Belinda V. Kweka Cyprian Fredrick Brenda Kitilya Kidola Jeremiah Eric Lyimo Suzanne Filteau Andrea M. Rehman Henrik Friis Mette F. Olsen Daniel Faurholt‐Jepsen Rikke Krogh‐Madsen George PrayGod

APMIS

2022-04-01

Fredrick Cyprian Mwita George PrayGod Erica Sanga Theresia Setebe Gaudensia Joseph Happyness Kunzi Jayne Webster Melissa Gladstone Rebecca Searle Maimuna Ahmed ADOLFINE HOKORORO Suzanne Filteau Henrik Friis André BRIEND Mette Frahm Olsen

Nutrients

Children with severe acute malnutrition (SAM) are at high risk of impaired development. Contributing causes include the inadequate intake of specific nutrients such as polyunsaturated fatty acids (PUFAs) and a lack of adequate stimulation. We conducted a pilot study assessing developmental and nutritional changes in children with SAM provided with a modified ready-to-use therapeutic food and context-specific psychosocial intervention in Mwanza, Tanzania. We recruited 82 children with SAM (6–36 months) and 88 sex- and age-matched non-malnourished children. We measured child development, using the Malawi Development Assessment Tool (MDAT), measures of family and maternal care for children, and whole-blood PUFA levels. At baseline, the mean total MDAT z-score of children with SAM was lower than non-malnourished children; −2.37 (95% confidence interval: −2.92; −1.82), as were their total n-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) levels. After 8 weeks of intervention, MDAT z-scores improved in all domains, especially fine motor, among children with SAM. Total n-3 and EPA levels increased, total n-6 fatty acids decreased, and DHA remained unchanged. Family and maternal care also improved. The suggested benefits of the combined interventions on the developmental and nutritional status of children with SAM will be tested in a future trial.

2024-02-28

Belinda V. Kweka, Cyprian Fredrick, Brenda Kitilya, Kidola Jeremiah, Eric Lyimo, Suzanne Filteau, Andrea M. Rehman, Henrik Friis, Mette F. Olsen, Daniel Faurholt-Jepsen, George PrayGod

APMIS (JOURNAL OF PATHOLOGY, MICROBIOLOGY, AND IMMUNOLOGY)

Aim

This study aimed to investigate sickle cell trait (SCT) associations with physical activity, markers of insulin secretion and resistance, and glucose among people living with HIV infection (PLWH), both antiretroviral therapy (ART) naïve and experienced, and HIV-uninfected adults.

Methods

This was a cross-sectional study conducted in Mwanza, north-western Tanzania. We used data of 668 participants attained from two sub-studies of CICADA study.

Results

Mean age was 40 (SD 11.5) years, 402 (61.7 %) were females and 157 (24.1 %) had SCT. PLWH were 422 (64.7 %), of these, 80 (18.9 %) were on ART. People with SCT had higher risk of having an isolated β-cell dysfunction compared to those without SCT (RRR=1.82, CI: 1.10, 3.01, P=0.02). People with SCT but without HIV infection had lower average acceleration on the trunk longitudinal axis (ACCx) and higher level of self-reported physical activity. 30 min oral glucose tolerance test among PLWH on ART was higher in those with SCT compared to those without SCT.

Conclusion

People with SCT are at higher risk of having β-cell dysfunction and those with SCT on ART are at more risk of developing diabetes. Future studies to investigate the interaction between SCT and HIV/ART on risk of diabetes should be considered.

2022-02-15

Kalpana Sabapathy Fredrick Cyprian Mwita Ethel Dauya Tsitsi Bandason Victoria Simms Chido Dziva Chikwari Aoife Doyle David Ross Anoop Shah Richard Hayes Aletta Schutte Katharina Kranzer Rashida Ferrand

Background Most cardiovascular mortality is due to hypertension and onset may be in youth. We investigated the prevalence of and risk factors for elevated blood pressure (BP) (hypertension (≥140/90mmHg) and high-normal BP (130-139/85-89mmHg)) among youth in Zimbabwe. Methods A population-based survey of randomly sampled 18-24 year olds from 24 communities in three provinces was conducted, with standardised questionnaires to collect socio-demographic, behavioural and clinical data. Height, weight and BP were recorded. The association of potential risk factors with elevated BP was examined using multivariable logistic regression. Findings Of 17,682 participants recruited (98% of those eligible), 17,637 had complete data. The median age was 20 (IQR: 19-22) years and 60.7% were female. After excluding pregnant women (N=754), the prevalence of hypertension and high-normal BP was 7.4% (95% CI:7.0-7.8) and 12.2% (95% CI:12.7-13.7), respectively. Prevalence of hypertension was higher in men (8.7% (95% CI:8.2-9.6) vs 6.6% (95% CI:6.0-6.9) in men and women, respectively) but with age increased to equivalent levels among women (at 18y 7.3% (95% CI:6.2-8.6) and 4.3% (95% CI:3.5-5.2); at 23-24 years 10.9% (95% CI:9.3- 12.5) and 9.50% (95% CI:8.4-10.7) in men and women, respectively). After adjusting for confounders, male sex ((aOR) 1.53 (95% CI:1.36-1.74)), increasing age (19-20 years aOR:1.20 (1.00-1.44); 21-22 years aOR:1.45 (95% CI 1.20-1.75); 23-24 years aOR 1.90 (95% CI:1.57-2.30), vs 18 years) and obesity (aOR 1.94 (95% CI:1.53-2.47)) were associated with hypertension. Being underweight (aOR 0.79 (0.63-0.98)) and living with HIV (aOR 0.71 (95% CI:0.55-0.92)) were associated with lower odds of hypertension. Interpretation Prevalence of elevated BP is high among youth in SSA and rises rapidly with age. Further research is needed to understand drivers of BP elevation and the extent of target organ damage in youth in SSA, to guide implementation of prevention and management strategies.

2023-07-03