Cleft Lip/Palate in Tanzanian Children and Its Relationship with Socio-Demographic Factors and Oral-Health Status

Cleft Lip/Palate in Tanzanian Children and Its Relationship with Socio-Demographic Factors and Oral-Health Status
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  prevalence overall and a six-fold increase among females [FPG: 2.22% vs.HbA1c: 13.31%]. Screening based on FPG-only identi fi ed older undiagnosedcases, with a mean age of 58.7 years [95% CI: (59.9, 63.4)]. Similarly, usingHbA1c identi fi ed younger individuals with prediabetes, with reduced BMIand waist circumference compared to FPG. Conclusions:  In this  fi rst study of a nationally-representative sample withbio-specimen measures,wefound that theprevalence of undiagnosed T2DMand prediabetes was signi fi cantly higher using HbA1c compared to FPG.Further evaluation is needed to fully assess the impact of using HbA1c cri-teria. P67. Twin Faces! Vitamin E and Respiratoryand Atopic Diseases Sreenivas Phanikumar Veeranki MBBS, DrPH, MPH, Yan Cao PhD,Shimin Zheng PhD. Vanderbilt University School of Medicine Purpose:  Atopy clinical studies identi fi ed a number of protective dietaryfactors, including vitamin E, with con fl icting results. This might be due todifferent isoforms of tocopherol that might regulate the allergen-mediatedin fl ammatory response. This study aims to determine association of vitaminE isoforms ( a - and  g -tocopherol) with wheeze and atopy. Methods:  Data (n  ¼  9463) on serum  a - and  g -tocopherol levels and atopywere obtained from the 2005-2006 National Health and Nutrition Exami-nation Survey. Atopy was de fi ned as having at least one positive allergen-speci fi c IgE level measured for a panel of 5 common aeroallergens- cat, dog,house dust mite, cock roach, and Alternaria species. Doctor-diagnosedwheeze in previous 12 months was assessed by self-reported questionnaire.Multivariablelogisticregressionwasconductedtoinvestigatetheassociationofserum a -and g -tocopherollevelswithwheezeandatopyadjustingforage,sex, race, smoking, body mass index and poverty income ratio. Results:  Overall, 15% and 28% of participants had wheeze and atopy,respectively. The odds of having a wheeze decreased across quartiles of   a -tocopherol, but increased with  g -tocopherol. Compared to respective  fi rstquartiles, the fourth quartile of   a -tocopherol was associated with decreasedoddsof wheeze(adjustedoddsratio[AOR]0.73,95% con fi dence interval[CI]:0.57-0.93), while that of   g -tocopherol was associated with increased odds(AOR 2.04, 95% CI: 1.66-2.51). Conclusion:  Serum  a -tocopherol was found to be protective factor forwheeze and atopy, while  g -tocopherol a risk factor. Findings contribute toongoingefforts inunderstandingtheroleofdietaryfactorsinrespiratoryandatopic diseases. Pediatrics P68. Epidemiological Study of the Attention-De fi citHyperactivity Disorder Among Moroccan Children Fatima-Zahra Azzaoui PhD, H. Hami, A. Ahami, S. Boughribil, S. Boulbaroud,M. Faculty of Science Ben M ’ Sik Elhioui Purpose:  The Gharb plain (zone of study) is one of the most importantagricultural and industrial regions of the Kingdom that suffers from theincrease of different polluting human activities and low incomes, especiallyin the rural zones. The objective of this study is to evaluate the AttentionDe fi cit Hyperactivity Disorder (ADHD) in urban, periurban and ruralschooled children living in Gharb plain (North-West of Morocco), and tostudy the relationship between this neurobehavioral disorder (ADHD) andthe quality of life and environment. Methods:  Thiscrosssectionalstudyisconductedamong130children,aged6to8 years. Two questionnaires are used; one based on the DSMVI toevaluateADHD and another about quality of life and environment of children. Results:  TheobtainedresultsshowthattheimportantpercentageofADHDisfound in the rural school children (33%), compared to 28% and 11% in peri-urban and urban ones, respectively. Indeed, signi fi cant correlations betweenthis disorder and the consumption of well water (p > 0.05), the storing con-dition of water (p > 0.01), the PICA syndrome (p > 0.05) and the decrease of red meat consumption (p > 0.01) are registered. Conclusions:  The ADHD disorder founded in these children appeared inconnection with some environmental and nutritional factors, but a deeperinvestigation is needed for studying all possible factors that can cause thisimpairment. P69. Associations Between Aggravation in Parenting andMaternal Age at Birth Hannah Crooke MPH, Catherine W. Striley PhD, MSW, MPE. University of Florida Purpose:  Adolescent and young mothers are more likely to face social andeconomic adversity. Parental aggravation has previously been linked withanxiety, stress and economic adversity. The purpose of this analysis was todetermine the relationship between maternal age at birth and maternalaggravation in parenting one year after birth. Methods:  Baseline and year one data from the Fragile Families and Child-hood Wellbeing study was used. Parental aggravation was measured withseven variables scored on a scale of 1-4 and averaged; maternal age was acontinuous variable. Model one showed associations between education,poverty and maternal age. Model two showed relationships betweenparental aggravation and having a low birth weight child, race, poverty, andeducation level. Parental aggravation was also modeled with partial beta-weights, created in model one, showing the effect of maternal age outside of education and poverty. Results:  Lowermaternalageatbirth was associatedwithbeingbetween50%and 90% of the federal poverty level (p ¼ 0.03), and having less education(p < 0.0001). Parental aggravation was associated with having a low birthweight child (p ¼ 0.003), and being black non-Hispanic (p ¼ 0.01) or Hispanic(p ¼ 0.006) compared to being white, non-Hispanic. Parental aggravationwasnotsigni fi cantlyassociatedwithindependenteffectsofmaternalageatbirth. Conclusions:  Parental aggravation is not associated with maternal age atbirth,butratherwithunderlyingfactorsalsoassociatedwithyoungmaternalage. Results should be used to further understand the complex nature of becoming a young mother, and help inform interventions that support andeducate this population. P70. Sociodemographic Aspects Associated with FerritinDe fi ciency in Colombian Children Katherine González-Ruíz MSc, Javier Martínez-Torres MPH, Jose Meneses-Echávez MPH, Robinson Ramirez Velez PhD, Jorge Correa-Bautista PhD.Universidad Manuela Beltran Purpose:  To examine the factors associated to ferritin de fi ciency in a rep-resentative sample of Colombian children ’ s. Method:  Descriptiveandtransversalstudy,secondarytothedataobtainedinthe National Survey of Nutritional Situation in Colombia (ENSIN 2010), in3.542 children ’ s between 12-59 months of age. Plasmatic levels of ferritinwere determined through chemiluminescence and the associated factors(sex, age,ethnicity, SISBEN score,region and geographic area)werecollectedwith a structured survey. Results:  The serum ferritin level CI95% 30.7 to 35.6  m g/L with the meanvalue of 32.1  m g/L. The 10.6% of children ’ s had ferritin levels lower than 12 m g/L. Regression models shown that to be into the 20-23 months of agegroup (OR 5.30 IC95% 3.40 to 8.25), to reside in atlantic zone (OR 2.24 IC95%1.29 to 3.90), paci fi c zone (OR 2.20 IC95% 1.26 to 3.87), and belong to anindigenous ethnic group (OR 2.14 IC95% 1.41 to 3.25), were associated toferritin de fi ciency. Conclusion:  Integral interventions addressing both nutritional and educa-tional components are required. P71. Cleft Lip/Palate in Tanzanian Children and Its Relationship with Socio-Demographic Factors and Oral-Health Status Matilda Mtaya Mlangwa PhD, Emeria Mugonzibwa PhD, Ditte Lundvig PhD,Frank Wagener PhD, Hans Von Den Hoff PhD, Anne Marie Kuijpers-JagtmanPhD. Muhimbili University of Health and Allied Sciences Purpose:  Cleft lip and palate are serious birth defects affecting approx-imately 1 in 600 newborns worldwide. Studies have shown inter-relation-ship between environmental risk factors and clefts, with psychosocial andoral-health impacts. The purpose of this study was to determine cleft-typeprevalence, associated socio-demographic risk indicators and oral healthimpacts in Tanzanian children.  Abstracts / Annals of Epidemiology 24 (2014) 682 e 702 698  Methods:  Cross sectional hospital-based study was conducted in 4 majorhospitals in Tanzania from 2012 -2014. Parents/guardians of 175 childrenwere assessed about their socio-demographic pro fi le by questionnaires.Children were clinically examined for cleft types and oral health status.Analysis elicited frequency distributions, cross tabulations and Chi-squarestatistics were used to assess bivariate relationships (P < 0.05). Results:  Majority were: boys (54.3%), below 5-years (86.3%; 37.7% below 1-year), rural dwellers (80.6%) and with low-educated parents (89.1%). Mostchildren had complete-unilateral cleft lip (52%), more on left side (37.1%).Complete-bilateral clefts were common (18%) than incomplete (4%). Hard-soft palate clefts were found in 37.1% and soft palate-only in 2.9%. Maloc-clusion, caries and poororalhygienewerefound in 48.6%, 28.4% and 42.3% of children, respectively. Signi fi cant association (p < 0.05) was such that; bilat-eral clefts were more in children below than above 1-year, cleft of the softpalate-only was more in children above than below 5-years and a cleft of both palates was more in urban than rural dwellers. Conclusion:  Complete-unilateral cleft lip was the commonest type,malocclusion were the commonest oral- health impacts, rural dwellers andlow-level of parents ’  educationweresigni fi cant risk indicators for lip/palate-clefts in Tanzanian children. P72. Longer Breastfeeding Duration Reduces the PositiveRelationships among Gestational Weight Gain, Birthweight,and Childhood Growth Yeyi Zhu PhD, Ladia M. Hernandez PhD, Yongquan Dong MS, John H. HimesPhD, Steven Hirschfeld PhD, MD, Michele R. Forman PhD. University of Texasat Austin Purpose:  The relationship between gestational weight gain (GWG) andchildhood growth remains controversial; thus an examinationwhetherearlylife nutrition mediates this relationship mayimproveour understanding. Weaimed to investigate whether the relationships among GWG, birthweight,and childhood anthropometrics were mediated through infant feedingpractices (i.e., breastfeeding duration and age at introduction of solid foods). Methods:  In a cross-sectional multi-ethnic study of 1387 mothers and theirchildren aged 0-5.9 years in the US (2011-2012), perinatal and socio-demo-graphic factors were collected from the mother via an interviewer-admin-istered questionnaire. Child anthropometrics included age- and sex-speci fi cz-scoresfor:weight-for-age(WAZ), height/length-for-age(HAZ), weight-for-height/length (WHZ) and body mass index-for-age (BMIZ), and ulnar length,a linear marker for skeletal growth. Mediation analysis was used to calculatestandardized coef  fi cients of the paths among GWG, birthweight, infantfeeding, and anthropometrics. Results:  Maternal GWG had a consistent positive effect on all anthro-pometrics mediated via birthweight, whereas longer breastfeeding durationreduced the positive associations of GWG and birthweight with WAZ, WHZ,and BMIZ (Π 2 ¼  -0.076, -0.062, and -0.124, respectively) in non-Hispanics.Longer breastfeeding duration and a later age at introduction of solid foodswere both positively associated with ulnar length (Π 2 ¼  0.021 and 0.030,respectively) not HAZ, suggesting for the  fi rst time a distinct effect of infantfeeding practices on limb growth. Conclusions:  Findings suggestpromotingbreastfeedingamongwomenwithexcessive GWG may mitigate offspring obesity. Future prospective researchinvestigating ethnic-speci fi c interrelationships among GWG, birthweight,infant feeding, and postnatal growth are warranted. Public Health P73. Performance-Enhancing Dietary Supplements and Other Health Related Factors Associated with Adverse MedicalOutcomes in Active Duty U.S. Army Soldiers Esther O. Dada MPH, Chiping Nieh PhD, Theresa Jackson PhD, MPH,Samar DeBakey MD, MPH, Bruce H. Jones MD, MPH. U.S. Army Institute of Public Health, U.S. Army Public Health Purpose:  Amid safety concerns over dietary supplements containing dime-thylamylamine (DMAA), this study examined associations between DMAAuse and other potential risk factors with experiencing adverse medicaloutcomes (AMOs) among Active Duty U.S. Army Soldiers. Methods:  A case-control study was conducted among 712 Army Soldierswith clinician-identi fi ed AMO (cardiac dysrhythmia, seizure, heat injury,rhabdomyolysis,cerebralhemorrhage,acute/subacutenecrosisof liver,acutekidney failure) and 1,077 controls, ascertained from Defense Medical Sur-veillance System. Participants completed questionnaire on DMAA use,physical activity/ fi tness, sleep, medication and substance use. Multivariatelogistic regression was performed to examine associations between DMAAuse and other potential risk factors and AMOs. Results:  No statistically signi fi cant association was observed between self-reported DMAA use and selected AMOs after controlling for relevant factors(adjusted odds ratio [aOR] 95% con fi dence interval [CI] of 0.85 (0.59-1.23)).However, Soldiers with multiple AMOs were twice as likely to have reportedusing DMAA compared tothose with one reported outcome (OR 2.28 (95% CI1.01-4.95)). Soldiers with prior AMO were almost 18 times more likely tohave a current AMO (aOR 17.86 (95% CI 9.60-33.22)). Soldiers who reportedantidepressantusewereaboutthreetimesmorelikelytoexperienceanAMO(aOR 2.75 (95% CI 1.96-3.87)). Conclusions:  While this study did not  fi nd that simply using DMAAincreasedthelikelihood of Service members experiencing anAMO,study didshow that those with multiple AMOs were twice as likely to use DMAA. Thestrongest predictor of AMOs was prior AMO suggesting the importance of prevention strategies to reduce reoccurrence. P74. Risk Pro fi les of Younger and Older Pregnant Women WhoConsume Alcohol During Pregnancy  Panagiota Kitsantas PhD, Kathleen Gaffney, Carol Wu. George MasonUniversity Purpose:  Recent studies indicate that older women are more likely to con-sume alcohol during pregnancy. However, little is known about alcoholconsumption during pregnancy within the context of maternal age. Thisstudy identi fi es risk pro fi les of younger and older women who are at risk of consuming alcohol during pregnancy using classi fi cation and regressiontrees (CART) analysis. Methods:  We used the 2002-2009 Pregnancy Risk Assessment MonitoringSystem (PRAMS) dataset (311,428 records U.S. women). Logistic regressionand classi fi cation trees were constructed separately for age groups,  24,25-29, and  30 years. Results:  Alcohol consumption by age group was: 3.7% for  24, 5.7% for 25-29, and 10.1% for  30 years of age.Women  24years were at greater risk of consuming alcohol if they also smoked (5.8%). Among nonsmokers, higherlevelsofeducationandbeingHispanicwereassociatedwitha35%increaseinalcohol use. Distinct high-risk subgroups emerged for the 25-29 year oldgroup. Speci fi cally, 12.8% of non-obese women who reported having expe-rienced abuse during pregnancy also reported drinking alcohol in the lasttrimester.About16%ofwomen  30yearswithatleast16yearsofeducation,white or Hispanic with normal or underweight BMI, drank alcohol duringtheir last trimester. Conclusions:  Given limited health care resources for prevention and treat-ment, the early identi fi cation of high-risk groups for prenatal alcohol use iscritical. This study provides evidence that risk factors contributing to alcoholconsumption during pregnancy may differ by maternal age. P75. Status Epilepticus and Subsequent Epilepsy  Angela M. Malek PhD, Dulaney A. Wilson PhD, Braxton B. Wannamaker MD,Gabriel U. Martz MD, Gigi Smith PhD, APRN, CPNP-PC, Anbesaw W. SelassieDrPH. Medical University of South Carolina Purpose:  The incidence of status epilepticus (SE), characterized by con-tinuous seizures lasting  > 5 minutes or repeated seizures without regainingconsciousness, ranges from 6.8-41 per 100,000 persons (DeLorenzo 1995;Wu 2002). Few studies have investigated SE and subsequent epilepsy. Weevaluated risk of subsequent epilepsy after SE and described associatedcomorbid conditions Methods:  This retrospective cohort study included South Carolina hospi-talizations and emergency department (ED) visits from 2000-2011. Allindividuals with SE were identi fi ed and classi fi ed based on a subsequentepilepsy diagnosis. Individuals with known epilepsy prior tothe diagnosis of SE and persons with epilepsia partialis continua were excluded. Descriptivestatisticswereusedtocomparedemographicandclinical characteristics.Cox  Abstracts / Annals of Epidemiology 24 (2014) 682 e 702  699
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