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1.
PLoS Med ; 17(3): e1003055, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32203504

RESUMO

BACKGROUND: Housing is essential to human well-being but neglected in global health. Today, housing in Africa is rapidly improving alongside economic development, creating an urgent need to understand how these changes can benefit health. We hypothesised that improved housing is associated with better health in children living in sub-Saharan Africa (SSA). We conducted a cross-sectional analysis of housing conditions relative to a range of child health outcomes in SSA. METHODS AND FINDINGS: Cross-sectional data were analysed for 824,694 children surveyed in 54 Demographic and Health Surveys, 21 Malaria Indicator Surveys, and two AIDS Indicator Surveys conducted in 33 countries between 2001 and 2017 that measured malaria infection by microscopy or rapid diagnostic test (RDT), diarrhoea, acute respiratory infections (ARIs), stunting, wasting, underweight, or anaemia in children aged 0-5 years. The mean age of children was 2.5 years, and 49.7% were female. Housing was categorised into a binary variable based on a United Nations definition comparing improved housing (with improved drinking water, improved sanitation, sufficient living area, and finished building materials) versus unimproved housing (all other houses). Associations between house type and child health outcomes were determined using conditional logistic regression within surveys, adjusting for prespecified covariables including age, sex, household wealth, insecticide-treated bed net use, and vaccination status. Individual survey odds ratios (ORs) were pooled using random-effects meta-analysis. Across surveys, improved housing was associated with 8%-18% lower odds of all outcomes except ARI (malaria infection by microscopy: adjusted OR [aOR] 0.88, 95% confidence intervals [CIs] 0.80-0.97, p = 0.01; malaria infection by RDT: aOR 0.82, 95% CI 0.77-0.88, p < 0.001; diarrhoea: aOR 0.92, 95% CI 0.88-0.97, p = 0.001; ARI: aOR 0.96, 95% CI 0.87-1.07, p = 0.49; stunting: aOR 0.83, 95% CI 0.77-0.88, p < 0.001; wasting: aOR 0.90, 95% CI 0.83-0.99, p = 0.03; underweight: aOR 0.85, 95% CI 0.80-0.90, p < 0.001; any anaemia: aOR 0.87, 95% CI 0.82-0.92, p < 0.001; severe anaemia: aOR 0.89, 95% CI 0.84-0.95, p < 0.001). In comparison, insecticide-treated net use was associated with 16%-17% lower odds of malaria infection (microscopy: aOR 0.83, 95% CI 0.78-0.88, p < 0.001; RDT: aOR 0.84, 95% CI 0.79-0.88, p < 0.001). Drinking water source and sanitation facility alone were not associated with diarrhoea. The main study limitations are the use of self-reported diarrhoea and ARI, as well as potential residual confounding by socioeconomic position, despite adjustments for household wealth and education. CONCLUSIONS: In this study, we observed that poor housing, which includes inadequate drinking water and sanitation facility, is associated with health outcomes known to increase child mortality in SSA. Improvements to housing may be protective against a number of important childhood infectious diseases as well as poor growth outcomes, with major potential to improve children's health and survival across SSA.


Assuntos
Anemia/epidemiologia , Saúde da Criança , Transtornos da Nutrição Infantil/epidemiologia , Diarreia/epidemiologia , Habitação , Malária/epidemiologia , Determinantes Sociais da Saúde , África ao Sul do Saara/epidemiologia , Fatores Etários , Anemia/diagnóstico , Anemia/mortalidade , Anemia/prevenção & controle , Transtornos da Nutrição Infantil/diagnóstico , Transtornos da Nutrição Infantil/mortalidade , Transtornos da Nutrição Infantil/prevenção & controle , Pré-Escolar , Estudos Transversais , Diarreia/diagnóstico , Diarreia/mortalidade , Diarreia/prevenção & controle , Água Potável , Feminino , Nível de Saúde , Inquéritos Epidemiológicos , Humanos , Lactente , Recém-Nascido , Mosquiteiros Tratados com Inseticida , Malária/diagnóstico , Malária/mortalidade , Malária/prevenção & controle , Masculino , Estudos Prospectivos , Fatores de Proteção , Medição de Risco , Fatores de Risco , Saneamento
2.
Anesth Analg ; 130(5): 1364-1380, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32167979

RESUMO

Anemia is common in the perioperative period and is associated with poor patient outcomes. Remarkably, anemia is frequently ignored until hemoglobin levels drop low enough to warrant a red blood cell transfusion. This simplified transfusion-based approach has unfortunately shifted clinical focus away from strategies to adequately prevent, diagnose, and treat anemia through direct management of the underlying cause(s). While recommendations have been published for the treatment of anemia before elective surgery, information regarding the design and implementation of evidence-based anemia management strategies is sparse. Moreover, anemia is not solely a concern of the preoperative encounter. Rather, anemia must be actively addressed throughout the perioperative spectrum of patient care. This article provides practical information regarding the implementation of anemia management strategies in surgical patients throughout the perioperative period. This includes evidence-based recommendations for the prevention, diagnosis, and treatment of anemia, including the utility of iron supplementation and erythropoiesis-stimulating agents (ESAs).


Assuntos
Anemia/diagnóstico , Anemia/prevenção & controle , Gerenciamento Clínico , Assistência Perioperatória/métodos , Anemia/sangue , Transfusão de Eritrócitos/métodos , Hematínicos/administração & dosagem , Humanos , Ferro/administração & dosagem , Ferro/sangue
3.
PLoS One ; 15(1): e0227351, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31923240

RESUMO

INTRODUCTION: Iron and Folic Acid Supplementation (IFAS) is an essential and affordable intervention strategy for prevention of anaemia during pregnancy. The supplements are currently provided for free to pregnant women in Kenya during antenatal care (ANC), but compliance remains low over the years. There is need for diversification of IFAS programme implementation by exploring other distribution channels to complement existing antenatal distribution and ensure consistent access to IFAS supplements. OBJECTIVES: To determine the effect of a community-based approach of IFAS distribution on compliance and assess side-effects experienced and their mitigation by pregnant women in Kiambu County. METHODOLOGY: A pretest-posttest quasi-experimental study design was used, consisting of an intervention and a control group, among 340 pregnant women 15-49 years, in five health facilities in Lari Sub-County in Kiambu County, between June 2016 and March 2017. Community health volunteers provided IFAS supplements, counselling and weekly follow-up to pregnant women in the intervention group while the control group followed standard practice from health facilities. Baseline and endline data were collected during antenatal care and compared. Quantitative data was analyzed using STATA version 14. Analysis of effect of intervention was done using Difference-In-Difference regression approach. RESULTS: Levels of compliance increased by 8% in intervention group and 6% in control group. There was increased awareness of IFAS side-effects across groups. The intervention group reported experiencing less side-effects and were better able to manage them compared to the control group. CONCLUSION: Implementation a community-based approach improved maternal compliance with IFAS, awareness of IFAS side effects and their management, with better improvement being recorded in the intervention group. Hence, there is need to integrate community-based approach with antenatal distribution of IFAS to improve supplementation.


Assuntos
Anemia/prevenção & controle , Ácido Fólico/uso terapêutico , Ferro/uso terapêutico , Gestantes , Adolescente , Adulto , Estudos de Casos e Controles , Serviços de Saúde Comunitária/normas , Suplementos Nutricionais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Quênia , Pessoa de Meia-Idade , Cooperação do Paciente , Gravidez , Cuidado Pré-Natal , Adulto Jovem
4.
Pesqui. vet. bras ; 40(1): 17-28, Jan. 2020. tab, graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1091657

RESUMO

The early use of antimicrobial therapy has been introduced in many farms to prevent diarrhea and respiratory disease in young calves; however, there is controversy about whether this practice has a beneficial effect on the health of these animals. This study evaluated the influence of the early use of antimicrobials on the health and performance of neonatal Holstein calves. Twenty-six Holstein calves were screened and divided into two groups, according to the administration (ATB+), or not (ATB-) of tulathromycin (2.5mg/kg, subcutaneously) within the first 12 hours of life. Calves were evaluated by general clinical examination, fecal score, respiratory score, and external palpation of the umbilical region, besides fecal output of dry matter. Anemia was determined by using an automatic system and, also, using a commercial kit for iron dosage. Diarrhea was diagnosed by a centrifuge-flotation technique using a sugar solution (Cryptosporidium) and multiplex semi-nested RT-PCR (rotavirus/coronavirus). The performance of the calves was estimated by Daily Weight Gain (DWG). The young dairy calves were evaluated within 12 hours of birth (≤12h) and at 3-5th (D3-5), 7-9th (D7-9), 13-15th (D13-15), 20-23rd (D20-23), and 27-30th (D27-30) days of life. No difference was noted between the ATB+ and ATB- groups concerning heart rate, respiratory frequency, and rectal temperature. Erythrogram showed a higher frequency of anemia in ATB- group (P=0.016) at the D3-5 check-up; lower values of serum iron were also observed simultaneously (P=0.051). Thirteen cases of respiratory disease were detected during this study; however, no significant difference was observed between the groups in this regard. The frequency of diarrhea (fecal score 2-3) was high in both groups, peaking at D13-D15. No differences were noted between the groups regarding the frequency of diarrhea when considering the dry fecal matter. The predominant etiological agent for diarrhea was Cryptosporidium spp.. The DWG was similar between groups, with maximum weight reduction on D13-15. The administration of tulathromycin in prophylactic dose (2.5mg/kg) at birth decreased the frequency of anemia but did not influence weight gain or the prevalence of diarrhea.(AU)


O uso precoce de antimicrobianos tem sido adotado em muitas fazendas para profilaxia das diarreias e doença respiratória em bezerras, no entanto existem controvérsias sobre os beneficios desta prática na saúde desses animais. Esta pesquisa avaliou a influência do uso precoce de antimicrobiano na sanidade e desempenho de bezerras holandesas recém-nascidas. Para tanto foram selecionadas 26 bezerras Holandesas distribuídas de acordo com a aplicação (ATB+) ou não (ATB-) de tulatromicina (2,5mg/Kg) por via subcutânea até 12h de vida. As bezerras foram examinadas por meio de exame clínico geral, escore fecal, escore respiratório e palpação externa da região umbilical, além da matéria seca fecal. A presença de anemias foi determinada pelo eritrograma utilizando sistema automático e além da dosagem de ferro utilizando kit comercial. O diagnóstico etiológico das diarreias foi investigado por meio da técnica de flutuação em solução saturada de sacarose (Cryptosporidium) e multiplex semi-nested RT-PCR (rotavírus/coronavírus). O desempenho das bezerras foi estimado pelo ganho de peso. As bezerras foram avaliadas até doze horas após o nascimento (≤12h); 3-5º (D3-5); 7-9º (D7-9); 13-15º (D13-15); 20-23º (D20-23); e 27-30º dias de vida (D27-30). Não foram encontradas diferenças entre os grupos ATB+ e ATB- em relação à frequência cardíaca, frequência respiratória e temperatura retal. O eritrograma revelou maior frequência de anemias no grupo ATB- (P=0,016) no D3-5. Neste momento também foram observados menores valores de ferro sérico (P=0,051). Foram detectados treze casos de doença respiratória durante o estudo, no entanto não foi possível detectar diferença entre os grupos. A frequência de diarreias (escore fecal 2 e 3) foi alta em ambos os grupos, observando-se pico no D13-15 (ATB+=92,3%; ATB-=92,3%). Não observamos diferenças entre os grupos em relação a frequência de diarreia considerando-se a matéria seca fecal. O agente etiológico predominante nas diarreias foi o Cryptosporidium. O ganho de peso diário foi igual entre grupos, com intensa redução no GPD no D13-15. A administração de tulatromicina na dose profilática (2,5mg/Kg) ao nascimento diminuiu a frequência de anemias e não influenciou no ganho de peso e prevalência de diarreias.(AU)


Assuntos
Animais , Feminino , Bovinos , Infecções por Rotavirus/veterinária , Macrolídeos/uso terapêutico , Disenteria/etiologia , Gastroenteropatias/etiologia , Anemia/prevenção & controle , Anti-Infecciosos/uso terapêutico , Coronavirus Bovino , Infecções por Coronavirus/veterinária , Criptosporidiose
5.
PLoS One ; 15(1): e0227090, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31910215

RESUMO

BACKGROUND: Iron-folic acid supplementation during pregnancy is among the very effective interventions to prevent iron deficiency anemia, low birth weight, and prematurity. There is a need of having recent studies on adherence to the supplement that consider the very recent interventions targeted to scale up the use of iron-folic acid (IFA) supplement. Therefore we sought to assess adherence to IFA supplement and its associated factors among antenatal care attending pregnant mothers in governmental health institutions of Adwa town. METHODS: Institution-based cross-sectional study was conducted among 629 antenatal care attending pregnant mothers. Systematic random sampling method was used to select the study subjects. Data were collected through face-to-face interview and chart-review. Bivariable and multivariable binary logistic regression was computed. Variables with P-value <0.05 were considered statistically significant at 95% confidence interval (CI). RESULT: Only 40.9% (95%CI: 37.0%- 44.7%) of participants were adherent (took four or more tablets per week). Women in the age group of 25-29 years [AOR: 2.22(1.21-4.07)] had increased odds of adherence as compared to those in the age group ≥ 35 years. Women who received nutrition counseling [AOR: 4.12(2.12-8.03)] and partner support [AOR: 2.23 (1.42-3.49)] had increased odds of adherence as compared to those who didn't receive nutrition counseling and partner support respectively. Similarly, women who had satisfactory knowledge on IFA supplement (AOR: 2.16(1.37-3.40)) had increased odds of adherence as compared to those who didn't have satisfactory knowledge on IFA supplement. CONCLUSION: Adherence to the supplement was low. Efforts shall be done to improve awareness of pregnant mothers about IFA supplement through targeted nutrition counseling that includes the engagement of a partner.


Assuntos
Ácido Fólico/administração & dosagem , Ferro/administração & dosagem , Adesão à Medicação/estatística & dados numéricos , Cuidado Pré-Natal/normas , Oligoelementos/administração & dosagem , Vitaminas/administração & dosagem , Adulto , Anemia/prevenção & controle , Uso de Medicamentos/estatística & dados numéricos , Etiópia , Feminino , Ácido Fólico/uso terapêutico , Conhecimentos, Atitudes e Prática em Saúde , Hospitais Públicos/estatística & dados numéricos , Humanos , Ferro/uso terapêutico , Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Oligoelementos/uso terapêutico , Vitaminas/uso terapêutico
6.
Natl Med J India ; 32(1): 38-40, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31823940

RESUMO

Aluminium utensils are ubiquitous in Indian households and other developing countries. Concerns have recently been raised on the pathological effects of aluminium on the human body, due to its leaching from utensils with long-term use, which has been associated with certain clinical conditions such as anaemia, dementia and osteo-malacia. While some studies suggest that cooking in utensils or aluminium foils is safe, others suggest that it may lead to toxic levels of aluminium in the body. However, studies have shown that leaching of aluminium from cooking utensils depends on many factors such as pH, temperature and cooking medium. In healthy controls, 0.01 %-1 % of orally ingested aluminium is absorbed from the gastrointestinal tract and is eliminated by the kidney. Although the metal has a tendency to accumulate in tissues and may result in their dysfunction, the literature suggests that the apprehension is more apt in patients with chronic renal insufficiency. This article offers solutions to mitigate the risk of aluminium toxicity.


Assuntos
Alumínio/farmacocinética , Utensílios de Alimentação e Culinária/normas , Absorção Intestinal , Indústria Manufatureira/normas , Eliminação Renal , Alumínio/normas , Alumínio/toxicidade , Anemia/induzido quimicamente , Anemia/prevenção & controle , Utensílios de Alimentação e Culinária/legislação & jurisprudência , Demência/induzido quimicamente , Demência/prevenção & controle , Temperatura Alta/efeitos adversos , Humanos , Índia , Indústria Manufatureira/legislação & jurisprudência , Osteomalacia/induzido quimicamente , Osteomalacia/prevenção & controle , Fatores de Tempo
7.
Asia Pac J Clin Nutr ; 28(4): 793-799, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31826377

RESUMO

BACKGROUND AND OBJECTIVES: Anemia impairs the health and wellbeing of women and increases the risk of maternal and neonatal adverse outcomes. The objectives of this study are to determine the prevalence of postpartum anemia among urban lactating women; investigate the predictors of anemia and explore the potential health effects on lactating performance. METHODS AND STUDY DESIGN: Multi-stage sampling methods were used to recruit 495 lactating women from 3 cities of China. Blood and breast milk samples were collected to analyze hemoglobin levels and iron content, respectively. The intakes and sources of iron-rich food and nutrients were investigated based on Food Frequency Questionnaire and 24 h dietary recall. RESULTS: The overall prevalence of postpartum anemia was 32.7%; no cases of severe anemia were encountered. Women who living in Guangzhou had a significant higher anemia prevalence. Regards to dietary intake, the amount of iron intake was generally good with a high proportion of heme iron. The animal sources ratio was 23.0%. Total iron intake and the sources of iron were not associated with anemia. Vitamin C intake was significantly higher in non-anemic women (Median (25th, 75 th) was (72.6 (38.4, 130.0) mg/d)) than anemic women (54.7 (30.7, 111.3) mg/d). Other nutrient enhancers were not associated with anemia. There were no significant differences in the iron content of breast milk between women with and without anemia (r=0.047, p=0.302). CONCLUSIONS: Postpartum anemia is common in urban Chinese women. A combination of interventions, including managing antenatal anemia and correcting inappropriate dietary habits will help to prevent postpartum anemia.


Assuntos
Anemia/epidemiologia , Anemia/prevenção & controle , Ferro na Dieta/administração & dosagem , Saúde Pública , Adulto , China , Estudos Transversais , Comportamento Alimentar , Feminino , Humanos , Lactação , Estado Nutricional , Período Pós-Parto , Gravidez , Fatores de Risco
8.
PLoS One ; 14(12): e0215195, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31800574

RESUMO

Although maternal survival has improved in the last decades, evidence on illnesses and the use of health services during pregnancy remains scarce. Therefore, we aimed to assess the incidence and risk factors for illnesses among pregnant women and measure the use of health services. A prospective cohort study was conducted in three kebeles in rural southern Ethiopia among 794 pregnant women from May 2017 to July 2018. Each woman was followed every two weeks at home. Poisson and survival regression models were used for analysis. The incidence rate of episodes of illnesses was 93 per 100 pregnant-woman-weeks (95%CI: 90.6, 94.2), with an average of eight episodes of illnesses per woman. Anaemia accounted for 22% (177 of 794 women), and hypertension 3% (21 women of 794 women). However, utilization of health services for any illness episodes was only 8% (95%CI: 7.6%, 8.9%). The main reasons for not using health services were that the women thought the illness would heal by itself, women thought the illness was not serious, women could not afford to visit the health institutions, or women lacked confidence in the health institutions. The risk factors for illnesses are having many previous pregnancies in life time (ARR = 1.42; 95%CI = 1.02, 1.96), having history of stillbirth (ARR = 1.30; 95%CI = 1.03, 1.64), having history of abortion (AHR = 1.06; 95%CI = 1.02, 1.11), and walking more than 60 minutes to access the nearest hospital (AHR = 1.08; 95%CI = 1.03, 1.14). The risk factors for low use of health services are also having history of abortion (AHR = 2.50; 95%CI = 1.00, 6.01) and walking more than 60 minutes to access the nearest hospital (AHR = 1.91; 95%CI = 1.00, 3.63). Rural Ethiopian pregnant women experience a high burden of illness during pregnancy. Unfortunately, very few of these women utilize health services.


Assuntos
Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Serviços de Saúde/estatística & dados numéricos , Complicações na Gravidez/prevenção & controle , Aborto Espontâneo/epidemiologia , Aborto Espontâneo/prevenção & controle , Adolescente , Adulto , Anemia/epidemiologia , Anemia/prevenção & controle , Etiópia/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Complicações na Gravidez/epidemiologia , Estudos Prospectivos , População Rural , Adulto Jovem
9.
Nutrients ; 11(12)2019 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-31783608

RESUMO

Dietary intake data are crucial for developing or evaluating nutrition interventions to improve the nutritional status of populations. The collection of accurate and reliable dietary data in developing countries, however, remains challenging. The emergence of new technologies, which facilitate electronic data capture, might address some of these challenges. This paper aims to describe an application developed to collect a multiple-pass 24-h dietary recall, using electronic data capture, and compare the results to those estimated using a paper-based method. In this study, a tablet-based application was developed, in the CommCare platform, to evaluate the effectiveness, for improving dietary adequacy, of a package of behavior change interventions to reduce stunting and anemia among 6-23-month-old children in East Java, Indonesia (Baduta project). Dietary intakes of energy and nutrients were estimated using electronic data capture in the cohort study of the Baduta project (n = 680). We compared these results with those estimated using paper-based data capture in the project's end-line cross-sectional study (n = 2740). We found a higher percentage of children classified as acceptable energy reporters (reported energy intake within the 95% CI of Total Energy Expenditure) with the electronic data capture compared with paper-based data capture (i.e., 60.8%, 72.4% and 80.7% for 6-8-, 9-11- and 12-23-month-old children, respectively, vs. 40.9%, 56.9%, and 54.3%, respectively). The estimated mean energy and nutrient intakes were not significantly different between these dietary data capture methods. These results suggest dietary data collection, using a tablet-based application, is feasible and can improve the quality of dietary data collected in developing countries.


Assuntos
Computadores de Mão , Dieta , Rememoração Mental , Avaliação Nutricional , Anemia/prevenção & controle , Aleitamento Materno , Estudos de Coortes , Estudos Transversais , Coleta de Dados/instrumentação , Coleta de Dados/métodos , Registros de Dieta , Ingestão de Energia , Transtornos do Crescimento/prevenção & controle , Humanos , Indonésia , Lactente , Nutrientes/administração & dosagem , Estudos Prospectivos
10.
Vet Parasitol ; 276: 108973, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31785456

RESUMO

The objective of this study was to measure the effect of the nutritional status of Creole goat kids on the host responses and the nematode population established after an experimental H. contortus infection. Fifty six kids were fed with 4 diets corresponding to 2 nutritional statuses: the low nutritional status (HAY, hay ad libitum and HB, Hay ad libitum + banana) and the high nutritional status (HS, hay ad libitum + soya meal and HSB, hay ad libitum + banana + soya meal). For each diet, 8 kids were experimentally infected with 10,000 H. contortus infective larvae (L3) and 6 kids were kept as non-infected controls. From the day of infection until 6 weeks post-infection, samples were collected to measure individual intake, total tract digestibility, parasitological and hematological parameters. The dry matter intake (DMI), the average daily gain (ADG), the crude protein (CP) and the digestible CP intake were higher in goats fed the HS and HSB diets, but no statistically significant interaction between the nutritional status and the infection was observed. The packed cell volume (PCV), the red blood cell counts (RBC) and the mean corpuscular volume (MCV) were higher with the HS and the HSB diets. In kids with the high nutritional status the nematode burden and pathophysiological impact of the infection were significantly lower but not the FEC. In conclusion, this reduced establishment rate was associated with an increased production of eggs by the female parasites and suggested a phenomenon of density-dependent prolificacy of H. contortus probably inherent to the fitness of the parasite population.


Assuntos
Doenças das Cabras/parasitologia , Hemoncose/veterinária , Haemonchus/crescimento & desenvolvimento , Estado Nutricional/fisiologia , Anemia/prevenção & controle , Anemia/veterinária , Ração Animal/análise , Ração Animal/normas , Animais , Dieta/veterinária , Digestão , Ingestão de Alimentos , Eosinófilos/citologia , Fezes/química , Fezes/parasitologia , Feminino , Doenças das Cabras/fisiopatologia , Doenças das Cabras/prevenção & controle , Cabras , Hemoncose/parasitologia , Hemoncose/fisiopatologia , Contagem de Leucócitos/veterinária , Masculino , Contagem de Ovos de Parasitas/veterinária , Pepsinogênio A/sangue
11.
Vopr Pitan ; 88(6): 73-79, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31860202

RESUMO

The problem of psychological and somatic health of convicts is very important for society. Nutrition is one of the factors directly affecting it. In order to respect the rights and legitimate interests of this category of persons in the Russian Federation nowadays, various nutritional standards are distinguished depending on gender, age, health, working conditions, etc. The aim of the work was to evaluate the clinical nutrition of convicted patients with anemia sentenced to imprisonment. Material and methods. An analysis of more than 100 weekly layouts of the products of correctional institutions of the Federal Penitentiary Service of Russia was conducted, according to which meals were organized for more than 39,000 convicts, including 2,000 convicts suffering from anemia. Results and discussion. The analysis revealed that the energy value of the diet for men convicted ranged from 3900 to 4200 kcal/day, and for women - from 3400 to 3900 kcal/day, which corresponded to the physiological needs for energy and nutrients. At the same time, at the legislative level, special elevated nutritional standards have been identified for convicted anemia patients who are in-patient treatment in institutions of the Federal Penitentiary Service, regardless of the place of detention. In the course of a comparative analysis of the diets of medical nutrition used for sick inmates and persons in medical organizations of Russia, differences were revealed not only in the number of items of food, but also in the daily consumption rate. The energy value of the diets of patients with anemia is 3200 kcal/day for persons in medical institutions, and 3180 kcal/day for prisoners held in prisons. As recommendations, it should be noted that it is advisable for convicts to be given 150 ml of natural milk for an afternoon snack or lunch, separately from the fish served for dinner, as well as the expediency of using low-fat dairy products in diets. Conclusion. Despite the differences in the nutritional standards of patients with anemia among convicts and patients at large, the overall balance of protein, carbohydrate, fat and mineral is almost identical, balanced and rational.


Assuntos
Anemia/epidemiologia , Ingestão de Energia , Refeições , Estado Nutricional , Valor Nutritivo , Prisões , Adulto , Anemia/prevenção & controle , Feminino , Humanos , Masculino , Federação Russa
13.
Nutrients ; 11(10)2019 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-31597360

RESUMO

Yingyangbao (YYB) is a nutrient-dense complementary food supplement for infants and young children in China. There has been considerable interest and research on the potential effects of YYB on hematological and anthropometric outcomes in China, but limited effort has been made to consolidate and synthesize the evidence to inform the research and policy agendas. Eight English databases and three Chinese databases were searched from January 2001 to June 2019 to identify YYB intervention studies. A total of 32 quasi-experimental, post-only, concurrent-control studies or pre-post studies were identified, and 26 were included in the meta-analyses. A pooled analysis of post-only studies with concurrent-control determined that YYB was associated with an increase of 4.43 g/L (95% confidence interval (CI) 1.55, 7.30) hemoglobin concentration, 2.46 cm (CI 0.96, 3.97) in height, and 0.79 kg (CI 0.25, 1.32) weight in infants and young children. YYB was also associated with reductions in the prevalence of anemia (risk ratio (RR) = 0.55; 95% CI: 0.45, 0.67), stunting (RR = 0.60; 95% CI: 0.44, 0.81), and underweight (RR = 0.51; 95% CI: 0.39, 0.65). Overall, YYB was found to be associated with improved hematological and anthropometric indicators among infants and young children in China; however, randomized trials are needed to causally assess the efficacy of YYB due to the inherent risk of bias in existing quasi-experimental studies; rigorous implementation and cost-effectiveness evaluations are also needed.


Assuntos
Fenômenos Fisiológicos da Nutrição do Lactente , Estado Nutricional , Anemia/prevenção & controle , Estatura , Pré-Escolar , China , Suplementos Nutricionais , Transtornos do Crescimento/prevenção & controle , Hemoglobinas/análise , Humanos , Lactente , Alimentos Infantis , MEDLINE , Micronutrientes/administração & dosagem , Pobreza , População Rural , Soja , Magreza/prevenção & controle , Síndrome de Emaciação/prevenção & controle , Ganho de Peso
14.
Enferm. glob ; 18(56): 273-281, oct. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-188273

RESUMO

Objetivo: Determinar la asociación entre los factores sociodemográficos y prenatales con la anemia en gestantes peruanas. Método: Análisis secundario de la muestra ENDES 2017. La muestra fue de 639 gestantes entre 15 a 49 años. La variable dependiente fue la anemia ferropénica y las variables independientes fueron los factores sociodemográficos y prenatales. Para el análisis bivariado se calculó la Razón de prevalencia. Resultados: Respecto a los factores sociodemográficos y la anemia, las gestantes con un nivel educativo superior tienen menos posibilidad de presentar anemia (PR: 0,91; IC 95%: 0,42-1.96; p= 0,041). Por otro lado, entre los factores obstétricos y prenatales asociados a la anemia fueron: iniciar el control prenatal en el tercer mes (PR: 1,4; IC 95%: 0,74-1,58; p= 0,03) y encontrarse en el segundo trimestre de embarazo (PR: 1,35; IC 95%: 0,74-1,58; p= 0,04). Mientras que las gestantes que tienen más hijos (PR: 0,87; IC 95%: 0,78-0,97; p= 0,02) tienen menos posibilidad de presentar anemia. Conclusión: El nivel educativo superior y tener más hijos son factores protectores de la anemia. El inicio de control prenatal a partir del tercer mes y el segundo trimestre de gestación se asociaron con la presencia de anemia en las gestantes


Objective: To determine the association between sociodemographic and prenatal factors with anemia in Peruvian pregnant women. Method: Secondary analysis of the ENDES 2017 sample. The sample consisted of pregnant women between 15 and 49 years old. The dependent variable was iron deficiency anemia and the independent variables were sociodemographic and prenatal factors. For the bivariate analysis. prevalence ratio was calculated. Results: Regarding sociodemographic factors and anemia, pregnant women with a higher educational level have less possibility of presenting anemia (PR: 0,91; 95% CI: 0,42-1,96; p = 0,041). On the other hand, among the obstetric and prenatal factors associated with anemia were: initiate prenatal control in the third month (PR: 1,4; 95% CI: 0,74-1,58, p = 0,03) and be found in the second trimester of pregnancy ( PR: 1,35, 95% CI: 0,74-1,58; p = 0,04). While pregnant women who have more children (PR: 0,87; 95% CI: 0,78-0,97; p = 0,02) are less likely to have anemia. Conclusion: The higher educational level and having more children are protective factors of anemia. The start of prenatal control from the third month and the second trimester of pregnancy were associated with the presence of anemia in pregnant women


Assuntos
Humanos , Feminino , Gravidez , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Anemia/epidemiologia , Índices de Eritrócitos/fisiologia , Complicações na Gravidez/prevenção & controle , Educação em Saúde/métodos , Cuidados de Enfermagem/métodos , Anemia Ferropriva/diagnóstico , Peru/epidemiologia , Fenômenos Fisiológicos da Nutrição Pré-Natal , Anemia/prevenção & controle , Fatores de Risco , Paridade , Estudos Epidemiológicos
17.
Vox Sang ; 114(7): 762-768, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31402471

RESUMO

To avoid risk for allogeneic transfusions in healthy bone marrow (BM) donors, 1-2 preoperative autologous blood donations (PAD) are usually collected before the BM harvest. We analysed the haematological parameters in BM donors before and after the harvest, to assess the efficacy of this practice in limiting the postharvest anaemia. Overall, 102 consecutive donors underwent BM harvest preceded by one (26 cases) or two PAD (76 cases), which were infused during BM collection. We analysed the parameters related to donors, PAD timing and BM graft characteristics. PAD induced a significant decrease in Hb (from 14·6 g/dl, IQ range 13·3-15·5 to12·9 g/dl, IQ range 11·8-13·9; P < 0·0001) in all donors, with a median Hb loss at day -1 of 10·9% (IQ range 6·8-14·2). The PAD-related Hb decrease was independent of sex or number of PAD, and was inversely related to the time elapsed from first or last PAD. In comparison with values recorded at day-1, BM harvest produced an additional Hb decrease, accounting for a median Hb loss of 18·9% (IQ range 14·9-24·4). Overall, in comparison with pre-PAD values, Hb levels at day +1 were reduced of 28·9% (IQ range 23·6-32·2), independently if donors had 1 or 2 PAD reinfused. In conclusion, these data show that two PAD do not carry any advantage over one PAD. An eventual benefit of PAD can be achieved only if an adequate interval between PAD and BM harvest elapses. Prospective randomized studies could be worth to establish if any role for PAD does exist in BM donors.


Assuntos
Anemia/etiologia , Doadores de Sangue , Transfusão de Sangue/métodos , Transplante de Medula Óssea/métodos , Coleta de Tecidos e Órgãos/métodos , Adulto , Anemia/prevenção & controle , Medula Óssea/cirurgia , Transplante de Medula Óssea/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Coleta de Tecidos e Órgãos/efeitos adversos
18.
Afr J Reprod Health ; 23(2): 35-43, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31433592

RESUMO

Anemia in pregnancy is a key public health problem worldwide. It results from a wide variety of causes. The World Health Organization (WHO) has recommended specific measures to help prevent anemia during pregnancy, which countries are required to integrate into their antenatal care. This study was designed to determine the factors influencing the use of anaemia preventing measures among antenatal clinic attendees in the Kintampo North Municipality, Ghana. A cross sectional study was conducted among pregnant women attending the clinics after 36 weeks of pregnancy. Demographic data and information on use of all interventions were obtained using a structured questionnaire. The factors associated with the use of the interventions were identified using multiple logistic regression. The use of all anemia preventing interventions among pregnant women was found to be 30%. The study identified that use of all anemia preventing measures among pregnant women is quite low. Provision of antihelmithics to pregnant women and their health education on the benefits of the use of anaemia preventing measures would help increase the usage of the interventions.


Assuntos
Anemia/prevenção & controle , Complicações Hematológicas na Gravidez/prevenção & controle , Cuidado Pré-Natal/estatística & dados numéricos , Adolescente , Adulto , Instituições de Assistência Ambulatorial , Anemia/epidemiologia , Estudos Transversais , Feminino , Gana/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Gravidez , Complicações Hematológicas na Gravidez/epidemiologia , Complicações Parasitárias na Gravidez/prevenção & controle , Gestantes , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
19.
Crit Care ; 23(1): 278, 2019 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-31399052

RESUMO

BACKGROUND: As many as 90% of patients develop anemia by their third day in an intensive care unit (ICU). We evaluated the efficacy of interventions to reduce phlebotomy-related blood loss on the volume of blood lost, hemoglobin levels, transfusions, and incidence of anemia. METHODS: We conducted a systematic review and meta-analysis using the Laboratory Medicine Best Practices (LMBP) systematic review methods for rating study quality and assessing the body of evidence. Searches of PubMed, Embase, Cochrane, Web of Science, PsychINFO, and CINAHL identified 2564 published references. We included studies of the impact of interventions to reduce phlebotomy-related blood loss on blood loss, hemoglobin levels, transfusions, or anemia among hospital inpatients. We excluded studies not published in English and studies that did not have a comparison group, did not report an outcome of interest, or were rated as poor quality. Twenty-one studies met these criteria. We conducted a meta-analysis if > 2 homogenous studies reported sufficient information for analysis. RESULTS: We found moderate, consistent evidence that devices that return blood from flushing venous or arterial lines to the patient reduced blood loss by approximately 25% in both neonatal ICU (NICU) and adult ICU patients [pooled estimate in adults, 24.7 (95% CI = 12.1-37.3)]. Bundled interventions that included blood conservation devices appeared to reduce blood loss by at least 25% (suggestive evidence). The evidence was insufficient to determine if these devices reduced hemoglobin decline or risk of anemia. The evidence suggested that small volume tubes reduced the risk of anemia, but was insufficient to determine if they affected the volume of blood loss or the rate of hemoglobin decline. CONCLUSIONS: Moderate, consistent evidence indicated that devices that return blood from testing or flushing lines to the patient reduce the volume of blood loss by approximately 25% among ICU patients. The results of this systematic review support the use of blood conservation systems with arterial or venous catheters to eliminate blood waste when drawing blood for testing. The evidence was insufficient to conclude the devices impacted hemoglobin levels or transfusion rates. The use of small volume tubes may reduce the risk of anemia.


Assuntos
Anemia/prevenção & controle , Flebotomia/métodos , Anemia/epidemiologia , Humanos , Doença Iatrogênica/epidemiologia , Doença Iatrogênica/prevenção & controle , Unidades de Terapia Intensiva/organização & administração , Unidades de Terapia Intensiva/estatística & dados numéricos , Flebotomia/normas , Flebotomia/tendências , Guias de Prática Clínica como Assunto
20.
Artigo em Inglês | MEDLINE | ID: mdl-31412579

RESUMO

Many developing countries have implemented nutrition intervention programs to reduce child malnutrition. However, the effectiveness of these programs differs greatly, and it remains unclear what is causing the differences in effectiveness across different programs. To shed some light on this issue, this article examines the role the specificity of policy targets, along with the incentives attached, plays in affecting the effectiveness of nutrition intervention programs. More specifically, we examined how different policy targets (and the associated incentives) affect primary students' dietary structure and (thus) their nutritional and health status by analyzing a randomized intervention in rural Northwestern China that was designed with two treatment arms. The two treatments provided the same nutrition subsidy to project students but with different policy targets, one with a specific target of "anemia reduction" and the other with a general target of "malnutrition reduction". Our analysis revealed that compared to the treatment arm with only a general policy target, the treatment arm with the specific "anemia reduction" target was more effective at improving students' nutritional and health status, as measured by the incidences of being anemic and underweight, presumably through helping them develop a dietary structure with more flesh meat, bean products, vegetables, and fruits.


Assuntos
Anemia/prevenção & controle , Transtornos da Nutrição Infantil/prevenção & controle , Estudantes , Anemia/epidemiologia , Criança , Transtornos da Nutrição Infantil/epidemiologia , Fenômenos Fisiológicos da Nutrição Infantil , Pré-Escolar , China/epidemiologia , Programas Governamentais , Inquéritos Epidemiológicos , Humanos , Avaliação de Programas e Projetos de Saúde , População Rural , Instituições Acadêmicas , Magreza
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