TY - JOUR
T1 - Household food insecurity, maternal nutrition, environmental risks and infants' health outcomes
T2 - Protocol of the IMPALA birth cohort study in Uganda
AU - Terfa, Zelalem G.
AU - Nantanda, Rebecca
AU - Lesosky, Maia
AU - Devereux, Graham
AU - Obasi, Angela
AU - Mortimer, Kevin
AU - Khan, Jahangir
AU - Rylance, Jamie
AU - Niessen, Louis Wihelmus
N1 - Funding Information:
Funding This research was commissioned by the National Institute of Health Research using Official Development Assistance funding (IMPALA grant number 16/136/35). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.
Publisher Copyright:
© 2022 Authors
PY - 2022/3/18
Y1 - 2022/3/18
N2 - Introduction In low- and middle-income countries (LMICs), food insecurity and undernutrition disproportionately affect women of reproductive age, infants and young children. The disease burden from undernutrition in these vulnerable sections of societies remains a major concern in LMICs. Biomass fuel use for cooking is also common in LMICs. Empirical evidence from high-income countries indicates that early life nutritional and environmental exposures and their effect on infant lung function are important; however, data from sub-Saharan Africa are scarce. Aim To estimate the association between infant lung function and household food insecurity, energy poverty and maternal dietary diversity. Methods and analysis Pregnant women will be recruited in an existing Health and Demographic Surveillance Site in South-West Uganda. Household food insecurity, sources and uses of energy, economic measures and maternal dietary diversity will be collected during pregnancy and after birth. Primary health outcomes will be infant lung function determined by tidal breath flow and volume analysis at 6-10 weeks of age. Infant weight and length will also be collected. A household Food Consumption Score and Minimum Dietary Diversity for Women (MDD-W) indicator will be constructed. The involved cost of dietary diversity will be estimated based on MDD-W. The association between household level and mothers' food access indicators and infant lung function will be evaluated using regression models. The Multidimensional Energy Poverty Index (MEPI) will be estimated and used as an indicator of households' environmental exposures. The association between household MEPI and infant lung function will be assessed using econometric models. Ethics and dissemination Ethical approvals have been obtained from Liverpool School of Tropical Medicine (18-059), the Uganda Virus Research Institute Ethics Committee (097/2018) and Uganda National Council for Science and Technology (SS 4846). Study results will be shared with participants, policy-makers, other stakeholders and published in peer-reviewed journals.
AB - Introduction In low- and middle-income countries (LMICs), food insecurity and undernutrition disproportionately affect women of reproductive age, infants and young children. The disease burden from undernutrition in these vulnerable sections of societies remains a major concern in LMICs. Biomass fuel use for cooking is also common in LMICs. Empirical evidence from high-income countries indicates that early life nutritional and environmental exposures and their effect on infant lung function are important; however, data from sub-Saharan Africa are scarce. Aim To estimate the association between infant lung function and household food insecurity, energy poverty and maternal dietary diversity. Methods and analysis Pregnant women will be recruited in an existing Health and Demographic Surveillance Site in South-West Uganda. Household food insecurity, sources and uses of energy, economic measures and maternal dietary diversity will be collected during pregnancy and after birth. Primary health outcomes will be infant lung function determined by tidal breath flow and volume analysis at 6-10 weeks of age. Infant weight and length will also be collected. A household Food Consumption Score and Minimum Dietary Diversity for Women (MDD-W) indicator will be constructed. The involved cost of dietary diversity will be estimated based on MDD-W. The association between household level and mothers' food access indicators and infant lung function will be evaluated using regression models. The Multidimensional Energy Poverty Index (MEPI) will be estimated and used as an indicator of households' environmental exposures. The association between household MEPI and infant lung function will be assessed using econometric models. Ethics and dissemination Ethical approvals have been obtained from Liverpool School of Tropical Medicine (18-059), the Uganda Virus Research Institute Ethics Committee (097/2018) and Uganda National Council for Science and Technology (SS 4846). Study results will be shared with participants, policy-makers, other stakeholders and published in peer-reviewed journals.
KW - economics
KW - epidemiology
KW - public health
KW - respiratory infections
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U2 - 10.1136/bmjopen-2021-050729
DO - 10.1136/bmjopen-2021-050729
M3 - Article
C2 - 35304392
AN - SCOPUS:85126654896
SN - 2044-6055
VL - 12
JO - BMJ open
JF - BMJ open
IS - 3
M1 - e050729
ER -