Pub Date : 2020-07-02DOI: 10.1080/16070658.2019.1575604
E. Viljoen, C. Macdougall, Mothusi D Mathibe, F. Veldman, S. Mda
Objective: This study aimed to identify dyslipidaemia in human immunodeficiency virus (HIV)-infected children. This was part of a larger study aiming at the treatment of dyslipidaemia in this population. Design: A cross-sectional quantitative study design was used. Setting: The Paediatric Outpatient Department HIV Clinic at Dr George Mukhari Academic Hospital (Garankuwa, Pretoria). Subjects: Children who received antiretroviral treatment (ART) for at least six months and were virologically supressed. Outcome measures: Fasting lipograms were evaluated against American paediatric thresholds for dyslipidaemia (NCEP ATPIII guidelines), and z-scores for weight-for-age (WAZ) and height-for-age (HAZ) were interpreted. Results: In total, 140 children were enrolled, median age at enrolment was 64.5 months (interquartile range IQR 42.5–94.6) and 51% were female. Median period of ART use was 34.0 months (IQR 23.2–52.8). Median ART commencement age was 18 months (IQR 8.1–34.0). Lipid profile results were available in 108 of the 140 children. Total cholesterol was classified borderline in 33% and elevated in 11% of the children. LDL cholesterol was borderline in 24% and elevated in 7%. HDL cholesterol was borderline in 20% and low in 30%. Triglyceride levels were borderline in 29% and elevated in 39% of the children. Children were considered as having dyslipidaemia if one or more of the four lipid profile levels were abnormal, or if at least two were borderline. By these criteria, 75% of the group were dyslipidaemic. A significant negative correlation was found between dyslipidaemia and enrolment HAZ indicating stunting (r-value −0.31; p < 0.05), also between dyslipidaemia and months’ duration on ART (r-value −0.25; p < 0.05) and a significant positive correlation was found between initiation on protease inhibitor (PI)-based regimen and dyslipidemia (p < 0.05). Conclusion: The prevalence of dyslipidaemia in HIV-infected children receiving ART is high. Participants who were stunted, or had a shorter ART duration, and those initiated on a PI-based regimen were more likely to have dyslipidaemia.
{"title":"Dyslipidaemia among HIV-infected children on antiretroviral therapy in Garankuwa, Pretoria","authors":"E. Viljoen, C. Macdougall, Mothusi D Mathibe, F. Veldman, S. Mda","doi":"10.1080/16070658.2019.1575604","DOIUrl":"https://doi.org/10.1080/16070658.2019.1575604","url":null,"abstract":"Objective: This study aimed to identify dyslipidaemia in human immunodeficiency virus (HIV)-infected children. This was part of a larger study aiming at the treatment of dyslipidaemia in this population. Design: A cross-sectional quantitative study design was used. Setting: The Paediatric Outpatient Department HIV Clinic at Dr George Mukhari Academic Hospital (Garankuwa, Pretoria). Subjects: Children who received antiretroviral treatment (ART) for at least six months and were virologically supressed. Outcome measures: Fasting lipograms were evaluated against American paediatric thresholds for dyslipidaemia (NCEP ATPIII guidelines), and z-scores for weight-for-age (WAZ) and height-for-age (HAZ) were interpreted. Results: In total, 140 children were enrolled, median age at enrolment was 64.5 months (interquartile range IQR 42.5–94.6) and 51% were female. Median period of ART use was 34.0 months (IQR 23.2–52.8). Median ART commencement age was 18 months (IQR 8.1–34.0). Lipid profile results were available in 108 of the 140 children. Total cholesterol was classified borderline in 33% and elevated in 11% of the children. LDL cholesterol was borderline in 24% and elevated in 7%. HDL cholesterol was borderline in 20% and low in 30%. Triglyceride levels were borderline in 29% and elevated in 39% of the children. Children were considered as having dyslipidaemia if one or more of the four lipid profile levels were abnormal, or if at least two were borderline. By these criteria, 75% of the group were dyslipidaemic. A significant negative correlation was found between dyslipidaemia and enrolment HAZ indicating stunting (r-value −0.31; p < 0.05), also between dyslipidaemia and months’ duration on ART (r-value −0.25; p < 0.05) and a significant positive correlation was found between initiation on protease inhibitor (PI)-based regimen and dyslipidemia (p < 0.05). Conclusion: The prevalence of dyslipidaemia in HIV-infected children receiving ART is high. Participants who were stunted, or had a shorter ART duration, and those initiated on a PI-based regimen were more likely to have dyslipidaemia.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"33 1","pages":"86 - 93"},"PeriodicalIF":1.1,"publicationDate":"2020-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/16070658.2019.1575604","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48765547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-30DOI: 10.1080/16070658.2020.1782027
S. McLaren, L. Steenkamp, H. McCarthy, Alexandra Rutishauser-Perera
Background: The relationship between overweight and under-nutrition, particularly in resource-poor settings, poses practical challenges for targeting nutrition interventions. Current anthropometric indicators including weight for length (WLZ) recommended by the WHO may be challenging in community settings. Objectives: The aim of this study was to assess whether MUAC can accurately identify children aged younger than two years with overweight and obesity. Method: A descriptive, cross-sectional study was used to collect data from a non-probability sample of 397 young South African children from October 2015 to February 2016. MUAC cut-off values were tested using a receiver operating characteristic and area under the curve (AUC). Results: The prevalence of overweight (WLZ > +2) and obesity (WLZ > +3) was 11% (n = 44) and 5% (21) respectively. A MUAC cut-off value for identifying male children 6 to 24 months old with overweight was determined at 16.5 cm (85% sensitivity, 71.4% specificity, AUC = 0.821) and female children at 16.5 cm (100% sensitivity, 76.6% specificity, AUC = 0.938). Conclusions: MUAC may be an appropriate tool for identifying children younger than two years old with overweight and obesity. The predicted MUAC cut-off values were able to identify infants and young children with overweight accurately.
{"title":"Screening for overweight using mid-upper arm circumference (MUAC) among children younger than two years in the Eastern Cape, South Africa","authors":"S. McLaren, L. Steenkamp, H. McCarthy, Alexandra Rutishauser-Perera","doi":"10.1080/16070658.2020.1782027","DOIUrl":"https://doi.org/10.1080/16070658.2020.1782027","url":null,"abstract":"Background: The relationship between overweight and under-nutrition, particularly in resource-poor settings, poses practical challenges for targeting nutrition interventions. Current anthropometric indicators including weight for length (WLZ) recommended by the WHO may be challenging in community settings. Objectives: The aim of this study was to assess whether MUAC can accurately identify children aged younger than two years with overweight and obesity. Method: A descriptive, cross-sectional study was used to collect data from a non-probability sample of 397 young South African children from October 2015 to February 2016. MUAC cut-off values were tested using a receiver operating characteristic and area under the curve (AUC). Results: The prevalence of overweight (WLZ > +2) and obesity (WLZ > +3) was 11% (n = 44) and 5% (21) respectively. A MUAC cut-off value for identifying male children 6 to 24 months old with overweight was determined at 16.5 cm (85% sensitivity, 71.4% specificity, AUC = 0.821) and female children at 16.5 cm (100% sensitivity, 76.6% specificity, AUC = 0.938). Conclusions: MUAC may be an appropriate tool for identifying children younger than two years old with overweight and obesity. The predicted MUAC cut-off values were able to identify infants and young children with overweight accurately.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"35 1","pages":"13 - 16"},"PeriodicalIF":1.1,"publicationDate":"2020-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/16070658.2020.1782027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43043284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-16DOI: 10.1080/16070658.2020.1769336
L. Steenkamp, M. Williams, J. Ronaasen, A. Feeley, I. Truter, P. Melariri
Objectives: To explore and describe caregivers’ handwashing knowledge and practices in the context of underprivileged urban communities. Design: A qualitative descriptive and exploratory study was conducted during August and September 2017, through five focus-group discussions, with caregivers of children younger than five years attending ECD centres. Setting: Early childhood development (ECD) centres in various underprivileged communities in Ibhayi and Motherwell, Nelson Mandela Bay. Subjects: Thirty-five adults, aged between 24 and 60 years, functioning as primary or secondary caregivers to 105 children, participated. Results: Three themes emerged, of which the first entailed the knowledge of handwashing and compliance with water, sanitation and hygiene (WASH) recommendations. Practical challenges that may prevent compliance with recommendations were highlighted. Handwashing as a social norm emerged as the second theme, and reflection on strategies at primary health care level to increase awareness regarding handwashing in communities was the third theme. Conclusion and recommendations: Current handwashing counselling at primary health care sites may not be perceived as relevant in underprivileged communities. However, with adequate support ECD practitioners have influence to change the handwashing behaviour and knowledge of pre-school children and families. Furthermore, communication and dissemination of handwashing messages should be clear, practical and relevant to address inappropriateness of current poster images and should include suggestions on what to do when experiencing infrastructure challenges and in times of water restrictions. Health-promotion strategies should focus on optimising handwashing practices while caring for pre-school children.
{"title":"Handwashing knowledge and practices among caregivers of pre-school children in underprivileged areas of Nelson Mandela Bay","authors":"L. Steenkamp, M. Williams, J. Ronaasen, A. Feeley, I. Truter, P. Melariri","doi":"10.1080/16070658.2020.1769336","DOIUrl":"https://doi.org/10.1080/16070658.2020.1769336","url":null,"abstract":"Objectives: To explore and describe caregivers’ handwashing knowledge and practices in the context of underprivileged urban communities. Design: A qualitative descriptive and exploratory study was conducted during August and September 2017, through five focus-group discussions, with caregivers of children younger than five years attending ECD centres. Setting: Early childhood development (ECD) centres in various underprivileged communities in Ibhayi and Motherwell, Nelson Mandela Bay. Subjects: Thirty-five adults, aged between 24 and 60 years, functioning as primary or secondary caregivers to 105 children, participated. Results: Three themes emerged, of which the first entailed the knowledge of handwashing and compliance with water, sanitation and hygiene (WASH) recommendations. Practical challenges that may prevent compliance with recommendations were highlighted. Handwashing as a social norm emerged as the second theme, and reflection on strategies at primary health care level to increase awareness regarding handwashing in communities was the third theme. Conclusion and recommendations: Current handwashing counselling at primary health care sites may not be perceived as relevant in underprivileged communities. However, with adequate support ECD practitioners have influence to change the handwashing behaviour and knowledge of pre-school children and families. Furthermore, communication and dissemination of handwashing messages should be clear, practical and relevant to address inappropriateness of current poster images and should include suggestions on what to do when experiencing infrastructure challenges and in times of water restrictions. Health-promotion strategies should focus on optimising handwashing practices while caring for pre-school children.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"35 1","pages":"8 - 12"},"PeriodicalIF":1.1,"publicationDate":"2020-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/16070658.2020.1769336","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41787219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-12DOI: 10.1080/16070658.2020.1757878
A. Morris-Paxton, I. Truter
Introduction: Numerous studies show the benefits of vitamin D: in the prevention of bone disease, supporting the immune system and the prevention and mitigation of cancer. Until recently, supplementation has been deemed unnecessary. Nonetheless, in the light of emerging evidence, some practitioners are adding vitamin D and its analogues (Anatomic Therapeutic Chemical (ATC) classification code A11CC) to their prescriptions. Therefore, the aim was to determine the medical insurance prescribing patterns of vitamin D in South Africa. Methods: A retrospective, cross-sectional drug utilisation study was conducted on a South African medical insurance administrator database for 2018. Products in ATC subgroup A11CC (vitamin D and analogues) were extracted and analysed. Results: A total of 302 patients received 1 164 prescriptions for a vitamin D or analogue product during 2018. The average age of patients was 47.14 (SD = 24.03) years, and the majority were female (58.28%). Very young patients and middle-aged patients received most of the prescriptions. Ergocalciferol (A11CC01) was the most frequently prescribed (59.79%), followed by alfacalcidol (A11CC), colecalciferol (A11CC05) and calcitriol (A11CC04). Ergocalciferol 50 000 IU tablets comprised the most frequently prescribed trade name product (59.45%), followed by alfacalcidol capsules (21.31%). Conclusion: Vitamin D was used across the age range. Vitamin D supplementation was primarily prescribed in the very young and older age groups, suggesting their need for additional supplementation. As the cost of additional supplements is relatively small compared with the treatment of deficiency disorders, vitamin D supplementation could have broad and positive effects on long-term health for very little outlay.
{"title":"Prescribing patterns of vitamin D and analogues in a private healthcare patient population in South Africa","authors":"A. Morris-Paxton, I. Truter","doi":"10.1080/16070658.2020.1757878","DOIUrl":"https://doi.org/10.1080/16070658.2020.1757878","url":null,"abstract":"Introduction: Numerous studies show the benefits of vitamin D: in the prevention of bone disease, supporting the immune system and the prevention and mitigation of cancer. Until recently, supplementation has been deemed unnecessary. Nonetheless, in the light of emerging evidence, some practitioners are adding vitamin D and its analogues (Anatomic Therapeutic Chemical (ATC) classification code A11CC) to their prescriptions. Therefore, the aim was to determine the medical insurance prescribing patterns of vitamin D in South Africa. Methods: A retrospective, cross-sectional drug utilisation study was conducted on a South African medical insurance administrator database for 2018. Products in ATC subgroup A11CC (vitamin D and analogues) were extracted and analysed. Results: A total of 302 patients received 1 164 prescriptions for a vitamin D or analogue product during 2018. The average age of patients was 47.14 (SD = 24.03) years, and the majority were female (58.28%). Very young patients and middle-aged patients received most of the prescriptions. Ergocalciferol (A11CC01) was the most frequently prescribed (59.79%), followed by alfacalcidol (A11CC), colecalciferol (A11CC05) and calcitriol (A11CC04). Ergocalciferol 50 000 IU tablets comprised the most frequently prescribed trade name product (59.45%), followed by alfacalcidol capsules (21.31%). Conclusion: Vitamin D was used across the age range. Vitamin D supplementation was primarily prescribed in the very young and older age groups, suggesting their need for additional supplementation. As the cost of additional supplements is relatively small compared with the treatment of deficiency disorders, vitamin D supplementation could have broad and positive effects on long-term health for very little outlay.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"35 1","pages":"1 - 7"},"PeriodicalIF":1.1,"publicationDate":"2020-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/16070658.2020.1757878","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46904729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-27DOI: 10.1080/16070658.2020.1751415
H. Spies, J. H. van den Berg, M. Nel
Introduction: In sub-Saharan Africa, a paucity of data exists in respect of the knowledge, attitudes and practices (KAP) of patients on maintenance haemodialysis (MHD) regarding the dietary adaptations they should make. Methods: In a descriptive, cross-sectional study, conducted in 2017, questionnaires were administered during structured interviews with 75 participants in five MHD-units in Bloemfontein to assess socio-demographics and KAP regarding the ‘renal’ diet. Results: The median age was 50.5 years; 70.7% of participants were male. Overall, 49.4% scored low (< 50%) on knowledge regarding restricted foods, food content of restricted minerals, and phosphate binders; 60.0% reported negative attitudes towards the diet, and 61.4% reported poor adherence practices. Participants with tertiary education (28.0%) had significantly higher knowledge scores than participants with only primary school education (6.7%) (95% CI 3.9%; 73.5%), or those who had only partially completed secondary school (17.3%) (95% CI 6.3%; 64.0%). Only 21.0% reported having received written, and 30.7% verbal, nutrition education in their home language, while 24.0% reported never receiving nutrition education in either their home or second language. Having received nutrition education in a home language and/or second language was associated with significantly higher knowledge scores (95% CI 3.7%; 49.5%). Most (77.3%) reported zero to one consultation with a dietitian per MHD year (NKF-K/DOQI recommends at least three/MHD year). Conclusion: This population on MHD presented with poor KAP regarding the ‘renal’ diet, and inadequate involvement of dietitians in their treatment. Receiving nutritional education in a first or second language significantly increased knowledge of, and insight into, the required dietary adaptations.
{"title":"Knowledge, attitude and practices of patients receiving maintenance haemodialysis in Bloemfontein, South Africa","authors":"H. Spies, J. H. van den Berg, M. Nel","doi":"10.1080/16070658.2020.1751415","DOIUrl":"https://doi.org/10.1080/16070658.2020.1751415","url":null,"abstract":"Introduction: In sub-Saharan Africa, a paucity of data exists in respect of the knowledge, attitudes and practices (KAP) of patients on maintenance haemodialysis (MHD) regarding the dietary adaptations they should make. Methods: In a descriptive, cross-sectional study, conducted in 2017, questionnaires were administered during structured interviews with 75 participants in five MHD-units in Bloemfontein to assess socio-demographics and KAP regarding the ‘renal’ diet. Results: The median age was 50.5 years; 70.7% of participants were male. Overall, 49.4% scored low (< 50%) on knowledge regarding restricted foods, food content of restricted minerals, and phosphate binders; 60.0% reported negative attitudes towards the diet, and 61.4% reported poor adherence practices. Participants with tertiary education (28.0%) had significantly higher knowledge scores than participants with only primary school education (6.7%) (95% CI 3.9%; 73.5%), or those who had only partially completed secondary school (17.3%) (95% CI 6.3%; 64.0%). Only 21.0% reported having received written, and 30.7% verbal, nutrition education in their home language, while 24.0% reported never receiving nutrition education in either their home or second language. Having received nutrition education in a home language and/or second language was associated with significantly higher knowledge scores (95% CI 3.7%; 49.5%). Most (77.3%) reported zero to one consultation with a dietitian per MHD year (NKF-K/DOQI recommends at least three/MHD year). Conclusion: This population on MHD presented with poor KAP regarding the ‘renal’ diet, and inadequate involvement of dietitians in their treatment. Receiving nutritional education in a first or second language significantly increased knowledge of, and insight into, the required dietary adaptations.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"34 1","pages":"116 - 122"},"PeriodicalIF":1.1,"publicationDate":"2020-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/16070658.2020.1751415","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43443641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-23DOI: 10.1080/16070658.2020.1733305
O. C. Otitoola, W. Oldewage-Theron, A. Egal
Background: Childhood obesity has become a growing global epidemic. In South Africa, overweight and obesity during childhood and adolescence are rising. The objectives of this study were (i) to estimate the prevalence of overweight and obesity among selected students in Cofimvaba, a rural settlement in Eastern Cape province, South Africa, and (ii) to assess the accuracy of the mid-upper arm circumference (MUAC) and ultrasound triceps skin-fold thickness (TSF) methods of predicting these health parameters Methods: A cross-sectional study was conducted on 211 students (109 girls and 102 boys) selected randomly from five public schools in Cofimvaba and aged 6–19 years. The weight, height, MUAC and TSF were determined by standard techniques. Data obtained were subjected to descriptive statistics, Pearson correlations and receiver operating characteristic (ROC) curve analysis. P < 0.05 was considered statistically significant. Result: Overall 1.9% (1.8% girls and 2.0% boys) of the respondents were underweight, 14.8% (21.1% and 7.8% boys) were overweight and 2.8% (4.6% girls and 1.0% boys) were obese. The prevalence of overweight and obesity was significantly higher (p < 0.05) in girls than boys during adolescence but there was no gender difference in children (6–9 years). Most of the students (80.6%) had a healthy weight, with boys being significantly (p < 0.05) healthier than girls. The BMI showed significant strong correlations with MUAC (r = 0.926; p < 0.001) and TSF (r = 0.643; p < 0.001). ROC curve analysis gave an area under the curve (AUC) of 0.795 (95% CI, 0.761–0.889) and 0.835 (95% CI, 0.771–0.899) for MUAC and TSF respectively. Conclusion: The study found a high prevalence of overweight children in the sample and a low prevalence of stunting and underweight. The adolescent girls are at a higher risk of being overweight and obese than the boys. MUAC and TSF can adequately predict overweight and obesity among the selected students.
{"title":"Prevalence of overweight and obesity among selected schoolchildren and adolescents in Cofimvaba, South Africa","authors":"O. C. Otitoola, W. Oldewage-Theron, A. Egal","doi":"10.1080/16070658.2020.1733305","DOIUrl":"https://doi.org/10.1080/16070658.2020.1733305","url":null,"abstract":"Background: Childhood obesity has become a growing global epidemic. In South Africa, overweight and obesity during childhood and adolescence are rising. The objectives of this study were (i) to estimate the prevalence of overweight and obesity among selected students in Cofimvaba, a rural settlement in Eastern Cape province, South Africa, and (ii) to assess the accuracy of the mid-upper arm circumference (MUAC) and ultrasound triceps skin-fold thickness (TSF) methods of predicting these health parameters Methods: A cross-sectional study was conducted on 211 students (109 girls and 102 boys) selected randomly from five public schools in Cofimvaba and aged 6–19 years. The weight, height, MUAC and TSF were determined by standard techniques. Data obtained were subjected to descriptive statistics, Pearson correlations and receiver operating characteristic (ROC) curve analysis. P < 0.05 was considered statistically significant. Result: Overall 1.9% (1.8% girls and 2.0% boys) of the respondents were underweight, 14.8% (21.1% and 7.8% boys) were overweight and 2.8% (4.6% girls and 1.0% boys) were obese. The prevalence of overweight and obesity was significantly higher (p < 0.05) in girls than boys during adolescence but there was no gender difference in children (6–9 years). Most of the students (80.6%) had a healthy weight, with boys being significantly (p < 0.05) healthier than girls. The BMI showed significant strong correlations with MUAC (r = 0.926; p < 0.001) and TSF (r = 0.643; p < 0.001). ROC curve analysis gave an area under the curve (AUC) of 0.795 (95% CI, 0.761–0.889) and 0.835 (95% CI, 0.771–0.899) for MUAC and TSF respectively. Conclusion: The study found a high prevalence of overweight children in the sample and a low prevalence of stunting and underweight. The adolescent girls are at a higher risk of being overweight and obese than the boys. MUAC and TSF can adequately predict overweight and obesity among the selected students.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"34 1","pages":"97 - 102"},"PeriodicalIF":1.1,"publicationDate":"2020-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/16070658.2020.1733305","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46744879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-16DOI: 10.1080/16070658.2020.1741902
Cj Martin, E. Muller, D. Labadarios, F. Veldman, Sm Kassier
Objective: To determine body composition (BC) and the correlation, if any, between indices measured by anthropometry and dual-energy X-ray absorptiometry (DEXA). Design: Cross-sectional descriptive. Setting: National sample of HIV-positive patients on the ‘positive-to-positive’ kidney transplant programme, South Africa. Methodology: 34 participants categorised as (i) HIV-positive transplant recipients from an HIV-positive donor (n = 16); and (ii) HIV-positive transplant candidates on the waiting list to receive a kidney from an HIV-positive donor (n = 18). Pearson's coefficient was used to correlate anthropometry with DEXA. Outcome measures: Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were compared with DEXA-derived percentage body fat (%BF), truncal fat (TF) and visceral adipose tissue (VAT). Mid arm muscle circumference (MAMC) was correlated with DEXA lean indices namely lean mass (LM), lean mass index (LMI) and appendicular lean mass index (ALMI). Results: Pearson's correlation coefficient between BMI and %BF was strong (r = 0.773, p < 0.001). The correlation between WC with TF (r = 0.799, p < 0.001) and VAT (r = 0.885, p < 0.001) was highly significant, as was the correlation for WHtR with TF and VAT (r = 0.778, p = 0.013 and r = 0.830, p < 0.001). MAMC best correlated with ALMI (r = 0.511, p = 0.011). Conclusion: BMI, WC, WHtR and MAMC are suitable indicators of overall and regional adiposity as well as musculature, based on correlations with DEXA derived %BF, TF, VAT and ALMI respectively. The findings support the use of these anthropometric indices for measurement of BC in this patient group as a cost-effective alternative to DEXA.
{"title":"Body composition of HIV-positive candidates for and recipients of a kidney transplant: comparative analysis between DEXA and anthropometric indices","authors":"Cj Martin, E. Muller, D. Labadarios, F. Veldman, Sm Kassier","doi":"10.1080/16070658.2020.1741902","DOIUrl":"https://doi.org/10.1080/16070658.2020.1741902","url":null,"abstract":"Objective: To determine body composition (BC) and the correlation, if any, between indices measured by anthropometry and dual-energy X-ray absorptiometry (DEXA). Design: Cross-sectional descriptive. Setting: National sample of HIV-positive patients on the ‘positive-to-positive’ kidney transplant programme, South Africa. Methodology: 34 participants categorised as (i) HIV-positive transplant recipients from an HIV-positive donor (n = 16); and (ii) HIV-positive transplant candidates on the waiting list to receive a kidney from an HIV-positive donor (n = 18). Pearson's coefficient was used to correlate anthropometry with DEXA. Outcome measures: Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were compared with DEXA-derived percentage body fat (%BF), truncal fat (TF) and visceral adipose tissue (VAT). Mid arm muscle circumference (MAMC) was correlated with DEXA lean indices namely lean mass (LM), lean mass index (LMI) and appendicular lean mass index (ALMI). Results: Pearson's correlation coefficient between BMI and %BF was strong (r = 0.773, p < 0.001). The correlation between WC with TF (r = 0.799, p < 0.001) and VAT (r = 0.885, p < 0.001) was highly significant, as was the correlation for WHtR with TF and VAT (r = 0.778, p = 0.013 and r = 0.830, p < 0.001). MAMC best correlated with ALMI (r = 0.511, p = 0.011). Conclusion: BMI, WC, WHtR and MAMC are suitable indicators of overall and regional adiposity as well as musculature, based on correlations with DEXA derived %BF, TF, VAT and ALMI respectively. The findings support the use of these anthropometric indices for measurement of BC in this patient group as a cost-effective alternative to DEXA.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"34 1","pages":"110 - 115"},"PeriodicalIF":1.1,"publicationDate":"2020-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/16070658.2020.1741902","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48937668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-27DOI: 10.1080/16070658.2020.1741903
Mesfin Agachew Woldekidan, D. Haile, Bilal Shikur, S. Gebreyesus
Background: The widely used nutritional assessment tool used for the elderly includes the Mini Nutritional Assessment (MNA) and Mini Nutritional Assessment–Short Form (MNA-SF) tool. These tools have not been evaluated for their validity and reliability among the elderly population of developing countries such as Ethiopia. This study aimed to evaluate the reliability and validity of the full and short form of the Mini Nutritional Assessment tool among the elderly in Ethiopia. Method: We evaluated the reliability and validity of the tools using a community-based cross-sectional study among 506 elderly individuals. Accuracy, sensitivity, specificity and cut-off point were evaluated to determine the validity of both the full MNA and MNA-SF tool. Reliability was assessed using Cronbach’s α coefficient. The criterion-related validity of the MNA tool was evaluated by computing the correlation between the total MNA score and anthropometric measurements. The Youden index was used to determine best cut-off points of the full MNA and MNA-SF. Result: The mean MNA score was 19.9 ± 4.5. Cronbach’s α value of the full MNA tool was 0.7. The overall accuracy of the full MNA was 91% (95% CI, 87.5%–94.9%). The sensitivity and specificity of the full MNA tool using an established cut-off point was 87.9% and 89.6% respectively. Youden index analysis showed that the best cut-off point to detect the malnourished and those at risk of malnutrition using the full MNA was 16 (sensitivity 90.4% and specificity 86.8%). The reliability of the MNA-SF as measured by Cronbach’s α was 0.5. The overall accuracy of the MNA-SF was found to be 93% (95% CI, 0.90–0.96). By using the Youden index the best cut-off point for MNA-SF to detect malnutrition was 7.5 (sensitivity 85.7% and specificity 89%). Conclusion: The full MNA tool was a valid and reliable tool to identify elderly individuals who are malnourished, at risk of malnutrition and well-nourished with modulation of cut-off points. However, the short MNA tool was valid and but not reliable in this study.
{"title":"Validity of Mini Nutritional Assessment tool among an elderly population in Yeka sub-city, Addis Ababa, Ethiopia","authors":"Mesfin Agachew Woldekidan, D. Haile, Bilal Shikur, S. Gebreyesus","doi":"10.1080/16070658.2020.1741903","DOIUrl":"https://doi.org/10.1080/16070658.2020.1741903","url":null,"abstract":"Background: The widely used nutritional assessment tool used for the elderly includes the Mini Nutritional Assessment (MNA) and Mini Nutritional Assessment–Short Form (MNA-SF) tool. These tools have not been evaluated for their validity and reliability among the elderly population of developing countries such as Ethiopia. This study aimed to evaluate the reliability and validity of the full and short form of the Mini Nutritional Assessment tool among the elderly in Ethiopia. Method: We evaluated the reliability and validity of the tools using a community-based cross-sectional study among 506 elderly individuals. Accuracy, sensitivity, specificity and cut-off point were evaluated to determine the validity of both the full MNA and MNA-SF tool. Reliability was assessed using Cronbach’s α coefficient. The criterion-related validity of the MNA tool was evaluated by computing the correlation between the total MNA score and anthropometric measurements. The Youden index was used to determine best cut-off points of the full MNA and MNA-SF. Result: The mean MNA score was 19.9 ± 4.5. Cronbach’s α value of the full MNA tool was 0.7. The overall accuracy of the full MNA was 91% (95% CI, 87.5%–94.9%). The sensitivity and specificity of the full MNA tool using an established cut-off point was 87.9% and 89.6% respectively. Youden index analysis showed that the best cut-off point to detect the malnourished and those at risk of malnutrition using the full MNA was 16 (sensitivity 90.4% and specificity 86.8%). The reliability of the MNA-SF as measured by Cronbach’s α was 0.5. The overall accuracy of the MNA-SF was found to be 93% (95% CI, 0.90–0.96). By using the Youden index the best cut-off point for MNA-SF to detect malnutrition was 7.5 (sensitivity 85.7% and specificity 89%). Conclusion: The full MNA tool was a valid and reliable tool to identify elderly individuals who are malnourished, at risk of malnutrition and well-nourished with modulation of cut-off points. However, the short MNA tool was valid and but not reliable in this study.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"34 1","pages":"103 - 109"},"PeriodicalIF":1.1,"publicationDate":"2020-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/16070658.2020.1741903","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42171299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-26DOI: 10.1080/16070658.2019.1697037
Thandi Xaba, S. Dlamini
Introduction: Non-communicable diseases (NCDs) account for more than 63% of all deaths globally. Intake of fruits and vegetables is linked to a lower risk of NCDs. Objectives: (a) to describe the socio-demographic, psychosocial, environmental and socio-economic profile of adults aged 18–64 years (study participants) in Alfred Duma Local Municipality (ADLM), (b) to assess the level of consumption of fruits and vegetables, and (c) to investigate association between socio-demographic, psychosocial, socio-economic factors and consumption of fruits and vegetables. Methodology: An observational, analytical, cross-sectional study involving 164 households from six selected municipal wards in ADLM was conducted. A structured questionnaire using a combination of 24-hour recall method and food frequency was used to collect data (Appendix). Multivariate analysis was used to identify factors associated with consumption of 2–3 or more servings of vegetables daily and 2 or more servings of fruit daily. Binary logistic regression was used to measure the strength of the associations between daily consumption and other variables. Results: Only 0.6% (n = 1) participants were found to be consuming an adequate amount of fruits and vegetables daily. Employment was associated with consumption of 2–3 daily servings of vegetables and two of fruits (OR 2.37; p-value 0.01 and OR 5.22; p-value < 0.001 for vegetables and fruits respectively). Local availability of vegetables was associated with consumption of vegetables (OR 2.35; p-value 0.014) but not fruits. Conclusion: Improving local availability of vegetables and employment may improve consumption in this municipality and help prevent NCDs. Summary: This study was conducted to assess consumption of fruits and vegetables in ADLM, and to identify factors associated with consumption. The study found that consumption of fruits and vegetables in ADLM is extremely poor. Local availability and employment were the main factors associated with consumption of fruits and vegetables. Supporting households in having vegetable gardens, and advocating for local vendors to sell fruits and vegetables on commute routes are key recommendations of this study.
{"title":"Factors associated with consumption of fruits and vegetables amongst adults in the Alfred Duma Local Municipality, Ladysmith","authors":"Thandi Xaba, S. Dlamini","doi":"10.1080/16070658.2019.1697037","DOIUrl":"https://doi.org/10.1080/16070658.2019.1697037","url":null,"abstract":"Introduction: Non-communicable diseases (NCDs) account for more than 63% of all deaths globally. Intake of fruits and vegetables is linked to a lower risk of NCDs. Objectives: (a) to describe the socio-demographic, psychosocial, environmental and socio-economic profile of adults aged 18–64 years (study participants) in Alfred Duma Local Municipality (ADLM), (b) to assess the level of consumption of fruits and vegetables, and (c) to investigate association between socio-demographic, psychosocial, socio-economic factors and consumption of fruits and vegetables. Methodology: An observational, analytical, cross-sectional study involving 164 households from six selected municipal wards in ADLM was conducted. A structured questionnaire using a combination of 24-hour recall method and food frequency was used to collect data (Appendix). Multivariate analysis was used to identify factors associated with consumption of 2–3 or more servings of vegetables daily and 2 or more servings of fruit daily. Binary logistic regression was used to measure the strength of the associations between daily consumption and other variables. Results: Only 0.6% (n = 1) participants were found to be consuming an adequate amount of fruits and vegetables daily. Employment was associated with consumption of 2–3 daily servings of vegetables and two of fruits (OR 2.37; p-value 0.01 and OR 5.22; p-value < 0.001 for vegetables and fruits respectively). Local availability of vegetables was associated with consumption of vegetables (OR 2.35; p-value 0.014) but not fruits. Conclusion: Improving local availability of vegetables and employment may improve consumption in this municipality and help prevent NCDs. Summary: This study was conducted to assess consumption of fruits and vegetables in ADLM, and to identify factors associated with consumption. The study found that consumption of fruits and vegetables in ADLM is extremely poor. Local availability and employment were the main factors associated with consumption of fruits and vegetables. Supporting households in having vegetable gardens, and advocating for local vendors to sell fruits and vegetables on commute routes are key recommendations of this study.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"34 1","pages":"72 - 83"},"PeriodicalIF":1.1,"publicationDate":"2020-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/16070658.2019.1697037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42326272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-12DOI: 10.1080/16070658.2019.1697038
C. Stevenson, R. Blaauw, E. Fredericks, J. Visser, S. Roux
Objective: Probiotics and nutrient intakes modulate gastrointestinal (GIT) microbiota and symptoms of irritable bowel syndrome (IBS). The extent to which these factors influence the microbiota is relatively unknown. The primary objective of this paper was to investigate the effect of a probiotic on gut microbiota and IBS symptoms. The secondary objective was exploring correlations between dietary intake and gut microbiota. Design: This study was an extension of a randomised clinical trial (Clinical Trials Registry NCT018867810). Dietary intake was recorded by three-day estimated food records. Faecal samples were collected at three time points: (1) baseline (A), (2) after eight weeks’ probiotic supplementation (Lactobacillus plantarum 299v) (B) and (3) following a two-week washout period (C). Total Bacteroides spp., Bifidobacteria bifidum and Lactobacillus plantarum were quantified by quantitative real-time polymerase chain reaction (qPCR). Results: Twenty-eight diarrhoea-predominant IBS (D-IBS) and 24 constipation-predominant IBS (C-IBS) patients participated. Lactobacillus plantarum profiles at baseline (A) were significantly different between C-IBS and D-IBS (−0.956 ± 1.239 vs. −1.700 ± 1.239; p = 0.024). There was no significant change in bacterial counts after completion of the trial (B) and following the washout period (C) between groups. In both groups there were significant direct correlations between fibre and Lactobacillus plantarum and inverse correlations between fibre and Bacteroides spp. There was no difference in symptom severity scores between treatment and placebo groups during the study. Conclusion: The probiotic had no effect on symptoms and GIT microbiota. Certain nutrients strongly correlate to certain bacterial profiles, suggesting that nutrients can significantly influence gastrointestinal microbiota composition.
目的:益生菌和营养摄入调节胃肠道(GIT)微生物群和肠易激综合征(IBS)症状。这些因素对微生物群的影响程度相对未知。本文的主要目的是研究益生菌对肠道微生物群和肠易激综合征症状的影响。次要目标是探索饮食摄入与肠道微生物群之间的相关性。设计:本研究是一项随机临床试验(临床试验注册中心NCT018867810)的延伸。膳食摄入量记录为三天的估计食物记录。在三个时间点收集粪便样本:(1)基线(A)，(2)补充益生菌8周后(植物乳杆菌299v) (B)和(3)两周清洗期后(C)。通过定量实时聚合酶链反应(qPCR)对总拟杆菌、两歧双歧杆菌和植物乳杆菌进行定量。结果:28例腹泻型IBS (D-IBS)和24例便秘型IBS (C-IBS)患者参与了研究。C-IBS和D-IBS的植物乳杆菌基线谱(A)差异显著(- 0.956±1.239 vs - 1.700±1.239;p = 0.024)。在试验结束(B)和洗脱期(C)之后，两组之间的细菌计数没有显著变化。在两组中，纤维和植物乳杆菌之间存在显著的直接相关，纤维和拟杆菌之间存在负相关。在研究期间，治疗组和安慰剂组在症状严重程度评分上没有差异。结论:益生菌对胃肠道症状及胃肠道菌群无明显影响。某些营养物质与某些细菌特征密切相关，这表明营养物质可以显著影响胃肠道微生物群的组成。
{"title":"Probiotic effect and dietary correlations on faecal microbiota profiles in irritable bowel syndrome","authors":"C. Stevenson, R. Blaauw, E. Fredericks, J. Visser, S. Roux","doi":"10.1080/16070658.2019.1697038","DOIUrl":"https://doi.org/10.1080/16070658.2019.1697038","url":null,"abstract":"Objective: Probiotics and nutrient intakes modulate gastrointestinal (GIT) microbiota and symptoms of irritable bowel syndrome (IBS). The extent to which these factors influence the microbiota is relatively unknown. The primary objective of this paper was to investigate the effect of a probiotic on gut microbiota and IBS symptoms. The secondary objective was exploring correlations between dietary intake and gut microbiota. Design: This study was an extension of a randomised clinical trial (Clinical Trials Registry NCT018867810). Dietary intake was recorded by three-day estimated food records. Faecal samples were collected at three time points: (1) baseline (A), (2) after eight weeks’ probiotic supplementation (Lactobacillus plantarum 299v) (B) and (3) following a two-week washout period (C). Total Bacteroides spp., Bifidobacteria bifidum and Lactobacillus plantarum were quantified by quantitative real-time polymerase chain reaction (qPCR). Results: Twenty-eight diarrhoea-predominant IBS (D-IBS) and 24 constipation-predominant IBS (C-IBS) patients participated. Lactobacillus plantarum profiles at baseline (A) were significantly different between C-IBS and D-IBS (−0.956 ± 1.239 vs. −1.700 ± 1.239; p = 0.024). There was no significant change in bacterial counts after completion of the trial (B) and following the washout period (C) between groups. In both groups there were significant direct correlations between fibre and Lactobacillus plantarum and inverse correlations between fibre and Bacteroides spp. There was no difference in symptom severity scores between treatment and placebo groups during the study. Conclusion: The probiotic had no effect on symptoms and GIT microbiota. Certain nutrients strongly correlate to certain bacterial profiles, suggesting that nutrients can significantly influence gastrointestinal microbiota composition.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"34 1","pages":"84 - 89"},"PeriodicalIF":1.1,"publicationDate":"2019-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/16070658.2019.1697038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42814141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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