Factors associated with acute malnutrition among children aged 6-59 months in Haiti, Burkina Faso and Madagascar: A pooled analysis.

BACKGROUND: Acute malnutrition is one of the main causes of morbidity and mortality among children under 5 years worldwide, and Action Contre la Faim (ACF) aims to address its causes and consequences. To better tailor humanitarian programs, ACF conducts standardized contextual studies called Link NCAs (Nutrition Causal Analysis), to identify factors associated with severe acute malnutrition (SAM) and moderate acute malnutrition (MAM). Data from three Link NCAs performed in 2018 and 2019 in Haiti, Burkina Faso and Madagascar were used to explore the prevalence of malnutrition by different indicators and associated risk factors among children aged 6-59 months. METHODS: Cross-sectional data, collected via household surveys applying two-stage cluster sampling, were pooled to build a sample of 1,356 children. Recommended anthropometric thresholds were used to define SAM (Weight-for-Height Z-score (WHZ) <-3 or Mid-upper Arm Circumference (MUAC) <115 mm and/or presence oedema), MAM (-3≤WHZ<-2 or 115≤MUAC<125 mm) and global acute malnutrition GAM (SAM or MAM) among children. Multivariate analyses for each anthropometric indicator were performed using logistic mixed models and adjusting for potential confounders. RESULTS: The prevalence of acute malnutrition was the highest in Madagascar. The risk of having GAM and MAM varied across countries, while the risk of having SAM varied across clusters. Being male, suffering from diarrhea, and having unwashed face and hands, were significantly associated with GAM by WHZ with adjusted odds ratio of 1.9 [95%Confidence interval (CI):1.1-3.2], 1.7 (95%CI: 1.0-3.1) and 1.9 (95%CI: 1.0-3.6) respectively. These factors were also associated with MAM by WHZ. None of the studied factors was significantly associated with SAM, which could be due to a small sample size. CONCLUSION: These results obtained from a large sample contribute to the evidence of the factors associated with undernutrition in children aged 6-59 months. Further research with larger sample sizes is needed to confirm these results.

Effects of Aircraft Noise Exposure on Heart Rate during Sleep in the Population Living Near Airports.

Background Noise in the vicinity of airports is a public health problem. Many laboratory studies have shown that heart rate is altered during sleep after exposure to road or railway noise. Fewer studies have looked at the effects of exposure to aircraft noise on heart rate during sleep in populations living near airports. Objective The aim of this study was to investigate the relationship between the sound pressure level (SPL) of aircraft noise and heart rate during sleep in populations living near airports in France. Methods In total, 92 people living near the Paris-Charles de Gaulle and Toulouse-Blagnac airports participated in this study. Heart rate was recorded every 15 s during one night, using an Actiheart monitor, with simultaneous measurements of SPL of aircraft noise inside the participants' bedrooms. Energy and event-related indicators were then estimated. Mixed linear regression models were applied, taking into account potential confounding factors, to investigate the relationship between energy indicators and heart rate during sleep measured every 15 s. Event-related analyses were also carried out in order to study the effects of an acoustic event associated with aircraft noise on heart rate during sleep. Results The more the SPL from all sources (LAeq,15s) and the SPL exceeded for 90% of the measurement period (LA90,15s) increased, the more heart rate also increased. No significant associations were observed between the maximum 1-s equivalent SPL associated with aircraft overflight (LAmax,1s) and differences between the heart rate recorded during or 15 or 30 s after an aircraft noise event and that recorded before the event. On the other hand, a positive and significant association was found between LAmax,1s and the heart rate amplitude calculated during an aircraft noise event. Results were unchanged when analyses were limited to participants who had lived more than five years in their present dwelling. Conclusion Our study shows that exposure to the maximum SPL linked to aircraft overflight affect the heart rate during sleep of residents near airports. However, further studies on a larger number of participants over several nights are needed to confirm these results.

The impact of aircraft noise exposure on objective parameters of sleep quality: results of the DEBATS study in France.

BACKGROUND: Noise in the vicinity of airports is a public health issue. Exposure to aircraft noise has been shown to have adverse effects on health and particularly on sleep. Many studies support the hypothesis that noise at night can affect subjective sleep quality. Fewer studies, however, have performed objective measurements of sleep. OBJECTIVES: This study aimed to investigate by actigraphy the relationship between aircraft noise exposure and objective parameters of sleep quality in the population living near two French airports. METHODS: This study includes 112 participants living in the vicinity of Paris-Charles de Gaulle and Toulouse-Blagnac airports. Wrist actigraphy measurements were performed during eight nights to evaluate objective parameters of sleep quality such as sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), time in bed (TB) and sleep efficiency (SE). Acoustic measurements were made simultaneously both inside the participants' bedrooms and outside (at the exterior frontage) to estimate aircraft noise levels. Energy indicators related to the sound energetic average for a given period of time, as well as indicators related to noise events (eg, the number of events that exceed a given threshold), were estimated. Logistic and linear regression models were used, taking into account potential confounders: age; gender; marital status; education; and body mass index (BMI). RESULTS: Energy indicators, in particular, indicators related to noise events were significantly associated with objective parameters of sleep quality. Increased levels of aircraft noise and increased numbers of aircraft noise events increased the time required for sleep onset (SOL) and the total wake time after sleep onset (WASO) and decreased sleep efficiency (SE). An association was also observed between aircraft noise exposure and an increase in total sleep time (TST) and time in bed (TB). CONCLUSION: The findings of the present study contribute to the overall evidence suggesting that nocturnal aircraft noise exposure may decrease the objective quality of sleep. Aircraft noise exposure affects objective parameters of sleep quality, not only regarding noise levels but also regarding the number of events. Mechanisms for adapting to sleep deprivation could be observed.

Aircraft Noise Exposure and Subjective Sleep Quality: The Results of the DEBATS Study in France.

Background: Exposure to aircraft noise has been shown to have adverse effects on health, particularly on sleep. Exposure to nighttime aircraft noise clearly affects sleep architecture, as well as subjective sleep quality. Objectives: This study aimed to investigate the relationship between aircraft noise exposure and subjective sleep quality in the population living near airports in France. Methods: A total of 1,244 individuals older than 18 and living near three French airports (Paris-Charles de Gaulle, Lyon-Saint-Exupéry, and Toulouse-Blagnac) were randomly selected to participate in the study. Information on sleep as well as health, socioeconomic, and lifestyle factors was collected by means of a face-to-face questionnaire performed at their place of residence by an interviewer. For each participant, aircraft noise exposure was estimated at home using noise maps. Logistic regression models were used with adjustment for potential confounders. Results: Aircraft noise exposure was significantly associated with a short total sleep time (TST; ≤ 6 h) and with the feeling of tiredness while awakening in the morning. An increase of 10 dB(A) in aircraft noise level at night was associated with an OR of 1.63 (95% CI: 1.15-2.32) for a short TST and an OR of 1.23 (95% CI: 1.00-1.54) for the feeling of tiredness while awakening in the morning. Conclusions: These findings contribute to the overall evidence suggesting that aircraft noise exposure at nighttime may decrease the subjective amount and quality of sleep.