Prevalence and Correlates of Vitamin D Deficiency among Young South African Infants: A Birth Cohort Study

Early-life vitamin D deficiency is associated with adverse child health outcomes, but the prevalence of vitamin D deficiency and its correlates in infants remains underexplored, particularly in sub-Saharan Africa. We aimed to investigate the prevalence of vitamin D deficiency and its correlates among young infants in South Africa. This study included 744 infants, aged 6–10 weeks from the Drakenstein Child Health Study, a population-based birth cohort. Infants were categorized into distinct categories based on serum 25(OH)D concentration level including deficient (<50 nmol/L), insufficient (50–74 nmol/L), and sufficient (≥75 nmol/L). Using multivariable Tobit and logistic regression models, we examined the correlates of serum 25(OH)D₃ levels. The overall prevalence of vitamin D deficiency was 81% (95% confidence intervals (CI]) 78–83). Multivariable regression analysis showed that serum 25(OH)D₃ concentration was independently associated with study site, socioeconomic status, and sex. Birth in winter and breastfeeding were the strongest predictors of lower serum 25(OH)D₃ concentration levels. Compared to non-breastfed children, children breastfed were at higher risk of vitamin D deficiency (AOR, 1.96; 95% CI, 1.04–3.67) and breastfeeding for more than one month was associated with greater likelihood of vitamin D deficiency (AOR, 5.40; 95% CI, 2.37–12.32) and lower vitamin D concentrations (−16.22 nmol/L; 95% CI, −21.06, −11.39). Vitamin D deficiency in infants is ubiquitous, under-recognised, and strongly associated with season of birth and breastfeeding in this setting. Nutritional interventions with vitamin D supplementation in national health programs in low- and middle-income countries are urgently needed to improve early-life vitamin D status in infants.     

“In the Bible Belt:” The role of religion in HIV care and prevention for transgender people in the United States South

Within the United States South, the socio-religious norms that shape life for many residents may have public health implications. Drawing from 12 key informant interviews, this study explores the role of religious institutions in HIV care and prevention access among transgender people of color in Southern cities. Findings suggest that while religious anti-transgender stigma is pervasive, the regional importance of faith-based beliefs and institutions necessitates targeted faith-based initiatives for the population. Broadly, findings suggest regional environments may demand interventions that negotiate historically marginalizing relationships between at-risk groups and dominant cultural institutions.     

The Relationship Between Violence Syndemics and Sexual Risk Behaviors Among African American Adolescents: Implications for Future Research

PurposeWe present a conceptual framework based on a review of the literature to highlight the interconnecting and reinforcing elements of a violence syndemic and how this syndemic influences sexual risk behaviors among African American heterosexual adolescents.MethodsWe review existing peer-reviewed published research from 2000 to 2020 that links a violence syndemic (i.e., racism and race-related stress, neighborhood and police violence, peer violence, and family violence and disruptions) to adolescent sexual risk behaviors. Empirical findings and theoretical underpinnings are used to document this relationship and illuminate the factors that mediate this relationship.ResultsEmpirical studies support the links between specific types of violence and sexual risk behaviors among African American adolescents. Further, existing studies point to the important relationships among the specific types of violence, supporting a violence syndemic approach.ConclusionsWhile more researchers are examining socio-ecological contextual factors as important predictors for sexual risk behaviors, there remains inadequate understanding about how violence types reinforce one another to heighten sexual risk behaviors among African American heterosexual adolescents. This article presents new directions for adolescent research, especially how a violence syndemic approach can be used to explain sexual risk, but also to refocus intervention design on the complex burdens experienced by this population.     

COVID-19 and Infant Hospitalizations for Seasonal Respiratory Virus Infections,New Zealand, 2020

In March 2020, a national elimination strategy for coronavirus disease was introduced in New Zealand. Since then, hospitalizations for lower respiratory tract infection among infants <2 years of age and cases of respiratory syncytial or influenza virus infection have dramatically decreased. These findings indicate additional benefits of coronavirus disease control strategies.     

Surveillance of COVID-19–Associated Multisystem Inflammatory Syndrome in Children,South Korea

A concerning development during the coronavirus disease pandemic has been multisystem inflammatory syndrome in children. Reports of this condition in East Asia have been limited. In South Korea, 3 cases were reported to the national surveillance system for multisystem inflammatory syndrome in children. All case-patients were hospitalized and survived with no major disease sequelae.     

African American polycystic kidney patients receive higher risk kidneys,but do not face increased risk for graft failure or post-transplant mortality

African Americans (AA) are disproportionately affected by end-stage renal disease (ESRD) and have worse outcomes following renal transplantation. Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic condition leading to ESRD necessitating transplant. We explored this population with respect to race by conducting a retrospective analysis of the UNOS database between 2005 and 2019. Our study included 10,842 (AA n = 1661; non-AA n = 9181) transplant recipients whose primary diagnosis was ADPKD. We further stratified the AA ADPKD population with respect to blood groups (AA blood type B n = 295 vs AA non-B blood type n = 1366), and also compared this cohort to AAs with a diagnosis of DM (n = 16,706) to identify unique trends in the ADPKD population. We analyzed recipient and donor characteristics, generated survival curves, and conducted multivariate analyses. African American ADPKD patients waited longer for transplants (924 days vs 747 days P < .001), and were more likely to be on dialysis (76% vs 62%; p < .001). This same group was also more likely to have AA donors (21% vs 9%; p < .001) and marginally higher KDPI kidneys (0.48 vs 0.45; p < .001). AA race was a risk factor for delayed graft function (DGF), increasing the chance of DGF by 45% (OR 1.45 95% CI 1.26–1.67; p < .001). AA race was not associated with graft failure (HR 1.10 95% CI 0.95–1.28; p = .21) or patient mortality (HR 0.84 95% CI 0.69–1.03; p = .09). Racial disparities exist in the ADPKD population. They should be continually studied and addressed to improve transplant equity.