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To determine the prevalence of co-morbidity of two important global health challenges, anaemia and stunting, among children aged 6–59 months in low- and middle-income countries.
Design
Secondary analysis of data from Demographic and Health Surveys (DHS) conducted 2005–2015. Child stunting and anaemia were defined using current WHO classifications. Sociodemographic characteristics of children with anaemia, stunting and co-morbidity of these conditions were compared with those of ‘healthy’ children in the sample (children who were not stunted and not anaemic) using multiple logistic models.
Setting
Low- and middle-income countries.
Subjects
Children aged 6–59 months.
Results
Data from 193 065 children from forty-three countries were included. The pooled proportion of co-morbid anaemia and stunting was 21·5 (95 % CI 21·2, 21·9) %, ranging from the lowest in Albania (2·6 %; 95 % CI 1·8, 3·7 %) to the highest in Yemen (43·3; 95 % CI 40·6, 46·1 %). Compared with the healthy group, children with co-morbidity were more likely to be living in rural areas, have mothers or main carers with lower educational levels and to live in poorer households. Inequality in children who had both anaemia and stunting was apparent in all countries.
Conclusions
Co-morbid anaemia and stunting among young children is highly prevalent in low- and middle-income countries, especially among more disadvantaged children. It is suggested that they be considered under a syndemic framework, the Childhood Anaemia and Stunting (CHAS) Syndemic, which acknowledges the interacting nature of these diseases and the social and environmental factors that promote their negative interaction.
In low- and middle-income countries little is known about changes in
women's mental health status from the perinatal period to 15 months
postpartum or the factors associated with different trajectories.
Aims
To determine the incidence and rates of recovery from common mental
disorders (CMD) among rural Vietnamese women and the risk and protective
factors associated with these outcomes from the perinatal period to 15
months after giving birth.
Method
In a population-based prospective study, a systematically recruited
cohort of women completed baseline assessments in either the last
trimester of pregnancy or 4–6 weeks after giving birth and were followed
up 15 months later. The common mental disorders of major depression,
generalised anxiety and panic disorder were assessed by
psychiatrist-administered Structured Clinical Interview for DSM-IV
Disorders at both baseline and follow-up.
Results
A total of 211 women provided complete data in this study. The incidence
rate of CMD in the first postpartum year was 13% (95% CI 8–19), and 70%
(95% CI 59–80) of women who had perinatal CMD recovered within the first
postpartum year. Incidence was associated with having experienced
childhood maltreatment, experiencing the intimate partner as providing
little care, sensitivity, kindness or affection, and the chronic stress
of household poverty. Recovery was associated with higher quality of a
woman's relationships with her intimate partner and her own mother,
longer period of mandated rest following birth, and sharing of domestic
tasks and infant care.
Conclusions
Modifiable social factors, in particular the quality of a woman's closest
relationships with her partner and her own mother, and participation by
family members in domestic work and infant care, are closely related to
women's mental health in the first year after giving birth in
resource-constrained settings.
High field magnetization experiments are reported for dilute Zn1−xMnxTe alloys (x≃0.03) at T=1.3K. The first magnetization step is analyzed including effects of internal field due to the interactions of Mn-Mn pairs with the remaining spins. An accurate estimate of the nearest neighbor (NN) exchange constant is obtained which agrees quite well recent neutron scattering experiments.
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