Repeated surveys of people who inject drugs: The exception, not the rule.

HIV surveillance is the continuous, systematic collection, analysis and interpretation of HIV-related data needed for the planning, implementation, and evaluation of the HIV response. Some communities are affected by HIV more than others and require more focused responses; one of these communities are people who inject drugs (PWID.) We reviewed HIV surveillance among PWID across all countries. We identified countries with specific repeated surveys among PWID using data submitted to the UNAIDS Global AIDS Monitoring system, supplemented by national reports from countries that do not report to UNAIDS. Countries with four or more surveys since 2011, with at least one since 2017, were sent a brief survey to ask the use and relevance of the collected data for their respective HIV responses and the challenges they foresaw. Thirty-two countries were polled, of which 17 responded. Respondents highlighted the utility of the surveys to measure HIV prevalence, antiretroviral treatment and other service use. Future funding and maintaining capacity to implement surveys are current or coming challenges.

Prevalence of Vitamin A Deficiency in Children Aged 6 to 17 Years - Western and Central Rural Areas, China, 2012-2021.

What is already known about this topic?: Vitamin A deficiency (VAD) is a leading global nutritional concern, ranking among the top four major nutritional deficiencies worldwide. The prevalence of VAD is unevenly distributed across various regions, both within China and globally. What is added by this report?: The report adds valuable insights into the vitamin A nutritional status of rural students aged 6-17 years who participated in the Nutrition Improvement Programme for Rural Compulsory Education Students (NIPRCES). Over the decade from 2012 to 2021, there was a modest improvement in vitamin A status. The prevalence of VAD and sub-clinical VAD (SVAD) declined as the students aged. Throughout the majority of the survey years, the incidence of VAD was higher among males and western regions compared to females and central regions, respectively. What are the implications for public health practice?: A comprehensive approach, incorporating dietary diversification, nutrition education, and food fortification, should be implemented to prevent VAD and SVAD especially in males, younger children and children in western areas.

Japanese Nursing Staff's Knowledge and Attitude toward Bereavement Care for Couples with Miscarriage/Stillbirth and Its Associated Factors.

Bereavement care is conducted to meet the emotional needs of grieving couples who are devastated by the experience of a miscarriage or stillbirth. From January to April 2022, we distributed a questionnaire that assessed the knowledge and attitudes of Japanese nursing staff (nurses and midwives) in Japan's Chugoku-Shikoku region toward bereavement care for couples with miscarriage/stillbirth. The 370 survey respondents' answers revealed that the nursing staff's knowledge regarding recurrent pregnancy loss and subsequent bereavement care was insufficient. About 41.1% and 64.1% of the respondents had received school and on-the-job education in bereavement care, respectively, and 79.2% expressed willingness to provide such care. Our analyses revealed that the following factors were associated with the nursing staff's knowledge level: parent status, age, reproductive history, midwifery license, work experience and environment, and on-the-job education. The following were correlated with the staff's willingness to provide bereavement care: work environment, midwifery license, bereavement care knowledge, and on-the-job education. Together our findings indicate that education plays a significant role in equipping caregivers to provide effective bereavement care for couples who have experienced a miscarriage or stillbirth.

Variations in Rope Skipping Counts Among Rural Primary and Secondary School Students - China, 2013-2021.

What is already known about this topic?: Physical fitness is closely associated with children's development. Limited research has been published on the changes in physical fitness among Chinese children during the implementation of the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES). What is added by this report?: This research utilized data from the NIPRCES between 2013 and 2021 to examine alterations in children's physical fitness levels. Over this period, there was a significant increase in the number of rope skipping counts among children. In 2021, variations in these counts were observed, which depended on factors such as age, gender, geographic location, and region. What are the implications for public health practice?: Physical fitness has been linked to a multitude of non-communicable diseases. Enhanced nutritional measures for children lead to significant improvements in their overall physical fitness, as evidenced by NIPRCES findings. It is crucial for policymakers to implement comprehensive interventions aimed at promoting and advancing children's physical fitness.

Frequency of Food Consumption Among Students Aged 8-15 Years - China, 2019 and 2021.

What is already known about this topic?: Malnutrition continues to be the primary cause of delayed growth and development among students in economically disadvantaged rural areas of China. Ensuring adequate and appropriate dietary intake is crucial for promoting the healthy growth of these students. What is added by this report?: In rural areas of central and western regions in China, the weekly consumption frequencies of meat, eggs, milk, legumes, fruits, and vegetables in 2021 were higher than those in 2019. However, the consumption levels remained relatively low in economically underdeveloped rural areas in 2021. What are the implications for public health practice?: Understanding the frequency of food consumption among students can provide a solid evidence base for the development of policies and strategies aimed at controlling and preventing malnutrition.

Perceptions of Primary Caregivers on Children's Weight Status Versus Actual Weight Status in Children Aged 6-15 Years - China, 2021.

What is already known about this topic?: Childhood obesity has been linked to adverse health outcomes during both childhood and adulthood. An accurate understanding of children's weight status by primary caregivers is essential for effective weight management strategies. What is added by this report?: The data utilized in this study were obtained from the 2021 Nutrition Improvement Program for Rural Compulsory Education Students in China. It was found that over one-third of primary caregivers underestimated their children's weight status, and more than half of the primary caregivers of overweight or obese children underreported the weight status of those children. A low level of agreement was observed between primary caregivers' perceptions of their children's weight status and the actual weight status. What are the implications for public health practice?: There is a relatively higher underestimation of children's weight in China, which necessitates more effective strategies to enhance the primary caregivers' perception of their children's weight status, especially in primary caregivers of males, younger children and children in urban areas.

Dietary Patterns and Associations with Myopia in Chinese Children.

Dietary shifts in populations undergoing rapid economic transitions have been proposed as partly contributing toward the rapid intergenerational rise in myopia prevalence; however, empirical evidence of the effect of dietary factors on myopia is limited. This study investigated the association between dietary factors and incident myopia in Chinese children aged 10-11 years. We evaluated dietary habits using a 72-item food frequency questionnaire (FFQ) among 7423 children. Myopic status was assessed using the "General Personal Information Questionnaire". Principal component analysis was used to extract dietary patterns and investigate their association with myopia. After adjusting for potential confounders, participants with the highest adherence to dietary pattern A (95% confidence interval (CI): 0.66-0.92, p for trend = 0.007) and dietary pattern C (95% CI: 0.58-0.80, p for trend < 0.001) had a lower risk of myopia than participants with the least adherence. Both of these dietary patterns are characterized by high consumption of meats, aquatic product, dairy and its products, eggs, legumes, vegetables, fruits, grains, and potatoes. Our findings suggest that other environmental factors, such as those related to the dietary environment, may contribute to the development of myopia. These findings can serve as a reference for diet-related primary prevention of myopia.

[Intake of main food among the children aged 6-17 years in different regions of China in 2019-2021].

OBJECTIVE: To analyze the intakes of main food among the children of 6-17 years in different regions of China from 2019 to 2021, and to provide a scientific basis for evaluation and guiding Chinese children to make reasonable diet. METHODS: Multistage stratified random sampling method was used to collect data in east China, north China, central China, south China, southwest, northwest and northeast seven areas of each random two provinces, randomly selected from each province one urban survey site and one rural survey site, 28 sites of the 13th Five Year National Science and Technology Basic Resources Survey Project-Chinese children aged 0-18 investigation and application of nutrition and health system in 14 provinces of China. The study included 6413 children aged 6 to 17. Three consecutive 24-hour recalls method combined with weighing were used to collect the information of food intake. According to the food classification in the standard version of the food composition list, the food was divided into cereals, tubers, fresh vegetables, fresh fruits, meat and poultry, fish and shrimp, eggs, milk, etc. , and the intake of various foods was calculated for boys and girls aged 6-8, 9-11, 12-14 and 15-17 in different regions. RESULTS: Compared with the average daily food intake of children of the same sex and age in the urban and rural, The average daily intake of cereals and tubers for boys aged 9-17, cereals for girls aged 9-17, tubers for girls aged 12-17, and fish and shrimp for boys of edible population aged 15-17 were higher in rural areas than in urban areas. There were differences in the average daily food intake and consumption rate of fresh vegetables, fresh fruits, meat and poultry, eggs and milk of the same sex and age, which were higher in urban than in rural areas(P<0.05). Compared with the average daily food intake of children of the same sex and age in the south and the north, the average daily intake of cereals and eggs for boys aged 9-14, cereals for girls aged 6-8, and fresh fruits for boys and girls of edible population aged 6-17 were higher in the north than in the south. There were differences in average daily intake and consumption rates of tubers, fresh vegetables, meat and poultry, milk and fish and shrimp of the same sex and age, which were higher in the south than in the north(P<0.05). Compared with the average daily food intake of children of the same sex and age in the eastern, central and western regions, the average daily intake of cereals for boys aged 6-14, cereals for girls aged 6-17, fresh fruits for boys and girls of edible population aged 6-17, and fish and shrimp for boys and girls of edible population aged 15-17 were lower in the eastern region than in the central and western regions. The average daily intake of tubers for boys aged 9-11 and 15-17, for girls aged 9-17 were higher in the western regions than the eastern and central regions. The average daily intake of eggs for boys and girls aged 12-17 was lower in western regions than the eastern and central regions. There were differences in average daily intake and consumption rates of fresh vegetables, meat and poultry and milk of the same sex and age, which were higher in the eastern region than in the central and western regions. (P<0.05). The proportion of coarse grains to cereals was low, between 3.7% and 10.1%. The proportion of pork to meat and poultry was high, between 56.1% and 71.4%. CONCLUSION: In China, there are differences in daily intake of main food for children aged 6 to 17 years old in urban and rural areas, north and south areas, east, central and west areas.

Effect of School-Based Nutrition and Health Education for Rural Chinese Children.

The nutritional status of rural Chinese children has improved in recent years, but their nutritional knowledge is still relatively lacking. School-based nutrition and health education was conducted for children in three counties of China from 2018 to 2020. The students in the intervention schools were given two-year nutrition and health education courses, while the control schools did not receive any intervention. Students' nutrition knowledge, dietary intake, and dietary behaviors were collected using a questionnaire, and height and weight were measured uniformly. The nutrition knowledge score in the intervention group was increased by 1.01 and 0.64 points in the first and second years. A multilevel model was used to evaluate the intervention effects. Statistically significant interactions between groups and time were observed in nutrition knowledge, the frequency of eating breakfast, and dietary intake, including meat, eggs, milk, and vegetables (p < 0.05), but not in nutritional status. Therefore, the supplementation of school-based nutrition and health education had a positive impact on the nutrition knowledge and dietary intake of rural Chinese children.

Changes in Fitness of Rural Primary School Students from Southwest China after Two-Year's Nutrition Intervention.

Children in China's poor rural areas often have insufficient protein and micronutrient intake. There is little research about the effect of milk and egg supplementation published on these children. A prospective randomized controlled trial was applied to evaluate the effect of milk and egg supplementation on the growth and fitness of poor rural primary school students in southwest China whose physical development was below national averages. A total of 955 healthy students aged 6-13 years old were recruited. The intervention group (538) received 200 g milk and 50 g braised egg at each school day, while the control group (417) kept their normal diet and received no extra supplementation. Serum vitamin D levels were measured by an enzyme-linked immunosorbent assay. A mixed linear model with repeated measures was performed to analyze the efficacy of the supplementation. Statistically significant interactions between groups and time were seen in weight in boys, but not in girls. Significant improvement in vitamin D levels, the broad jump, and the 8 × 50 m shuttle run were observed in both genders. Therefore, the supplementation of egg and milk for two years might have a positive effect on growth and physical fitness and decreasing vitamin D deficiency in poor rural Chinese children.

Sugar-Sweetened Beverage Consumption Status and Its Association with Childhood Obesity among Chinese Children Aged 6-17 Years.

OBJECTIVE: There is a remarkable growth in sugar-sweetened (SSB) production and obesity prevalence among school-aged children in China. This paper describes SSB consumption and its association with obesity among Chinese children aged 6-17 years in 2012. METHODS: in total, 25,553 children aged 6~17 years enrolled in the China Nutrition and Health Surveillance 2010-2013 were included in this study. Data of SSB consumption frequency and quantity were obtained from a food frequency questionnaire, and the children's nutritional status was assessed. Multivariate logistic regression was used to evaluate the association between SSB consumption and obesity status. RESULTS: SSB intake was estimated as 181.0 g/day, occurring 2.2 times/week. Older children, males, children from urban areas, and children with higher socioeconomic status were more likely to consume SSBs. Children who consumed SSBs 1~<5 times/week (11.7%) and >5 times/week (12.9%) were more likely to be overweight/obesity than those who consumed SSBs less than once/week. CONCLUSION: SSB consumption was common among Chinese school-aged children, especially among males, older children, and children from urban areas. High consumption of SSBs was associated with a higher prevalence of overweight/obesity. Actions and plans are required to reduce SSB consumption and control childhood obesity in China.

Association between milk consumption and the nutritional status of poor rural Chinese students in 2016.

BACKGROUND AND OBJECTIVES: Milk promotes the growth of children's height. However, the relationship between milk consumption and anemia or obesity remain unclear. We explored the association between milk consumption and the nutritional status of poor rural Chinese students, including anemia, height, weight, malnutrition, and overweight/obesity. METHODS AND STUDY DESIGN: A total of 22,315 students aged 8-16 years were recruited. The frequency of milk consumption and other information were investigated using the questionnaire. Students' morning fasting height, weight, and whole-blood hemoglobin were measured. The children were classified as malnutrition, normal weight, and overweight/obesity according to their age-specific height and BMI. Multivariate linear and multiple logistic regression were used to analyze the association between milk consumption and nutritional status. RESULTS: In total, 10.6% of students drank milk at least once a day. Compared to students who drank milk <1 time/week, The heights and weights of students who consumed milk 1-3 times/week, 4-6 times/week, and at least once per day were 0.8, 0.9, and 1.3 cm greater and 0.8, 0.6, and 1.0 kg heavier. Students who drank milk at least once a day (OR=0.817), and 1-3 times/week (OR=0.868) had a significantly lower prevalence of malnutrition. Students who drank milk 4-6 times/week (OR=0.472) had a significantly lower prevalence of anemia. However, no significant association was identified between milk consumption and overweight/obesity. CONCLUSIONS: Frequent consumption of milk was associated with these students having a lower risk of malnutrition and anemia, being taller, and being heavier.

Health Status and Food Intake Frequency of Elderly Residents During COVID-19 Community Closure - Jiangxia District, Wuhan City, China, 2020.

What is already known about this topic? Elderly persons are vulnerable to infectious diseases, and nutritional status and health conditions were important to evaluate for disease prevention and ability to recover for the elderly during the coronavirus disease 2019 (COVID-19) pandemic. What is added by this report? In our study, a rapid assessment questionnaire was used to investigate the change of household life and dietary intake of the elderly (aged 60 years or more) during community closure. Food consumption frequency of aquatic food products, soybeans, and fresh fruits declined dramatically with reductions of 70.9%, 70.9%, and 53.0%, respectively, and 49.6% of the elderly lived with chronic non-communicable diseases but had little knowledge of nutrition and health. What are the implications for public health practice? Community closure measures in Wuhan City have played a key role in cutting off the transmission route of COVID-19 and protecting vulnerable groups. As a high-risk population, the elderly should be advised to maintain and strengthen a balanced diet with proper nutrition through increasing intake of aquatic food products, soybeans, fruits, and vegetables, reducing total caloric intake, and decreasing oil and salt consumption. These measures will be significant for the elderly to reduce the risk of chronic disease complications and COVID-19 infection and to decrease the chance of critical illness.

[Breakfast food varieties of children aged 6-17 in China from 2010 to 2012].

OBJECTIVE: To analyze breakfast food varieties among children aged 6-17 in China from 2010 to 2012. METHODS: Data came from China National Nutrition and Health Surveillance in 2010-2012. By using multi-stage stratified sampling and population proportional stratified random sampling method, 5822 children aged 6-17 from 150 sites in 31 provinces, autonomous regions or municipalities in China were selected as subjects. Information on breakfast food varieties was collected by using the 24 h recall method for 3 consecutive days, and compared by different ages, genders and regions. RESULTS: The rate of school-aged children aged 6 to 17 years in China who ingested cereals, vegetables and fruits, meat, fish and eggs, milk, soy bean and nuts was 88.1%, 47.8%, 49.5% and 33.1% respectively. The rate of breakfast food reaching 3 kinds or above was 41.7%, and the rate of breakfast food varieties reached 3 kinds or above among children aged 15-17 years and poor rural children were lower than other groups(P<0.05). There was no significant difference in different gender. CONCLUSION: It is common that the kinds of breakfast food for school-age children cannot reach 3 or above. More attention and improvement measures are needed for children of high age groups and poor rural areas.

[Relationship between breakfast and nutrition status study of children aged 6-17 in China from 2010 to 2012].

OBJECTIVE: To study the relationship between the frequency of breakfast and nutrition status of children aged 6-17 in China. METHODS: Data were collected from China National Nutrition and Health Surveillance in 2010-2012. By using multi-stage stratified sampling and population proportional stratified random sampling method, the research objects were 28 431 children aged 6-17 years. The information of breakfast frequency in the past week were collected by questionnaire, the child's height, weight and personal basic information were also collected. RESULTS: The rate of malnutrition for children who did not eat breakfast in the past week was 16. 5%( 59/356), the rates of stunting and wasting were 5. 6%( 20/358) and 11. 0%( 39/356) respectively, which were significantly higher than the rates of children who ate breakfast everyday( P <0. 05). The risks of stunting, wasting and malnutrition in children who did not have breakfast were 1. 855( 95% CI 1. 149-2. 995), 1. 449( 95% CI 1. 017-2. 065) and1. 646( 95% CI 1. 220-2. 221) times, respectively, of the ones who had breakfast every day. The overall rate of overweight and obesity for children who had breakfast every day was 17. 1%( 4347/25360), which was significantly higher than the rate of children who did not eat breakfast( P < 0. 001), Logistic regression analysis showed that breakfast frequency was not a factor affecting children's overweight and obesity. CONCLUSION: The risks of malnutrition prevalence for the children who don't have breakfast are more than the ones who have breakfast every day. Breakfast skipping is an independent factor to malnutrition that can increase risk of malnutrition.

[Scheme of the "Nutrition Campus" pilot program].

The "Nutrition Campus "pilot program is based on findings from"Nutritional status and intervention strategy study for urban primary and secondary students". The "Campus nutrition education strategy study in urban primary and secondary students"in Shunyi, Beijing was launched in the first place as a leading part of the pilot program. A total of 12 primary and secondary schools from 8 pilot districts/counties of 8 provinces/cities are involved in the program to prevent and control child malnutrition in all kinds. The students, parents, teachers, kitchen staff, and school administrators are intervened in the forms of a series of activities of nutrition and health education, physical activity promotion, and healthy school meal support. The supportive school nutrition environment is created in the mean time. The first phase of the program is Year 2017. The ultimate purpose of the program is to explore an effective, generalizable, referenceable model adopting comprehensive intervention methods to promote nutrition and health of children in the school setting for different regions.

[Analysis for the blood mineral content of children aged 3 to 12 years in 7 cities and 2 towns in China].

OBJECTIVE: To investigate the status of blood mineral content of children aged 3 to 12 years in Chinese cities and countryside and explore the possible related influencing factors. METHODS: The multistage stratified cluster random sampling was used to select one kindergarten and one primary school in seven cities (Beijing and Guangzhou and so on) and two towns randomly. Firstly, we selected one bottom class, middle class, top class in one kindergarten and one second grade and fifth grade in one primary school randomly. Then all of the healthful students of these classes were investigated and the blood mineral content of calcium, magnesium, lead, iron, copper, and zinc were detected. RESULTS: In the research, 1 842 students were investigated. The means of calcium, magnesium, lead, iron, copper, and zinc were in the standard range. The blood lead content of the boys was higher than that of the girls. The blood mineral content of different ages had statistical significance. The blood calcium and blood copper contents of the preschool children were higher than those of the school children. However, the school children had significantly higher blood lead, iron, and zinc contents in comparison with those of the preschool children. The incidences of iron deficiency and zinc deficiency were 35.5% and 39.6%, respectively. The incidence of iron deficiency and zinc deficiency of different ages had statistical significance, and with the age increasing, the incidence showed a decreasing trend. The incidences of iron deficiency and zinc deficiency of children whose age was more than or equal to 3 years and less than 4 years were up to 47.1% and 64.6%, respectively. The incidence of iron deficiency of the children in the countryside area was significantly higher than those in the first-tier cities. However, the incidence of zinc deficiency of the children in the countryside area was significantly lower than those in the first-tier cities and second-tier cities. CONCLUSION: The status of iron deficiency and zinc deficiency of children aged 3 to 12 years in Chinese cities and countryside were still serious. We should pay more attention to the nutrition interventional research on iron and zinc.

Breast milk macronutrient composition and the associated factors in urban Chinese mothers.

BACKGROUND: Infancy is a critical period of growth and physiological development, in which breast milk is the best source of nutrients. Compared to western countries, research on breast milk of Chinese population are limited. Thus, it is necessary to measure breast milk energy and macronutrient concentrations of healthy urban Chinese mothers at different lactation stages, to expand the database of milk composition of Chinese population, and to examine whether dietary or other maternal factors can affect the levels of macronutrients in breast milk. METHODS: Breast milk of full expression of one side breast from 436 urban Chinese lactating mothers at 5-11 days, 12-30 days, 31-60 days, 61-120 days, and 121-240 days postpartum was obtained at 9:00 a.m. to 11:00 a.m. Total energy, lactose, protein, and fat contents were measured. 24-hour dietary recall was surveyed, and maternal nutrient intakes were analyzed. RESULTS: Milk composition changed over the course of lactation and large individual variations were documented. The concentrations were 61.3 kcal/dl for total energy, 7.1 g/dl for lactose, 0.9 g/dl for protein, and 3.4 g/dl for fat in mature milk. Stage of lactation was a strong factor affecting milk composition. Minimal evidence was found for associations between maternal current dietary intake and milk macronutrient concentration, consistently with prior research. Maternal body mass index (BMI) was positively associated with milk fat content, to a greater extent than did dietary intake. All other maternal characteristics were not significant for milk composition. CONCLUSION: These findings suggest that milk composition is generally weakly associated with maternal factors except for stage of lactation, and is likely to be more susceptible to long-term maternal nutritional status than short-term dietary fluctuation.