RESUMEN
PURPOSE: This study aimed to assess the agreement in EBF between maternal recall and the dose-to-mother (DTM) technique. METHODS: Indonesia, Malaysia, Mongolia, Pakistan, Sri Lanka, Thailand, and Vietnam participated in the study. A total of 207 and 118 mother-infant pairs were assessed at 3 and 6 months of child's age. Using a standardized questionnaire, mothers were asked to recall child feeding during the previous 24 h, at 3 and 6 months. Those recalled to be EBF proceeded to be assessed using DTM technique. Non-milk oral intake (NMOI) cutoff of 86.6 g/d was used to classify EBF. RESULTS: According to DTM, 66% of infants were EBF at 3 months, while only 22% were EBF at 6 months. At 3 months, the overall % agreement between maternal recall and DTM method was 68%, kappa 0.06 (95% CI: 0.07-0.20), and at 6 months, the % agreement was only 21%, kappa -0.031 (95% CI -0.168 to 0.107). Human milk intakes were similar at 3 months and 6 months when expressed as g/d, but decreased when expressed as g/kg/d, with a large variation within and between countries; Pakistan being the lowest. CONCLUSION: This study showed there were declining levels of EBF from 3 to 6 months in the participating countries from Asia and the agreement between maternal recall and DTM technique to classify EBF was low. To ensure that the DTM technique can be more widely used in evaluating breastfeeding promotion programs, consensus on the appropriate NMOI cutoff and simplification of the DTM protocol is necessary.
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Lactancia Materna , Madres , Femenino , Humanos , Lactante , Deuterio , Leche Humana , TailandiaRESUMEN
OBJECTIVE: To assess the prevalence of undernutrition, incidence of infectious diseases and the situation of feeding practices to determine the risk factors for undernutrition among children aged 6 to 18 months in rural Vietnam. DESIGN: A cross-sectional study was conducted among one hundred eighty-eight mother-child pairs in Bac Giang, Vietnam. Weight and height of the children were measured and referred to data from the WHO/CDC/NCHS. Incidence of infectious diseases was diagnosed based on the WHO Recommended Surveillance Standards. Data on socio-demographic variables and feeding practices were obtained through a structured questionnaire. RESULT: The prevalence of underweight, stunting and wasting was 19.7%, 23.4% and 5.3%, respectively. The incidence of diarrhea and acute respiratory infections (ARIs) during the last 14 days of the interview was 12.2% and 20.2%, respectively. Although 99% of the children were breastfed, the prevalence of exclusive breastfeeding in the first 4 mo was 21.3%. Non-exclusive breastfeeding in the first 4 month (OR 3.95, p=0.025) and low birth weight (OR 4.38, p=0.009) were associated with underweight in the children, while incidence of infectious disease was not (OR 1.16, p=0.734). CONCLUSION: Undernutrition is highly prevalent in the study site and non-exclusive breast feeding is one of the risk factors.
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Lactancia Materna/epidemiología , Enfermedades Transmisibles/epidemiología , Estado Nutricional , Estatura , Peso Corporal , Estudios Transversales , Femenino , Humanos , Incidencia , Lactante , Masculino , Desnutrición/epidemiología , Factores Socioeconómicos , Vietnam/epidemiologíaRESUMEN
OBJECTIVES: To assess the folate and vitamin B12 status of a group of Vietnamese women of reproductive age and to estimate the rate of neural tube defects (NTD) based on red blood cell (RBC) folate concentrations. DESIGN AND SUBJECTS: A representative sample of non-pregnant women (15-49 years) living in Hanoi City (n 244) and Hai Duong Province (n 245). MEASURES: RBC folate, plasma vitamin B12 and plasma holo-transcobalamin (holoTC), a sensitive indicator of vitamin B12 status. RESULTS: Mean (95% CI) concentrations of RBC folate, plasma B12 and plasma holoTC were 856 (837, 876) nmol/l, 494 (475, 513) pmol/l and 78 (74, 82) pmol/l, respectively. Only 3% and 4% of women had plasma B12 and holoTC concentrations indicative of deficiency. No woman had an RBC folate concentration indicative of deficiency (<317 nmol/l). Only 47% of women had an RBC folate concentration > or = 905 nmol/l. Accordingly, we predict the NTD rate in these regions of Vietnam to be 14.7 (14.2, 15.1) per 10,000 pregnancies. CONCLUSION: There was no evidence of folate and vitamin B12 deficiency among this population of Vietnamese women. However, suboptimal folate status may be placing three out of five women at increased risk of NTD. Reductions in NTD rates are still possible and women would benefit from additional folic acid during the periconceptional period from either supplements or fortified foods.
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Eritrocitos/química , Deficiencia de Ácido Fólico/epidemiología , Ácido Fólico/sangre , Defectos del Tubo Neural/epidemiología , Deficiencia de Vitamina B 12/epidemiología , Vitamina B 12/sangre , Adolescente , Adulto , Femenino , Deficiencia de Ácido Fólico/sangre , Humanos , Persona de Mediana Edad , Defectos del Tubo Neural/sangre , Evaluación Nutricional , Estado Nutricional , Factores de Riesgo , Transcobalaminas/metabolismo , Vietnam/epidemiología , Deficiencia de Vitamina B 12/sangre , Salud de la Mujer , Adulto JovenRESUMEN
In 2003, the authors conducted a population-based, cross-sectional survey to determine the prevalence of osteoporosis and related factors in Vietnamese adult women by using quantitative ultrasound at the heel bone (calcaneus). A total of 2,232 adult women aged > or =20 years, living in Hanoi City, and free of illnesses affecting bone metabolism were randomly selected to participate in the study. Subjects' bone mass was assessed by speed of sound at the calcaneus, referred to as quantitative ultrasound measurement. The T-score threshold, defined as < or =-1.8, was used to identify subjects with osteoporosis. The crude prevalence of osteoporosis in Hanoi City was 15.4%; after adjustment for age, it was 9.0%. Among premenopausal women, the crude prevalence of osteoporosis was higher in the urban areas compared with the rural areas. By contrast, postmenopausal women in the rural areas had a higher prevalence of osteoporosis. Multiple logistic regression analysis revealed that factors associated with low speed of sound were age, menopause, educational level, lifelong occupation, recreational weight-bearing exercise, number of births, and height. Results suggest that osteoporosis is a noteworthy problem in Vietnam, and intervention strategies should be considered to control it, especially in high-risk populations.