Early-life nutritional supplementation protects against home environmental risks in Ghanaian children's social-emotional development.

Introduction: This study examines how an early-life small-quantity lipid-based nutrient supplement (LNS) interacts with the home environment to influence Ghanaian children's social-emotional functioning at preschool age.

Method: In a randomized controlled trial, 1,320 Ghanaian women received either daily LNS, multiple micronutrients (MMN) or iron and folic acid (IFA) during pregnancy through 6 months postpartum. Infants in the LNS group received the daily supplement from 6 to 18 months.

Economic, socio-emotional, and food security conditions during COVID-19 pandemic among caregivers of young adolescents aged 10-12 yrs in a semi-urban setting in Ghana.

Background Few studies have described the consequences of the COVID - 19 pandemic among caregivers of young adolescents in sub-Saharan Africa. We aimed to explore the consequences of COVID-19 on economic, socio-emotional, and household food security conditions among caregivers of young adolescents in a semi-urban setting in the Eastern Region of Ghana. Methods In this cross-sectional study, caregivers of young adolescents aged 10-12yrs in the Somanya-Kpong area were enrolled.

Anemia, micronutrient deficiency, and elevated biomarkers of inflammation among women and children in two districts in the Northern Region of Ghana: A pilot study.

Introduction: Previous data had shown a high prevalence of anemia and various micronutrient deficiencies (MNDs) in the Tolon and Kumbungu districts. We aimed to reassess these outcomes among lactating women (LW), women of reproductive age (WRA), and preschool children (PSC) to inform the design of a MN-fortified bouillon cubes trial, including the choice of micronutrients and selection of study sites; among WRA and PSC, we aimed to identify factors associated with anemia, MND, and inflammation, and to examine anemia co-occurring with MND and inflammation.

Methods: In this cross-sectional study (Nov 2020-Jan 2021), we randomly selected 7 urban and 7 rural clusters per district from those accessible at the time, recruited participants through a random walk-based search, and collected and analyzed breastmilk (LW) and venous blood (WRA and PSC).

Assessing equity in effects of nutritional supplementation for child growth, development, and anemia.

Undernutrition in early childhood causes stunted growth, cognitive delays, and anemia, with effects often magnified among children from the poorest households. Small-quantity lipid-based nutrient supplements (SQ-LNS) are effective in addressing undernutrition and improving child development. As momentum builds to scale up SQ-LNS for children aged 6-24 months in the Global South, a key concern is achieving equity in its distribution and outcomes.

Contribution of Maternal Adherence to the Effect of Multiple Micronutrient Supplementation During Pregnancy: A Systematic Review and Individual Participant Data Meta-analysis.

Multiple micronutrient supplements (MMS) in pregnancy reduces risk of infant low birthweight (LBW) and improves other maternal and infant outcomes compared with iron and folic acid (IFA) supplements alone. However, the impact of timing of initiation and adherence on the MMS effectiveness in real-world programs remains unclear. To address this, we conducted a 2-stage individual participant data meta-analysis that included 15 randomized trials (61,204 pregnant women) and assessed whether the relative effect of MMS differed by the following: adherence alone; adherence in combination with gestational age at initiation; and the total number of tablets taken.

Deferrals for Low Haemoglobin and Anaemia Among First-Time Prospective Blood Donors in Southern Ghana: Results From the BLOODSAFE Ghana-Iron and Nutritional Counselling Strategy Pilot (BLIS) Study.

In Ghana, prevalence of anaemia is higher than the worldwide average and contributes to deferral of blood donors. A cross-sectional study was carried out as part of a pilot study aimed at improving haemoglobin levels and promoting repeat donations to retain donors who were deferred due to low haemoglobin. The copper sulphate test was used to determine low haemoglobin and anaemia assessed by the World Health Organization (WHO) gender-specific criteria.

Effect of prenatal multiple micronutrient supplementation compared with iron and folic acid supplementation on size at birth and subsequent growth through 24 mo of age: a systematic review and meta-analysis.

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.

A mixed-methods study of the drivers of stunting reduction among children under-5 in Ghana, 2003-2017.

Background: Childhood stunting prevalence declined rapidly in Ghana in recent decades. Substantial economic growth over the same period will have contributed directly and indirectly to improved population health and nutrition in the country, but Ghana's progress in reducing stunting has outpaced that of multiple other countries with comparable or higher economic growth rates.

Objectives: We aimed to better understand Ghana's exemplary progress in stunting reduction by examining the national-, community-, household-, and individual-level factors associated with the steep decline in stunting prevalence in recent decades.

Impact of Small-Quantity Lipid-Based Nutrient Supplements on Pubertal Status of 9-13-Year Olds: A Follow-Up Study of the iLiNS-DYAD-Ghana Trial.

Background: Early and delayed puberty are both associated with adverse health and psychosocial outcomes.

Objectives: We assessed the impact of provision of small-quantity lipid-based nutrient supplement (SQ-LNS) to mothers during pregnancy and 6 mo postpartum and to their children aged 6-18 mo, on pubertal status.

Methods: This study was a follow-up to a partially double-blind randomized controlled trial.

The Potential for Bouillon Fortification to Reduce Dietary Micronutrient Inadequacy: Modeling Analyses Using National Survey Data from Cameroon, Ghana, and Haiti.

Background: Bouillon is commonly consumed in some countries where micronutrient deficiencies are prevalent, but it has not been widely adopted as a micronutrient fortification vehicle.

Objectives: We modeled the potential impacts of bouillon fortification on dietary micronutrient adequacy to inform future discussions around bouillon fortification programs.

Methods: We analyzed the dietary intake of women of reproductive age (WRA) and 1- to 5-y-old children from a national dietary survey in Cameroon, and "apparent intake" (using the nutrient density approach) of WRA, children, and men from 3 household surveys in Cameroon, Ghana, and Haiti.

Use of Population-Based Compartmental Modeling and Retinol Isotope Dilution to Study Vitamin A Kinetics and Total Body Stores among Ghanaian Women of Reproductive Age.

Background: Limited data are available on vitamin A kinetics and total body stores (TBS) in women. Such information can be obtained using compartmental modeling and retinol isotope dilution (RID).

Objectives: Objectives were to apply population-based ("super-subject") modeling to determine retinol kinetics in nonpregnant Ghanaian women of reproductive age and to use RID to predict TBS in the group and its individuals.

Impact of iron supplementation among anemic voluntary first-time blood donors: Results from the BLOODSAFE pilot trial in Ghana.

Introduction: In sub-Saharan Africa (SSA), an adequate supply of safe blood for transfusion is a major developmental challenge. In Ghana, deferral from blood donation for anemia accounts for nearly half of the ineligible blood donors. We conducted a longitudinal two-arm parallel-group non-inferiority trial to test if iron supplementation among blood donors with iron deficiency (ID) or anemia could increase their hemoglobin levels to near those without ID or anemia.

Effects of prenatal small-quantity lipid-based nutrient supplements on pregnancy, birth, and infant outcomes: a systematic review and meta-analysis of individual participant data from randomized controlled trials in low- and middle-income countries.

Background: Undernutrition during pregnancy increases the risk of giving birth to a small vulnerable newborn. Small-quantity lipid-based nutrient supplements (SQ-LNSs) contain both macro- and micronutrients and can help prevent multiple nutritional deficiencies.

Objectives: We examined the effects of SQ-LNSs provided during pregnancy compared with 1) iron and folic acid or standard of care (IFA/SOC) or 2) multiple micronutrient supplements (MMSs) and identified characteristics that modified the estimates of effects of SQ-LNSs on birth outcomes.

Assessing Children's Autonomic Nervous System Activity During Structured Tasks: A Feasibility and Reliability Study in Ghana.

The significance of physiological regulation in relation to behavioral and emotional regulation is well documented, but primarily in economically advantaged contexts. Few studies have been conducted in low- and middle-income countries. We investigated the feasibility and reliability of measuring autonomic nervous system (ANS) activity and behavior during challenge tasks in 30 children aged 8-10 years in Ghana during two visits, 1 week apart.

Infant and young child feeding practices among mothers in the pilot Micronutrient Powder Initiative in four geographically and ethnically diverse districts in Ghana.

In Ghana, breastfeeding and complementary feeding counselling have been used as a nutritional intervention to promote optimal Infant and Young Child Feeding (IYCF) and nutrition. This study examined IYCF practices in four geographically and ethnically diverse districts (Ho West, Tain, Talensi and Tolon). A qualitative study involving key informant interviews (KIIs) and focus group discussions (FGDs) was conducted between November and December 2019 among women who participated in a pilot micronutrient powder intervention for children 6-23 months of age.

Effect of multiple micronutrient-fortified bouillon on micronutrient status among women and children in the Northern Region of Ghana: Protocol for the Condiment Micronutrient Innovation Trial (CoMIT), a community-based randomized controlled trial.

Introduction: Micronutrient deficiencies are prevalent in West Africa, particularly among women of reproductive age (WRA) and young children. Bouillon is a promising food fortification vehicle due to its widespread consumption. This study aims to evaluate the impact of multiple micronutrient-fortified bouillon cubes, compared to control bouillon cubes (fortified with iodine only), on micronutrient status and hemoglobin concentrations among lactating and non-lactating WRA and young children in northern Ghana.

Sustained effects of small-quantity lipid-based nutrient supplements provided during the first 1000 days on child growth at 9-11 y in a randomized controlled trial in Ghana.

Background: There is limited research on whether nutritional supplementation in the first 1000 d affects long-term child outcomes. We previously demonstrated that pre- and postnatal small-quantity lipid-based nutrient supplements (SQ-LNS) increased birth weight and child length at 18 mo of age in Ghana.

Objectives: We aimed to investigate the effect of pre- and postnatal SQ-LNS on child growth and blood pressure at 9-11 y.

Acceptability of Multiple Micronutrient-Fortified Bouillon Cubes among Women and Their Households in 2 Districts in The Northern Region of Ghana.

Background: Bouillon is a promising large-scale food fortification vehicle, but there is uncertainty regarding the types and concentrations of micronutrients that are feasible to add without compromising consumer acceptability.

Objective: The objective of this study was to evaluate the acceptability of 2 different multiple micronutrient-fortified bouillon cube formulations, compared with a bouillon cube fortified with iodine only.

Methods: We conducted a double-blind, randomized, controlled acceptability study in 2 districts in northern Ghana.

Neonatal mortality risk of vulnerable newborns by fine stratum of gestational age and birthweight for 230 679 live births in nine low- and middle-income countries, 2000-2017.

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.

Seasonal Factors Are Associated with Activities of Enzymes Involved in High-Density Lipoprotein Metabolism among Pregnant Females in Ghana.

Background: Small-quantity lipid-based nutrient supplements (SQ-LNS) during pregnancy and postnatally were previously shown to improve high-density lipoprotein (HDL) cholesterol efflux capacity (CEC) and length in the children of supplemented mothers at 18 mo of age in the International Lipid-Based Nutrient Supplements (iLiNS) DYAD trial in Ghana. However, the effects of SQ-LNS on maternal HDL functionality during pregnancy are unknown.

Objective: The goal of this cross-sectional, secondary outcome analysis was to compare HDL function in mothers supplemented with SQ-LNS vs.

Prenatal and postnatal small-quantity lipid-based nutrient supplements and children's social-emotional difficulties at ages 9-11 y in Ghana: follow-up of a randomized controlled trial.

Background: Provision of small-quantity lipid-based nutrient supplements (SQ-LNSs) during early life improves growth and development. In the International Lipid-Based Nutrient Supplements DYAD-Ghana trial, prenatal and postnatal SQ-LNS reduced social-emotional difficulties at age 5 y, with greater effects among children in less-enriched home environments.

Objectives: We aimed to investigate the effect of prenatal and postnatal SQ-LNS on children's social-emotional problems at age 9-11 y.

Neonatal mortality risk of vulnerable newborns: A descriptive analysis of subnational, population-based birth cohorts for 238 203 live births in low- and middle-income settings from 2000 to 2017.

Objective: 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.