Publications by authors named "Tahmeed Ahmed"

486 Publications

Effects of leaves on hemoglobin and serum retinol levels and underweight status among adolescent girls in rural Bangladesh.

Front Nutr 2022 22;9:959890. Epub 2022 Jul 22.

Icddr, b, Nutrition and Clinical Services Division, Dhaka, Bangladesh.

Objectives: has been used for centuries due to its medicinal properties and health benefits. The plant has antifungal, anti-viral, and anti-inflammatory properties. We aimed to evaluate the effect of consumption of Moringa leaves, along with a regular diet on serum hemoglobin and retinol and underweight status among rural Bangladeshi adolescent girls.

Methods: This school-based quasi-experimental study involved 226 adolescent girls (12-14 years-old). Intervention group ( = 113) received a meal comprising rice, concentrated dal, and fried potato with Moringa pakora (oil-fried snack); the control group (at a different school in an adjacent area with similar population demographics) received calorie-matched meal without Moringa pakora for 6 months. We used generalized liner regression (GLM) analysis, to explore the effect of the intervention among the groups between baseline and endline.

Results: Mean age of the intervention and control groups were 12.7 ± 0.7 and 13.3 ± 0.8 years, respectively. After adjusting for maternal education, absenteeism, asset index, BMI-for-age Z-score, GLM regression showed significant positive changes in hemoglobin (intervention vs. control: coef = 0.41, = 0.010) and serum retinol (coef = 0.27, = 0.00). No significant changes in weight was observed between groups.

Conclusion: Consumption of Moringa leaves has the potential to improving hemoglobin and serum retinol level and should be encouraged as regular diet.
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http://dx.doi.org/10.3389/fnut.2022.959890DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9353109PMC
July 2022

Enhanced women's decision-making power after the intervention in north-eastern Bangladesh: a cluster randomised pre-post study.

BMJ Open 2022 08 3;12(8):e054148. Epub 2022 Aug 3.

Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh.

Objectives: Women's decision-making power is a dimension of empowerment and is crucial for better physical and psychosocial outcomes of mothers. , a large-scale development programme in Bangladesh, actively provided social interventions on behaviour change communication to empower women belonging to the poorest social segment. This paper aims to assess the impact of the intervention on various indicators related to women's decision-making power.

Design, Setting And Participants: The evaluation design was a cluster randomised pre-post design with two cross-sectional surveys conducted among beneficiary women with at least one child aged <23 months from randomly selected poor or very poor beneficiary households in Sylhet division.

Outcome Measure: Decision-making indicators included food purchases, major household purchases, food preparation, children's healthcare as well as women's own healthcare and visiting family and relatives.

Results: Our findings suggest that 45% of women were able to make decisions on food purchases, 25% on major household purchases, 78% on food preparation, 59% on children's healthcare, 51% on their own healthcare and 43% on visiting family and relatives at baseline in the intervention group, whereas the results were almost the same in the control group. In contrast, at the endline survey, the respective proportions were 75%, 56%, 87%, 80%, 77% and 67% in the intervention group, which were significantly improved when compared with the control group. The prevalence of those outcome indicators were 64%, 41%, 80%, 71%, 68% and 56%, respectively, in the control group. As per multiple logistic regression analysis and structural equation modelling, the intervention had a substantial influence on the latent variable of women's decision-making power.

Conclusion: In terms of food purchases, major household purchases, children's healthcare, their own healthcare and visiting family and relatives, the intervention favourably influenced the decision-making power of rural women living in a vulnerable region of Bangladesh.

Trial Registration Number: RIDIE-STUDY-ID-5d5678361809b.
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http://dx.doi.org/10.1136/bmjopen-2021-054148DOI Listing
August 2022

Association of Secretor Status with Enteropathy and Growth among Children in Bangladesh Aged 1-24 Months.

Am J Trop Med Hyg 2022 Jul 11. Epub 2022 Jul 11.

Nutrition and Clinical Services Division, International Centre for Diarrhoeal Diseases Research, Dhaka, Bangladesh (icddr,b).

Secretor status refers to the ability of an individual to secrete blood group antigens into body fluids and onto the different epithelial surfaces. Concurrent findings have demonstrated an association of the secretor status of children with susceptibility to a plethora of enteropathogens. We aimed to determine a possible association of secretor status of children with childhood enteropathy, an important causal factor for childhood growth failure. Participants of the MAL-ED birth cohort study from the Bangladesh site were enrolled along with their mothers. Saliva was analyzed for determining blood groups and secretor status of the children and their mothers by using an in-house ELISA. Approximately 59% of children and 65% of mothers were found to be secretor positive. Secretor-positive children were found to have a significantly positive association with alpha-1-antitrypsin (β-coefficient: 0.11, 95% CI: 0.07, 0.21, P < 0.01) and with environmental enteric dysfunction score (β-coefficient: 0.32, 95% CI: 0.29, 0.65, P = 0.05). However, despite a negative effect size, secretor-positive children did not show any statistical significance with length-for-age and weight-for-age z scores (LAZ and WAZ), respectively. Our findings indicate toward the genetic factor of secretor status of children being associated with childhood growth faltering, through increased susceptibility to distinct enteropathogens and the consequent development of enteric inflammation and enteropathy among children. However, these findings are only applicable in Bangladeshi settings and thus need to be validated in several other similar settings, to establish a possible relationship between the secretor status of children with enteropathy and resulting childhood growth failure.
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http://dx.doi.org/10.4269/ajtmh.22-0183DOI Listing
July 2022

Association between Pathogenic Variants of Diarrheagenic Escherichia coli and Growth in Children under 5 Years of Age in the Global Enteric Multicenter Study.

Am J Trop Med Hyg 2022 07 6;107(1):72-81. Epub 2022 Jun 6.

There is a lack of information highlighting associations between different pathogenic variants of diarrheagenic Escherichia coli and childhood growth. Pathogenic variants of E. coli from stool samples, collected from 22,567 children enrolled in the Global Enteric Multicenter Study from December 2007 to March 2011, were detected by real-time polymerase chain reaction. We estimated the associations of different pathogenic variants of diarrheagenic E. coli with child growth. The association between an explanatory variable and the outcome variable was assessed using multiple linear regression, where the dependent variables were height-for-age, weight-for-age, and weight-for-height z-scores, and the independent variable was the presence of different pathogenic variants of diarrheagenic E. coli. After adjusting for potential covariates, such as age, gender, diarrhea, breastfeeding status, mother's education, number of under-5 children, handwashing practice, handwashing material, source of drinking water, wealth index, available toilet facility, copathogens, comorbidity, time, and study site, the multivariable model identified a negative association between different pathogenic variants of diarrheagenic E. coli and child growth. Our analyses may provide the cornerstone for prospective epidemiologic investigation for the development of preventive measures for diarrheagenic E. coli and combat childhood undernutrition.
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http://dx.doi.org/10.4269/ajtmh.22-0096DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9294710PMC
July 2022

Infection With Pathotypes Is Associated With Biomarkers of Gut Enteropathy and Nutritional Status Among Malnourished Children in Bangladesh.

Front Cell Infect Microbiol 2022 6;12:901324. Epub 2022 Jul 6.

Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.

() pathotypes are the most common cause of diarrhea, especially in developing countries. Environmental Enteric Dysfunction (EED) is presumed to be the result of infection with one or more pathotypes and can affect intestinal health and childhood growth. We sought to investigate the association of pathotypes infection with biomarkers of EED and nutritional status among slum-dwelling malnourished children in Bangladesh. This study comprised a total of 1050 stunted and at risk of stunting children. TaqMan Array Card assays were used to determine the presence of pathotypes in feces. Prevalence of infection with EAEC was highest (68.8%) in this cohort of children, followed by EPEC (55.9%), ETEC (44%), Shigella/EIEC (19.4%) and STEC (3.2%). The levels of myeloperoxidase and calprotectin were significantly higher in EAEC (P=0.02 and P=0.04), EPEC (P=0.02 and P=0.03) and Shigella/EIEC (P=0.05 and P=0.02) positive participants while, only calprotectin was significantly higher in ETEC (P=0.01) positive participants. Reg1B was significantly higher in participants with EAEC (P=0.004) while, neopterin levels were significantly lower in ETEC (P=0.003) and Shigella/EIEC (P=0.003) positive cases. A significant positive relationship was observed between EAEC and fecal levels of Reg1B (β = 0.28; 95% CI = 0.12, 0.43; p-value<0.001). Besides, ETEC was found to be positively and significantly associated with the levels of calprotectin (β = 0.14; 95 percent CI = 0.01, 0.26; p-value=0.037) and negatively with neopterin (β = -0.16; 95% CI = -0.30, -0.02; p-value=0.021). On the other hand, infection with EPEC was found to be negatively associated with length-for-age (β = -0.12; 95% CI = -0.22, -0.03; p-value=0.011) and weight-for-age (β = -0.11; 95% CI = -0.22, -0.01; p-value=0.037). The study findings suggest that infection with certain pathotypes (EAEC and ETEC) influences gut health and EPEC is associated with linear growth and underweight in Bangladeshi children.
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http://dx.doi.org/10.3389/fcimb.2022.901324DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9299418PMC
July 2022

Burden, Clinical Characteristics, Risk Factors, and Seasonality of Adenovirus 40/41 Diarrhea in Children in Eight Low-Resource Settings.

Open Forum Infect Dis 2022 Jul 13;9(7):ofac241. Epub 2022 May 13.

Haydom Global Health Research Centre, Haydom, Tanzania.

Background: The application of molecular diagnostics has identified enteric group adenovirus serotypes 40 and 41 as important causes of diarrhea in children. However, many aspects of the epidemiology of adenovirus 40/41 diarrhea have not been described.

Methods: We used data from the 8-site Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project birth cohort study to describe site- and age-specific incidence, risk factors, clinical characteristics, and seasonality.

Results: The incidence of adenovirus 40/41 diarrhea was substantially higher by quantitative polymerase chain reaction than enzyme immunoassay and peaked at ∼30 episodes per 100 child-years in children aged 7-15 months, with substantial variation in incidence between sites. A significant burden was also seen in children 0-6 months of age, higher than other viral etiologies with the exception of rotavirus. Children with adenovirus 40/41 diarrhea were more likely to have a fever than children with norovirus, sapovirus, and astrovirus (adjusted odds ratio [aOR], 1.62; 95% CI, 1.16-2.26) but less likely than children with rotavirus (aOR, 0.66; 95% CI, 0.49-0.91). Exclusive breastfeeding was strongly protective against adenovirus 40/41 diarrhea (hazard ratio, 0.64; 95% CI, 0.48-0.85), but no other risk factors were identified. The seasonality of adenovirus 40/41 diarrhea varied substantially between sites and did not have clear associations with seasonal variations in temperature or rainfall.

Conclusions: This study supports the situation of adenovirus 40/41 as a pathogen of substantial importance, especially in infants. Fever was a distinguishing characteristic in comparison to other nonrotavirus viral etiologies, and promotion of exclusive breastfeeding may reduce the high observed burden in the first 6 months of life.
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http://dx.doi.org/10.1093/ofid/ofac241DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9277636PMC
July 2022

Zinc kinetics correlate with length-for-age z scores in Bangladeshi infants.

J Pediatr Gastroenterol Nutr 2022 Jul 15. Epub 2022 Jul 15.

Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA 94720 (JCK).

Objectives: Stunting (length-for-age z score, LAZ < -2) has multiple causes and is prevalent in areas with low dietary zinc (Zn) intake. Zinc kinetics from non-stunted infants were used in a published model for predicting linear growth; here we directly measure zinc kinetics in stunted infants.

Methods: Zinc kinetics were determined in 9-mo old Bangladeshi infants (n=10), who were non-wasted (weight-for-length z score (WLZ) ≥ -2), ranging in LAZ from -2.9 to -0.43. Stable isotopes were administered 2 h after a meal as oral (70Zn) and intravenous (67Zn) tracers. After isotope administration, blood was sampled within 5 h and all urine and feces were collected for 24 h. Urine was sampled twice-daily out to 9 days. Data were analysed by compartmental modeling. Daily zinc intake was estimated by the model as the sum of zinc used for growth plus that lost via urine and feces. Zinc absorbed (the amount required to maintain steady state) was the sum of zinc used for growth plus urine and endogenous fecal excretions.

Results: The LAZ score correlated with serum zinc concentration (R=0.77, P=0.001), urinary zinc excretion (R=0.66, P=0.010) and fractional zinc absorption from calculated daily intake (R=0.58, P=0.030). In stunted infants (n=8) the amount of zinc absorbed did not increase with calculated zinc intake unlike published values for non-stunted infants.

Conclusions: Zinc kinetics in Bangladeshi infants correlate with LAZ and show that malabsorption of supplemental sources of zinc may occur in stunted infants.
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http://dx.doi.org/10.1097/MPG.0000000000003554DOI Listing
July 2022

Does a child's mid-upper arm circumference-for-age z-score represent another nutritional indicator of childhood malnutrition status?

Matern Child Nutr 2022 Jul 12:e13404. Epub 2022 Jul 12.

Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh.

Child wasting is defined as a weight-for-height/length z-score (WLZ/WHZ) < -2, and this indicator of nutritional status is used worldwide. However, a precise measurement is required for the assessment of a child's nutritional status, which may not always be possible due to expensive instruments, especially in poor resource settings. In some instances, mid-upper arm circumference-for-age z-score (MUACZ) is also being used for screening purposes, which is a simple and useful nutritional indicator. The objective of this paper is to identify the optimal cut-off point for the MUACZ to identify wasted children, and also to determine if the same factors are associated with MUACZ and wasting. Data were derived from the Suchana evaluation data. The optimal cut-off value was estimated via receiver operating characteristic (ROC) curve analysis using acute malnutrition as a gold standard with maximum sensitivity and specificity. Multiple logistic regression was used to assess the associated factors with the MUACZ. Using the gold standard indicator of nonwasting (WLZ ≥ -2), a positive outcome, the optimal cut-off point for the MUACZ was -1.27. The area under the ROC curve was 0.88, indicating that the model had a power of 88% to differentiate between the positive and negative classes. It implies that a child's MUACZ was correlated with WLZ, and a MUACZ below -1.27 appeared to accurately identify wasting among children aged 3-23 months. MUACZ < -1.27 might be another useful indicator of childhood wasting than a WLZ < -2.
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http://dx.doi.org/10.1111/mcn.13404DOI Listing
July 2022

Food Safety Practices and Stunting among School-Age Children-An Observational Study Finding from an Urban Slum of Bangladesh.

Int J Environ Res Public Health 2022 Jun 30;19(13). Epub 2022 Jun 30.

Nutrition and Clinical Services Division, icddr,b, Dhaka 1212, Bangladesh.

Food safety incorporates the handling, preparation, and storage of food materials in ways that prevent foodborne illness. We aimed to investigate the typical food safety practices in a Bangladeshi slum context and to explore if stunting among school-age children was associated with various components of food safety. We analysed the MAL-ED birth cohort data from the Bangladesh site. A total of 265 healthy children were enrolled in the study; we could follow up and collect food safety-related data from 187 participants. The average age of the children was 6.5 years (standard deviation or SD 0.04) and 49% of them were female. About 26% of the children were stunted. In our bivariate analysis, caregivers' handwashing practice after using the toilet, treatment of drinking water, presence of insects/pests in the cooking area, and child's eating ready-made/street food more than three times per day were significantly associated with stunting. After adjusting for pertinent factors, treatment of drinking water (adjusted odds ratio or AOR = 2.50, 95% confidence interval or CI: 1.03, 6.05), and child's eating ready-made/street food more than three times/day (AOR = 2.34, 95%CI: 1.06, 5.15) remained significantly associated with stunting. Diverse aspects of food safety practices have a substantial association with stunting among school-age children living in an unhygienic slum environment in Dhaka, Bangladesh.
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http://dx.doi.org/10.3390/ijerph19138044DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9265275PMC
June 2022

Developing shelf-stable Microbiota Directed Complementary Food (MDCF) prototypes for malnourished children: study protocol for a randomized, single-blinded, clinical study.

BMC Pediatr 2022 07 1;22(1):385. Epub 2022 Jul 1.

Nutrition and Clinical Services Division, icddr,b, Dhaka, 1212, Bangladesh.

Background: Childhood undernutrition is a major public health concern that needs special attention to achieve 2025 global nutrition targets. Moderate acute malnutrition (MAM), manifest as wasting (low weight-for-height), affects 33 million children under 5, yet there are currently no global guidelines for its treatment. We recently performed a randomized-controlled clinical study of a microbiota-directed complementary food formulation (MDCF-2) in 12-18-month-old Bangladeshi children with MAM. The results revealed that MDCF-2, freshly prepared each day, produced a significantly greater improvement in ponderal growth than a standard ready-to-use supplementary food (RUSF), an effect that is associated with repair of the disrupted gut microbial community development that occurs in children with MAM. To test the generalizability of these results in acutely malnourished children at other sites, there is a pressing need for a packaged, shelf-stable, organoleptically-acceptable formulation that is bioequivalent to MDCF-2. This report describes the protocol for a clinical study to evaluate candidate formulations designed to meet these criteria.

Methods: A randomized single-blind study will be conducted in 8-12-month-old Bangladeshi children with MAM to compare the efficacy of alternative shelf-stable MDCF prototypes versus the current MDCF-2 formulation that is produced fresh each day. V4-16S rDNA amplicon and shotgun sequencing datasets will be generated from faecal DNA samples collected from each child enrolled in each group prior to, during, and after treatment to determine the abundances of MDCF-2-responsive bacterial taxa. Efficacy will be assessed by quantifying the change in representation of MDCF-2-responsive gut bacterial taxa after 4-weeks of treatment with freshly prepared MDCF-2 compared to their changes in abundance after treatment with the prototype MDCFs. Equivalence will be defined as the absence of a statistically significant difference, after 4-weeks of treatment, in the representation of faecal bacterial taxa associated with the response to MDCF-2 in participants receiving a test MDCF.

Discussion: This trial aims to establish acceptability and equivalence with respect to microbiota repair, of scalable, shelf-stable formulations of MDCF-2 in 8-12-month-old Bangladeshi children with moderate acute malnutrition.

Trial Registration: ClinicalTrials.gov (NCT05094024). The trial has been registered before starting enrolment on 23 October 2021.
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http://dx.doi.org/10.1186/s12887-022-03436-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9247958PMC
July 2022

Prevalence and outcome of anemia among children hospitalized for pneumonia and their risk of mortality in a developing country.

Sci Rep 2022 Jun 24;12(1):10741. Epub 2022 Jun 24.

International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.

Data are limited on the prevalence and outcome of anemia and its risk on mortality among children under five years of age hospitalized for pneumonia/severe pneumonia. Thus, we conducted a secondary analysis of data extracted from Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh to address the evidence gap. Among 3468 children fulfilling the study criteria,1712 (49.4%) had anemia. If children aged ≤ 1.0, > 1.0 to 2.0, > 2.0 to < 6.0, and ≥ 6.0 to 59 months had blood hemoglobin (Hb) value of ≤ 10.7 g/dL, ≤ 9.4 g/dL, ≤ 9.5 g/dL, and ≤ 11 g/dl respectively; we considered them anemic. The trend of prevalence of anemia was found to be inversely related to increasing age (Chi-square for linear trend analysis was done to understand the relation of anemia with increasing age, which was = 6.96; p = 0.008). During hospitalization anemic children more often developed respiratory failure (7.2% vs. 4.4%, p < 0.001) and fatal outcome (7.1.0% vs. 4.2%, p < 0.001) than the children who did not have anemia. After adjusting for potential confounders, such as female sex, lack of immunization, abnormal mental status, severe acute malnutrition, dehydration, hypoxemia, severe sepsis, and bacteremia using multivariable logistic regression analysis, anemia was found to be independently associated with fatal outcome (OR = 1.88, 95% CI 1.23-2.89, p = 0.004). Thus, future interventional studies on the early management of anemia may be warranted to understand whether the intervention reduces the morbidity and deaths in such children.
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http://dx.doi.org/10.1038/s41598-022-14818-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9232587PMC
June 2022

Comparative Clinical Characteristics, Laboratory Findings, and Outcomes of Hypoxemic and Non-Hypoxemic Patients Treated at a Makeshift COVID-19 Unit in Bangladesh: A Retrospective Chart Analysis.

J Clin Med 2022 May 24;11(11). Epub 2022 May 24.

International Centre for Diarrhoeal Disease Research, (icddr,b), Dhaka 1000, Bangladesh.

Background: Starting on 31 December 2019, from Wuhan City, China, Coronavirus disease 2019 (COVID-19) caused a global pandemic by 11 March 2020. Bangladesh detected its first case on 8 March 2020, only 66 days later the detection of the first case in China. We aimed to describe the epidemiology, clinical features, laboratory characteristics, and outcomes of Bangladeshi COVID-19 patients.

Methods: This retrospective chart analysis compared Bangladeshi COVID-19 patients with hypoxemia compared to those without hypoxemia treated in a makeshift COVID-19 unit of icddr,b.

Results: By March 2021, 207 remained in-patient. Nineteen patients (9.2%) died, whereas 10 (4.8%) were referred to different facilities for definitive care. Out of 207 in-patients, 88 patients required oxygen therapy. Multivariable logistic regression identified age (1.07 (1.02-1.13)), dyspnea (3.56 (1.06-11.96)), high CRP (1.13 (1.03-1.25)), and lymphopenia (6.18 (1.81-21.10)) as the independent predictors for hypoxemia in patients hospitalized for COVID 19 (for all, < 0.05).

Conclusion: Older age, dyspnea, high CRP, and lymphopenia are simple, but important, clinical and laboratory parameters. These may help clinicians to identify COVID-19 patients early who are at risk of fatal hypoxemia. Close monitoring, and prompt and aggressive treatment of these patients would curb their morbidity and mortality, especially in resource-limited settings.
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http://dx.doi.org/10.3390/jcm11112968DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9181205PMC
May 2022

Stunting Status of Ever-Married Adolescent Mothers and Its Association with Childhood Stunting with a Comparison by Geographical Region in Bangladesh.

Int J Environ Res Public Health 2022 05 31;19(11). Epub 2022 May 31.

Nutrition and Clinical Services Division, icddr,b, Dhaka 1212, Bangladesh.

The adolescence period is considered a life stage worthy of strategic health investments since it is a critical period of physical and neuro-maturational development. Adolescent girls face different health difficulties in that phase of life. Children born to adolescent mothers are at a higher risk of undernutrition. This paper aims to estimate the prevalence of stunting among adolescent mothers and their children in Bangladesh by time period and determine the associated factors of adolescent maternal stunting status. We also sought to establish the relationship between maternal and childhood stunting by comparing the geographical regions in Bangladesh. We derived data from the nationally representative Bangladesh Demographic and Health Survey, which was conducted between 2007 and 2017/18. The outcome variables of this study were ever-married adolescent girls' stunting status and their children's stunting status. Interaction analysis between administrative division and maternal stunting status was conducted with childhood stunting as the outcome variable to investigate the impact of maternal stunting status on their children's stunting compared to geographical location. Our results indicated that in comparison to other divisions, the frequency of stunting among children and adolescent mothers was higher in the Sylhet region. It also revealed that children whose mothers were stunted had a 2.36 times increased chance of being stunted. Our study suggests that education for women could help them attain self-sufficiency and, as a result, reduce the prevalence of poor childhood nutrition, especially stunting.
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http://dx.doi.org/10.3390/ijerph19116748DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9180893PMC
May 2022

Association of human milk oligosaccharides and nutritional status of young infants among Bangladeshi mother-infant dyads.

Sci Rep 2022 06 8;12(1):9456. Epub 2022 Jun 8.

Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.

Human milk oligosaccharides (HMOs) support the development of a healthy gut microbiome and the growth of infants. We aimed to determine the association of different HMOs with severe acute malnutrition (SAM) among Bangladeshi young infants. This study was nested within a single-blind, randomized, pilot clinical trial (NCT0366657). A total of 45 breastmilk samples from mothers of < 6 months old infants who had SAM (n = 26) or were non-malnourished (n = 19) and were analyzed for constituent HMOs. Of the infants with SAM, 14 (53.85%) had secretor mothers, and 11 (57.89%) of the non-malnourished infants had secretor mothers. A one-unit increase in the relative abundance of sialylated HMOs was associated with higher odds of SAM in age and sex adjusted model (aOR = 2.00, 90% CI 1.30, 3.06), in age, sex, and secretor status adjusted model (aOR = 1.96, 90% CI 1.29, 2.98), and also in age and sex adjusted model among non-secretor mothers (aOR = 2.86, 90% CI 1.07, 7.62). In adjusted models, there was no evidence of a statistically significant association between SAM and fucosylated or undecorated HMOs. Our study demonstrates that a higher relative abundance of sialylated HMOs in mothers' breastmilk may have a negative impact on young infants' nutritional status.
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http://dx.doi.org/10.1038/s41598-022-13296-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9177541PMC
June 2022

The influence of demographic and meteorological factors on temporal patterns of rotavirus infection in Dhaka, Bangladesh.

Proc Biol Sci 2022 06 8;289(1976):20212727. Epub 2022 Jun 8.

Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA.

To quantify the potential impact of rotavirus vaccines and identify strategies to improve vaccine performance in Bangladesh, a better understanding of the drivers of pre-vaccination rotavirus patterns is required. We developed and fitted mathematical models to 23 years (1990-2012) of weekly rotavirus surveillance data from Dhaka with and without incorporating long-term and seasonal variation in the birth rate and meteorological factors. We performed external model validation using data between 2013 and 2019 from the regions of Dhaka and Matlab. The models showed good agreement with the observed age distribution of rotavirus cases and captured the observed shift in seasonal patterns of rotavirus hospitalizations from biannual to annual peaks. The declining long-term trend in the birth rate in Bangladesh was the key driver of the observed shift from biannual to annual winter rotavirus patterns. Meteorological indices were also important: a 1°C, 1% and 1 mm increase in diurnal temperature range, surface water presence and degree of wetness were associated with a 19%, 3.9% and 0.6% increase in the transmission rate, respectively. The model demonstrated reasonable predictions for both Dhaka and Matlab, and can be used to evaluate the impact of rotavirus vaccination in Bangladesh against changing patterns of disease incidence.
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http://dx.doi.org/10.1098/rspb.2021.2727DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9174722PMC
June 2022

COVID-19 among staff and their family members of a healthcare research institution in Bangladesh between March 2020 and April 2021: a test-negative case-control study.

BMJ Open 2022 06 1;12(6):e058074. Epub 2022 Jun 1.

Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh.

Objective: To identify factors associated with COVID-19 positivity among staff and their family members of icddr,b, a health research institute located in Bangladesh.

Setting: Dhaka, Bangladesh.

Participants: A total of 4295 symptomatic people were tested for SARS-CoV-2 by reverse-transcription PCR between 19 March 2020 and 15 April 2021. Multivariable logistic regression was done to identify the factors associated with COVID-19 positivity by contrasting test positives with test negatives.

Result: Forty-three per cent of the participants were tested positive for SARS-CoV-2. The median age was high in positive cases (37 years vs 34 years). Among the positive cases, 97% were recovered, 2.1% had reinfections, 24 died and 41 were active cases as of 15 April 2021. Multivariable regression analysis showed that age more than 60 years (adjusted OR (aOR)=2.1, 95% CI 1.3 to 3.3; p<0.05), blood group AB (aOR=1.5, 95% CI 1.1 to 2; p<0.05), fever (aOR=3.1, 95% CI 2.6 to 3.7; p<0.05), cough (aOR=1.3, 95% CI 1.1 to 1.6; p<0.05) and anosmia (aOR=2.7, 95% CI 1.3 to 5.7; p<0.05) were significantly associated with higher odds of being COVID-19 positive when compared with participants who were tested negative.

Conclusions: The study findings suggest that older age, fever, cough and anosmia were associated with COVID-19 among the study participants.
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http://dx.doi.org/10.1136/bmjopen-2021-058074DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9160595PMC
June 2022

Household food insecurity and unimproved toilet facilities associate with child morbidity: evidence from a cross-sectional study in Bangladesh.

BMC Public Health 2022 05 31;22(1):1075. Epub 2022 May 31.

Nutrition and Clinical Services Division, icddr,b, Mohakhali, Dhaka, 1212, Bangladesh.

Background: Despite recent progress in rural economic development and food production, the prevalence of household food insecurity (FI) and use of unimproved toilet facilities are widespread in Bangladesh. Evidence regarding the consequencs of household FI and poor sanitation on child morbidity is scarce. This study aimed to understand the association of FI and unimproved toilet facility with morbidity status of under-5 children in Bangladesh.

Methods: We used data from a cross-sectional survey that was conducted as part of an evaluation of the Maternal, Infant and Young Child Nutrition (MIYCN) Program in 9 districts of Bangladesh. The study population included children aged 6-59 months and their caregivers, identified using a two-stage cluster-sampling procedure. Child morbidity status was the outcome variable, and household FI status and type of toilet used were considered the main exposure variables in this study. We performed logistic regression, calculated adjusted odds ratios (AOR) to assess the association of child morbidity with household FI and unimproved toilet facility after adjusting for potential confounders.

Results: A total of 1,728 households were eligible for this analysis. About 23% of the households were food-insecure, and a large number of households had improved toilet facilities (93.4%). In the multivariable logistic regression model, we found that children in food-insecure households with unimproved toilet facility had 5.88 (AOR: 5.88; 95% CI 2.52, 13.70) times more chance, of being morbid compared to the children of food-secure households with improved toilet facility. A similar association of FI and toilet facilities with each of the morbidity components was observed, including diarrhea (AOR:3.6; 95% CI 1.79, 7.89), fever (AOR:3.47; 95% CI 1.72, 6.99), difficult or fast breathing with cough (AOR:3.88; 95% CI 1.99, 7.59), and difficult or fast breathing with blocked or running nose (AOR:1.29; 95% CI 0.56, 2.95).

Conclusions: Our study shows that household FI and unimproved toilet facility jointly have more deteriorative effects on child morbidity than either of these conditions alone. Therefore, it is recommended to consider these two critical factors while designing a public health intervention for reducing morbidity among under-five children.
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http://dx.doi.org/10.1186/s12889-022-13469-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9158165PMC
May 2022

Evaluating the impact of a countrywide, market-based roll-out of multiple micronutrient supplementation on low birth weight in Bangladesh: protocol for a two-arm, quasi-experimental and mixed-methods evaluation study.

BMJ Open 2022 05 30;12(5):e060230. Epub 2022 May 30.

Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh.

Introduction: Multiple micronutrient supplementation (MMS) during pregnancy has a greater potential for reducing the risk of low birth weight (LBW) compared with the standard iron-folic acid supplementation. WHO recently included MMS on their Essential Medicines List. The Social Marketing Company (SMC) in Bangladesh is implementing a countrywide, market-based roll-out of MMS to pregnant women. We aimed to evaluate the implementation of the supplementation programme and its impact on reducing LBW.

Methods And Analysis: A two-arm, quasi-experimental and mixed-methods evaluation design will be used to evaluate the impact of this 36-month roll-out of MMS. In the intervention areas, pregnant women will purchase MMS products from the SMC's pharmacy networks. Pregnant women in comparison areas will not be exposed to this product until the end of the study. We will collect 4500 pregnant women's data on anthropometric, socioeconomic, nutrition-related and relevant programme indicators during recruitment and bimonthly follow-up until the end of their pregnancy. We will measure children's birth weight within 72 hours of birth and evaluate the changes in LBW prevalence. We will observe market-based MMS service delivery-related conditions of the pharmacies and the quality of the provider's service delivery. Concurrently, we will carry out a process evaluation to appraise the programme activities and recommend course correction. Cluster-adjusted multivariable logistic regression or log-binomial regression analysis of quantitative outcome data will be performed. For qualitative data, we will follow a thematic analysis approach. We will consolidate our study findings by triangulating the data derived from different methods.

Ethics And Dissemination: This study received ethical approval from the institutional review board of icddr,b (PR number 21001). We will recruit eligible participants after obtaining their informed written/verbal consent (and assent where needed) with full disclosure about the study. The results will be disseminated through peer-reviewed publications and conference presentations.

Trial Registration Number: NCT05108454.
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http://dx.doi.org/10.1136/bmjopen-2021-060230DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9152943PMC
May 2022

Incidence of Asymptomatic Infection and Association with the Composite Index of Anthropometric Failure among Children Aged 1-24 Months in Low-Resource Settings.

Life (Basel) 2022 Apr 19;12(5). Epub 2022 Apr 19.

Nutrition and Clinical Services Division, icddr,b, 68 Shaheed Tajuddin Ahmed Sharani, Dhaka 1212, Bangladesh.

Asymptomatic or subclinical infection by diarrheal enteropathogens during childhood has been linked to poor health and nutritional outcomes. In this study, we aimed to assess the impact of asymptomatic infection on different forms of childhood malnutrition including the composite index of anthropometric failure (CIAF). We used data from 1715 children enrolled in the multi-country birth cohort study, MAL-ED, from November 2009 to February 2012. Monthly non-diarrheal stools were collected and assessed using TaqMan Array Cards (TAC). Poisson regression was used to calculate incidence rates of asymptomatic infection. Generalized estimating equations (GEE) were used to assess the association between asymptomatic infection and nutritional indicators after adjusting for relevant covariates. Incidence rates per 100 child-months were higher in Tanzania, Bangladesh and Peru. Overall, after adjusting for relevant covariates, asymptomatic infection was significantly associated with stunting (aOR 1.60; 95% CI: 1.50, 1.70), wasting (aOR 1.26; 95% CI: 1.09, 1.46), underweight (aOR 1.45; 95% CI: 1.35, 1.56), and CIAF (aOR 1.55; 95% CI: 1.46, 1.65) in all the study sites except for Brazil. The high incidence rates of asymptomatic infection underscore the immediate need for vaccines to avert the long-term sequelae involving childhood growth.
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http://dx.doi.org/10.3390/life12050607DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9147227PMC
April 2022

Seroprevalence of SARS-CoV-2 infection and associated factors among Bangladeshi slum and non-slum dwellers in pre-COVID-19 vaccination era: October 2020 to February 2021.

PLoS One 2022 23;17(5):e0268093. Epub 2022 May 23.

Health Systems and Population Studies Division, icddrb, Dhaka, Bangladesh.

Background: Seroprevalence studies have been carried out in many developed and developing countries to evaluate ongoing and past infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Data on this infection in marginalized populations in urban slums are limited, which may offer crucial information to update prevention and mitigation policies and strategies. We aimed to determine the seroprevalence of SARS-CoV-2 infection and factors associated with seropositivity in slum and non-slum communities in two large cities in Bangladesh.

Methods: A cross-sectional study was carried out among the target population in Dhaka and Chattogram cities between October 2020 and February 2021. Questionnaire-based data, anthropometric and blood pressure measurements and blood were obtained. SARS-CoV-2 serology was assessed by Roche Elecsys® Anti-SARS-CoV-2 immunoassay.

Results: Among the 3220 participants (2444 adults, ≥18 years; 776 children, 10-17 years), the overall weighted seroprevalence was 67.3% (95% confidence intervals (CI) = 65.2, 69.3) with 71.0% in slum (95% CI = 68.7, 72.2) and 62.2% in non-slum (95% CI = 58.5, 65.8). The weighted seroprevalence was 72.9% in Dhaka and 54.2% in Chattogram. Seroprevalence was positively associated with limited years of formal education (adjusted odds ratio [aOR] = 1.61; 95% CI = 1.43, 1.82), lower income (aOR = 1.23; 95% CI = 1.03, 1.46), overweight (aOR = 1.2835; 95% CI = 1.26, 1.97), diabetes (aOR = 1.67; 95% CI = 1.21, 2.32) and heart disease (aOR = 1.38; 95% CI = 1.03, 1.86). Contrarily, negative associations were found between seropositivity and regular wearing of masks and washing hands, and prior BCG vaccination. About 63% of the population had asymptomatic infection; only 33% slum and 49% non-slum population showed symptomatic infection.

Conclusion: The estimated seroprevalence of SARS-CoV-2 was more prominent in impoverished informal settlements than in the adjacent middle-income non-slum areas. Additional factors associated with seropositivity included limited education, low income, overweight and pre-existing chronic conditions. Behavioral factors such as regular wearing of masks and washing hands were associated with lower probability of seropositivity.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0268093PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9126397PMC
May 2022

Prevalence, Predictive Factors, and Outcomes of Respiratory Failure in Children With Pneumonia Admitted in a Developing Country.

Front Pediatr 2022 4;10:841628. Epub 2022 May 4.

Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.

Background: Pneumonia has been the leading infectious cause of morbidity and mortality in children under 5 years of age for the last several decades. Although most of these deaths occur due to respiratory failure, published data are limited regarding predicting factors and outcomes of respiratory failure in children hospitalized with pneumonia or severe pneumonia.

Objective: This study aimed to explore the prevalence, predicting factors, and outcomes of respiratory failure in children under-five with pneumonia or severe pneumonia.

Methods: In this retrospective chart analysis, we enrolled children under 5 years of age hospitalized with pneumonia or severe pneumonia in the Dhaka Hospital of International Centre for Diarrheal Disease Research, Bangladesh (icddr,b) between August 2013 and December 2017. Comparisons were made between children with respiratory failure ( = 212) and those without respiratory failure ( = 4,412). Respiratory failure was defined when the oxygen saturation/fraction of inspired oxygen (SpO/FiO) was <315.

Results: A total of 4,625 children with pneumonia or severe pneumonia were admitted during this study period. Among them, 212 (4.6%) children developed respiratory failure and formed the case group. A total of 4,412 (95.3%) children did not develop respiratory failure and formed the comparison group. In logistic regression analysis, after adjusting with potential confounders, severe sepsis [adjusted odds ratio (aOR): 12.68, 95% CI: 8.74-18.40], convulsion (aOR: 4.52, 95% CI: 3.06-6.68), anemia (aOR: 1.76, 95% CI: 1.20-2.57), and severe underweight (aOR: 1.97, 95% CI: 1.34-2.89) were found to be independently associated with respiratory failure. As expected, children with respiratory failure more often had fatal outcome than without respiratory failure (74, 1%, < 0.001).

Conclusion: The results of our analyses revealed that prevalence of respiratory failure was 4.6% among under-five children hospitalized for pneumonia or severe pneumonia. Severe sepsis, convulsion, anemia, and severe underweight were the independent predictors for respiratory failure in such children and their case-fatality rate was significantly higher than those without respiratory failure. Early recognition of these predicting factors of respiratory failure may help clinicians imitating prompt treatment that may further help to reduce deaths in such children, especially in resource-limited settings.
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http://dx.doi.org/10.3389/fped.2022.841628DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9115563PMC
May 2022

The effect of electronic job aid assisted one-to-one counselling to support exclusive breastfeeding among 0-5-month-old infants in rural Bangladesh.

Matern Child Nutr 2022 07 19;18(3):e13377. Epub 2022 May 19.

Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.

Exclusive breastfeeding (EBF) for the first 6 months has established benefits, yet had slow improvements globally. Little is known about electronic job aid-assisted counselling to support EBF. As a secondary outcome of a cluster randomized controlled trial in Bangladesh, we assessed the effect of electronic job aid-supported nutrition counselling and practical demonstration on EBF. We randomized pregnant women to one of five study arms in the trial and followed mother-child dyads until 2 years of age. Community health workers (CHWs) provided breastfeeding counselling with or without prenatal and complementary nutrient supplements in all four intervention arms. The comparison arm continued with the usual practice where mothers could receive nutrition counselling at routine antenatal and postnatal care, and during careseeking for childhood illnesses. We assessed breastfeeding indicators at birth and monthly until the child was 6 months old, in both intervention and comparison arms. To evaluate the effect of nutrition counselling on breastfeeding, we combined all four intervention arms and compared them with the comparison arm. Intervention newborns had half the risk (relative risk [RR]: 0.54, 95% confidence interval [CI]: 0.39, 0.76) of receiving prelacteal feeds than those in the comparison arm. EBF declined steeply in the comparison arm after 3 months of age. EBF was 16% higher in the intervention than the comparison arm at 4 months (RR: 1.16, 95% CI: 1.08, 1.23) and 22% higher at 5 months of age (RR: 1.22, 95% CI: 1.12, 1.33). Maternal background and household characteristics did not modify the intervention effect, and we observed no difference in EBF among caesarean versus vaginal births. Breastfeeding counselling and practical demonstration using an electronic job aid by CHWs are promising interventions to improve EBF and are scalable into existing community-based programmes.
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http://dx.doi.org/10.1111/mcn.13377DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9218319PMC
July 2022

Maternal Underweight and Its Association with Composite Index of Anthropometric Failure among Children under Two Years of Age with Diarrhea in Bangladesh.

Nutrients 2022 May 5;14(9). Epub 2022 May 5.

Nutrition and Clinical Services Division, icddr,b, Dhaka 1212, Bangladesh.

Malnutrition in women has been a long-standing public health concern, with serious effects on child survival and development. Maternal body mass index (BMI) is an important maternal nutritional indicator. There are few published studies although child anthropometric failures do not occur in isolation and identifying children with single versus several co-occurring failures can better capture cases of growth failure in combination: stunting, wasting, and underweight. In the context of multiple anthropometric failures, traditional markers used to assess children's nutritional status tend to underestimate overall undernutrition. Using the composite index of anthropometric failure (CIAF), we aimed to assess the association between maternal undernutrition and child undernutrition among children with diarrhea under the age of two and to investigate the correlates. Using 1431 mother-child dyads from the Antibiotic for Children with Diarrhea (ABCD) trial, we extracted children's data at enrollment and on day 90 and day 180 follow-ups. ABCD was a randomized, multi-country, multi-site, double-blind, placebo-controlled clinical trial. The Bangladesh site collected data from July 2017 to July 2019. The outcome variable, CIAF, allows combinations of height-for-age, height-for-weight, and weight-for-age to determine the overall prevalence of undernutrition. The generalized estimating equation was used to explore the correlates of CIAF. After adjusting all the potential covariates, maternal undernutrition status was found to be strongly associated with child undernutrition using the CIAF [aOR: 1.4 (95% CI: 1.0, 1.9), -value = 0.043] among the children with diarrhea under 2 years old. Maternal higher education had a protective effect on CIAF [aOR: 0.7 (95% CI: 0.5, 0.9), -value = 0.033]. Our study findings highlight the importance of an integrated approach focusing on maternal nutrition and maternal education could affect a reduction in child undernutrition based on CIAF.
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http://dx.doi.org/10.3390/nu14091935DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9105738PMC
May 2022

Plasma Kynurenine to Tryptophan Ratio Is Not Associated with Undernutrition in Adults but Reduced after Nutrition Intervention: Results from a Community-Based Study in Bangladesh.

Nutrients 2022 Apr 20;14(9). Epub 2022 Apr 20.

Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh.

Infections and persistent immunological activation are linked to increased kynurenine (KYN) and the KYN-to-Tryptophan (TRP) or KT ratio and may be critical factors in undernutrition. We sought to determine the association between the KT ratio and adult malnutrition, as well as investigate if nutritional supplementation had any influence on the decrease of the KT ratio. A total of 525 undernourished adults aged 18-45 years were recruited and provided a nutrition intervention for 60 feeding days. TRP and KYN concentrations were determined from plasma samples using LC-MS/MS. At baseline, the median (interquartile range (IQR)) TRP, KYN and KT ratios were 24.1 (17.6, 34.3) µmol/L, 0.76 (0.53, 1.18) µmol/L and 30.9 (24.5, 41.7), respectively. Following intervention, the median (IQR) KYN and KT ratios were significantly reduced to 0.713 (0.46, 1.12) µmol/L and 27.5 (21.3, 35.8). The KT ratio was found to be inversely linked with adult BMI (coefficient: -0.09; 95% CI: -0.18, 0.004; -value = 0.06) but not statistically significant. Additionally, Plasma CRP was correlated positively, while LRP1 was inversely correlated with the KT ratio. Our data suggest that in Bangladeshi adults, the KT ratio is not related to the pathophysiology of malnutrition but correlated with inflammatory and anti-inflammatory biomarkers, and the ratio can be reduced by a nutrition intervention.
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http://dx.doi.org/10.3390/nu14091708DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9104876PMC
April 2022

Gut microbiome development and childhood undernutrition.

Cell Host Microbe 2022 05;30(5):617-626

The Edison Family Center for Genome Sciences and Systems Biology, Washington University in St. Louis, St. Louis, MO 63110, USA; Center for Gut Microbiome Research, Washington University in St. Louis, St. Louis, MO 63110, USA. Electronic address:

Forty-five percent of deaths among children under 5 years of age are associated with undernutrition. Globally, almost 200 million children exhibit the two major forms of undernutrition-wasting (low weight-for-height) or stunting (low height-for-age), with many affected by both. Undernutrition is not due to food insecurity alone. Growing evidence indicates that perturbed postnatal gut microbiome development contributes to its pathogenesis. This perspective focuses on defining and repairing these defects in gut microbiome development. We describe an approach that involves the analysis of well-phenotyped human cohorts, followed by preclinical studies using gnotobiotic animals colonized with microbiota from these cohorts. Additionally, these models can be used to identify therapeutic targets and candidates that can then be tested clinically. Furthermore, introducing pretreatment microbiota from trial participants into gnotobiotic animals and re-enacting trial conditions allow mechanisms to be dissected. We highlight these recent advances as well as gaps in existing knowledge that present opportunities for future research.
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http://dx.doi.org/10.1016/j.chom.2022.04.002DOI Listing
May 2022

Products of gut microbial Toll/interleukin-1 receptor domain NADase activities in gnotobiotic mice and Bangladeshi children with malnutrition.

Cell Rep 2022 04;39(4):110738

Edison Family Center for Genome Sciences and Systems Biology, Washington University School of Medicine, St. Louis, MO 63110, USA; Center for Gut Microbiome and Nutrition Research, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA. Electronic address:

Perturbed gut microbiome development has been linked to childhood malnutrition. Here, we characterize bacterial Toll/interleukin-1 receptor (TIR) protein domains that metabolize nicotinamide adenine dinucleotide (NAD), a co-enzyme with far-reaching effects on human physiology. A consortium of 26 human gut bacterial strains, representing the diversity of TIRs observed in the microbiome and the NAD hydrolase (NADase) activities of a subset of 152 bacterial TIRs assayed in vitro, was introduced into germ-free mice. Integrating mass spectrometry and microbial RNA sequencing (RNA-seq) with consortium membership manipulation disclosed that a variant of cyclic-ADPR (v-cADPR-x) is a specific product of TIR NADase activity and a prominent, colonization-discriminatory, taxon-specific metabolite. Guided by bioinformatic analyses of biochemically validated TIRs, we find that acute malnutrition is associated with decreased fecal levels of genes encoding TIRs known or predicted to generate v-cADPR-x, as well as decreased levels of the metabolite itself. These results underscore the need to consider microbiome TIR NADases when evaluating NAD metabolism in the human holobiont.
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http://dx.doi.org/10.1016/j.celrep.2022.110738DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9092222PMC
April 2022

Exploratory Analysis of Selected Components of the mTOR Pathway Reveals Potentially Crucial Associations with Childhood Malnutrition.

Nutrients 2022 Apr 12;14(8). Epub 2022 Apr 12.

Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh.

Dysregulations in the mammalian target of rapamycin (mTOR) pathway are associated with several human anomalies. We aimed to elucidate possible implications for potential aberrations in the mTOR pathway with childhood malnutrition. We analyzed the activity of phospho-mTORC1 and the expressions of several mTOR pathway genes, namely: , , , and from peripheral blood mononuclear cells isolated from venous blood of children suffering from different forms of malnutrition and compared them with those from healthy children. Significant reduction in the phosphorylation of mTORC1 was noted, as well as a decrease in expression of gene and increase in gene expression were observed between malnourished children in comparison to the healthy children. The deregulation in the activity of the and gene was significantly associated with all forms of childhood malnutrition. Our findings provide key insights into possible down-modulation in the overall activity of the mTOR pathway in childhood malnutrition. Further studies focusing on the analysis of a multitude of components involved in the mTOR pathway both at the gene and protein expression levels are required for conclusive evidence for the aforementioned proposition.
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http://dx.doi.org/10.3390/nu14081612DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9031007PMC
April 2022

Socioeconomic Inequalities in Women's Undernutrition: Evidence from Nationally Representative Cross-Sectional Bangladesh Demographic and Health Survey 2017-2018.

Int J Environ Res Public Health 2022 04 13;19(8). Epub 2022 Apr 13.

The National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 2601, Australia.

The objective of this study was to explore the socioeconomic inequalities in undernutrition among ever-married women of reproductive age. We used nationally representative cross-sectional data from the Bangladesh Demographic and Health Survey, 2017-2018. Undernutrition was defined as a body mass index (BMI) of <18.5 kg/m. The concentration index (C) was used to measure the socioeconomic inequality in the prevalence of women's undernutrition. A multiple binary logistic regression model was carried out to find out the factors associated with women's undernutrition. The prevalence of undernutrition among women of 15-49 years was 12%. Among them, 8.5% of women were from urban and 12.7% of women were from rural areas. The prevalence of undernutrition was highest (21.9%) among women who belonged to the adolescent age group (15-19 years). The C showed that undernutrition was more prevalent among the socioeconomically worst-off (poorest) group in Bangladesh (C = -0.26). An adjusted multiple logistic regression model indicated that women less than 19 years of age had higher odds (adjusted odds ratio, AOR: 2.81; 95% confidence interval, CI: 2.23, 3.55) of being undernourished. Women from the poorest wealth quintile (AOR: 3.93, 95% CI: 3.21, 4.81) had higher odds of being undernourished. On the other hand, women who had completed secondary or higher education (AOR: 0.55; 95% CI: 0.49, 0.61), married women who were living with their husbands (AOR: 0.72, 95% CI: 0.61, 0.86), and women exposed to mass media (AOR: 0.87, 95% CI: 0.79, 0.97) were less likely to be undernourished. Intervention strategies should be developed targeting the poorest to combat undernutrition in women of reproductive age in Bangladesh.
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http://dx.doi.org/10.3390/ijerph19084698DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9031436PMC
April 2022

A Microbiota-Directed Food Intervention for Undernourished Children. Reply.

N Engl J Med 2022 04;386(15):1484

Washington University School of Medicine, St. Louis, MO

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http://dx.doi.org/10.1056/NEJMc2110544DOI Listing
April 2022

treatment promotes weight gain in Bangladeshi infants with severe acute malnutrition.

Sci Transl Med 2022 04 13;14(640):eabk1107. Epub 2022 Apr 13.

Edison Family Center for Genome Sciences and Systems Biology, Washington University School of Medicine, St. Louis, MO 63110, USA.

Disrupted development of the gut microbiota is a contributing cause of childhood malnutrition. subspecies is a prominent early colonizer of the infant gut that consumes human milk oligosaccharides (HMOs). We found that the absolute abundance of is lower in 3- to 24-month-old Bangladeshi infants with severe acute malnutrition (SAM) compared to their healthy age-matched counterparts. A single-blind, placebo-controlled trial (SYNERGIE) was conducted in 2- to 6-month-old Bangladeshi infants with SAM. A commercial U.S. donor-derived strain (EVC001) was administered daily with or without the HMO lacto--neotetraose for 28 days. This intervention increased fecal abundance in infants with SAM, although to levels still 10- to 100-fold lower than in untreated healthy controls. EVC001 treatment promoted weight gain that was associated with reduced intestinal inflammation markers in infants with SAM. We cultured fecal strains from Bangladeshi infants and colonized gnotobiotic mice with these cultured strains. The gnotobiotic mice were fed a diet representative of that consumed by 6-month-old Bangladeshi infants, with or without HMO supplementation. One strain, Bg_2D9, expressing two gene clusters involved in uptake and utilization of -glycans and plant-derived polysaccharides, exhibited superior fitness over EVC001. The fitness advantage of Bg_2D9 was confirmed in a gnotobiotic mouse model of mother-to-infant gut microbiota transmission where dams received a pretreatment fecal community from a SAM infant in the SYNERGIE trial. Whether Bg_2D9 is superior to EVC001 for treating malnourished infants who consume a diet with limited breastmilk requires further clinical testing.
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http://dx.doi.org/10.1126/scitranslmed.abk1107DOI Listing
April 2022
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