Percorrer por autor "Soares, Ânia"
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- Effectiveness of nutrition and WASH/malaria educational community-based interventions in reducing anemia in children from AngolaPublication . Fançony, Cláudia; Soares, Ânia; Lavinha, João; Barros, Henrique; Brito, MiguelWe found no published data in Angola regarding the effect of combining nutrition-specific and nutrition-sensitive approaches in the reduction of anemia in preschool children. Thus, we implemented a cluster-randomized controlled trial to determine the effectiveness of two educational-plus-therapeutic interventions, in Nutrition and WASH/Malaria, in reducing anemia. We compared them to (1) a test-and-treat intervention and (2) with each other. A block randomization was performed to allocate 6 isolated hamlets to 3 study arms. A difference-in-difference technique, using Fit Generalized estimating models, was used to determine differences between the children successfully followed in all groups, between 2015 and 2016. We found no significant differences in anemia´s and hemoglobin variability between educational and the control group. However, the WASH/Malaria group had 22.8% higher prevalence of anemia when compared with the Nutrition group, having also higher prevalence of P. falciparum. Thus, our results suggest that adding a 12-month educational Nutrition or a WASH/Malaria component to a test-and-treat approach may have a limited effect in controlling anemia. Possibly, the intensity and duration of the educational interventions were not sufficient to observe the amount of behavior change needed to stop transmission and improve the general child feeding practices.
- Efficacy of nutrition and WASH/malaria educational community-based interventions in reducing anemia in preschool children from Bengo, Angola: study protocol of a randomized controlled trialPublication . Fançoni, Cláudia; Soares, Ânia; Lavinha, João; Barros, Henrique; Brito, MiguelAngola reports one of the highest infant mortality rates in the world, and anemia represents one of its important causes. Recent studies, in under-five children from the Bengo province of Angola, described high prevalence’s, suggesting malaria, undernutrition and urogenital schistosomiasis as important contributors for the occurrence and spatial variations of anemia. Educational community-based interventions, either in Nutrition and Water, Sanitation, Hygiene and Malaria are recommended to correct anemia. Herein, we designed a cluster-randomized controlled trial to study the efficacy of two educational-plus-therapeutic interventions in the reduction of anemia: one in nutrition and the other in WASH/Malaria. Socioeconomic, nutritional, anthropometric, parasitological and biochemical data will be collected from all willing-to-participate children, aging under four and resident in the Health Research Center of Angola study area. Considering the multifactorial causes of this condition, determining the efficacy of both interventions might help to document weaknesses and opportunities for planning integrated strategies to reduce anemia.
- Iron deficiency anaemia among 6-to-36-month children from northern AngolaPublication . Fançony, Cláudia; Soares, Ânia; Lavinha, João; Barros, Henrique; Brito, MiguelBackground: Angola is one of the southern African countries with the highest prevalence of anemia. Identifying anemia determinants is an important step in the design of evidence-based control strategies. In this study, we aim at documenting the factors associated with Iron Deficiency Anaemia (IDA) in 948 children recruited at the Health Research Center of Angola study area during 2015. Methods: Data on demographic, socio-economic, and parental practices regarding water, sanitation, hygiene, malaria infection, and infant and young child feeding were collected, as well as parasitological, biochemical, and molecular data. Total and age-stratified multivariate multinomial regression models were fitted to estimate the magnitude of associations between anemia and its determinants. Results: Anaemia was found in 44.4% of children, of which 46.0% had IDA. Overall, regression models associated IDA with age, gender and inflammation and non-IDA with age, zinc deficiency and overload, P. falciparum infection, sickle cell trait/anemia. Among 6-to-23-month-old children, IDA was associated with continued breastfeeding, and among 24-to-36-month-old children, IDA was associated with stunting. Furthermore, zinc deficiency was associated with non-IDA among both age groups children. Inflammation was associated with IDA and non-IDA in either 6-to-23 and 24-to-36 months old children. Conclusion: The main variables associated with IDA and non-IDA within this geographic setting were commonly reported in Africa, but not specifically associated with anemia. Additionally, the associations of anemia with inflammation, zinc deficiency, and infections could be suggesting the occurrence of nutritional immunity and should be further investigated. In age groups, zinc overload was observed to protect under 6 months children from Non-IDA, while continued breastfeeding was associated with increased IDA prevalence in 6-to-23 months children, and stunting was suggested to increase the odds of IDA in 24-to-36 month children. This site-specific etiology profile provides an essential first set of evidences able to inform the planification of preventive and corrective actions/programs. Nevertheless, regional and country representative data is needed.
- Prevalence and determinants of under and overnutrition among under five children in Bengo Province, AngolaPublication . Brito, Miguel; Tamayo, Sara; Fançony, Cláudia; Soares, ÂniaIntroduction - Children malnutrition is a major public health problem in developing countries. Identifying the risk factors of malnutrition and determining their magnitude is necessary to develop nutritional interventions to confront this problem. Aim - The aim of this study is to assess the determinants associated to under and overnutrition in children under 5 years in Bengo Province, Angola. Methods - A community-based cross-sectional study was used during August to September 2014. A questionnaire adapted from ProPAN 14, willing to collect data on children’s general health care, breastfeeding and feeding practices, food ingestion in the previous 24 hours, socioeconomic characteristics and water supply, was applied. Anthropometric measures were collected from all children and mothers to determine their nutritional status Univariate and multivariate analysis were performed to identify factors related to malnutrition. Results - The survey was conducted during 30 days and comprehended 808 children aged 0 to 59 months, from which 50.5% were male Infant wasting, stunting, and underweight prevalence were 7.7%, 35.8%, and 15.2% respectively. The prevalence of overnutrition was 4.2%, with 3.4% of overweight and 0.8% obese. Risk factors significantly associated with stunting were increased age of children (OR = 4.45, 95%CI 1.98, 9.95), low birth weight (OR = 2.23; 95%CI 1.20, 4.11), insufficient information about child feeding among caregivers (OR = 2.23; 95%CI 1.20, 4.15), and non-exclusive breastfeeding (OR = 1.88; 95%CI 1.30, 2.76). Inadequate dietary diversity was significantly associated with a higher risk of wasting (OR = 2.97; 95%CI 1.21, 7.32). Both stunting and wasting were significantly associated with diarrhea in the previous two weeks (OR = 1.50; 95%CI 1.07, 2.08 and OR = 3.08; 95%CI 1.48, 6.41, respectively) and living in a household with more than two children aged under five (OR = 1.50; 95%CI 1.04, 2.18 and OR = 3.19; 95%CI 1.51, 6.77, respectively). Conclusion - Undernutrition is common among children under 5 years in Bengo province. Age, birth weight, child feeding knowledge, type of breastfeeding, dietary diversity, diarrhea morbidity and the number of under-five children living at household were related to undernutrition. The presented results evidence the need of nutritional interventions in order to control children malnutrition risk factors.
- Zinc deficiency interacts with intestinal/urogenital parasites in the pathway to anemia in preschool children, Bengo-AngolaPublication . Fançony, Cláudia; Soares, Ânia; Lavinha, João; Brito, MiguelIn host organisms with normal micronutrient status, nutritional immunity is a strongly regulated response aiming at decreasing the progression and severity of infections. Zinc deficiency may disturb this balance, impairing immune responses to infections, which may indirectly increase infection-related anemia. Since zinc deficiency may associate directly with anemia, the role of infections is often overlooked. Herein, we investigated the participation of infections (or inflammation) in the causal pathway between zinc deficiency and anemia. This transversal study, conducted in 2015 in Bengo-Angola, enrolled 852 under-3-year-old children. Logistic regression models were used to investigate the interaction and mediation effects, and significance was confirmed by the Sobel test. In sum, 6.8% of children had zinc deficiency, 45.9% had anemia, and 15.6% had at least one intestinal/urogenital parasite. Furthermore, we found (1) no evidence that inflammation mediates or interacts with zinc deficiency to cause anemia, and (2) zinc deficiency interacts with infections, significantly increasing the odds of anemia (OR: 13.26, p = 0.022). This interaction was stronger among children with iron deficiency anemia (OR: 46.66, p = 0.003). Our results suggest that zinc deficiency may impair the immune response to infections and/or those intestinal parasites could have developed mechanisms to avoid zinc-limited environments. Further studies are needed to corroborate these suggestions.