clove and Anemia

Iron deficiency anemia affects hundreds of millions of women and children worldwide and is associated with impaired infant outcomes. Small-quantity lipid-based nutrient supplement (LNS) have been found to reduce the prevalence of anemia and iron deficiency in some trials.. We evaluated the effectiveness of daily LNS supplementation on child anemia and micronutrient status in Madagascar within the context of an existing, scaled-up nutrition program.. We cluster-randomized 125 communities to (T0) a routine program with monthly growth monitoring and nutrition education; (T1) T0 + home visits for intensive nutrition counselling; (T2) T1 + LNS for children aged 6-18 mo; (T3) T2 + LNS for pregnant/lactating women; or (T4) T1 + parenting messages. Pregnant women and infants aged <12 mo were enrolled in 2014 and followed for 2 y. Child outcome measures included hemoglobin and anemia assessed using the HemoCue 301 system (n = 3561), and serum ferritin and soluble transferrin receptor as markers of iron status, retinol-binding protein as a marker of vitamin A status, and C-reactive protein and α-1 acid glycoprotein from a finger stick blood draw among a subsample (n = 387). We estimated mean difference using linear regression and prevalence ratios using modified Poisson regression accounting for the clustered design. All analyses were intention-to-treat.. Children in the LNS groups (T2 and T3) had ∼40% lower prevalence of anemia and iron deficiency anemia and 25% lower prevalence of iron deficiency than children in the control group (T0) (P < 0.05 for all). There were no differences in any of the biomarkers when comparing children in the T4 group with those in T0; nor were there differences between T3 and T2.. Our findings suggest the provision of LNS in the context of a large-scale program offers significant benefits on anemia and iron status in young children.This trial was registered at www.isrctn.com as ISRCTN14393738.

Topics: Adult; Anemia; Child, Preschool; Cluster Analysis; Dietary Supplements; Female; Humans; Infant; Infant, Newborn; Lipids; Longitudinal Studies; Madagascar; Micronutrients; Nutritional Status; Pregnancy; Young Adult

Anaemia occurs in children when the haemoglobin level in the blood is less than the normal (11 g/dL), the consequence is the decrease of oxygen quantity in the tissues. It is a prevalent public health problem in many low-income countries, including Madagascar, and data on risk factors are lacking. We used existing data collected within the pathophysiology of environmental enteric dysfunction (EED) in Madagascar and the Central African Republic project (AFRIBIOTA project) conducted in underprivileged neighbourhoods of Antananarivo to investigate the factors associated with anaemia in children 24 to 59 months of age.. Children included in the AFRIBIOTA project in Antananarivo for whom data on haemoglobin and ferritin concentrations were available were included in the study. Logistic regression modelling was performed to identify factors associated with anaemia.. Of the 414 children included in this data analysis, 24.4% were found to suffer from anaemia. We found that older children (adjusted OR: 0.95; 95% CI: 0.93-0.98) were less likely to have anaemia. Those with iron deficiency (adjusted OR: 6.1; 95% CI: 3.4-11.1) and those with a high level of faecal calprotectin (adjusted OR: 2.5; 95% CI: 1.4-4.4) were more likely to have anaemia than controls.. To reduce anaemia in the children in this underprivileged area, more emphasis should be given to national strategies that improve children's dietary quality and micronutrient intake. Furthermore, existing measures should be broadened to include measures to reduce infectious disease burden.

Topics: Adolescent; Anemia; Anemia, Iron-Deficiency; Child; Child, Preschool; Ferritins; Humans; Iron Deficiencies; Madagascar; Poverty; Prevalence

This study assesses the impact of an integrated infant and young child feeding (IYCF) and micronutrient powder (MNP) intervention on children's risk of anemia and IYCF practices in Madagascar. Quantitative baseline and endline surveys were conducted in representative households with children 6-23 months from two districts, where an 18-month IYCF-MNP intervention was implemented. Relative risks comparing children's risk of anemia and maternal IYCF knowledge and practices at baseline versus endline, and also at endline among MNP-users versus non-users were estimated using log-binomial regression models. 372 and 475 children aged 6-23 months were assessed at baseline and endline respectively. Prevalence of anemia fell from 75.3% to 64.9% from baseline to endline (

Topics: Adult; Anemia; Caregivers; Dietary Supplements; Female; Humans; Infant; Infant Nutritional Physiological Phenomena; Madagascar; Male; Micronutrients; Nutrition Surveys; Powders

Terrestrial wildlife is the primary source of meat for hundreds of millions of people throughout the developing world. Despite widespread human reliance on wildlife for food, the impact of wildlife depletion on human health remains poorly understood. Here we studied a prospective longitudinal cohort of 77 preadolescent children (under 12 y of age) in rural northeastern Madagascar and show that consuming more wildlife was associated with significantly higher hemoglobin concentrations. Our empirical models demonstrate that removing access to wildlife would induce a 29% increase in the numbers of children suffering from anemia and a tripling of anemia cases among children in the poorest households. The well-known progression from anemia to future disease demonstrates the powerful and far-reaching effects of lost wildlife access on a variety of human health outcomes, including cognitive, motor, and physical deficits. Loss of access to wildlife could arise either from the diligent enforcement of existing conservation policy or from unbridled unsustainable harvest, leading to depletion. Conservation enforcement would enact a more rapid restriction of resources, but self-depletion would potentially lead, albeit more slowly, both to irrevocable local wildlife extinctions and loss of the harvested resource. Our research quantifies costs of reduced access to wildlife for a rural community in Madagascar and illuminates pathways that may broadly link reduced natural resource access to declines in childhood health.

Topics: Anemia; Animals; Animals, Wild; Biodiversity; Child; Child Nutritional Physiological Phenomena; Child, Preschool; Conservation of Natural Resources; Diet; Female; Health Status; Hemoglobins; Humans; Incidence; Longitudinal Studies; Madagascar; Male; Meat; Prospective Studies; Rural Health; Rural Population

The parents 'educational conditions are one of the factors of health inequalities among children. During May 2009, the parents' instruction level of children admitted at the triage unit of a Pediatric Service in Antananarivo, Madagascar was evaluated and related to the severity of their children' health status and to the mode of reference. All the surviving children (from 2 months to 15 years old) were included in this study. Patients were classified by the IMCI guideline and we analyzed the educational level of their mothers. Each patient was classified as severe illness or without severe illness, according to IMCI algorithm. The quality of referring physician was recorded: public physicians, liberal physicians, nurses, or without referral. Among 296 children, 9 (3%) died before admission, 217 (75.6%) were included. Among them, 123 (56.7%) had a severe illness and 38,2% general signs of danger. The severity (92.3 versus 54.4%; P = 0.003), the number of severe dehydration (15.4 versus 3.9%; P = 0,027) and malnutrition (15.4 versus 4.4%; P = 0.039) were related with a poor parents educational level. The referral agents were mostly liberal physicians (56.7%), public physicians (26.7%) or nurses (1.8%). Mothers with higher educational level preferred to attend liberal physicians (58 versus 41.9%; P = 0.1). The reference delay was shorter if there was a severe illness (6.41 versus 19.6 days; P < 0.000) or no medical referral (51.1 versus 24.4%; P > 0.000). Despite the fact that access to hospital care was respectful of a two-step process (85.3%), the number of patients with severe illness was high among families with low educational level. Theses results suggest to educate in priority the mother with low education, in order to recognize the general signs of danger and facilitate early first health care.

Topics: Adolescent; Algorithms; Anemia; Child; Child, Preschool; Dehydration; Diagnosis-Related Groups; Diarrhea; Educational Status; Emergencies; Emergency Service, Hospital; Female; Fever; Hospitals, Urban; Humans; Infant; Madagascar; Male; Malnutrition; Mothers; Pneumonia; Prospective Studies; Referral and Consultation; Severity of Illness Index; Socioeconomic Factors

The Island of Sainte Marie is located at 6 km from the Eastern Coast of Madagascar. The climate is a muggy tropical one, with an average temperature rising above 20 degrees C all along the year and precipitations superior to 2500 mm. In 1990, a clinical surveillance of ten affections has been performed by every health units of the Island: paludal syndromes, nutrition disorders and anemia have been the focus of symptomatic definition. Blood samples have been taken from 100 pupils of the village of Ambodiforaha for hemogram determination and research of malaria hematozoon. Four pupils out of five show biological anemia, more than 10% suffer from acute anemia (less than 3.5 millions of red blood cells for each microliters, hematocrit inferior to 30, less than 9 g of hemoglobin for 100 ml). 87% suffer from nutritional anemia, 17% from iron-deficient anemia. Those figures cannot be found in health statistics. There is a high rate of nutritional and iron deficient anemia, but the problem is not well perceived or not at all by the health system. Anemia must be related to the strength of paludal transmission, to the importance of nutrition disorders and the prevalence of intestinal parasitosis. A better knowledge of the epidemiology of anemias and their morbid consequences would allow the setting of a prevention programme useful for children under 5 years and for pregnant women.

Topics: Adolescent; Anemia; Child; Child Nutrition Disorders; Child, Preschool; Female; Health Surveys; Hematocrit; Hemoglobins; Humans; Indian Ocean Islands; Intestinal Diseases, Parasitic; Madagascar; Malaria; Male; Population Surveillance; Prevalence; Referral and Consultation; Seasons

A Gram-negative organism isolated from a btich, in Madagascar, was examined by bacteriologic, immunologic and metabolic methods, in parallel with cultures representative of the Brucella species. The organism fits well into the genus Brucella on the basis of its growth, biochemical and antigenic characteristics and was found to have the metabolic pattern on L-asparagine (-), L-arginine (+) and DL-ornithine (+) that identifies and defines the species Brucella suis. It is of rough colonial morphology and electron microscopy showed a cell wall structure similar to that of other rough Brucella. By all the other recommended criteria for btotype identification it was found to be similar to Brucella suis biotype 5 best known as Brucella canis. In contrast to the strains of this biotype, it grows on basic fuchsin at 20 mug/ml and on safranine O at 200 mug/ml. These differences obtained with just one strain would not justify by now the proposal for a new biotype. We favor the designation Brucella suis biotype 5 proposed by Meyer, and the validity of Brucella canis (Carmichael and Bruner) as a separate species is discussed. It is the first strain of Brucella isolated in Madagascar.

Topics: Abortion, Induced; Anemia; Animals; Brucella; Dog Diseases; Dogs; Female; Immunodiffusion; Immunoelectrophoresis; Madagascar

Topics: Anemia; Humans; Hypersplenism; Hypertension; Hypertension, Portal; Madagascar; Schistosomiasis; Splenomegaly; Venous Pressure

Topics: Anemia; Anemia, Sickle Cell; Anthropology; Black People; Humans; Madagascar

Topics: Anemia; Anemia, Sickle Cell; Black People; Erythrocytes, Abnormal; Humans; Madagascar