27 research outputs found
Factors associated with post-neonatal mortality - In rural parts of Faridabad District, Haryana (A community based case control study)
No full textDiarrhea, Stimulation and Growth Predict Neurodevelopment in Young North Indian Children
No full textBackground and Objective. Infants and young children in low to middle-income countries are at risk for adverse neurodevelopment due to multiple risk factors. In this study, we sought to identify stimulation and learning opportunities, growth, and burden of respiratory infections and diarrhea as predictors for neurodevelopment. Methods. We visited 422 North Indian children 6 to 30 months old weekly for six months. Childhood illnesses were assessed biweekly. At end study, we assessed neurodevelopment using the Ages and Stages Questionnaire 3rd ed. (ASQ-3) and gathered information on stimulation and learning opportunities. We identified predictors for ASQ-3 scores in multiple linear and logistic regression models. Results. We were able to explain 30.5% of the variation in the total ASQ-3 score by the identified predictors. When adjusting for child characteristics and annual family income, stimulation and learning opportunities explained most of the variation by 25.1%. Height for age (standardized beta: 0.12, p<.05) and weight for height z-scores (std. beta: 0.09, p<.05) were positively associated with the total ASQ-3 score, while number of days with diarrhea was negatively associated with these scores (std. beta: -0.13, p<0.01). Conclusion. Our results support the importance of early child stimulation and general nutrition for child development. Our study also suggests that diarrhea is an additional risk factor for adverse neurodevelopment in vulnerable children
The assessment of developmental status using the Ages and Stages questionnaire-3 in nutritional research in north Indian young children
No full textObjective and background: For large epidemiological studies in low and middle-income countries, inexpensive and easily administered developmental assessment tools are called for. This report evaluates the feasibility of the assessment tool Ages and Stages Questionnaire 3.edition (ASQ-3) “home procedure” in a field trial in 422 North Indian young children. Methods: ASQ-3 was translated and adjusted for a North Indian Hindi setting. Three examiners were trained by a clinical psychologist to perform the assessments. During the main study, ten % of the assessments were done by two examiners to estimate inter-observer agreement. During all sessions, the examiners recorded whether the scoring was based on observation of the skill during the session, or on caregiver’ s report of the child’ s skill. Intra class correlation coefficient was calculated to estimate the agreement between the raters and between the raters and a gold standard. Pearson product moment correlation coefficient and standardized alphas were calculated to measure internal consistency. Principal findings: Inter-observer agreement was strong both during training exercises and during the main study. In the Motor subscales and the Problem Solving subscale most items could be observed during the session. The standardized alphas for the total ASQ-3 scale across all ages were strong, while the alpha values for the different subscales and age levels varied. The correlations between the total score and the subscale scores were consistently strong, while the correlations between subscale scores were moderate. Conclusions/significance: We found that the translated and adjusted ASQ-3 “home procedure” was a feasible procedure for the collection of reliable data on the developmental status in infants and young children. Examiners were effectively trained over a short period of time, and the total ASQ scores showed adequate variability. However, further adjustments are needed to obtain satisfying alpha values in all subscales, and to ensure variability in all items when transferred to a North Indian cultural context
Prevalence and predictors of anemia in a population of North Indian children
No full textObjective: Anemia is an important health concern worldwide, particularly in poor populations such as in India. The objective of this study was to determine the prevalence and predictors of anemia and iron status. Methods: One thousand children ages 6 to 30 mo were included in a study undertaken in low- to middle-income neighborhoods in New Delhi, India. Children of Tigri and Dakshinpuri were identified through a community survey. Plasma concentrations of hemoglobin (Hb), soluble transferrin receptor (sTfR), folate, vitamin B12, and total homocysteine (tHcy) were measured. Predictors for plasma Hb concentration were identified in multiple linear regression models and considered significant if P-value <0.05. Results: The prevalence of anemia (Hb concentration <11 g/dL) was 69.6% (n = 696) whereas the prevalence of iron deficiency (elevated sTfR i.e., >4.7 nmol/L) was 31% (n = 309). The main predictors for Hb concentration were plasma concentrations of sTfR (standardized beta coefficient [β], -0.49; P < 0.001), folate (β, 0.15; P < 0.001), vitamin B12 (β, 0.10; P < 0.001), tHcy (β, -0.11; P < 0.001) among the biomarkers. Length-for-age Z score (β, 0.08; P = 0.002) and family income (β, 0.06; P = 0.027) also predicted Hb concentration. Conclusion: Anemia was common in this population. Iron, folate, and vitamin B12 status were important predictors for plasma Hb concentration. Improving the status of these nutrients might reduce the burden of childhood anemia in India
Associations between log (base2) days of diarrhea and changes in ASQ-scores.
No full text<p>The graphs were constructed using generalized additive models in R, the solid line depicts the association of the total ASQ-score and log (base2) days of diarrhea. The Y-axis is centered on the mean total ASQ-score. The shaded area spans the 95% confidence interval of this association.</p
Variables predicting ASQ-3 subscale score in North Indian children 12–36 months<sup>1</sup>.
No full text<p>*** p<.001,</p><p>** p<.01,</p><p>* p<.05, logistic regression P-value,</p><p><sup>1</sup> For the 422 assessed children, the mean subscales scores vary from 44.8 to 47.8, all with a range from 0 to 60.</p><p>Variables predicting ASQ-3 subscale score in North Indian children 12–36 months<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0121743#t003fn004" target="_blank"><sup>1</sup></a>.</p
Vitamin B-12, folic acid, and growth in 6- to 30-month-old children: a randomized controlled trial
No full textBackground: Folate and vitamin B-12 are important for growth. Many children in low- and middle-income countries have inadequate intakes of these nutrients. Methods: We undertook a randomized, placebo controlled double-blind trial in 1000 North Indian children, 6 to 35 months of age, providing twice the recommended daily allowance of folic acid and/or vitamin B-12, or placebo, daily for 6 months. By using a factorial design, we allocated children in a 1:1:1:1 ratio in blocks of 16. We measured the effect of giving vitamin B-12, folic acid, or the combination of both on linear and ponderal growth. We also identified predictors for growth in multiple linear regression models and effect modifiers for the effect of folic acid or vitamin B-12 supplementation on growth. Results: The overall effect of either of the vitamins was significant only for weight; children who received vitamin B-12 increased their mean weight-for-age z scores by 0.07 (95% confidence interval: 0.01 to 0.13). Weight-for-age z scores and height-for-age z scores increased significantly after vitamin B-12 supplementation in wasted, underweight, and stunted children. These subgrouping variables significantly modified the effect of vitamin B-12 on growth. Vitamin B-12 status at baseline predicted linear and ponderal growth in children not receiving vitamin B-12 supplements but not in those who did (P-interaction <.001). Conclusions: We provide evidence that poor vitamin B-12 status contributes to poor growth. We recommend studies with larger doses and longer follow-up to confirm our findings
Hierarchical Regression Analysis for variables predicting total ASQ-3 scores in North Indian children 12–36 months<sup>1</sup>.
No full text<p>*** p<.001,</p><p>** p<.01,</p><p>* p<.05,</p><p><sup>1</sup> For the 422 assessed children, the mean total ASQ-3 score was 231.9 (SD = 50) with scores ranging from a minimum of 30 to a maximum of 300.</p><p><sup><i>2</i></sup> All models are adjusted for child characteristics (age, sex and breastfeeding status), and annual family income,</p><p><sup><i>3</i></sup> unstandardized Beta coefficient,</p><p><sup><i>4</i></sup> standardized regression coefficient, Beta values for model 7 only.</p><p>Hierarchical Regression Analysis for variables predicting total ASQ-3 scores in North Indian children 12–36 months<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0121743#t002fn004" target="_blank"><sup>1</sup></a>.</p
A dose-escalation safety and immunogenicity study of live attenuated oral rotavirus vaccine 116E in infants: a randomized, double-blind, placebo-controlled trial
No full textBackground: Rotavirus infections cause ~122,000 deaths among Indian children annually. Methods: The neonatal rotavirus candidate vaccine 116E was tested in a double-blind, placebo-controlled dose-escalation trial in India. Two doses of the Vero cell-adapted vaccine were evaluated. One hundred eighty-seven infants received a vaccine dose of 1×104 focus-forming units (ffu) and 182 received a dose of 1×105 ffu in a 1:1 randomization with placebo recipients. Infants received the vaccine at 8, 12, and 16 weeks, separately from routine vaccines. Results: No significant differences in clinical adverse events or laboratory toxicity were observed between vaccine and placebo recipients. There were no vaccine-related serious adverse events. A 4-fold increase in rotavirus immunoglobulin A titer was observed in 66.7% and 64.5% of infants after the first administration and in 62.1% and 89.7% of infants after 3 administrations of doses of 1×104 ffu and 1×105 ffu, respectively; the differences between these groups and placebo recipients were statistically significant. Conclusions: Three administrations of vaccine doses of 1×104 ffu and 1×105 ffu were safe. The 1×105-ffu dose of 116E demonstrated a robust immune response after 3 administrations. These favorable results warrant further development of the vaccine candidate and provide optimism that vaccinating infants in the developing world will prevent serious sequelae of rotavirus infection
Associations between height for age z-scores and changes in ASQ-scores.
No full text<p>The graphs were constructed using generalized additive models in R, the solid line depicts the association of the ASQ-score and HAZ. The Y-axis is centered on the mean total ASQ-score. The shaded area spans the 95% confidence interval of this association.</p
