Publications by authors named "Diego Bassani"

Background: Assessments of the efficacy of interventions to improve child growth are often based on differences in mean height-for-age -scores (HAZ) and stunting (HAZ<-2) in randomized controlled trials (RCTs). However, this approach does not account for children's starting skeletal age and does not enable assessment of the extent to which interventions optimized linear growth.

Objectives: The objectives of this study were to develop and apply a new method using height-age to express linear growth effects in RCTs.

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Context: Robust associations have been identified between fertility during adolescence and the disablement process, including pathologies, impairments, functional limitations and disability. Limited theoretical or empirical research considers how and why such relationships exist generally or with the individual associated components of disablement.

Objective: To consolidate and critically evaluate literature to describe testable, theory-based hypotheses to guide future research on the mechanisms by which fertility during adolescence contributes to disablement.

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Pakistan has among the highest rates of maternal, perinatal, and neonatal mortality globally. Many of these deaths are potentially preventable with low-cost, scalable interventions delivered through community-based health worker programs to the most remote communities. We conducted a cross-sectional survey of 10,264 households during the baseline phase of a cluster randomized controlled trial (cRCT) in Gilgit-Baltistan, Pakistan from June-August 2021.

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Background: Ongoing high neonatal mortality rates (NMRs) represent a global challenge. In 2021, of the 5 million deaths reported worldwide for children under five years of age, 47% were newborns. Pakistan has one of the five highest national NMRs in the world, with an estimated 39 neonatal deaths per 1,000 live births.

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Background: We aimed to estimate associations between human milk oligosaccharides (HMOs) and infant growth (length-for-age (LAZ) and weight-for-length (WLZ) z-scores) at 12 months postnatal age.

Methods: In this secondary analysis of data from a maternal vitamin D trial in Dhaka, Bangladesh (N = 192), absolute concentrations of HMOs were measured in 13 ± 1 week(s) postpartum milk samples, infant anthropometric measurements were obtained soon after birth and at 12 months postpartum, and infant feeding was classified during 6 months postpartum. Associations between individual HMOs or HMO groups and LAZ or WLZ were estimated by multivariable linear regression adjusting for infant feeding pattern, maternal secretor status, and other potential confounders.

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Objective: Longitudinal patterns of growth in early childhood are associated with health conditions throughout life. Knowledge of such patterns and the ability to predict them can lead to better prevention and improved health promotion in adulthood. However, growth analyses are characterized by significant variability, and pattern detection is affected by the method applied.

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Stunting prevalence is commonly used to track population-level child nutritional status. However, other metrics derived from anthropometric datasets may be used as alternatives to stunting or provide complementary perspectives on the status of linear growth faltering in low- and middle-income countries (LMICs). Data from 156 Demographic and Health Surveys in 63 LMICs (years 2000 to 2020) were used to generate 2 types of linear growth metrics: (i) measures of location of height distributions (including stunting) for under-5 years (<5y) and 2 to 5 years (2-5y); (ii) model-derived metrics including predicted mean height-for-age z-score (HAZ) at 0, 2, and 5 years; interval slopes of HAZ, height-for-age difference (HAD), and growth delay (GD) from 1 month to 2 years (1mo-2y) and 2-5y; and the SITAR intensity parameter (SITAR-IP) for <5y.

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Article Synopsis
  • - Maternal depressive symptoms negatively impact the sleep quality of children, and this study aimed to explore their connection to parasomnias (abnormal sleep behaviors) in 11-year-olds, utilizing data from a cohort of 4231 individuals in Pelotas, Brazil.
  • - Researchers identified five trajectories of maternal depression: chronic-low, chronic-moderate, increasing, decreasing, and chronic-high, with varying impacts on the prevalence of parasomnias in children, which was found to be 16.8% overall.
  • - The study concluded that children whose mothers exhibited chronic depressive symptoms had a significantly higher risk of experiencing parasomnias, particularly confused arousals, compared to those with mothers in the chronic-low trajectory group.
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Child growth patterns assessment is critical to design public health interventions. However, current analytical approaches may overlook population heterogeneity. To overcome this limitation, we developed a growth trajectories clustering pipeline that incorporates a shape-respecting distance, baseline centering (i.

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Background: Over 250 million children under 5 years, globally, are at risk of developmental delay. Interventions during the first 2 years of life have enduring positive effects if children at risk are identified, using standardized assessments, within this window. However, identifying developmental delay during infancy is challenging and there are limited infant development assessments suitable for use in low- and middle-income (LMIC) settings.

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Introduction: Bayesian adaptive designs for clinical trials have gained popularity in the recent years due to the flexibility and efficiency that they offer. We consider the scenario where the outcome of interest comprises events with relatively low risk of occurrence and different case definitions resulting in varying control group risk assumptions. This is a scenario that occurs frequently for infectious diseases in global health research.

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Background: Indicators of child height, such as mean height-for-age -scores (HAZ), height-for-age difference (HAD) and stunting prevalence, do not account for differences in population-average bone developmental stage.

Aim: Propose a measure of child height that conveys the dependency of linear growth on stage rather than chronological age.

Subjects And Methods: Using Demographic and Health Surveys (2000-2018; 64 countries), we generated: (1) predicted HAZ at specific ages (HAZ regressed on age); (2) height-age (age at which mean height matches the WHO Growth Standards median); (3) Growth delay (GD), the difference between chronological age and height-age; (4) HAD; and (5) stunting prevalence.

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Background: The health management information system (HMIS) is an integral component of a strong health care system. Despite its importance for decision-making, the quality of HMIS data remains of concern in low- and middle-income countries. To address challenges with the quality of maternal and child health (MCH) data gathered within Malawi's HMIS, we conducted a pilot study evaluating different support modalities to district-level HMIS offices.

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Background: Although most births in Mali occur in health facilities, a substantial number of newborns still die during delivery and within the first 7 days of life, mainly because of existing training deficiencies and the challenges of maintaining intrapartum and postpartum care skills.

Objective: This trial aims to assess the effectiveness and cost-effectiveness of an intervention combining clinical audits and low-dose, high-frequency (LDHF) in-service training of health care providers and community health workers to reduce perinatal mortality.

Methods: The study is a three-arm cluster randomized controlled trial in the Koulikoro region in Mali.

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Objectives: Group antenatal care (G-ANC) is an innovative model in which antenatal care is delivered to a group of 8-12 women of similar gestational age. Evidence from high-income countries suggests G-ANC is particularly effective for women from marginalised populations, including adolescents. The objective of this study was to examine the experiences of Senegalese adolescents engaged in group antenatal care.

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To investigate the associations of maternal excess weight before pregnancy with (1) weaning at 3 months of age, (2) duration of exclusive breast-feeding at 6 months of age, (3) duration of any breast-feeding at 12 months of age and (4) to compare the magnitude of these associations over four decades. Data were from participants in the Pelotas (Brazil) Birth Cohorts born in 1982 ( 5334), 1993 ( 1442), 2004 ( 4092) and 2015 ( 4102). Maternal pre-pregnancy weight was collected after the delivery and breast-feeding status was assessed when children were 3 and 12 months old.

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Background: Effective measurement of Gender Equality and Women's Empowerment (GEWE) is challenging in low and middle-income countries (LMICs), and even more so in humanitarian settings. Conflict, natural disasters, and epidemics may increase gender inequities, but also present an opportunity to address them. This scoping review describes and identifies gaps in the measurement tools, methods, and indicators used to measure GEWE in humanitarian settings, and presents a dashboard that can be used by researchers, organizations and governments to identify GEWE measurement tools.

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Introduction: Children's growth status is an important measure commonly used as a proxy indicator of advancements in a country's health, human capital and economic development. We aimed to assess the feasibility of using Super-Imposition by Translation And Rotation (SITAR) models for summarising population-based cross-sectional height-by-age data of children under 5 years across 64 countries.

Methods: Using 145 publicly available Demographic and Health Surveys of children under 5 years across 64 low-income and middle-income countries from 2000 to 2018, we created a multicountry pseudo-longitudinal dataset of children's heights.

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Adequate health literacy is important for strong health outcomes during pregnancy, particularly among mothers with high risk of adverse outcomes related to pregnancy and childbirth. Understanding the health literacy of young pregnant women in low-income settings could support strategies to reduce adverse outcomes in this population. This exploratory study assessed the health literacy of young pregnant adolescents and young adults from a rural area in Northeast Brazil and associated factors such as socioeconomic conditions, adequacy of prenatal care, and social support from family and friends.

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Background: Adolescent pregnancy is a public health concern worldwide, particularly in low-income settings. Adolescent mothers face higher risks during pregnancy and delivery compared to adult mothers and yet, may also experience worse quality of obstetrical care. This study evaluates adherence to meeting Brazilian recommendations for prenatal care by comparing first-time adolescent versus adult mothers in a rural, low-income setting.

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Objectives: To characterize the relationship of echocardiographic markers of left heart overload and flow in peripheral major end-organ vessels (eg, celiac artery) with the presence of reversed holodiastolic flow in the descending aorta, considered a surrogate marker of an increased transductal shunt volume, in preterm patients with a patent ductus arteriosus (PDA).

Methods: This work was a retrospective study of data from echocardiography performed to investigate the hemodynamic significance of a PDA in preterm patients. We studied differences in echocardiographic markers of the PDA shunt volume according to patterns of flow in the postductal descending aorta (no PDA, PDA with antegrade diastolic flow, and PDA with reversed diastolic flow).

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Objective: To explore the association between behavioural characteristics with the prevalence of abdominal obesity (AO) among a population of Southern Brazilian shift working women.

Design: A cross-sectional study was conducted. AO was estimated using waist circumference (WC), and it was used to classify women as having AO (WC ≥ 88 cm).

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Objective: To illustrate that a mediation framework can help integrate inferences from three growth models to enable a comprehensive view of the associations between growth during specific developmental windows and mid-childhood IQ.

Design: We analysed direct and indirect associations between mid-childhood IQ and length/height growth in five early-life age intervals bounded by conception, birth, early, mid and late infancy, and mid-childhood using estimates from three growth models (lifecourse, conditional change and change score) applied to three historical birth cohorts.

Participants And Setting: 12 088 term-born children from the Collaborative Perinatal Project (CPP) in the USA (n=2170), the Promotion of Breastfeeding Intervention Trial (PROBIT) in Belarus (n=8275) and the Cebu Longitudinal Health and Nutrition Survey (CLHNS) in the Philippines (n=1643).

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Background: In 2018, Pakistan had the world's highest neonatal mortality rate. Within Pakistan, most neonatal deaths occur in rural areas where access to health facilities is limited, and robust vital registration systems are lacking. To improve newborn survival, there is a need to better understand the causes of neonatal death in high burden settings and engage caregivers in the promotion of newborn health.

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Child growth standards are commonly used to derive age- and sex-standardized anthropometric indices but are often inappropriately applied to preterm-born children (<37 weeks of gestational age (GA)) in epidemiology studies. Using the 2004 Pelotas Birth Cohort, we examined the impact of correcting for GA in the application of child growth standards on the magnitude and direction of associations in 2 a priori-selected exposure-outcome scenarios: infant length-for-age z score (LAZ) and mid-childhood body mass index (scenario A), and infant LAZ and mid-childhood intelligence quotient (scenario B). GA was a confounder that had a strong (scenario A) or weak (scenario B) association with the outcome.

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