Household Food Insufficiency and Child Nutritional Status in Urban Slum, Dhaka, Bangladesh.

Introduction: Malnourished children are about 20% in the developing world. Food insecurity is a key risk factor for child malnutrition. Food insuffi ciency, an extreme form of household food insecurity, can aff ect physiological mechanisms that are linked to an individual’s nutritional status. Food-insuffi cient children are also more likely to have poorer health status and to experience a range of negative academic and psychosocial outcomes. Methods: We administered a cross-sectional socioeconomic survey to 354 households in research site, including a validated food insuffi ciency measurement questionnaire, and obtained anthropometric measurements from children aged 12 to 24 months. We used chi-square tests to assess the relationship between household food insuffi ciency and nutritional status of children. Results: Average age of study children was 18 months and standard deviation was (± 3.2 months). Th e status of household food insuffi ciency was 56%. Th e prevalence of underweight, stunting and wasting was 24%, 36% and 8% respectively. Th e household food insuffi ciency was signifi cantly (p<0.05) associated with underweight and stunting but not with wasting (p>0.05). Discussion: Th e study results indicate that food insuffi ciency is associated with stunting and underweight but not with wasting in urban slum of Bangladesh. We also found that child malnutrition is associated with mother’s education, father’s education, monthly family income and people per room.

Low-dose β-carotene Supplementation and Deworming Improve Serum Vitamin A and β-carotene Concentrations in Preschool Children of Bangladesh.

Despite the national vitamin A and antihelminthic prophylaxis programmes, both intestinal geohelminths and subclinical vitamin A deficiency continue to be prevalent among children in developing countries. Studies on potential synergistic effects of vitamin A supplementation and deworming on retinol status have inconsistent results. The purpose of the present study was to investigate the impacts of low-dose β-carotene supplementation and antihelminthic therapy on serum retinol and β-carotene concentrations in preschool children of Bangladesh. Two hundred and forty-four children, known to be infected with Ascaris lumbricoides, were randomized into four treatment groups: I-IV. Group I and II received two oral doses of 400 mg of albendazole each, the first dose at baseline and the second dose after four months; Group III and IV received placebo in place of albendazole. In addition, Group I and III received 1.2 mg of β-carotene powder in capsule daily for six months, and Group II and IV received placebo in place of β-carotene. Serum retinol and β-carotene levels were measured before and after six months of the interventions. Serum retinol and β-carotene increased significantly in Group I where both antihelminthic therapy and daily β-carotene supplementation were given (p<0.05 and p<0.001 respectively). Antihelminthic therapy alone only improved serum β-carotene concentration (p<0.0001). Low-dose β-carotene supplementation, along with an antihelminthic therapy, synergistically improved vitamin A status. This finding has public-health implications for improving vitamin A status of children in developing countries.

Aetiology of diarrhoea in a birth cohort of children aged 0-2 year(s) in rural Mirzapur, Bangladesh.

The incidence of aetiology-specific diarrhoea and the pathogenicity of infectious agents in a birth cohort (n=252) in rural Bangladesh were determined. Stool specimens or rectal swabs were collected from diarrhoeal cases over two years and routinely on a monthly basis. Stool samples from children with diarrhoea were compared with stool samples from children without diarrhoea to calculate rates of isolation and pathogenicity of agents. In total, 1750 stool specimens from diarrhoea patients and 5679 stool specimens from children without diarrhoea were tested. An infectious agent was identified in 58% of the stool specimens from diarrhoea patients and 21.6% of the stool specimens from children without diarrhoea. The most commonly-isolated pathogens from all specimens were enterotoxigenic Escherichia coli (ETEC), enteroadherent E. coli, Shigella, Campylobacter jejuni, Giardia, and rotavirus. ETEC (ST and LT-ST toxin), enterotoxigenic Bacteroides fragilis, Shigella, and rotavirus were associated more with disease than with asymptomatic infections. Aetiology-specific infections were associated with acute episodes. The isolated enteropathogens were essentially the same as those found in other tropical rural settings. Enterotoxigenic B. fragilis was also identified as a pathogen. Ongoing vaccine efforts focusing on Shigella, rotavirus, and ETEC would be useful.