The seasonal relationships between household dietary diversity and child growth in a rural Timor-Leste community.
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ABSTRACT:
SUBMITTER: Guizzo Dri G
PROVIDER: S-EPMC9218308 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Improving the dietary quality of women and children is essential to reduce all forms of malnutrition. In this study, we assessed seasonal child and maternal dietary diversity and consumption of animal-source foods (ASF), using 1,236 observations from combined data collected among 167 mother-child dyads in rural Timor-Leste. We used generalized linear and logistic mixed-effects models to examine the dietary differentials of mothers and children in two agricultural livelihood zones and across the seasons, as well as to identify household and agroecological characteristics associated with children's dietary quality in relation to their mothers'. We found dietary quality to be marginally better in coastal than in mid-altitude zones. However, women's diets were strikingly poor, and their intake of ASF was lower than among children. Mothers exhibited preferential allocation patterns of specific ASF, dairy products and eggs, to children. The intake of ASF was predicted by seasonality. Flesh foods and red meat were much more likely to be consumed during the dry season, when cultural ceremonies are often performed. We found a positive and strongly significant association between children's dietary indicators-dietary diversity score, minimum dietary diversity and ASF consumption, and those of their mothers'. Maternal dietary quality and educational attainment, more so than agroecological characteristics, were explanatory factors of children's diet. Our study highlights that addressing the dietary quality of children in Timor-Leste would benefit from improving women's diets through better access to nutritious foods and to secondary education.
| S-EPMC7729527 | biostudies-literature
Project description:BACKGROUND: The island of Timor lies at the south-eastern edge of Indonesia on the boundary of the Oriental and Australian faunal regions. The country of Timor-Leste, which occupies the eastern part of the island, is malarious, but anopheline faunal surveys and malaria vector incrimination date back to the 1960 s. Over the last decade the malaria vectors of south-east Asia and the south-west Pacific have been intensely studied using molecular techniques that can confirm identification within complexes of isomorphic species. The aim of this study is to accurately identify the Anopheles fauna of Timor-Leste using these techniques. METHODS: The survey was carried out over the period February to June 2001. Standard entomological techniques--human landing collections, larval collections and CO2 baited light traps--were used to collect anophelines from the main geographical regions: coastal plains, inland plains, and highlands. Specimens were processed for identification by morphology and genotyped for the ribosomal DNA ITS2 by restriction analysis and/or DNA sequencing. Phylogenetic relationship of Anopheles sundaicus and Anopheles subpictus individuals was also assessed using DNA sequences from the ITS2 and mitochondrial cytochrome-b. All specimens, other than those from larval surveys, were processed to detect the presence of the Plasmodium parasite circumsporozoite protein by ELISA for vector incrimination. RESULTS: Of 2,030 specimens collected, seven species were identified by morphology: Anopheles barbirostris, Anopheles aconitus, Anopheles annularis, Anopheles maculatus, Anopheles peditaeniatus, An. sundaicus and Anopheles vagus. These were confirmed by molecular analysis with the addition of Anopheles flavirostris and an unidentified species designated here as An. vagus genotype B. This latter species was morphologically similar to An. vagus and An. subpictus and is likely to be the An. subpictus described by other workers for Timor. However, genetically this species showed strong affinities to the An. sundaicus complex. Anopheles vagus was the most common species but was rarely collected coming to bite humans; An. barbirostris and An. vagus genotype B were the two most common species collected in human landing catches and both were found positive for CS protein. CONCLUSIONS: The anopheline fauna of Timor-Leste is of Oriental origin with no evidence of elements from the Australian Region. The existence of species complexes will make the use of morphological markers problematic in the country. Using molecular analysis a number of issues regarding the anopheline fauna of Timor-Leste were resolved and nine putative species of Anopheles were identified; two species: An. barbirostris and An. vagus genotype B, were incriminated as malaria vectors.
| S-EPMC2829033 | biostudies-literature
Project description:Distinct, partly competing, "waves" have been proposed to explain human migration in(to) today's Island Southeast Asia and Australia based on genetic (and other) evidence. The paucity of high quality and high resolution data has impeded insights so far. In this study, one of the first in a forensic environment, we used the Ion Torrent Personal Genome Machine (PGM) for generating complete mitogenome sequences via stand-alone massively parallel sequencing and describe a standard data validation practice.In this first representative investigation on the mitochondrial DNA (mtDNA) variation of East Timor (Timor-Leste) population including >300 individuals, we put special emphasis on the reconstruction of the initial settlement, in particular on the previously poorly resolved haplogroup P1, an indigenous lineage of the Southwest Pacific region. Our results suggest a colonization of southern Sahul (Australia) >37 kya, limited subsequent exchange, and a parallel incubation of initial settlers in northern Sahul (New Guinea) followed by westward migrations <28 kya.The temporal proximity and possible coincidence of these latter dispersals, which encompassed autochthonous haplogroups, with the postulated "later" events of (South) East Asian origin pinpoints a highly dynamic migratory phase.
| S-EPMC4342813 | biostudies-literature
Project description:Fieldwork conducted throughout Timor-Leste in September 2004 and July 2009 resulted in a collection or recording of 263 herpetological specimens (100 amphibians, 163 reptiles), comprising at least seven species of frogs and toads, 20 species of lizards, seven species of snakes, two species of turtles, and one species of crocodile. Among the amphibians, the most frequently encountered species were toads (Duttaphrynus melanostictus), rice paddy frogs (genus Fejervarya), and rhacophorid treefrogs (Polypedates cf. leucomystax). All three variants of rice paddy frogs encountered represent undescribed species similar to Fejervarya verruculosa from neighboring Wetar Island. Records of Fejervarya cancrivora and Fejervarya limnocharis for Timor Island are apparently errors based on misidentification. We obtained voucher specimens for a total of 147 lizards and voucher photographs only for four specimens of Varanus timorensis. Aside from geckos frequently associated with human habitations (e.g., Gehyra mutilata, Gekko gecko, Hemidactylus frenatus, Hemidactylus platyurus), we discovered an as yet undescribed species of bent-toed gecko, genus Cyrtodactylus, in the Same valley. Our specimens of Hemidactylus platyurus are the first record of this species from Timor-Leste. Commonly encountered skinks included four-fingered skinks (genus Carlia), wedge skinks (genus Sphenomorphus), and night skinks (genus Eremiascincus). Notable among the 15 snakes collected was the frequency of pitvipers (Cryptelytrops insularis), which amounted to over 25% of all snakes. Our specimen of the wolfsnake Lycodon subcinctus is the first record of this species for Timor-Leste. Based on these findings, it appears that the biodiversity of amphibians and reptiles in this remote corner of Wallacea is much greater than previously thought, particularly with respect to scincid lizards. The detail we provide in the species accounts is designed to allow the use of this report as a preliminary field guide to the amphibians and reptiles of Timor-Leste. However, survey work is ongoing.
| S-EPMC3118819 | biostudies-other
Project description:BACKGROUND:Timor-Leste built its health workforce up from extremely low levels after its war of independence, with the assistance of Cuban training, but faces challenges as the first cohorts of doctors will shortly be freed from their contracts with government. Retaining doctors, nurses and midwives in remote areas requires a good understanding of health worker preferences. METHODS:The article reports on a discrete choice experiment (DCE) carried out amongst 441 health workers, including 173 doctors, 150 nurses and 118 midwives. Qualitative methods were conducted during the design phase. The attributes which emerged were wages, skills upgrading/specialisation, location, working conditions, transportation and housing. FINDINGS:One of the main findings of the study is the relative lack of importance of wages for doctors, which could be linked to high intrinsic motivation, perceptions of having an already highly paid job (relative to local conditions), and/or being in a relatively early stage of their career for most respondents. Professional development provides the highest satisfaction with jobs, followed by the working conditions. Doctors with less experience, males and the unmarried are more flexible about location. For nurses and midwives, skill upgrading emerged as the most cost effective method. CONCLUSIONS:The study is the first of its kind conducted in Timor-Leste. It provides policy-relevant information to balance financial and non-financial incentives for different cadres and profiles of staff. It also augments a thin literature on the preferences of working doctors (as opposed to medical students) in low and middle income countries and provides insights into the ability to instil motivation to work in rural areas, which may be influenced by rural recruitment and Cuban-style training, with its emphasis on community service.
| S-EPMC5112867 | biostudies-literature
Project description:Background:Health financing and delivery reforms designed to achieve universal health coverage (UHC) need to be informed by an understanding of factors that both promote access to health care and undermine it. This study examines the level of health care utilisation in Timor-Leste and the factors that drive it. Methods:Data from a nationally representative cross-sectional survey of health care utilisation in 1712 households were used to develop multilevel models exploring how need and predisposing and enabling factors explain health care utilisation at both primary and secondary care facilities. Results:Need was found to be the key driver in seeking both primary care and hospital services. Rural households were less likely to go to hospital (odds ratio 0.7) than urban households. The poorest quintile was also less likely to use more expensive hospital services than other socio-economic groups. Conclusions:Understanding the determinants of seeking health care in Timor-Leste is of considerable policy significance, because health care is free at the point of use. Our findings indicate that the public resources for health care are subsidising the rich more than the poor. Health care reforms in Timor-Leste need to reduce the 'other' costs of health care, such as distance barriers, to address these inequities.
| S-EPMC6204763 | biostudies-literature
Project description:A greater understanding of gendered roles in fisheries is necessary to value the often-hidden roles that women play in fisheries and households. We examine women's contributions to household food and income using focus group discussions, market surveys, and landings data in six communities in Timor-Leste. Women were actively fishing more days per month than men. Gleaning was the most frequent activity and 100% of trips returned with catch for food and/or income. Mollusc and crab catches were common and exploitation appeared targeted on a dynamic reappraisal of changing food values and changing estimates of group needs. With as many as 80% of households in coastal areas involved in fishing, and at least 50% of women fishing, this highlights the current lack of women's engagement as a critical gap in fisheries management approaches. The current androcentric dialogue limits social-ecological understanding of these systems and the potential for their effective stewardship.
| S-EPMC7708585 | biostudies-literature
Project description:Households in low-income settings are vulnerable to seasonal changes in dietary diversity because of fluctuations in food availability and access. We assessed seasonal differences in household dietary diversity in Burkina Faso, and determined the extent to which household socioeconomic status and crop production diversity modify changes in dietary diversity across seasons, using data from the nationally representative 2014 Burkina Faso Continuous Multisectoral Survey (EMC). A household dietary diversity score based on nine food groups was created from household food consumption data collected during four rounds of the 2014 EMC. Plot-level crop production data, and data on household assets and education were used to create variables on crop diversity and household socioeconomic status, respectively. Analyses included data for 10,790 households for which food consumption data were available for at least one round. Accounting for repeated measurements and controlling for the complex survey design and confounding covariates using a weighted multi-level model, household dietary diversity was significantly higher during both lean seasons periods, and higher still during the harvest season as compared to the post-harvest season (mean: post-harvest: 4.76 (SE 0.04); beginning of lean: 5.13 (SE 0.05); end of lean: 5.21 (SE 0.05); harvest: 5.72 (SE 0.04)), but was not different between the beginning and the end of lean season. Seasonal differences in household dietary diversity were greater among households with higher food expenditures, greater crop production, and greater monetary value of crops sale (P<0.05). Seasonal changes in household dietary diversity in Burkina Faso may reflect nutritional differences among agricultural households, and may be modified both by households' socioeconomic status and agricultural characteristics.
| S-EPMC5957435 | biostudies-literature
Project description:Dengue remains an important public health problem in Timor-Leste, with several major epidemics occurring over the last 10 years. The aim of this study was to identify dengue clusters at high geographical resolution and to determine the association between local environmental characteristics and the distribution and transmission of the disease.Notifications of dengue cases that occurred from January 2005 to December 2013 were obtained from the Ministry of Health, Timor-Leste. The population of each suco (the third-level administrative subdivision) was obtained from the Population and Housing Census 2010. Spatial autocorrelation in dengue incidence was explored using Moran's I statistic, Local Indicators of Spatial Association (LISA), and the Getis-Ord statistics. A multivariate, Zero-Inflated, Poisson (ZIP) regression model was developed with a conditional autoregressive (CAR) prior structure, and with posterior parameters estimated using Bayesian Markov chain Monte Carlo (MCMC) simulation with Gibbs sampling.The analysis used data from 3206 cases. Dengue incidence was highly seasonal with a large peak in January. Patients ? 14 years were found to be 74% [95% credible interval (CrI): 72-76%] less likely to be infected than those < 14 years, and females were 12% (95% CrI: 4-21%) more likely to suffer from dengue as compared to males. Dengue incidence increased by 0.7% (95% CrI: 0.6-0.8%) for a 1 °C increase in mean temperature; and 47% (95% CrI: 29-59%) for a 1 mm increase in precipitation. There was no significant residual spatial clustering after accounting for climate and demographic variables.Dengue incidence was highly seasonal and spatially clustered, with positive associations with temperature, precipitation and demographic factors. These factors explained the observed spatial heterogeneity of infection.
| S-EPMC5755460 | biostudies-literature
Project description:Dengue is an ongoing health risk for Peace Corps Volunteers (PCVs) working in the tropics. On May 2019, the Peace Corps Office of Health Services notified the Centers for Disease Control and Prevention (CDC) of a dengue outbreak among PCVs in Timor-Leste. The purpose of this investigation was to identify the clinical, demographic, and epidemiological characteristics of PCVs with dengue and recommend dengue preventive measures. To identify PCVs with dengue and describe disease severity, the medical records of PCVs reporting fever during September 2018-June 2019 were reviewed. To identify factors associated with dengue virus (DENV) infection, we administered a questionnaire on demographics, travel history, and mosquito avoidance behaviors and collected blood specimens to detect the anti-DENV IgM antibody to diagnose recent infection. Of 35 PCVs in-country, 11 (31%) tested positive for dengue (NS1, IgM, PCR), eight requiring hospitalization and medical evacuation. Among 27 (77%) PCVs who participated in the investigation, all reported having been recently bitten by mosquitoes and 56% reported being bitten most often at home; only 16 (59%) reported having screens on bedroom windows. Nearly all (93%) PCVs reported using a bed net every night; fewer (70%) reported using mosquito repellent at least once a day. No behaviors were significantly associated with DENV infection. Raising awareness of dengue risk among PCVs and continuing to encourage mosquito avoidance behavior to prevent dengue is critical. Access to and use of measures to avoid mosquito bites should be improved or implemented. Peace Corps medical officers should continue to receive an annual refresher training on dengue clinical management.
| S-EPMC8176509 | biostudies-literature