Factors affecting nutritional status among children aged below five years in Rwanda's Western and Southern Provinces.

BACKGROUND: The state of a child's nutrition is a critical indicator of their overall health and wellbeing. Public health still faces challenges from undernutrition, especially in developing nations across the globe. In Rwanda, around 33% of children aged under five years suffer from chronic undernutrition. Many factors, such as poverty, illiteracy, poor WASH practices, improper child feeding practices, and insufficient healthcare, are the leading causes of undernutrition. The study aims to assess infant and young child feeding practices, WASH, food security, and their association with the nutritional status of children under five years in Rwanda's Western and Southern provinces. METHODS: A community-based cross-sectional study design was applied to study factors affecting the nutritional status of children under five years in 439 households in the Karongi, Nyabihu, and Nyamagabe districts of Rwanda. The study assessed anemia, stunting, underweight, and wasting indicators, and collected data was analyzed using SPSS version 25. RESULTS: The study findings indicate that among the children surveyed, 29.2% (128) were identified as stunted, 5.9% (26) were underweight, 2.3% (10) suffered from wasting, and 20.9% (31) had anemia. Factors associated with these conditions included larger household size [AOR = 2.108; 95% CI (1.016-4.371)], positively associated with stunting. Additionally, children from households where the head was above 60 years old were more likely to exhibit stunting [AOR = 4.809; 95% CI (1.513, 15.283)]. Furthermore, a high household dietary diversity score was positively linked to being underweight [AOR = 6.061; 95% CI (1.535,23.942)]. CONCLUSION: Household characteristics like size, dietary diversity, and the age of the household head affect children's nutritional status. Improving these conditions would enhance children's nutritional status.

Integrated Analysis of Cytokine Profiles in Malaria Patients Discloses Selective Upregulation of TGF-ß1, ß3, and IL-9 in Mild Clinical Presentation.

The proper control of Plasmodium infection requires a finely balanced immune response. Here, we evaluated the implication of TGF-ß1 and TGF-ß3 in this process using novel monoclonal antibodies to measure their plasma concentrations in comparison with other cytokines and the expression of FOXP3 mRNA. Plasma cytokine levels were measured in 80 patients with severe anaemic malaria and 186 with a mild presentation using ELISA, and rtPCR was used to measure FOXP3 mRNA expression. While no mature TGF-ß isoforms were detected in the plasma, the latent TGF-ß1 and TGF-ß3 were strongly upregulated in patients with mild malaria and nearly undetected in patients with severe disease. Similar selective upregulation in mild patients was observed for IL-9 and FOXP3 mRNA, while IL-7, IL-10, IL-17, and IL-27, although higher in mild cases, were also detected in severe disease. In contrast, a clearly skewed trend of severe cases towards higher pro-inflammatory (IL-6, IL-13, TNF-α) and Th1 (IFN-γ) responses was observed, which was associated with a higher level of parasitaemia as well as lower IgG and higher IgM responses. Together, these results suggest that the stimulation of regulatory T cells through TGF-ß1/TGF-ß3 and IL-9 is paramount to an effective and balanced protective immunity in natural human malaria infection.

Prevalence Mapping of Schistosoma mansoni Among Pre-school Age Children in Rwanda.

Schistosoma mansoni is endemic in Rwanda, and control programs have been implemented with a special focus on school-age children (SAC), ignoring pre-school age children (pre-SAC) for which the actual prevalence of the disease is not well established. This study consisted of a cross-sectional quantitative mapping of the distribution of Schistosoma mansoni and identification of associated risk factors among pre-SAC throughout the country. The study covered all the 17 districts of Rwanda endemic for Schistosoma mansoni, with a total sample of 4,675 children enrolled from 80 purposively selected villages. The parasitological assessment of children's urine and stool samples was conducted using CCA and Kato Katz methods, respectively, for infection detection. A standard questionnaire was used to collect data on the risk factors, and geospatial assessment was performed using tablets and GPS to record geographic coordinates for plotting locations on maps using ArcGIS software. The overall prevalence of S. mansoni infection across the surveyed areas was 24 and 0.8% by CCA and Kato-Katz, respectively. Infection was significantly associated with bathing children in open water bodies. Furthermore, pre-SAC looked after by siblings (sisters) were two times as much likely to be infected compared to those looked after by mothers. Schistosomiasis control interventions are needed for pre-SAC to limit their exposure to open water bodies with expectations of adapted chemotherapy to be availed. Community-based deworming campaigns may be the best way to ensure good treatment coverage of pre-SAC in Rwanda.