Prevalence and Risk Factors of Vitamin D, Calcium and Phosphate Deficiency among Apparently Healthy Children Aged 6-24 Months in a Semi-urban Community in Southwest, Nigeria.

BACKGROUND: Adequate levels of calcium, phosphate and Vitamin D are essential for bone physiology and growth, as well as preventing some common childhood illnesses. This study aimed to determine the prevalence of the deficiencies of these nutrients and factors affecting their serum levels in Nigerian children. METHODS: This was a cross-sectional study that involved 220 apparently healthy children aged 6-24 months in Ikenne Local Government Area of Ogun State, Nigeria. Serum calcium and phosphate were assayed using the calorimetric method, while Vitamin D (25-OH Vitamin D) was assayed with ELISA. RESULTS: The mean (±standard deviation [SD]) serum Vitamin D level was 55.07 ± 16.53 ng/ml, while the mean (±SD) serum calcium and phosphate were 2.27 ± 0.13 mmol/l and 1.28 ± 0.18 mmol/l, respectively. Eleven (5%) of the children had hypovitaminosis D, 23 (10.5%) had hypocalcaemia and 12 (5.5%) had hypophosphataemia. Factors found to be significantly associated with hypovitaminosis D included low consumption of milk and the use of a hijab veil, while malnutrition (both undernutrition and overnutrition) was significantly associated with hypocalcaemia. CONCLUSION: The prevalence levels of hypovitaminosis D and hypophosphataemia were low, while hypocalcaemia was more common. Low milk consumption and use of a hijab veil were risk factors for hypovitaminosis D, while malnutrition was a risk factor for hypocalcaemia. Malnourished children, especially overnourished ones, should be routinely screened for hypocalcaemia because of its high prevalence among them.

An automated computational data pipeline to rapidly acquire, score, and rank toxicological data for ecological hazard assessment.

Biological Evaluations support Endangered Species Act (ESA) consultation with the US Fish and Wildlife Service and National Marine Fisheries Service by federal action agencies, such as the USEPA, regarding impacts of federal activities on threatened or endangered species. However, they are often time-consuming and challenging to conduct. The identification of pollutant benchmarks or guidance to protect taxa for states and tribes when USEPA has not yet developed criteria recommendations is also of importance to ensure a streamlined approach to Clean Water Act program implementation. Due to substantial workloads, tight regulatory timelines, and the often-protracted length of ESA consultations, there is a need to streamline the development of biological evaluation toxicity assessments for determining the impact of chemical pollutants on ESA-listed species. Moreover, there is limited availability of species-specific toxicity data for many contaminants, further complicating the consultation process. New approach methodologies are being increasingly used in toxicology and chemical safety assessment to rapidly and cost-effectively provide data that can fill gaps in hazard and/or exposure characterization. Here, we present the development of an automated computational pipeline-RASRTox (Rapidly Acquire, Score, and Rank Toxicological data)-to rapidly extract and categorize ecological toxicity benchmark values from curated data sources (ECOTOX, ToxCast) and well-established quantitative structure-activity relationships (TEST, ECOSAR). As a proof of concept, points-of-departure (PODs) generated in RASRTox for 13 chemicals were compared against benchmark values derived using traditional methods-toxicity reference values (TRVs) and water quality criteria (WQC). The RASRTox PODs were generally within an order of magnitude of corresponding TRVs, though less concordant compared with WQC. The greatest utility of RASRTox, however, lies in its ability to quickly and systematically identify critical studies that may serve as a basis for screening value derivation by toxicologists as part of an ecological hazard assessment. As such, the strategy described in this case study can potentially be adapted for other risk assessment contexts and stakeholder needs. Integr Environ Assess Manag 2024;00:1-15. © 2024 Society of Environmental Toxicology & Chemistry (SETAC). This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.

Pattern and characteristics of growth faltering in early infancy in an urban sub-Saharan African setting.

OBJECTIVE: To determine the pattern of and factors associated with changes in nutritional status in early infancy in a resource-poor setting. METHODS: A cohort study in Lagos, Nigeria, in which the nutritional status at birth was compared with status at the first postnatal check-up routinely scheduled for 6-8 weeks based on the World Health Organization's multicenter growth reference and the Centers for Disease Control and Prevention 2000 growth charts. Factors associated with improved, worsened or steady nutritional status at follow-up based on z-scores for weight-for-age, length-for-age and weight-for-length were determined with multinomial regression analysis. RESULTS: The mean length-for-age and weight-for-length based on the Centers for Disease Control and Prevention for the 445 full-term singletons studied were higher than the corresponding World Health Organization's multicenter growth reference values at birth and at follow-up, while mean weight-for-age was lower at birth but higher subsequently. Some 20.7% of infants were undernourished by at least one nutritional measure initially, which declined to 16.4% at follow-up. Also 8.1% of the infants remained undernourished, 8.3% became undernourished, and 5.6% became well-nourished at follow-up. Low birthweight full-term infants were significantly likely to remain undernourished (p < 0.001) or become well-nourished (p < 0.001) at follow-up while the offspring of elderly mothers (p = 0.024) or first-time mothers (p = 0.036) had an elevated risk of remaining undernourished by at least one measure at follow-up. CONCLUSIONS: Many infants are likely to exhibit individual nutritional changes at variance with the overall/summary trend. Those whose nutritional status is likely to deteriorate or remain poor require timely intervention to minimize the risk of subsequent developmental delays/deficits from early infancy.

Is home birth a marker for severe malnutrition in early infancy in urban communities of low-income countries?

This matched case-control study set out to determine the association between place of delivery and severe undernutrition in early infancy in a low-income country. All infants (aged 0-3 months) with severe undernutrition attending four well-child clinics for routine immunization in inner-city Lagos, Nigeria were matched for age and sex with well-nourished peers. The main outcome measures were the adjusted-matched-odds ratios from conditional logistic regression analysis of undernutrition based on z-scores below -3 for weight-for-age, height/length-for-age and body-mass-index-for-age using current World Health Organization's Multicentre Growth Reference (WHO-MGR). From an eligible population of 7075 mother-infant pairs, 918 severely undernourished infants were enlisted as cases matched with 1836 controls. While there was no statistically significant difference between infants born outside hospitals as a group compared to those born in hospitals, infants delivered at residential homes compared to public hospitals had two-to-three fold odds of being severely underweight (p=0.002), severely stunted (p < 0.001) and severely wasted (p=0.008) after controlling for potential confounders. Infants delivered in private hospitals were also significantly associated with severe stunting (p=0.032). This study demonstrates that delivery in homes and private hospitals are potential markers for severe undernutrition in early infancy in this urban population and merits closer attention in any early nutritional intervention in comparable settings of low-income countries.

Predictors of growth velocity in early infancy in a resource-poor setting.

OBJECTIVE: To determine the pattern and predictors of growth velocity in early infancy in a resource-poor setting. METHODS: Weight velocity between birth and first postnatal visit was determined in a cohort of preterm and full-term infants in Lagos, Nigeria using three mathematical methods reported in the literature. Maternal and infant factors predictive of weight velocity were identified by multiple linear regression analysis. RESULTS: Overall, 658 infants were enrolled with mean gestational age of 37.7±2.0 weeks, birthweight of 3.2±0.6 kg and median age of 45 (interquartile range: 42-48) days at follow-up. Offspring of older and HIV-positive mothers had significantly lower mean weight velocities while male infants and those with low birthweight and fetal growth restriction had significantly higher mean weight velocity than their peers. These patterns were consistent across the three growth models. Maternal age (p=0.004), antenatal care (p=0.007), HIV-status (p=0.008) and gender (p<0.001) were predictive of weight velocity. Higher weight velocity was strongly associated with lower birthweight (p<0.001) indicative of "catch-up" growth as well as with higher gestational age (p<0.001). CONCLUSIONS: While maternal status is predictive of early growth faltering, preterm infants warrant timely intervention to forestall/minimise the potential health and developmental consequences associated with their sub-optimal growth trajectory.

Relationship between Painful Crisis and Serum Zinc Level in Children with Sickle Cell Anaemia.

Sickle cell anaemia (SCA) is associated with zinc deficiency; zinc supplementation may ameliorate some of its clinical manifestations including the relief of painful crisis. Subjects and Methods. Serum zinc levels were determined in 71 children with SCA and painful crisis and in equal numbers in steady state. Seventy-one children with AA genotype acted as controls. Qualitative assessment of zinc content of 24-hour dietary recall and the last meal consumed before blood was drawn was taken. Serum zinc was determined using atomic absorption spectrophotometer. Haemoglobin concentration and packed cell volume (PCV) were determined using standard methods. Results. The mean serum zinc concentration in the study was less than international reference range. The controls had significantly higher serum zinc concentrations than the SCA group (42.7 ± 13.6 versus 32.3 ± 14.0 µg/dL, P < .000); this difference was due to the significantly lower values of serum zinc in SCA with painful crisis compared with the remaining two groups F = 30.9, P<.000. There was a positive correlation between serum zinc and haemoglobin concentration only in the control group (r = 0.4; P = .001). Conclusion. The serum zinc levels in this study were low. Painful crisis in SCA may exert greater demand for zinc utilization in children with SCA thereby resulting in lower serum levels.

Prevalence, pattern and risk factors for undernutrition in early infancy using the WHO Multicentre Growth Reference: a community-based study.

This cross-sectional study set out to determine the prevalence, pattern and risk factors for undernutrition during early infancy in a setting with substantial non-hospital births against the backdrop of limited evidence on nutritional status in the first three months of life based on an exclusively breast-fed reference population. Undernutrition based on z-scores below -2 for weight-for-age, height/length-for-age and body-mass-index-for-age among infants (0-3 months) attending clinics for routine Bacille de Calmette-Guérin (BCG) immunisation in Lagos, Nigeria from July 2005 to March 2008 was determined using current World Health Organisation's Multicentre Growth Reference (WHO-MGR). Maternal and infant factors associated with undernutrition were explored with multivariable logistic regression analyses. Of the 5888 full-term infants enrolled 51% were born outside hospital and 99.4% were exclusively breast-fed. 811 (13.8%) were underweight (weight-for-age), 1802 (30.8%) were stunted (height/length-for-age) and 579 (10.0%) were wasted (body-mass-index-for-age). Altogether, 3635 (61.6%) infants were not undernourished while 192 (3.3%) were undernourished by all three nutritional measures. Intrauterine growth restriction was a significant contributor to undernutrition. Maternal age, multiple pregnancies and gender were associated with all nutritional indices. Additionally, maternal education, ownership/type of residence, parity, antenatal care, place of delivery and hyperbilirubinaemia were predictive of underweight, stunting and wasting. We conclude that undernutrition is prevalent in the first three months of life in this population and can be detected early at routine immunisation clinics shortly after birth. Maternal/perinatal history offers valuable predictors in resource-poor communities where the majority of births occur outside hospital.

Sexual maturation and psychiatric morbidity among persons with sickle cell anaemia in a Nigerian teaching hospital.

BACKGROUND: Sickle Cell Anaemia (SCA), an inherited HbSS disease, is common in Nigeria with attendant high morbidity and mortality most especially in the setting of poor health care services. Impaired physical and sexual development is one of the prominent complications of SCA; and with attendant secondary psychiatric sequelae. METHODS: A cross-sectional study was carried out at the haematology clinic of Lagos University Teaching Hospital (LUTH), among adolescent attendees (10-19 years) with SCA. Age and sex-matched controls were recruited from Action Health Incorporated (AHI), an NGO to promote adolescent health advocacy. The haemoglobin genotypes SS for subjects and AA for controls were confirmed with gel electrophoresis. Each subject and control was physically examined for the assessment of external genitalia (sexual) maturation using Tanner Staging Method, and were also evaluated with General Health Questionnaire-version 12 (GHQ-12). RESULTS: In all, 136 adolescents with SCA and of equal sex distribution and equal number of controls were studied, with mean ages of 14.3 +/- 2.8 and 13.5 +/- 2.6 years, respectively. On GHQ assessment, 113 (83%) subjects and 25 (18.4%) controls had GHQ scores of 5, indicating probable presence of psychopathology. For both males and females, the subjects significantly lagged behind the controls in different areas of sexual maturation, with corresponding significant higher GHQ scores among the subjects. For example, in sexual maturation rate (SMR) stage 1 of pubic hair development, the mean ages for male subjects and controls were 11.9 +/- 1.5 and 10.7 +/- 0.9 years, respectively, with significant "t" of 5.06 at p < 0.03*; for females: 13.0 +/- 2.6 and 10.4 +/- 0.6 years for subjects and controls respectively with significant "t" of 4.36 at p < 0.04*. The corresponding GHQ scores were for subjects: < 5 for 6 and > or = 5 for 20 of the subjects respectively; and for controls, the GHQ scores were < 5 for 9 and nil of controls for > or = 5 score. The difference in GHQ scores for subjects and controls in this stage 1 pubic hair maturation was significant with chi2 = 16.15, df = 1, p = 0.00. CONCLUSION: It is concluded that SCA subjects had significantly delayed sexual maturation and increased risk of psychiatric morbidity when compared to controls. The need for genetic counseling to reduce the prevalence of SCA was emphasized.