Browsing by Autor "Parminder S. Suchdev"

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Early deterioration of iron status among a cohort of Bolivian infants
(Wiley, 2016) Rachel M. Burke; Paulina A. Rebolledo; Anna Aceituno; Rita Revollo; Volga Iñiguez; Mitchel Klein; Carolyn Drews‐Botsch; Juan S. León; Parminder S. Suchdev
Iron deficiency (ID) and iron deficiency anemia (IDA) are major contributors to infant and maternal morbidity worldwide. There is limited longitudinal data on iron status in young infants and on methods to adjust iron biomarkers for inflammation. We aimed to quantify the prevalence of inflammation-adjusted ID, anemia, and IDA over the first year in a cohort of Bolivian infants and their mothers. Healthy mother-infant dyads were recruited from two peri-urban hospitals. Infants provided three blood draws (2, 6-8, and 12-18 months; N = 160); mothers provided two blood draws (1 and 6-8 months postpartum [plus third anemia measurement at 12-18 months]; N = 250). Blood was analyzed for hemoglobin, ferritin, soluble transferrin receptor, C-reactive protein (CRP), and alpha(1)-acid glycoprotein (AGP). Iron biomarkers were adjusted for inflammation using CRP and AGP; hemoglobin cutoffs were adjusted for altitude. Inflammation (elevated CRP or AGP) was 17% among toddlers 12-18 months of age. ID (inflammation-adjusted ferritin) increased with age (<1%, 56%, and 79% at each blood draw), as did anemia and IDA (anemia: 70%, 76%, and 81%; IDA: <1%, 46%, and 68%). Maternal ID declined from the first to second assessment (39% vs. 27%). Inflammation-adjusted ID prevalence was up to 15 percentage points higher than unadjusted estimates. The high prevalence of ID, anemia, and IDA in this cohort of Bolivian infants beginning at 6-8 months of age suggests that early interventions may be necessary in vulnerable populations.
Effect of infant feeding practices on iron status in a cohort study of Bolivian infants
(BioMed Central, 2018) Rachel M. Burke; Paulina A. Rebolledo; Anna Aceituno; Rita Revollo; Volga Iñiguez; Mitchel Klein; Carolyn Drews‐Botsch; Juan S. León; Parminder S. Suchdev
Effects of Inflammation on Biomarkers of Vitamin A Status among a Cohort of Bolivian Infants
(Multidisciplinary Digital Publishing Institute, 2018) Rachel M. Burke; Ralph D. Whitehead; Janet Figueroa; Denis R. Whelan; Anna Aceituno; Paulina A. Rebolledo; Rita Revollo; Juan S. León; Parminder S. Suchdev
Globally, vitamin A deficiency (VAD) affects nearly 200 million children with negative health consequences. VAD can be measured by a retinol-binding protein (RBP) and serum retinol concentrations. Their concentrations are not always present in a 1:1 molar ratio and are affected by inflammation. This study sought to quantify VAD and its impact on infant mortality and infectious morbidity during the first 18 months of life in a cohort of mother-infant dyads in El Alto, Bolivia, while accounting for the previously mentioned measurement issues. Healthy mother-infant dyads (<i>n</i> = 461) were enrolled from two hospitals and followed for 12 to 18 months. Three serum samples were collected (at one to two, six to eight, and 12 to 18 months of infant age) and analyzed for RBP, and a random 10% subsample was analyzed for retinol. Linear regression of RBP on retinol was used to generate RBP cut-offs equivalent to retinol <0.7 µmol/L. All measures of RBP and retinol were adjusted for inflammation, which was measured by a C-reactive protein and alpha (1)-acid glycoprotein serum concentrations using linear regression. Infant mortality and morbidity rates were calculated and compared by early VAD status at two months of age. Retinol and RBP were weakly affected by inflammation. This association varied with infant age. Estimated VAD (RBP < 0.7 µmol/L) decreased from 71.0% to 14.8% to 7.7% at two, six to eight, and 12 to 18 months of age. VAD was almost nonexistent in mothers. Early VAD was not significantly associated with infant mortality or morbidity rates. This study confirmed a relationship between inflammation and vitamin A biomarkers for some subsets of the population and suggested that the vitamin A status in early infancy improves with age and may not have significantly affected morbidity in this population of healthy infants.
Using a monitoring and evaluation framework to improve study efficiency and quality during a prospective cohort study in infants receiving rotavirus vaccination in El Alto, Bolivia: the Infant Nutrition, Inflammation, and Diarrheal Illness (NIDI) study
(BioMed Central, 2017) Anna Aceituno; Kaitlyn K. Stanhope; Paulina A. Rebolledo; Rachel M. Burke; Rita Revollo; Volga Iñiguez; Parminder S. Suchdev; Juan S. León
Vitamin A Deficiency and Mother‐Infant Correlations in Bolivia
(Wiley, 2015) Alexander Cattran; Rachel M. Burke; Adam C. Lipus; Rita Revollo; Volga Iñiguez; Juan S. León; Parminder S. Suchdev
Vitamin A deficiency (VAD) affects an estimated one‐third of preschool‐aged children in developing countries and is an important contributor to global child mortality. The goal of this analysis was to identify risk factors of VAD in a cohort of Bolivian infants. Healthy infants (n=163) were recruited from 2 hospitals in El Alto, Bolivia, and followed from 1 to 6 months of age. Blood specimens taken at 6 months were analyzed for retinol‐binding protein (RBP) levels (VAD defined as RBP < 0.7 µmol/L), C‐Reactive Protein (CRP), and alpha(1)‐acid glycoprotein (AGP). Potential covariates in logistic regression models of VAD included infant gender, stunting (length‐for‐age Z score < ‐2), iron deficiency (ferritin< 12 μg/L), acute respiratory or diarrheal illness, breastfeeding, maternal age, maternal vitamin A supplementation, maternal employment, and access to private toilets. Elevated CRP (>5 mg/L) and AGP (>1 g/L) were included in all models to account for inflammation. Prevalence of VAD was 25%. Backwards elimination indicated maternal age (OR: 4.6, 90% CI: [1.8‐11.4] for 25‐30 vs. 20‐25 years), maternal employment (0.4 [0.2‐0.9]) and elevated CRP (3.1 [1.2‐7.9]) were significantly associated with VAD using an alpha of 10%. These results suggest that sociodemographics may be an important risk factor for VAD, while inflammation also affects measures of VAD. A limitation of this study is the small sample size and subsequent lack of power, which will be improved as data collection continues.