Guatemalan Children Research Articles

TOXOPLASMA GONDII INFECTION IN RURAL GUATEMALAN CHILDREN

To determine the prevalence and risk factors for Toxoplasma gondii infection in Guatemalan children, in 1999 and 2003 we surveyed caretakers and serologically tested children in the San Juan Sacatepequez area using Platelia Toxo IgG TMB enzyme immunoassay kits. In 1999, of 532 children six months to two years old, 66 (12.4%) were antibody positive. In 2003, in 500 children 3-10 years old antibody prevalence increased from 24% to 43% at age five years then leveled off. By multivariate analysis, drinking well water (relative risk [RR] = 1.78, 95% confidence limit [CL] = 1.00, 3.17, P = 0.05) and not cleaning up cat feces (RR = 2.06, 95% CL = 1.00, 4.28, P = 0.05) increased the risk of T. gondii seropositivity. Most T. gondii infections in children from these villages occurred by age five, but half were still not infected by adolescence. Therefore, it is important to educate girls entering child-bearing age about the risks of acute T. gondii infection and the local risk factors for infection.

Impact of improved stoves, house construction and child location on levels of indoor air pollution exposure in young Guatemalan children.

The goal of this study was to assess the impact of improved stoves, house ventilation, and child location on levels of indoor air pollution and child exposure in a rural Guatemalan population reliant on wood fuel. The study was a random sample of 204 households with children less than 18 months in a rural village in the western highlands of Guatemala. Socio-economic and household information was obtained by interview and observation. Twenty-four hour carbon monoxide (CO) was used as the primary measure of kitchen pollution and child exposure in all homes, using Gastec diffusion tubes. Twenty-four hour kitchen PM(3.5) was measured in a random sub-sample (n=29) of kitchens with co-located CO tubes. Almost 50% of the homes still used open fires, around 30% used chimney stoves (planchas) mostly from a large donor-funded programme, and the remainder of homes used various combinations including bottled gas and open fires. The 24-h kitchen CO was lowest for homes with self-purchased planchas: mean (95% CI) CO of 3.09 ppm (1.87-4.30) vs. 12.4 ppm (10.2-14.5) for open fires. The same ranking was found for child CO exposure, but with proportionately smaller differentials (P<0.0001). The 24-h kitchen PM(3.5) in the sub-sample showed similar differences (n=24, P<0.05). The predicted child PM for all 203 children (based on a regression model from the sub-sample) was 375 microg/m(3) (270-480) for self-purchased planchas and 536 microg/m(3) (488-584) for open fires. Multivariate analysis showed that stove/fuel type was the most important determinant of kitchen CO, with some effect of kitchen volume and eaves. Stove/fuel type was also the key determinant of child CO, with some effect of child position during cooking. The improved stoves in this community have been effective in reducing indoor air pollution and child exposure, although both measures were still high by international standards. Large donor-funded stove programmes need to aim for wider acceptance and uptake by the local families. Better stove maintenance is also required.

Reducing diarrhoea in Guatemalan children: randomized controlled trial of flocculant-disinfectant for drinking water

To examine the effect of a new point-of-use treatment for drinking-water, a commercially developed flocculant-disinfectant, on the prevalence of diarrhoea in children. We conducted a randomized controlled trial among 514 rural Guatemalan households, divided into 42 neighbourhood clusters, for 13 weeks, from 4 November 2002 through 31 January 2003. Clusters assigned to water treatment with the flocculant-disinfectant were compared with those using their usual water-handling practices. The longitudinal prevalence of diarrhoea was calculated as the proportion of total days with diarrhoea divided by the total number of days of observation. The prevalence of diarrhoea was compared using the Wilcoxon rank-sum test. The 1702 people in households receiving the disinfectant had a prevalence of diarrhoea that was 40% lower than that among the 1699 people using standard water-handling practices (0.9% versus 1.5%; P = 0.001). In households using the flocculant-disinfectant, children < 1 year of age had a 39% lower prevalence of diarrhoea than those in households using their standard practices (3.7% versus 6.0%; P = 0.005). In settings where families rarely treat drinking-water, we introduced a novel flocculant-disinfectant that reduced the longitudinal prevalence of diarrhoea, especially among children aged < 1 year, among whom diarrhoea has been strongly associated with mortality. Successful introduction and use of this product could contribute to preventing diarrhoeal disease globally.

Meningitis and pneumonia in Guatemalan children: the importance of Haemophilus influenzae type b and Streptococcus pneumoniae.

To determine the epidemiology of Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae invasive infections in hospitalized Guatemalan children. This is an important issue since Hib vaccine has not been incorporated into the routine immunization program in Guatemala and information from hospital records in 1995 indicated a low incidence of Hib and S. pneumoniae as causes of meningitis and invasive infections. Children who were hospitalized in Guatemala City with clinical signs compatible with bacterial infections were evaluated for evidence of Hib or S. pneumoniae infection. Normally sterile body fluids were cultured, and antigen detection was performed on cerebrospinal fluid (CSF) and pleural fluid. Of 1 203 children 1-59 months of age hospitalized over a 28-month period, 725 of them (60.3%) had a primary diagnosis of pneumonia, 357 (29.7%) of meningitis, 60 (5.0%) of cellulitis, and 61 (5.1%) of sepsis and other conditions. Hib was identified in 20.0% of children with meningitis and S. pneumoniae in 12.9%. The average annual incidence of Hib meningitis was 13.8 cases per 100 000 children under 5 years of age, and 32.4% of meningitides caused by Hib and 58.7% of S. pneumoniae meningitides occurred prior to 6 months of age. Case fatality rates were 14.1%, 37.0%, and 18.0%, respectively, for children with Hib, S. pneumoniae, and culture-negative and antigen-negative meningitis. Prior antibiotic therapy was common and was associated with significant reductions in CSF-culture-positive results for children with other evidence of Hib or S. pneumoniae meningitis. Improvements in case detection, culture methods, and latex agglutination for antigen detection in CSF resulted in identification of Hib and S. pneumoniae as important causes of severe disease in Guatemalan children. Using a cutoff of > 10 white blood cells per cubic millimeter in CSF would improve the sensitivity for detection of bacterial meningitis and help estimate the burden of bacterial meningitis in Guatemala and other developing countries.

High prevalence of cobalamin deficiency in Guatemalan schoolchildren: associations with low plasma holotranscobalamin II and elevated serum methylmalonic acid and plasma homocysteine concentrations

Studies conducted in Guatemala, Mexico, and Venezuela have found high prevalences of low plasma cobalamin (vitamin B-12) concentrations in infants and children. It is not known whether these low cobalamin concentrations are accompanied by altered metabolic functions. We sought to assess the prevalence of cobalamin deficiency in Guatemalan children by using sensitive and specific markers of deficiency. Children (n = 553) were screened for low plasma cobalamin. Those with low plasma cobalamin (< 162 pmol/L) were matched by age, grade, and sex to those with marginal (162-221 pmol/L) and adequate (> 221 pmol/L) concentrations. In this matched subset (n = 180), additional biochemical indicators of cobalamin deficiency were measured. Of the 553 children screened, 11% had low plasma cobalamin and an additional 22% had marginal concentrations. The prevalences of elevated serum methylmalonic acid (MMA), plasma homocysteine, or both were significantly higher in children with low and marginal plasma cobalamin than in children with adequate plasma cobalamin. Mean serum MMA was high in all groups compared with values reported in other populations. Mean plasma holotranscobalamin II concentrations were significantly lower in children with low rather than marginal or adequate plasma cobalamin. However, holotranscobalamin II was a less sensitive indicator of cobalamin depletion than was MMA. Biochemical markers of cobalamin deficiency confirmed that the cobalamin status of children with low and marginal plasma cobalamin is inadequate to support normal metabolic function.

Syntax and Epistemology in Guatemalan Children's Spanish: The Case of Non-Consciousness and Non-Coreference

In this article, I report results of an acquisition experiment with a group of Spanish-speaking children regarding their knowledge of a semantic restriction that prevents a referring expression from coreferring with a pronoun in certain syntactic configurations if its referent lacks consciousness. Sixteen children (5 to 7 years old) participated in a modified Truth-Value Judgment Task (Crain and McKee (1985)). I show children's performance on the relevant sentences to be very similar to that of adults. Individual participant analyses confirm that children at this age possess the relevant semantic knowledge. Finally, I provide a model that shows how children can acquire knowledge of the semantic constraint using only positive data, and I suggest an epistemological implication of this research.

New Stoves for Better Children's Health?

ArticleOpen AccessNew Stoves for Better Children's Health? E Dooley E Dooley Search for more papers by this author Published:1 January 2003https://doi.org/10.1289/ehp.111-a33Cited by:4AboutSectionsPDF ToolsDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InReddit FiguresReferencesRelatedDetailsCited By Skinner M, Bhandari R, Haque M and Nilsson E (2015) Environmentally induced epigenetic transgenerational inheritance of altered SRY genomic binding during gonadal sex determination, Environmental Epigenetics, 10.1093/eep/dvv004, 1:1, (dvv004), ., . Kim H, Kim H, Kang M, Trang N, Baek H, Moon J, Shin J, Suh S, Ryang D, Kook H and Shin M (2014) Profiling of Biomarkers for the Exposure of Polycyclic Aromatic Hydrocarbons: Lamin-A/C Isoform 3, Poly[ADP-ribose] Polymerase 1, and Mitochondria Copy Number Are Identified as Universal Biomarkers, BioMed Research International, 10.1155/2014/605135, 2014, (1-12), . Jeng H and Bocca S (2013) Influence of Exposure to Benzo[a]pyrene on Mice Testicular Germ Cells during Spermatogenesis, Journal of Toxicology, 10.1155/2013/387850, 2013, (1-9), . Bruce N, McCracken J, Albalak R, Scheid M, Smith K, Lopez V and West C (2004) Impact of improved stoves, house construction and child location on levels of indoor air pollution exposure in young Guatemalan children, Journal of Exposure Science & Environmental Epidemiology, 10.1038/sj.jea.7500355, 14:S1, (S26-S33), Online publication date: 1-Apr-2004. Vol. 111, No. 1 January 2003Metrics About Article Metrics Publication History Originally published1 January 2003Published in print1 January 2003 Financial disclosuresPDF download License information EHP is an open-access journal published with support from the National Institute of Environmental Health Sciences, National Institutes of Health. All content is public domain unless otherwise noted. Note to readers with disabilities EHP strives to ensure that all journal content is accessible to all readers. However, some figures and Supplemental Material published in EHP articles may not conform to 508 standards due to the complexity of the information being presented. If you need assistance accessing journal content, please contact [email protected]. Our staff will work with you to assess and meet your accessibility needs within 3 working days.

Occurrence of aflatoxins and fumonisins in Incaparina from Guatemala

The occurrence of aflatoxins and fumonisins in Incaparina was investigated. Incaparina is a mixture of corn and cottonseed flour with added vitamins, minerals and a preservative. It has been marketed as a high-protein food supplement, particularly for children on protein-deficient diets. According to estimates, 80% of Guatemalan children in their first year are given Incaparina to provide an adequate diet. Eight samples of Incaparina manufactured in Guatemala were collected. Five were from three different geographical locations in the USA and three were from Guatemala. Seven were examined for fungal contamination and analysed for aflatoxins and fumonisins. Aspergillus flavus was the predominant fungus in all samples purchased in the USA and in one sample purchased from Guatemala, whereas Fusarium verticillioides was present in only two samples (one from the USA and one from Guatemala). All samples contained aflatoxins, ranging from 3 to 214 ng g-1 and <2 to 32ng g-1 for aflatoxin B1 and aflatoxin B2, respectively; and one sample contained aflatoxin G 1 (7 ng g-1). Total aflatoxins present ranged from 3 to 244 ng g-1. All samples contained fumonisins, ranging from 0.2 to 1.7 μg g-1, <0.1 to 0.6 μg g-1, and <0.1 to 0.2 μg g-1 for fumonisins B1, fumonisin B2, and fumonisin B3, respectively. Total fumonisins present ranged from 0.2 to 2.2 μg g-1. The identity of aflatoxin B1 was confirmed using both the chemical derivatization method and liquid chromatographic (LC)/mass spectrometric (MS) analysis. Appropriate regulatory action was recommended for the import of Incaparina and has been in effect since 22 December 1998.

Schooling and traditional collaborative social organization of problem solving by Mayan mothers and children.

Traditional indigenous social organization in the Americas has been characterized as involving horizontal multiparty engagements, in contrast with schooling, which often relies on hierarchy and division of labor. This study examined whether the social organization of problem solving of Guatemalan Mayan indigenous mothers and children varied with the mothers' extent of experience with school. We observed 47 mothers as they constructed a puzzle with 3 children (ages 6-12 years). Mayan mothers with little schooling (0-2 grades) were involved more in horizontal, multiparty engagements, whereas Mayan mothers with extensive experience with schooling (12 or more grades) were involved more in hierarchical, division-of-labor engagements with the children. The results suggest that Western formal schooling contributes to the reshaping of traditional collaborative social organization among indigenous Mayan people.

Schooling and traditional collaborative social organization of problem solving by Mayan mothers and children.

Traditional indigenous social organization in the Americas has been characterized as involving horizontal multiparty engagements, in contrast with schooling, which often relies on hierarchy and division of labor. This study examined whether the social organization of problem solving of Guatemalan Mayan indigenous mothers and children varied with the mothers' extent of experience with school. We observed 47 mothers as they constructed a puzzle with 3 children (ages 6-12 years). Mayan mothers with little schooling (0-2 grades) were involved more in horizontal, multiparty engagements, whereas Mayan mothers with extensive experience with schooling (12 or more grades) were involved more in hierarchical, division-of-labor engagements with the children. The results suggest that Western formal schooling contributes to the reshaping of traditional collaborative social organization among indigenous Mayan people.

Debate over extent of trafficking in Guatemalan children

Debate over extent of trafficking in Guatemalan children

A description of child illness and treatment behavior in Guatemala

This paper uses a new calendar design implemented in the Guatemalan Survey of Family Health to analyze diarrheal and respiratory illness among children. The calendar provides a much richer description of child illness and treatment behavior than do conventional data typically collected in health interview surveys. The resulting estimates reveal that Guatemalan children experience high rates of diarrheal and respiratory illness and that these illnesses often involve multiple symptoms that only partially overlap one another. In addition, estimates from the calendar demonstrate that the measurement of illness frequency is fairly complex and that classification of illness into distinct categories may not always be feasible or meaningful. Results regarding treatment behavior indicate that the vast majority of illnesses are treated and that mothers almost always receive advice regarding their children’s illnesses from relatives. On the other hand, health providers are sought for advice and treatment in only about one-third of illnesses. When families do seek providers, they are more likely to rely on biomedical ones — especially pharmacists, doctors and personnel at health posts and centers — than traditional practitioners. By far, the most common form of treatment — recommended by both relatives and providers — consists of readily available Western medicines. In contrast, the use of traditional remedies appears to be relatively low.

Influence of sex, seasonality, ethnicity, and geographic location on the components of total energy expenditure in young children: implications for energy requirements.

BackgroundThere are limited data on the influence of body composition, sex, seasonality, ethnicity, and geographic location on the components of energy expenditure in children. ObjectiveThe objective was to examine the determinants of total energy expenditure (TEE), resting energy expenditure (REE), and activity-related energy expenditure (AEE) in children. DesignCross-sectional data from 232 children (4-10 y of age) from 4 ethnic groups (white American, African American, Guatemalan Mestizo, and Native American Mohawk) were examined. ResultsIn 104 white children studied in Vermont and Alabama, TEE was significantly higher in spring than in fall, higher in boys than in girls, and higher in children in Vermont (all effects: approximately ≈ 0.42 MJ/d, P < 0.05). The significant effect of sex was explained through REE; the influences of season and location were explained through AEE. In all children, there was no effect of sex but a significant effect of ethnicity (P < 0.01) on TEE: a significant effect of sex (P < 0.01) and no effect of ethnicity (P = 0.16) on REE; and no effect of sex and a significant effect of ethnicity on AEE. The significant effects of ethnicity were due to lower values in Guatemalan children. TEE correlated most strongly with weight (r = 0.81) and fat-free mass (r = 0.79-0.81); REE with weight (r = 0.85) and fat-free mass (r = 0.80-0.87); and AEE with maximal oxygen consumption (r = 0.54), fat-free mass (r = 0.50), and fat mass (r = 0.49). Conclusions1) Season and location influenced TEE in children through their effects on AEE, 2) a higher REE in boys was consistent across all groups examined, 3) Guatemalan children had lower TEE due to a lower AEE, 4) body weight may be the best predictor of TEE, and 5) maximal oxygen consumption was the strongest marker of AEE. Am J Clin Nutr 1998; 68:675–82.

Monitoring of fluid changes in hospitalized, malnourished, guatemalan children using bioelectrical impedance spectroscopy (BIS)

Monitoring of fluid changes in hospitalized, malnourished, guatemalan children using bioelectrical impedance spectroscopy (BIS)

Longitudinal analysis of deciduous tooth emergence: II. Parametric survival analysis in Bangladeshi, Guatemalan, Japanese, and Javanese children

We present a form of parametric survival analysis that incorporates exact, interval-censored, and right-censored times to deciduous tooth emergence. The method is an extension of common cross-sectional procedures such as logit and probit analysis, so that data arising from mixed longitudinal and cross-sectional studies can be properly combined. We extended the method to incorporate and estimate a proportion of agenic teeth. While we concentrate on deciduous tooth emergence, the method is relevant to studies of permanent tooth emergence and other developmental events. Deciduous tooth emergence data were analyzed from four longitudinal studies. The samples are 1,271 rural Guatemalan children examined every three months up to age two and every six months thereafter as part of the INCAP study; 397 rural Bangladeshi children examined monthly to age one and quarterly thereafter as part of the Meheran Growth and Development Study; 468 rural Indonesian children examined monthly as part of the Ngaglik study; and 114 urban Japanese children examined monthly in studies from 1910 and 1920. Although all four studies were longitudinal, many observations from the Guatemala and Bangladesh studies were effectively cross-sectionally observed. Three different parametric forms were used to model the eruption process: a normal distribution, a lognormal distribution, and a lognormal distribution with age shifted to shortly after conception. All three distributions produced reliable estimates of central tendencies, but the shifted lognormal distribution produced the best overall estimates of shape (variance) parameters. Estimates of emergence were compared to other studies that used similar methods. Japanese children showed relatively fast emergence times for all teeth. Bangladeshi and Javanese children showed emergence times that were slower than are found in most previous studies. Estimates of agenesis were not significantly different from zero for most teeth. One or two central incisors showed significant agenesis that ranged from 0.1 to 0.8% in three of the samples; even so, failure to model the agenic proportion did not seriously bias the estimates. Am J Phys Anthropol 105:209–230, 1998. © 1998 Wiley-Liss, Inc.

Studies on the bioconversion of β-carotene to active vitamin A in underprivileged Guatemalan children

The mechanism by which the rate of β-carotene conversion to active vitamin A in the enterocyte is poorly understood. It is postulated that body vitamin A status plays a very important role. Unitl recently, it has not been possible to detect and quantify the product of β-carotene bioconversion, i.e., retinal, in the gut, and retinyl ester, in the circulation. This study aimed at confirming that a rise in plasma retinyl palmitate concentration would occur after administration of β-carotene to underprivileged Guatemalan schoolchildren. Twenty rural children, aged 7 to 11 years, received 30 mg of pure, crystalline β-carotene in oral capsules in the fasting state. Thirteen peri-urban poor children participated as controls; each received capsules of cellulose. Standard meals with low vitamin A levels were served during the observation period. Plasma levels of β-carotene, retinol, and retinyl palmitate were determined by HPLC at baseline, 2 hr, and 24 hr after ingestion of capsules. Anthropometric and biochemical characteristics were similar in both groups at baseline. An average increase of 0.15 ± 0.05 μmol/L in retinyl esters was observed in the supplemented group at 2 hr, with a return to baseline levels at 24 hr; whereas in the control group no retinyl esters were detected at all at any time. A tendency of a greater retinyl ester response with a lower baseline circulating retinol level was observed. This is the first instance in which β-carotene bioconversion to retinyl palmitate has been quantified in children. We propose that the rise in retinyl esters after oral administration of β-carotene could be used to examine the factors that influence the rate of bioconversion of β-carotene to active vitamin A.

Dietary management of acute diarrhea with local foods in a Guatemalan rural community

A community-based, randomized trial was conducted to evaluate a locally available diet for the management of acute diarrhea (n = 99 episodes) in 90 Guatemalan children, 4-42 months of age. The Test Diet (TD), a combination of a semi-solid pap (maize flour, black beans, oil) and a liquid gruel, Incaparina (maize flour, cotton seed flour, sugar), in addition to breast-milk and other home foods (group TD, n = 45 episodes) was offered for 14 d and compared to usual home feeding (group HF, n = 54 episodes). Diarrhea episodes after admission were significantly shorter for group TD (median 2.0 d) than group HF (median 4.4 d, p = 0.003) after adjusting for potential confounders. Weight gains did not differ significantly between groups. We conclude that community-based dietary management of acute childhood diarrhea using energy-dense, locally available foods is feasible and may shorten diarrhea duration. This may encourage mothers to follow recommendations for continued feeding during diarrhea in developing country environments.

Body composition, resting metabolic rate, and energy requirements of short- and normal-stature, low-income Guatemalan children

We examined body composition using bioelectrical impedance analysis and isotope dilution (18O and 2H), resting metabolic rate (RMR) by indirect calorimetry, and total energy expenditure (TEE) by doubly labeled water in 15 short-stature (height-for-age < or = -1.5 SD) and 15 normal-stature (height-for-age > -1.5 SD) Guatemalan children aged 4-6 y. Although, in absolute terms significant group differences were found in fat-free mass (FFM), fat mass, and total body water (TBW), there were no significant differences in fat mass and TBW after adjustment for FFM. RMR of the short-stature children (3791 +/- 376 kJ/d) was not significantly different from that of normal-stature children (4038 +/- 531 kJ/d), and the regression between RMR and FFM was also not significantly different between groups. TEE was not significantly different in short-stature (4753 +/- 761 kJ/d) compared with normal-stature children (5304 +/- 1020 kJ/d); the regression between TEE and FFM was not significantly different between the two groups. There were no significant group differences in RMR and TEE after adjustment for FFM. FFM was the strongest predictor of TEE, but could only explain 29% of the variance. We conclude that 1) the lower TBW and fat mass in the short-stature group is proportional to their lower FFM, 2) there is no significant difference in either RMR or TEE between short- and normal-stature children, and 3) TEE is highly variable among these children and cannot be explained by differences in body size alone.

Growth retardation starts in the first three months of life among rural Guatemalan children.

We tested the hypothesis that growth faltering in rural Guatemala starts earlier than between 3-6 months of life, as generally assumed. The sample included children from the INCAP longitudinal trial (1969-1977), who had adequate birth weight (> -1 s.d.) (n = 79). Two groups were formed according to weight-for-age (WAZ) at 3 y: Group A: WAZ < -2 s.d. (growth-retarded), and Group B: WAZ > or = -2 s.d. Weight increments were computed and sex- and gender-specific deficits in weight increments from 0-36 months were calculated by comparing values of the WHO/CDC reference data. For the period between 0-12 months, weight increments were also compared to velocity standards: (1) the Fels data and (2) the WHO growth curves for breast fed infants. At 3 y of age, growth-retarded children were 3.6 kg smaller than the WHO/CDC median. Depending on the reference data used, between 19 and 34% of the deficit at 3 y of age was due to failure to thrive during the first 3 months of life, an additional 12-19% occurred between 3 and 6 months and 12-25% between 6 and 9 months. By 12 months of age, infants had accumulated 45-80% of their total deficit in weight at 3 y of age. Compared to group B, children from group A had greater morbidity during their first 9 months of life, and their mothers had poorer nutritional status at 3 months postpartum. There were indications that children from group A came from more deprived families. Growth faltering starts soon after birth in rural Guatemala and thus, effective interventions should be targeted to mothers and their infant as early as possible during the first year.

Report to the Convention Against Torture – Torture of Guatemalan Children, Guatemala, Casa Alianza.

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