School of Vocational Studies
https://hdl.handle.net/20.500.12504/4
2024-03-29T08:13:32ZLongitudinal assessments of child growth: a six-year follow-up of a cluster-randomized maternal education trial
https://hdl.handle.net/20.500.12504/1609
Longitudinal assessments of child growth: a six-year follow-up of a cluster-randomized maternal education trial
Prudence, Atukunda; Moses, Ngari; Xi, Chen; Ane, C. Westerberg; Per, O. Iversen; Grace, Muhoozi
Background & aims:
Child growth impairments are rampant in sub-Saharan Africa. To combat this
important health problem, long-term follow-up studies are needed to examine possible benefits and
sustainability of various interventions designed to correct inadequate child growth. Our aim was to
perform a follow-up study of children aged 60e72 months whose mothers participated in a two-armed
cluster-randomized education intervention trial lasting 6 months in rural Uganda when their children
were 6e8 months old with data collection at 20e24 and at 36 months. The education focused on
nutrition, hygiene, and child stimulation.
Methods:
We measured growth using anthropometry converted to z-scores according to WHO guide-
lines. We also included assessments of body composition using bioimpedance. We used multilevel mixed
effect linear regression models with maximum likelihood method, unstructured variance-covariance
structure, and the cluster as a random effect component to compare data from the intervention
(receiving the education and routine health care) with the control group (receiving only routine health
care).
Results:
Of the 511 children included in the original trial, data from 166/263 (63%) and 141/248 (57%) of
the children in the intervention and control group, respectively, were available for the current follow-up
study. We found no significant differences in any anthropometrical z-score between the two study
groups at child age of 60e72 months, except that children in the intervention group had lower
(P ¼ 0.006) weight-for-height z-score than the controls. There were no significant differences in the
trajectories of z-scores or height growth velocity (cm/year) from baseline (start of original trial) to child
age of 60e72 months. Neither did we detect any significant difference between the intervention and
control group regarding body composition (fat mass, fat free mass, and total body water) at child age 60
e72 months. Separate gender analyses had no significant impact on any of the growth or body
composition findings.
Conclusion:
In this long-term study of children participating in a randomized maternal education trial,
we found no significant impact of the intervention on anthropometrical z-scores, height growth velocity
or body composition.
2021-08-01T00:00:00ZThe association between dietary diversity and development among children under 24 months in rural Uganda: analysis of a cluster-randomised maternal education trial
https://hdl.handle.net/20.500.12504/1606
The association between dietary diversity and development among children under 24 months in rural Uganda: analysis of a cluster-randomised maternal education trial
Paul, Kakwangire; Cami, Moss; Nicholas, Matovu; Prudence, Atukunda; Ane, C Westerberg; Per, O Iversen; Grace, Muhoozi
Objective:
To assess the association between dietary diversity and development
among children under 24 months in rural Uganda and to establish other factors that
could be associated with development among these children.
Design:
A secondary data analysis of a cluster-randomised controlled maternal education trial (n 511) was conducted on a sub-sample of 385 children. We used adjusted ORs (AORs) to assess the associations of dietary diversity scores (DDS) and other baseline factors assessed at 6–8 months with child development domains (communication, fine motor, gross motor, personal–social and problem solving) at 20–24 months of age.
Setting:
Rural areas in Kabale and Kisoro districts of south-western Uganda.
Participants:
Children under 24 months.
Results:
After multivariable analysis, DDS at 6–8 months were positively associated with normal fine motor skills development at 20–24 months (AOR = 1·18; 95 % CI 1·01, 1·37; P = 0·02). No significant association was found between DDS and other development domains. Children who were not ill at 6–8 months had higher odds of developing normal communication (AOR = 1·73; 95 % CI 1·08, 2·77) and gross motor (AOR = 1·91; 95 % CI 1·09, 3·36) skills than sick children. Girls had lower odds of developing normal gross motor skills compared with boys (AOR = 0·58; 95 % CI 0·33, 0·98). Maternal/caregiver nutritional education intervention was positively associated with development of gross motor, fine motor and problem-solving skills (P-values < 0·05).
Conclusions:
We found an association between child DDS at 6–8 months and improvement in fine motor skills development at 20–24 months. Child illness status, maternal/caregiver nutritional education intervention and sex were other significant baseline predictors of child development at 20–24 months.
2021-03-01T00:00:00ZThe association of urine markers of iodine intake with development and growth among children in rural Uganda: a secondary analysis of a randomised education trial
https://hdl.handle.net/20.500.12504/1605
The association of urine markers of iodine intake with development and growth among children in rural Uganda: a secondary analysis of a randomised education trial
Prudence, Atukunda; Grace, KM Muhoozi; Lien, M Diep; Jens, P Berg; Ane, C Westerberg; Per, O Iversen
Objective:
We examined associations of urine iodide excretion, proxy for iodine intake, with child development and growth.
Design:
This is a secondary analysis of a 1:1 cluster-randomised trial with a 6-month nutrition/stimulation/hygiene education intervention among mothers of children aged 6–8 months to improve child development and growth. Development was
assessed using Bayley Scales of Infant and Toddler Development–III (BSID-III) and Ages and Stages Questionnaire (ASQ), whereas anthropometry was used to assess growth. Urine iodide concentration (UIC) and urine iodide/creatinine ratio (ICR) were measured.
Setting:
The current study was conducted in southern Uganda.
Participants:
We randomly selected 155 children from the 511 enrolled into the original trial and analysed data when they were aged 20–24 and 36 months.
Results:
Median UIC for both study groups at 20–24 and 36 months were similar (P > 0·05) and within the normal range of 100–199 μg/l (0·79–1·60 μmol/l), whereas the intervention group had significantly higher ICR at 20–24 months.
The BSID-III cognitive score was positively associated (P = 0·028) with ICR at 20–24 months in the intervention group. The ASQ gross motor score was negatively associated (P = 0·020) with ICR at 20–24 months among the controls. ICR
was not significantly associated with anthropometry in the two study groups at either time-point.
Conclusions:
Following the intervention, a positive association was noted between ICR and child’s cognitive score at 20–24 months, whereas no positive association with ICR and growth was detected. Iodine sufficiency may be important for child’s cognitive development in this setting.
2020-07-01T00:00:00ZNutritional status of children 7–36 months old from millet consuming communities of Masindi District, Western Uganda
https://hdl.handle.net/20.500.12504/1579
Nutritional status of children 7–36 months old from millet consuming communities of Masindi District, Western Uganda
Evyline, Isingoma Barugahara; Samuel, Kuria Mbugua; Gichohi, Karuri Edward
Background
Several national reports have indicated poor nutritional status among children from Western Uganda where millet porridge is a predominant complementary food. However, little is known about the nutritional status of 7–36 months old children from millet consuming communities of Western Uganda.
Methods
A cross-sectional study was conducted in Bujenje County of Masindi District. A total of 636 children from 23 villages within Bwijanga and Budongo sub counties were randomly selected. Anthropometric measurements of children were taken. Data on demographic and socioeconomic characteristics of children’s households, their dietary practices and morbidity patterns was collected using a self-administered questionnaire. A statistical Package for the Social Sciences (SPSS) version 20 and Emergency Nutritional Assessment (ENA) Software Version 2010 were used for analysing data. The relationship between demographic and socioeconomic characteristics of households and children’s nutritional status was determined using Chi-square tests. Pearson’s correlation coefficient was used to determine the association between children’s nutritional status and the amount of millet porridge consumed. A p-value of < 0.05 indicated statistical significance.
Results
A proportion of 30.5% children were stunted, 11.6% underweight and 7.4% wasted. Underweight and wasting were significantly high in Budongo sub county at p = 0.044 and p = 0.005 respectively. Stunting and underweight were highest between 12 and 23 months at p = 0.005 and 0.020 respectively. Although millet porridges formed the bulk of children’s meals, they could only cater for < 60% of the recommended daily nutrient intake. Children with diarrhoea were 1.4 and 2 times likely to become stunted and underweight at p = 0.025 and 0.007 respectively. Feeding practices for children with diarrhoea were contrary to World Health Organisation’s recommendations in more than 50% of the studied children. There was a significant association between Height-for-Age Z scores, Weight-for-Height Z scores and the amount of millet porridge consumed by children (r = − 0.20, p < 0.001 and r = 0.14, p < 0.001 respectively).
Conclusions
Results showed slightly higher percentages of stunted, underweight and wasted children compared to national figures. This was attributed to high incidences of diarrhoea and inadequate feeding practices especially for children 12–36 months old.
2019-01-01T00:00:00Z