Multiple Micronutrient Supplementation during Pregnancy and Lactation in Low-to-Middle-Income Developing Country Settings: Impact on Pregnancy Outcomes

2014 ◽  
Vol 65 (1) ◽  
pp. 4-12 ◽  
Author(s):  
Rehana A. Salam ◽  
Jai K. Das ◽  
Zulfiqar A. Bhutta
Keyword(s):  
Developing Country ◽  
Pregnancy Outcomes ◽  
Micronutrient Supplementation ◽  
Middle Income ◽  
Multiple Micronutrient ◽  
Pregnancy And Lactation

Multiple Micronutrient Supplementation during Pregnancy in Developing-Country Settings: Policy and Program Implications of the Results of a Meta-Analysis

2009 ◽  
Vol 30 (4_suppl4) ◽  
pp. S556-S573 ◽  
Author(s):  
Roger Shrimpton ◽  
Sandra L. Huffman ◽  
Elizabeth R. Zehner ◽  
Ian Darnton-Hill ◽  
Nita Dalmiya
Keyword(s):  
Developing Country ◽  
Meta Analysis ◽  
Micronutrient Supplementation ◽  
Multiple Micronutrient

scholarly journals New Evidence Should Inform WHO Guidelines on Multiple Micronutrient Supplementation in Pregnancy

2019 ◽  
Vol 149 (3) ◽  
pp. 359-361 ◽  
Author(s):  
Christopher R Sudfeld ◽  
Emily R Smith
Keyword(s):  
Neonatal Mortality ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Micronutrient Supplementation ◽  
Who Guidelines ◽  
Middle Income ◽  
Middle Income Countries ◽  
Multiple Micronutrient ◽  
Iron And Folic Acid ◽  
New Evidence

ABSTRACT Recent data from an individual patient data (IPD) meta-analysis of 17 randomized control trials including >100,000 women living in low- and middle-income countries found that multiple micronutrient supplementation (MMS) in pregnancy reduced the risk of low birth weight, preterm birth, and being born small for gestational age. Further, MMS reduced the risk of neonatal and infant mortality for females, and there was no evidence of increased risk among the 26 subgroups examined. The 2016 WHO antenatal care guidelines, which were released before the IPD meta-analysis, did not universally recommend MMS, noting: “There is some evidence of additional benefit … but there is also some evidence of risk.” The guidelines suggest that MMS may increase the risk of neonatal mortality based on an exploratory subgroup analysis of 6 randomized trials. However, we identified several issues with this subgroup analysis. In this report we correct and update the subgroup analysis and show that there is no evidence that MMS increases the risk of neonatal mortality. There is growing scientific consensus that MMS containing iron and folic acid (IFA) is superior to IFA alone. The WHO guidelines currently state that “policy-makers in populations with a high prevalence of nutritional deficiencies might consider the benefits of MMN [multiple micronutrient] supplements on maternal health to outweigh the disadvantages, and may choose to give MMN supplements that include iron and folic acid.” This equivocal guidance has created confusion about the best course of action for public health programs in low- and middle-income countries. Given the new evidence, WHO should review their statements regarding the potential neonatal mortality risks and re-evaluate the overall potential benefits of implementing MMS as a public health program.

scholarly journals Review of the evidence regarding the use of antenatal multiple micronutrient supplementation in low‐ and middle‐income countries

2019 ◽  
Vol 1444 (1) ◽  
pp. 6-21 ◽  
Author(s):  
Megan W. Bourassa ◽  
Saskia J.M. Osendarp ◽  
Seth Adu‐Afarwuah ◽  
Saima Ahmed ◽  
Clayton Ajello ◽  
...  
Keyword(s):  
Micronutrient Supplementation ◽  
Middle Income ◽  
Middle Income Countries ◽  
Multiple Micronutrient ◽  
Low And Middle Income

Burden of pediatric neurosurgical disease in a rural developing country: perspectives from southwest Nigeria

2021 ◽  
pp. 1-6
Author(s):  
Toyin A. Oyemolade ◽  
Amos O. Adeleye ◽  
Ayodele J. Olusola ◽  
Busayo A. Ehinola ◽  
Ebosetale P. Aikhomu ◽  
...  
Keyword(s):  
Developing Country ◽  
Age Distribution ◽  
Significant Proportion ◽  
Hospital Treatment ◽  
Middle Income ◽  
Female Ratio ◽  
Common Presentation ◽  
Neurosurgical Patients ◽  
Specialized Care ◽  
Southwest Nigeria

OBJECTIVE The proportion of the global burden of neurosurgical disease represented by pediatric neurosurgical pathology is unknown, especially in lower-middle income countries (LMICs) where there exists no known data-driven literature on the subject. In this study, the authors aimed to quantify the pediatric neurosurgical disease profile in a rural area of a developing country. METHODS This was a prospective observational study of all pediatric neurosurgical patients managed at a single center over a 30-month period. RESULTS Overall, 226 pediatric patients were included in the study (150 males and 76 females, male/female ratio 2:1), accounting for 20.4% of the total patient population during the study period. The modal age distribution was the 0- to 4-year-old group (32.3%), and head injury was the most common presentation, occurring alone in 157 patients (69.5%). Hydrocephalus alone was seen in 21 patients (9.3%) and in combination with myelomeningocele in 4 patients (1.8%). Brain tumors were found in 6 patients (2.7%), infective lesions in 6 patients (2.7%), and encephaloceles in 2 patients (0.9%). The treatment outcome was good in 170 patients (75.2%). Fourteen patients (6.2%) were referred to more advanced health facilities for specialized care; 29 patients (12.8%) were discharged against medical advice, mostly because of financial constraints; and 8 patients (3.5%) died. Several surgical cases could not be performed because of sundry logistical constraints. CONCLUSIONS Pediatric neurosurgical disease accounted for one-fifth of the neurosurgical workload at a tertiary health facility in southwest Nigeria. Trauma was the most common presentation, and optimal in-hospital treatment, including surgery, was hampered by severe logistical constraints in a significant proportion of the cases.

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