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1.
The objectives of the present study were to identify predictors of serum retinol concentration as well as to assess the prevalence of low serum retinol concentration, in both the whole population after correcting for the effect of serum C-reactive protein (CRP) (using multiple categories), and the healthy subgroup. A cross-sectional study of 579 apparently healthy children, aged 3-7 years from a Dhaka slum, Bangladesh, was conducted. The effects of age, gender, serum CRP and alpha1-antichymotrypsin, reported morbidity (during the previous 2 weeks), Ascaris lumbricoides and Trichuris trichiura infections, parental education, wasting, stunting and underweight on serum retinol were estimated using multiple linear regression. The mean serum retinol concentration was 0.84 (sd 0.27) micromol/l. Elevated serum CRP levels, reported diarrhoea, reported nasal discharge and T. trichiura infection were negative predictors of serum retinol, whereas maternal education was a positive predictor. Compared with a serum CRP level of < 1 mg/l, CRP levels of 2 to < 5, 5 to < 10 and > or = 10 mg/l were associated with 0.12, 0.16 and 0.32 micromol/l lower serum retinol, respectively. The prevalence of low serum retinol (< 0.70 micromol/l) fell from 31.2 % to 15.6 % in the whole population, after correcting for the effect of CRP, and was 20.1 % in the healthy subgroup (CRP < 2 mg/l). The prevalence of low serum retinol was high but overestimated due to the effect of CRP. Interventions are needed to address low serum retinol in Bangladesh. Controlling diarrhoea, nasal discharge and T. trichiura infection and improving maternal education may be important interventions. The use of multiple categories of acute-phase proteins and cut-off values that indicate elevated levels need further research.  相似文献   

2.
BACKGROUND: Folate and iron status and hemoglobin concentrations are important to maternal and infant health. OBJECTIVE: Our goal was to identify predictors of serum folate, serum ferritin, and hemoglobin. DESIGN: This was a cross-sectional study of 1669 pregnant women (22-35 wk of gestation) in Harare, Zimbabwe, who were receiving prenatal care. The statistical effects of age, season, gestational age, gravidity, HIV-1 infection, malaria parasitemia, and serum alpha1-antichymotrypsin (ACT) on serum folate, serum ferritin (log10 transformed), and hemoglobin were estimated by using multiple linear regression analyses. RESULTS: Serum folate (x: 11.4 micromol/L) was 0.52-nmol/L (95% CI: 0.04, 1.0) lower in HIV-infected women than in uninfected women and 0.65-nmol/L (0.014, 1.28) lower in weeks 25-35 than in weeks 22-25. Serum ferritin (geometric x: 11.6 microg/L) was 0.93 times (0.86, 0.99) lower in HIV-infected women and 2.25 times (1.41, 3.61) higher in women with malaria parasitemia than in uninfected women. Similarly, serum ferritin was 0.71 times (0.63, 0.79) higher in weeks 32-35 than in weeks 22-25 and 1.21 times (1.12, 1.29) higher in gravida > or =3 than in gravida 1. Elevated serum ACT was a strong predictor of serum folate, serum ferritin, and hemoglobin. HIV infection was associated with a 12.9-g/L (8.9, 16.8) lower hemoglobin concentration in women with nondepleted iron stores but low serum retinol and a 7-8-g/L lower hemoglobin concentration in women with other combinations of serum ferritin and retinol (P for interaction = 0.038). Season, age, gestational age, and gravidity were not significant predictors of hemoglobin. Low serum folate, ferritin, and retinol were associated with low hemoglobin. CONCLUSIONS: HIV was associated with lower serum folate, serum ferritin, and hemoglobin. HIV infection was also associated with lower hemoglobin, particularly in women with stored iron and low serum retinol. Low serum folate, ferritin, and retinol were associated with low hemoglobin.  相似文献   

3.
BACKGROUND: Vitamin A status during pregnancy is important to maternal and infant health. OBJECTIVE: Our goal was to identify predictors of serum beta-carotene and retinol. DESIGN: This was a cross-sectional study of 1669 women (22-35 wk of gestation) in Harare, Zimbabwe, who were receiving prenatal care. The statistical effects of age, season, gestational age, gravidity, HIV-1 infection, malaria parasitemia, and serum alpha1-antichymotrypsin (ACT) on serum beta-carotene (log10 transformed) and retinol were estimated by using multiple linear regression analyses. RESULTS: HIV infection was found in 31.5% of the women; 0.4% had malaria. Serum beta-carotene concentrations (geometric x: 0.19 micromol/L) were lower in HIV-infected women than in uninfected women (10beta = 0.78; 95% CI: 0.72, 0.84) and increased with age (10beta = 1.05; 1.02, 1.07) in gravida 1 but not in gravida > or =2 (P for interaction = 0.00002). Serum retinol (x: 0.92 micromol/L) increased with age (beta = 0.004; 0.0001, 0.008) in uninfected women but not in HIV-infected women (P for interaction = 0.02) and was 0.05-micromol/L (0.02, 0.09) lower in HIV-infected women than in uninfected women at 24 y of age. Furthermore, gestational age, season, use of prenatal supplements, and malaria were predictors of serum beta-carotene. Serum retinol was lower in women carrying male (beta = -0.04; -0.08, -0.00005) and multiple (beta = -0.21; -0.35, -0.08) fetuses. Serum ACT concentrations of 0.3-0.4, 0.4-0.5, and >0.5 g/L were associated with 3%, 11%, and 44% lower serum beta-carotene and 0.04-, 0.15-, and 0.41-micromol/L lower serum retinol. Serum ACT (g/L) was higher in women with malaria than in those without (beta = 0.10; 0.03, 0.16) and in gravida 1 than in gravida > or =2 (beta = 0.012; 0.003, 0.021), but was not higher in HIV-infected women than in uninfected women (beta = 0.001; -0.008, 0.011). CONCLUSIONS: HIV infection, malaria, gravidity, and gestational age were predictors of serum beta-carotene and retinol. Serum ACT was an important predictor of both and was associated with gravidity and gestational age.  相似文献   

4.

Background

Globally, millions of people suffer from intestinal parasitic infections. These infections are among the most common resulting in considerable morbidity and mortality. In Ethiopia and particularly in Jimma and its surroundings intestinal parasitic infections are highly prevalent because of low living standards and poor environmental sanitation. The objective of the survey was to determine the prevalence and predictors of intestinal parasitosis among school children in four woredas of Jimma zone surrounding Gilgel gibe hydraulic dam and serve as a base line data to help evaluate health promoting activities for the future and monitor those already delivered to the community.

Methods

A cross-sectional study was carried out in October, 2008 in four Woredas of Jimma zone bordering Gilgel Gibe Dam. Children attending grades 1–8 in the schools located within 10 Kms ofthe Dam in the four bordering woredas and those living 30 Kms away from the shore line were the study subjects. Six hundred twenty four and 321 children were selected from the schools around Gilgel Gibe dam and from the schools in Bulbul, respectively. Data on background of participant was collected and stool specimen collected and processed. Data were filtered and entered into computer then analyzed using SPSS for windows version 13.0.1.

Results

Of the 937 selected individuals, 855 participated in the study giving a response rate of 91.2%. The prevalence of intestinal parasitosis was 47.1% where 174 (20%) had Ascaris lumbricoides monoinfection; 4.3% had dual infection involving Ascaris lumbricoides and hookworm and 0.2% had triple infection but all the infections were of light intensity. In addition, there was no association between prevalence of intestinal parasitosis with availability or regular use of latrine and clinical symptoms.

Conclusion

The prevalence and intensity of intestinal parasites in the study area is lower than national, urban and rural setting of Jimma zone. These might be due to a better awareness of the study community on prevention of intestinal parasitosis following increased health promoting activities in the area, delivered through various activities of Jimma Public health training program.  相似文献   

5.
To assess the relationship of serum cholesterol level to anthropometric measurements and dietary intake, we measured serum cholesterol, height, weight, triceps skinfold, and 24-hour dietary intake in 80 children (mean age = 9.8 years) during April 1989. The mean serum cholesterol level was 3.95 mmol/l. In comparison with national data, weight-for-height and triceps skinfold measurements exceeded the 90th percentile in 18 (23%) and 26 (33%) of the children, respectively. Mean cholesterol and fat intakes were 114 mg/1,000 kcal and 36% of energy, respectively. In multiple stepwise regression analyses, weight-for-height measurement and saturated fatty acid intake were most predictive of serum cholesterol levels. Diets of children who consumed 30% of energy or less from fat (low-fat group) met or exceeded the Recommended Dietary Allowances except for energy and vitamin E and were higher in percentage of energy from carbohydrate, dietary fiber, magnesium, iron, and copper than were diets of children who consumed 31% of energy or more from fat (high-fat group). Children in the high-fat group ate more red/processed meats, baked desserts, and fats/oils than children in the low-fat group. Our data indicate that programs to reduce risk of cardiovascular disease in children may need to focus on maintaining ideal body weight and reducing saturated fatty acid intake.  相似文献   

6.

Background  

Toxicological studies and limited human studies have demonstrated associations between exposure to polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs) and polychlorinated biphenyls (PCBs) and adverse developmental and reproductive health effects. Given that children may be particularly susceptible to reproductive and developmental effects of organochlorines, and the paucity of information available regarding childhood exposures to dioxins in particular, we undertook a pilot study to describe the distribution of, and identify potential predictors of exposure to, dioxin-like compounds and dioxins among adolescent boys in Chapaevsk, Russia. The pilot study was also designed to guide the development of a large prospective cohort study on the relationship of exposure to PCDDs, PCDFs, and PCBs with growth and pubertal development in peri-pubertal Chapaevsk boys.  相似文献   

7.
In this study the hair zinc levels of 115 healthy subjects, 50 girls and 65 boys, between the age groups 0 to 15 years were determined by using atomic absorption spectrophotometry. The hair zinc levels obtained generally agree with those reported in the literature. The hair zinc levels of the subjects were studied as a function of age, sex and color of hair. It was found that the levels of hair zinc increased as a function of age, whereas no statistically significant differences with respect to sex and color of hair were observed. In a protein-calorie malnourished group of 11 girls and six boys between the ages 0 to 3 years, it was found that the hair zinc levels were significantly higher than a group of healthy subjects of the same age range. In a protein-calorie malnourished group of seven subjects no correlation was found between hair zinc and serum levels.  相似文献   

8.
OBJECTIVE: To assess the impact of zinc supplementation during acute diarrhoea on subsequent growth and morbidity in malnourished young children. DESIGN: Double blind randomized controlled clinical trial SETTING: International Centre for Diarrhoeal Disease Research, Bangladesh. SUBJECTS: Sixty-five children aged 3-24 months with acute diarrhoea for less than 3 d. INTERVENTION: Either elemental zinc (20 mg/d) in a multivitamin syrup or multivitamin syrup alone divided in three divided daily doses for a period of two weeks. Children were followed up weekly at home to assess subsequent growth and morbidity for a period of eight weeks. MAIN OUTCOME MEASURES: Gain in length and body weight and reduction in diarrhoea and respiratory tract infection. RESULTS: During the follow-up, zinc supplemented children showed significantly greater cumulative length gain (18.9 mm vs 14.5 mm, P <0.03) and comparable body weight gain than the children of the control group. Subsequent length gain was not correlated with initial height in the zinc-supplemented group (r=-0.13), P = 0.5), but was significantly correlated in the control group (r = -0.6, P < 0.0007). Zinc-supplemented and stunted children (< or = 90% length for age n = 18) experienced significantly fewer episodes of diarrhoea (0.07 vs 0.6, P < 0.05) and respiratory illness (1.0 vs 2.4, P < 0.01) compared to the control group. The underweight children (< or = 71% weight/age n = 38) receiving zinc-supplementation also had fewer episodes of diarrhoea (0.4 vs 1.0, P<0.04) and shorter duration of diarrhoeal episodes (1.0 vs 3.0d, P<0.04) compared to their counterparts in the control group. CONCLUSION: These results suggest that a short course of zinc supplementation to malnourished children during acute diarrhoea reduces growth-faltering and diarrhoeal and respiratory morbidity during subsequent two months.  相似文献   

9.
BackgroundVaccine-preventable infectious diseases are often responsible for childhood morbidity and high rates of mortality. Immune response to the vaccine is associated with multiple factors in early childhood and measured by antibody titers. Among them, micronutrient deficiencies such as vitamin D and zinc deficiencies are the most important in resource-limited settings like Bangladesh.ObjectiveWe aimed to evaluate the association of vaccine response to low serum zinc and vitamin D levels in children.MethodsWe evaluated vaccine response for measles and poliovirus, tetanus and pertussis toxoid, and Ig A antibody levels to rotavirus by ELISA and serum vitamin D and zinc at 7 and 15 months in the MAL-ED birth cohort of the Bangladesh site. By using population-specific generalized estimating equations (GEE), the association between each explanatory variable and the binary outcome variable was examined longitudinally where the dependent variable was vaccine titers and the independent variables were low serum vitamin D and zinc levels.ResultsThe GEE multivariable model identified a positive association between serum zinc level and tetanus vaccine titer (OR: 1.84; 95% CI: 1.07–3.17 and p value = 0.028) after adjusting for age, gender, birth weight, WAMI score, diarrhea, ALRI, exclusive breastfeeding, serum ferritin, serum retinol and undernutrition (stunting, wasting, underweight). No association was found between the rest of the vaccine titers with serum vitamin D and zinc level (p > 0.05).ConclusionIn the MAL-ED birth cohort, where children were followed for five years, serum zinc level had a positive impact on tetanus vaccine titers.  相似文献   

10.
The purpose of this study was to examine the hypothesis that serum levels of phospholipid (PL) fatty acids (FA) and minerals are associated with the components of metabolic syndrome (MetS) in the Chinese population and the profiles of changes may differ from patients with MetS from Western countries. The levels of serum PL, FA, and minerals were examined in 201 subjects (52 with MetS and 149 healthy controls without any MetS components) in China. The saturated FA proportion in serum was significantly higher, whereas the proportion of total polyunsaturated FA (PUFA), n-3 and n-6 PUFA (22:6n-3: −16%, P = .006; 20:4n-6: −36%, P < .001), and estimated δ-5 desaturase were significantly lower in the MetS group compared with those that are not MetS. Subjects with MetS had higher levels of serum Zn (P = .037) and Mg (P < .001) than subjects without MetS. The proportion of n-3 PUFA was significantly negatively correlated with body mass index and waist circumference. In conclusion, serum PL FA composition and serum minerals in Chinese men with MetS differed significantly from that of healthy individuals, reflecting a decrease in n-3 and n-6 PUFA, especially 22:6n-3 and 20:4n-6, and an increase in saturated FA, magnesium, and zinc. These changes may reflect improper dietary intake in subjects with MetS, and dietary modification could be useful to prevent MetS and as an adjunctive therapy.  相似文献   

11.
A survey conducted on a quota sample of 42 developmentally delayed children included assessment of maternal nutrition knowledge and attitudes. A 24-hour recall was combined with a two-day food record for calculation of dietary iron intakes of the children. Serum ferritin levels were used to assess subjects' iron stores. Maternal education was positively correlated with maternal nutrition knowledge, attitude toward meal planning, and stricter attitudes toward feeding children. Maternal nutrition knowledge and strictness attitudes significantly correlated with dietary iron intake. Relative feeding skills and age correlated with serum ferritin levels.  相似文献   

12.
13.
Aging induces a dysregulation of immune and inflammation functions that may affect protein synthesis rates in lymphoid tissue and plasma proteins. We quantified in vivo synthesis rates of thymus, spleen and plasma proteins, including albumin and acute phase proteins, in adult (8 mo old) and old (22 mo old) rats using the flooding dose method [L-(1-(13)C) phenylalanine]. Immunosenescence was reflected by thymus atrophy and spleen hypertrophy in old rats but not in adult rats. A low albumin plasma level associated with high concentrations of fibrinogen, alpha(2)-macroglobulin, alpha(1)-acid glycoprotein and proteins other than albumin revealed a low grade inflammation in old rats. Protein fractional synthesis rates (FSR) and protein synthesis efficiencies of thymus were 29 and 26% lower in old than in adult rats, respectively; these variables did not differ in spleen. Protein absolute synthesis rates (ASR) of the thymus and spleen were 76% lower and 67% greater in old than adult rats, respectively. The FSR and ASR of albumin and other plasma proteins were greater in old than in adult rats. Protein synthesis measurement is a valuable nonimmunological tool to assess, in vivo, immune and inflammatory variables. Alterations in secondary lymphoid organs and plasma protein synthesis may contribute to the significant repartitioning of amino acids in old compared with adult rats and may be involved in sarcopenia.  相似文献   

14.
目的:探讨胎膜早破及其绒膜羊膜炎时孕妇血和脐血白细胞介素-8(interleukin-8,IL-8)的意义。方法:采用放射免疫法对30例胎膜早破孕妇血和脐血进行IL-8的测定,并以正常足月妊娠孕妇20例做对照。组织绒膜羊膜炎通过产后胎盘病理确诊。结果:胎膜早破孕妇血和脐血IL-8的水平明显高于对照组(P<0.01~0.02),随着破膜时间延长IL-8升高,且时间超过30小时IL-8明显升高,绒膜羊膜炎患者孕妇血和脐血IL-8与非绒膜羊膜炎比较,有显著差异(P<0.001)孕妇血和脐血IL-8的变化与产力无关(P>0.05),两组孕妇血和脐血IL-8水平呈正相关(P<0.001)。结论:孕妇血IL-8的浓度可作为足月胎膜早破组织绒膜羊膜炎筛选的一个指标。  相似文献   

15.

Background

Childhood vaccination rates in Nigeria are among the lowest in the world and this affects morbidity and mortality rates. A 2011 mixed methods study in two states in Nigeria examined coverage of measles vaccination and reasons for not vaccinating children.

Methods

A household survey covered a stratified random cluster sample of 180 enumeration areas in Bauchi and Cross River States. Cluster-adjusted bivariate and then multivariate analysis examined associations between measles vaccination and potential determinants among children aged 12-23 months, including household socio-economic status, parental knowledge and attitudes about vaccination, and access to vaccination services. Focus groups of parents in the same sites subsequently discussed the survey findings and gave reasons for non-vaccination. A knowledge to action strategy shared findings with stakeholders, including state government, local governments and communities, to stimulate evidence-based actions to increase vaccination rates.

Results

Interviewers collected data on 2,836 children aged 12-23 months in Cross River and 2,421 children in Bauchi. Mothers reported 81.8% of children in Cross River and 42.0% in Bauchi had received measles vaccine. In both states, children were more likely to receive measles vaccine if their mothers thought immunisation worthwhile, if immunisation was discussed in the home, if their mothers had more education, and if they had a birth certificate. In Bauchi, maternal awareness about immunization, mothers’ involvement in deciding about immunization, and fathers’ education increased the chances of vaccination. In Cross River, children from communities with a government immunisation facility were more likely to have received measles vaccine. Focus groups revealed lack of knowledge and negative attitudes about vaccination, and complaints about having to pay for vaccination. Health planners in both states used the findings to support efforts to increase vaccination rates.

Conclusion

Measles vaccination remains sub-optimal, particularly in Bauchi. Efforts to counter negative perceptions about vaccination and to ensure vaccinations are actually provided free may help to increase vaccination rates. Parents need to be made aware that vaccination should be free, including for children without a birth certificate, and vaccination could be an opportunity for issuing birth certificates. The study provides pointers for state level planning to increase vaccination rates.
  相似文献   

16.
17.
Protein-calorie malnutrition is a known risk factor for increased morbidity and mortality in maintenance hemodialysis patients (MHD). Serum albumin is the most commonly measured nutritional index in MHD patients because of its easy routine availability and association with outcomes of interest. However, its long half-life of approximately 20 days makes it a late index of nutritional status, and its exclusive use may delay implementation of appropriate nutritional interventions. Serum prealbumin and transferrin have been proposed as earlier nutritional markers. However, the temporal associations among these indices and serum albumin have not been well documented. To assess the ability of serum prealbumin and serum transferrin to predict changes in serum albumin over time, we prospectively analyzed these parameters in 105 MHD patients every month for 6 consecutive months. The mixed model analysis showed that early changes in either serum transferrin or prealbumin predicted and were significantly associated with changes in serum albumin (P<.0001). Using a prototype equation, a change of 0.12 g/dL in serum albumin concentration can be predicted by a 10% change in the same direction of serum transferrin and prealbumin. We conclude that clinically significant changes in albumin can be reliably predicted by earlier changes in serum transferrin and prealbumin.  相似文献   

18.
Mercury is an immunotoxic substance that has been shown to induce autoimmune disease in rodent models, characterized by lymphoproliferation, overproduction of immunoglobulin (IgG and IgE), and high circulating levels of auto-antibodies directed at antigens located in the nucleus (antinuclear auto-antibodies, or ANA) or the nucleolus (antinucleolar auto-antibodies, or ANoA). We have reported elevated levels of ANA and ANoA in human populations exposed to mercury in artisanal gold mining, though other confounding variables that may also modulate ANA/ANoA levels were not well controlled. The goal of this study is to specifically test whether occupational and environmental conditions (other than mercury exposure) that are associated with artisanal gold mining affect the prevalence of markers of autoimmune dysfunction. We measured ANA, ANoA, and cytokine concentrations in serum and compared results from mercury-exposed artisanal gold miners to those from diamond and emerald miners working under similar conditions and with similar socio-economic status and risks of infectious disease. Mercury-exposed gold miners had higher prevalence of detectable ANA and ANoA and higher titers of ANA and ANoA as compared to diamond and emerald miners with no occupational mercury exposure. Also, mercury-exposed gold miners with detectable ANA or ANoA in serum had significantly higher concentrations of pro-inflammatory cytokines IL-1β, TNF-α, and IFN-γ in serum as compared to the diamond and emerald miners. This study provides further evidence that mercury exposure may lead to autoimmune dysfunction and systemic inflammation in affected populations.  相似文献   

19.
目的 探讨孤独症患儿血清中鞘脂类代谢产物水平及其与临床诊断量表的相关性, 评价其对孤独症的潜在诊断价值。方法 对73例孤独症儿童和63例正常对照儿童血清鞘脂类进行分析, 找出与孤独症有关的代谢产物并测其水平;用同法对另100例孤独症儿童和100例正常对照儿童进行验证, 并分析其与孤独症儿童行为检查量表(Autism Behavior Checklist, ABC)和儿童孤独症评定量表(Childhood Autism Rating Scale, CARS)的相关性, 绘制ROC曲线。结果 筛选出两种与孤独症有关的鞘脂类代谢产物植物鞘氨醇(phytosphingosine, PSO)和1-磷酸鞘氨醇(sphingosine-1-phosphate, S1P), 其含量在孤独症组明显升高(P<0.05);验证发现孤独症组PSO和S1P含量明显升高(P<0.05), S1P与ABC总分呈显著正相关。PSO的ROC曲线得到其曲线下面积(AUC)和Youden指数最大值均为1.000, 最佳临界值为44.883, 对应的敏感度和特异度为100%。S1P的AUC为0.961, Youden指数最大值为0.868, 最佳临界值为47.678, 对应的敏感度为91.7%, 特异度为95.1%。结论 孤独症患儿血清中PSO和S1P含量与正常儿童存在明显差异, 提示鞘脂类代谢异常可能与孤独症有一定关联, 且二者对孤独症有较好的诊断价值, ROC曲线确定的最佳临界值分别为44.883和47.678。  相似文献   

20.
METHODS. The relation between green tea consumption and serum lipid concentrations was examined using cross-sectional data on 1,306 males who received the retirement health examination at the Self-Defense Forces Fukuoka Hospital between October 1986 and December 1988. RESULTS. After adjustment for rank, smoking, alcohol use, physical activity, and body mass index, serum total cholesterol levels were found to be inversely related to the consumption of green tea while no association was noted with serum triglycerides and high-density lipoprotein cholesterol. Adjusted mean concentrations of total cholesterol were 8 mg/dl lower in men drinking nine cups or more per day than in those consuming zero to two cups per day. Serum cholesterol levels were inversely associated with traditional Japanese dietary habits (intake of rice and soy bean paste soup) and positively associated with Westernized habits. Additional adjustment for these dietary variables did not alter the inverse relation between green tea and total cholesterol.  相似文献   

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