Trop Med Int Health
September 2025
Objectives: Childhood mortality is a key indicator of progress in health and development in low- and middle-income countries, traditionally measured through household surveys with face-to-face interviews. This study explored an alternative approach that used mobile phone interviews with women in Mozambique.
Methods: Using two sampling approaches, we interviewed women of reproductive age about their pregnancy history through mobile phones.
Background: Prenatal multiple micronutrient supplementation (MMS), in comparison to iron and folic acid supplementation (IFA), improves pregnancy outcomes, but less is known about their effect on infant growth.
Objectives: We conducted a systematic review of trials comparing maternal MMS to IFA and assessed the effect on infants' anthropometric outcomes at birth, 3, 6, 12, 18, and 24 mo of age.
Methods: We included trials from a Cochrane review and new studies identified through systematic literature searches in 3 databases.
Background: Impaired linear growth and stunting in children under 5 y is a marker of multiple deprivations in low-income and middle-income countries.
Objectives: We aimed to assess drivers and policies influencing improvements in linear growth and stunting reduction in 10 countries with annual rates of reduction in childhood stunting averaging 1.1% (range: 0.
PLOS Glob Public Health
February 2025
Children who receive therapeutic feeding for wasting treatment but do not reach the anthropometric definitions of recovery (usually within 12-16 weeks) are categorised as 'non-responders' and considered as treatment failures. We conducted a pooled analysis to explore the growth trajectories of non-responders and the appropriateness of the definition of 'non-response'. We pooled 14 studies of children aged 6-59 months receiving treatment for wasting.
View Article and Find Full Text PDFIn Bangladesh, anaemia is estimated to affect 52% of children 6-59 months, with the youngest children (6-23 months) experiencing the highest levels of anaemia (71%). Micronutrient powders (MNPs) are designed to increase micronutrient intake in young children; however, in some settings, the prevalence of anaemia may remain elevated despite the high coverage of MNPs. In a secondary analysis of the Zinc in Powders trial (ZiPT), we identified risk factors that were associated with anaemia among Bangladeshi children 9-11 months of age who received standard 15-component MNPs, including 10 mg of iron, daily for 24 weeks.
View Article and Find Full Text PDFBackground: While countries' coronavirus disease 2019 (COVID-19) emergency contingency and response plans aimed to prevent and control the spread of the virus, they also caused major disruptions to health services. We assessed the effects of COVID-19 on coverage and inequalities in select maternal, newborn, and child health services in Burkina Faso.
Methods: We analysed data from two cross-sectional household surveys conducted in two provinces, one rural and one urban.
Adolescents in low- and middle-income countries (LMICs) are a vulnerable population given increased nutritional needs as puberty approaches. School-based nutrition programs exist in some settings, but the comprehensive provision of nutrition services requires knowledge of the mechanisms to reach out-of-school adolescents. A comprehensive scoping review was performed using formal and informal search strategies to landscape all potential delivery platforms with nutrition services to reach adolescents.
View Article and Find Full Text PDFBackground: Information on the causes of deaths from diarrhoea in children younger than 5 years is needed to design improved preventive and therapeutic approaches. We aimed to conduct a systematic analysis of studies to report estimates of the causes of deaths from diarrhoea in children younger than 5 years at global and regional levels during 2000-21.
Methods: For this systematic review and Bayesian multinomial analysis, we included 12 pathogens with the highest attributable incidence in the Global Enteric Multicenter Study.
Objective: To describe the mortality risks by fine strata of gestational age and birthweight among 230 679 live births in nine low- and middle-income countries (LMICs) from 2000 to 2017.
Design: Descriptive multi-country secondary data analysis.
Setting: Nine LMICs in sub-Saharan Africa, Southern and Eastern Asia, and Latin America.
Background: Reduction of Tanzania's neonatal mortality rate has lagged behind that for all under-fives, and perinatal mortality has remained stagnant over the past two decades. We conducted a national verbal and social autopsy (VASA) study to estimate the causes and social determinants of stillbirths and neonatal deaths with the aim of identifying relevant health care and social interventions.
Methods: A VASA interview was conducted of all stillbirths and neonatal deaths in the prior 5 years identified by the 2015-16 Tanzania Demographic and Health Survey.
Int J Infect Dis
December 2023
The effective management of the 33 million children with moderate acute malnutrition (MAM) is key to reducing childhood morbidity and mortality. In this review, we aim to evaluate the effectiveness of specially formulated foods (SFFs) compared to non-food-based approaches to manage MAM in children >6 months old. We conducted a search on ten databases until 23 August 2021 and included five studies, covering 3387 participants.
View Article and Find Full Text PDFBackground: Low birth weight (LBW) is associated with neonatal mortality and sequelae of lifelong health problems; prioritizing the most promising antenatal interventions may guide resource allocation and improve health outcomes.
Objective: We sought to identify the most promising interventions that are not yet included in the policy recommendations of the World Health Organization (WHO) but could complement antenatal care and reduce the prevalence of LBW and related adverse birth outcomes in low- and middle-income settings.
Methods: We utilized an adapted Child Health and Nutrition Research Initiative (CHNRI) prioritization method.
Despite major achievements in child survival, the burden of neonatal mortality has remained high and even increased in some countries since 1990. Currently, most neonatal deaths are attributable to being born preterm, small for gestational age (SGA), or with low birthweight (LBW). Besides neonatal mortality, these conditions are associated with stillbirth and multiple morbidities, with short-term and long-term adverse consequences for the newborn, their families, and society, resulting in a major loss of human capital.
View Article and Find Full Text PDFSmall newborns are vulnerable to mortality and lifelong loss of human capital. Measures of vulnerability previously focused on liveborn low-birthweight (LBW) babies, yet LBW reduction targets are off-track. There are two pathways to LBW, preterm birth and fetal growth restriction (FGR), with the FGR pathway resulting in the baby being small for gestational age (SGA).
View Article and Find Full Text PDFA package of care for all pregnant women within eight scheduled antenatal care contacts is recommended by WHO. Some interventions for reducing and managing the outcomes for small vulnerable newborns (SVNs) exist within the WHO package and need to be more fully implemented, but additional effective measures are needed. We summarise evidence-based antenatal and intrapartum interventions (up to and including clamping the umbilical cord) to prevent vulnerable births or improve outcomes, informed by systematic reviews.
View Article and Find Full Text PDFObjective: We aimed to understand the mortality risks of vulnerable newborns (defined as preterm and/or born weighing smaller or larger compared to a standard population), in low- and middle-income countries (LMICs).
Design: Descriptive multi-country, secondary analysis of individual-level study data of babies born since 2000.
Setting: Sixteen subnational, population-based studies from nine LMICs in sub-Saharan Africa, Southern and Eastern Asia, and Latin America.
Sub-Saharan Africa lacks timely, reliable, and accurate national data on mortality and causes of death (CODs). In 2018 Mozambique launched a sample registration system (Countrywide Mortality Surveillance for Action [COMSA]-Mozambique), which collects continuous birth, death, and COD data from 700 randomly selected clusters, a nationally representative population of 828,663 persons. Verbal and social autopsy interviews are conducted for COD determination.
View Article and Find Full Text PDFSince March 2018, the Countrywide Mortality Surveillance for Action project, implemented as a national sample registration system by the Mozambique Instituto Nacional de Saude and the Instituto Nacional de Estatistica in 700 geographic clusters randomly distributed across the 11 provinces, has trained and deployed community surveillance agents (CSAs) to report births and deaths in each cluster prospectively. An independent, retrospective data collection was conducted to assess the completeness of surveillance data. Record linkage procedures were used to match households and vital events reported in the two data sources.
View Article and Find Full Text PDFContext: The timing of introducing complementary feeding (CF) is crucial because premature or delayed CF can be associated with adverse health outcomes in childhood and adulthood.
Objective: This systematic review aims to evaluate the impact of the timing of CF introduction on health, nutrition, and developmental outcomes among normal-term infants.
Data Sources: Electronic databases and trial registries were searched, along with the reference lists of the included studies and relevant systematic reviews.
Meta-analyses consistently have found that antenatal multiple micronutrient supplementation (MMS) compared with iron and folic acid (IFA) alone reduce adverse birth outcomes. In 2020, the World Health Organization (WHO) placed a conditional recommendation for MMS and requested additional trials using ultrasounds to establish gestational age, because the evidence on low birthweight (LBW), preterm birth and small for gestational age (SGA) was considered inconsistent. We conducted meta-analyses to determine if the effects of MMS on LBW, preterm birth and SGA differed by gestational age assessment method.
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