Browsing by Author "Iversen, Ole Per"
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Item 8-Year Follow-up of a Maternal Education Trial in a Low-Resource Setting(Pediatrics, 2024-04) Kakwangire, Paul; Muhoozi, K. M. Grace; Ngari, Moses; Matovu, Nicholas; Westerberg, Cecilie Ane; Iversen, Ole Per; Atukunda, PrudenceOBJECTIVES: Nutrition and stimulation interventions promote early childhood development, but little is known about their long-term benefits in low- and middle-income countries. We conducted a follow-up study of a cluster-randomized maternal education trial performed in children aged 6 to 8 months to assess the sustainability of developmental benefits after 8 years. METHODS: The education intervention lasted 6 months and consisted of nutrition, hygiene, sanitation, and child stimulation aspects. We assessed child processing and cognitive abilities using the Kaufman Assessment Battery for Children Second Edition (KABC-II) and attention and inhibitory control using the Test of Variables of Attention after 8 years. The original trial included 511 mother-child pairs (intervention, n 5 263; control, n 5 248), whereas in the current study, 361 (71%; intervention, n 5 185; control, n 5 176) pairs were available for analyses. RESULTS: The intervention group scored higher than the controls (all P < .001) on all 5 KABC-II subscales and on the KABC-II global score (mean difference: 14; 95% confidence interval, 12–16; P < .001). For all 5 Test of Variables of Attention variables, the intervention group scored higher than the controls on both the visual and auditory tasks (all P < .05). Because the intervention was delivered as a package, a limitation is that we cannot pinpoint the individual contribution of each component (nutrition, hygiene, and stimulation) to the developmental benefits. CONCLUSIONS: The intervention group consistently scored markedly higher on both neuropsychological tests. Thus, even 8 years after the original maternal education intervention, the developmental benefits that we observed at child age of 1, 2, and 3 years, were sustained.Item Aflatoxins:(MDPI, 2020-02) Wacoo, Paul Alex; Atukunda, Prudence; Muhoozi, Grace; Braster, Martin; Wagner, Marijke; Broek, J van den Tim; Sybesma, Wilbert; Westerberg, C. Ane; Iversen, Ole Per; Kort, RemcoChronic exposure of children in sub-Saharan Africa to aflatoxins has been associated with low birth weight, stunted growth, immune suppression, and liver function damage. Lactobacillus species have been shown to reduce aflatoxin contamination during the process of food fermentation. Twenty-three Lactobacillus strains were isolated from fecal samples obtained from a cohort of rural Ugandan children at the age of 54 to 60 months, typed by 16S rRNA gene sequencing, and characterized in terms of their ability to bind aflatoxin B1 in vitro. Evidence for chronic exposure of these children to aflatoxin B1 in the study area was obtained by analysis of local foods (maize flour and peanuts), followed by the identification of the breakdown product aflatoxin M1 in their urine samples. Surprisingly, Lactobacillus in the gut microbiota of 140 children from the same cohort at 24 and 36 months showed the highest positive correlation coefficient with stunting among all bacterial genera identified in the stool samples. This correlation was interpreted to be associated with dietary changes from breastfeeding to plant-based solid foods that pose an additional risk for aflatoxin contamination, on one hand, and lead to increased intake of Lactobacillus species on the other. Keywords: Stunting; aflatoxin B1; Lactic acid bacteria; aflatoxin binding; gut microbiota