Child development, growth and microbiota: follow-up of a randomized education trial in Uganda

Abstract

Child development, growth and microbiota: follow-up of a randomized education trial in Uganda Background Undernutrition impairs child development outcomes and growth. In this follow-up study of an open cluster-randomized intervention trial we examined the effects of an education package delivered to mothers in rural Uganda on their children' s development, growth and gut microbiota at 36 months of age. Methods The parental trial included 511 mother-child pairs recruited when the children were 6-8 months. In that trial, a nutrition, stimulation and hygiene education was delivered to mothers in the intervention group while the control group received routine health care. A follow-up sample of 155 pairs (intervention n = 77, control n = 78) were re-enrolled when the children were 24 months. Developmental outcomes were assessed with the Bayley Scales of Infant and Toddler Development (BSID-III) composite scores for cognitive (primary endpoint), language and motor development. Development outcomes were also evaluated using the Ages and Stages Questionnaire (ASQ) and the Mullen Scales of Early Learning (MSEL). Other outcomes included growth and gut microbiota composition. Results The demographic characteristics were not different (P > 0.05) between the intervention and control groups and similar to those of the parental study. The intervention group had higher BSID-III scores than controls, with mean difference 10.13 (95% confidence interval (CI): 3.31-17.05, P = 0.002); 7.59 (1.62-13.66, P = 0.01); 9.00 (2.92-15.40, P = 0.005), for cognitive, language and motor composite scores, respectively. An improvement in the intervention compared to the control group was obtained for both the ASQ and the MSEL scores. The mean difference in height-forage z-score was higher in the intervention compared to the control group: 0.50 (0.25-0.75, P = 0.0001). Gut microbiota composition did not differ significantly between the two study groups. Conclusions The maternal education intervention had positive effects on child development and growth at three years, but did not alter gut microbiota composition. This intervention may be applicable in other low-resource settings. Trial registration ClinicalTrials.gov registration number NCT02098031.

No associations between microbiota signalling substances and cognitive, language and motor development among three‐year‐old rural Ugandan children

“…Our previous RCT showed that maternal education in nutrition, hygiene and stimulation markedly improved children's cognitive, language and motor skills. 3 The number of bacteria and species did not differ between the intervention and control groups. However, bacteria-derived signalling mediators could play a causative role in mediating these positive developmental findings, such as short-chain fatty acids (SCFA) and/or other elements of the gut-brain axis, such as the kynurenine pathway.…”

Aflatoxins: Occurrence, Exposure, and Binding to Lactobacillus Species from the Gut Microbiota of Rural Ugandan Children

“…These children took part in a randomized trial in the two districts of Kabale and Kisoro, located in the southwestern part of Uganda ( Figure 1). The trial assessed the effect of an educational intervention (focusing on nutrition, hygiene, and stimulation) on their growth and development as described in detail in previous publications [30,31]. Samples of the stool and urine were taken from every child in this study.…”

“…All isolated strains are accessible from the strain collection of the Department of Molecular Cell Biology, Vrije Universiteit Amsterdam, The Netherlands, as well as the Department of Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Uganda, in order to assure benefit sharing in accordance with the Nagoya protocol [41]. The correlation between the Lactobacillus species isolated at 54-60 months and microbiota at 20-24 and 36 months was assessed by matching the V4 amplicon sequences of our nearly full-length 16S rRNA sequences with our previously collected microbiota data (Sequence Read Archive SUB4476421) [31].…”

“…In this study, 23 Lactobacillus strains were isolated from fecal samples of 10 children aged 54 to 60 months ( Table 2). The identification of the strains was performed based on 16S rRNA gene sequencing [31]. As nearly full-length 16S rRNA sequencing was applied, only one unambiguous identification was found on the species level of either L. casei or L. paracasei with both a percentage identity of 96% ( Supplementary File S3).…”

Predicting Low Birth Weight: A comparison of Anthropometric Measurements taken by Midwives and Community Health Workers in Uganda

“…Anthropometric parameters vary in terms of populations across communities, regions and countries [7]. Genetic factors including ethnicity [8] and environmental factors such as metrological and nutrition [8,9] have been found to predict anthropometric parameters. From a study in eastern Uganda, it was reported that foot length when compared to chest, mid upper arm, head , thigh and calf circumferences, is the best predictor of low birth weight [10].…”