Growth Impairment In Children Research Articles

Aflatoxin exposure among young children in urban low-income areas of Nairobi and association with child growth

Populations in tropical and subtropical developing countries are exposed to largely uncontrolled levels of aflatoxins through food. These countries (especially in Africa and Asia) also present a high prevalence of stunting. Studies have reported an association between aflatoxin exposure and growth impairment in children but there is not yet conclusive evidence that aflatoxins are a significant cause of stunting in children, thus further research is warranted. In this cross-sectional study, 204 low-income households were randomly selected in two low-income areas of Nairobi, Kenya. Korogocho is a higher population density area and Dagoretti a lower population density area. We asked questions about household demographics and a 24-hour dietary recall was conducted in children aged 1–3 years. Child anthropometric measurements were also conducted. Height-for-age Z-scores (HAZ), weight-for-age Z-scores (WAZ) and weight-for-height Z-scores (WHZ) were calculated for each child using World Health Organization (WHO) growth standards reference data. Samples of foods were taken from the household or from the retailer for analysis using competitive enzyme-linked immunosorbent assay (ELISA). Laboratory results for aflatoxin levels in the food samples collected were used to calculate the daily aflatoxin intake, according to the results from the dietary assessment. The study found 41% of children sampled had stunted growth. Boys were more stunted than girls (p=0.057) and Korogocho had more stunted children than Dagoretti (p=0.041). In all, 98% of food samples collected tested positive for aflatoxin and there was an average exposure to aflatoxins of 21.3 ng/kg bodyweight per day. Exposure to aflatoxin M1 (AFM1), location and sex were significantly associated with HAZ, with boys and children from Korogocho having lower HAZ, and AFM1 was negatively associated with HAZ (p=0.047), indicating that AFM1 was associated with stunting. There was no association between total aflatoxins (aflatoxin B [AFB] and aflatoxin G [AFG]) and HAZ, WAZ and WHZ. The study showed a high prevalence of malnutrition, especially stunting, in two low-income urban sites, and this was most pronounced in the high-density area. The reported association between AFM1 and stunted children indicates that more research is needed on the health impacts of this aflatoxin in growing children. Keywords: stunting, aflatoxin M1, contamination, exposure, mycotoxin, ELISA, aflatoxins, mycotoxins, aflatoxin B1

Pengetahuan Berhubungan dengan Sikap Ibu dalam Kemampuan Menstimulasi Pertumbuhan dan Perkembangan Anak Balita dengan Gizi Kurang

<p>Nutrition is an important factor in determining the level of health. The state of malnutrition in children results in impaired growth and development of children. Knowledge or cognitive domain is very important for the formation of maternal attitudes and actions in stimulating the growth and development of children.<br />Children who are directed stimulation will grow faster than children who did not receive stimulation. The purpose of study is to know the relationship of knowledge with mother attitude in the ability to stimulating growth and development of young children with less nutrition in Banaran village work area Galur II Health Centers Kulon Progo Yogyakarta. This type of research is an analytic survey, with the cross sectional approach. The sampling technique is purposive sampling, with 43 respondents. Bivariate analysis used Spearman Rank correlation. The results showed the knowledge of mothers with 25.6% in good category category, 67.4% in enough category, and 7,0% in less category. While the mother’s attitude showed 18.6% in good categories, and 81.4% in enough category. The results of the statistical test showed r=0.467 with a significance level of correlation coefficient 0.002. Conclusion, the research indicated that significant relationship between knowledge with mother attitude in the ability to stimulating growth and development of young children with less nutrition in Banaran village work area Galur II Health Centers Kulon Progo Yogyakarta.</p>

Growth impairment in children with pulmonary hypertension

Growth impairment in children with pulmonary hypertension

Stunted at 10 Years. Linear Growth Trajectories and Stunting from Birth to Pre-Adolescence in a Rural Bangladeshi Cohort.

BackgroundFew studies in low-income settings analyse linear growth trajectories from foetal life to pre-adolescence. The aim of this study is to describe linear growth and stunting from birth to 10 years in rural Bangladesh and to analyse whether maternal and environmental determinants at conception are associated with linear growth throughout childhood and stunting at 10 years.Methods and FindingsPregnant women participating in the MINIMat trial were identified in early pregnancy and a birth cohort (n = 1054) was followed with 19 growth measurements from birth to 10 years. Analyses of baseline predictors and mean height-for-age Z-scores (HAZ) over time were modelled using GLMM. Logistic regression analysis was used to investigate the associations between baseline predictors and stunting (HAZ<-2) at 10 years. HAZ decreased to 2 years, followed by an increase up to 10 years, while the average height-for-age difference in cm (HAD) to the WHO reference median continued to increase up to 10 years. Prevalence of stunting was highest at 2 years (50%) decreasing to 29% at 10 years. Maternal height, maternal educational level and season of conception were all independent predictors of HAZ from birth to pre-adolescence (p<0.001) and stunting at 10 years. The highest probability to be stunted at 10 years was for children born by short mothers (<147.5 cm) (ORadj 2.93, 95% CI: 2.06–4.20), mothers with no education (ORadj 1.74, 95% CI 1.17–2.81) or those conceived in the pre-monsoon season (ORadj 1.94, 95% CI 1.37–2.77).ConclusionsHeight growth trajectories and prevalence of stunting in pre-adolescence showed strong intergenerational associations, social differentials, and environmental influence from foetal life. Targeting women before and during pregnancy is needed for the prevention of impaired child growth.

Steroid Administration and Growth Impairment in Children with Crohn's Disease.

Growth impairment remains a major concern in children with Crohn's disease, but evidence remains unclear, in particular, whether steroid use is implicated. We aimed to (1) determine the frequency of temporary (TGI) and permanent (PGI) growth impairment in children administered steroids and (2) examine whether cumulative steroid administration was associated with TGI and/or PGI. A retrospective cohort study was performed in patients with Crohn's disease (<18 yr) administered steroids at the gastroenterology clinics of Sainte-Justine Hospital, Montreal. Steroid dosage, height during follow-up, adult height (after age 20), and parental heights were ascertained. Patients with height z score <-1.64 on more than 1 occasion before age 18 were considered as patients with TGI. Patients with adult heights <8.5 cm below the expected target heights were considered as patients with PGI. Association between steroid dosage and TGI/PGI was studied using logistic regression analyses. Data from the Swiss IBD Cohort Study were analyzed for comparison. A total of 221 children were studied. Approximately 19% (42/221) children were deemed as TGI, and 8/137 patients (5.8%) had PGI. TGI was associated with diagnosis at younger age (P value 0.002) and steroid administration at younger age (P value 0.001), but not with steroid dosage. Final adult height was associated with target height, but not with cumulative steroid dosage. Rates of PGI in the Swiss cohort were ∼ 9.1% in steroid users and 2.7% in nonusers. Most children with TGI attain normal adult heights. Cumulative steroid use does not seem to be associated with either TGI or PGI in children with Crohn's disease.

Anthropometric Effect of Mucoperiosteal Nostril Floor Reconstruction in Complete Cleft Lip.

The primary objective of this study was to investigate whether growth impairment in children with cleft lip is caused by reconstructing the nostril floor using lateral nasal and premaxillary mucoperiosteal flaps. The effects on growth and symmetry of tip rhinoplasty at the time of initial repair, as well as cleft sidedness are similarly investigated. An Institutional Review Board approved, retrospective, single-center study at an academic children's hospital from July 2005 to 2010 was designed. Seventy-four patients with unilateral cleft lip ± palate were followed postsurgical repair of the cleft lip deformity. Serial digital photographs from clinical encounters were analyzed. Anthropometric measurements of 10 soft tissue landmarks were extracted from anteroposterior and submental vertex views at serial visits; growth velocities, defined as c = Δd/Δt, were generated using linear mixed models on selected measurements to study time-related changes on growth. The effects on growth and symmetry of primary tip rhinoplasty on perinasal landmarks and nostril floor reconstruction with medial and lateral nasal mucoperiosteal flaps on perioral and perinasal landmarks were analyzed. Proxies for midfacial height (en-al) and maxillary height (al-ch) were used to evaluate the effect of mucoperiosteal dissection, whereas nostril width, height, and angle were used as proxies to evaluate the effects of tip rhinoplasty. Seventy-four patients met the inclusion criteria. Midface height (En-Al) growth velocity was 0.014 mm/month and maxillary height (Al-Ch) was relatively stable at -0.0059 mm/month with no difference between the subgroups. Nostril height growth was -0.0046 mm/month, nostril width was 0.03 mm/mo, and nostril angle -0.09 °/mo showed no difference between patient with or without primary tip rhinoplasty. Patients with complete cleft showed more asymmetry than those with incomplete clefts in lip and maxillary landmarks at T0 (P < 0.001). Mucoperiosteal reconstruction of the nostril floor at the time of lip repair does not affect anthropometric growth velocities over a 5-year follow-up. Within the limitations of the selected landmarks, primary tip rhinoplasty did not significantly improve symmetry at 5 years, but also did not affect the growth of the nose. Patients with complete clefts display more postoperative asymmetry than those with incomplete clefts.

Impaired cardiac growth and function in children and adolescents after heart transplantation assessed by cardiac magnetic resonance

Impaired cardiac growth and function in children and adolescents after heart transplantation assessed by cardiac magnetic resonance

Changes in Bone Metabolic Parameters Under Imatinib Treatment in Children with Chronic Myeloid Leukemia (CML)

Objectives: Tyrosine kinase inhibitors (TKIs) demonstrate outstanding efficacy for treatment of CML, however, also exert well-known off-target effects. Among these, inhibition of osteoclast's and osteoblast's growth and differentiation [Vandyke K et al Blood 2010] results in longitudinal growth impairment in children and adolescents [Shima H et al J Pediatr 2011; Millot F et al Eur J Cancer 2014; Tauer JT et al Blood 2014, ASH abstract 522] under longtime imatinib treatment. In children enrolled into trial CML-paed II on ongoing imatinib exposure we investigated blood levels of calcium, phosphate, 25-vitamin D3 [25-vitD3], 1.25-vitamin D3 [1.25-vitD3], parathyroid hormone [PTH], and metabolic markers of bone resorption (osteoclasts: C-terminal cross-linking telopeptide of collagen type I [CTX-I]) and bone formation (osteoblasts: bone alkaline phosphatase [BAP], osteocalcin [OC], procollagen type 1 N propeptide [PINP]) in order to get a deeper insight in alterations associated with bone remodeling in a longitudinal timely fashion.Methods: 119 patients [pts] (70 male/49 female, median age 12 years, range 1-18 yrs) enrolled into the trial received 260-340 mg imatinib/sqm daily within one week after diagnosis (Dx) when CML had been confirmed by either cytogenetics or PCR. 20 to 30 pts out of this cohort could successfully be monitored repeatedly over a median period of 3 years for all parameters planned to be analyzed by collecting blood and urine three-monthly under appropriate circumstances (immediate processing, freezing, light protection, dry ice shipment to study center). Assays were performed in a central laboratory as described previously [Jaeger BA et al Med Sci Monit 2012]. Age normalized reference values were used as standard deviation scores (SDS) for statistical analysis by REML fit linear mixed effect-model with software R version 3.1.1. [https://www.r-project.org/].Results: At Dx mean OC levels were found elevated to the upper normal range (+1.5 SDS) but increased further on up to +5 SDS within the next 3 mo. Also mean BAP-SDS and PINP-SDS increased during follow-up compared to measurements at diagnosis but remained within the normal range. At mo 3 increased CTX-I (+3 SDS) indicated enhanced bone resorption followed by elevated measurements in the upper normal range (+1.5 SDS) over the next 33 mo. 25-vitD3 levels were found stable in the very low but still normal -2 SDS range in the summer time (May - Oct.) but below that range (-2.5 SDS) in the winter time (Nov.-April). 1.25-vitD3 measurements showed a course with a sharp and steep increase from -2 SDS at Dx to + 2 SDS at mo 3 of treatment falling to normal levels (0 SDS) at mo 12 and thereafter. Serum calcium and phosphate remained in the normal range throughout the whole treatment period of 33 mo analyzed while all pts showed low urinary calcium (-6 SDS) at diagnosis and at mo 3 followed by levels in the lowest normal range (-2 SDS) from mo 9 onwards. Urinary phosphate levels also gradually increased from -6 SDS at Dx to normal values at mo 12. PTH ranged within +1SDS to +2 SDS during the total period of monitoring.Conclusion: Children with CML under imatinib treatment exhibit moderate secondary hyperparathyroidism in conjunction with pathologically low 25-vitD3 levels. OC as marker of bone formation is highly elevated possibly due to inhibition of osteoclasts' activity by imatinib via blockade of c-FMS. Bone resorption is also increased, however, to a lesser extent (+ 1.5 SDS) as demonstrated by elevated CTX-I in the upper normal range (+2 SDS). This dysbalanced osseous activity affects bone remodelling and in not-outgrown pts causes longitudinal growth impairment. Most importantly, a typical pattern of changes in most osseous metabolic markers is observed showing an initial increase at mo 3 (phase 1) followed by stable, but not normalized values (phase 2) from mo 9 onwards [see Fig. 1]. This is in line with the clinical observation that skeletal pain may be severe under TKI treatment but usually disappears by the end of the first year. Also in rodent models a typical biphasic spatio-temporal shifting of bone formation and resorption at the epiphyseal line could be demonstrated [Tauer JT et al PLoS One 2015]. These osseous changes mandate close monitoring in pediatric patients under long-term TKI exposure. [Display omitted] DisclosuresSuttorp:Novartis, BMS, Pfizer: Consultancy, Honoraria, Research Funding.

Fecal Markers of Environmental Enteropathy are Associated with Animal Exposure and Caregiver Hygiene in Bangladesh.

Undernutrition is estimated to be an underlying cause of over half of all deaths in young children globally. There is a growing body of literature suggesting that increased exposure to enteric pathogens is responsible for environmental enteropathy (EE), a disorder associated with impaired growth in children. To determine if household unsanitary environmental conditions were significantly associated with EE and stunting in children, we conducted a cohort of 216 children (≤ 30 months) in rural Bangladesh. Stool was analyzed for four fecal markers of EE: alpha-1-antitrypsin, myeloperoxidase, and neopterin combined to form an EE disease activity score, and calprotectin. We observed a significant association between having an animal corral in a child's sleeping room and elevated EE scores (1.0 point difference, 95% confidence interval [CI]: 0.13, 1.88) and a two times higher odds of stunting (height-for-age z-score < -2) (odds ratio [OR]: 2.53, 95% CI: 1.08, 5.43) after adjusting for potential confounders. In addition, children of caregivers with visibly soiled hands had significantly elevated fecal calprotectin (μg/g) (384.1, 95% CI: 152.37, 615.83). These findings suggest that close contact with animals and caregiver hygiene may be important risk factors for EE in young children. These findings are consistent with the hypothesis that unsanitary environmental conditions can lead to EE in susceptible pediatric populations.

Exposure to cows is not associated with diarrhoea or impaired child growth in rural Odisha, India: a cohort study.

Exposure to animal livestock has been linked to zoonotic transmission, especially of gastrointestinal pathogens. Exposure to animals may contribute to chronic asymptomatic intestinal infection, environmental enteropathy and child under-nutrition in low-income settings. We conducted a cohort study to explore the effect of exposure to cows on growth and endemic diarrhoea in children aged <5 years in a rural, low-income setting in the Indian state of Odisha. The study enrolled 1992 households with 2739 children. Height measurements were available for 824 children. Exposure to cows was measured as (1) the presence of a cowshed within or outside the compound, (2) the number of cows owned by a household, and (3) the number of cowsheds located within 50 m of a household. In a sub-study of 518 households, fly traps were used to count the number of synanthropic flies that may act as vectors for gastrointestinal pathogens. We found no evidence that environmental exposure to cows contributes to growth deficiency in children in rural India, neither directly by affecting growth, nor indirectly by increasing the risk of diarrhoea. We found no strong evidence that the presence of a cowshed increased the number synanthropic flies in households.

Advances in understanding Giardia: determinants and mechanisms of chronic sequelae.

Giardia lamblia is a flagellated protozoan that is the most common cause of intestinal parasitic infection in children living in resource-limited settings. The pathogenicity of Giardia has been debated since the parasite was first identified, and clinical outcomes vary across studies. Among recent perplexing findings are diametrically opposed associations between Giardia and acute versus persistent diarrhea and a poorly understood potential for long-term sequelae, including impaired child growth and cognitive development. The mechanisms driving these protean clinical outcomes remain elusive, but recent advances suggest that variability in Giardia strains, host nutritional status, the composition of microbiota, co-infecting enteropathogens, host genetically determined mucosal immune responses, and immune modulation by Giardia are all relevant factors influencing disease manifestations after Giardia infection.

Sa2000 Cumulative Steroid Usage Is Not Associated With Permanent Growth Impairment in Children With Crohn's Disease

Sa2000 Cumulative Steroid Usage Is Not Associated With Permanent Growth Impairment in Children With Crohn's Disease

Growth impairment in children with pre-dialysis chronic kidney disease in Japan.

Growth impairment is a major complication of chronic kidney disease (CKD) in children. However, no cohort studies have examined the growth of Asian children with pre-dialysis CKD. We sent cross-sectional surveys to 113 Japanese medical institutions that were treating 447 children with CKD stages 3-5 in 2010 and 2011. Of 447 children included in our survey conducted in 2010, height and CKD stage were evaluable for 297 children in 2011, and height standard deviation score (height SDS) was calculated in these children. Height SDS decreased with increasing CKD stage (P < 0.001) in boys and girls. Height SDS also decreased significantly with increasing CKD stage among patients with congenital anomalies of the kidney and urinary tract (P < 0.001). Risk factors for growth impairment included CKD stages 4 and 5 (relative to stage 3), being small-for-date, and asphyxia at birth. Among children with a height SDS ≤-2.0, growth hormone was used in 19.5, 31.0, and 25.0 % of children with CKD stages 3, 4, and 5, respectively. This prospective cohort study revealed marked growth impairment in Japanese children with CKD stages 3-5 relative to healthy children. CKD-related risk factors for growth impairment included advanced CKD (stages 4 and 5), being small-for-date, and asphyxia at birth. Growth hormone was infrequently used in this cohort of children with pre-dialysis CKD.

The effect of nutrition and severity of iron deficiency anaemia on growth in children from two months to two years of age

Iron deficiency anaemia (IDA) is associated with increased morbidity, mortality, impaired growth and cognitive development of children. PURPOSE: to evaluate the effect of nutrition and severity of IDA on growth in children from 2 to 24 months of age. METHODS 172 children aged 2-24 months with IDA were categorized into two groups: G1 (0-12 months) and G2 (13-24 months). Diet was studied through interview. Anthropometric parameters: height-for-age (HA) and weight-for-age were assessed by standardized methods. IDA was defined as haemoglobin (Hb), mean corpuscular volume, serum iron, and transferrin saturation below age-related reference values of the World Health Organization. Anaemia was classified as severe, moderate, and mild according to Hb concentration. Associations between variables were analyzed by logistic regression. RESULTS High proportions of children predominantly fed on cow’s milk with scarce or absent intake of meat, eggs, vegetables were found in G1 (30.2%) and G2 (19.8%). Predominant cow’s milk feeding was significantly associated with growth retardation (HA<3rd percentile). In G2, severe anemia (Hb<70 g/l) exhibited significant (p=0.0344) association with stunting. CONCLUSIONS Inadequate nutrition and severe IDA increase risk of growth retardation in the first two years of life. Promotion of appropriate feeding practices is important in prevention and control of IDA.

A prospective study of growth and biomarkers of exposure to aflatoxin and fumonisin during early childhood in Tanzania.

Background: Aflatoxin and fumonisin are toxic food contaminants. Knowledge about effects of their exposure and coexposure on child growth is inadequate.Objective: We investigated the association between child growth and aflatoxin and fumonisin exposure in Tanzania.Methods: A total of 166 children were recruited at 6–14 months of age and studied at recruitment, and at the 6th and 12th month following recruitment. Blood and urine samples were collected and analyzed for plasma aflatoxin–albumin adducts (AF-alb) using ELISA, and urinary fumonisin B1 (UFB1) using liquid chromatography–mass spectrometry, respectively. Anthropometric measurements were taken, and growth index z-scores were computed.Results: AF-alb geometric mean concentrations (95% CIs) were 4.7 (3.9, 5.6), 12.9 (9.9, 16.7), and 23.5 (19.9, 27.7) pg/mg albumin at recruitment, 6 months, and 12 months from recruitment, respectively. At these respective sampling times, geometric mean UFB1 concentrations (95% CI) were 313.9 (257.4, 382.9), 167.3 (135.4, 206.7), and 569.5 (464.5, 698.2) pg/mL urine, and the prevalence of stunted children was 44%, 55%, and 56%, respectively. UFB1 concentrations at recruitment were negatively associated with length-for-age z-scores (LAZ) at 6 months (p = 0.016) and at 12 months from recruitment (p = 0.014). The mean UFB1 of the three sampling times (at recruitment and at 6 and 12 months from recruitment) in each child was negatively associated with LAZ (p < 0.001) and length velocity (p = 0.004) at 12 months from recruitment. The negative association between AF-alb and child growth did not reach statistical significance.Conclusions: Exposure to fumonisin alone or coexposure with aflatoxins may contribute to child growth impairment.Citation: Shirima CP, Kimanya ME, Routledge MN, Srey C, Kinabo JL, Humpf HU, Wild CP, Tu YK, Gong YY. 2015. A prospective study of growth and biomarkers of exposure to aflatoxin and fumonisin during early childhood in Tanzania. Environ Health Perspect 123:173–178; http://dx.doi.org/10.1289/ehp.1408097

PS-030 Congenital Heart Disease And Microcephaly At Birth: A Danish Population-based Cohort Study Of Children With Down Syndrome

Background and aims Neurodevelopmental disorders are common in children with congenital heart disease (CHD) and largely ascribed to prenatal factors such as impaired cerebral growth. It remains to be established whether this is due to impaired intrauterine cerebral blood flow or genuine genetic causes. Down syndrome (DS) is a known cause of CHD, neurodevelopmental disorders and microcephaly. Hence, studies on DS may provide insight into the causes of impaired cerebral growth in CHD. We aimed to assess the risk of microcephaly in children with DS and CHD compared to children with DS and no CHD. Methods Children with DS (n = 389) and specific birth characteristics were identified in national registries. Head circumference and the risk of microcephaly (head circumference Results There was no difference in head circumference between the groups, 0.0 cm (95% CI -0.4–0.4). Adjustment did not significantly alter the results. The risk of microcephaly was slightly higher in newborns with CHD, OR 1.4 (95% CI 0.8–2.6). Adjustment did not significantly alter the results. Conclusions We did not find indications of impaired head growth in children with DS and concomitant CHD. There might be a slight increase in the risk of microcephaly. We suggest that the most common types of CHD in DS i.e. atrioventricular septal defects, ventricular septal defects and atrial septal defects do not impair prenatal cerebral growth in children with DS.

Health and wealth in children and adolescents with chronic kidney disease (K-CAD study)

BackgroundThe impact of reduced kidney function in children is substantial. End-stage kidney disease (ESKD), the most severe form of chronic kidney disease (CKD), is a devastating illness associated with substantially increased mortality, impaired growth and psychosocial maladjustment in children. Understanding how to address the complex causes of mortality and morbidity in children with CKD requires explicit information about the risk factors that lead to adverse outcomes. In addition to biological influences, the socioeconomic circumstances of caregivers may play a significant role in the health and well-being of children with CKD.Methods/DesignA prospective cohort study (n = 380 children and n = 380 caregivers) will be conducted to determine the prevalence of economic hardship among caregivers of children with CKD. All participants will be followed biennially over a period of 5 years to determine the association between the changing socioeconomic status of the caregivers and the health and overall well-being of school-aged children with CKD. Face to face, semi-structured interviews with the caregivers (n = 45) will also be conducted to understand their perspectives on the economic, financial and psychosocial impact of CKD and how this affects the health outcomes of their child with CKD. The primary outcomes of the study are the effects of the socioeconomic status of the caregivers and self-reported health status of the children. Secondary outcomes included the prevalence of economic hardship and the distribution of wealth among the caregivers of children with CKD.DiscussionFindings from this study presents not only a snapshot of the current economic and social situation of the caregivers of children and adolescents with CKD but will also provide definitive evidence of determining whether a link between socioeconomic status of caregivers and outcomes of children with CKD exists.

Potential Role of IGF‐1 z Score to Predict Permanent Linear Growth Impairment in Children With IBD

In this pilot study, we analyzed serum insulin-like growth factor 1 (IGF-1)- and IGF-binding protein-3-for-age z scores from 54 inflammatory bowel disease children with no, temporary, or permanent growth impairment. Although our findings did not reach statistical significance, patients with permanent linear growth impairment had lower IGF-1-for-age z scores (-1.76 [-2.25 to -0.43]) compared with those with no or temporary growth impairment (-0.84 [-1.49 to -0.3]) and -1.16 [-1.59 to -1.51], respectively). IGF-binding protein-3 levels were similar across the 3 groups. In the absence of significant inflammation and malnutrition, lower IGF-1-for-age z scores may help distinguish patients likely to have permanent growth impairment from those whose growth impairment is likely to be temporary.

English

The deficiency of zinc (Zn) in human nutrition, commonly found in cereal-based diets accounts for impaired growth (stunting) in children. Since cereals are generally low in this element, bio-fortification may represent an opportunity to increase Zn intake by humans. A study was carried out to evaluate Zn uptake by maize and wheat when they are supplied with increasing rates of foliar or soil applied Zn. Maize and wheat were grown in the field and supplied with 0, 10, 20, 30, or 40 kg Zn ha-1 as ZnSO4 applied to the soil, or, 0,1,2,4, or 8 kg Zn ha-1 as foliar spray. Zinc application to soil increased maize and wheat yields beyond increments obtained with foliar application, but Zn mass concentration in maize grain was better with foliar applications. Mean maize yield was 1.78 ton ha-1 with soil application and 1.14 ton ha-1 with foliar application. This was in relation to an average of 52 mg Zn uptake by maize under each of the application methods. Wheat yield was 3.69 ton ha-1 under soil application and 2.74 ton ha-1 under foliar application. In this case, Zn uptake was higher under soil application (11.31 mg) than under foliar application (7.25 mg). Sesquioxide bound Zn was shown to be best correlated with plant Zn uptake. It was shown that Zn application is beneficial on Zambian soils, and while soil application increases crop yields, foliar application can be more useful to increase Zn mass concentration in maize. &nbsp; Key words: Foliar spray, maize grain yield, wheat grain yield, zinc fractions, zinc uptake &nbsp; &nbsp;&nbsp;

Public Health Impacts of Foodborne Mycotoxins

Mycotoxins are toxic and carcinogenic metabolites produced by fungi that colonize food crops. The most agriculturally important mycotoxins known today are aflatoxins, which cause liver cancer and have also been implicated in child growth impairment and acute toxicoses; fumonisins, which have been associated with esophageal cancer (EC) and neural tube defects (NTDs); deoxynivalenol (DON) and other trichothecenes, which are immunotoxic and cause gastroenteritis; and ochratoxin A (OTA), which has been associated with renal diseases. This review describes the adverse human health impacts associated with these major groups of mycotoxins. First, we provide background on the fungi that produce these different mycotoxins and on the food crops commonly infected. Then, we describe each group of mycotoxins in greater detail, as well as the adverse effects associated with each mycotoxin and the populations worldwide at risk. We conclude with a brief discussion on estimations of global burden of disease caused by dietary mycotoxin exposure.