Urban Infants Research Articles

Human Infant Fecal Microbiota Differentially Influences the Mucosal Immune Pathways Upon Influenza Infection in a Humanized Gnotobiotic Pig Model

In this study, we evaluated the impact of human gut microbiota on the immune pathways in the respiratory tract using a gnotobiotic (Gn) piglet model. We humanized piglets with rural and urban infant fecal microbiota (RIFM and UIFM, respectively) and then infected them with a H1N1 swine influenza virus. We analyzed the microbial diversity and structure of the intestinal and respiratory tracts of the piglets before and after the influenza virus infection and measured the viral load and immune responses. We found that the viral load in the upper respiratory tract of UIFM transplanted piglets was higher than their rural cohorts (RIFM), while virus-specific antibody responses were comparable. The relative cytokine gene expression in the tracheobronchial (respiratory tract) and mesenteric (gastrointestinal) lymph nodes, lungs, blood, and spleen of RIFM and UIFM piglets revealed a trend in reciprocal regulation of proinflammatory, innate, and adaptive immune-associated cytokines as well as the frequency of T-helper/memory cells, cytotoxic T cells, and myeloid immune cell subsets. We also observed different phylum-level shifts of the fecal microbiota in response to influenza virus infection between the two piglet groups, suggesting the potential impact of the gut microbiota on the immune responses to influenza virus infection and lung microbiota. In conclusion, Gn piglets humanized with diverse infant fecal microbiota had differential immune regulation, with UIFM favoring the activation of proinflammatory immune mediators following an influenza virus infection compared to their rural RIFM cohorts. Furthermore, Gn piglets can be a useful model in investigating the impact of diverse human microbiota of the gastrointestinal tract, probably also the respiratory tract, on respiratory health and testing specific probiotic- or prebiotic-based therapeutics.

Development strategies for reducing infant mortality: A focus on healthcare infrastructure and policy in emerging Asian countries

The journey towards better healthcare sustainability in Asian nations demands a comprehensive investigation into the impact of urban governance, poverty, and female literacy on infant mortality rates. This study undertakes a rigorous exploration of these key factors to pave the way for evidence-based policy interventions, utilizing data from a panel of six selected Asian countries: Pakistan, China, India, Indonesia, Malaysia, and the Philippines, spanning the years 2001 to 2020. The findings reveal that adequate sanitation facilities, higher female literacy rates, and sustained economic growth contribute to a reduction in infant mortality. Conversely, increased poverty levels and limited women’s autonomy exacerbate the infant mortality rates observed in these countries. The Granger causality analysis validates the reciprocal relationship between urban sanitation (and poverty) and infant mortality rates. Furthermore, the study establishes a causal relationship where female literacy rates Granger-cause infant mortality rates, and conversely, infant mortality rates Granger-cause women’s autonomy in these countries. The variance decomposition analysis indicates that sustained economic growth, improved female literacy rates, and enhanced women’s empowerment will likely impact infant mortality rates in the coming decade. Consequently, in low-income regions where numerous children face potentially hazardous circumstances, it is imperative to allocate resources towards establishing and maintaining accessible fundamental knowledge regarding sanitation services, as this will aid in reducing infant mortality rates.

Fungi and bacteria in the beds of rural and urban infants correlate with later risk of atopic diseases.

Rural children have a lower risk of asthma and atopic diseases than urban children. However, whether indoor microbiota in non-farming rural homes provides protection is unclear. Here, we examine if microbes in the beds of rural and urban infants are associated with later development of atopic diseases. We studied fungi and bacteria in the beds of 6-month-old infants (n = 514) in association with the risk of asthma, allergic rhinitis, eczema and aeroallergen sensitization at 6 years of age in the prospective COPSAC2010 cohort. Both fungal and bacterial diversity were lower in the beds of children, who later developed allergic rhinitis (-0.22 [-0.43,-0.01], padj = .04 and -.24 [-0.42,-0.05], padj = .01 respectively) and lower bacterial richness was discovered in beds of children later developing asthma (-41.34 [-76.95,-5.73], padj = .02) or allergic rhinitis (-45.65 [-81.19,-10.10], padj = .01). Interestingly, higher fungal diversity and richness were discovered in the beds of children developing eczema (0.23 [0.02,0.43], padj = .03 and 29.21 [1.59,56.83], padj = .04 respectively). We defined a limited set of fungal and bacterial genera that predicted rural/urban environment. Some rural-associated bacterial genera such as Romboutsia and Bacillus and fungal genera Spegazzinia and Physcia were also associated with reduced risk of diseases, including eczema. These fungal and bacterial fingerprints predicting the living environment were associated with asthma and allergic rhinitis, but not eczema, with rural compositions being protective. The bed dust bacteria mediated 27% of the protective association of a rural living environment for allergic rhinitis (p = .04). Bed dust microbes can be differentially associated with airway- and skin-related diseases. The differing bed dust microbiota between rural and urban infants may influence their later risk of asthma and allergic rhinitis.

Anemia status of infants and young children aged six to thirty-six months in Ma'anshan City: A retrospective study.

Anemia in infants and young children can have long-term effects on cognitive and physical development. In Ma'anshan City, China, there has been growing concern about the prevalence of anemia among children aged 6 to 36 mo. Understanding the factors influencing this condition is crucial for targeted interventions and improving overall child health in the region. To analyze the anemia status and influencing factors of infants and young children aged 6 to 36 mo in Ma'anshan City, China. Providing scientific evidence for reducing the incidence of anemia and improving the health level of children in this age group. The study encompassed 37698 infants and young children, aged from 6 to 36 mo, who underwent health examinations at the Ma'anshan Maternal and Child Health Hospital from January 2018 to October 2022 were included in the study. Basic information, physical examination, and hemoglobin detection data were collected. Descriptive analysis was used to analyze the prevalence of anemia in children in the region, and univariate analysis was used to analyze the influencing factors of anemia. The mean hemoglobin level of infants and young children aged 9 to 36 mo increased with age, and the anemia detection rate decreased with age. The anemia detection rate in rural infants aged 6, 9, and 12 mo was higher than that in urban infants. Although the anemia detection rate was higher in 6-mo-old boys than girls, it was higher in 24-mo-old girls than boys. There were statistically significant differences in the anemia detection rates among 9-mo-old and 12-mo-old infants with different nutritional statuses (emaciation, overweight, obese, and normal). Moreover, there were no statistically significant differences in anemia detection rates among infants and young children with different nutritional statuses at other ages. Besides, the anemia detection rates in obese infants aged 9 and 12 mo were higher than those in normal and overweight infants, with statistically significant differences. Finally, there were no statistically significant differences in the anemia detection rates between emaciation infants and those with other nutritional statuses. The anemia situation among infants and young children aged 6 to 36 mo in Ma'anshan City, China, is relatively prominent and influenced by various factors. Our result shown that attention should be paid to the anemic infant and young child population, with strengthened education and targeted prevention and dietary guidance to help them establish good living habits, improve nutritional status, and reduce the occurrence of anemia to improve children's health levels.

Urbanization associates with restricted gut microbiome diversity and delayed maturation in infants

Alterations of the microbiome are linked to increasingly common diseases such as obesity, allergy, and inflammatory bowel disease. Post-industrial lifestyles are thought to contribute to the gut microbiome alterations that cause or aggravate these diseases. Comparing communities across the industrialization spectrum can reveal associations between gut microbiome alterations and lifestyle and health, and help pinpoint which specific aspect of the post-industrial lifestyle is linked to microbiome alterations. Here, we compare the gut microbiomes of 60 mother and infant pairs from rural and urban areas of Senegal over two time points. We find that urban mothers, who were more frequently overweight, had different gut microbiome compositions than rural mothers, showing an expansion of Lachnospiraceae and Enterobacter. Urban infants, on the other hand, showed a delayed gut microbiome maturation and a higher susceptibility to infectious diseases. Thus, we identify new microbiome features associated with industrialization, whose association with disease may be further investigated.

Association of Rural Residence With Surgical Outcomes Among Infants at US Children's Hospitals.

Disparities in pediatric health outcomes are widespread. It is unclear whether rurality negatively impacts outcomes of infants with surgical congenital diseases. This study compared outcomes of rural versus urban infants requiring complex surgical care at children's hospitals in the United States. Rural and urban infants (aged <1 year) receiving surgical care at children's hospitals from 2016 to 2019 for esophageal atresia, gastroschisis, Hirschsprung's disease, anorectal malformation, and congenital diaphragmatic hernia were compared over a 1-year postoperative period using the Pediatric Health Information System. Generalized linear mixed effects models compared outcomes of rural and urban infants. Among 5732 infants, 20.2% lived in rural areas. Rural infants were more frequently white, lived farther from the hospital, and lived in areas with lower median household income compared with urban infants (all P < .001). Rural infants with anorectal malformation and gastroschisis had lower adjusted hospital days over 1 year; rural infants with esophageal atresia had higher adjusted odds of 30-day hospital readmission. Adjusted mortality, hospital days, and readmissions were otherwise similar between the 2 groups. Outcomes remained similar when comparing urban infants to rural infant subgroups with the longest hospital travel distance (≥60 miles) and lowest median household income (<$35 000). Despite longer travel distances and lower financial resources, rural infants with congenital anomalies have similar postoperative outcomes to urban infants when treated at children's hospitals. Future work is needed to examine outcomes for infants treated outside children's hospitals and to determine whether efforts are necessary to increase access to children's hospitals.

The effect of distance covered to the nearby medical facility on the death of infants in rural and urban areas of Kakamega Central Sub-County, Kakamega County, Kenya

Purpose of the study: At the backdrop of the third sustainable development goal, Kenya’s infant mortality rate is 36 while that of Kakamega is 37. This study assessed the effect of distance covered to the nearby medical facility on the death of infants in rural and urban areas of Kakamega Central Sub-County, Kakamega County, Kenya. Data and Methods: A cross-sectional research design was employed to collect data from a sample of women population within childbearing ages of 15 to 49 years in Kakamega Central Sub-County. Analyses were done on the Statistical Package for Social Sciences computer program at descriptive and inferential levels. Results: Straight-line distance covered to the nearby medical facility was significantly related to urban neonatal mortality. A straight-line distance of 1.1 to 3.9 kilometres from one’s residence to the nearby medical facility had a 1.127 higher likelihood of neonatal mortality in comparison to an at most 1 kilometre straight-line distance. Further, an increase in travel-time was associated with an increase in the likelihood of infant mortality. The adjusted odds ratios of infant mortality increased by 167.2 percent and 643.6 percent for a 30 minutes’ and 60 minutes’ increase in travel time in urban and rural areas, respectively. Conclusion: Straight-line distance influenced infant mortality in urban areas but not rural areas. Travel-time influenced both rural and urban infant mortalities. There is need observe equitable geospatial distribution of medical facilities and proper equipment of the same in Kakamega Central Sub-County in order to observe the acceptable density of medical facilities in correspondence with the population.

After NICU discharge: Feeding and growth of low-income urban preterm infants through the first year.

Little is known about preterm infant feeding and growth in the outpatient setting, and there are no standardized post-hospital discharge feeding guidelines. This study aims to describe post-neonatal intensive care unit (NICU) discharge growth trajectories of very preterm (<32 weeks gestational age (GA)) and moderately preterm (32-34 0/7 weeks GA) infants managed by community providers and to determine the association between post-discharge feeding type and growth Z-scores and z-score changes through 12 months corrected age (CA). This retrospective cohort study included very preterm infants (n = 104) and moderately preterm infants (n = 109) born 2010-2014 and followed in community clinics for low-income, urban families. Infant home feeding and anthropometry were abstracted from medical records. Repeated measures analysis of variance calculated adjusted growth z-scores and z-score differences between 4 and 12 months CA. Linear regression models estimated associations between 4 months CA feeding type and 12 months CA anthropometry. Moderately preterm infants on nutrient-enriched vs. standard term feeds at 4 months CA had significantly lower length z-scores at NICU discharge that persisted to 12 months CA (-0.04 (0.13) vs. 0.37 (0.21), respectively, P = .03), with comparable length z-score increase for both groups between 4 and 12 months CA. Very preterm infants' 4 months CA feeding type predicted 12 month CA body mass index z-scores (β=-0.66 (-1.28, -0.04)). Community providers may manage preterm infant post-NICU discharge feeding in the context of growth. Further research is needed to explore modifiable drivers of infant feeding and socio-environmental factors that influence preterm infant growth trajectories.

Study design and rationale for the PAASIM project: a matched cohort study on urban water supply improvements and infant enteric pathogen infection, gut microbiome development and health in Mozambique

IntroductionDespite clear linkages between provision of clean water and improvements in child health, limited information exists about the health impacts of large water infrastructure improvements in low-income settings. Billions of...

Early onset of otitis media is a strong predictor of subsequent disease in urban Aboriginal infants: Djaalinj Waakinj cohort study.

Australian Aboriginal and/orTorresStraitIslanderchildren in rural/remote areas suffer high rates of persistent otitis media (OM) from early infancy. We aimed to determine the proportion of Aboriginal infants living in an urban area who have OM and investigate associated risk factors. Between 2017 and 2020, the Djaalinj Waakinj cohort study enrolled 125 Aboriginal infants at 0-12 weeks of age in the Perth South Metropolitan region, Western Australia. Proportion of children with OM based on tympanometry at ages 2, 6 and 12 months was evaluated, type B tympanogram indicating middle ear effusion. Potential risk factors were investigated by logistic regression with generalised estimating equations. The proportion of children with OM was 35% (29/83) at 2months, 49% (34/70) at 6months and 49% (33/68) at 12 months of age. About 70% (16/23) of those with OM at ages 2 and/or 6months had OM at 12 months compared with 20% (3/15) if no prior OM (relative risk=3.48, 95% confidence interval (CI): 1.22-40.1). On multivariate analysis, infants living in houses with ≥1 person/room were at increased risk of OM (odds ratio=1.78, 95% CI: 0.96-3.32). Approximately half of Aboriginal infants enrolled into the South Metropolitan Perth project have OM by the age of 6months and early onset of disease strongly predicts subsequent OM. Early surveillance for OM in urban areas is needed for early detection and management to reduce the risk of long-term hearing loss which can have serious developmental, social, behavioural, educational and economic consequences.

Modernisation Factors of Infant Mortality Transition in Late Imperial Perm Province

This article studies urban infant mortality in the post-reform period of Perm Province. The work reconstructs the dynamics of infant mortality in cities and villages of the Middle Urals, highlighting the patterns of individual cities and identified factors of evolution. It is based on published state and zemstvo statistics, archival documents from medical institutions and public organisations, as well as Orthodox Church parish records from Ekaterinburg. Methodologically, the work relies on general demographic indices, descriptive statistics techniques, seasonality coefficients, and dynamic series analysis. During the first half of the nineteenth century, the mining Urals had extremely high birth and death rates and the highest infant mortality rate in European Russia. The Great Reforms launched the demographic transition in the region, resulting, among other things, in the Empire’s most significant infant mortality decline in the early twentieth century. The earliest and fastest infant mortality decline took place in cities. Small towns had slightly better rates than rural areas, while Perm and especially Ekaterinburg had significant reductions. The main reasons behind the changes in infant mortality were economic employment diversification, the weakening of ethno-religious traditions, and the creation of medical infrastructure. In daily life, these factors manifested in the smoothing of demographic seasonality, increased period between birth and baptism, the introduction of artificial nourishment with the help of glass feeding bottles and rubber comforters, and moving childbirths and infant care to hospitals. Ekaterinburg, the economic capital of the region, was the place where these factors had the best effect.

A systematic review suggests marked differences in the prevalence of infant-directed vocalization across groups of populations.

Anthropological reports have long suggested that speaking to young children is very infrequent in certain populations (notably farming ones), which is in line with scattered quantitative studies. A systematic review was undertaken to use available literature in order to estimate the extent of population variation. Database searches, expert lists, and citation searches led to the discovery of 29 reports on the frequency of vocalizations directed to infants aged 24 months or younger, based on systematic observations of spontaneous activity in the infant's natural environment lasting at least 30 min in length. Together, these studies provide evidence on 1314 infants growing up in a range of communities (urban, foraging, farming). For populations located outside of North America, the frequency with which vocalization was directed to urban infants was much higher than that for rural infants (including both foraging and farming, medians=12.6 vs. 3.6% of observations contained infant-directed vocalization behaviors). We benchmarked this effect against socio-economic status (SES) variation in the United States, which was much smaller. Infants in high SES American homes were spoken to only slightly more frequently than those in low SES homes (medians=16.4 vs. 15.1% of observations contained infant-directed vocalization behaviors). Although published research represents a biased sample of the world's populations, these results invite further cross-population research to understand the causes and effects of such considerable population group differences.

Clinical and epidemiologic description of a severe outbreak of Salmonellosis in an urban nursery school

ObjetivosSe describe clínica y epidemiológicamente un brote de infección gastrointestinal por Salmonella entérica ser. (serotipo) Enteritidis, en una escuela infantil urbana, que conllevó elevada morbilidad e importante alarma social. La comunicación inmediata, así como el estudio adecuado del brote, en ambas vertientes, permitieron identificar el patógeno y establecer medidas de control en un plazo razonable de tiempo. Se discuten aspectos controvertidos como la indicación de antibioterapia o el momento de cierre del centro.Material y métodosSe recogió retrospectivamente información clínica, analítica y epidemiológica, y se revisó la metodología y resultados del estudio del brote.Resultados57 niños (3-45 meses) de 92 asistentes al centro, fueron afectados y tuvieron confirmación microbiológica. Diarrea y fiebre fueron los principales síntomas. 74% acudieron al hospital, y 37% ingresaron, (estancia media 3,3 días). Fueron factores asociados al ingreso: deshidratación, elevación significativa de reactantes de fase aguda y coagulopatía. 12 recibieron cefotaxima parenteral. Se registraron 2 complicaciones: 1 bacteriemia y 1 reingreso. La sospecha inicial del origen del brote fueron los alimentos, pero el análisis de las muestras testigo fue negativo. 5 trabajadores fueron positivos (2 sintomáticos). Vigilancia Epidemiológica concluyó que el origen probable del brote fue un portador asintomático y la manipulación incorrecta de pañales. El centro permaneció cerrado 8 días. Se realizaron medidas de limpieza y desinfección, instrucción sobre cambio de pañales y seguimiento de portadores.ConclusionesLa agrupación en tiempo y espacio de casos debe ser notificada inmediatamente para el control precoz del brote. Los niños pueden presentar formas graves de gastroenteritis por Salmonella.

Sunlight, dietary habits, genetic polymorphisms and vitamin D deficiency in urban and rural infants of Bangladesh

We conducted an observational study to assess the prevalence and risk factors of vitamin D deficiency in 12–24 months old children living in urban and rural Bangladesh. Serum 25-hydroxyvitamin D (free 25(OH)D) level, socio-demographic status, anthropometric status, dietary intake, exposure to sunlight and single nucleotide polymorphisms in vitamin-D pathway genes were measured in 208 children. Vitamin D deficiency (free 25(OH)D < 50 nmol/l) was reported in 47% of the children. Multivariable logistic regression model identified duration to sunlight exposure (regression coefficient, β = − 0.01; 95% CI 0.00, − 0.02; p-value < 0.05), UV index (β = − 0.36; 95% CI 0.00, − 0.02; p-value < 0.05) and breast-feeding (β = − 1.15; 95% CI − 0.43, − 1.86; p-value < 0.05) to be negatively associated with vitamin D deficiency. We measured the role of single nucleotide polymorphisms in pathway genes (GC-rs7041 T > G, rs4588 C > A, CYP2R1-rs206793 A > G, CYP27B1-rs10877012 A > C and DHCR7-rs12785878 G > T) and found statistically significant differences in serum vitamin D levels between various genotypes. SNPs for CYP27B1 (CA & CC genotype) had statistically significant positive association (β = 1.61; 95% CI 2.79, 0.42; p-value < 0.05) and TT genotype of GC-rs7041 had negative association (β = − 1.33; 95% CI − 0.02, − 2.64; p-value < 0.05) with vitamin-D deficiency in the surveyed children.

Connecting to Early Intervention Services After Neonatal Intensive Care Unit Discharge in a Medicaid Sample.

To describe caregiver perspectives regarding connecting to early intervention (EI) services after neonatal intensive care unit discharge in a Medicaid sample. Open-ended semistructured interviews and focus groups were conducted with English- or Spanish-speaking families enrolled in Medicaid in an urban high-risk infant follow-up clinic at a safety-net center, which serves preterm and high-risk term infants. We generated salient themes using inductive-deductive thematic analysis. Thirty-two participants completed the study. The infant's median (interquartile range) birth weight was 1365 (969, 2800) grams; 50% were Hispanic; 31% reported living in a neighborhood with fourth quartile economic hardship. Eighty-one percent were classified as having chronic complex disease per the Pediatric Medical Complexity Algorithm and 63% had a diagnosis of developmental delay. A conceptual model was constructed and the analysis revealed major themes describing families' challenges and ideas to facilitate connection to EI. We identified subthemes related to the person in environment: health care environment/support and socio-economic resources, parent perspectives and built environment; provider level factors such as appointment scheduling, staff limitations, and parent suggestions to improve health care and service navigation, which included improved information sharing, the importance of patient advocates, video resources, early referrals to EI facilitated by the discharging hospital and system workarounds. The results from this study may provide a granular roadmap for providers to help facilitate referrals to EI services. We identified several ideas such as using advocates and providing transitional resources, including online media, that might improve the connection to EI services.

Designing a Mobile Health Solution to Facilitate the Transition from NICU to Home: A Qualitative Study.

There is limited information about caregiver and provider perspectives regarding the design of a mobile health solution to facilitate the transition from the neonatal intensive care unit (NICU) to home. Focus groups were conducted with English- or Spanish-speaking families enrolled in an urban high-risk infant follow-up clinic and with their care providers. We generated salient themes using an inductive thematic analysis. Twenty-two participants completed the study. Among caregivers, the infant’s median gestational age (IQR) was 29 (23, 34) weeks and 63% were Hispanic. Among the providers, 55% had practiced for more than 10 years and 18% were bilingual. Key stakeholder (family and provider) priorities for designing a mobile health solution were organized into eight domains, i.e., implementation ideas around user interface and timing, providing path planning and information, increasing support, improving engagement with providers and services, mitigating barriers to care after discharge and strengthening parenting role and confidence. The results from this study suggest that families and healthcare providers prioritize path planning, information and support as the pillars for designing an effective NICU-to-home transition mobile health application. Implications for product development include family empowerment, being a credible source of information and creating a resource for caregiver support and mental health.

Mother Schooling and Malnutrition among Children of Rural-Urban Pakistan

&#x0D; Background: Although many causes of malnutrition are discussed in previous studies, the impact of mother schooling on malnutrition among children of rural-urban Pakistan and mediating factors is not posited in case of Pakistan. Hence, this study examine the effect of mother schooling and intervening linkages on acute and chronic malnutrition.&#x0D; Methods: The prior empirical relationship is examined by calculating adjusted risk-ratio with the help of binary logistic regression analyses using a sample size of 3184 rural-urban mothers retrieved from the latest Pakistan Demographic and Health Survey 2012-13 (PDHS).&#x0D; Results: The urban mothers without education are more likely to have stunted and underweighted infants as compared to rural ones. Rural (urban) mothers with poor (moderate) economic position have more chances of having stunted infants than urban (rural) mothers. However, only urban mothers with poor status have more chances of having underweight kids relative to mothers with rich class. The rural mothers with empowerment and with seeking for medical services are less likelihood to have stunted infants than urban ones.&#x0D; Value of the Study: The impact of mediating factors arising from education on rural infants’ health is higher than that on urban infants&#x0D;

Bacteroides Microbial Source Tracking Markers Perform Poorly in Predicting Enterobacteriaceae and Enteric Pathogen Contamination of Cow Milk Products and Milk-Containing Infant Food.

Consumption of microbiologically contaminated food is one of the leading causes of diarrheal diseases. Understanding the source of enteric pathogens in food is important to guide effective interventions. Enterobacteriaceae bacterial assays typically used to assess food safety do not shed light on the source. Source-specific Bacteroides microbial source tracking (MST) markers have been proposed as alternative indicators for water fecal contamination assessment but have not been evaluated as an alternative fecal indicator in animal-derived foods. This study tested various milk products collected from vendors in urban Kenyan communities and infant foods made with the milk (n = 394 pairs) using conventional culture methods and TaqMan qPCR for enteric pathogens and human and bovine-sourced MST markers. Detection profiles of various enteric pathogens and Bacteroides MST markers in milk products differed from that of milk-containing infant foods. MST markers were more frequently detected in infant food prepared by caregivers, indicating recent contamination events were more likely to occur during food preparation at home. However, Bacteroides MST markers had lower sensitivity in detecting enteric pathogens in food than traditional Enterobacteriaceae indicators. Bacteroides MST markers tested in this study were not associated with the detection of culturable Salmonella enterica and Shigella sonnei in milk products or milk-containing infant food. The findings show that while Bacteroides MST markers could provide valuable information about how foods become contaminated, they may not be suitable for predicting the origin of the enteric pathogen contamination sources.

Why were infants dying and what were they dying from? Infant mortality patterns in the Greek urban centre of Hermoupolis, Syros (1860–1940)

ABSTRACT The reduction in infant mortality has been a significant component of mortality decline in all north-western European populations. Infant mortality in Greece has been studied before, though most rates refer to rural populations or short periods of time; while the national ones have been based on multiple assumptions. Only rarely there is available evidence about the evolution of infant mortality in urban Greece in a long-term perspective. This paper, therefore, fills this gap by employing individual-level data, a rare collection of oral histories and qualitative sources from the major urban centre of Hermoupolis, on the Greek island of Syros, for the period 1860–1940. Infant mortality in Hermoupolis was found to be among the highest in the country for most of the study period. Even though it had been argued that infant mortality in Greece declined in the 1930s, Hermoupolis experienced an earlier decline, situated in the late 1890s. Main factors that were found to be related to this decline include wider access to water, changes in the registration system, fertility decline, improvements in living standards and nutrition among lower strata infants and improvements in maternal literacy. Diarrhoeal diseases killed most infants especially during the hot and dry summer months. Despite the widespread practice of breastfeeding in the city, seasonality analysis indicated the early initiation of supplementary food. This paper contributes to the existing literature by extending our understanding of the factors that facilitated the reduction of urban infant mortality beyond Western Europe and North America.

More Than Shelter: Housing for Urban Maternal and Infant Health.

Housing quality, stability, and affordability have a direct relationship to socioemotional and physical health. Both city planning and public health have long recognized the role of housing in health, but the complexity of this relationship in regard to infant and maternal health is less understood. Focusing on literature specifically relevant to U.S. metropolitan areas, I conduct a multidisciplinary literature review to understand the influence of housing factors and interventions that impact infant and maternal health. The paper seeks to achieve three primary goals. First, to identify the primary “pathways” by which housing influences infant and maternal health. Second, the review focuses on the role and influence of historical housing discrimination on maternal health outcomes. Third, the review identifies emergent practice-based housing interventions in planning and public health practice to support infant and maternal health. The literature suggests that the impact of housing on infant health is complex, multifaceted, and intergenerational. Historical housing discrimination also directly impacts contemporary infant and maternal health outcomes. Policy interventions to support infant health through housing are just emerging but demonstrate promising outcomes. Structural barriers to housing affordability in the United States will require new resources to foster greater collaboration between the housing and the health sectors.