RESUMO
Aflatoxin exposure has been proposed to affect child height-for-age. The following hypothesized associations were tested in Guatemala: (1) aflatoxin (B1, B2, G1, G2) exposure and environmental enteric dysfunction (EED) and child height-for-age z-score; and (2) aflatoxin exposures and subsequent symptoms of aflatoxins. Maize consumption data, health data, and samples of maize from households were collected from mothers and their children - under five - in October 2016 (n = 320) and February 2017 (n = 120). Maize samples were tested for aflatoxin levels and maize consumption data were used to compute an aflatoxin exposure level. Results suggest that there was a significant negative correlation between the putative aflatoxin exposure level and child height-for-age z-score (-0.073, p = 0.030), but not for EED. Furthermore, aflatoxin exposure was significantly correlated with aflatoxin symptoms only at the same time point (0.123, p = 0.026). These results support the potential need for engineered solutions to household aflatoxin transmission problems in rural communities of Guatemala.
Assuntos
Aflatoxinas/análise , Contaminação de Alimentos/análise , Zea mays , Estatura , Pré-Escolar , Exposição Ambiental/análise , Feminino , Guatemala , Humanos , MasculinoRESUMO
Guatemala has the sixth worst stunting rate with 48% of children under five years of age classified as stunted according to World Health Organization standards. This study utilizes two different yet complimentary system-analysis approaches to analyze correlations among environmental and demographic variables, environmental enteric dysfunction (EED), and child height-for-age (stunting metric) in Guatemala. Two descriptive models constructed around applicable environmental and demographic factors on child height-for-age and EED were analyzed using Network Analysis (NA) and Structural Equation Modeling (SEM). Data from two populations of children between the age of three months and five years were used. The first population (nâ¯=â¯2103) was drawn from the Food for Peace Baseline Survey conducted by the US Agency for International Development (USAID) in 2012, and the second population (nâ¯=â¯372) was drawn from an independent survey conducted by the San Vicente Health Center in 2016. The results from the NA of the height-for-age model confirmed pathogen exposure, nutrition, and prenatal health as important, and the results from the NA of the EED model confirmed water source, water treatment, and type of sanitation as important. The results from the SEM of the height-for-age model confirmed a statistically significant correlation among child height-for-age and child-mother interaction (-0.092, pâ¯=â¯0.076) while the SEM of the EED model confirmed the statistically significant correlation among EED and type of water treatment (-0.115, pâ¯=â¯0.013). Our approach supports important efforts to understand the complex set of factors associated with child stunting among communities sharing similarities with San Vicente.
Assuntos
Estatura , Transtornos do Crescimento/etiologia , Relações Mãe-Filho , Estado Nutricional , Purificação da Água , Pré-Escolar , Cidades , Feminino , Transtornos do Crescimento/epidemiologia , Guatemala/epidemiologia , Inquéritos Epidemiológicos , Humanos , Lactente , Masculino , Modelos Biológicos , Mães , Prevalência , Características de Residência , Saneamento , Análise de Sistemas , Abastecimento de ÁguaRESUMO
Objectives This study investigated the association of the familial coexistence of child stunting and maternal overweight with indigenous women in Guatemala. Methods We selected 2388 child-mother pairs from the data set of the Living Standards Measurement Study conducted in Guatemala in 2000. This study examined the association between maternal and household characteristics and the nutritional status of children aged 6-60 months and mothers aged 18-49 years by using multivariable logistic regression models. Results Compared with non-indigenous households, a significantly higher percentage of indigenous households exhibited stunted child and overweight mother (SCOM) pairs (15.9 vs. 22.2%). Compared with normal-weight mothers, overweight mothers were less likely to have stunted children [adjusted odds ratio (AOR) 0.66, 95% confidence interval (CI) 0.50-0.88]. However, compared with mothers who were not short and overweight, short and overweight mothers were significantly more likely to have stunted children (AOR 1.80, 95% CI 1.19-2.73) and were more likely to be indigenous women living in urban areas (AOR 3.01, 95% CI 1.19-7.60) or rural areas (AOR 3.02, 95% CI 1.28-7.14). The order of observed prevalence of SCOM pairs in different types of households was as follows: urban indigenous (25.0%), rural indigenous (21.2%), rural non-indigenous (19.8%), and urban non-indigenous households (10.7%). Conclusions for Practice Urban indigenous households were more likely to have SCOM pairs. This study provided useful information for identifying the most vulnerable groups and areas with a high prevalence of the familial coexistence of child stunting and maternal overweight.