Impact of inflammation on the biomarkers of iron status in a cross-sectional survey of Lao women and children.

Anaemia is prevalent in South East Asia and Fe deficiency (ID) is considered to be the main cause, but the role of subclinical inflammation in the aetiology is uncertain. In the present study, we determined the influence of inflammation on the biomarkers of Fe status in women and children, and herein, we discuss the proportion of anaemia associated with ID. As part of the 2006 Lao People's Democratic Republic (The Lao PDR) National Nutrition Survey, blood collected from 482 young children and 816 non-pregnant women was analysed. Plasma ferritin, transferrin receptor (sTfR), Hb, C-reactive protein (CRP) and α-1-acid glycoprotein (AGP) concentrations were measured. ID was assessed using ferritin concentrations ( < 12 (children) or < 15 (adults) µg/l), sTfR concentrations (>8.3 mg/l) and body Fe stores (BIS < 0). Elevated CRP (>5 mg/l) and/or AGP (>1 g/l) concentrations were used to categorise inflammation status in order to correct the Fe biomarkers for inflammation. Inflammation was present in 14% of adults and 43% of children. Anaemia was present in 37.6% of both women (Hb concentrations < 120 g/l) and children (Hb concentrations < 110 g/l). Correcting ferritin concentrations for inflammation increased the prevalence of ID from 24.3 to 26% for women and from 18 to 21% for children (P< 0.001 for both). Ferritin concentrations were more helpful in detecting ID than sTfR concentrations or BIS, but regression analysis found that sTfr concentrations explained more of the variance in Hb concentrations in both women (20%) and children (17%) than ferritin concentrations (5 and 1.4%, respectively). Nevertheless, the total variance in Hb concentrations explained was only 26 and 18 % in women and children, respectively, and other factors may be more important than ID in contributing to anaemia in The Lao PDR.

Short-Term Acceptability of Ready-to-Use Therapeutic Foods in Two Provinces of Lao People's Democratic Republic.

BACKGROUND: In Lao PDR, acute malnutrition remains a public health problem, with around 9% of children under 5 being affected. Outpatient treatment of severe acute malnutrition requires ready-to-use therapeutic foods (RUTFs), but concerns have been raised about the acceptability of globally available products. Culturally acceptable RUTFs could be locally developed, but data are lacking on RUTF preferences in Lao PDR. METHODS: In a crossover-designed study, four different RUTFs were tested for short-term acceptability and organoleptic qualities (two globally available: peanut-based, which is the current standard, and wheat-milk-based RUTFs; two regionally produced: a mung-bean-based and a fish-rice-based RUTF). Organoleptic properties were evaluated by 83 caretaker-child pair participants through a taste test and a 30 min consumption test. Short-term acceptability was assessed through a 3-day intake test. The study sites were in Phongsaly (North Laos) and Attapeu (South Laos). Focus group discussions were conducted at the beginning and the end of the study. RESULTS: The mung bean RUTF was the favorite among caretakers, with an acceptability percentage of 96.2%, and scored better (p-value < 0.05) for all organoleptic variables than the other three RUTFs. Overall, 3 days after receiving take-home rations, the mean percentage of consumption was above 80% for all the RUTFs, with the mung bean product being the most consumed. CONCLUSIONS: The regionally produced mung bean RUTF was the most accepted, whereas the other regionally produced fish-based RUTF was the least accepted, showing the complexity of finding culturally acceptable solutions to fight malnutrition. For Lao PDR, a mung-bean-based RUTF seems the way forward, even if the current standard peanut-based RUTF appeared to be acceptable, albeit not the most preferred.

Factors associated with a measles outbreak in children admitted at Mahosot Hospital, Vientiane, Laos.

BACKGROUND: In 2002 and 2003 there were large outbreaks of measles in many provinces of Laos, including in Vientiane. We therefore conducted a study to determine risk factors associated with measles amongst children admitted at Mahosot Hospital, Vientiane. METHODS: A retrospective case-control study was conducted in 50 children with clinical measles who were matched by age and sex with 50 healthy children (who had never had a febrile rash) living in the same villages as the cases. RESULTS: The proportion of children with complete immunizations was significantly lower in the group with clinical measles compared to the controls [13/50 (26%) vs 34/50 (68%), P < 0.001). The percentage of children who had received measles vaccine at 9-23 months of age was significantly lower in the group with clinical measles compared to the healthy controls [12/50 (24%) vs 24/50 (48%), P = 0.01). The family educational and socio-economic status did not differ significantly (P > 0.05) between cases and controls. CONCLUSION: These results emphasize the importance of intensification of measles immunization coverage in Laos. The strengthening of campaigns with large, widespread high second dose coverage is likely to be a key measure to prevent further measles outbreaks in Laos (192 words).