Does India Need a Universal High-Dose Vitamin A Supplementation Program?

High dose vitamin A (HDVA) concentrate began to be distributed in India in 1970 as a short-term, stop-gap approach to reduce clinical signs of vitamin A deficiency. As this problem declined globally, the purpose of distributing them changed to the reduction of young child mortality. However, their impact on this has also declined, if not disappeared, as suggested in India by the enormous DEVTA study.

In a rural area of Bangladesh, traditional birth attendant training improved early infant feeding practices: a pragmatic cluster randomized trial.

In rural Bangladesh, most births take place at home. There is little evidence regarding the influence of traditional birth attendants (TBAs) or community volunteers (CVs) on early infant feeding practices. We conducted a pragmatic cluster randomized controlled trial in Panchagarh District to examine the effects of training and post-training supervision of TBAs/CVs on early breastfeeding practices.

Diet Diversity in Pastoral and Agro-pastoral Households in Ugandan Rangeland Ecosystems.

We explore how diet diversity differs with agricultural seasons and between households within pastoral and agro-pastoral livelihood systems, using variety of foods consumed as a less complex proxy indicator of food insecurity than benchmark indicators like anthropometry and serum nutrients. The study was in the central part of the rangelands in Uganda. Seventy nine households were monitored for three seasons, and eight food groups consumed during a 24 hour diet recall period used to create a household diet diversity score (HDDS).

Exclusive breastfeeding: measurement and indicators.

Background: Accurate measurement of the duration of exclusive breastfeeding is complicated by factors related to definitions, timing, duration of recall, methods of analysis, and sample biases. Clearly prospective methods are likely to be more accurate but are too expensive to use in most large-scale surveys. Internationally, most surveys use a point-in-time or current status measurement (usually 24-hour recall) and report their findings using an indicator established by the World Health Organisation (WHO) in 1991 that involves combining all babies less than six months old in order to obtain a large enough sample size to result in stable proportions that can be compared over time.

Sex differences in nutritional status of HIV-exposed children in Rwanda: a longitudinal study.

Objective: To examine sex differences in nutritional status in relation to feeding practices over time in a cohort of HIV-exposed children participating in a complementary feeding programme in Rwanda.

Methods: We applied a longitudinal design with three measurements 2-3 months apart among infants participating in a complementary feeding programme who were 6-12 months old at baseline. Using early feeding practices and a composite infant and child feeding index (ICFI) as indicators of dietary patterns, we conducted a multivariate analysis using a cross-sectional time series to assess sex differences in nutritional status and to determine whether there was a link to discrepancies in dietary patterns.

Vitamin A policies need rethinking.

The prevalence of vitamin A (VA) deficiency, which affects about one-third of children in developing countries, is falling only slowly. This is despite extensive distribution and administration of periodic (4- to 6-monthly) high-dose VA capsules over the past 20 years, now covering a reported 80% of children in developing countries. This massive programme was motivated largely by an expectation of reducing child mortality, stemming from findings in the 1980s and early 90s.

Infant feeding counselling of HIV-infected women in two areas in Kenya in 2008.

While WHO no longer recommends individual infant feeding counselling to HIV-positive women, it may still be practised in some settings and for specific cases. In any case, lessons can be learned by examining how well front line health workers are able to take on counselling tasks. This qualitative study was designed to assess how counsellors deal with challenges they face in two Kenyan provinces.

Randomized placebo-controlled trial of guava juice as a source of ascorbic acid to reduce iron deficiency in Tarahumara indigenous schoolchildren of northern Mexico.

Objective: Assess the efficacy of a 10-week consumption of guava juice on the iron status of children with mild iron deficiency anemia.

Methods: Ninety-five boarding school children aged 6-9 years identified as anemic were randomly allocated to receive 300 mL of natural guava juice containing ∼200 mg of ascorbic acid (AA) or placebo (guava-flavored juice free of AA) with the main meal (5 d/wk). Information about dietary intake was collected at weeks 3, 5, and 7 at school and household levels.

Vitamins and minerals for women: recent programs and intervention trials.

Women's nutrition has received little attention in nutrition programming, even though clinical trials and intervention trials have suggested that dietary improvement or supplementation with several nutrients may improve their health, especially in low-income settings, the main focus of this paper. Most attention so far has focused on how improvements in maternal nutrition can improve health outcomes for infants and young children. Adequate vitamin D and calcium nutrition throughout life may reduce the risk of osteoporosis, and calcium supplementation during pregnancy may reduce preeclampsia and low birth weight.

Iron-fortified rice is as efficacious as supplemental iron drops in infants and young children.

How to improve iron status among infants and young children is of continued concern in low- to middle-income countries, including Brazil. In a double blind, 5-mo, home-based, randomized trial in Brazil, we gave one group of mildly anemic 6- to 24-mo-old children (n = 175) rice fortified with micronized ferric pyrophosphate using the Ultra Rice technology and a placebo solution (URG) and another group identical nonfortified rice and iron drops. We instructed parents on the correct dosage of iron drops and to feed their children rice as they normally would.

Tanzania national survey on iodine deficiency: impact after twelve years of salt iodation.

Background: In many low-income countries, children are at high risk of iodine deficiency disorders, including brain damage. In the early 1990s, Tanzania, a country that previously suffered from moderate to severe iodine deficiency, adopted universal salt iodation (USI) as an intervention strategy, but its impact remained unknown.

Methods: We report on the first national survey in mainland Tanzania, conducted in 2004 to assess the extent to which iodated salt was used and its apparent impact on the total goitre prevalence (TGP) and urinary iodine concentrations (UIC) among the schoolchildren after USI was initiated.

Improved salt iodation methods for small-scale salt producers in low-resource settings in Tanzania.

Background: Universal salt iodation will prevent iodine deficiency disorders (IDD). Globally, salt-iodation technologies mostly target large and medium-scale salt-producers. Since most producers in low-income countries are small-scale, we examined and improved the performance of hand and knapsack-sprayers used locally in Tanzania.

Relationship of parental characteristics and feeding practices to overweight in infants and young children in Beijing, China.

Background: Childhood obesity has become a major public health problem in many countries. To explore the risk factors of overweight in infants and young children might be helpful in developing an early overweight intervention strategy.

Objective: To assess the prevalence of overweight and the relationship of parental characteristics and feeding practices to overweight in infants and young children in Beijing, China.