| 51. |
- Karlsson, Omar, et al.
(författare)
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Child wasting before and after age two years: A cross-sectional study of 94 countries
- 2022
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Ingår i: EClinicalMedicine. - : Elsevier BV. - 2589-5370. ; 46
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundWasting reflects infections and poor nutrition and affects almost 50 million children at any given time. Wasting comes with immediate risk of mortality and increased risks for long-term negative consequences for development. Children under two are particularly sensitive to undernutrition and infections. We estimated the age patterning in wasting prevalence.MethodsWe calculated wasting prevalence and used Poisson regression models to estimate prevalence ratios comparing prevalence in children under and over two years using data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 94 mostly low- and middle-income countries, including 804,172 children under five, born to a nationally representative sample of women 15–49 years old. Wasting prevalence was defined as the percentage of children with weight-for-height below –2 z-score from the median of the WHO 2006 growth standard.FindingsWasting prevalence for children under two was 14% (95% CI: 13, 14) while it was 9% (95% CI: 9, 9) for children 2–4 years old—leading to a prevalence ratio of 0·66 (95% CI: 0·64, 0·67) in our pooled sample. Prevalence ratios were less than one, indicating lower prevalence in children over two, in 87 countries and statistically significantly lower than one at a 5% level (non-adjusted) in 68 countries. Wasting prevalence was generally lower in children under two for males and females and the wealthiest and poorest households.InterpretationSince wasting prevalence was observed to be greater among children 0–2 years, and adverse exposure to undernutrition and infections are particularly harmful and interventions are more effective during the 1000 days from conception until age two, nutrition interventions should ensure coverage of children under two through programmatic measures to increase detection and enrollment in wasting programs.
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| 52. |
- Karlsson, Omar, et al.
(författare)
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Consumption of Vitamin-A-Rich Foods and Vitamin A Supplementation for Children under Two Years Old in 51 Low- and Middle-Income Countries
- 2021
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Ingår i: Nutrients. - : MDPI AG. - 2072-6643. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Vitamin A supplementation for children 6-59 months old is an important intervention that boosts immune function, especially where children do not consume enough vitamin-A-rich foods. However, the low coverage of vitamin A supplementation is a persistent problem in low- and middle-income countries. We first estimated the percentage of children 6-23 months old receiving the minimum dietary diversity, vitamin-A-rich foods, and vitamin A supplementation, and second, the difference in the percentage receiving vitamin A supplementation between children 6-23 months old and children 24-59 months old using nationally representative cross-sectional household surveys, namely, the Demographic and Health Surveys, conducted from 2010 to 2019 in 51 low- and middle-income countries. Overall, 22% (95% CI: 22, 23) of children received the minimum dietary diversity, 55% (95% CI: 54, 55) received vitamin-A-rich foods, 59% (95% CI: 58, 59) received vitamin A supplementation, and 78% (95% CI: 78, 79) received either vitamin-A-rich foods or supplementation. A wide variation across countries was observed; for example, the percentage of children that received either vitamin-A-rich foods or supplementation ranged from 53% (95% CI: 49, 57) in Guinea to 96% (95% CI: 95, 97) in Burundi. The coverage of vitamin A supplementation should be improved, especially for children 6-23 months old, in most countries, particularly where the consumption of vitamin-A-rich foods is inadequate.
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| 53. |
- Karlsson, Omar, et al.
(författare)
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Estimating heritability of height without zygosity information for twins under five years in low- and middle-income countries : An application of normal finite mixture distribution models
- 2022
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Ingår i: SSM - Population Health. - : Elsevier BV. - 2352-8273. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Twin studies are widely used to estimate heritability of traits and typically rely on knowing the zygosity of twin pairs in order to determine variation attributable to genetics. Most twin studies are conducted in high resource settings. Large scale household survey data, such as the Demographic and Health Surveys, collect various biomarkers for children under five years old in low- and middle-income countries. These data include twins but no information on zygosity. We applied mixture models to obtain heritability estimates without knowing zygosity of twins, using 249 Demographic and Health Surveys from 79 low- and middle-income countries (14,524 twin pairs). We focused on height of children, adjusted for age and sex, but also provided estimates for other biomarkers available in the data. We estimated that the heritability of height in our sample was 46%.
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| 54. |
- Karlsson, Omar, et al.
(författare)
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Maternal height-standardized prevalence of stunting in 67 low- and- middle-income countries
- 2022
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Ingår i: Journal of Epidemiology. - 0917-5040. ; 32:7, s. 337-337
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Prevalence of stunting is frequently used as a marker of population-level child undernutrition. Parental height varies widely in low- and middle-income countries (LMIC) and is also a major determinant of stunting. While stunting is a useful measure of child health, with multiple causal components, removing the component attributable to parental height may in some cases be helpful to identify shortcoming in current environments.Methods: We estimated maternal height-standardized prevalence of stunting (SPS) in 67 LMIC and parental height-SPS in 20 LMICs and compared with crude prevalence of stunting (CPS) using data on 575,767 children under-five from 67 Demographic and Health Surveys (DHS). We supplemented the DHS with population-level measures of other child health outcomes from the World Health Organization's (WHO) Global Health Observatory and the United Nations' Inter-Agency Group for Child Mortality Estimation. Prevalence of stunting was defined as percentage of children with height-for-age falling below -2 z-scores from the 2006 WHO growth standard.Findings: The average CPS across countries was 27.8% (95% CI: 27.5 to 28.1) and the average SPS was 23.3% (95% CI: 23.0 to 23.6). The rank of countries according to SPS differed substantially from the rank according to CPS. Guatemala, Bangladesh, and Nepal had the biggest improvement in ranking according to SPS compared to CPS, while Gambia, Mali, and Senegal had the biggest decline in ranking. Guatemala had the largest difference between CPS and SPS with a CPS of 45.2 (95% CI: 43.7 to 46.9) and SPS of 14.1 (95% CI: 12.6 to 15.8). Senegal had the largest increase in the prevalence after standardizing maternal height, with a CPS of 28.8% (95% CI: 25.8 to 30.2) and SPS of 31.6% (95% CI: 29.5 to 33.8). SPS correlates better than CPS with other population-level measures of child health.Conclusions: Our study suggests that CPS is sensitive to adjustment for maternal height. Maternal height, while a strong predictor of child stunting, is not amenable to policy interventions. We showed the plausibility of SPS in capturing current exposures to undernutrition and infections in children.
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| 55. |
- Karlsson, Omar, et al.
(författare)
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Patterns in child stunting by age : A cross-sectional study of 94 low- and middle-income countries
- 2023
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Ingår i: Maternal and Child Nutrition. - 1740-8709. ; 19:4
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Tidskriftsartikel (refereegranskat)abstract
- Child stunting prevalence is primarily used as an indicator of impeded physical growth due to undernutrition and infections, which also increases the risk of mortality, morbidity and cognitive problems, particularly when occurring during the 1000 days from conception to age 2 years. This paper estimated the relationship between stunting prevalence and age for children 0-59 months old in 94 low- and middle-income countries. The overall stunting prevalence was 32%. We found higher stunting prevalence among older children until around 28 months of age-presumably from longer exposure times and accumulation of adverse exposures to undernutrition and infections. In most countries, the stunting prevalence was lower for older children after around 28 months-presumably mostly due to further adverse exposures being less detrimental for older children, and catch-up growth. The age for which stunting prevalence was the highest was fairly consistent across countries. Stunting prevalence and gradient of the rise in stunting prevalence by age varied across world regions, countries, living standards and sex. Poorer countries and households had a higher prevalence at all ages and a sharper positive age gradient before age 2. Boys had higher stunting prevalence but had peak stunting prevalence at lower ages than girls. Stunting prevalence was similar for boys and girls after around age 45 months. These results suggest that programmes to prevent undernutrition and infections should focus on younger children to optimise impact in reducing stunting prevalence. Importantly, however, since some catch-up growth may be achieved after age 2, screening around this time can be beneficial.
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| 56. |
- Karlsson, Omar, et al.
(författare)
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Prevalence of Children Aged 6 to 23 Months Who Did Not Consume Animal Milk, Formula, or Solid or Semisolid Food During the Last 24 Hours Across Low- and Middle-Income Countries
- 2024
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Ingår i: JAMA Network Open. - 2574-3805. ; 7:2
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE: The introduction of solid or semisolid foods alongside breast milk plays a vital role in meeting nutritional requirements during early childhood, which is crucial for child growth and development. Understanding the prevalence of zero-food children (defined for research purposes as children aged 6 to 23 months who did not consume animal milk, formula, or solid or semisolid food during the last 24 hours) is essential for targeted interventions to improve feeding practices.OBJECTIVE: To estimate the percentage of zero-food children in 92 low- and middle-income countries.DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study analyzed nationally representative cross-sectional household data of children aged 6 to 23 months from the Demographic and Health Surveys and the Multiple Indicator Cluster Surveys conducted between May 20, 2010, and January 27, 2022. Data were obtained from 92 low- and middle-income countries. Standardized procedures were followed to ensure data comparability and reliability. Both percentage and number of zero-food children were estimated.MAIN OUTCOMES AND MEASURES: The outcome studied was defined as a binary variable indicating children aged 6 to 23 months who had not been fed any animal milk, formula, or solid or semisolid foods during the 24 hours before each survey, as reported by the mother or caretaker.RESULTS: A sample of 276 379 children aged 6 to 23 months (mean age, 14.2 months [95% CI, 14.15-14.26 months]) in 92 low- and middle-income countries was obtained, of whom 51.4% (95% CI, 51.1%-51.8%) were boys. The estimated percentage of zero-food children was 10.4% (95% CI, 10.1%-10.7%) in the pooled sample, ranging from 0.1% (95% CI, 0%-0.6%) in Costa Rica to 21.8% (95% CI, 19.3%-24.4%) in Guinea. The prevalence of zero-food children was particularly high in West and Central Africa, where the overall prevalence was 10.5% (95% CI, 10.1%-11.0%), and in India, where the prevalence was 19.3% (95% CI, 18.9%-19.8%). India accounted for almost half of zero-food children in this study.CONCLUSIONS AND RELEVANCE: In this cross-sectional study of 276 379 children aged 6 to 23 months, substantial disparities in the estimates of food consumption across 92 low- and middle-income countries were found. The prevalence of zero-food children underscores the need for targeted interventions to improve infant and young child feeding practices and ensure optimal nutrition during this critical period of development. The issue is particularly urgent in West and Central Africa and India.
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| 57. |
- Karlsson, Omar, et al.
(författare)
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Refrigerator ownership and child health and nutrition in low- and middle-income countries
- 2023
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Ingår i: Global Food Security. - 2211-9124. ; 37
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Tidskriftsartikel (refereegranskat)abstract
- Undernutrition and diarrhea cause stunted growth and poor child health. Refrigerators allow consumption of perishable foods and reduce food contaminations causing diarrhea. This study used 188 Demographic and Health Surveys from 66 low- and middle-income countries with adjusted regressions and coarsened exact matching, comparing children within the same neighborhoods and narrow groups of household wealth, as well as other important variables, simultaneously. Children in households with a refrigerator had 0.08 (95% confidence interval: 0.03, 0.13) to 0.12 (95% confidence interval: 0.01, 0.23) greater height-for-age z-score. Results for diarrhea and complementary feeding of perishable foods were less robust, which may relate to shortcomings in these measures, although point estimates indicated beneficial effects, particularly at low socioeconomic status.
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| 58. |
- Karlsson, Omar, et al.
(författare)
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Socioeconomic and gender inequalities in neonatal, postneonatal and child mortality in India : A repeated cross-sectional study, 2005-2016
- 2019
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 73:7, s. 660-667
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Tidskriftsartikel (refereegranskat)abstract
- Background: In India, excess female under-5 mortality is well documented. Under-5 mortality is also known to be patterned by socioeconomic factors. This study examines sex differentials and sex-specific wealth gradients in neonatal, postneonatal and child mortality in India. Methods: Repeated cross-sectional study of nationally representative samples of 298 955 children 0-60 months old from the National Family Health Surveys conducted in 2005-2006 and 2015-2016. The study used logistic regression models as well as Cox proportional hazards models. Results: Overall, boys had greater neonatal mortality than girls and the difference increased between 2005-2006 and 2015-2016. Girls had greater postneonatal and child mortality, but the difference decreased between the surveys and was not statistically significant for child mortality in 2015-2016. A negative wealth gradient was found for all mortality outcomes. Neonatal mortality was persistently greater for boys. Girls had higher child mortality than boys at low levels of wealth and greater postneonatal mortality over much of the wealth distribution. The wealth gradient in neonatal mortality increased between surveys. Females had a stronger wealth gradient than boys for child mortality. Conclusion: Not distinguishing between neonatal, postneonatal and child mortality masks important gender-specific and wealth-specific disparities in under-5 mortality in India. Substantial gains towards the Sustainable Development Goals can be made by combating neonatal mortality, especially at low levels of wealth. Although impressive improvements have been made in reducing the female disadvantage in postneonatal and child mortality, concerted engagements are necessary to eliminate the gender gap - especially in poor households and in north India.
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| 59. |
- Kitsomboonloha, R., et al.
(författare)
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Selective growth of zinc oxide nanorods on inkjet printed seed patterns
- 2009
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Ingår i: Journal of Crystal Growth. - : Elsevier. - 0022-0248 .- 1873-5002. ; 311:8, s. 2352-2358
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Tidskriftsartikel (refereegranskat)abstract
- A method for the selective patterning of zinc oxide (ZnO) nanorods is presented that combines inkjet printing of zinc acetate precursors on a substrate used to form ZnO nanocrystallites that subsequently grow into nanorods in a reaction bath containing zinc acetate and hexamethylamine during a hydrothermal process. A total of 100 μm patterns were formed on glass substrates kept at fixed temperatures by printing dots that can also form lines, arrays and rectangular patterns through the use of a 50 μm printhead. Different concentrations of zinc acetate (0.1-1 M) ink-jetted onto the substrates led to the growth of 100 nm to 1 μm wide ZnO nanorods vertically out of the substrates. The length of the ZnO nanorods could be controlled by the concentration of the precursor solution during the hydrothermal process as well as the duration of growth process.
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| 60. |
- Kobayashi, Lindsay C., et al.
(författare)
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Education modifies the relationship between height and cognitive function in a cross-sectional population-based study of older adults in Rural South Africa
- 2019
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Ingår i: European Journal of Epidemiology. - : Springer. - 0393-2990 .- 1573-7284. ; 34:2, s. 131-139
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to estimate the relationship between height (a measure of early-life cumulative net nutrition) and later-life cognitive function among older rural South African adults, and whether education modified this relationship. Data were from baseline in-person interviews with 5059 adults40years in the population-based Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) study in Agincourt sub-district, South Africa, in 2015. Linear regression was used to estimate the relationship between height quintile and latent cognitive function z-score (representing episodic memory, time orientation, and numeracy), with adjustment for life course covariates and a height-by-education interaction. Mean (SD) height was 162.7 (8.9) cm. Nearly half the sample had no formal education (46%; 2307/5059). Mean age- and sex-adjusted cognitive z-scores increased from -0.68 (95% CI: -0.76 to -0.61) in those with no education in the shortest height quintile to 0.62 (95% CI: 0.52-0.71) in those with at least 8years of education in the tallest height quintile. There was a linear height disparity in cognitive z-scores for those with no formal education (adjusted =0.10; 95% CI: 0.08-0.13 per height quintile), but no height disparity in cognitive z-scores in those with any level of education. Short stature is associated with poor cognitive function and may be a risk factor for cognitive impairment among older adults living in rural South Africa. The height disparity in cognitive function was negated for older adults who had any level of education.
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