Browsing by Author "Diep, M Lien"

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    Child development, growth and microbiota :
    (Journal of global health, 2019) Atukunda, Prudence; Muhoozi, K. M. Grace; Broek, J van den Tim; Kort, Remco; Diep, M Lien; Kaaya, N Archileo; Iversen, O Per; Westerberg, C Ane
    Background Undernutrition impairs child development outcomes and growth. In this follow-up study of an open cluster-randomized intervention trial we examined the effects of an education package delivered to mothers in rural Uganda on their children’s development, growth and gut microbiota at 36 months of age. Methods: The parental trial included 511 mother-child pairs recruited when the children were 6-8 months. In that trial, a nutrition, stimulation and hygiene education was delivered to mothers in the intervention group while the control group received routine health care. A follow-up sample of 155 pairs (intervention n=77, control n=78) were re-enrolled when the children were 24 months. Developmental outcomes were assessed with the Bayley Scales of Infant and Toddler Development (BSID-III) composite scores for cognitive (primary endpoint), language and motor development. Development outcomes were also evaluated using the Ages and Stages Questionnaire (ASQ) and the Mullen Scales of Early Learning (MSEL). Other outcomes included growth and gut microbiota composition. Results The demographic characteristics were not different (P>0.05) between the intervention and control groups and similar to those of the parental study. The intervention group had higher BSID-III scores than controls, with mean difference 10.13 (95% confidence interval (CI): 3.31-17.05, P=0.002); 7.59 (1.62-13.66, P=0.01); 9.00 (2.92-15.40, P=0.005), for cognitive, language and motor composite scores, respectively. An improvement in the intervention compared to the control group was obtained for both the ASQ and the MSEL scores. The mean difference in height-for-age z-score was higher in the intervention compared to the control group: 0.50 (0.25-0.75, P=0.0001). Gut microbiota composition did not differ significantly between the two study groups. Conclusions The maternal education intervention had positive effects on child development and growth at three years, but did not alter gut microbiota composition. This intervention may be applicable in other low-resource settings.
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    The association of urine markers of iodine intake with development and growth among children in rural Uganda:
    (Cambridge University Press, 2020-07) Atukunda, Prudence; Muhoozi, K. M. Grace; Diep, M Lien; Berg, P Jens; Westerberg, C Ane; Iversen, O. Per
    Objective: We examined associations of urine iodide excretion, proxy for iodine intake, with child development and growth. Design: This is a secondary analysis of a 1:1 cluster-randomised trial with a 6-month nutrition/stimulation/hygiene education intervention among mothers of children aged 6–8 months to improve child development and growth. Development was assessed using Bayley Scales of Infant and Toddler Development–III (BSID-III) and Ages and Stages Questionnaire (ASQ), whereas anthropometry was used to assess growth. Urine iodide concentration (UIC) and urine iodide/creatinine ratio (ICR) were measured. Setting: The current study was conducted in southern Uganda. Participants: We randomly selected 155 children from the 511 enrolled into the original trial and analysed data when they were aged 20–24 and 36 months. Results: Median UIC for both study groups at 20–24 and 36 months were similar (P > 0•05) and within the normal range of 100–199 μg/l (0•79–1•60 μmol/l), whereas the intervention group had significantly higher ICR at 20–24 months. The BSID-III cognitive score was positively associated (P = 0•028) with ICR at 20–24 months in the intervention group. The ASQ gross motor score was negatively associated (P = 0•020) with ICR at 20–24 months among the controls. ICR was not significantly associated with anthropometry in the two study groups at either time-point. Conclusions: Following the intervention, a positive association was noted between ICR and child’s cognitive score at 20–24 months, whereas no positive association with ICR and growth was detected. Iodine sufficiency may be important for child’s cognitive development in this setting. Keywords: Child development, Education, Growth, Iodide, Mothers, Nutrition, Uganda