Acceptability and feasibility of infant-feeding options: experiences of HIV-infected mothers in the World Health Organization Kesho Bora mother-to-child transmission prevention (PMTCT) trial in Burkina Faso.

In Burkina Faso, prolonged breastfeeding with introduction of ritual fluids from birth is a deep-seated norm. We explored HIV-infected mothers' views and experiences of the acceptability and feasibility of the World Health Organization's recommended infant-feeding options within a mother-to-child-transmission prevention trial. A qualitative study was conducted on 17 formula-feeding and 19 breastfeeding mothers, from a larger cohort of 51 eligible HIV-infected women, consenting to participate in separate focus group discussions in early post-partum.

A sustainable food support for non-breastfed infants: implementation and acceptability within a WHO mother-to-child HIV transmission prevention trial in Burkina Faso.

Objective: To provide HIV-positive mothers who opted for exclusive breastfeeding or formula feeding from birth to 6 months postpartum as a means of prevention of mother-to-child transmission (PMTCT) of HIV with a sustainable infant food support programme (FSP) from 6 to 12 months postpartum. We describe the implementation and assessment of this pilot initiative.

Design: The FSP included a 6-month provision of locally produced infant fortified mix (IFM; 418 kJ/100 g of gruel) for non-breastfed infants coupled with infant-feeding and psychosocial counselling and support.

Active malaria morbidity management has limited impact on height status of preschool Senegalese children.

Although infections contribute to growth faltering in preschool children, malaria prevention seems to have limited impact on height status. In 2002-2003, a malaria intermittent preventive treatment (IPT) trial was conducted in Senegal, including randomly selected preschool children from 11 villages. A rapid decrease in stunting prevalence (from 28.

Amodiaquine dosage and tolerability for intermittent preventive treatment to prevent malaria in children.

Sulfadoxine-pyrimethamine with amodiaquine (SP-AQ) is a highly efficacious regimen for intermittent preventive treatment to prevent malaria in children (IPTc), but the amodiaquine component is not always well tolerated. We determined the association between amodiaquine dosage by body weight and mild adverse events (AEs) and investigated whether alternative age-based regimens could improve dosing accuracy and tolerability, using data from two trials of IPTc in Senegal, one in which AQ dose was determined by age and the other in which it was determined by weight category. Both dosage strategies resulted in some children receiving AQ doses above the recommended therapeutic range.

Randomized trial of piperaquine with sulfadoxine-pyrimethamine or dihydroartemisinin for malaria intermittent preventive treatment in children.

Background: The long terminal half life of piperaquine makes it suitable for intermittent preventive treatment for malaria but no studies of its use for prevention have been done in Africa. We did a cluster randomized trial to determine whether piperaquine in combination with either dihydroartemisin (DHA) or sulfadoxine-pyrimethamine (SP) is as effective, and better tolerated, than SP plus amodiaquine (AQ), when used for intermittent preventive treatment in children delivered by community health workers in a rural area of Senegal.

Methods: Treatments were delivered to children 3-59 months of age in their homes once per month during the transmission season by community health workers.

Enhanced post-natal growth is associated with elevated blood pressure in young Senegalese adults.

Background: Evidence suggests that intrauterine growth restriction followed by rapid post-natal growth is associated with high blood pressure. We assessed the effect of early size and post-natal growth on blood pressure in a population from West Africa, where fetal growth retardation and childhood malnutrition are common.

Methods: A total of 1288 Senegalese subjects were followed from infancy to young adulthood (mean age 17.

Impact of child malnutrition on the specific anti-Plasmodium falciparum antibody response.

Background: In sub-Saharan Africa, preschool children represent the population most vulnerable to malaria and malnutrition. It is widely recognized that malnutrition compromises the immune function, resulting in higher risk of infection. However, very few studies have investigated the relationship between malaria, malnutrition and specific immunity.

Lipodystrophy and metabolic disorders in HIV-1-infected adults on 4- to 9-year antiretroviral therapy in Senegal: a case-control study.

Objective: To assess adverse effects of long-term highly active antiretroviral therapy (HAART), that is, lipodystrophy and metabolic disorders, in a cohort of African patients.

Methods: One hundred eighty HIV-1-infected patients treated with HAART for 4-9 years in Dakar and 180 age-matched and sex-matched controls were enrolled. Regional subcutaneous fat changes were assessed by physicians, and fasting blood samples were drawn.

Influence of wasting and stunting at the onset of the rainy season on subsequent malaria morbidity among rural preschool children in Senegal.

In sub-Saharan Africa, malaria and malnutrition are major causes of morbidity and mortality in children less than five years of age. To explore the impact of malnutrition on subsequent susceptibility to malaria, a cohort of 874 rural preschool children in Senegal was followed-up during one malaria transmission season from July through December. Data on nutritional status and Plasmodium falciparum parasitemia were collected at baseline.

A trial of the efficacy, safety and impact on drug resistance of four drug regimens for seasonal intermittent preventive treatment for malaria in Senegalese children.

Unlabelled: In the Sahel, most malaria deaths occur among children 1-4 years old during a short transmission season. A trial of seasonal intermittent preventive treatment (IPT) with sulfadoxine-pyrimethamine (SP) and a single dose of artesunate (AS) showed an 86% reduction in the incidence of malaria in Senegal but this may not be the optimum regimen. We compared this regimen with three alternatives.

Impact of intermittent preventive anti-malarial treatment on the growth and nutritional status of preschool children in rural Senegal (west Africa).

Negative consequences of malaria might account for seasonality in nutritional status in children in the Sahel. We report the impact of a randomized, double-blind, placebo-controlled trial of seasonal intermittent preventive anti-malarial treatment on growth and nutritional status in 1,063 Senegalese preschool children. A combination of artesunate and sulfadoxine-pyrimethamine was given monthly from September to November.

Constraints on the delivery of animal-source foods to infants and young children: case studies from five countries.

Unlabelled: BACKGROUND. Optimal feeding of infants and young children in developing countries includes daily feeding of animal-source foods. OBJECTIVE.

Seasonal variations and trends in weight and arm circumference of non-pregnant rural Senegalese women, 1990-1997.

Objective: To describe levels, monthly variations and trends in weight and arm circumference of non-pregnant lactating women living in the Sahel, characterized by one short yearly rainy season (July-October).

Methods: A mixed unbalanced cross-sectional longitudinal observational study conducted at 3, 5, 7 and 10 months postpartum among 3869 women living in the Sine area in central Senegal who had brought their infants into dispensaries for immunization from January 1990 to February 1997, and 1-5 consecutive children per woman (26 106 visits).

Results: Mean weight was 55.

[Assessment of 24 years of infant growth monitoring in a rural area of Senegal (1969-1992)].

Unlabelled: Undernutrition in young children in developing countries is associated with an increased risk of death. But in several studies, a decrease in mortality was not associated with any decrease in the prevalence of undernutrition.

Study Area: A rural population of Casamance (Senegal) has been under yearly demographic surveillance by The French National Institute of Demographic Studies (INED) since 1985.

Preschool stunting, adolescent migration, catch-up growth, and adult height in young senegalese men and women of rural origin.

Available data on the long-term consequences of preschool stunting are scarce and conflicting. The objective of this study was to assess the amount of catch-up growth from preschool stunting and the effect of migration (change in environment) during adolescence. A cohort study from preschool age (1-5 y) to adulthood (18-23 y) was conducted among 2874 subjects born in a rural area of Senegal.

The relationship between iron status and thyroid hormone concentration in iron-deficient adolescent Iranian girls.

Extensive data from animal and human studies indicate that iron deficiency impairs thyroid metabolism. The aim of this study was to determine thyroid hormone status in iron-deficient adolescent girls. By stepwise random sampling from among all public high schools for girls in Lar and its vicinity in southern Iran, 103 out of 431 iron deficient subjects were selected.

Early breastfeeding cessation in rural Senegal: causes, modes, and consequences.

Objectives: We studied reasons for cessation of breastfeeding before the age of 15 months, replacement feeding modes, and child mortality in West Africa.

Methods: Data were gathered for 12208 children born between 1987 and 1997 in a rural area of Senegal. Interviews were conducted with caregivers of early-weaned children, and child mortality risks were assessed.

Effects of administration of iron, iodine and simultaneous iron-plus-iodine on the thyroid hormone profile in iron-deficient adolescent Iranian girls.

Objective: To investigate whether iron supplementation can improve thyroid hormone function in iron-deficient adolescent girls.

Design: A double-blind randomized intervention study.

Setting: The study was performed from 2002 through 2003 in the Islamic Republic of Iran.

Longitudinal estimates of puberty timing in Senegalese adolescent girls.

This study aimed to assess the timing of sexual maturation (breast development and menarche occurrence) among sub-Saharan African adolescent girls from rural areas. In the framework of a longitudinal study of growth at puberty, the stages of pubertal development (Tanner classification) and menarche occurrence were recorded at intervals between 1995 and 2000 in a sample of 406 Senegalese adolescent girls from a rural area. Nutritional status was estimated during infancy, childhood, and adolescence within this sample, and body composition was estimated only during adolescence.

Early short-term infant food supplementation, maternal weight loss and duration of breast-feeding: a randomised controlled trial in rural Senegal.

Objective: Early supplementation of breastfed infants may have consequences both for the mother and the child. We hypothesised that it would result in decreased maternal weight loss and in shorter durations of breastfeeding and birth intervals.

Design: Controlled randomised population-based trial.

Non-specific effects of vaccination on child survival? A prospective study in Senegal.

Objectives: Several studies have shown an association between vaccination and child mortality in developing countries. The present paper examines this issue using data from a Senegalese rural area which has been monitored from 1983 to the present.

Methods: We analysed two birth cohorts, comprising 7796 and 3573 persons who had received either BCG and DTP (diphtheria-tetanus-pertussis) simultaneously or neither of these vaccines, and who had been followed from birth to 2 years of age.

A young child feeding index is not associated with either height-for-age or height velocity in rural Senegalese children.

Ruel and Menon recently published a young child feeding index based on characteristics taken from 24-h and 7-d recalls. A strong positive association was found in 7 Latin American Demographic and Health Surveys for 12- to 36-mo-old children (1). The aim of this study was to test for associations of this index with height-for-age and linear growth in African children.

Risk factors for acellular and whole-cell pertussis vaccine failure in Senegalese children.

Although use of acellular pertussis vaccine was associated with a higher rate of vaccine failure than that of whole-cell vaccine in the Senegal Pertussis Trial conducted in 1990-1994 on 4189 children, risk factors for vaccine failure regarding exposure and susceptibility to pertussis have not been studied so far. Pertussis occurred in 346 vaccinated children. Three factors were found to be associated with vaccine failure, independently of the vaccine type, namely the degree of exposure, birth rank, and time since weaning.