Swallowability of Minitablets among Children Aged 6-23 Months: An Exploratory, Randomized Crossover Study.
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ABSTRACT:
SUBMITTER: Mitsui N
PROVIDER: S-EPMC8779905 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Dysphagia (difficulty swallowing) affects up to 13% of persons 65 years and older and 51% of older persons in nursing homes and can contribute to reduced adherence to oral medications. This was an exploratory, single-center, open-label, randomized, crossover study in healthy older adult participants. Primary objectives were evaluation of palatability (taste) and swallowability of the contents of pimavanserin 34 mg capsules mixed with selected soft foods or a liquid nutritional supplement. Secondary objectives included evaluation of additional palatability endpoints and ease of capsule manipulation for mixing. A total of 18 healthy, older adult participants (mean age 65 years) were included. Mean participant ratings for all food vehicles were "moderately like" to "neither like nor dislike" for palatability and "very easy" to "somewhat easy" for swallowability. Capsule manipulation to allow sprinkling of contents was rated "very easy" or "somewhat easy" by most participants. There were five treatment-emergent adverse events, all mild; two were deemed related to study treatment. The palatability and swallowability of pimavanserin was considered acceptable when administered with certain soft foods or a liquid nutritional supplement by the study participants.
| S-EPMC8293179 | biostudies-literature
Project description:Background:Dietary diversity (DD) is among the core infant and young child feeding (IYCF) indicators. However, in many developing countries, meeting the minimum standards of DD is challenging and information concerning its determinants is limited. Objective:To assess the level and predictors of DD among children aged 6-23 months in rural communities of Aleta Wondo district, Sidama zone, Southern Ethiopia. Method:A community-based cross-sectional study was conducted in rural Aleta Wondo in February 2016. Multistage sampling was employed to recruit 502 children aged 6-23 months. DD was assessed by asking the mother whether the index child had received food from the standard seven food groups in the previous day, without setting minimum intake restrictions. Ultimately, the dietary diversity score (DDS) was rated on a 7-point scale, and it was modeled using linear regression analysis. The outputs are presented using adjusted regression coefficients (?). Results:Only 12.0% (95% confidence interval: 9.0-15.0%) of the children met the minimum recommended DD, receiving from four or more from seven food groups. The analysis identified eleven significant predictors of DDS. As the maternal knowledge of IYCF increases by a unit, DDS raised by 0.21 units (p = 0.004). Unit increment in the husband's involvement in the IYCF score was linked with 0.32 units improvement in DDS (p = 0.016). One unit change in the ordinal category of household food insecurity was associated with 0.13 reduction in DDS (p = 0.001). Similarly, household wealth index (??=?0.54, p = 0.041), father's literacy (??=?0.48, p = 0.002), ownership of home garden (??=?0.38, p = 0.01), mother's participation in cooking demonstrations (??=?0.19, p = 0.036), and child age in months (??=?0.04, p = 0.001) were all positively associated with DDS. Furthermore, receiving IYCF information via mass media (??=?0.04, p = 0.001) and during antenatal (??=?0.91, p = 0.022) and postnatal checkups (??=?0.21, p = 0.043) were positive predictors of DDS. Conclusions:Promoting the socioeconomic status of the community, strengthening of home gardening, involving husbands in IYCF, and enhancing maternal knowledge of IYCF may advance DD.
| S-EPMC6878804 | biostudies-literature
Project description:ObjectivesNational immunisation coverage rate masks subnational immunisation coverage gaps at the state and local district levels. The objective of the current study was to determine the sociodemographic factors associated with incomplete immunisation in children at a sub-national level.DesignCross-sectional study using the WHO sampling method (2018 Reference Manual).SettingFifty randomly selected clusters (wards) in four districts (two urban and two rural) in Enugu state, Nigeria.Participants1254 mothers of children aged 12-23 months in July 2020.Primary and secondary outcome measuresFully immunised children and not fully immunised children.ResultsFull immunisation coverage (FIC) rate in Enugu state was 78.9% (95% CI 76.5% to 81.1%). However, stark difference exists in FIC rate in urban versus rural districts. Only 55.5% of children in rural communities are fully immunised compared with 94.5% in urban communities. Significant factors associated with incomplete immunisation are: children of single mothers (aOR=5.74, 95% CI 1.45 to 22.76), children delivered without skilled birth attendant present (aOR=1.93, 95% CI 1.24 to 2.99), children of mothers who did not receive postnatal care (aOR=6.53, 95% CI 4.17 to 10.22), children of mothers with poor knowledge of routine immunisation (aOR=1.76, 95% CI 1.09 to 2.87), dwelling in rural district (aOR=7.49, 95% CI 4.84 to 11.59), low-income families (aOR=1.56, 95% CI 1.17 to 2.81) and living further than 30 min from the nearest vaccination facility (aOR=2.15, 95% CI 1.31 to 3.52).ConclusionsAlthough the proportion of fully immunised children in Enugu state is low, it is significantly lower in rural districts. Study findings suggest the need for innovative solutions to improve geographical accessibility and reinforce the importance of reporting vaccination coverage at local district level to identify districts for more targeted interventions.
| S-EPMC8237740 | biostudies-literature
Project description:ObjectivesPoor complementary feeding practices have consistently contributed to the burden of child undernutrition in Indonesia. This study aimed to estimate the prevalence and predictors of the time of the introduction of solid, semi-solid, and soft foods (ISSSF), minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD).MethodsWe analyzed 4804 last-born infants aged 6-23 months from the 2017 Indonesia Demographic and Health Survey, which employed multistage cluster random sampling. The outcomes were calculated based on the 2021 World Health Organization/United Nations Children's Fund guidelines. The predictors of the 4 complementary feeding indicators were assessed using multivariate Poisson regression with robust variance adjusting for potential confounders and study design.ResultsThe prevalence of ISSSF, MDD, MMF, and MAD was 86.1%, 54.3%, 71.8%, and 37.6%, respectively, with younger children less likely to meet 3 out of the 4 outcomes. Parental education, the presence of a birth attendant, and maternal media consumption were among the predictors of MDD and MAD. Children from families with higher income were more likely to meet MDD than those from low-income households (adjusted prevalence ratio [aPR], 1.16; 95% confidence interval [CI], 1.05 to 1.28). Living in an urban area was positively associated with MMF (aPR, 1.09; 95% CI, 1.04 to 1.15) and MAD (aPR, 1.12; 95% CI 1.02 to 1.24). In eastern regions, the prevalence of children achieving MDD and MAD was lower than in those living in Java and Bali.ConclusionsIt is crucial that more attention and efforts are made to improve the recommended practices throughout Indonesia, since the prevalence of adequate complementary feeding practices remains low.
| S-EPMC9742402 | biostudies-literature
Project description:It is unclear whether routine prenatal anemia control interventions can reduce anemia risk in young children. This study examines the associations between prenatal iron supplementation and/or deworming and anemia in children aged 6-23 months in sub-Saharan Africa (SSA). We analyzed data from Demographic and Health Surveys conducted between 2003 and 2014 in 25 SSA countries. The surveys collected data on prenatal iron supplementation and deworming and determined children's hemoglobin levels through blood testing. We assessed the associations between prenatal iron supplementation and/or deworming and anemia using multinomial logistic regression. The study included 31,815 mother-child pairs: 25.0%, 41.4%, and 4.8% of children had mild, moderate, and severe anemia, respectively. Compared with children whose mothers did not take iron and deworming drugs prenatally, the risk of moderate/severe anemia was reduced among children whose mothers took only iron supplements for ≥6 months (odds ratio [OR]: 0.58; 95% confidence interval [CI]: 0.45-0.76); only deworming drugs (OR: 0.73; 95% CI: 0.56-0.93); deworming drugs plus iron for <6 months (OR: 0.79; 95% CI: 0.67-0.93); and deworming drugs plus iron for ≥6 months (OR: 0.77; 95% CI: 0.59-0.99). Prenatal use of only iron for <6 months was not associated with moderate/severe anemia. Prenatal iron and/or deworming drugs had no effect on mild anemia. Prenatal anemia control interventions are associated with reduced risk of moderate/severe anemia but not with mild anemia in young children in SSA. Iron supplements should be taken for ≥6 months or with deworming drugs prenatally to reduce moderate/severe anemia risk in children.
| S-EPMC6866217 | biostudies-literature
Project description:BackgroundAnemia, the world's most common micro-nutrient deficiency disorder, can affect a person at any time and at all stages of life. Though all members of the community may face the problem, children aged 6-23 months are particularly at higher risk. If left untreated, it adversely affects the health, cognitive development, school achievement, and work performance. However, little was investigated among young children in Sub-Saharan countries including Ethiopia. This research aimed to investigate its magnitude and correlates to address the gap and guide design of evidence based intervention.MethodsA community-based cross-sectional study was conducted from May -June 2016 in rural districts of Wolaita Zone. Multi-stage sampling technique was applied and 990 mother-child pairs were selected. Socio-demography, health and nutritional characteristics were collected by administering interview questionnaire to mothers/care-givers. Blood samples were taken to diagnose anemia by using HemoCue device, and the status was determined using cut-offs used for children aged 6-59 months. Hemoglobin concentration below 11.0 g/dl was considered anemic. Data were analyzed with Stata V14. Bivariate and multivariable logistic regressions were applied to identify candidates and predictor variables respectively. Statistical significance was determined at p-value < 0.05 at 95% confidence interval.ResultsThe mean hemoglobin level of children was 10.44±1.3g/dl, and 65.7% of them were anemic. Among anemic children, 0.4% were severely anemic (<7.0g/dl), while 28.1% and 37.2% were mildly (10.0-10.9g/dl) and moderately (7.0-9.9g/dl) anemic, respectively. In the multivariable analysis, having maternal age of 35 years and above (AOR = 1.96), being government employee (AOR = 0.29), being merchant (AOR = 0.43) and 'other' occupation (AOR = 3.17) were correlated with anemia in children in rural Wolaita. Similarly, receiving anti-helminthic drugs (AOR = 0.39), being female child (AOR = 1.76), consuming poor dietary diversity (AOR = 1.40), and having moderate household food insecurity (AOR = 1.72) were associated with anemia in rural Wolaita.ConclusionA large majority of children in the rural Wolaita were anemic and the need for proven public health interventions such as food diversification, provision of anti-helminthic drugs and ensuring household food security is crucial. In addition, educating women on nutrition and diet diversification, as well as engaging them with alternative sources of income might be interventions in the study area.
| S-EPMC6407854 | biostudies-literature
Project description:BackgroundAlthough minimum dietary diversity (MDD) is one of the core indicators of a high-quality diet for infants and young children, meeting this dietary diversity standard remains a challenge in Ethiopia. Therefore, adequate information on the status and factors affecting minimum dietary diversity is essential to identify potential strategic interventions. This study to study is to assess DD and associated factors among children aged 6 to 23 months in Chelia District, Ethiopia.MethodsA community-based cross-sectional study was conducted in the seven kebeles of Chelia District from 12th April to April 30th, 2020. Kebele is the smallest administrative unit in Ethiopia. Multistage sampling was used to select 631 participants who had a child aged 6 to 23 months. Data was entered into the Epi data version 3.1 and analyzed using Statistical Package for Social Science (SPSS) version 24. A binary logistic regression was fitted to identify significant factors associated with met MDD at 95% CI and a p-value < 0.05.ResultsLess than one-quarter (17.32%) of infants and young children aged 6 to 23 months had met MDD. The dominant group of foods consumed was composed of grains, roots, and tubers. Children aged18-23 months (AOR = 3.26, 1.36-7.79), mothers aged 35-44 years (AOR = 3.25, 1.38-7.45), housewives as household heads (AOR = 3.41, 1.56-2.37), children of smaller family size (AOR = 3.89, 1.18-12.78), and caregivers who studied grade 9-12 (AOR = 9.98, 5.66-17.10), who received information about food diversity during ANC (AOR = 1.48, 2.21-11.23) and PNC (AOR = 3.94, 2.04-7.63) visit, who travels less than one hour to reach the market (AOR = 2.94, 1.24-6.91) and who had high family income (AOR = 4.12, 1.90-8.19) were significantly associated with meeting MDD.ConclusionDietary diversity among children aged 6 to 23 months in Chelia District is low. It is proposed that caregivers on MDD be educated/trained and encouraged to share information during health service in order to increase the diverse diet and achieve a better dietary diversity score for infants and younger children.
| S-EPMC8665635 | biostudies-literature
Project description:ObjectiveTo investigate the current situation of anaemia among children aged 6-23 months in a rural county in China, and to explore the influencing factors and the main causes of anaemia.DesignA cross-sectional study.SettingHuzhu County in Qinghai Province, China PARTICIPANTS: We selected 38 sampled villages using Proportional to Population Size sampling method. We obtained the name list of children aged 6-23 months in each sampled village and planned to survey all the eligible children aged 6-23 months and their caregivers.Primary and secondary outcomes measuresThe prevalence of anaemia, the influencing factors of anaemia, the laboratory tests for biological causes of anaemia, including serum ferritin, soluble transferrin receptor, folic acid, homocysteine and vitamin B12.ResultsA total of 754 children aged 6-23 months and their caregivers were surveyed, and 183 anaemic children aged 12-23 months were collected venous blood sample. The anaemia prevalence of children aged 6-23 months in Huzhu County was 59.1%. Children of younger age (OR=0.968, 95% CI 0.940 to 0.998), Tibetan nationality (OR=3.123, 95% CI 1.473 to 6.623) and not introducing meat (OR=0.698, 95% CI 0.499 to 0.976) were more likely to be anaemic. More than 80% of children with anaemia were due to iron deficiency (ID), and 20.2% of them had both iron and folic acid deficiencies.ConclusionsThe anaemia prevalence of children aged 6-23 months in Huzhu County was high and children of younger age, Tibetan nationality and not introducing meat were more likely to be anaemic. The main cause of anaemia was nutritional anaemia, with the vast majority being ID. Interventions of feeding counselling and nutrients supplements are appropriate and should be further strengthened.Trial registration numberChiCTRPRC12002444.
| S-EPMC6738674 | biostudies-literature
Project description:In nations like Ethiopia, vaccination rates are low despite being one of the most effective public health treatments to protect infants from common infectious diseases that can be prevented by immunization. In Worebabo District, the reasons of the underutilization of vaccination programs are poorly understood. Therefore, this study aimed to identify determinants of incomplete childhood vaccination in the study setting. Community based unmatched case-control study was carried out among 441 mothers of children aged 12–23 months old (147 cases and 294 controls) in Worebabo District, Ethiopia from March 1—April 30, 2020. Using a multistage sampling process, mothers were chosen. Health professionals were trained to collect data using a pre-tested standardized questionnaire. Data entered into Epi Info version 7.2 and put through statistical analysis in SPSS version 23. Binary logistic regression was performed to determine the odds ratio with a 95%CL. A p-value of under 0.05 was estimated statistically significant. The study found that older moms (>35 years old) were more likely than younger mothers to fail to properly immunize their children (AOR = 2.4, 95% CI: 1.09, 5.28). In addition, mothers with incomplete vaccinations had lower knowledge of the benefits of vaccination (AOR = 2.02, 95% CI: 1.20, 3.39), Negative attitudes towards immunization (AOR = 4.9, 95% CI: 2.82, 8.49), less access to prenatal care (AOR = 3.68, 95% CI: 1.58, 8.54), home delivery (AOR = 5.47, 95% CI: 2.58)., 11.58), absent home visits (AOR = 3.56, 95% CI: 1.69, 7.48), and longer time to reach vaccination site (>1 h) (AOR = 10.07)., 95% CI: 1.75, 57.79) were found associated with mother incomplete vaccination of the child. Mothers being older age, less access to antenatal care services, place of home delivery, longer time to reach vaccination site, negative attitude and poor knowledge towards the benefit of vaccination were associated with mothers’ incomplete vaccination of the child. Therefore, health professionals should inform and counsel mothers about the advantages of childhood immunization as well as the consequences of incomplete or not vaccination of children at the time of the facility visit and by community health workers during the routine home visit.
| S-EPMC10431650 | biostudies-literature
Project description:BACKGROUND:Vaccination is one of the most cost-effective means of public health interventions to prevent childhood deaths from infectious diseases. Although several fragmented studies have been conducted concerning full vaccination coverage among children aged 12-23 months in Ethiopia, the pooled estimate has not been determined so far. Therefore, this systematic review and meta-analysis aims to estimate the pooled prevalence of full vaccination coverage among children aged 12-23 months in Ethiopian. METHODS:To find potentially relevant studies, we systematically searched five major databases (i.e., PubMed/MEDLINE, CINAHL, EMBASE, Google Scholar, and Science Direct). This review included community based cross-sectional studies reported in English language; had good quality, and published from the 1st of January 2000 to the 20th of November 2019. Data were analyzed using Stata™ Version 14.1 software. The pooled estimates with 95% confidence intervals (CIs) were presented using forest plots. Higgins and Egger's tests were used to assess heterogeneity and publication bias, respectively. Primary estimates were pooled using a random effects meta-analysis model. RESULTS:Of the total of 851 identified articles 21 studies involving 12,094 children met the inclusion criteria and were included in this meta-analysis. The included studies sample size ranged from 173 to 923. The lowest proportion of full vaccination coverage was reported from Afar Region [21% (95% CI: 18, 24%)], whereas the highest proportion of full vaccination coverage was reported from Amhara Region [73% (95% CI: 67, 79%)]. The overall prevalence of full vaccination coverage among children in Ethiopia was 60% (95% CI: 51, 69%). CONCLUSIONS:Our finding suggested that six in every 10 children in Ethiopia were fully vaccinated. However, this finding is much lower than the World Health Organization recommended rate. Moreover, high regional variations in terms of full vaccination coverage across the country was observed. Therefore, a special attention should be given to improve the overall childhood vaccination coverage.
| S-EPMC7249262 | biostudies-literature