Zeitschriftenartikel zum Thema „Anemia Tanzania Nutritional aspects“

Background Malnutrition, anemia, micronutrient deficiency and parasitic infections continue to impact the nutritional status and health of children in lower-income countries. However, not enough data concerning this issue is available. The aim of this study was to assess the distribution of nutritional indicators, anemia and micronutrient deficiency and their underlying risk factors among schoolchildren in south-eastern Tanzania. Methodology/Principal findings This cross-sectional study enrolled primary schoolchildren aged 6–12 years from Kikwawila and Kiberege wards, Tanzania. In total, 471 schoolchildren underwent a physical examination and provided blood, stool and urine samples for an assessment of the levels of different micronutrients, nutritional and anemia status, and parasitic infection status. We employed bivariate and multivariate logistic regression to determine the association between nutritional statuses, anemia, micronutrient deficiency and parasitic infections. We found that 23.90%, 12.60% and 16.20% of schoolchildren were stunted, underweight and wasted, respectively. About 14.0% of schoolchildren were found to be anemic. Children diagnosed with Plasmodium falciparum infection were more likely to have low levels of ferritin (aOR: 10.40, 95% CI: 2.88-40.53) and elevated levels of serum soluble transferrin receptor (aOR: 3.59, 95% CI: 1.27-11.23), respectively. Vitamin A (34.71%) and vitamin B12 (8.79%) were the most prevalent micronutrients found to be deficient in diagnosed children. Finally, we found that schoolchildren attending the most rural schools were five times more likely to be diagnosed with at least one micronutrient deficiency (aOR: 5.04, 95% CI: 2.38–11.44). Conclusions/Significance Malnutrition, anemia and micronutrient deficiency still pose a significant health burden among schoolchildren living in rural Tanzania. To effectively tackle this burden, health interventions such as deworming, micronutrient supplementation, vector control, health education and access to clean water and improved sanitation should be strengthened and made sustainable.

Inadequate consumption of micronutrient-dense and protein-rich foods such as vegetables, legumes and meat is an important contributing cause for anemia and deficiencies of vitamin A and iron in rural communities of Tanzania and Mozambique. A cross-sectional study was conducted to assess the nutritional status (anthropometrics and hemoglobin) and diets in particular micronutrient intake of female and male pigeon pea farmers from Lindi, Tanzania, and Gurué, the Zambézia province of Mozambique. A total of 1526 farmers (669 from Tanzania, 857 from Mozambique) were studied, of whom 16% were overweight and 35% were anemic. The highest prevalence of overweight and anemia, at 35% and 48%, was observed in Tanzanian and Mozambican women, respectively. Overall, only a small proportion of women and men reached the recommended daily dietary intake of vitamin A (10%), iron (51%) and zinc (44%). Multiple regression models revealed that dark green leafy vegetables (DGLVs) highly predicted vitamin A intake, whereas legumes in Tanzania and starchy plants in Mozambique were actually the dominant sources of vitamin A. Cereals covered over half of the iron and the zinc intake in both countries. An increased consumption of micronutrient-rich DGLVs and legumes, while reducing the high amounts of refined maize or polished rice, is suggested to counteract the high prevalence of anemia and overweight among smallholder farmers in East and South Eastern Africa.

Learning achievement is generally related to aspects of knowledge while learning outcomes include aspects of student character formation. Factors that can improve learning achievement include students' nutritional status. This study aims to determine the relationship between nutritional status and student achievement at SMP IT Madina Samarinda. This research is an analytic observational study with a cross sectional approach. The research location is SMP IT Madina Samarinda. The population in this study were 138 female students. The sample size in this study was 57 female students who were taken by random sampling. Data processing used univariate and bivariate data analysis. The research results used Kendall's Tau B statistical test with p <0.05. There is no relationship between BMI/U nutritional status and learning achievement p value = 0.894 > α=0.05, there is no relationship between anemia nutritional status and learning achievement p value = 0.671> α=0.05 and there is no relationship between knowledge of anemia and anemia 0.244 >α = 0.05. There is no significant relationship between BMI/U nutritional status and student achievement at SMP IT Madina Samarinda.

Background: Anemia is a severe public health problem affecting more than half of children under five years of age in low-, middle- and high-income countries. The study aimed to determine the prevalence and factors associated with anemia among children under five years of age in northern Tanzania. Methods: This community-based cross-sectional study was conducted in Rombo district, Kilimanjaro region, northern Tanzania, in April 2016. Multistage sampling technique was used to select a total of 602 consenting mothers and their children aged 6-59 months and interviewed using a questionnaire. Data were analyzed using Stata version 15.1. We used generalized linear models (binomial family and logit link function) with a robust variance estimator to determine factors associated with anemia. Results: Prevalence of anemia was 37.9%, and it was significantly higher among children aged 6-23 months (48.3%) compared to those aged 24-59 months (28.5%). There were no significant differences in anemia prevalence by sex of the child. Adjusted for other factors, children aged 6-23 months had over two times higher odds of being anemic (OR=2.47, 95% CI 1.73, 3.53, p<0.001) compared to those aged 24-59 months. No significant association was found between maternal and nutritional characteristics with anemia among children in this study. Conclusion: Prevalence of anemia was lower than the national and regional estimates, and it still constitutes a significant public health problem, especially among children aged 6-23 months. The study recommends iron supplementation, food fortification, dietary diversification, and management of childhood illnesses interventions for mothers and children under two years.

Background: Anemia is a severe public health problem affecting more than half of children under five years of age in low-, middle- and high-income countries. We aimed to determine the prevalence and factors associated with anemia among children under five years of age in northern Tanzania. Methods: This was a community-based cross-sectional study conducted in Rombo district, Kilimanjaro region, northern Tanzania in April 2016. Multistage sampling technique was used to select a total of 602 consenting mothers and their children aged 6-59 months and interviewed using a questionnaire. Data were analyzed using Stata version 15.1. We used generalized linear models (binomial family and logit link function) with robust variance estimator to determine factors associated with anemia. Results: Prevalence of anemia was 37.9%, and it was significantly higher among children aged 6-23 months (48.3%) compared to those aged 24-59 months (28.5%). There were no significant differences in anemia prevalence by sex of the child. Adjusted for other factors, children aged 6-23 months had over two times higher odds of being anemic (OR=2.44, 95% CI 1.71, 3.49, p<0.001) compared to those aged 24-59 months. No significant association was found between maternal and nutritional characteristics with anemia among children in this study. Conclusion: Prevalence of anemia was lower than the national and regional prevalence but it still constitutes a significant public health problem, especially among children aged 6-23 months. Interventions such as iron supplementation, food fortification and dietary diversification and management of childhood illnesses in this setting should be targeted towards mothers and children less than two years.

Iron deficiency (ID) is the most frequent nutritional deficiency in the whole population worldwide, and the second most common cause of anemia in the elderly. The prevalence of anemia is expecting to rise shortly, because of an ageing population. Even though WHO criteria define anemia as a hemoglobin serum concentration <12 g/dL in women and <13 g/dL in men, several authors propose different and specific cut-off values for the elderly. Anemia in aged subjects impacts health and quality of life, and it is associated with several negative outcomes, such as longer time of hospitalization and a higher risk of disability. Furthermore, it is an independent risk factor of increased morbidity and mortality. Even though iron deficiency anemia is a common disorder in older adults, it should be not considered as a normal ageing consequence, but a sign of underlying dysfunction. Relating to the molecular mechanism in Iron Deficiency Anemia (IDA), hepcidin has a key role in iron homeostasis. It downregulates the iron exporter ferroportin, inhibiting both iron absorption and release. IDA is frequently dependent on blood loss, especially caused by gastrointestinal lesions. Thus, a diagnostic algorithm for IDA should include invasive investigation such as endoscopic procedures. The treatment choice is influenced by the severity of anemia, underlying conditions, comorbidities, and the clinical state of the patient. Correction of anemia and iron supplementation should be associated with the treatment of the causal disease.

Vegetable crops supply esseential vitamina and minerals for human nutrition and survival. However, most scientists concentrated their effort on crops low in nutrition value, causing much health problem in the developing world. In Asia alone, 300,000 children blind each year due to vitamin A deficiency and 40% population suffered from iron-deficient anemia. Their health and social consequence was unmeasurable. A practical remedy was to increase consumption of DGLVs through home garden program. Field experiment conducted in East-West Center in Hawaii documented that a 200 sq. ft. small garden could yield vegetable fulfilling RDA of 5 people 200% of vitamin A value and ascorbic acid, 27% iron and 9% protein. Promotion of home garden program requires research, training and education, codination, and policy support. Horticulturists should play important role on all these aspects. Seeds for Peace Project and proposal for establishing home garden training centers at different levels will be reported.

One of the most common problems with the area of health and nutritional research is the limited number of quality books available that can provide research methodology, health indicators and their trend in a single volume. Statistical Aspects of Community Health and Nutrition is a one of the problem-based text book which completely fulfils the gap and stands to our expectations. This book is a single but comprehensive resource on maternal and infant mortality, anemia especially in adolescents and women in reproductive age group and, their causes, prevention, evaluation and validation methods including 30 clusters design, logistic regression and findings of recent relevant studies. Despite above, author also discusses the food insecurity and hunger, tuberculosis, influenza like prevalent diseases, their hotspot and available estimates, techniques for analyzing multiple response data, and small area estimation.

Iron deficiency is defined as a condition in which there is not an adequate iron level necessary to maintain the normal physiologic functions. Having the magnitude of epidemics, anemia is a global public health problem, which affects both the emerging countries and the developed ones, with major consequences for human health and for social and economic development. Nowadays, iron deficiency and especially iron-deficiency anemia, remains one of the most severe and important nutritional deficiencies. Each group of age is vulnerable. Infants, small children, pre-school children and teenagers show a higher risk of iron deficiency. Accordingly, the World Health Organization developed an ample package of public health measures that approaches all the aspects related to iron deficiency and iron-deficiency anemia. Trying to diminish the prevalence of iron deficiency and iron deficiency anemia, the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) has synthesized in 2014 the recommendations used also at present for martial prophylaxis.

Abstract Over 3 million people in the United Staes aged 65 years and older are anemic. This condition is associated with significant functional impairment and, perhaps, increased mortality. In March 2004, the American Society of Hematology (in conjunction with the National Institute of Aging) convened a “blue ribbon” panel of twenty physicians who are experts on various aspects of this topic. This paper highlights important consensus concepts resulting from that meeting. In particular, four areas of thought are shared. First, the epidemiology of anemia in the elderly is reviewed, including its definition, its expression in different racial groups, and its wide-ranging manifestations. Second, the pathophysiology of anemia in the elderly is reviewed as pertains to three general etiological categories (nutritional, chronic diseases, and so-called “unexplained” anemias). Particular emphasis is given to pathophysiologic mechanisms of anemia that are potentially unique to this age group. Third, a practical approach to the diagnosis and management of anemia for this patient population for the practicing hematologist is provided. Finally, the public health implications of anemia in the elderly for key stakeholder constituencies will be discussed in the oral presentation.

The paper presents detailed zooarchaeological and taphonomic results on the Later Stone Age (LSA) faunal assemblage. The contributions of various taphonomic agents in the formation of the assemblage are accentuated. The assemblage is well-preserved and the majority of specimens are not highly weathered. Fluvial disturbance did not play a significant role and can be ruled out as a significant taphonomic agent in the formation. Results indicate that LSA humans exploited high-quality nutritional resources mainly of the large-sized animals and aquatic resources as extra sources of meat and fat. The assemblage preserves stone tools butchery marks (cut marks and percussion marks) and carnivore marks (tooth marks) albeit few. Overall, the faunal assemblage exhibits high anthropogenic inputs and marginal carnivore involvement. Keywords: Zooarchaeology; Taphonomy; Later Stone Age; Serengeti National Park; Loiyangalani; Tanzania

Inadequate consumption of micronutrient-dense foods such as vegetables and meat are an important contributing cause for anemia and deficiencies of iron and vitamin A in rural communities of Tanzania. A cross-sectional study was conducted in 2016 to examine nutritional and micronutrient status and their associations to the diet of female small-scale farmers in the sub-humid Kilosa (n = 333) and the semi-arid Chamwino (n = 333) districts, in the Morogoro and Dodoma region. An overall higher prevalence of overweight (19.7%) and obesity (7.1%) than of underweight (5.9%) was detected. Significantly more women in the two villages of Kilosa (27–40%) than in the two villages of Chamwino district (19–21%) were overweight/obese, but also more frequently had anemia (34–41% vs. 11–17%), iron deficiency (24–32% vs. 15–17%), and low serum retinol (21–24% vs. 8–9%). Overall, only a small proportion of women reached recommended daily micronutrient intakes: 27% for vitamin A, 17% for iron, 7% for zinc, and 12–38% for B-vitamins. The amount of dark green leafy vegetables (DGLV) consumed was the main determinant of vitamin A and iron intake by women in Chamwino and corresponded to higher hemoglobin, serum retinol and iron status than in the villages of the Kilosa district; in agreement, DGLV consumption also predicted iron and vitamin A intake in Kilosa district. DGLV consumed with wholemeal millet was advantageous in terms of women’s vitamin A and iron intake and status over the predominantly maize-rice-based diet lacking vegetables.

Dyslipidemia is a common nutritional and metabolic disorder in patients with chronic kidney disease. Accumulating evidence supports the hypothesis that prolonged metabolic imbalance of lipids leads to ectopic fat distribution in the peripheral organs (lipotoxicity), including the kidney, heart, and skeletal muscle, which accelerates peripheral inflammation and afflictions. Thus, lipotoxicity may partly explain progression of renal dysfunction and even extrarenal complications, including renal anemia, heart failure, and sarcopenia. Additionally, endoplasmic reticulum stress activated by the unfolded protein response pathway plays a pivotal role in lipotoxicity by modulating the expression of key enzymes in lipid synthesis and oxidation. Here, we review the molecular mechanisms underlying lipid deposition and resultant tissue damage in the kidney, heart, and skeletal muscle, with the goal of illuminating the nutritional aspects of these pathologies.

Background. Children with sickle cell anemia are at a higher risk of developing neurological sequelae like abnormal intellectual functioning, poor academic performance, abnormal fine motor functioning, and attentional deficits. There is a paucity of data about neurocognitive impairment among children with sickle cell anemia in Tanzania. Recognition of the magnitude of neurocognitive impairment will help to provide insight in the causative as well as preventive aspects of the same. Therefore, this study was carried out to determine the prevalence and factors associated with neurocognitive impairment in children with sickle cell anemia. Methods. This is a cross-sectional comparative study between children with SCA and a control group of the hemoglobin AA sibling. It was carried out in Muhimbili National Hospital during a five-month period. The Rey–Osterrieth Complex Figure test (ROCF) which is used to test memory and visual special functions and KOH block design tools that have been previously validated through another study locally were used. Additional information on demographic characteristics was also collected using a predetermined questionnaire. Proportions and comparisons of means were used to examine associations between neurocognitive impairment and independent variables for associated factors. Results. A total of 313 children were included in the final analysis. Among all the participants, the majority of the participants in the sickle cell group were of the age group 14-15 years (45.9%). In the comparison group, the majority were of the age group 9-10 years (43.8%). The neurocognitive scores in children with sickle cell anemia were significantly different from the normal siblings. In the copy ROCF, the neurocognitive function in SCA participants was 68.2% below the mean as compared to 45% of their counterparts, p≤0.001. Additionally, there was no difference in memory in children with SCA compared to normal siblings (14.8% vs. 12.5%, respectively, p=0.606). Children with SCA had a higher proportion of impaired IQ (85.4%) as compared to children without SCA (72.5%), and the difference was statistically significant, p=0.009. Factors associated with neurocognitive impairment were age above 13 years, BMI, and absenteeism from school. Conclusion and Recommendation. Children with SCA had more impairment in terms of copying and IQ. We recommend assessment at the younger age group, increased sample size in future studies, and long-term cohort follow-up.

Histoplasmosis is an uncommon opportunistic infection in human immunodeficiency virus (HIV) positive children. The most common form is primary disseminated histoplasmosis, characterized by persistent fever and failure to thrive. A 10-year-old HIV positive girl presented to the Baylor College of Medicine Children’s Foundation—Tanzania Mbeya Center of Excellence (COE) with ulcerated skin lesions and a violaceous facial rash. She also had persistent fevers, severe acute malnutrition, and severe anemia. At diagnosis, the patient was failing first line antiretroviral therapy (ART) with a cluster of differentiation 4 immune cells (CD4) of 24 cells/µL and an HIV viral load (VL) of 196,658 cp/mL. The patient was changed to a second line ART regimen (abacavir, lamivudine, and ritonavir-boosted lopinavir) and received nutritional support, blood transfusions, multiple antibiotics, and meticulous wound care. She also received comprehensive symptom management, psychosocial support, and emergency housing through the COE’s palliative care program. Biopsy of a lesion showed intracytoplasmic organisms consistent with Histoplasmosis capsulatum var capsulatum. The patient was treated with conventional amphotericin B and oral itraconazole and she achieved wound healing as well as immune reconstitution and HIV viral suppression. Amphotericin infusions were given as an outpatient despite the resource constraints of the setting in southwestern Tanzania. Histoplasmosis should be considered in the differential diagnosis of the immunocompromised host with unusual skin manifestations and persistent fever.

Abstrak: Pada era 4.0 terjadi persaingan yang ketat diberbagai aspek, diperlukan sumber daya manusia yang berkualitas. Dalam menghasilkan SDM yang berkualitas dapat terhambat karena kesehatan dan status gizi. Angka Kejadian anemia masih tinggi.Terutama pada wanita remaja, remaja rentanmengalami anemia karena sedang dalammasa transisi dan juga karena menstruasi. Anemia dapat disebabkan oleh beberapa faktordiantara nya kurang nya asupan gizi, selain itu pola menstruasi, pengetahuantentang anemia, anemia kekurangan zat besi bisa dipenuhi dengan mengkonsumsi zat fe, akan tetapimengkonsumsi suplemen yang mengandung zat besi dalam jumlah banyak dapatmerusak lapisan usus. Berdasarkan hasil penelitian yang telah dilakukan oleh penulis bahwa kacang hijau dan kacang kedelai dapat meningkatkan kadar hemoglobin dan saturasi oksigen dalam darah, maka tujuan pengabdian masyarakat ini untuk meningkatkan pengetahuan remaja tentang anemia. Metode pelaksanaan adalah dengan melakukan pemeriksaan gratis tekanan darah, pemeriksaan HB dan pemeriksaan saturasi oksigen, kemudian memlakukan pendidikan kesehatan sesuai hasilpenelitian yang telah dilakukan. Hasil kegiatan pengabdian masyarakat pre test pengetahuan remaja 60.98% dalam kategori baik, 34.15% kategori cukup, 4.87% kategori kurang, post test 82.93% kategori baik, 17.07% kategori cukup. Terdapat perubahan pengatahuan remaja sebelum dan sesudah pendidikan kesehatan. Pengetahuan remaja setelah dilakukan pengabdian masyarakat menjadi lebih tahu tentang efektivitas kacang hijau dan kacang kedelai. Yang lebih efektif dalam meningkatkan kadar hemoglobin dan saturasi oksigen adalah kacang hijau.Abstract: In the era of 4.0, there was intense competition in various aspects, it required quality human resources. In producing quality human resources, it can be hampered by health and nutritional status. The incidence of anemia is still high. Especially in adolescent women, adolescents are prone to experiencing anemia because they are in a transitional period and menstruation. Anemia can be caused by several factors, including lack of nutritional intake, besides menstrual patterns, knowledge of anemia, iron deficiency anemia can be met by consuming iron, but taking supplements that contain large amounts of iron can damage the intestinal lining. Based on the results of research conducted by the author that green beans and soybeans can increase hemoglobin levels and oxygen saturation in the blood, this community service aims to increase adolescent knowledge about anemia. The research method is to do a free blood pressure check, HB examination, and oxygen saturation check, then apply health education according to the research results. The results of community service activities pretest adolescent knowledge 60.98% in the excellent category, 34.15% in enough category, 4.87% in the low category, 82.93% in the outstanding category, 17.07% in the excellent category. There were changes in adolescent knowledge before and after health education. Community service becomes more aware of the effectiveness of green beans and soybeans. Mung beans are more effective at increasing hemoglobin levels and oxygen saturation.

Growth failure is almost inextricably linked with chronic kidney disease (CKD) and end-stage renal disease (ESRD). Growth failure in CKD has been associated with both increased morbidity and mortality. Growth failure in the setting of kidney disease is multifactorial and is related to poor nutritional status as well as comorbidities, such as anemia, bone and mineral disorders, and alterations in hormonal responses, as well as to aspects of treatment such as steroid exposure. This review covers updated management of growth failure in these children including adequate nutrition, treatment of metabolic alterations, and early administration of recombinant human growth hormone (GH).

Breast-feeding and weaning practices were observed for a cohort of 81 children under 3 years of age in the context of a longitudinal study of social, ecological and nutritional factors affecting growth in a semi-nomadic population of pastoralists in northern Tanzania (WaDatoga of Mbulu District). The adequacy of indigenous infant and young child feeding practices was assessed in relation to current international recommendations. Objectives were to provide baseline data for future investigations of any changes in young child feeding practices which accompany population shifts towards settlement and non-pastoral modes of subsistence, and to improve understanding of the strengths and limitations of indigenous feeding practices in this type of population. It was found that while breast-feeding was universally initiated, other aspects of young child feeding practices do not meet current international recommendations. Prelacteal feeds are commonly used, supplementary feeding with non-human milks usually occurs before 4 months of age, use of solid foods normally begins later than 6 months, and breast-feeding does not continue until 2 years of age for the majority of children. The data have implications for the design of breast-feeding promotion and improved weaning food interventions among African pastoralists.

Available evidence suggests that trace elements, such as zinc, once thought to have no nutritional relevance, are possibly deficient in large sections of the human population. Conditioned deficiencies have been reported to result from malabsorption syndromes, acrodermatitis enteropathica, alcoholism, gastrointestinal disease, thermal injury, chronic diseases (eg, diabetes, sickle cell anemia), and in total parenteral nutrition therapy. Awareness that patients with these problems are at risk has led health professionals to focus increasingly on the importance of zinc therapy in the prevention and treatment of deficiency. More recently zinc toxicity and its role in human nutrition and well-being have come under investigation. Reports have focused on the role of zinc toxicity in causes of copper deficiency, changes in the immune system and alterations in blood lipids. As the numerous challenges presented by the study of zinc in human nutrition are met, more appropriate recommendations for dietary and therapeutic zinc intake are being made.

Background Evaluation of agricultural research often neglects consumption and nutrition aspects. Yet agricultural research can address micronutrient malnutrition by improving both quantity and quality of food intake. Objective To briefly review the conceptual linkages between agriculture and nutrition, to estimate the strength of the relationship between iron intake and productivity outcomes, and to estimate the nutritional benefit of improved mungbean varieties in terms of net present value. This paper presents a methodology for assessing the nutritional impact of mungbean, and summarizes current impact evidence on the path from mungbean research to consumption. Methods A consumption study was conducted among female piece-rate workers in Pakistan to analyze the impact of iron consumption on productivity, measured in wages. A two-stage least-squares analysis was used to estimate the elasticity of iron intake on wages. The results derived from this study were extrapolated to country level using secondary data sources. Results We found that anemia among women was widespread. Approximately two-thirds of women suffered from mild or severe anemia (Hb < 12 g/dL). We found the elasticity of bioavailable iron on productivity measured in wages was 0.056, and the marginal effect was 9.17 Pakistani rupees per additional mg of bioavailable iron consumed. Using the model results we estimated the impact of mungbean research on nutrition, in terms of productivity effects, and found it was substantial, ranging from US$7.6 to 10.1 million cumulative present value (in 1995 US$ at 5% discount rate). Conclusions Agriculture certainly plays an important role in the reduction of malnutrition. Agricultural research has greatly contributed to the reduction of hunger and starvation by providing millions of hungry people with access to low-cost staple foods. Now, as the challenge shifts to the reduction of micronutrient deficiencies, more efforts must be directed toward crops high in micronutrients, such as pulses and vegetables.

Background Cerebral palsy is an extremely severe brain injury associated with multiple nutritional and clinical issues, such as underweight, gastroesophageal reflux, constipation, and nutrient deficiency. Evidence-based dietary and nutritional interventions may improve the quality of life of children with cerebral palsy. Aim Systematically review randomized clinical trials evaluating nutritional and dietary interventions in the clinical, nutritional, and neurodevelopmental aspects of children with cerebral palsy. Methods A search was performed in electronic databases (LILACS, Medline, Web of Science, Embase, Scopus, Cochrane Library, ClinicalTrials.gov, Brazilian Digital Library of Theses and Dissertations, ProQuest Dissertations and Theses Database, OpenGrey) using keywords. The search was firstly performed in May 2020 and updated on June 18th, 2021. Eligible studies were randomized clinical trials, that included children between 2 and 12 years old, and evaluated the effect of nutritional or dietetic interventions on clinical, nutritional or neurodevelopmental outcomes. Risk of bias was investigated using the RoB-2 tool. The study was registered on PROSPERO (CRD42020181284). Results Fifteen studies were selected. Positive results included the use of whey-based or pectin-enriched enteral formulas for gastroesophageal reflux (n = 6); 25-hydroxy-vitamin D supplementation for hypovitaminosis D (n = 2); supplementation with lipid mixture or diet with high-density energy for improvements in anthropometric measures (n = 2); supplementation with probiotics, prebiotics, symbiotics or magnesium for constipation (n = 2); nutritional support system for gross motor function (n = 1); lactoferrin and iron hydroxide polymaltose for iron deficiency anemia (n = 1); and educational intervention to improve feeding skills (n = 1). The overall risk of bias was high for 60% of the studies, and some concerns were raised for the remaining 40%. Conclusion Some promising dietary and nutritional interventions may promote important clinical improvements for patients with cerebral palsy. However, evidence is weak, as few clinical trials have been published with many methodological errors, leading to a high risk of bias.

Background: Anemia in pregnancy is a major public health problem especially in Low and Middle-income countries (LMIC) including Ghana and is defined by the World Health Organization (WHO) as being present when the hemoglobin concentration in the peripheral blood is 11g/dl or less. In most African countries anemia in pregnancy occurs if the hemoglobin concentration falls below 10g/dl. Pregnant women are at a higher risk of developing anemia due to several factors such as hemodilution, nutritional factors, multiple gestation, socio-economic status and malaria infestation. Anemia in pregnancy is an important cause of maternal mortality and affects half of pregnant women worldwide; with 56% of West African pregnant women being anemic. The objective of this study is to assess the prevalence and identify the risk factors associated with anemia among pregnant women receiving antenatal care at the West Gonja Hospital(WGH) Methods: A cross-sectional was conducted with 136 pregnant women receiving antenatal care at the WGH between January 2017 to February 2018. Random sampling was used to select participants and data was collected using a structured questionnaire. Data was analyzed using the SPSS Version 24.0. Results: A total 71(52.2%) of the study population were anemic, while 65 (47.8%) were not anemic. 20(74.1%) of the 27 pregnant housewives were anemic, while 11(64.7%) of the pregnant farmers were anemic. 27 (96.4%) of the 28 pregnant women who took their iron/folate supplement only some few days were anemic. 12 (100%) of the 12 participants who took their iron/folate supplement a few times a week were anemic. 4 (80%) of the 5 participants who never took their iron/folate supplement were anemic. 21 (70%) of those who did not sleep under ITN were anemic. 33 (84.6%) of the 39 patients who were diagnosed with malaria were also anemic. 28 (87.5%) of the 32 participants who took only 2 meals a day were anemic. 27 (79.4%) of the 34 patients who took liver, beef, chicken and fish only twice weekly were anemic. 15 (88.2%) of the 17 patients who drank tea some days in a week were anemic. Conclusion: Although most of the pregnant women were adequately educated on the most relevant aspects of anemia in pregnancy, more than half of them were still anemic. Anemia was more prevalent among pregnant uneducated housewives with poor nutritional habits. All the pregnant sickle cell disease patients as well as those diagnosed with malaria were also anemic.

Background: Anemia in pregnancy is a major public health problem especially in Low and Middle-income countries (LMIC) including Ghana and is defined by the World Health Organization (WHO) as being present when the hemoglobin concentration in the peripheral blood is 11g/dl or less. In most African countries anemia in pregnancy occurs if the hemoglobin concentration falls below 10g/dl. Pregnant women are at a higher risk of developing anemia due to several factors such as hemodilution, nutritional factors, multiple gestation, socio-economic status and malaria infestation. Anemia in pregnancy is an important cause of maternal mortality and affects half of pregnant women worldwide; with 56% of West African pregnant women being anemic. The objective of this study is to assess the prevalence and identify the risk factors associated with anemia among pregnant women receiving antenatal care at the West Gonja Hospital (WGH) Methods: A cross-sectional was conducted with 136 pregnant women receiving antenatal care at the WGH between January 2017 to February 2018. Random sampling was used to select participants and data was collected using a structured questionnaire. Data was analyzed using the SPSS Version 24.0. Results: A total 71(52.2%) of the study population were anemic, while 65 (47.8%) were not anemic. 20(74.1%) of the 27 pregnant housewives were anemic, while 11(64.7%) of the pregnant farmers were anemic. 27 (96.4%) of the 28 pregnant women who took their iron/folate supplement only some few days were anemic. 12 (100%) of the 12 participants who took their iron/folate supplement a few times a week were anemic. 4 (80%) of the 5 participants who never took their iron/folate supplement were anemic. 21 (70%) of those who did not sleep under ITN were anemic. 33 (84.6%) of the 39 patients who were diagnosed with malaria were also anemic. 28 (87.5%) of the 32 participants who took only 2 meals a day were anemic. 27 (79.4%) of the 34 patients who took liver, beef, chicken and fish only twice weekly were anemic. 15 (88.2%) of the 17 patients who drank tea some days in a week were anemic. Conclusion: Although most of the pregnant women were adequately educated on the most relevant aspects of anemia in pregnancy, more than half of them were still anemic. Anemia was more prevalent among pregnant uneducated housewives with poor nutritional habits. All the pregnant sickle cell disease patients as well as those diagnosed with malaria were also anemic.

Ageing is the multidimensional process in humans with changes occurring in physical, psychological and social aspects which increase their proneness to health ailments. The associated functional impairment and physical inability will influence on their absorption and metabolism leading to the changes in nutritional status. Epidemiological study was conducted among the elderly subjects with respective to understand the quality of health in relation to the nutritional profile. Using a purposive randomized sampling technique, the elderly subjects were selected and assessed for the nutrition and health condition. The investigation comprises approximately 90 subjects of old age institutions and 90 subjects of residents from different domiciles. The study was conducted using standardized validated tools and checklist with oral interview technique and one to one interactions. Findings: In accordance with the body mass evaluation; approximately 59% elderly living at own houses were under Grade 1, Grade 2 and Grade 3 obesity in comparison to their counterpart. Medical health records indicated iron deficiency anemia among 10% of subjects. Gastritis, Diabetes, hypertension, arthritis was observed to be the major health problems. Comparatively 64% male elderly from household had oral problems and underwent for dentures. Often had three meal patterns in a day. Henceforth, there is a need to understand and address on the nutritional needs, etiology and demographic characteristics interlinked with comorbidities and health disabilities among aging population. Evidently a significant association was noticed between nutritional status on morbidities and health quality among elderly. Key words: Old age home, elderly, Ageing, nutritional profile, quality of health.

Background Malnutrition and malaria are common co-morbidities in low-income countries, especially among under-fives children. But the malnutrition situation in Masasi and Nanyumbu districts, its interaction with malaria infection and the influence of socioeconomic factors are not well understood. Methods Children aged between 3–59 months in Masasi and Nanyumbu were screened for nutritional status and malaria infection in the community. Nutritional status was determined using age and anthropometric parameters. Z-scores (weight for age (WAZ), height for age (HAZ) and weight for height (WHZ)) were calculated based on the World Health Organisation (WHO) growth reference curves. Malaria infection was determined using malaria rapid diagnostic test and microscopy. Hemoglobin concentration was assessed using HemoCue spectrophotometer, and anemia was classified as hemoglobin concentration < 11.0g/dL. Structured questionnaire was used to collect socio- demographic information electronically. Results A total of 2242 children, 1539 (68.6%) from Masasi and 1169 (52.1%) females were involved in the study. The mean z-scores (WAZ = -0.60 and HAZ = -1.56) were lower than the WHO reference population. The overall prevalence of malnutrition was 49%, and it was significantly higher in Nanyumbu (52.5%) than in Masasi (47.3%), (x2 = 5.045, p = 0.025). Prevalence of malnutrition was higher in boys (53.0%) than in girls (45.0%) (x2 = 13.9, p < 0.001). Stunting was the most prevalent component of undernutrition; it was slightly prevalent in Nanyumbu (46.5%) compared to Masasi (42.0%), (x2 = 3.624, p = 0.057) and in boys (48.2%) than in girls (39.1%), x2 = 17.44, p<0.001. Only 15.8% of the undernourished children had malaria infection. Sex, age group and anaemia were significantly associated with undernourishment (p<0.05), while district and malaria infection were marginally (p≤0.06) associated with undernourishment. None of the undernutrition indices was associated with malaria infection. Conclusion Undernutrition was highly prevalent in the study population and was influenced sex, age, anaemia and malaria infection. More emphasis is needed to address the malnutrition problem especially stunting in Masasi and Nanyumbu districts.

ABSTRACTAnemia is one of the major nutritional problems in Asia, including Indonesia. According to Rikesdas 2018 data, anemia in young women (27.2%) is higher than in young men (20.3%). The utilization that can overcome anemia is that local shellfish contain protein, one of which can overcome anemia, while red beans contain protein and iron which can increase hemoglobin (Hb) levels in the body of young women. This study aims to determine the results of organoleptic tests and the content of protein and iron in bakpao substitution of local clam flour with red bean paste filling for anemia sufferers in young women. This research was carried out at the Department of Nutrition, Poltekkes, Ministry of Health, Makassar on March 23-31, 2022. The method in this study is Pre-Experiment with a Post Test Group Design research design. The panelists for the hendonic test were 35 panelists of poltekkes students of the Ministry of Health Makassar, for the protein and iron analysis test carried out in the Quality Control laboratory of SMK SMTI Makassar.The results showed that based on the Kruskall Wallis test there was no difference in the aspects of aroma (p = 0.64) and texture (p = 0.131), while for the aspects of color and taste there was a difference between F1, F2 and F3. The protein content in F1 products is (538.5%), while the iron content in F1 products is (111.8 ppm). It is necessary to conduct further studies on the use of steamed bun products to overcome anemia in young women by using other flours and other fillings that contain high levels of protein and iron.Keywords : Steamed Buns, Local Shellfish, Kidney Beans, Anemia, Protein and Iron.ABSTRAKAnemia merupakan salah satu masalah gizi utama di Asia, termasuk Indonesia. Menurut data Rikesdas 2018, anemia pada remaja putri (27,2%) lebih tinggi dibandingkan dengan remaja putra (20,3%). Adapun pemanfaatan yang dapat mengatasi anemia yaitu kerang lokal mengandung protein yang salah satunya dapat mengatasi anemia, sedangkan kacang merah mengandung protein dan zat besi yang dapat meningkatkan kadar hemoglobin (Hb) pada tubuh remaja putri. Penelitian ini bertujuan untuk mengetahui hasil uji organoleptik dan kandungan protein dan zat besi pada bakpao substitusi tepung kerang lokal dengan isian pasta kacang merah bagi penderita anemia pada remaja putri. Penelitian ini dilaksanakan di Jurusan Gizi Poltekkes Kemenkes Makassar pada tanggal 23 – 31 Maret 2022. Metode dalam penelitian ini adalah Pra Eksperimen dengan desain penelitian Post Test Group Design. Adapun panelis untuk uji hendonik sebanyak 35 panelis mahasiswa Poltekkes Kemenkes Makassar, untuk uji analisis protein dan zat besi dilaksanakan di laboratorium Quality Control SMK SMTI Makassar. Hasil penelitian menunjukkan bahwa berdasarkan uji Kruskall Wallis tidak ada perbedaan terhadap aspek aroma (p=0,64) dan tekstur (p=0,131), sedangkan untuk aspek warna dan rasa ada perbedaan antara F1, F2 dan F3. Untuk kandungan protein pada produk F1 sebesar (538,5%), sedangkan kandungan zat besi pada produk F1 sebesar (111,8 ppm). Perlu dilakukan studi lanjut mengenai pemanfaatan produk bakpao untuk mengatasi anemia pada remaja putri dengan menggunakan tepung lain dan isian lain yang mengandung tinggi kadar protein dan zat besi.Kata Kunci : Bakpao, Kerang Lokal, Kacang Merah, Anemia, Protein dan Zat Besi.

Malnutrition in hospitals is often overlooked, underdiagnosed, and untreated. Malnourished patients have increased risk for infection and pressure injuries, longer duration of mechanical ventilation, anemia, depressed cardiac and respiratory functions, and an overall higher risk for mortality. These complications contribute to longer hospital stays and higher health care costs. The benefits of early nutritional support in hospitals may be enhanced by use of a new nutrition care bundle that addresses all aspects of nutrition assessment and intervention. The bundle has 6 main components: assessment of malnutrition, initiation and maintenance of enteral nutrition, reduction of aspiration, implementation of enteral feeding protocols, avoiding the use of gastric residual volumes, and early initiation of parenteral nutrition when enteral feedings cannot be initiated. Implementing the nutrition bundle can help ensure that patients receive adequate nutrition during their hospital stay, thereby reducing adverse outcomes.

INTRODUCTION Iron deficiency anemia (IDA) affects approximately 3% of children 1 to 3 years of age and is associated with poor neurocognitive outcomes. Children of Hispanic/Latino ethnicity, from primarily Spanish-speaking homes, and/or those of low socioeconomic status, are disproportionately affected. Oral iron therapy for 3 to 6 months is considered standard care therapy and mitigates these effects. Yet non-adherence often results in treatment failure, prolonging the treatment course and negative health consequences of IDA. Limited previous work has focused on interventions to improve adherence to iron therapy. Behavior change interventions, particularly when designed within a theoretical framework, can improve rates of treatment adherence. Our objective was to design a theoretically-based behavioral intervention to improve adherence to oral iron therapy in young children with nutritional IDA. METHODS Formative research was conducted via a mixed-methods study of 20 children with nutritional IDA and their primary caretaker. Demographic information, including number of children and caregivers in the home, was obtained from the primary caregiver. Clinical aspects of patients' IDA diagnosis and iron therapy were obtained from the electronic medical record. Semi-structured interviews with caregivers were conducted to characterize barriers to and facilitators of iron therapy. A framework for a technology-based intervention, named IRONCHILD, was created to coincide with clinical visit time points over a three-month period. Results from the formative research, along with constructs from the self-determination theory of motivation (autonomy, competence, relatedness), informed message content for the intervention scripts. This theory was selected because the degree to which its three principle constructs (basic psychological needs) are met drives levels of motivation to perform a specific behavior such as medication adherence. Three scripted online intervention sessions were developed, professionally translated into Spanish, and then animated by a professional animation and web design studio. Audio recording with a professional bilingual voice actor provided the narration for online sessions. RESULTS IRONCHILD is an interactive website with specific message content designed to be delivered at three standard of care clinical visits (Figure). At the initial visit, participants are introduced to a relational agent or virtual health educator, Maria, who is a pediatric nurse and mother of a child formerly treated for IDA. Maria provides an introduction to the overall program format and content and guides each session. Participants next view a Topic Introduction animation that provides an overview of the diagnosis of IDA, its clinical consequences, and a typical treatment course with oral iron therapy. This is followed by two unique content segments that provide information on (1) dietary counseling and (2) administration of oral iron therapy. Following each of the content segment, participants view question/response options, make a selection, and receive feedback. At the end of the session, participants select goal(s) related to therapy adherence for the interval between clinical visits. The second session provides two additional content segments that focus on (1) problem-solving for difficulties related to medication administration and (2) identifying motivating factors to adhere to therapy. The third session allows users to access all previous content and provides closing information about adhering to any ongoing treatment recommendations from their child's provider. Between visits, access to the website occurs via a unique username and password caregivers can use to logon to the website and view previous sessions. All aspects of IRONCHILD are available in both English and Spanish. Finally, an administrative dashboard for IRONCHILD captures program usage information as families log onto the program and navigate the sessions (e.g., number of log-ins; responses to question prompts; goals set; goal attainment). CONCLUSIONS IRONCHILD is a theoretically-based online intervention designed to improve adherence to oral iron therapy in caregivers of young children with nutritional IDA. Further research is needed to assess the effectiveness of the intervention on adherence as well as factors that affect implementation into routine clinical care.

The authors focus iron intake regulation in the body and the probable mechanisms related to iron absorption. They analyze the impact of iron absorption deficiency resulting in iron deficiency anemia, a public health issue of great impact in the world influencing child and maternal health risk increase. This paper aims at highlighting the problems affecting the uptake or inhibiting processes of iron absorption in an attempt to correlate information on conditioning factors and current findings. This study is a document based descriptive study comprising literature review. In food, iron has different forms, such as the heme and non-heme forms following different absorption pathways with different efficiency rates, depending on conditioning factors, such as diet profile, physiological aspects, iron chemical state, absorption regulation, transportation, storing, excretion and the presence of disease, They also discuss the current difficulties in dealing with iron nutritional deficiency in vulnerable groups, children and pregnant women, and focus data on iron consumption, adhesion to breast feeding and the frequency of prenatal care visits.

ABSTRACTObjective: to determine the nutritional guidance during prenatal visits with a focus on health promotion, using as basis the concept of primary health care. Method: this is about a descriptive-exploratory study from qualitative approach. Data were collected through interviews, after signing an informed consent, conducted from October 2002 to March 2003, with five nurses during the prenatal visits in the Family Health units in Recife-PE city, totaling 14 sessions. Data were analyzed according to analysis of manifest content. The study was approved by the Committee of Ethics in Research of Agamenon Magalhães Hospital in meeting 26/02/2008. Results: from the interviews analysis, we observe the presence of nutritional counseling during prenatal consultation with emphasis on the feeding habits of food intake and the use of ferrous sulfate to treat anemia. The guidelines had a speech centering, biological and content way without considering the choice of the pregnant woman´s autonomy to care. Conclusion: it was possible to verify that the guidelines do not dazzle aspects of health promotion in primary care perspective. The actions were guided from the technical and scientific know without examining the choices of the pregnant woman to achieve the benefits of the care and maintenance of health through healthy eating habits. Descriptors: prenatal care; nursing; nutrition education; health promotion.RESUMOObjetivo: verificar as orientações nutricionais durante a consulta pré-natal com enfoque na promoção da saúde, utilizando-se como base o conceito de atenção primária de saúde. Método: trata-se de estudo descritivo, exploratório com abordagem qualitativa. Os dados foram coletados por meio de entrevistas gravadas, após a assinatura do termo de consentimento livre e esclarecido, realizadas entre outubro de 2002 a março de 2003, com cinco enfermeiras durante a consulta pré-natal em unidades de Saúde da Família em Recife–PE, totalizando 14 atendimentos. Os dados foram analisados segundo a análise do conteúdo manifesto. Este estudo foi aprovado pelo Comitê de Ética do Hospital Agamenon Magalhães-PE na reunião do dia 26/02/2008. Resultados: a partir da análise da entrevistas, observam-se a presença da orientação nutricional durante as consulta de pré-natal com ênfase para o hábito alimentar na ingestão dos alimentos e o uso do sulfato ferroso no tratamento da anemia. As orientações tinham um discurso centralizador, biologicista e conteudista sem considerar as escolhas da gestante para a autonomia do cuidado. Conclusão: foi possível verificar que as orientações não deslumbram aspectos da promoção da saúde na perspectiva da atenção primária. As ações eram norteadas a partir do saber técnico científico sem apreciar as escolhas da gestante para alcançar os benefícios do cuidado e da manutenção da saúde através de hábitos alimentares saudáveis. Descritores: cuidado pré-natal; enfermagem; educação nutricional; promoção em saúde. RESUMENObjetivo: determinar la orientación nutricional durante las visitas prenatales con un enfoque en la promoción de la salud, utilizando como base el concepto de atención primaria de salud. Método: el estudio de enfoque descriptivo, exploratorio y cualitativo. Los datos fueron recolectados a través de entrevistas, después de firmar un consentimiento informado, realizado entre octubre de 2002 y marzo de 2003 con cinco enfermeras durante las visitas prenatales en las unidades de Salud de la Familia en Recife-PE, por un total de 14 sesiones. Los datos fueron analizados de acuerdo con el análisis de contenido manifiesto. El estudio fue examinado por el Comité de Ética en Pesquisas con seres humanos del Hospital Agamenon Magalhães en la reunión de 26/02/2008. Resultados: a partir del análisis de las entrevistas, se observa la presencia de orientación nutricional durante la consulta prenatal con énfasis en los hábitos alimenticios de la ingesta de alimentos y el uso de sulfato ferroso para tratar la anemia. Las directrices había un discurso centrado, forma biológica y el contenido sin tener en cuenta las decisiones de la autonomía de la mujer embarazada a la atención. Conclusión: se pudo verificar que las directrices no deslumbrar a los aspectos de promoción de la salud en la perspectiva de la atención primaria. Las acciones se orientaron de la técnica y los conocimientos científicos sin examinar las opciones de la mujer embarazada para lograr los beneficios del cuidado y mantenimiento de la salud a través de hábitos alimenticios saludables. Descriptores: atención prenatal; enfermería; educación nutricional; promoción de la salud.

Abstract Objectives Background: In 2007 the Bill and Melinda Gates Foundation (BMGF) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) collaborated to address concerns about the safety and efficacy of interventions to prevent and treat nutritional iron deficiency (NID) particularly in the context of malaria. The “Iron and Malaria Project” (IMP) addressed how iron might not be safe, iron assessment, and the value of interventions to address NID. This presentation will: Describe the novel approach used to achieve the IMP goals, describe the IMP accomplishments and impacts, and summarize lessons learned. Methods The IMP had: 1) Research Track: NICHD initiated 2 funding opportunity announcements resulting in 10 funded projects; 2) Translation Track: a) consultations with global stakeholders; b) risk: benefit analyses on the use of interventions to prevent and treat NID; c) a collaboration with the CDC to develop standards for a sTfR assay; d) the BOND project to harmonize the process for discovery, development and deployment of nutrient biomarkers; e) the INSPIRE project, a review of extant evidence on reciprocal relationships between nutrition and inflammation; and f) the BRINDA project, a collaboration with the CDC, GAIN, and WHO to study the impact of inflammation on interpretation of biomarkers of iron and other determinants of anemia and develop approaches to account for this interaction. Results Funded grants included 4 basic science projects exploring mechanisms to explain iron and malaria interactions and 6 clinical studies addressing various aspects of the iron malaria relationship. To date, 72 journal publications have resulted. Using the NIH Relative Citation Ratio metric, 2/3 have scientific influence scores ≥the 50th percentile of all NIH-funded research publications and 15 have scores ≥ the 90th percentile. Conclusions The IMP leveraged the attributes of this public-private partnership between BMGF and NICHD/NIH to accomplish its goals. The partnership's complementarity and synergy resulted in broad traction and collaboration with a global community invested in solving the challenges of iron and malaria. Funding Sources BMGF $9.3 million, NIH Office of Dietary Supplements $1.3 million.

Background Coronavirus disease (COVID-19) has a severe impact on all aspects of patient care. Among the numerous biomarkers of potential validity for diagnostic and clinical management of COVID-19 are biomarkers at the interface of iron metabolism and inflammation. Methods The follow-up study included 54 hospitalized patients with laboratory-confirmed COVID-19 with a moderate and severe/critical form of the disease. Iron deficiency specific biomarkers such as iron, ferritin, transferrin receptor, hepcidin, and zinc protoporphyrin (ZnPP) as well as relevant markers of inflammation were evaluated twice: in the first five days when the patient was admitted to the hospital and during five to 15 days; and their validity to diagnose iron deficiency was further assessed. The regression and Receiver Operating Characteristics (ROC) analyses were performed to evaluate the prognosis and determine the probability for predicting the severity of the disease in the first five days of COVID-19. Results Based on hemoglobin values, anemia was observed in 21 of 54 patients. Of all iron deficiency anemia-related markers, only ZnPP was significantly elevated (P<0.001) in the anemic group. When patients were grouped according to the severity of disease, slight differences in hemoglobin or other anemia-related parameters could be observed. However, the levels of ZnPP were significantly increased in the severely ill group of patients. The ratio of ZnPP to lymphocyte count (ZnPP/L) had a discrimination power stronger than the neutrophil to lymphocyte count ratio (N/L) to determine disease severity. Additionally, only two markers were independently associated with the severity of COVID-19 in logistic regression analysis; D-dimer (OR (5.606)(95% CI 1.019–30.867)) and ZnPP/L ratio (OR (74.313) (95% CI 1.081–5108.103)). Conclusions For the first time ZnPP in COVID-19 patients were reported in this study. Among all iron-related markers tested, ZnPP was the only one that was associated with anemia as based on hemoglobin. The increase in ZnPP might indicate that the underlying cause of anemia in COVID-19 patients is not only due to the inflammation but also of nutritional origin. Additionally, the ZnPP/L ratio might be a valid prognostic marker for the severity of COVID-19.

The number of maternal and infant mortality in Indonesia is still high. Most of Indonesian neonatal mortality occurs in the first week of life with low-weight birth (LwB) / premature as the main cause. Birth weight is an important and reliable indicator for the survival of neonates and infants, both in terms of physical growth and development of the mental status. LwB caused by many complicated factors that related each others as if maternal factors that also affect the baby's weight at their birth. The purpose of this study was to identified the determinant factors that affect the incidence of LwB based on the related research topic. The data source obtained from the scientific journals with LwB studies during the years of 2009 untill 2016 with the total of 14 studies consisting of scientific papers and thesis. In this study, researchers divided into five risk factors associated with LwB. From those factors then it divided again into 20 aspects. The result show that the maternal nutritional aspec and anemia status have become significant risk factors againts the low-weight birth incidence.

Burns represent one of the worldwide leading causes of injury. Burn wounds are associated with increased mortality and morbidity, especially the impaired quality of life due to hypertrophic scarring, scar pain and itching, paresthesia, and contractures. To properly influence the burn wound healing, it is important to establish a correct classification of the acute injury and to understand the main phase of burn wound healing process. There are various local and systemic factors that can be influenced to obtain proper healing. The most important factors include local necrosis and infection, increased local pressure and edema, anemia, hypoxia, hypotension, the presence of important chronic disease and medication, immunosuppression, nutritional status, age, and body constitution. After adequate fluid resuscitation and patient stabilization, the main step is represented by the detachment of the devitalized tissues and rapid coverage of the lesion. There are various methods to be used, like autologous or allogenic skin grafting, the use of skin substitutes, or tissue bioengineering. Knowing all these aspects, allows clinicians to properly define a therapeutic management for patients presenting severe burns.

Abstract Introduction: Global health research is hampered by the lack of inexpensive and reliable assays to annotate clinical study cohorts for geographically localized endemic genetic disorders. The most prevalent modifier in Africa is sickle cell disease (SCD, HbSS). In SCD, sickling of erythrocytes by polymerization of hemoglobin S (HbS) causes vaso-occlusion and hemolysis, leading to significant morbidity/mortality and constituting a major healthcare and economic burden. The inhomogeneity bias introduced into the clinical data of patient cohorts by the changes associated to undiagnosed SCD is a significant challenge. Thus, our aims were to: a) optimize a paper-based screening test for SCD for its application in suboptimal and resource-limited conditions, b) demonstrate the feasibility of retrospective SCD annotation of a large cohort of children enrolled in a global health research study, and c) extract novel evidence on potential differences in clinical presentation between febrile children with and without SCD enrolled in this cohort. Materials & Methods: First, we adapted and simplified a paper-based SCD assay (Piety et al. 2017) for suboptimal sample conditions (frozen EDTA-whole blood) and limited-resource settings. Five microlitres of thawed EDTA-whole blood was solubilized (high phosphate buffer with saponin/sodium hydrosulfite), and blotted on standard blotting paper. Dots formed by capillarity, and their aspect depended on HbS%. A high-resolution scanner and two smartphone brands were compared for image capture. An algorithm for visual calling of the presence an HbS allele was developed, and the freeware ImageJ determined peripheral/central pixel intensities. An HbS dosimetric curve was determined after identification of optimal parameter correlations by scatter plot matrix. Second, blood samples from 1103 children aged 9 to 35 months enrolled in a randomized open prospective non-inferiority pediatric cohort study on algorithm-based management of febrile illnesses in Tanzania (ePOCT Trial, 2014-6, NCT02225769, Swiss/Tanzanian IRB approval, Keitel et al.2017) were assayed with the optimized paper test. In parallel, confirmation by gold-standard alkaline Hb electrophoresis (Helena Biosciences, UK) was performed. Third, clinical data from the newly SCD-annotated ePOCT database was analyzed (STATA software suite) to identify clinical features associated with febrile illnesses in the HbAA/AS/SS groups. Results: All EDTA-blood samples frozen onsite in Tanzania (shipped and then stored for >1 year) could be assayed. The test was rapid (5'), inexpensive (0.05 USD/test) and accessible (widely available reagents, no requirement for costly equipment, open-source freeware). Determination of HbS status (homozygous HbSS/AA or heterozygous HbSA) was effective both visually and by informatic means. Smartphone cameras yielded identical results (R2=0.96 & 0.97) when compared to a high-definition scanner. Local prevalence was at 1.6% and 13.6% for HbSS and HbAS respectively, in line with previously published data. By visual sorting of blood dots, the assay was 100% sensitive and 75.8% specific for the determination of HbSS-SCD and 97.6% sensitive and 87.5% specific for the identification of an HbS allele (in an hetero- or homozygous state). After analysis of the annotated ePOCT multiparametric clinical dataset, we observed that cough as the main complaint was more prevalent in children with HbSS (OR 3.1, 95% CI: 1.1-8.3). HbSS children were more severely malnourished (MUAC/age average z-scores -0.7 vs 0.0, p=0.01) and slightly more anemic (Hb 9.1 vs 9.8 g/dL, p=0.06) when compared to HbAA counterparts. Interestingly, children with HbAS had a better nutrition status than those with HbAA (MUAC/age average z-score 0.14, p<0.01). Also, education of mothers of HbSS children was significantly lower (primary education OR 0.3 (95% CI: 0.1-0.8). Conclusions: We demonstrated that the retrospective annotation of clinical cohorts for SCD with an optimized paper-based assay is feasible, straightforward and inexpensive. Our approach has the potential to eliminate the interpretation bias associated with SCD, and thus facilitate the downstream analysis of valuable datasets in other studies. As a proof of principle, we examined a properly annotated dataset highlighting novel features of febrile illness in children with SCD and HbAS carriers in Africa. Disclosures No relevant conflicts of interest to declare.

The results of clinical examination of patients of animals, collected history and conducted laboratory blood tests with determination of the number of red blood cells, leukocytes, platelets, hemoglobin, glucose, total protein, total bilirubin, activity of ALT, AST, alkaline phosphatase and α-amylase enzymes are presented in the article. The features of the course and some diagnostic aspects of pancreatitis in cats are described. According to the results of the studies and their detailed analysis, it has been established that the clinical manifestation of pancreatitis in cats has certain differences from the manifestation of this disease in other carnivores, namely dogs, and is characterized by nonspecific clinical features - inhibition, anorexia, cachexia, occasionally – vomiting. Dehydration, pallor of visible mucous membranes of the conjunctiva and skin, or, in severe cases, their jaundice, abdominal pain, fever, or hypothermia are typical for sick animals. Thus, according to the results of own research and the collected information on the clinical condition of cats, the manifestation of the disease in the form of oppression and cachexia was observed in 100% of patients, vomiting – in 10%, anorexia – in 80% of patients. In 33% of diseased animals, a fever of constant type was diagnosed to 41.6 °C, in the rest of the animals the temperature of the body was normal or at its lower limit. Laboratory tests of anemia showed anemia with a decrease in the number of red blood cells and hemoglobin to 4.6 ± 0.57 T/L and 91.7 ± 5.62 g/l, respectively. Anemia was not regenerative, confirmation of why there was no blood in sick animals of reticulocytes. As a manifestation of the compensatory possibilities of the body of sick cats for the development of pancreatitis can be considered not significantly expressed thrombocytopenia. Thus, the number of blood platelets in experimental animals was in the range of 136.8 ± 32.2 G/L, at a rate of 250–600 G/L. This can be explained by the fact that platelets are also involved in protecting the body from microorganisms and toxins, and this pathological process is accompanied by their reduction. Hyperproteinemia, hypoalbuminemia, hyperbilirubinemia, hyperglycemia, hyperbilirubinemia, and hyperfermentemia of transaminases and α-amylase were determined by biochemical blood tests in cats for pancreatitis. Therefore, in 67% of patients in cats hyperglycemia with elevated values of glucose content up to 8.9 ± 0.85 g/l was detected, indicating a violation of the endocrine function of the pancreas. In 100% of the sick animals, an increase in the total protein content was observed on average up to 86.2 ± 3.7 g/l, which can be considered as a consequence of the dehydration of the patient's body and an increase in the proportion of blood globulin. Most number of oll cats has a violation of the function of the liver. Thus, the damage to the integrity of membranes and hepatocyte cytolysis was indicative of an increase in the activity of blood serum enzymes – ALT (up to 186.3 ± 23.1 OD/L) and AST (up to 159.2 ± 31.6 OD/l). In violation of the delay in the removal of bile, the permeability of membranes of the epithelium of the biliary tract indicated an increase in the activity of alkaline phosphatase to 230.2 ± 10.5 ODP/l in 67% of cases. For other cases, it was characterized by a decrease in its activity to 9.3 ± 0.3 Od/liter, which can be explained by the development of an imbalance in the nutritional intestinal microflora, that is, the presence in the sick of cats of dysbiosis, also caused by a violation of the metabolism of vitamin C in their body. Swelling resulting from inflammation of the pancreas and tissues surrounding it has probably led to mechanical obstruction of the total bile duct, which was confirmed by an increase in the total bilirubin level to 14.2 ± 2.4 μmol/l.

Iron deficiency, one of the most common nutritional deficient disorders, frequently affects infants, adolescents and pregnant women and impairs growth, development and immune responses. Iron deficiency may also be secondary to gastrointestinal conditions such as gastrectomy and inflammatory bowel disease, as well as cancer and chronic uremia. Iron supplementation is the most commonly selected treatment option for iron deficiency. This review summarizes the iron compounds currently recommended for the iron fortification of foods and for clinical use. Additionally, this review discusses and compares the important aspects of high-quality iron compounds/products and classes of compounds that enhance iron bioavailability. The development of efficient iron fortification methods remains the most cost-effective and long-term approach to the treatment of iron deficiency or related anemia. To date, no orally administered options for iron fortification can sufficiently replace the parenteral administration of iron supplements, which includes the intramuscular injection of iron-dextran to neonatal piglets and intravenous injection of iron supplements to patients with gastrointestinal disorders. Iron bioavailability may be enhanced by encouraging customers to ingest iron-enriched foods together with dietary sources of vitamin C, folic acid and/or oligosaccharides.

ObjectivesTo describe the characteristics and disability-related needs of children and adolescents with physical disabilities in the Kilimanjaro region, North-Eastern Tanzania.DesignA cross-sectional community survey was conducted from November 2020 to June 2021. Trained research assistants interviewed primary children’s carers using a questionnaire based on the International Classification of Functioning, Disability and Health-Children and Youth Framework. Data were analysed using IBM SPSS Statistics V.27. The Pearson χ2test was used to examine differences between age, gender and self-reported needs. The independent t-test assessed difference in needs according to age and gender.SettingKilimanjaro region, Tanzania.ParticipantsChildren and adolescents, aged 2–18 years, with physical disabilities (n=212).ResultsAlmost 40% had severe speech (n=84) and joint mobility (n=79) impairments, and more than half (n=124) had severe or complete difficulties walking. In aspects of self-care (caring for body parts, toileting, dressing, eating and drinking), most had severe and complete difficulties. Almost 70% (n=135) of households were located near health facilities without rehabilitation services. About one-quarter (n=51) had never received rehabilitation services. More than 90% (n=196) needed assistive devices, and therapeutic exercises (n=193). Over three-quarters needed nutritional supplements (n=162).ConclusionChildren and adolescents with physical disabilities in North-Eastern Tanzania have impaired speech and joint mobility, and difficulties in communication, self-care and walking. Rehabilitation services essential for addressing these impairments and activity limitations are either scarce or inaccessible. Action is needed to facilitate urban and rural access to rehabilitation services in order to improve the well-being of children and adolescents with physical disabilities.

Objective: The objective of this study was to assess the nutritional status of people living with HIV and acquired immunodeficiency syndrome (PLHAs) on antiretroviral treatment (ART) and their knowledge with respect to role of nutrition in maintaining their health and to know the association of various factors with nutritional status and knowledge among PLHAs attending ART centers.Methods: A cross-sectional study carried out at ART center of a tertiary care institution in Maharashtra. A total of 104 PLHAs who were started on ART for the 1st time and completed minimum 6 months of treatment and who gave consent were included in the study. Data were collected by personal interview technique after taking informed consent with the help of pre-tested, prevalidated questionnaire with predetermined scoring system along with anthropometric measurements and relevant investigations maintaining strict confidentiality. Those with <50% scores were marked as unsatisfactory and more than 50% as satisfactory. Data were entered into Excel Sheet and were analyzed with SPSS 17.1 software.Results: In our study, 51.92% of the study participants were female, mean age was 38.5±9.6, 14.42% were illiterate, 32% had undergone primary education, and equally had secondary education. 16.35% were drivers and almost all were married (96.15%). Mean hemoglobin (Hb%) before and after ART was 10.45±2.13 and 10.64±2.16, while mean CD4 count before and after ART was 177.26±146.52 and 413.69±266.25, respectively, while post-ART mean body mass index (BMI) was 20.55±3.07. Majority (75%) were on ART for more than 12 months. Majority (65.38%) had unsatisfactory score with respect to overall knowledge regarding nutrition. 28.85% were underweight and 2.88% obese; while 17.31% were overweight and rest were normal. 46.15% were anemic. Statistical significant difference was noted among age, educational status, marital status, knowledge score, and anemia status with respect to BMI. Logistic regression with BMI as an outcome showed that age binary had some association. It means that there are 2.7 times odds of normal BMI in higher age group. Statistically significant difference was also noted in mean CD4 count before and after ART therapy. Regression analysis showed that CD4 count post-ART depends on pre-ART CD4 count, ART duration, and gender of the individual. With each unit increases in pre-ART CD4 and ART duration, there is increase of 0.44 and 4.5 units in after ART CD4. Post-ART CD4 count increased more among females compared to males in our study.Conclusion: There exists a wide gap in PLHAs knowledge regarding nutritional aspects. The study also shows that good nutrition has good influence on CD4 count. PLHAs belonging to higher age 40 years, married, and educated, those who had better knowledge score and good Hb% had better nutrition. Therefore, there is an urgent need for nutritional interventions like frequent health educational sessions on nutrition to increase the knowledge of PLHAs can be emphasized during each follow-up visit at ART centers. There is a need to identify PLHAs with no or minimum nutritional support and provides nutritional supplementation, for which planning and policy section needs adequate research evidences from India.

In Africa, the natural history of SCD is often assumed to be same to the African Diaspora in the US, Jamaica, Europe or Latin America. Yet the environment can be different, including different pathogen exposure, such as malaria. To help better understand this, over 2000 references were identified using the names of all current or past names of African continent countries and the truncated word sickl$, followed by secondary nested and cross reference searches. Six cases series describing causes of death were identified, representing 182 children (Ndugwa, 1973, Athale, 1994, Koko, 1998, Diagne, 2000, Rahimy, 2003, Van-Dunem, 2007). Gender was reported in 172, 73 were female (42%). Age was reported in 118, 52 were < 5 years (44%). Four studies described some impediment to care or arrival for care in extremis in1/4 to over ½ of patients that died. In Uganda, 9/12 (75%) patient died at home. In Gabon 6/23 (26%) patients died within 4 hours of reaching the hospital and 11/23 (48%) within 24 hours. In Benin 2/10 (20%) died of splenic sequestration diagnosed at home; 38/64 (53%) of patients in Mozambique that died, lived outside of the capital. Causes of death were identified in 146 individuals. These included: fever/sepsis: n=59 (40%), including meningitis: n=15 (10%) and pyelonephritis: n=2 (1%); acute anemia: n=43 (29%), including spleen sequestration: n=28 (19%) and aplastic anemia: n=8 (5%); pain: n=22 (15%); acute chest syndrome/pneumonia: n=18 (12%); CNS: n=8 (5%), including stroke: n=4 (3%), seizure/ coma: n=5 (3%); liver disease: n=5 (3%) including hepatitis: n=3 (2%); Other: n=19 (13%) including wasting/ malnutrition: n=7 (5%), heart failure/cardiomyopathy: n=4 (3%), diarrhea and vomiting: n=3 (2%), transfusion reaction: n=2 (1%). Infectious pathogens were identified in 26, including malaria: n=10 (38%), S. pneumoniae: n=3 (12%), Salmonella: n=2 (8%), H. influenza, Klebsiella and Citrobacter: n=1 (4%) each; viral agents were reported in n=8 (31%) including HBV: n=5 (19%), HIV: n=3 (12%). Reported general population hemoglobinopathy surveys after birth revealed the following Relative Risk (RR) of observing individuals with hemoglobin SS compared to Hardy Weinberg expected frequencies (some age cohorts overlap; Tanzania '56, Benin '09, Burkina Faso '70, Central African Republic'75, Gabon'65/'80, Gambia'56, Ghana '56/‘57/'00/'10, Kenya '04/'10, Malawi '72/'00/'04, Mozambique '86, Nigeria '56/'70/'79/'81/'84/'05, Senegal '69, Sierra Leone '56). Age 0-1 years, total n=2112 observed n=22 (1.0%), expected n=16.5 (0.8%), RR=1.3 (95% CI=0.7,2.5), p=0.441. Age 0-6 years, total n=4078; observed n=39 (1.0%); expected n=40.6 (1.0%); RR=1.0 (95% CI=0.6,1.5), p=0.925. Age 5-19 years, total n=1880; observed n= 5 (0.3%); expected n= 24.8 (1.3%); RR=0.2 (95% CI=0.1,0.5); p<0.001. Adults, total n=12814; observed n= 20 (0.2%); expected n= 118.9 (0.9%); RR=0.2 (95% CI=0.1,0.3), p<0.001. Pregnant, total n=5815; observed n= 19 (0.3%); expected n= 78.5 (1.3%), RR=0.2 (95% CI=0.1,0.4), p<0.001. Cohorts of children with SCD are indicated in the table. In summary, access to care, as well as acute anemias are a frequent cause of mortality. Along with viral pathogens and transfusion related deaths this indicates the importance of a safe blood supply. By adulthood, the observed frequency of individuals with SCD is only 1/5 of expected. However, reported clinic cohorts suggest similar if not better survival than in the general population, possibly due to lost to follow up, but also malaria/bacterial infection prevention and nutritional support. Careful prospective studies are needed.TableCohorts of children in Africa with Sickle Cell AnemiaCountryAge median years, (range)Death/TotalnFollow up yearsPatient-yearsDeaths/100 patient-yearsU5M/100 child-yrs♦Uganda, 735 -9, (0-20)12/6282--2.7Senegal, ‘008 (0-22)11/323710331.12.2Senegal, 03330/55612--2.2Benin,032.910/2361.5-6.59831.02.4Kenya,096 (0-13)2/1241.21181.72.7♦: Under five year old mortality 2009 (source: Unicef), divided by 5Prophylactic interventions: Uganda: chloroquine; Senegal: chloroquine (wet season), nets, penicillin prophylaxis <5 yrs, folic acid, parasite treatment & iron supplement as needed; Benin: chloroquine, nets, penicillin prophylaxis, antibiotics for fever, folic acid, nutritional support; Kenya; Proguanil, folic acid, nutritional support, parasite treatment & iron supplement as needed. Disclosures: No relevant conflicts of interest to declare.

All people have a right to good nutrition. However in Sri Lanka, still anemia, underweight and stunting prevail with regional disparities. There are many determinants for poor nutrition and which leads to many adverse outcomes. As these determinants are multifaceted it requires several different sectors to work collaboratively, complement their activities and share resources to improve the nutritional status of the country. In this article; the initiatives such as development of the National Nutrition policy and Strategic frame work; establishment of Presidential Secretariat, Nutrition Secretariat, Nutrition Steering Committee and Nutrition Coordination Division; the contribution of different divisions of the Ministry of Health such as Nutrition Division, Family Health Bureau, Health Education Bureau, Epidemiology Unit, Food Safety unit, Environment and Occupational Health unit, Non Communicable Disease Unit, Youth, Elderly and Disabled unit, Estate and Urban Health Unit, Medical Research Institute, Medical Statistics Unit; Hospital Nutrition Units, food supplement programmes; the assistance of United Nations agencies, Professional Associations, other Ministries of the government and Non-Governmental Organizations; the importance of National Nutrition Surveillance system and the coordination by the Nutrition Coordination Division are described. Author’s feelings regarding the coordination between nutrition related units in the country were expressed. Subsequently, favorable aspects and deficiencies were evaluated and the possible underlying factors and consequences were analyzed. In conclusion, it can be said that a strong coordinating body for inter - sectoral coordination, information feedback, data sharing and analysis; assessment of current level of multi sectoral coordination and multi sectoral interventions; development of provincial specific strategies and micro plans at house hold level; strengthening of community based organizations, village committees and volunteers; proper streamlining of multiple information systems in the country in order to monitor & evaluate the operations to avoid duplications and negligence; are required. Accordingly, recommendations were provided to address the issue.

In overcoming Iron Deficiency Anemia and stunting, the Indonesian government seeks to increase the content of iron (Fe) and zinc (Zn) in milled rice through fortification and biofortification. Fortivit rice is rice fortification produced by BULOG. Inpari Nutri Zinc is biofortified rice grown from plant breeding by the Ministry of Agriculture, which ID Food currently produces. This study is a continuation of the IFFRI research collaboration on the Implementation and Research of Precision Agriculture in Biofortified Rice Strain. This study aimed to characterize the biofortified rice as a result of fertilization recommendations in previous studies and compare biofortified rice with fortified rice in several aspects, including micronutrient contents especially Zn, organoleptic, and production costs. The highest Zn content of Nutri Zinc was found in the aleuron, so that the post-harvest process caused a decrease in Zn level. The differences in fertilization recommendations have an impact on the Zn content in brown rice, each layer of aleurone, and the rice endosperm. The nutritional content of Fortivit and Nutri Zinc rice was relatively the same as non-fortified/biofortified rice. The washing and cooking process caused a decrease eof about 4 percent in Zn content in fortified rice, while in biofortified rice, there was relatively no decrease. Although there was a decrease in Zn in fortified rice, overall, the Zn content was still much higher than in biofortified rice. Based on the results of the hedonic test, fortifed rice (Fortivit) was the most preferred for all sensory attributes. In biofortified rice (Nutri Zinc), respondents prefer the rice with 100 percent milling grade the most. Fortivit rice had a faster research time and a lower estimated cost in research. In the contrary, it had a higher estimated cost in production than Nutri Zinc rice. Nonetheless, the selling price of Fortivit rice is cheaper than Nutri Zinc rice on the market. keywords: rice, fortification, biofortification, Fe, Zn

ABSTRACT Finger millet (Eleusine coracana (L) commonly known as ragi is an important crop used for food, forage and industrial products. Finger millet has a wide ecological and geographical adaptability and resilience to various agro-climatic adversities hence, it is highly suited to drought condition and marginal land and requires low external input in cultivation.. Farmers participatory field demonstrations of ragi variety Arjun and Bhairabi were conducted at two villages ie Pedawada of Malkangiri block and MPV -1 of Kalimela block of Malkangiri district, comprising 40 farmers in cluster approach in Kharif 2018 and 2019 , by Krishi Vigyan Kendra, Malkangiri , in South Eastern Ghat Zone of Odisha . Conducting front line demonstrations on farmer’s field help to identify the constraints and potential of the finger millet in the specific area as well as it helps in improving the economic and social status of the farmers. Observation on growth and yield parameters were taken and economic analysis was done. The final seed yield was recorded at the time of harvest and the gross return in (Rs ha -1) was calculated based on prevailing market prices. The results from the demonstration conclusively proved that finger millet variety Arjun (OEB-526) recorded the higher yield ( 18.8 q ha-1) , followed by Bhairabi ( 15.3 q ha-1) and farmer’s traditional variety Nali Mandia ( Dasaraberi) recorded an average yield of (8.6 q ha-1 ) . HYV Finger millet variety Arjun with proper nutrient management and plant protection measures gave 118 % higher over farmer’s practices. The technological and extension gap was 1.9 q ha-1 and 12.07 q ha-1 respectively. Similarly, technological index was 8.2 percent. The benefit cost ratio was 2.4 and 1.9 in case of Arjun and Bhairabi respectively and in case of farmer’s variety Nali Mandia it was 1.4. Hence the existing local finger millet variety can be replaced by HYV Arjun ans Bhairabi , since it fits good to the existing rainfed farming situation for higher productivity. By conducting front line demonstrations on millet on large scale in farmer’s field, yield potential of finger millet can be enhanced largely which will increase in the income level of farmers and improve the livelihood condition of the farming community. Introduction Among small millets, finger millet (Elusine coracana L,) locally known as Ragi/Mandia is the most important crop grown in tribal districts of Odisha and it is the staple food of the tribals. It was originated about 5000 years ago in east Africa (possibly Ethiopia) and was introduced into India, 3000 years ago (Upadhyaya et al., 2006) and it is highly suited to drought condition and marginal land and requires low external input in cultivation. Millet is a collective term referring to a number of small seeded annual grasses that are cultivated as grain crops, primarily on marginal lands in dry areas in temperate, subtropical and tropical regions (Baker, 1996). Nutritionally finger millet is superior to major cereal crops and rich source of micronutrients such as calcium, phosphorous, magnesium and iron. And it has several health benefits. Finger millet grains contain higher amount of proteins, oils and minerals than the grains of rice, maize or sorghum (Reed et al., 1976). Vadivoo and Joseph (1998) mentioned finger millet grains contain 13.24% moisture, 7.6% protein, 74.36% carbohydrate, 74.36% carbon, 1.52% dietary fiber, 2.35% minerals, 1.35% fat and energy 341.6 cal/100g. (Joshi and Katoch, 1990; Ravindran, 1991). It is a rich source of micronutrients such as calcium, phosphorus, magnesium and iron. Cysteine, tyrosine, tryptophan and methionine are the right spectrum of amino acids found in finger millet protein (Rachie, 1975). The increase in global temperature leads to climate changes that directly affect crop production and increase people's hunger and malnutrition around the world.. With regard to protein (6-8%) and fat (1-2%) it is comparable to rice and with respect to mineral and micronutrient contents it is superior to rice and wheat (Babu et al., 1987). It is also known for several health benefits such as anti-diabetic, anti-tumerogenic, atherosclerogenic effects, antioxidant, which are mainly attributed due to its polyphenol and dietary fiber contents. Being indigenous minor millet it is used in the preparation of various foods both in natural and malted forms. Grains of this millet are converted into flours for preparation of products like porridge, puddings, pancakes, biscuits, roti, bread, noodles, and other snacks. Besides this, it is also used as a nourishing food for infants when malted and is regarded as wholesome food for diabetic's patients. Diversification of food production must be encouraged both at national and household level in tandem with increasing yields. Growing of traditional food crops suitable for the area is one of the possible potential successful approaches for improving household food security. Malkangiri is one of the seven districts where a flagship programme called “Special Programme for Promotion of Millets in Tribal Areas of Odisha (hereafter, Odisha Millets Mission, (OMM)” has been launched by Department of Agriculture and Farmers Empowerment, Odisha in order to revive millets in rainfed farming systems and household consumption. It was started in kharif 2017 in four blocks of the district, namely Chitrakonda, Korkunda, Mathili and Khairiput. The Government of Odisha launched Odisha Millets Mission (OMM) also known as the Special Programme for Promotion of Millets in Tribal Areas of Odisha in 2017 to revive millets in farms and on plates. The aim was to tackle malnutrition by introducing millets in the public distribution system (PDS) and other state nutrition schemes. The focus is on reviving millets in farms and putting it on plates.” Millet, a nutritious and climate-resilient crop, has traditionally been cultivated and consumed by tribal communities in the rainfed regions of southern Odisha. Technology gap, i.e. poor knowledge about newly released crop production and protection technologies and their management practices in the farmers’ fields is a major constraint in Ragi production. So far, no systematic approach was implemented to study the technological gap existing in various components of Ragi cultivation. Awareness of scientific production technology like HYV of ragi, seed treatment with fungicide, use of insecticide and bio-fertilizers, is lacking in Malkangiri district which were a key reason for low productivity. The production potential could be increased by adopting recommended scientific and sustainable management production practices with improved high yielding varieties and timely use of other critical inputs. Objective The field experiment was undertaken to study the performance of three finger millet varieties Local Mandia (Nali Mandia), Bhairabi and Arjun in rainfed upland situation in kharif season. The present investigation was undertaken to evaluate the field performance of newly released finger millet varieties Arjun and Bhairabi under rainfed condition. The demonstrations were carried out in Malkangiri district covering two villages like Pedawada and MPV-6 to find out the existing technological and extension gap along with technology index with an objective to popularize the ragi varieties having higher yield potential. Material and methods The study was carried out in operational area of Krishi Vigyan Kendra (KVK), Malkangiri during Kharif season in the year 2018 and 2019. The study was under taken in Malkangiri and Kalimela blocks of Malkangiri district of Odisha and the blocks were selected purposefully as Finger millet is the major cereals crop grown in large area in Kharif season. The demonstrations were conducted in two different adopted villages Pedawada and MPV-6 in cluster approach. The Front Line Demonstration (FLD) is an applied approach to accelerate the dissemination of proven technologies at farmer’s fields in a participatory mode with an objective to explore the maximum available resources of crop production and also to bridge the productivity gaps by enhancing the production in national basket.The necessary steps for selection of site and farmers and layout of demonstrations etc were followed as suggested by Choudhary (1999). Forty numbers front line demonstrations on HYV Ragi were conducted in two clusters comprising 40 numbers of farmers. All the participating farmers were trained on various aspects of Ragi production technologies and recommended agronomic practices and certified seeds of Ragi variety Arjun and Bhairabi were used for demonstration. The soil of demonstration site was slightly acidic in reaction (pH-5.0 to 5.25) with sandy loam in texture and EC was 0.134 (dS m −1). The available nitrogen, phosphorus and potassium was between 214 .00, 22 .00, 142 .00 (Kg ha−1) respectively with 0.48 (%) Organic Carbon. The crop was sown in under rainfed condition in the first to second week of July. The crop was raised with recommended agronomic practices and harvested within 4th week of November up to 2nd week of December. Krishi Vigyan Kendra ( KVK), Malkangiri conducted front line demonstration with HYV varieties like Bhiarabi and Arjun and farmer’ local var Dasaraberi as check Finger millet Variety Arjun (OEB-526) is having Maturity duration 110 days and average yield 20.7q/ha with moderate resistance to leaf, neck and finger blast and brown seed and Bhairabi is a HYV of Ragi with Maturity duration 110 days and average yield 17.6 q/ha. Moderate resistance to leaf, neck blast and brown seeded and protein content 81%. Local variety Dsaraberi or Nali Mandia is having 105 days duration and drought tolerant variety used as farmers variety as local check . The technologies demonstrated were as follows: Popularization of high yielding Ragi variety, Seed treatment with Trichoderma viride @ 4g kg-1 seed , Line sowing with, soil test based fertilizer application along with need based plant protection measures. The field was ploughed two times and planking was done after each plugging, Need based plant protection measures were taken; along with soil test based fertilizer application was done with fertilizer dose 40:30:60 kg. N: P2O5: K2O kg ha -1. In case of local checks existing practices being used by farmers were followed. The observations were recorded for various parameters of the crop. The farmers’ practices were maintained in case of local checks. The field observations were taken from demonstration plot and farmer’s plot as well. Parameters like Plant height, number of fingers per plant, length of finger , no of fingers per year, 1000 seed weight and seed yield were recorded at maturity stage and the gross returns (Rs ha -1 ) were calculated on the basis of prevailing market price of the produce. The extension gap, technology gap, technology index along with B: C ratio was calculated and the data were statistically analyzed applying the statistical techniques. Statistical tools such as percentage, mean score, Standard deviation, co-efficient of variation, Fisher‘s “F” test, were employed for analysis of data. The farmer’s practices (FP) plots were maintained as local check for comparison study. The data obtained from intervention practices (IP) and famers practices (FP) were analyzed for extension gap, technological gap, technological index and benefit cost ratio study as per (Samui et al., 2000) as given below. Technology gap = Pi (Potential yield) - Di (Demonstration yield) Extension gap = Di (Demonstration Yield) - Fi (Farmers yield) Technology index = X 100 Result and Discussion The results obtained from the present investigation are summarized below. The Table 1 depicts the major differences observed between demonstration package and farmer’s practices in ragi production in the study area. The major differences were observed between demonstration package and farmer’s practices were regarding recommended varieties, seed treatment, soil test based fertilizer application, keeping optimum plant population by thinning, weed management and plant protection measures. The data of Table 1 shows that under the demonstrated plot only recommended high yielding variety, proper weeding and optimum plant population maintaining by thinning and the farmers used herbicides and the farmers timely performed all the other package and practices. It was also observed that farmers were unaware about balanced fertilizer application, seed treatment, and use of fertilizers application and maintenance of plant population for enhancing the yield. Majority of the farmers in the study area were unaware about use of weed management practices. The findings are in corroborated with the findings of (Katar et al., 2011) From the Table 2 it was revealed that in the district Malkangiri the productivity of finger millet was 6.38 (q ha-1) as compare to state average productivity 8.67 (q ha-1), but there exists a gap between potential yield and farmers yield, which can be minimized by adoption High yielding varieties with improved management practices. The productivity of finger millet was very low in the district as the crop is mostly grown along the hillsides on sloppy land on light textured soil. It was also coupled with negligence in adoption of improved varieties no input like fertilizers use and no plant protection measures and improper method and time of sowing. However, there is a wide gap between the Potential and the actual production realized by the farmers due to partial adoption of recommended package of practices by the growers. Several constraints contributed to yield fluctuation on Ragi production, including: unreliable rainfall; lack of high yielding variety ,disease tolerant varieties; pests and diseases incidence; low producer prices; poor agronomic practices; and lack of institutional support (Bucheyeki et al., 2008; Okoko et al., 1998). One of the central problems of ragi production and processing in this district is due to an uncertain production environment owing to rain fed cultivation, the low resource base of smallholder farmers and processors, and no scope for post harvest management and value addition facilities and poor marketing facility. The results clearly indicated from the Table 3 that the positive effects of FLDs over the existing practices. HYV Ragi Arjun recorded higher yield 18.8(q ha-1) followed by Bhairabi 15.53 (q ha-1) which was 21 % more and the yield performance of these two HYV varieties was higher than the farmer’s variety. This is due to higher of panicle length, more number of tillers and more number of fingers per panicle in HYV of ragi as compared to local variety. The results are in conformity with the findings of (Tomar et al. , 2003). The results clearly indicated the positive effects of FLDs over the existing practices towards enhancing the productivity. It is revealed form table 4 that, as the calculated ‘F’ value at α=0.05 level was found to be larger than table value, indicating significant difference in yield between farmer’s variety and recommended varieties. There was significant difference between average yield of ragi under Farmers practice (FP) and Recommended practice (RP) in variety Arjun under this demonstration. It was concluded that the yield of these HYV ragi varieties was significantly higher as compared to farmer’s variety. The economics and B:C ratio of farmers practice and Demonstration practice has been presented in Table 6. From the table it was revealed that Benefit: Cost ratio (B:C) was recorded to be higher under demonstrations against control treatments during all the years of experimentation. The cost of cultivation in HYV variety was higher due to more labour cost involved in transplanting and also it included cost of fertilizers and plant protection chemicals and also net returns was higher as compared to farmer’s practice. The B: C ratio was found to be 2.4 in case of variety Arjun as compared to 1.9 in case of variety Bhairabi. The results on economic analysis indicated that HYV ragi Arjun and Bhairabi performed better than local variety Ragi. The HYV variety Arjun recorded higher gross return upto Rs 54,332 and followed by Bhairabi Rs 44,289 per ha which was significantly higher than farmers practice and it was due to higher productivity of varieties under demonstration. Conclusion The results revealed that in Malkangiri district finger millet variety Arjun rerecorded highest yield followed by Variety Bhirabi with proper package and practices under rainfed upland condition. From the above study it was concluded that use of finger millet varieties like Arjun or Bhairabi with scientific methods and technological practices of can reduce the technological gap and enhance the productivity in the district. Yield improvement in Finger Millet in the demonstration was due to use of HYV seed and scientific management practices adopted by the farmers. Yield of Finger Millet can be increased to a great extent by conducting effective front line demonstrations in larger area with proven technologies. Finger millet is one of future smart food crop of India and can be grown in the drought condition. This crop is rich in nutrient for food insecurity and within few years because of increase in population of world and depletion of area of production.. The principal reasons of lower productivity of finger millet in the district Malkangiri were lack of knowledge among the farmers about cultivation of HYV finger millet varieties and improper fertilization, late season sowing and severe weed infestation in crop at critical stages. From the above findings, it can be concluded that use of scientific methods of Finger millet cultivation can reduce the technology gap to a considerable extent thus leading to increased productivity of millets in the district. 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Abstract Background Anemia in pregnancy is behind a significant burden of maternal mortality and poor birth outcomes globally. Efforts to address it need evidence on trends and its pertinent factors as they vary from one area to another. Methods We pooled data of 23,203 women of reproductive age whose hemoglobin levels were measured from two Tanzania Demographic and Health Surveys (TDHS). Of them, 2,194 women were pregnant. Analyses employed descriptive analyses to determine the burden of anemia, its characteristics, and severity; GIS mapping to determine the regional changes of anemia between 2005 and 2015; and logistic regression to determine the remaining determinants of anemia among pregnant women using Stata 15. Results The burden of anemia among pregnant women in Tanzania has remained unprecedently high, and varies between regions. There was no significant decline of anemia in general between the two periods after adjusting for individual, households, reproductive, and child characteristics [AOR = 0.964, 95% CI = 0.774–1.202, p = 0.747). Anemia is currently prevalent in 57% of pregnant women in Tanzania. The prevalence is more likely to be higher among women aged 15–19 years than those aged between 20–34 years. It is more likely to be prevalent among those within large families, with no formal education, food insecurity, lack of health insurance, had no antimalaria during pregnancy, and had low frequency of ANC attendance. On the other hand, delivery in a health facility may be potentially protective against anemia. Conclusions Anemia in pregnancy remained persistently high and prevalent among 57% of pregnant women in Tanzania. Efforts to address anemia are crucial and need to be focused in regions with increasing burden of anemia among pregnant women. It is imperative to address important risk factors such as food insecurity, strengthening universal health coverage, empowering women of reproductive age with education and especially nutritional knowledge and advocating for early antenatal booking, attendance, and facility delivery.

ABSTRACT Objective: To assess the association between anemia and nutritional aspects in adolescent athletes from a large sport club. Methods: This is a cross-sectional study, involving 298 athletes aged between 10 and 17 years, submitted to measurement of skin folds, weight and height, and collection of capillary blood in duplicate to determine hemoglobin values. It was carried out in a random sample composed of athletes from eight sport modalities. Results: Regarding nutritional status, 10.1% of athletes were overweight based on body mass index and 70 (23.5%) athletes had a percentage of body fat classified as high or very high. The prevalence of anemia was 16.4%, being more prevalent in judo (37.1%), basketball (34%) and futsal (20.5%) athletes. Low hemoglobin levels were significantly associated with shorter stature (p=0.006). Conclusions: There was a significant association between anemia and short stature, suggesting that the athlete's height-weight development may be affected in suboptimal conditions of oxygen distribution.

BackgroundAnemia in pregnancy is a serious threat to maternal and child health and is a major public health problem. However, the risk factors associated with its incidence are unclear and controversial.MethodsPubMed, Ovid Embase, Web of Science, and Cochrane databases were systematically searched (inception to June 27, 2022). The screening of search results, extraction of relevant data, and evaluation of study quality were performed independently by two reviewers.ResultsA total of 51 studies of high quality (NOS score ≥ 7) were included, including 42 cross-sectional studies, six case-control studies, and three cohort studies. Meta-analysis showed that infected parasite, history of malarial attack, tea/coffee after meals, meal frequency ≤ 2 times per day, frequency of eating meat ≤ 1 time per week, frequency of eating vegetables ≤ 3 times per week, multiple pregnancies, multiparous, low household income, no antenatal care, rural residence, diet diversity score ≤ 3, have more than 3 children, history of menorrhagia, underweight, family size ≥ 5, middle upper arm circumference &lt; 23, second trimester, third trimester, birth interval ≤ 2 year were all risk factors for anemia in pregnancy.ConclusionsPrevention of anemia in pregnancy is essential to promote maternal and child health. Sufficient attention should be paid to the above risk factors from the social level and pregnant women's own aspects to reduce the occurrence of anemia in pregnancy.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42022344937.

Obviously iron deficiency is determined as the most prevalent nutritional problem in the world today. It is provoked by a lack of iron in the diet. In South Florida, since pregnant women tend to neglect prenatal care, the prevalence of anemia primarily occurs during the first and second trimesters of their pregnancy. Accordingly, medical studies show that premature deliveries, low birth weight, birth defects, infant mortality, etc. result from iron deficiency anemia. In this, birth defects are, however, considered as quite associated with folic acid deficiency anemia. That explains why, this paper also deals with the study published by the March of Dimes on folic acid and pregnancy. In addition, the paper approaches qualitatively the socioeconomic and sociocultural aspects of the disease according to eight (8) interviews conducted in Broward and Miami Date counties to highlight the existing preventive programs for vulnerable population such as women, infants and children in South Florida, USA.

Iron deficiency (ID) is the most common widespread nutritional disorder in the world in both developing and developed countries and remains a leading cause of anemia mainly affecting children between the ages of 6 to 59 months. ID can be understood as a state in which there is insufficient total body iron to maintain normal physiologic functions and which can vary in intensity from mild forms to the most severe condition which is anemia. The prevalence of ID among children under the age of three years old is high, varying according to the regions of the world, between about 10% in the USA to 33% in African countries, South-East Asia and Eastern Mediterranean. In view of the importance of ID for human health, with its physical, emotional, social and economic repercussions, it is important to know all aspects related to this nutritional deficiency so that actions for prevention, identification and early treatment of those affected can be developed. This article briefly reviews the importance of iron for children's health, highlighting metabolism, clinical changes, diagnosis and measures that can solve or minimize this serious public health problem.