |
Collapse
|
2
|
Lawn JE, Ohuma EO, Bradley E, Idueta LS, Hazel E, Okwaraji YB, Erchick DJ, Yargawa J, Katz J, Lee ACC, Diaz M, Salasibew M, Requejo J, Hayashi C, Moller AB, Borghi E, Black RE, Blencowe H. Small babies, big risks: global estimates of prevalence and mortality for vulnerable newborns to accelerate change and improve counting. Lancet 2023; 401:1707-1719. [PMID: 37167989 DOI: 10.1016/s0140-6736(23)00522-6] [Citation(s) in RCA: 51] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 02/23/2023] [Accepted: 03/02/2023] [Indexed: 05/13/2023]
Abstract
Small newborns are vulnerable to mortality and lifelong loss of human capital. Measures of vulnerability previously focused on liveborn low-birthweight (LBW) babies, yet LBW reduction targets are off-track. There are two pathways to LBW, preterm birth and fetal growth restriction (FGR), with the FGR pathway resulting in the baby being small for gestational age (SGA). Data on LBW babies are available from 158 (81%) of 194 WHO member states and the occupied Palestinian territory, including east Jerusalem, with 113 (58%) having national administrative data, whereas data on preterm births are available from 103 (53%) of 195 countries and areas, with only 64 (33%) providing national administrative data. National administrative data on SGA are available for only eight countries. Global estimates for 2020 suggest 13·4 million livebirths were preterm, with rates over the past decade remaining static, and 23·4 million were SGA. In this Series paper, we estimated prevalence in 2020 for three mutually exclusive types of small vulnerable newborns (SVNs; preterm non-SGA, term SGA, and preterm SGA) using individual-level data (2010-20) from 23 national datasets (∼110 million livebirths) and 31 studies in 18 countries (∼0·4 million livebirths). We found 11·9 million (50% credible interval [Crl] 9·1-12·2 million; 8·8%, 50% Crl 6·8-9·0%) of global livebirths were preterm non-SGA, 21·9 million (50% Crl 20·1-25·5 million; 16·3%, 14·9-18·9%) were term SGA, and 1·5 million (50% Crl 1·2-4·2 million; 1·1%, 50% Crl 0·9-3·1%) were preterm SGA. Over half (55·3%) of the 2·4 million neonatal deaths worldwide in 2020 were attributed to one of the SVN types, of which 73·4% were preterm and the remainder were term SGA. Analyses from 12 of the 23 countries with national data (0·6 million stillbirths at ≥22 weeks gestation) showed around 74% of stillbirths were preterm, including 16·0% preterm SGA and approximately one-fifth of term stillbirths were SGA. There are an estimated 1·9 million stillbirths per year associated with similar vulnerability pathways; hence integrating stillbirths to burden assessments and relevant indicators is crucial. Data can be improved by counting, weighing, and assessing the gestational age of every newborn, whether liveborn or stillborn, and classifying small newborns by the three vulnerability types. The use of these more specific types could accelerate prevention and help target care for the most vulnerable babies.
Collapse
Affiliation(s)
- Joy E Lawn
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK.
| | - Eric O Ohuma
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Ellen Bradley
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Elizabeth Hazel
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Yemisrach B Okwaraji
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Daniel J Erchick
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Judith Yargawa
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Joanne Katz
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Anne C C Lee
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Mike Diaz
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Mihretab Salasibew
- Monitoring Learning and Evaluation, Children's Investment Fund Foundation, London, UK
| | - Jennifer Requejo
- Division of Data, Analytics, Planning and Monitoring, United Nations Children's Fund, New York, NY, USA
| | - Chika Hayashi
- Division of Data, Analytics, Planning and Monitoring, United Nations Children's Fund, New York, NY, USA
| | - Ann-Beth Moller
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Elaine Borghi
- Department of Nutrition and Food Safety, World Health Organization, Geneva, Switzerland
| | - Robert E Black
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Hannah Blencowe
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
3
|
Lelijveld N, Benedict RK, Wrottesley SV, Bhutta ZA, Borghi E, Cole TJ, Croft T, Frongillo EA, Hayashi C, Namaste S, Sharma D, Tumilowicz A, Wells JC, Ezzati M, Patton GC, Mates E. Towards standardised and valid anthropometric indicators of nutritional status in middle childhood and adolescence. Lancet Child Adolesc Health 2022; 6:738-746. [PMID: 36027904 DOI: 10.1016/s2352-4642(22)00196-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/10/2022] [Accepted: 06/21/2022] [Indexed: 06/15/2023]
Abstract
Recognition of the importance of nutrition during middle childhood (age 5-9 years) and adolescence (age 10-19 years) is increasing, particularly in the context of global food insecurity and rising overweight and obesity rates. Until now, policy makers have been slow to respond to rapidly changing patterns of malnutrition across these age groups. One barrier has been a scarcity of consistent and regular nutrition surveillance systems for these age groups. What should be measured, and how best to operationalise anthropometric indicators that have been the cornerstone of nutrition surveillance in younger children and in adults, has been the topic of ongoing debate. Even with consensus on the importance of a given anthropometric indicator, difficulties arise in interpreting trends over time and between countries owing to the use of different terminologies, reference data, and cutoff points. In this Viewpoint we highlight the need to revisit anthropometric indicators across middle childhood and adolescence, a process that will require WHO and UNICEF coordination, the engagement of national implementors and policy makers, and partnership with research communities and donors.
Collapse
Affiliation(s)
| | | | | | - Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada; Centre of Excellence in Women & Child Health, The Aga Khan University, Karachi, Pakistan
| | | | - Tim J Cole
- Population Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Trevor Croft
- The Demographic and Health Surveys Program, ICF, Rockville, MD, USA
| | - Edward A Frongillo
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | | | - Sorrel Namaste
- The Demographic and Health Surveys Program, ICF, Rockville, MD, USA
| | | | | | - Jonathan C Wells
- Population Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Majid Ezzati
- School of Public Health, Imperial College London, London, UK; Regional Institute for Population Studies, University of Ghana, Accra, Ghana
| | - George C Patton
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | | |
Collapse
|
4
|
Krasevec J, Blencowe H, Coffey C, Okwaraji YB, Estevez D, Stevens GA, Ohuma EO, Conkle J, Gatica-Domínguez G, Bradley E, Muthamia BK, Dalmiya N, Lawn JE, Borghi E, Hayashi C. Study protocol for UNICEF and WHO estimates of global, regional, and national low birthweight prevalence for 2000 to 2020. Gates Open Res 2022; 6:80. [PMID: 37265999 PMCID: PMC10229761 DOI: 10.12688/gatesopenres.13666.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2022] [Indexed: 09/04/2023] Open
Abstract
Background Reducing low birthweight (LBW, weight at birth less than 2,500g) prevalence by at least 30% between 2012 and 2025 is a target endorsed by the World Health Assembly that can contribute to achieving Sustainable Development Goal 2 (Zero Hunger) by 2030. The 2019 LBW estimates indicated a global prevalence of 14.6% (20.5 million newborns) in 2015. We aim to develop updated LBW estimates at global, regional, and national levels for up to 202 countries for the period of 2000 to 2020. Methods Two types of sources for LBW data will be sought: national administrative data and population-based surveys. Administrative data will be searched for countries with a facility birth rate ≥80% and included when birthweight data account for ≥80% of UN estimated live births for that country and year. Surveys with birthweight data published since release of the 2019 edition of the LBW estimates will be adjusted using the standard methodology applied for the previous estimates. Risk of bias assessments will be undertaken. Covariates will be selected based on a conceptual framework of plausible associations with LBW, covariate time-series data quality, collinearity between covariates and correlations with LBW. National LBW prevalence will be estimated using a Bayesian multilevel-mixed regression model, then aggregated to derive regional and global estimates through population-weighted averages. Conclusion Whilst availability of LBW data has increased, especially with more facility births, gaps remain in the quantity and quality of data, particularly in low-and middle-income countries. Challenges include high percentages of missing data, lack of adherence to reporting standards, inaccurate measurement, and data heaping. Updated LBW estimates are important to highlight the global burden of LBW, track progress towards nutrition targets, and inform investments in programmes. Reliable, nationally representative data are key, alongside investments to improve the measurement and recording of an accurate birthweight for every baby.
Collapse
Affiliation(s)
- Julia Krasevec
- Division of Data, Analytics, Planning and Monitoring, United Nations Children’s Fund, New York, NY, 10017, USA
| | - Hannah Blencowe
- Centre for Maternal, Adolescent, Reproductive & Child Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Christopher Coffey
- Division of Data, Analytics, Planning and Monitoring, United Nations Children’s Fund, New York, NY, 10017, USA
| | - Yemisrach B. Okwaraji
- Centre for Maternal, Adolescent, Reproductive & Child Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Diana Estevez
- Division of Data Analytics and Delivery for Impact, World Health Organization, Geneva, 1202, Switzerland
| | | | - Eric O. Ohuma
- Centre for Maternal, Adolescent, Reproductive & Child Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Joel Conkle
- Division of Data, Analytics, Planning and Monitoring, United Nations Children’s Fund, New York, NY, 10017, USA
| | | | - Ellen Bradley
- Centre for Maternal, Adolescent, Reproductive & Child Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Ben Kimathi Muthamia
- Division of Data, Analytics, Planning and Monitoring, United Nations Children’s Fund, New York, NY, 10017, USA
| | - Nita Dalmiya
- Programme Group, United Nations Children’s Fund, New York, NY, 10017, USA
| | - Joy E. Lawn
- Centre for Maternal, Adolescent, Reproductive & Child Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Elaine Borghi
- Department of Nutrition and Food Safety, World Health Organization, Geneva, 1202, Switzerland
| | - Chika Hayashi
- Division of Data, Analytics, Planning and Monitoring, United Nations Children’s Fund, New York, NY, 10017, USA
| |
Collapse
|
5
|
Leroy JL, Frongillo EA, Borghi E. Using height-adjusted stunting prevalence will fail disadvantaged children worldwide. The Lancet Global Health 2022; 10:e620. [PMID: 35427513 PMCID: PMC9023752 DOI: 10.1016/s2214-109x(22)00076-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 02/15/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Jef L Leroy
- International Food Policy Research Institute, Washington, DC 20005, USA.
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA
| | | |
Collapse
|
6
|
Cozzi S, Timon G, Tagliavini E, Piro R, Borghi E, Tiseo M, Iotti C, ciammella P. PO-1271 Redetermination Of Pd-L1 Expression After Chemo-Radiation In Locally Advanced Pd-L1 Negative NSCLC (RECAL TRIAL. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03235-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
7
|
Stevens GA, Paciorek CJ, Flores-Urrutia MC, Borghi E, Namaste S, Wirth JP, Suchdev PS, Ezzati M, Rohner F, Flaxman SR, Rogers LM. National, regional, and global estimates of anaemia by severity in women and children for 2000-19: a pooled analysis of population-representative data. Lancet Glob Health 2022; 10:e627-e639. [PMID: 35427520 PMCID: PMC9023869 DOI: 10.1016/s2214-109x(22)00084-5] [Citation(s) in RCA: 99] [Impact Index Per Article: 49.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 01/23/2022] [Accepted: 02/21/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND Anaemia causes health and economic harms. The prevalence of anaemia in women aged 15-49 years, by pregnancy status, is indicator 2.2.3 of the UN Sustainable Development Goals, and the aim of halving the anaemia prevalence in women of reproductive age by 2030 is an extension of the 2025 global nutrition targets endorsed by the World Health Assembly (WHA). We aimed to estimate the prevalence of anaemia by severity for children aged 6-59 months, non-pregnant women aged 15-49 years, and pregnant women aged 15-49 years in 197 countries and territories and globally for the period 2000-19. METHODS For this pooled analysis of population-representative data, we collated 489 data sources on haemoglobin distribution in children and women from 133 countries, including 4·5 million haemoglobin measurements. Our data sources comprised health examination, nutrition, and household surveys, accessed as anonymised individual records or as summary statistics such as mean haemoglobin and anaemia prevalence. We used a Bayesian hierarchical mixture model to estimate haemoglobin distributions in each population and country-year. This model allowed for coherent estimation of mean haemoglobin and prevalence of anaemia by severity. FINDINGS Globally, in 2019, 40% (95% uncertainty interval [UI] 36-44) of children aged 6-59 months were anaemic, compared to 48% (45-51) in 2000. Globally, the prevalence of anaemia in non-pregnant women aged 15-49 years changed little between 2000 and 2019, from 31% (95% UI 28-34) to 30% (27-33), while in pregnant women aged 15-49 years it decreased from 41% (39-43) to 36% (34-39). In 2019, the prevalence of anaemia in children aged 6-59 months exceeded 70% in 11 countries and exceeded 50% in all women aged 15-49 years in ten countries. Globally in all populations and in most countries and regions, the prevalence of mild anaemia changed little, while moderate and severe anaemia declined in most populations and geographical locations, indicating a shift towards mild anaemia. INTERPRETATION Globally, regionally, and in nearly all countries, progress on anaemia in women aged 15-49 years is insufficient to meet the WHA global nutrition target to halve anaemia prevalence by 2030, and the prevalence of anaemia in children also remains high. A better understanding of the context-specific causes of anaemia and quality implementation of effective multisectoral actions to address these causes are needed. FUNDING USAID, US Centers for Disease Control and Prevention, and Bill & Melinda Gates Foundation.
Collapse
Affiliation(s)
- Gretchen A Stevens
- Independent researcher, Los Angeles, CA, USA; School of Public Health, Imperial College London, London, UK
| | | | | | - Elaine Borghi
- Department of Nutrition and Food Safety, World Health Organization, Geneva, Switzerland
| | | | | | - Parminder S Suchdev
- Department of Pediatrics and Hubert Department of Global Health, Emory University, Atlanta, GA, USA
| | - Majid Ezzati
- School of Public Health, Imperial College London, London, UK; Regional Institute for Population Studies, University of Ghana, Legon, Ghana
| | | | - Seth R Flaxman
- Department of Computer Science, University of Oxford, Oxford, UK
| | - Lisa M Rogers
- Department of Nutrition and Food Safety, World Health Organization, Geneva, Switzerland.
| |
Collapse
|
8
|
Saraswati CM, Borghi E, da Silva Breda JJR, Flores-Urrutia MC, Williams J, Hayashi C, Frongillo EA, McLain AC. Estimating Childhood Stunting and Overweight Trends in the European Region from Sparse Longitudinal Data. J Nutr 2022; 152:1773-1782. [PMID: 35349691 PMCID: PMC9258559 DOI: 10.1093/jn/nxac072] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 03/01/2022] [Accepted: 03/16/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Monitoring countries' progress toward the achievement of their nutrition targets is an important task, but data sparsity makes monitoring trends challenging. Childhood stunting and overweight data in the European region over the last 30 y have had low coverage and frequency, with most data only covering a portion of the complete age interval of 0-59 mo. OBJECTIVES We implemented a statistical method to extract useful information on child malnutrition trends from sparse longitudinal data for these indicators. METHODS Heteroscedastic penalized longitudinal mixed models were used to accommodate data sparsity and predict region-wide, country-level trends over time. We leveraged prevalence estimates stratified by sex and partial age intervals (i.e., intervals that do not cover the complete 0-59 mo), which expanded the available data (for stunting: from 84 sources and 428 prevalence estimates to 99 sources and 1786 estimates), improving the robustness of our analysis. RESULTS Results indicated a generally decreasing trend in stunting and a stable, slightly diminishing rate for overweight, with large differences in trends between low- and middle-income countries compared with high-income countries. No differences were found between age groups and between sexes. Cross-validation results indicated that both stunting and overweight models were robust in estimating the indicators for our data (root mean squared error: 0.061 and 0.056; median absolute deviation: 0.045 and 0.042; for stunting and overweight, respectively). CONCLUSIONS These statistical methods can provide useful and robust information on child malnutrition trends over time, even when data are sparse.
Collapse
Affiliation(s)
| | - Elaine Borghi
- Department of Nutrition and Food Safety, WHO, Geneva, Switzerland
| | | | | | | | - Chika Hayashi
- Division of Data, Analytics, Planning and Monitoring, UNICEF, New York, NY, USA
| | | | - Alexander C McLain
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| |
Collapse
|
9
|
Zhao L, Cao B, Borghi E, Chatterji S, Garcia-Saiso S, Rashidian A, Doctor HV, D'Agostino M, Karamagi HC, Novillo-Ortiz D, Landry M, Hosseinpoor AR, Noor A, Riley L, Cox A, Gao J, Litavecz S, Asma S. Data gaps towards health development goals, 47 low- and middle-income countries. Bull World Health Organ 2022; 100:40-49. [PMID: 35017756 PMCID: PMC8722627 DOI: 10.2471/blt.21.286254] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 10/11/2021] [Accepted: 10/22/2021] [Indexed: 11/27/2022] Open
Abstract
Objective To assess the availability and gaps in data for measuring progress towards health-related sustainable development goals and other targets in selected low- and middle-income countries. Methods We used 14 international population surveys to evaluate the health data systems in the 47 least developed countries over the years 2015–2020. We reviewed the survey instruments to determine whether they contained tools that could be used to measure 46 health-related indicators defined by the World Health Organization. We recorded the number of countries with data available on the indicators from these surveys. Findings Twenty-seven indicators were measurable by the surveys we identified. The two health emergency indicators were not measurable by current surveys. The percentage of countries that used surveys to collect data over 2015–2020 were lowest for tuberculosis (2/47; 4.3%), hepatitis B (3/47; 6.4%), human immunodeficiency virus (11/47; 23.4%), child development status and child abuse (both 13/47; 27.7%), compared with safe drinking water (37/47; 78.7%) and births attended by skilled health personnel (36/47; 76.6%). Nineteen countries collected data on 21 or more indicators over 2015–2020 while nine collected data on no indicators; over 2018–2020 these numbers reduced to six and 20, respectively. Conclusion Examining selected international surveys provided a quick summary of health data available in the 47 least developed countries. We found major gaps in health data due to long survey cycles and lack of appropriate survey instruments. Novel indicators and survey instruments would be needed to track the fast-changing situation of health emergencies.
Collapse
Affiliation(s)
- Luhua Zhao
- Data, Analytics and Delivery for Impact Division, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Bochen Cao
- Data, Analytics and Delivery for Impact Division, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Elaine Borghi
- Data, Analytics and Delivery for Impact Division, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Somnath Chatterji
- Data, Analytics and Delivery for Impact Division, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Sebastian Garcia-Saiso
- Regional Office for the Americas, World Health Organization, Washington, DC, United States of America (USA)
| | - Arash Rashidian
- Regional Office for the Eastern Mediterranean, World Health Organization, Cairo, Egypt
| | - Henry Victor Doctor
- Regional Office for the Eastern Mediterranean, World Health Organization, Cairo, Egypt
| | - Marcelo D'Agostino
- Regional Office for the Americas, World Health Organization, Washington, DC, United States of America (USA)
| | | | | | - Mark Landry
- Regional Office for South-East Asia, World Health Organization, New Delhi, India
| | - Ahmad Reza Hosseinpoor
- Data, Analytics and Delivery for Impact Division, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Abdisalan Noor
- Data, Analytics and Delivery for Impact Division, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Leanne Riley
- Data, Analytics and Delivery for Impact Division, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Adrienne Cox
- Regional Office for the Americas, World Health Organization, Washington, DC, United States of America (USA)
| | - Jun Gao
- Regional Office for the Western Pacific, World Health Organization, Manila, Philippines
| | | | - Samira Asma
- Data, Analytics and Delivery for Impact Division, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| |
Collapse
|
10
|
Jawaldeh AA, Doggui R, Borghi E, Aguenaou H, Ammari LE, Abul-Fadl A, McColl K. Tackling Childhood Stunting in the Eastern Mediterranean Region in the Context of COVID-19. Children (Basel) 2020; 7:children7110239. [PMID: 33227997 PMCID: PMC7699289 DOI: 10.3390/children7110239] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/11/2020] [Accepted: 11/13/2020] [Indexed: 12/05/2022]
Abstract
Over 20 million children under 5 years old in the WHO Eastern Mediterranean Region have stunted growth, as a result of chronic malnutrition, with damaging long-term consequences for individuals and societies. This review extracted and analyzed data from the UNICEF, WHO and the World Bank malnutrition estimates to present an overall picture of childhood stunting in the region. The number of children under 5 in the region who are affected by stunting has dropped from 24.5 million (40%) in 1990 to 20.6 million (24.2%) in 2019. The reduction rate since the 2012 baseline is only about two fifths of that required and much more rapid progress will be needed to reach the internationally agreed targets by 2025 and 2030. Prevalence is highest in low-income countries and those with a lower Human Development Index. The COVID-19 pandemic threatens to undermine efforts to reduce stunting, through its impact on access and affordability of safe and nutritious foods and access to important health services. Priority areas for action to tackle stunting as part of a comprehensive, multisectoral nutrition strategy are proposed. In light of the threat that COVID-19 will exacerbate the already heavy burden of malnutrition in the Eastern Mediterranean Region, implementation of such strategies is more important than ever.
Collapse
Affiliation(s)
- Ayoub Al Jawaldeh
- WHO Regional Office for Eastern Mediterranean Region, Cairo 11371, Egypt
- Correspondence: (A.A.J.); (K.M.)
| | - Radhouene Doggui
- Department of Family Medicine, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada;
- Centre de Formation méDicale du Nouveau-Brunswick, Moncton, NB E1A 7R1, Canada
| | - Elaine Borghi
- WHO Department of Nutrition and Food Safety, Geneva, 1211 Geneva, Switzerland;
| | - Hassan Aguenaou
- Joint Unit of Research in Nutrition and Food, RDC-Nutrition AFRA/IEA, Ibn Tofail University-CNESTEN, Kénitra 14000, Morocco;
| | - Laila El Ammari
- Programme National de Nutrition, Ministère de la Santé, Rabat 10090, Morocco;
| | - Azza Abul-Fadl
- Benha Faculty of Medicine, Benha University 26B, Cairo 11211, Egypt;
| | - Karen McColl
- Karen McColl Consulting, West Sussex PO21 4NB, UK
- Correspondence: (A.A.J.); (K.M.)
| |
Collapse
|
11
|
Herzog PL, Borghi E, Traxlmayr MW, Obinger C, Sikes HD, Peterbauer CK. Developing a cell-bound detection system for the screening of oxidase activity using the fluorescent peroxide sensor roGFP2-Orp1. Protein Eng Des Sel 2020; 33:gzaa019. [PMID: 32930800 PMCID: PMC7720637 DOI: 10.1093/protein/gzaa019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 06/02/2020] [Accepted: 07/08/2020] [Indexed: 11/14/2022] Open
Abstract
Accurate yet efficient high-throughput screenings have emerged as essential technology for enzyme engineering via directed evolution. Modern high-throughput screening platforms for oxidoreductases are commonly assisted by technologies such as surface display and rely on emulsification techniques to facilitate single-cell analysis via fluorescence-activated cell sorting. Empowered by the dramatically increased throughput, the screening of significantly larger sequence spaces in acceptable time frames is achieved but usually comes at the cost of restricted applicability. In this work, we tackle this problem by utilizing roGFP2-Orp1 as a fluorescent one-component detection system for enzymatic H2O2 formation. We determined the kinetic parameters of the roGFP2-Orp1 reaction with H2O2 and established an efficient immobilization technique for the sensor on Saccharomyces cerevisiae cells employing the lectin Concanavalin A. This allowed to realize a peroxide-sensing shell on enzyme-displaying cells, a system that was successfully employed to screen for H2O2 formation of enzyme variants in a whole-cell setting.
Collapse
Affiliation(s)
- P L Herzog
- Food Biotechnology Laboratory, Department of Food Science and Technology, BOKU – University of Natural Resources and Life Sciences, Muthgasse 11, 1190 Vienna, Austria
| | - E Borghi
- Department of Life Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi 287, 41124 Modena, Italy
| | - M W Traxlmayr
- Institute of Biochemistry, Department of Chemistry, BOKU – University of Natural Resources and Life Sciences, Muthgasse 18, 1190 Vienna, Austria
| | - C Obinger
- Institute of Biochemistry, Department of Chemistry, BOKU – University of Natural Resources and Life Sciences, Muthgasse 18, 1190 Vienna, Austria
| | - H D Sikes
- Department of Chemical Engineering, MIT – Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge 02139, MA, USA
| | - C K Peterbauer
- Food Biotechnology Laboratory, Department of Food Science and Technology, BOKU – University of Natural Resources and Life Sciences, Muthgasse 11, 1190 Vienna, Austria
| |
Collapse
|
12
|
Hemalatha R, Pandey A, Kinyoki D, Ramji S, Lodha R, Kumar GA, Kassebaum NJ, Borghi E, Agrawal D, Gupta SS, Laxmaiah A, Kar A, Mathai M, Varghese CM, Awasthi S, Bansal PG, Chakma JK, Collison M, Dwivedi S, Golechha MJ, Gonmei Z, Jerath SG, Kant R, Khera AK, Krishnankutty RP, Kurpad AV, Ladusingh L, Malhotra R, Mamidi RS, Manguerra H, Mathew JL, Mutreja P, Nimmathota A, Pati A, Purwar M, Radhakrishna KV, Raina N, Sankar MJ, Saraf DS, Schipp M, Sharma R, Shekhar C, Sinha A, Sreenivas V, Reddy KS, Bekedam HJ, Swaminathan S, Lim SS, Dandona R, Murray CJ, Hay SI, Toteja G, Dandona L. Mapping of variations in child stunting, wasting and underweight within the states of India: the Global Burden of Disease Study 2000-2017. EClinicalMedicine 2020; 22:100317. [PMID: 32510044 PMCID: PMC7264980 DOI: 10.1016/j.eclinm.2020.100317] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND To inform actions at the district level under the National Nutrition Mission (NNM), we assessed the prevalence trends of child growth failure (CGF) indicators for all districts in India and inequality between districts within the states. METHODS We assessed the trends of CGF indicators (stunting, wasting and underweight) from 2000 to 2017 across the districts of India, aggregated from 5 × 5 km grid estimates, using all accessible data from various surveys with subnational geographical information. The states were categorised into three groups using their Socio-demographic Index (SDI) levels calculated as part of the Global Burden of Disease Study based on per capita income, mean education and fertility rate in women younger than 25 years. Inequality between districts within the states was assessed using coefficient of variation (CV). We projected the prevalence of CGF indicators for the districts up to 2030 based on the trends from 2000 to 2017 to compare with the NNM 2022 targets for stunting and underweight, and the WHO/UNICEF 2030 targets for stunting and wasting. We assessed Pearson correlation coefficient between two major national surveys for district-level estimates of CGF indicators in the states. FINDINGS The prevalence of stunting ranged 3.8-fold from 16.4% (95% UI 15.2-17.8) to 62.8% (95% UI 61.5-64.0) among the 723 districts of India in 2017, wasting ranged 5.4-fold from 5.5% (95% UI 5.1-6.1) to 30.0% (95% UI 28.2-31.8), and underweight ranged 4.6-fold from 11.0% (95% UI 10.5-11.9) to 51.0% (95% UI 49.9-52.1). 36.1% of the districts in India had stunting prevalence 40% or more, with 67.0% districts in the low SDI states group and only 1.1% districts in the high SDI states with this level of stunting. The prevalence of stunting declined significantly from 2010 to 2017 in 98.5% of the districts with a maximum decline of 41.2% (95% UI 40.3-42.5), wasting in 61.3% with a maximum decline of 44.0% (95% UI 42.3-46.7), and underweight in 95.0% with a maximum decline of 53.9% (95% UI 52.8-55.4). The CV varied 7.4-fold for stunting, 12.2-fold for wasting, and 8.6-fold for underweight between the states in 2017; the CV increased for stunting in 28 out of 31 states, for wasting in 16 states, and for underweight in 20 states from 2000 to 2017. In order to reach the NNM 2022 targets for stunting and underweight individually, 82.6% and 98.5% of the districts in India would need a rate of improvement higher than they had up to 2017, respectively. To achieve the WHO/UNICEF 2030 target for wasting, all districts in India would need a rate of improvement higher than they had up to 2017. The correlation between the two national surveys for district-level estimates was poor, with Pearson correlation coefficient of 0.7 only in Odisha and four small north-eastern states out of the 27 states covered by these surveys. INTERPRETATION CGF indicators have improved in India, but there are substantial variations between the districts in their magnitude and rate of decline, and the inequality between districts has increased in a large proportion of the states. The poor correlation between the national surveys for CGF estimates highlights the need to standardise collection of anthropometric data in India. The district-level trends in this report provide a useful reference for targeting the efforts under NNM to reduce CGF across India and meet the Indian and global targets.
Collapse
|
13
|
Blencowe H, Krasevec J, de Onis M, Black RE, An X, Stevens GA, Borghi E, Hayashi C, Estevez D, Cegolon L, Shiekh S, Ponce Hardy V, Lawn JE, Cousens S. National, regional, and worldwide estimates of low birthweight in 2015, with trends from 2000: a systematic analysis. Lancet Glob Health 2019; 7:e849-e860. [PMID: 31103470 PMCID: PMC6560046 DOI: 10.1016/s2214-109x(18)30565-5] [Citation(s) in RCA: 489] [Impact Index Per Article: 97.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 11/19/2018] [Indexed: 11/30/2022]
Abstract
Background Low birthweight (LBW) of less than 2500 g is an important marker of maternal and fetal health, predicting mortality, stunting, and adult-onset chronic conditions. Global nutrition targets set at the World Health Assembly in 2012 include an ambitious 30% reduction in LBW prevalence between 2012 and 2025. Estimates to track progress towards this target are lacking; with this analysis, we aim to assist in setting a baseline against which to assess progress towards the achievement of the World Health Assembly targets. Methods We sought to identify all available LBW input data for livebirths for the years 2000–16. We considered population-based national or nationally representative datasets for inclusion if they contained information on birthweight or LBW prevalence for livebirths. A new method for survey adjustment was developed and used. For 57 countries with higher quality time-series data, we smoothed country-reported trends in birthweight data by use of B-spline regression. For all other countries, we estimated LBW prevalence and trends by use of a restricted maximum likelihood approach with country-level random effects. Uncertainty ranges were obtained through bootstrapping. Results were summed at the regional and worldwide level. Findings We collated 1447 country-years of birthweight data (281 million births) for 148 countries of 195 UN member states (47 countries had no data meeting inclusion criteria). The estimated worldwide LBW prevalence in 2015 was 14·6% (uncertainty range [UR] 12·4–17·1) compared with 17·5% (14·1–21·3) in 2000 (average annual reduction rate [AARR] 1·23%). In 2015, an estimated 20·5 million (UR 17·4–24·0 million) livebirths were LBW, 91% from low-and-middle income countries, mainly southern Asia (48%) and sub-Saharan Africa (24%). Interpretation Although these estimates suggest some progress in reducing LBW between 2000 and 2015, achieving the 2·74% AARR required between 2012 and 2025 to meet the global nutrition target will require more than doubling progress, involving both improved measurement and programme investments to address the causes of LBW throughout the lifecycle. Funding Bill & Melinda Gates Foundation, The Children's Investment Fund Foundation, United Nations Children's Fund (UNICEF), and WHO.
Collapse
Affiliation(s)
- Hannah Blencowe
- Maternal Adolescent Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK.
| | - Julia Krasevec
- Data and Analytics, Division of Data, Research and Policy, UNICEF, NY, USA
| | - Mercedes de Onis
- Department of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland
| | - Robert E Black
- Institute for International Programs, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Xiaoyi An
- Data and Analytics, Division of Data, Research and Policy, UNICEF, NY, USA
| | - Gretchen A Stevens
- Department of Information Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Elaine Borghi
- Department of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland
| | - Chika Hayashi
- Data and Analytics, Division of Data, Research and Policy, UNICEF, NY, USA
| | - Diana Estevez
- Department of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland
| | - Luca Cegolon
- Maternal Adolescent Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK; Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy; Local Health Unit N2, Public Health Department Treviso, Italy
| | - Suhail Shiekh
- Maternal Adolescent Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Victoria Ponce Hardy
- Maternal Adolescent Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Joy E Lawn
- Maternal Adolescent Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Simon Cousens
- Maternal Adolescent Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
14
|
McLain AC, Frongillo EA, Feng J, Borghi E. Prediction intervals for penalized longitudinal models with multisource summary measures: An application to childhood malnutrition. Stat Med 2019; 38:1002-1012. [PMID: 30430613 DOI: 10.1002/sim.8024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 08/15/2018] [Accepted: 10/12/2018] [Indexed: 11/05/2022]
Abstract
In many global health analyses, it is of interest to examine countries' progress using indicators of socio-economic conditions based on national surveys from varying sources. This results in longitudinal data where heteroscedastic summary measures, rather than individual level data, are available. Administration of national surveys can be sporadic, resulting in sparse data measurements for some countries. Furthermore, the trend of the indicators over time is usually nonlinear and varies by country. It is of interest to track the current level of indicators to determine if countries are meeting certain thresholds, such as those indicated in the United Nations Sustainable Development Goals. In addition, estimation of confidence and prediction intervals are vital to determine true changes in prevalence and where data is low in quantity and/or quality. In this article, we use heteroscedastic penalized longitudinal models with survey summary data to estimate yearly prevalence of malnutrition quantities. We develop and compare methods to estimate confidence and prediction intervals using asymptotic and parametric bootstrap techniques. The intervals can incorporate data from multiple sources or other general data-smoothing steps. The methods are applied to African countries in the UNICEF-WHO-The World Bank joint child malnutrition data set. The properties of the intervals are demonstrated through simulation studies and cross-validation of real data.
Collapse
Affiliation(s)
- Alexander C McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Juan Feng
- Food and Agriculture Organization, United Nations, Rome, Italy
| | | |
Collapse
|
15
|
Verduci E, Moretti F, Bassanini G, Banderali G, Rovelli V, Casiraghi MC, Morace G, Borgo F, Borghi E. Phenylketonuric diet negatively impacts on butyrate production. Nutr Metab Cardiovasc Dis 2018; 28:385-392. [PMID: 29502926 DOI: 10.1016/j.numecd.2018.01.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 01/12/2018] [Accepted: 01/15/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIMS Phenylalanine (Phe) restricted diet, combined with Phe-free l-amino acid supplementation, is the mainstay of treatment for phenylketonuria (PKU). Being the diet a key factor modulating gut microbiota composition, the aim of the present paper was to compare dietary intakes, gut microbiota biodiversity and short chain fatty acids (SCFAs) production in children with PKU, on low-Phe diet, and in children with mild hyperphenylalaninemia (MHP), on unrestricted diet. METHODS AND RESULTS We enrolled 21 PKU and 21 MHP children matched for gender, age and body mass index z-score. Dietary intakes, including glycemic index (GI) and glycemic load (GL), and fecal microbiota analyses, by means of denaturing gradient gel electrophoresis (DGGE) and Real-time PCR were assessed. Fecal SCFAs were quantified by gas chromatographic analysis. RESULTS We observed an increased carbohydrate (% of total energy), fiber and vegetables intakes (g/day) in PKU compared with MHP children (p = 0.047), as well a higher daily GI and GL (maximum p < 0.001). Compared with MHP, PKU showed a lower degree of microbial diversity and a decrease in fecal butyrate content (p = 0.02). Accordingly, two of the most abundant butyrate-producing genera, Faecalibacterium spp. and Roseburia spp., were found significantly depleted in PKU children (p = 0.02 and p = 0.03, respectively). CONCLUSION The low-Phe diet, characterized by a higher carbohydrate intake, increases GI and GL, resulting in a different quality of substrates for microbial fermentation. Further analyses, thoroughly evaluating microbial species altered by PKU diet are needed to better investigate gut microbiota in PKU children and to eventually pave the way for pre/probiotic supplementations.
Collapse
Affiliation(s)
- E Verduci
- Department of Pediatrics, San Paolo Hospital, Università degli Studi di Milano, Milan, Italy.
| | - F Moretti
- Department of Pediatrics, San Paolo Hospital, Università degli Studi di Milano, Milan, Italy
| | - G Bassanini
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - G Banderali
- Department of Pediatrics, San Paolo Hospital, Università degli Studi di Milano, Milan, Italy
| | - V Rovelli
- Department of Pediatrics, San Paolo Hospital, Università degli Studi di Milano, Milan, Italy
| | - M C Casiraghi
- Department of Food, Environmental and Nutritional Sciences, Università degli Studi di Milano, Milan, Italy
| | - G Morace
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - F Borgo
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - E Borghi
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| |
Collapse
|
16
|
Soldini S, Posteraro B, Vella A, De Carolis E, Borghi E, Falleni M, Losito AR, Maiuro G, Trecarichi EM, Sanguinetti M, Tumbarello M. Microbiologic and clinical characteristics of biofilm-forming Candida parapsilosis isolates associated with fungaemia and their impact on mortality. Clin Microbiol Infect 2017; 24:771-777. [PMID: 29133157 DOI: 10.1016/j.cmi.2017.11.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 10/23/2017] [Accepted: 11/04/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Biofilm formation (BF) by fungal isolates may dramatically complicate infection. We determined the ability of Candida parapsilosis isolates from single fungaemia episodes to form biofilms and we analysed biofilm subgroups for antifungal susceptibility and pathogenic potential. We then correlated BF with clinical characteristics and outcomes of the episodes. METHODS BF was measured using the crystal violet biomass assay. Antifungal susceptibility of preformed biofilms was assessed, and virulence was studied using the Galleria mellonella model. A retrospective analysis of patients' clinical records was performed. RESULTS Of 190 patient-unique isolates, 84, 38 and 68 were identified as having high BF (HBF), moderate BF (MBF) or low BF (LBF), respectively. Among 30 randomly selected isolates, nine (eight HBF and one MBF), six (all HBF) and one (HBF) isolates had elevated sessile minimum inhibitory concentrations to fluconazole, anidulafungin or amphotericin B; all HBF and MBF isolates had elevated voriconazole sessile minimum inhibitory concentrations. G. mellonella killing rates of HBF isolates were significantly greater than MBF (or LBF) isolates (50% vs. 20%, 2 days from infection). By comparing HBF/MBF (106 patients) and LBF (84 patients) groups, we found that HBF/MBF patients had more central venous catheter-related fungaemias (62/106 (58.5%) vs. 29/84 (34.5%), p 0.001) and were more likely to die at 30 days from fungaemia onset (61/106 (57.5%) vs. 28/84 (33.3%), p 0.01). In the HBF/MBF group, azole antifungal therapy and central venous catheter removal were significantly associated with a higher and lower 30-day mortality rate, respectively. CONCLUSIONS C. parapsilosis BF influences the clinical outcome in patients with fungaemia.
Collapse
Affiliation(s)
- S Soldini
- Institute of Microbiology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - B Posteraro
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - A Vella
- Institute of Microbiology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - E De Carolis
- Institute of Microbiology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - E Borghi
- Laboratory of Microbiology, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - M Falleni
- Division of Human Pathology, Università degli Studi di Milano, Milan, Italy
| | - A R Losito
- Institute of Infectious Diseases, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - G Maiuro
- Institute of Infectious Diseases, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - E M Trecarichi
- Institute of Infectious Diseases, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - M Sanguinetti
- Institute of Microbiology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy.
| | - M Tumbarello
- Institute of Infectious Diseases, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| |
Collapse
|
17
|
Fiorino S, Bacchi-Reggiani L, Detotto E, Battilana M, Borghi E, Denitto C, Dickmans C, Facchini B, Moretti R, Parini S, Testi M, Zamboni A, Cuppini A, Pisani L, Nava S. Efficacy of non-invasive mechanical ventilation in the general ward in patients with chronic obstructive pulmonary disease admitted for hypercapnic acute respiratory failure and pH < 7.35: a feasibility pilot study. Intern Med J 2016; 45:527-37. [PMID: 25684643 DOI: 10.1111/imj.12726] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 01/12/2015] [Indexed: 11/29/2022]
Abstract
AIM To date non-invasive (NIV) mechanical ventilation use is not recommended in chronic obstructive pulmonary disease (COPD) patients with acute respiratory failure (ARF) and pH < 7.30 outside a 'protected environment'. We assessed NIV efficacy and feasibility in improving arterial blood gases (ABG) and in-hospital outcome in patients with ARF and severe respiratory acidosis (RA) admitted to an experienced rural medical ward. METHODS This paper is a prospective pilot cohort study conducted in the General Medicine Ward of Budrio's District Hospital. Two hundred and seventy-two patients with ARF were admitted to our Department, 112, meeting predefined inclusion criteria (pH < 7.35, PaCO2 > 45 mmHg). Patients were divided according to the severity of acidosis into: group A (pH < 7.26), group B (7.26 ≤ pH < 7.30) and group C (7.30 ≤ pH < 7.35). ABG were assessed at admission, at 2-6 h, 24 h, 48 h and at discharge. RESULTS Group A included 55 patients (24 men, mean age: 80.8 ± 8.3 years), group B 31 (12 men, mean age: 80.3 ± 9.4 years) and group C 26 (15 men, mean age: 78.6 ± 9.9 years). ABG improved within the first hours in 92/112 (82%) patients, who were all successfully discharged. Eighteen percent (20/112) of the patients died during the hospital stay, no significant difference emerged in mortality rate (MR) within the groups (23%, 16% and 8%, for groups A, B and C, respectively) and between patients with or without pneumonia: 8/29 (27%) versus 12/83 (14%). On multivariable analysis, only age and Glasgow Coma Scale had an impact on the clinical outcome. CONCLUSION In a non-'highly protected' environment such as an experienced medical ward of a rural hospital, NIV is effective not only in patients with mild, but also with severe forms of RA. MR did not vary according to the level of initial pH.
Collapse
Affiliation(s)
- S Fiorino
- Unità Operativa di Medicina Interna, Ospedale di Budrio (Bologna), Department of Internal Medicine, Azienda Unità Sanitaria Locale di Bologna, Bologna, Italy
| | - L Bacchi-Reggiani
- Istituto di Cardiologia, Azienda Ospedaliera Policlinico S. Orsola-Malpighi, Department of Specialist, Diagnostic, and Experimental Medicine, School of Medicine, University of Bologna, Bologna, Italy
| | - E Detotto
- Unità Operativa di Medicina Interna, Ospedale di Budrio (Bologna), Department of Internal Medicine, Azienda Unità Sanitaria Locale di Bologna, Bologna, Italy
| | - M Battilana
- Unità Operativa di Medicina Interna, Ospedale di Budrio (Bologna), Department of Internal Medicine, Azienda Unità Sanitaria Locale di Bologna, Bologna, Italy
| | - E Borghi
- Unità Operativa di Medicina Interna, Ospedale di Budrio (Bologna), Department of Internal Medicine, Azienda Unità Sanitaria Locale di Bologna, Bologna, Italy
| | - C Denitto
- Unità Operativa di Medicina Interna, Ospedale di Budrio (Bologna), Department of Internal Medicine, Azienda Unità Sanitaria Locale di Bologna, Bologna, Italy
| | - C Dickmans
- Unità Operativa di Medicina Interna, Ospedale di Budrio (Bologna), Department of Internal Medicine, Azienda Unità Sanitaria Locale di Bologna, Bologna, Italy
| | - B Facchini
- Unità Operativa di Medicina Interna, Ospedale di Budrio (Bologna), Department of Internal Medicine, Azienda Unità Sanitaria Locale di Bologna, Bologna, Italy
| | - R Moretti
- Unità Operativa di Medicina Interna, Ospedale di Budrio (Bologna), Department of Internal Medicine, Azienda Unità Sanitaria Locale di Bologna, Bologna, Italy
| | - S Parini
- Unità Operativa di Medicina Interna, Ospedale di Budrio (Bologna), Department of Internal Medicine, Azienda Unità Sanitaria Locale di Bologna, Bologna, Italy
| | - M Testi
- Unità Operativa di Medicina Interna, Ospedale di Budrio (Bologna), Department of Internal Medicine, Azienda Unità Sanitaria Locale di Bologna, Bologna, Italy
| | - A Zamboni
- Unità Operativa di Medicina Interna, Ospedale di Budrio (Bologna), Department of Internal Medicine, Azienda Unità Sanitaria Locale di Bologna, Bologna, Italy
| | - A Cuppini
- Unità Operativa di Medicina Interna, Ospedale di Budrio (Bologna), Department of Internal Medicine, Azienda Unità Sanitaria Locale di Bologna, Bologna, Italy
| | - L Pisani
- Terapia Intensiva Pneumologia S. Orsola, Azienda Ospedaliera Policlinico S. Orsola-Malpighi, Department of Specialist, Diagnostic, and Experimental Medicine, School of Medicine, University of Bologna, Bologna, Italy
| | - S Nava
- Terapia Intensiva Pneumologia S. Orsola, Azienda Ospedaliera Policlinico S. Orsola-Malpighi, Department of Specialist, Diagnostic, and Experimental Medicine, School of Medicine, University of Bologna, Bologna, Italy
| |
Collapse
|
18
|
Onyango AW, Borghi E, de Onis M, Frongillo EA, Victora CG, Dewey KG, Lartey A, Bhandari N, Baerug A, Garza C. Successive 1-Month Weight Increments in Infancy Can Be Used to Screen for Faltering Linear Growth. J Nutr 2015; 145:2725-31. [PMID: 26468489 DOI: 10.3945/jn.115.211896] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 09/13/2015] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Linear growth faltering in the first 2 y contributes greatly to a high stunting burden, and prevention is hampered by the limited capacity in primary health care for timely screening and intervention. OBJECTIVE This study aimed to determine an approach to predicting long-term stunting from consecutive 1-mo weight increments in the first year of life. METHODS By using the reference sample of the WHO velocity standards, the analysis explored patterns of consecutive monthly weight increments among healthy infants. Four candidate screening thresholds of successive increments that could predict stunting were considered, and one was selected for further testing. The selected threshold was applied in a cohort of Bangladeshi infants to assess its predictive value for stunting at ages 12 and 24 mo. RESULTS Between birth and age 12 mo, 72.6% of infants in the WHO sample tracked within 1 SD of their weight and length. The selected screening criterion ("event") was 2 consecutive monthly increments below the 15th percentile. Bangladeshi infants were born relatively small and, on average, tracked downward from approximately age 6 to <24 mo (51% stunted). The population-attributable risk of stunting associated with the event was 14% at 12 mo and 9% at 24 mo. Assuming the screening strategy is effective, the estimated preventable proportion in the group who experienced the event would be 34% at 12 mo and 24% at 24 mo. CONCLUSIONS This analysis offers an approach for frontline workers to identify children at risk of stunting, allowing for timely initiation of preventive measures. It opens avenues for further investigation into evidence-informed application of the WHO growth velocity standards.
Collapse
Affiliation(s)
- Adelheid W Onyango
- Family and Reproductive Health Cluster, WHO Regional Office for Africa, Brazzaville, Republic of Congo;
| | | | | | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | | | - Kathryn G Dewey
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA
| | | | - Nita Bhandari
- Center for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Anne Baerug
- Norwegian National Advisory Unit on Breastfeeding, Oslo University Hospital, Oslo, Norway; and
| | | | | |
Collapse
|
19
|
Haddad L, Achadi E, Bendech MA, Ahuja A, Bhatia K, Bhutta Z, Blössner M, Borghi E, Colecraft E, de Onis M, Eriksen K, Fanzo J, Flores-Ayala R, Fracassi P, Kimani-Murage E, Koukoubou EN, Krasevec J, Newby H, Nugent R, Oenema S, Martin-Prével Y, Randel J, Requejo J, Shyam T, Udomkesmalee E, Reddy KS. The Global Nutrition Report 2014: actions and accountability to accelerate the world's progress on nutrition. J Nutr 2015; 145:663-71. [PMID: 25740908 PMCID: PMC5129664 DOI: 10.3945/jn.114.206078] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 02/02/2015] [Indexed: 11/14/2022] Open
Abstract
In 2013, the Nutrition for Growth Summit called for a Global Nutrition Report (GNR) to strengthen accountability in nutrition so that progress in reducing malnutrition could be accelerated. This article summarizes the results of the first GNR. By focusing on undernutrition and overweight, the GNR puts malnutrition in a new light. Nearly every country in the world is affected by malnutrition, and multiple malnutrition burdens are the "new normal." Unfortunately, the world is off track to meet the 2025 World Health Assembly (WHA) targets for nutrition. Many countries are, however, making good progress on WHA indicators, providing inspiration and guidance for others. Beyond the WHA goals, nutrition needs to be more strongly represented in the Sustainable Development Goal (SDG) framework. At present, it is only explicitly mentioned in 1 of 169 SDG targets despite the many contributions improved nutritional status will make to their attainment. To achieve improvements in nutrition status, it is vital to scale up nutrition programs. We identify bottlenecks in the scale-up of nutrition-specific and nutrition-sensitive approaches and highlight actions to accelerate coverage and reach. Holding stakeholders to account for delivery on nutrition actions requires a well-functioning accountability infrastructure, which is lacking in nutrition. New accountability mechanisms need piloting and evaluation, financial resource flows to nutrition need to be made explicit, nutrition spending targets should be established, and some key data gaps need to be filled. For example, many UN member states cannot report on their WHA progress and those that can often rely on data >5 y old. The world can accelerate malnutrition reduction substantially, but this will require stronger accountability mechanisms to hold all stakeholders to account.
Collapse
Affiliation(s)
- Lawrence Haddad
- International Food Policy Research Institute, Washington, DC;
| | | | | | - Arti Ahuja
- Women and Child Development, Odisha, India
| | - Komal Bhatia
- Institute of Development Studies, Brighton, United Kingdom
| | - Zulfiqar Bhutta
- Center for Global Child Health, Hospital for Sick Children, Toronto, Canada,Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Stineke Oenema
- Interchurch Organization for Development Cooperation (ICCO) Alliance, Utrecht, The Netherlands
| | | | | | - Jennifer Requejo
- Partnership for Maternal, Newborn and Child Health, WHO, Geneva, Switzerland
| | - Tara Shyam
- Institute of Development Studies, Brighton, United Kingdom
| | | | | |
Collapse
|
20
|
Perdoni F, Falleni M, Tosi D, Cirasola D, Romagnoli S, Braidotti P, Clementi E, Bulfamante G, Borghi E. A histological procedure to study fungal infection in the wax moth Galleria mellonella. Eur J Histochem 2014; 58:2428. [PMID: 25308852 PMCID: PMC4194400 DOI: 10.4081/ejh.2014.2428] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 07/21/2014] [Accepted: 07/29/2014] [Indexed: 12/21/2022] Open
Abstract
The invertebrate model Galleria mellonella is a widely used factitious host to study the microbial pathogenesis in vivo. However, a specific procedure for the recovery and the processing of the infected tissues, important for a better understanding of the host-pathogen interactions, has not been reported to our knowledge. In the present study we describe a new procedure of fixation and processing of larval tissue that allows studying the larval topographic anatomy and assessing the morphological changes due to the fungal infection. Lepidopteran larvae were infected with Candida albicans strains displaying various biofilm-forming abilities. The whole larvae were then examined for tissue changes by histological techniques. We show that comparing cutting planes, serial transversal sections of paraffin-embedded larva result in better accuracy and information recovering. Using this technique, it was possible to preserve the integrity of G. mellonella internal structures allowing the detailed analysis of morphological differences in different experimental groups (i.e., healthy vs infected larvae). We were also able to study strain-related differences in the pathogenesis of C. albicans by observing the immune response elicited and the invasiveness of two isolates within the larval tissues. In general, by processing the whole larva and optimizing routinely histochemical stainings, it is possible to visualize and analyse infected tissues. Various degrees of pathogenicity (strain- or inoculum-related), and the infection time course can be described in details. Moreover, the host immune response events can be followed throughout the infectious process leading to a comprehensive picture of the studied phenomenon.
Collapse
|
21
|
Mozzanica F, Ginocchio D, Borghi E, Bachmann C, Schindler A. Reliability and Validity of the Italian Version of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V). Folia Phoniatr Logop 2014; 65:257-65. [DOI: 10.1159/000356479] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
22
|
Montagna MT, Lovero G, Borghi E, Amato G, Andreoni S, Campion L, Lo Cascio G, Lombardi G, Luzzaro F, Manso E, Mussap M, Pecile P, Perin S, Tangorra E, Tronci M, Iatta R, Morace G. Candidemia in intensive care unit: a nationwide prospective observational survey (GISIA-3 study) and review of the European literature from 2000 through 2013. Eur Rev Med Pharmacol Sci 2014; 18:661-674. [PMID: 24668706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Candida bloodstream infections (BSI) represent an important problem in Intensive Care Units (ICUs). The epidemiology of candidemia is changing with an increase in the proportion of Candida (C.) non-albicans. OBJECTIVES An Italian 2-year observational survey on ICU was conducted to evaluate the species distribution and possible differences between BSI caused by C. albicans and C. non-albicans. For comparative purposes, we performed a European literature-based review to evaluate distribution and frequency of Candida spp. causing ICU candidemia, during the period 2000-2013. MATERIALS AND METHODS This laboratory-based survey involved 15 microbiology centers (GISIA-3 study). All candidemia episodes in adult patients were considered. Data were prospectively collected from 2007 to 2008. PubMed was searched for peer-reviewed articles. RESULTS In total, 462 candidemia episodes were collected. C. albicans accounted for 49.4% of the isolates, followed by C. parapsilosis (26.2%) and C. glabrata (10.4%). Mortality was higher in patients with C. non-albicans than C. albicans (47.3% vs. 32.4 %, p > 0.05). Among risk factors, parenteral nutrition was more common (p = 0.02) in non-albicans candidemia, while surgery was more frequent (p = 0.02) in C. albicans candidemia. Twenty-four relevant articles were identified. C. albicans was the predominant species in almost all studies (range 37.9% -76.3%). C. glabrata was commonly isolated in the German-speaking countries, France, UK and North Europe; C. parapsilosis in Turkey, Greece and Spain. CONCLUSIONS Although C. non-albicans BSI is increasing, our study shows that C. albicans is still the predominant species in ICU candidemia. There are differences in the epidemiology of Candida BSI among European countries, with a prevalence of C. glabrata and C. parapsilosis in Northern and Southern countries, respectively.
Collapse
Affiliation(s)
- M T Montagna
- Department of Biomedical Science and Human Oncology, Hygiene Section, University of Bari Aldo Moro, Bari, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
de Onis M, Dewey KG, Borghi E, Onyango AW, Blössner M, Daelmans B, Piwoz E, Branca F. The World Health Organization's global target for reducing childhood stunting by 2025: rationale and proposed actions. Matern Child Nutr 2013; 9 Suppl 2:6-26. [PMID: 24074315 PMCID: PMC6860845 DOI: 10.1111/mcn.12075] [Citation(s) in RCA: 210] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
In 2012, the World Health Organization adopted a resolution on maternal, infant and young child nutrition that included a global target to reduce by 40% the number of stunted under-five children by 2025. The target was based on analyses of time series data from 148 countries and national success stories in tackling undernutrition. The global target translates to a 3.9% reduction per year and implies decreasing the number of stunted children from 171 million in 2010 to about 100 million in 2025. However, at current rates of progress, there will be 127 million stunted children by 2025, that is, 27 million more than the target or a reduction of only 26%. The translation of the global target into national targets needs to consider nutrition profiles, risk factor trends, demographic changes, experience with developing and implementing nutrition policies, and health system development. This paper presents a methodology to set individual country targets, without precluding the use of others. Any method applied will be influenced by country-specific population growth rates. A key question is what countries should do to meet the target. Nutrition interventions alone are almost certainly insufficient, hence the importance of ongoing efforts to foster nutrition-sensitive development and encourage development of evidence-based, multisectoral plans to address stunting at national scale, combining direct nutrition interventions with strategies concerning health, family planning, water and sanitation, and other factors that affect the risk of stunting. In addition, an accountability framework needs to be developed and surveillance systems strengthened to monitor the achievement of commitments and targets.
Collapse
Affiliation(s)
- Mercedes de Onis
- Department of NutritionWorld Health OrganizationGenevaSwitzerland
| | - Kathryn G. Dewey
- Department of NutritionUniversity of California, DavisDavisCaliforniaUSA
| | - Elaine Borghi
- Department of NutritionWorld Health OrganizationGenevaSwitzerland
| | | | - Monika Blössner
- Department of NutritionWorld Health OrganizationGenevaSwitzerland
| | - Bernadette Daelmans
- Department of Maternal, Newborn, Child and Adolescent HealthWorld Health OrganizationGenevaSwitzerland
| | - Ellen Piwoz
- Global Health ProgramBill and Melinda Gates FoundationSeattleWashingtonUSA
| | - Francesco Branca
- Department of NutritionWorld Health OrganizationGenevaSwitzerland
| |
Collapse
|
24
|
Garza C, Borghi E, Onyango AW, de Onis M. Parental height and child growth from birth to 2 years in the WHO Multicentre Growth Reference Study. Matern Child Nutr 2013; 9 Suppl 2:58-68. [PMID: 24074318 PMCID: PMC6860547 DOI: 10.1111/mcn.12085] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Linear growth from birth to 2 years of children enrolled in the World Health Organization Multicentre Growth Reference Study was similar despite substantial parental height differences among the six study sites. Within-site variability in child length attributable to parental height was estimated by repeated measures analysis of variance using generalized linear models. This approach was also used to examine relationships among selected traits (e.g. breastfeeding duration and child morbidity) and linear growth between 6 and 24 months of age. Differences in intergenerational adult heights were evaluated within sites by comparing mid-parental heights (average of the mother's and father's heights) to the children's predicted adult height. Mid-parental height consistently accounted for greater proportions of observed variability in attained child length than did either paternal or maternal height alone. The proportion of variability explained by mid-parental height ranged from 11% in Ghana to 21% in India. The average proportion of between-child variability accounted for by mid-parental height was 16% and the analogous within-child estimate was 6%. In the Norwegian and US samples, no significant differences were observed between mid-parental and children's predicted adult heights. For the other sites, predicted adult heights exceeded mid-parental heights by 6.2-7.8 cm. To the extent that adult height is predicted by height at age 2 years, these results support the expectation that significant community-wide advances in stature are attainable within one generation when care and nutrition approximate international recommendations, notwithstanding adverse conditions likely experienced by the previous generation.
Collapse
Affiliation(s)
| | - Elaine Borghi
- Department of NutritionWorld Health OrganizationGenevaSwitzerland
| | | | - Mercedes de Onis
- Department of NutritionWorld Health OrganizationGenevaSwitzerland
| | | |
Collapse
|
25
|
Lutter CK, Daelmans BMEG, de Onis M, Kothari MT, Ruel MT, Arimond M, Deitchler M, Dewey KG, Blössner M, Borghi E. Undernutrition, poor feeding practices, and low coverage of key nutrition interventions. Pediatrics 2011; 128:e1418-27. [PMID: 22065267 DOI: 10.1542/peds.2011-1392] [Citation(s) in RCA: 139] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To estimate the global burden of malnutrition and highlight data on child feeding practices and coverage of key nutrition interventions. METHODS Linear mixed-effects modeling was used to estimate prevalence rates and numbers of underweight and stunted children according to United Nations region from 1990 to 2010 by using surveys from 147 countries. Indicators of infant and young child feeding practices and intervention coverage were calculated from Demographic and Health Survey data from 46 developing countries between 2002 and 2008. RESULTS In 2010, globally, an estimated 27% (171 million) of children younger than 5 years were stunted and 16% (104 million) were underweight. Africa and Asia have more severe burdens of undernutrition, but the problem persists in some Latin American countries. Few children in the developing world benefit from optimal breastfeeding and complementary feeding practices. Fewer than half of infants were put to the breast within 1 hour of birth, and 36% of infants younger than 6 months were exclusively breastfed. Fewer than one-third of 6- to 23-month-old children met the minimum criteria for dietary diversity, and only ∼50% received the minimum number of meals. Although effective health-sector-based interventions for tackling childhood undernutrition are known, intervention-coverage data are available for only a small proportion of them and reveal mostly low coverage. CONCLUSIONS Undernutrition continues to be high and progress toward reaching Millennium Development Goal 1 has been slow. Previously unrecognized extremely poor breastfeeding and complementary feeding practices and lack of comprehensive data on intervention coverage require urgent action to improve child nutrition.
Collapse
Affiliation(s)
- Chessa K Lutter
- Pan American Health Organization, Washington, DC 20037-2895, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Maggiorella L, Barouch G, Devaux C, Pottier A, Deutsch E, Bourhis J, Borghi E, Levy L. 2001 ORAL Nanoscale Radiotherapy – NBTXR3 Hafnium Oxide Nanoparticles as Promising Cancer Therapy. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)70959-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
27
|
de Onis M, Siyam A, Borghi E, Onyango AW, Piwoz E, Garza C. Comparison of the World Health Organization growth velocity standards with existing US reference data. Pediatrics 2011; 128:e18-26. [PMID: 21708799 DOI: 10.1542/peds.2010-2630] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The goal of this study was to compare World Health Organization (WHO) growth velocity standards with reference data based on US children. METHODS Comparisons were made between reference values for weight and length gains based on serial data from US children and the WHO child growth standards. We compared weight velocities for boys and girls for selected percentiles (5th, 25th, 50th, 75th, and 95th) for 1-month intervals from birth to 6 months, 2-month intervals up to 12 months, and 3-month intervals up to 24 months. For length, we compared 2-month intervals from birth to 6 months and 3-month intervals up to 24 months. RESULTS WHO and US monthly weight increments were similar at the 5th percentile up to 3 months of age; values for other US percentiles were below the WHO percentiles ∼150 g on average. From 3 months onward, the US values converged to a narrow range of <100 g between estimated percentiles. Two- and 3-month weight gains showed similar variations. Differences between the WHO and US values were more pronounced at the lower end of the distribution. For length, medians were in closer agreement, but as occurred with weight, values at the outer US percentiles converged to a narrower range with increasing age compared with those of the WHO standards. CONCLUSIONS There are important differences between the WHO standards and the reference values for growth velocity based on US data. The WHO values are a better tool for assessing growth velocity and making clinical decisions.
Collapse
Affiliation(s)
- Mercedes de Onis
- Department of Nutrition, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland.
| | | | | | | | | | | |
Collapse
|
28
|
Onyango AW, Nommsen-Rivers L, Siyam A, Borghi E, de Onis M, Garza C, Lartey A, Baerug A, Bhandari N, Dewey KG, Araújo CL, Mohamed AJ, Van den Broeck J. Post-partum weight change patterns in the WHO Multicentre Growth Reference Study. Matern Child Nutr 2011; 7:228-40. [PMID: 21338469 DOI: 10.1111/j.1740-8709.2010.00295.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The interplay of factors that affect post-partum loss or retention of weight gained during pregnancy is not fully understood. The objective of this paper is to describe patterns of weight change in the six sites of the World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) and explore variables that explain variation in weight change within and between sites. Mothers of 1743 breastfed children enrolled in the MGRS had weights measured at days 7, 14, 28 and 42 post-partum, monthly from 2 to 12 months and bimonthly thereafter until 24 months post-partum. Height, maternal age, parity and employment status were recorded and breastfeeding was monitored throughout the follow-up. Weight change patterns varied significantly among sites. Ghanaian and Omani mothers lost little or gained weight post-partum. In Brazil, India, Norway and USA, mothers on average lost weight during the first year followed by stabilization in the second year. Lactation intensity and duration explained little of the variation in weight change patterns. In most sites, obese mothers tended to lose less weight than normal-weight mothers. In Brazil and Oman, primiparous mothers lost about 1 kg more than multiparous mothers in the first 6 months. In India and Ghana, multiparous mothers lost about 0.6 kg more than primiparas in the second 6 months. Culturally defined mother-care practices probably play a role in weight change patterns among lactating women. This hypothesis should stimulate investigation into gestational weight gain and post-partum losses in different ethnocultural contexts.
Collapse
Affiliation(s)
- Adelheid W Onyango
- Department of Nutrition for Health and Development, World Health Organization, Geneva 27, Switzerland.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Fourati Ben Mustapha S, Khrouf M, Kacem Ben Rejeb K, Elloumi Chaabene H, Merdassi G, Wahbi D, Ben Meftah M, Zhioua F, Zhioua A, Azzarello A, Host T, Mikkelsen AL, Theofanakis CP, Dinopoulou V, Mavrogianni D, Partsinevelos GA, Drakakis P, Stefanidis K, Bletsa A, Loutradis D, Rienzi L, Cobo A, Paffoni A, Scarduelli C, Capalbo A, Garrido N, Remohi J, Ragni G, Ubaldi FM, Herrer R, Quera M, GIL E, Serna J, Grondahl ML, Bogstad J, Agerholm IE, Lemmen JG, Bentin-Ley U, Lundstrom P, Kesmodel US, Raaschou-Jensen M, Ladelund S, Guzman L, Ortega C, Albuz FK, Gilchrist RB, Devroey P, Smitz J, De Vos M, Bielanska M, Leveille MC, Borghi E, Magli MC, Figueroa MJ, Mascaretti G, Ferraretti AP, Gianaroli L, Szlit E, Leocata Nieto F, Maggiotto G, Arenas G, Tarducci Bonfiglio N, Ahumada A, Asch R, Sciorio R, Dayoub N, Thong J, Pickering S, Ten J, Carracedo MA, Guerrero J, Rodriguez-Arnedo A, Llacer J, Bernabeu R, Tatone C, Heizenrieder T, Di Emidio G, Treffon P, Seidel T, Eichenlaub-Ritter U, Cortezzi SS, Cabral EC, Ferreira CR, Trevisan MG, Figueira RCS, Braga DPAF, Eberlin MN, Iaconelli Jr. A, Borges Jr. E, Zabala A, Pessino T, Blanco L, Rey Valzacchi G, Leocata F, Ahumada A, Vanden Meerschaut F, Heindryckx B, Qian C, Deforce D, Leybaert L, De Sutter P, De las Heras M, De Pablo JL, Navarro B, Agirregoikoa JA, Barrenetxea G, Cruz M, Perez-Cano I, Gadea B, Herrero J, Martinez M, Roldan M, Munoz M, Pellicer A, Meseguer M, Munoz M, Cruz M, Roldan M, Gadea B, Galindo N, Martinez M, Pellicer A, Meseguer M, Perez-Cano I, Scarselli F, Alviggi E, Colasante A, Minasi MG, Rubino P, Lobascio M, Ferrero S, Litwicka K, Varricchio MT, Giannini P, Piscitelli P, Franco G, Zavaglia D, Nagy ZP, Greco E, Urner F, Wirthner D, Murisier F, Mock P, Germond M, Amorocho Llanos B, Calderon G, Lopez D, Fernandez L, Nicolas M, Landeras J, Finn-Sell SL, Leandri R, Fleming TP, Macklon NS, Cheong YC, Eckert JJ, Lee JH, Jung YJ, Hwang HK, Kang A, An SJ, Jung JY, Kwon HC, Lee SJ, Palini S, Zolla L, De Stefani S, Scala V, D'Alessandro A, Polli V, Rocchi P, Tiezzi A, Pelosi E, Dusi L, Bulletti C, Fadini R, Lain M, Mignini Renzini M, Brambillasca F, Coticchio G, Merola M, Guglielmo MC, Dal Canto M, Figueira R, Setti AS, Braga DPAF, Iaconelli Jr. A, Borges Jr. E, Worrilow KC, Uzochukwu CD, Eid S, Le Gac S, Esteves TC, van Rossem F, van den Berg A, Boiani M, Kasapi E, Panagiotidis Y, Goudakou M, Papatheodorou A, Pasadaki T, Prapas N, Prapas Y, Panagiotidis Y, Kasapi E, Goudakou M, Papatheodorou A, Pasadaki T, Vanderzwalmen P, Prapas N, Prapas Y, Norasing S, Atchajaroensatit P, Tawiwong W, Thepmanee O, Saenlao S, Aojanepong J, Hunsajarupan P, Sajjachareonpong K, Punyatanasakchai P, Maneepalviratn S, Jetsawangsri U, Herrero J, Cruz M, Tejera A, Rubio I, Romero JL, Meseguer M, Nordhoff V, Schlatt S, Schuring AN, Kiesel L, Kliesch S, Azambuja R, Okada L, Lazzari V, Dorfman L, Michelon J, Badalotti M, Badalotti F, Petracco A, Schwarzer C, Esteves TC, Nordhoff V, Schlatt S, Boiani M, Versieren K, Heindryckx B, De Croo I, Lierman S, De Vos W, Van den Abbeel E, Gerris J, De Sutter P, Milacic I, Borogovac D, Veljkovic M, Arsic B, Jovic Bojovic D, Lekic D, Pavlovic D, Garalejic E, Guglielmo MC, Coticchio G, Albertini DF, Dal Canto M, Brambillasca F, Mignini Renzini M, De Ponti E, Fadini R, Sanges F, Talevi R, Capalbo A, Papini L, Mollo V, Ubaldi FM, Rienzi LF, Gualtieri R, Albuz FK, Guzman L, Orteg C, Gilchrist RB, Devroey P, De Vos M, Smitz J, Choi J, Lee H, Ku S, Kim S, Choi Y, Kim J, Moon S, Demilly E, Assou S, Moussaddykine S, Dechaud H, Hamamah S, Takisawa T, Doshida M, Hattori H, Nakamura Y, Kyoya T, Shibuya Y, Nakajo Y, Tasaka A, Toya M, Kyono K, Novo S, Penon O, Gomez R, Barrios L, Duch M, Santalo J, Esteve J, Nogues C, Plaza JA, Perez-Garcia L, Ibanez E, Chavez S, Loewke K, Behr B, Reijo Pera R, Huang S, Wang H, Soong Y, Chang C, Okimura T, Kuwayama M, Mori C, Morita M, Uchiyama K, Aono F, Kato K, Takehara Y, Kato O, Minasi M, Casciani V, Scarselli F, Rubino P, Colasante A, Arizzi L, Litwicka K, Ferrero S, Mencacci C, Piscitelli C, Giannini P, Cucinelli F, Tocci A, Nagy ZP, Greco E, Wydooghe E, Vandaele L, Dewulf J, Van den Abbeel E, De Sutter P, Van Soom A, Moon JH, Son WY, Mahfoudh A, Henderson S, Jin SG, Shalom-Paz E, Dahan M, Holzer H, Mahmoud K, Triki-Hmam C, Terras K, Zhioua F, Hfaiedh T, Ben Aribia MH, Otsubo H, Egashira A, Tanaka K, Matsuguma T, Murakami M, Murakami K, Otsuka M, Yoshioka N, Araki Y, Kuramoto T, Smit JG, Sterrenburg MD, Eijkemans MJC, Al-Inany HG, Youssef MAFM, Broekmans FJM, Willoughby K, DiPaolo L, Deys L, Lagunov A, Amin S, Faghih M, Hughes E, Karnis M, Ashkar F, King WA, Neal MS, Antonova I, Veleva L, Petkova L, Shterev A, Nogales C, Martinez E, Ariza M, Cernuda D, Gaytan M, Linan A, Guillen A, Bronet F, Cottin V, Fabian D, Allemann F, Koller A, Spira JC, Agudo D, Martinez-Burgos M, Arnanz A, Basile N, Rodriguez A, Bronet F, Cho YS, Filioli Uranio M, Ambruosi B, Paternoster MS, Totaro P, Sardanelli AM, Dell'Aquila ME, Zollner U, Hofmann T, Zollner KP, Kovacic B, Roglic P, Vlaisavljevic V, Sole M, Santalo J, Boada M, Coroleu B, Veiga A, Martiny G, Molinari M, Revelli A, Chimote NM, Chimote M, Mehta B, Chimote NN, Sheikh N, Nath N, Mukherjee A, Rakic K, Reljic M, Kovacic B, Vlaisavljevic V, Ingerslev HJ, Kirkegaard K, Hindkjaer J, Grondahl ML, Kesmodel US, Agerholm I, Kitasaka H, Fukunaga N, Nagai R, Yoshimura T, Tamura F, Kitamura K, Hasegawa N, Nakayama K, Katou M, Itoi F, Asano E, Deguchi N, Ooyama K, Hashiba Y, Asada Y, Michaeli M, Rotfarb N, Karchovsky E, Ruzov O, Atamny R, Slush K, Fainaru O, Ellenbogen A, Chekuri S, Chaisrisawatsuk T, Chen P, Pangestu M, Jansen S, Catt S, Molinari E, Racca C, Revelli A, Ryu C, Kang S, Lee J, Chung D, Roh S, Chi H, Yokota Y, Yokota M, Yokota H, Sato S, Nakagawa M, Komatsubara M, Makita M, Araki Y, Yoshimura T, Asada Y, Fukunaga N, Nagai R, Kitasaka H, Itoi F, Tamura F, Kitamura K, Hasegawa N, Katou M, Nakayama K, Asano E, Deguchi N, Oyama K, Hashiba Y, Naruse K, Kilani S, Chapman MG, Kwik M, Chapman M, Guven S, Odaci E, Yildirim O, Kart C, Unsal MA, Yulug E, Isachenko E, Maettner R, Strehler E, Isachenko V, Hancke K, Kreienberg R, Sterzik K, Coticchio G, Guglielmo MC, Dal Canto M, Albertini DF, Brambillasca F, Mignini Renzini M, Fadini R, Zheng XY, Wang LN, Liu P, Qiao J, Inoue F, Dashtizad M, Wahid H, Rosnina Y, Daliri M, Hajarian H, Akbarpour M, Abbas Mazni O, Knez K, Tomaevic T, Vrtacnik Bokal E, Zorn B, Virant Klun I, Koster M, Liebenthron J, Nicolov A, van der Ven K, van der Ven H, Montag M, Fayazi M, Salehnia M, Beigi Boroujeni M, Khansarinejad B, Deignan K, Emerson G, Mocanu E, Wang JJ, Andonov M, Linara E, Ahuja KK, Nachef S, Figueira RCS, Braga DPAF, Setti AS, Iaconelli Jr. A, Pasqualotto FF, Borges Jr. E, Pasqualotto E, Borges Jr. E, Pasqualotto FF, Chang CC, Bernal DP, Elliott TA, Shapiro DB, Toledo AA, Nagy ZP, Economou K, Davies S, Argyrou M, Doriza S, Sisi P, Moschopoulou M, Karagianni A, Mendorou C, Polidoropoulos N, Papanicopoulos C, Stefanis P, Karamalegos C, Cazlaris H, Koutsilieris M, Mastrominas M, Gotts S, Doshi A, Harper J, Serhal P, Borini A, Guzeloglu-Kayisli O, Bianchi V, Seli E, Bianchi V, Lappi M, Bonu MA, Borini A, Mizuta S, Hashimoto H, Kuroda Y, Matsumoto Y, Mizusawa Y, Ogata S, Yamada S, Kokeguchi S, Noda Y, Shiotani M, Stojkovic M, Ilic M, Markovic N, Stojkovic P, Feng G, Zhang B, Zhou H, Zhou L, Gan X, Qin X, Shu J, Wu F, Molina Botella I, Lazaro Ibanez E, Debon Aucejo A, Pertusa J, Fernandez Colom PJ, Pellicer A, Li C, Zhang Y, Cui Y, Zhao H, Liu J, Oliveira JBA, Petersen CG, Mauri AL, Massaro FC, Silva LFI, Ricci J, Cavagna M, Pontes A, Vagnini LD, Baruffi RLR, Franco Jr. JG, Massaro FC, Petersen CG, Vagnini LD, Mauri AL, Silva LFI, Felipe V, Cavagna M, Pontes A, Baruffi RLR, Oliveira JBA, Franco Jr. JG, Vilela M, Tiveron M, Lombardi C, Viglierchio MI, Marconi G, Rawe V, Wale PL, Gardner DK, Nakagawa K, Sugiyama R, Nishi Y, Kuribayashi Y, Jyuen H, Yamashiro E, Shirai A, Sugiyama R, Inoue M, Salehnia M, Hovatta O, Tohonen V, Inzunza J, Parmegiani L, Cognigni GE, Bernardi S, Ciampaglia W, Infante FE, Tabarelli de Fatis C, Pocognoli P, Arnone A, Maccarini AM, Troilo E, Filicori M, Radwan P, Polac I, Borowiecka M, Bijak M, Radwan M. POSTER VIEWING SESSION - EMBRYOLOGY. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.79] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
30
|
Dul EC, van Ravenswaaij-Arts CMA, Groen H, van Echten-Arends J, Land JA, Tyulenev Y, Naumenko V, Kurilo L, Shileiko L, Segal A, Klimova R, Kushch A, Ribas-Maynou J, Garcia-Peiro A, Abad C, Amengual MJ, Benet J, Navarro J, Colasante A, Lobascio AM, Scarselli F, Minasi MG, Alviggi E, Rubino P, Casciani V, Pena R, Varricchio MT, Litwicka K, Ferrero S, Zavaglia D, Franco G, Nagy ZP, Greco E, Romany L, Meseguer M, Garcia-Herrero S, Pellicer A, Garrido N, Dam A, Pijnenburg A, Hendriks JC, Westphal JR, Ramos L, Kremer JAM, Eertmans F, Bogaert V, Puype B, Geisler W, Clusmann C, Klopsch I, Strowitzki T, Eggert-Kruse W, Maettner R, Isachenko E, Isachenko V, Strehler E, Sterzik K, Band G, Madgar I, Brietbart H, Naor Z, Cunha-Filho JS, Souza CA, Krebs VG, Santos KD, Koff WJ, Stein A, Hammoud I, Albert M, Bergere M, Bailly M, Boitrelle F, Vialard F, Wainer R, Izard V, Selva J, Cohen - Bacrie P, Belloc S, de mouzon J, Cohen-Bacrie M, Alvarez S, Junca AM, Dumont M, Douard S, Prisant N, Tomita K, Hashimoto S, Akamatsu Y, Satoh M, Mori R, Inoue T, Ohnishi Y, Ito K, Nakaoka Y, Morimoto Y, Smith VJH, Ahuja KK, Atig F, Raffa M, Sfar MT, Saad A, Ajina M, Braga DPAF, Halpern G, Figueira RCS, Setti AS, Iaconelli Jr. A, Borges Jr. E, Medeiros GS, Borges Jr. E, Pasqualotto EB, Pasqualotto FF, Nadalini M, Tarozzi N, Di Santo M, Borini A, Lopez-Fernandez C, Arroyo F, Caballero P, Nunez-Calonge R, Fernandez JL, Gosalvez J, Gosalvez J, Lopez-Fernandez C, Gosalbez A, Cortes S, Caballero P, Nunez-Calonge R, Zikopoulos K, Lazaros L, Vartholomatos G, Kaponis A, Makrydimas G, Plachouras N, Sofikitis N, Kalantaridou S, Hatzi E, Georgiou I, Belloc S, de Mouzon J, Cohen-Bacrie M, Junca AM, Dumont M, Amar E, Cohen-Bacrie P, Vuillaume ML, Brugnon F, Artonne C, Janny L, Pons-Rejraji H, Fedder J, Bosco L, Ruvolo G, Bruccoleri AM, Manno M, Roccheri MC, Cittadini E, Bochev I, Gavrilov P, Kyurkchiev S, Shterev A, Carlomagno G, Colone M, Condorelli RA, Stringaro A, Calogero AE, Zakova J, Kralikova M, Crha I, Ventruba P, Melounova J, Matejovicova M, Vodova M, Lousova E, Sanchez Toledo M, Alvarez LLeo C, Garcia Garrido C, Resta Serra M, Belmonte Andujar LL, Gonzalez de Merlo G, Crha I, Zakova J, Ventruba P, Lousova E, Pohanka M, Huser M, Amiri I, Karimi J, Goodarzi MT, Tavilani H, Filannino A, Magli MC, Boudjema E, Crippa A, Ferraretti AP, Gianaroli L, Robles F, Magli MC, Crippa A, Filannino A, Ferraretti AP, Gianaroli L, Huang H, Yao DJ, Huang HJ, Li JR, Fan SK, Wang ML, Yung-Kuei S, Amer S, Mahran A, Darne J, Shaw R, Boudjema E, Magli MC, Borghi E, Cetera C, Ferraretti AP, Gianaroli L, Shukla U, Ogutu D, Deval B, Jansa M, Savvas M, Narvekar N, Houska P, Dackland AL, Bjorndahl L, Kvist U, Crippa A, Magli MC, Muzii L, Barboni B, Ferraretti AP, Gianaroli L, Samanta L, Kar S, Yakovenko SA, Troshina MN, Rutman BK, Dyakonov SA, Holmes E, Bjorndahl L, Kvist U, Feijo C, Verza Junior S, Esteves SC, Berta CL, Caille AM, Ghersevich SA, Zumoffen C, Munuce MJ, San Celestino M, Agudo D, Alonso M, Sanjurjo P, Becerra D, Bronet F, Garcia-Velasco JA, Pacheco A, Lafuente R, Lopez G, Checa MA, Carreras R, Brassesco M, Oneta M, Savasi V, Parrilla B, Guarneri D, Laureti A, Pagano F, Cetin I, Ekwurtzel E, Bjorndahl L, Kvist U, Morgante G, Piomboni P, Stendardi A, Serafini F, De Leo V, Focarelli R, Dumont M, Belloc S, Junca AM, Benkhalifa M, Cohen-Bacrie M, De Mouzon J, Entezami F, Cohen-Bacrie P, Junca A, Belloc S, Dumont M, Cohen-Bacrie M, Benkhalifa M, De Mouzon JJ, Entezami F, Cohen-Bacrie P, Mangiarini A, Capitanio E, Paffoni A, Restelli L, Guarneri C, Scarduelli C, Ragni G, Harrison K, Irving J, Martin N, Sherrin D, Yazdani A, Almeida C, Correia S, Rocha E, Alves A, Cunha M, Ferraz L, Silva S, Sousa M, Barros A, Perdrix A, Travers A, Milazzo JP, Clatot F, Mousset-Simeon N, Mace B, Rives N, Clarke HS, Callow A, Saxton D, Pacey AA, Sapir O, Oron G, Ben-Haroush A, Garor R, Feldberg D, Pinkas H, Stein A, Wertheimer A, Fisch B, Palacios E, Gonzalvo MC, Clavero A, Ramirez JP, Rosales A, Mozas J, Bjorndahl L, Castilla JA, Mugica J, Ramon O, Valdivia A, Exposito A, Casis L, Matorras R, Bongers R, Gottardo F, Zitzmann M, Kliesch S, Cordes T, Kamischke A, Schultze-Mosgau A, Buendgen N, Diedrich K, Griesinger G, Crisol L, Aspichueta F, Exposito A, Hernandez ML, Ruiz-Sanz JI, Mendoza R, Matorras R, Sanchez-Tusie AA, Bermudez A, Lopez P, Churchill GC, Trevino CL, Maldonado I, Dabbah J. POSTER VIEWING SESSION - ANDROLOGY. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
31
|
Morace G, Borghi E. Fungal infections in ICU patients: epidemiology and the role of diagnostics. Minerva Anestesiol 2010; 76:950-956. [PMID: 21102391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Invasive fungal infections (IFIs) are on the increase not only among oncology and transplant patients but also among patients admitted to intensive care units (ICU). The rise in ICU IFIs can be attributed to the growing use of complex surgical procedures, invasive medical devices, and long-term, broad-spectrum antibiotic therapy. The majority of these life-threatening infections are caused by the well-known opportunistic pathogens Candida albicans and Aspergillus fumigatus, but new opportunistic pathogens, including yeast-like and other filamentous fungi, have emerged as additional causes. Invasive Candida infections, particularly candidemia, represent the most common IFI in critically ill patients. The species that cause candidemia markedly differ in their responses to antifungal drugs; for this reason, therapy must be tailored to the susceptibility characteristics of the infectious agent. Candidemia caused by non-albicans Candida species is increasing worldwide, and these infections are generally associated with high mortality rates, particularly bloodstream infections caused by C. krusei, which is innately resistant to fluconazole, or C. glabrata, which easily develops azole resistance. Although invasive yeast infections can be considered the most important causes of morbidity and mortality in ICU patients, pulmonary aspergillosis has recently emerged as an additional complication. Diagnosis of IFIs can be achieved using conventional approaches (microscopy, culture, and serology) and newer methods, including antigen detection and polymerase chain reaction (PCR) assays. Because most of the conventional approaches lack sensitivity, antigen detection and PCR assays could represent a valid alternative; however, these procedures need to be standardized and evaluated in a large number of patients.
Collapse
Affiliation(s)
- G Morace
- Department of Public Health, Unit of Microbiology and Virology, University of Milan, Milan, Italy.
| | | |
Collapse
|
32
|
Abstract
BACKGROUND Childhood obesity is associated with serious health problems and the risk of premature illness and death later in life. Monitoring related trends is important. OBJECTIVE The objective was to quantify the worldwide prevalence and trends of overweight and obesity among preschool children on the basis of the new World Health Organization standards. DESIGN A total of 450 nationally representative cross-sectional surveys from 144 countries were analyzed. Overweight and obesity were defined as the proportion of preschool children with values >2 SDs and >3 SDs, respectively, from the World Health Organization growth standard median. Being "at risk of overweight" was defined as the proportion with values >1 SD and ≤2 SDs, respectively. Linear mixed-effects modeling was used to estimate the rates and numbers of affected children. RESULTS In 2010, 43 million children (35 million in developing countries) were estimated to be overweight and obese; 92 million were at risk of overweight. The worldwide prevalence of childhood overweight and obesity increased from 4.2% (95% CI: 3.2%, 5.2%) in 1990 to 6.7% (95% CI: 5.6%, 7.7%) in 2010. This trend is expected to reach 9.1% (95% CI: 7.3%, 10.9%), or ≈60 million, in 2020. The estimated prevalence of childhood overweight and obesity in Africa in 2010 was 8.5% (95% CI: 7.4%, 9.5%) and is expected to reach 12.7% (95% CI: 10.6%, 14.8%) in 2020. The prevalence is lower in Asia than in Africa (4.9% in 2010), but the number of affected children (18 million) is higher in Asia. CONCLUSIONS Childhood overweight and obesity have increased dramatically since 1990. These findings confirm the need for effective interventions starting as early as infancy to reverse anticipated trends.
Collapse
Affiliation(s)
- Mercedes de Onis
- Growth Assessment and Surveillance Unit, Department of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland.
| | | | | |
Collapse
|
33
|
|
34
|
de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ 2008; 85:660-7. [PMID: 18026621 DOI: 10.2471/blt.07.043497] [Citation(s) in RCA: 4848] [Impact Index Per Article: 303.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2007] [Accepted: 07/15/2007] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To construct growth curves for school-aged children and adolescents that accord with the WHO Child Growth Standards for preschool children and the body mass index (BMI) cut-offs for adults. METHODS Data from the 1977 National Center for Health Statistics (NCHS)/WHO growth reference (1-24 years) were merged with data from the under-fives growth standards' cross-sectional sample (18-71 months) to smooth the transition between the two samples. State-of-the-art statistical methods used to construct the WHO Child Growth Standards (0-5 years), i.e. the Box-Cox power exponential (BCPE) method with appropriate diagnostic tools for the selection of best models, were applied to this combined sample. FINDINGS The merged data sets resulted in a smooth transition at 5 years for height-for-age, weight-for-age and BMI-for-age. For BMI-for-age across all centiles the magnitude of the difference between the two curves at age 5 years is mostly 0.0 kg/m(2) to 0.1 kg/m(2). At 19 years, the new BMI values at +1 standard deviation (SD) are 25.4 kg/m(2) for boys and 25.0 kg/m(2) for girls. These values are equivalent to the overweight cut-off for adults (> or = 25.0 kg/m(2)). Similarly, the +2 SD value (29.7 kg/m(2) for both sexes) compares closely with the cut-off for obesity (> or = 30.0 kg/m(2)). CONCLUSION The new curves are closely aligned with the WHO Child Growth Standards at 5 years, and the recommended adult cut-offs for overweight and obesity at 19 years. They fill the gap in growth curves and provide an appropriate reference for the 5 to 19 years age group.
Collapse
Affiliation(s)
- Mercedes de Onis
- Department of Nutrition, World Health Organization, Geneva, Switzerland.
| | | | | | | | | | | |
Collapse
|
35
|
Schindler A, Borghi E, Tiddia C, Ginocchio D, Felisati G, Ottaviani F. Adaptation and validation of the Italian MD Anderson Dysphagia Inventory (MDADI). Rev Laryngol Otol Rhinol (Bord) 2008; 129:97-100. [PMID: 18767327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Oropharyngeal dysphagia is a common symptom in patients with head and neck tumours. The MD Anderson Dysphagia Inventory (MDADI) is a questionnaire currently used in North America for the assessment of dysphagia-related disability in patients with head and neck cancer. The aim of the study is to analyze reliability and clinical validity of the Italian MDADI. MATERIAL AND METHOD 48 persons with no history of dysphagia and 50 head and neck cancer patients with a chronic and stable dysphagia have been included in the study. Each subject completed alone the Italian MDADI twice with a week interval between the two questionnaire completion. Intra-subject reliability was analyzed through Pearson test in both groups of subjects. Clinical validity was calculated through the non parametric Mann Whitney test of the first MDADI assessment in both groups. RESULTS Internal consistency and test-retest reliability were high for each MDADI subscale in subjects without dysphagia as well as in those with dysphagia. The difference between MDADI values in subjects with and without dysphagia was significant for each subscale. DISCUSSION The Italian MDADI is reliable and clinically valid. The application of the MDADI is recommended in clinical practice as well as in descriptive, outcome and efficacy research.
Collapse
Affiliation(s)
- A Schindler
- University of Milan, Department of Clinical Sciences L. Sacco, Via GB Grassi 74, 20157 Milano, Italy.
| | | | | | | | | | | |
Collapse
|
36
|
de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ 2007; 85:660-667. [PMID: 18026621 DOI: 10.1590/s0042-96862007000900010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2007] [Accepted: 07/15/2007] [Indexed: 05/26/2023] Open
Abstract
OBJECTIVE To construct growth curves for school-aged children and adolescents that accord with the WHO Child Growth Standards for preschool children and the body mass index (BMI) cut-offs for adults. METHODS Data from the 1977 National Center for Health Statistics (NCHS)/WHO growth reference (1-24 years) were merged with data from the under-fives growth standards' cross-sectional sample (18-71 months) to smooth the transition between the two samples. State-of-the-art statistical methods used to construct the WHO Child Growth Standards (0-5 years), i.e. the Box-Cox power exponential (BCPE) method with appropriate diagnostic tools for the selection of best models, were applied to this combined sample. FINDINGS The merged data sets resulted in a smooth transition at 5 years for height-for-age, weight-for-age and BMI-for-age. For BMI-for-age across all centiles the magnitude of the difference between the two curves at age 5 years is mostly 0.0 kg/m(2) to 0.1 kg/m(2). At 19 years, the new BMI values at +1 standard deviation (SD) are 25.4 kg/m(2) for boys and 25.0 kg/m(2) for girls. These values are equivalent to the overweight cut-off for adults (> or = 25.0 kg/m(2)). Similarly, the +2 SD value (29.7 kg/m(2) for both sexes) compares closely with the cut-off for obesity (> or = 30.0 kg/m(2)). CONCLUSION The new curves are closely aligned with the WHO Child Growth Standards at 5 years, and the recommended adult cut-offs for overweight and obesity at 19 years. They fill the gap in growth curves and provide an appropriate reference for the 5 to 19 years age group.
Collapse
Affiliation(s)
- Mercedes de Onis
- Department of Nutrition, World Health Organization, Geneva, Switzerland.
| | | | | | | | | | | |
Collapse
|
37
|
Farace F, Massard C, Borghi E, Bidart JM, Soria JC. Vascular disrupting therapy-induced mobilization of circulating endothelial progenitor cells. Ann Oncol 2007; 18:1421-2. [PMID: 17693656 DOI: 10.1093/annonc/mdm367] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
|
38
|
de Onis M, Onyango AW, Borghi E, Garza C, Yang H. Comparison of the World Health Organization (WHO) Child Growth Standards and the National Center for Health Statistics/WHO international growth reference: implications for child health programmes. Public Health Nutr 2007; 9:942-7. [PMID: 17010261 DOI: 10.1017/phn20062005] [Citation(s) in RCA: 407] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To compare growth patterns and estimates of malnutrition based on the World Health Organization (WHO) Child Growth Standards ('the WHO standards') and the National Center for Health Statistics (NCHS)/WHO international growth reference ('the NCHS reference'), and discuss implications for child health programmes. DESIGN Secondary analysis of longitudinal data to compare growth patterns (birth to 12 months) and data from two cross-sectional surveys to compare estimates of malnutrition among under-fives. SETTINGS Bangladesh, Dominican Republic and a pooled sample of infants from North America and Northern Europe. SUBJECTS Respectively 4787, 10 381 and 226 infants and children. RESULTS Healthy breast-fed infants tracked along the WHO standard's weight-for-age mean Z-score while appearing to falter on the NCHS reference from 2 months onwards. Underweight rates increased during the first six months and thereafter decreased when based on the WHO standards. For all age groups stunting rates were higher according to the WHO standards. Wasting and severe wasting were substantially higher during the first half of infancy. Thereafter, the prevalence of severe wasting continued to be 1.5 to 2.5 times that of the NCHS reference. The increase in overweight rates based on the WHO standards varied by age group, with an overall relative increase of 34%. CONCLUSIONS The WHO standards provide a better tool to monitor the rapid and changing rate of growth in early infancy. Their adoption will have important implications for child health with respect to the assessment of lactation performance and the adequacy of infant feeding. Population estimates of malnutrition will vary by age, growth indicator and the nutritional status of index populations.
Collapse
Affiliation(s)
- Mercedes de Onis
- Department of Nutrition, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland.
| | | | | | | | | |
Collapse
|
39
|
Abstract
The evaluation of child growth trajectories and the interventions designed to improve child health are highly dependent on the growth charts used. The U.S. CDC and the WHO, in May 2000 and April 2006, respectively, released new growth charts to replace the 1977 NCHS reference. The WHO charts are based for the first time on a prescriptive, prospective, international sample of infants selected to represent optimum growth. This article compares the WHO and CDC curves and evaluates the growth performance of healthy breast-fed infants according to both. As expected, there are important differences between the WHO and CDC charts that vary by age group, growth indicator, and specific Z-score curve. Differences are particularly important during infancy, which is likely due to differences in study design and characteristics of the sample, such as type of feeding. Overall, the CDC charts reflect a heavier, and somewhat shorter, sample than the WHO sample. This results in lower rates of undernutrition (except during the first 6 mo of life) and higher rates of overweight and obesity when based on the WHO standards. Healthy breast-fed infants track along the WHO standard's weight-for-age mean Z-score while appearing to falter on the CDC chart from 2 mo onwards. Shorter measurement intervals in the WHO standards result in a better tool for monitoring the rapid and changing rate of growth in early infancy. Their adoption would have important implications for the assessment of lactation performance and the adequacy of infant feeding and would bring coherence between the tools used to assess growth and U.S. national guidelines that recommend breast-feeding as the optimal source of nutrition during infancy.
Collapse
Affiliation(s)
- Mercedes de Onis
- Department of Nutrition, World Health Organization, Geneva, Switzerland.
| | | | | | | |
Collapse
|
40
|
Gianaroli L, Magli MC, Ferraretti AP, Lappi M, Borghi E, Ermini B. Oocyte euploidy, pronuclear zygote morphology and embryo chromosomal complement. Hum Reprod 2006; 22:241-9. [PMID: 16936301 DOI: 10.1093/humrep/del334] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Pronuclear morphology has been proposed as an indicator of embryo development and chromosomal complement. In this study, the morphology of pronuclear zygotes generated from euploid oocytes [diagnosed by first polar body (PB1) analysis] was evaluated and compared with the configurations observed in chromosomally normal embryos (diagnosed by blastomere analysis). MATERIALS AND METHODS Group 1--238 patients underwent 273 assisted conception cycles in combination with the screening of aneuploidy on PB1 for the chromosomes 13, 15, 16, 18, 21 and 22. Only normal oocytes were inseminated. Group 2--218 patients underwent 318 assisted conception cycles with aneuploidy screening on day 3 embryos. In both groups, oocytes were checked for fertilization and pronuclear morphology at 16 h after insemination. RESULTS Seventy-three percent of zygotes from Group 1 had the configurations with centralized and juxtaposed pronuclei, large-size aligned or scattered nucleoli and PB located in the longitudinal or perpendicular axis of pronuclei. In Group 2, these configurations corresponded to those with the highest proportion of chromosomally normal embryos. Accordingly, in both groups, these configurations had a higher implantation rate than all the others. CONCLUSIONS These observations confirm that some patterns of pronuclear morphology are associated with a higher proportion of euploidy and implantation reaffirming the relevance of this scoring system for the prediction of zygote viability.
Collapse
Affiliation(s)
- L Gianaroli
- S.I.S.Me.R., Reproductive Medicine Unit, Bologna, Italy.
| | | | | | | | | | | |
Collapse
|
41
|
Borghi E, de Onis M, Garza C, Van den Broeck J, Frongillo EA, Grummer-Strawn L, Van Buuren S, Pan H, Molinari L, Martorell R, Onyango AW, Martines JC. Construction of the World Health Organization child growth standards: selection of methods for attained growth curves. Stat Med 2006; 25:247-65. [PMID: 16143968 DOI: 10.1002/sim.2227] [Citation(s) in RCA: 243] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The World Health Organization (WHO), in collaboration with a number of research institutions worldwide, is developing new child growth standards. As part of a broad consultative process for selecting the best statistical methods, WHO convened a group of statisticians and child growth experts to review available methods, develop a strategy for assessing their strengths and weaknesses, and discuss methodological issues likely to be faced in the process of constructing the new growth curves. To select the method(s) to be used, the group proposed a two-stage decision-making process. First, to select a few relevant methods based on a list of set criteria and, second, to compare the methods using available tests or other established procedures. The group reviewed 30 methods for attained growth curves. Using the pre-defined criteria, a few were selected combining five distributions and two smoothing techniques. Because the number of selected methods was considered too large to be fully tested, a preliminary study was recommended to evaluate goodness of fit of the five distributions. Methods based on distributions with poor performance will be eliminated and the remaining methods fully tested and compared.
Collapse
Affiliation(s)
- E Borghi
- Department of Nutrition, WHO, Geneva, Switzerland
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
de Onis M, Blössner M, Borghi E, Morris R, Frongillo EA. Methodology for estimating regional and global trends of child malnutrition. Int J Epidemiol 2004; 33:1260-70. [PMID: 15542535 DOI: 10.1093/ije/dyh202] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Child malnutrition is an important indicator for monitoring progress towards the Millennium Development Goals (MDG). This paper describes the methodology developed by the World Health Organization (WHO) to derive global and regional trends of child stunting and underweight, and reports trends in prevalence and numbers affected for 1990-2005. METHODS National prevalence data from 139 countries were extracted from the WHO Global Database on Child Growth and Malnutrition. A total of 419 and 388 survey data points were available for underweight and stunting, respectively. To estimate trends we used linear mixed-effect models allowing for random effects at country level and for heterogeneous covariance structures. One model was fitted for each United Nation's region using the logit transform of the prevalence and results back-transformed to the original scale. Best models were selected based on explicit statistical and graphical criteria. RESULTS During 1990-2000 global stunting and underweight prevalences declined from 34% to 27% and 27% to 22%, respectively. Large declines were achieved in Eastern and South-eastern Asia, while South-central Asia continued to suffer very high levels of malnutrition. Substantial improvements were also made in Latin America and the Caribbean, whereas in Africa numbers of stunted and underweight children increased from 40 to 45, and 25 to 31 million, respectively. CONCLUSION Linear mixed-effect models made best use of all available information. Trends are uneven across regions, with some showing a need for more concerted and efficient interventions to meet the MDG of reducing levels of child malnutrition by half between 1990 and 2015.
Collapse
Affiliation(s)
- Mercedes de Onis
- Department of Nutrition, World Health Organization, Geneva, Switzerland.
| | | | | | | | | |
Collapse
|
43
|
Gérard-Blanluet M, Romana S, Munier C, Le Lorc'h M, Kanafani S, Sinico M, Touboul C, Levaillant JM, Haddad B, Lopez N, Lelong F, De Villemeur TB, Verloes A, Borghi E. Classical West “syndrome” phenotype with a subtelomeric 4p trisomy. Am J Med Genet A 2004; 130A:299-302. [PMID: 15378535 DOI: 10.1002/ajmg.a.30314] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We report a girl with mild mental retardation with onset of infantile spasms at age of 9 months. Treatment with a short course of adrenocorticotropic hormone (ACTH) was successful. Initially, a diagnosis of idiopathic West syndrome, with good neurological outcome and disappearance of epilepsy after treatment, was made. Conventional karyotype was normal. Reinvestigations were done at age 8 years, because of a new pregnancy. Karyotyping of both parents was done because of mild dysmorphic features in the proband, and to eliminate other causes than early age epilepsy as the etiology of her mental retardation. Parental karyotypes showed a balanced paternal translocation (4p;17q) resulting in partial 4p trisomy, without significant 17q monosomy in the proband. Chromosomal abnormalities usually lead to a severe West syndrome with poor prognosis of neurological outcome (persistent severe epilepsy, mental retardation, and behavioral disturbances). The presence of an undetected cytogenetic anomaly in our proband with transient hypsarythmia is unusual and led us to propose systematic telomeric screening in apparently "idiopathic" West syndrome patients with mild mental retardation and subtle dysmorphic features.
Collapse
Affiliation(s)
- Marion Gérard-Blanluet
- Department of Neonatalogy, Clinical Genetics, Centre Hospitalier Intercommunal, Créteil, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Abstract
CONTEXT One key target of the United Nations Millennium Development goals is to reduce the prevalence of underweight among children younger than 5 years by half between 1990 and 2015. OBJECTIVE To estimate trends in childhood underweight by geographic regions of the world. DESIGN, SETTING, AND PARTICIPANTS Time series study of prevalence of underweight, defined as weight 2 SDs below the mean weight for age of the National Center for Health Statistics and World Health Organization (WHO) reference population. National prevalence rates derived from the WHO Global Database on Child Growth and Malnutrition, which includes data on approximately 31 million children younger than 5 years who participated in 419 national nutritional surveys in 139 countries from 1965 through 2002. MAIN OUTCOME MEASURES Linear mixed-effects modeling was used to estimate prevalence rates and numbers of underweight children by region in 1990 and 2015 and to calculate the changes (ie, increase or decrease) to these values between 1990 and 2015. RESULTS Worldwide, underweight prevalence was projected to decline from 26.5% in 1990 to 17.6% in 2015, a change of -34% (95% confidence interval [CI], -43% to -23%). In developed countries, the prevalence was estimated to decrease from 1.6% to 0.9%, a change of -41% (95% CI, -92% to 343%). In developing regions, the prevalence was forecasted to decline from 30.2% to 19.3%, a change of -36% (95% CI, -45% to -26%). In Africa, the prevalence of underweight was forecasted to increase from 24.0% to 26.8%, a change of 12% (95% CI, 8%-16%). In Asia, the prevalence was estimated to decrease from 35.1% to 18.5%, a change of -47% (95% CI, -58% to -34%). Worldwide, the number of underweight children was projected to decline from 163.8 million in 1990 to 113.4 million in 2015, a change of -31% (95% CI, -40% to -20%). Numbers are projected to decrease in all subregions except the subregions of sub-Saharan, Eastern, Middle, and Western Africa, which are expected to experience substantial increases in the number of underweight children. CONCLUSIONS An overall improvement in the global situation is anticipated; however, neither the world as a whole, nor the developing regions, are expected to achieve the Millennium Development goals. This is largely due to the deteriorating situation in Africa where all subregions, except Northern Africa, are expected to fail to meet the goal.
Collapse
Affiliation(s)
- Mercedes de Onis
- Department of Nutrition, World Health Organization, Geneva, Switzerland.
| | | | | | | | | |
Collapse
|
45
|
Borghi E, Solari PL. Structural quantitative information on the active sites of hemocyanins and related model compounds by the XAS approach: the role of multiple-scattering calculations. Micron 2004; 35:81-6. [PMID: 15036299 DOI: 10.1016/j.micron.2003.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In this contribution, we will present an overview of the role of the multiple scattering (MS) calculations in the X-ray absorption spectroscopy (XAS) approach in order to extract from experimental data quantitative structural information on the active sites of the hemocyanin derivatives and of the related model compounds considered.
Collapse
Affiliation(s)
- E Borghi
- Dipartimento di Chimica, Università La Sapienza, p.le A. Moro 5, 00185 Roma, Italy.
| | | |
Collapse
|
46
|
Bertini I, Borghi E, Luchinat C. Investigation of the system carbon dioxide-bicarbonate(1-) ion in the presence of copper(II) bovine carbonic anhydrase B. J Am Chem Soc 2002. [DOI: 10.1021/ja00517a051] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
47
|
Beltramini M, Borghi E, Di Muro P, La Monaca A, Salvato B, Santini C. Functional SAXS study of haemocyanin dioxygen-carrier protein. J Mol Struct 1996. [DOI: 10.1016/s0022-2860(96)09292-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
48
|
Beltramini M, Borghi E, Di Muro P, La Monaca A, Salvato B, Santini C. The use of small-angle X-ray scattering in the study of quaternary organisation of giant proteins. J Mol Struct 1996. [DOI: 10.1016/s0022-2860(96)09291-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
49
|
Georgi G, Ginanneschi M, Chelli M, Papini AM, Laschi F, Borghi E. Histidyl-glycyl containing peptides. Characterization complexation properties of H(L-His-Gly)2-R with hydrogen and alkali metal ions in the gas phase. Rapid Commun Mass Spectrom 1996; 10:1266-1272. [PMID: 8814769 DOI: 10.1002/(sici)1097-0231(19960731)10:10<1266::aid-rcm648>3.0.co;2-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The two histidyl-glycyl containing peptides, H(L-His-Gly)2-OH and its methyl ester (H(L-His-Gly)2-OCH3, have been structurally characterized by liquid secondary-ion mass spectrometry. Both high-internal-energy ion fragmentations produced in the source and metastable decompositions occurring in the first field-free region have been studied. The mass spectra show the presence of y-, a- and b-type ions, a1 being the most abundant fragment ion. The metastable decompositions are dominated by the loss of a water molecule and by y-type ions. The interactions of the two peptides with alkali metal ions (Li, Na, K) have been evaluated both by normal mass spectrometry and by tandem mass spectrometry to obtain selected daughter-ion spectra. The occurrence of mono-, bi- and trimetallated species has been detected in the gas phase. While, in the case of the protonated species, y-type ions are predominant, in the presence of an alkali metal ion (Cat), they show lower abundances (Cat = Li) or are absent (Cat = Na, K) both in the mass spectra produced in the source and in metastable decompositions. In most of these cases, a very intense low-internal-energy ion, which is represented by [a3 + Cat - H]+ and which can be produced by interaction of the metal with a deprotonated amide nitrogen, is recorded. This mechanism should be favored by the ¿anchoring¿ effect exerted by the imidazole ring of the histidine which promotes interaction with metals. Other metastable decompositions yield abundant [b3 + Cat - H]+ ions or involve the loss of the side-chain of the histidine. The formation of [b3 + Cat +OH]+ ions, observed only in the case of the free acid peptide, is due to the interaction of the metal ion with the C-terminus carboxyl group. Bi- and trimetallated species have also been detected in the gas phase and characterized.
Collapse
Affiliation(s)
- G Georgi
- Centro Interdipartimentale di Analisi e Determinazioni Strutturali, Università di Siena, Italy
| | | | | | | | | | | |
Collapse
|
50
|
Deleuze JF, Dhorne S, Hazan J, Borghi E, Raynaud N, Pollet N, Meunier-Rotival M, Deschatrette J, Alagille D, Hadchouel M. Deleted chromosome 20 from a patient with Alagille syndrome isolated in a cell hybrid through leucine transport selection: study of three candidate genes. Mamm Genome 1994; 5:663-9. [PMID: 7873876 DOI: 10.1007/bf00426072] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Alagille syndrome (AGS) is a well-defined genetic entity assigned to the short arm of Chromosome (Chr) 20 by a series of observations of AGS patients associated with microdeletions in this region. By fusing lymphoblastoid cells of an AGS patient that exhibited a microdeletion in the short arm of Chr 20 encompassing bands p11.23 to p12.3 with rodent thermosensitive mutant cells (CHOtsH1-1) deficient in-leucyl-tRNA synthetase, we isolated a somatic cell hybrid segregating the deleted human Chr 20. This hybrid clone, designated NR2, was characterized by several methods, including PCR, with eight pairs of oligonucleotides mapped to Chr 20: D20S5, D20S41, D20S42, D20S56, D20S57, D20S58, adenosine deaminase (ADA), and Prion protein (PRIP); Restriction Fragment Length Polymorphism (RFLP) analyses with four genomic anonymous probes (D20S5, cD3H12, D20S17, D20S18); and fluorescent in situ hybridization (FISH) with total human DNA and D20Z1, a sequence specific to the human Chr 20 centromere, as probes. The NR2 hybrid allowed us to exclude three candidate genes for AGS: hepatic nuclear factor 3 beta (HNF3 beta), paired box 1 (PAX1), and cystatin C (CST3) as shown by their localization outside of the deletion. The NR2 hybrid is a powerful tool for the mapping of new probes of this region, as well as for obtaining new informative probes specific for the deletion by subtractive cloning of the region. Such markers will be useful for linkage analysis and screening of cDNA libraries.
Collapse
|