Grandi Byen—supporting child growth and development through integrated, responsive parenting, nutrition and hygiene: study protocol for a randomized controlled trial

Kohl, Patricia L.; Gyimah, Emmanuel; Diaz, Jenna; Kuhlmann, F; Dulience, Sherlie Jean-Louis; Embaye, Fithi; Brown, Derek S.; Guo, Shenyang; Luby, Joan L.; Nicholas, Jennifer L.; Turner, Jay; Chapnick, Melissa; Pierre, Joseline Marhone; Boncy, Jacques; Fleur, Rony St.; Black, Maureen M.; Iannotti, Lora

doi:10.1186/s12887-021-03089-x

Cited by 7 publications

(8 citation statements)

References 77 publications

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“…Haiti. Importantly, this study allows for refinement of future studies to focus on Haitian-specific contexts and will be tested using the framework of an on-going randomized trial (36). Overall, our study demonstrates a high burden of DEC in Cap-Haitien, Haiti.…”

Section: Discussionmentioning

confidence: 84%

“…Since the study design does not allow us to predict the impact an episode of diarrhea has on growth, prospective studies with intensive sampling and broader pathogen detection are required in Haiti. Importantly, this study allows for refinement of future studies to focus on Haitian-specific contexts and will be tested using the framework of an on-going randomized trial (36).…”

Section: Discussionmentioning

confidence: 99%

“…Haitien. Using the existing research infrastructure, additional studies to confirm these findings and estimate the impact of specific prevention efforts on outcomes will be performed (36).…”

Section: Introductionmentioning

confidence: 99%

“…This work demonstrates a high burden of DEC in community-dwelling, undernourished children in Cap-Haitien. Using the existing research infrastructure, additional studies to confirm these findings and estimate the impact of specific prevention efforts on outcomes will be performed (36).…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of diarrheagenicEscherichia coliand impact on child health in Cap-Haitien, Haiti

Diaz

Iannotti

Dulience

et al. 2022

Preprint

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Background Diarrheagenic Escherichia coli (DEC) are common pathogens infecting children during their growth and development. Determining the epidemiology and the impact of DEC on child anthropometric measures informs prioritization of prevention efforts. These relationships were evaluated in a novel setting, Cap-Haitien, Haiti. Methods A case-control study of children 6-36 months of age enrolled 99 cases with diarrhea and 96 asymptomatic controls. Assessments were performed at enrollment and one month follow-up. Established PCR methodologies targeted DEC using fecal swabs. The association between pathogens and anthropometric z-scores was determined using multiple linear regression. Results Enterotoxigenic Escherichia coli (ETEC) was identified in 21.9% of cases vs. 16.1% of controls with heat-stable producing ETEC significantly associated with symptomatic disease. Enteroaggregative E. coli (EAEC) was found in 30.2% of cases vs. 27.3% of controls, and typical enteropathogenic E. coli in 6.3% vs. 4.0% of cases and controls, respectively. Multivariate linear regression demonstrated ETEC and EAEC were significantly associated with reduced weight-age z-score (WAZ) and height-age z-score (HAZ) after adjusting for confounders. Conclusions DEC are prevalent in north Haitian children. ETEC, EAEC, household environment, and diet are associated with unfavorable anthropometric measures. Further studies may quantify the contribution of individual pathogens to adverse health outcomes.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence of diarrheagenicEscherichia coliand impact on child health in Cap-Haitien, Haiti

Diaz

Iannotti

Dulience

et al. 2022

Preprint

Self Cite

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“…Likewise, to our knowledge, none of the 6 recommendations specifically formulated to combat child undernutrition during the pandemic (Osendarp et al, 2021 ) were systematically implemented in this population, nor was any training on these practices provided. Better parental feeding practices (Black & Aboud, 2011 ; Kohl et al, 2022 ; Pradana Putri & Rong, 2021 ) or quarantine‐related reduction in diarrheal and other illnesses or physical activity could have accounted for the improved child growth. However, none of these measures were directly assessed in this study.…”

Section: Discussionmentioning

confidence: 99%

Trajectories of child growth, child development, and home child‐rearing quality during the Covid pandemic in rural Nepal

Miller

Neupane²,

Joshi

et al. 2022

Child

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Background Children, especially disadvantaged children in poor countries, were expected to be among the “biggest victims” of the Covid pandemic. Economic burdens, decreased nutritious foods, reduced medical care, school closures, and ill‐health or death of family members were predicted to increase child undernutrition and developmental delays, and diminish home child‐rearing quality. Methods A planned nutrition intervention could not be implemented due to Covid restrictions. However, three surveys (pre‐Covid [December 2019], July 2021, and September 2021) in 280 Nepali households (309 parent‐dyads, 368 children, 6–66 months old) collected demographics, child anthropometry and development (Ages and Stages Questionnaire‐3 [ASQ‐3]), and home child‐rearing quality (caregiver engagement, learning resources, adult supervision [UNICEF's Multiple Indicator Cluster Survey]). Mixed‐effect regression models adjusted for household (wealth, maternal education) and child factors (age, gender) and survey round. Results Height, mid‐upper‐arm circumference, and head circumference measurements improved over time. The total ASQ‐3 score did not change: Communication scores increased while fine motor and personal‐social scores declined. Girls' growth and development worsened more than boys. Caregiver engagement (especially mothers') generally declined, but learning resource availability increased. More children were left unsupervised at Round 2 than Round 1 or 3. Conclusions In this sample, some aspects of child growth, development, and home child‐rearing quality improved while others declined. Better understanding of these changes in child well‐being and the family environment during the pandemic could provide insight on how to protect children during future crises.

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Choline, DHA, and Diarrheal Disease Associated with Growth Faltering in a Case-Control Study

Diaz

Dulience

Wolthausen

et al. 2022

Current Developments in Nutrition

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Background Children with recurrent infectious diarrhea are susceptible to growth faltering. Docosahexaenoic acid (DHA) and choline may play a role in this relationship due to their involvement in lipid metabolism, gut immunity, and inflammatory pathways. Objectives This study aimed to characterize the contributions made by DHA and choline status and enteric damage in young children in the association between diarrheal illness and child growth. Methods A longitudinal, case-control study was conducted among children ages 6–36 months (N = 195) in Cap-Haitien, Haiti. Mother-child dyads were recruited from community health posts and out-patient clinics. Cases were defined as children experiencing acute diarrhea within the last three days and matched to healthy controls. Child anthropometry, dietary intake, blood, and stool samples were collected at baseline and follow-up. Plasma DHA, choline, and betaine were determined by liquid chromatography-tandem mass spectrometry methods (n = 49) and intestinal fatty acid-binding protein (I-FABP) by enzyme-linked immunoassay (n = 183). Multivariate regression models were applied with mediation analyses to examine associations and adjust for confounding factors. Results At baseline, mean plasma DHA concentrations [1.03 µg/ml (95% CI: 0.91, 1.15)] were not significantly different between cases and controls, nor was there a difference in the mean plasma choline concentrations [4.5 µg/ml (95% CI: 3.8, 5.1)] between groups. Mean plasma I-FABP concentrations were significantly higher at follow-up in cases [3.34 (95% CI: 3.28, 3.40)] vs. controls [3.20 (95% CI: 3.13, 3.27)] (p = 0.002). In adjusted multilinear regression models, higher plasma DHA concentrations at follow-up were associated with a negative change in weight-age-z-score (p = 0.016), and follow-up I-FABP was inversely associated with height-age-z-score (p = 0.035). No interaction or mediation effects were found. Conclusions I-FABP concentrations were significantly higher in cases compared to controls at follow-up, suggesting ongoing enteric damage and increased risk for malnutrition. Plasma DHA and I-FABP may have a role in childhood growth outcomes.

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Grandi Byen—supporting child growth and development through integrated, responsive parenting, nutrition and hygiene: study protocol for a randomized controlled trial

Cited by 7 publications

References 77 publications

Prevalence of diarrheagenicEscherichia coliand impact on child health in Cap-Haitien, Haiti

Prevalence of diarrheagenicEscherichia coliand impact on child health in Cap-Haitien, Haiti

Trajectories of child growth, child development, and home child‐rearing quality during the Covid pandemic in rural Nepal

Choline, DHA, and Diarrheal Disease Associated with Growth Faltering in a Case-Control Study

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