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2013
Neumann CG, Bwibo NO, Jiang L, Weiss RE. "School snacks decrease morbidity in Kenyan schoolchildren: a cluster randomized, controlled feeding intervention trial." Public Health Nutr. 2013:1-12. Abstractschool_snacks_decrease_morbidity_in_kenyan_schoolchildren.pdf

OBJECTIVE: To examine the effects of three different school snacks on morbidity outcomes. DESIGN: Twelve schools were randomized to either one of three feeding groups or a Control group. There were three schools per group in this cluster randomized trial. Children in feeding group schools received school snacks of a local plant-based dish, githeri, with meat, milk or extra oil added. The oil used was later found to be fortified with retinol. Physical status, food intake and morbidity outcomes were assessed longitudinally over two years. SETTING: Rural Embu District, Kenya, an area with high prevalence of vitamin A deficiency. SUBJECTS: Standard 1 schoolchildren (n 902; analytic sample) enrolled in two cohorts from the same schools one year apart. RESULTS: The Meat and Plain Githeri (i.e. githeri + oil) groups showed the greatest declines in the probability of a morbidity outcome (PMO) for total and severe illnesses, malaria, poor appetite, reduced activity, fever and chills. The Meat group showed significantly greater declines in PMO for gastroenteritis (mainly diarrhoea) and typhoid compared with the Control group, for jaundice compared with the Plain Githeri group, and for skin infection compared with the Milk group. The Milk group showed the greatest decline in PMO for upper respiratory infection. For nearly all morbidity outcomes the Control group had the highest PMO and the least decline over time. CONCLUSIONS: The intervention study showed beneficial effects of both animal-source foods and of vitamin A-fortified oil on morbidity status.

Neumann CG, Jiang L, Weiss RE, Grillenberger M, Gewa CA, Siekmann JH, Murphy SP, Bwibo NO. "Meat supplementation increases arm muscle area in Kenyan schoolchildren." Br. J. Nutr.. 2013;109(7):1230-40. Abstractmeat_supplementation_increases_arm_muscle_area_in_kenyan_schoolchildren.pdf

The present study examines the effect of animal-source-food (ASF) intake on arm muscle area growth as part of a larger study examining causal links between ASF intake, growth rate, physical activity, cognitive function and micronutrient status in Kenyan schoolchildren. This randomised, controlled feeding intervention study was designed with three isoenergetic feeding interventions of meat, milk, and plain traditional vegetable stew (githeri), and a control group receiving no snack. A total of twelve elementary schools were randomly assigned to interventions, with three schools per group, and two cohorts of 518 and 392 schoolchildren were enrolled 1 year apart. Children in each cohort were given feedings at school and studied for three school terms per year over 2 years, a total of 9 months per year: cohort I from 1998 to 2000 and cohort II from 1999 to 2001. Food intake was assessed by 24 h recall every 1-2 months and biochemical analysis for micronutrient status conducted annually (in cohort I only). Anthropometric measurements included height, weight, triceps skinfold (TSF) and mid-upper-arm circumference (MUAC). Mid-upper-arm muscle area (MAMA) and mid-upper-arm fat area (MAFA) were calculated. The two cohorts were combined for analyses. The meat group showed the steepest rates of gain in MUAC and MAMA over time, and the milk group showed the next largest significant MUAC and MAMA gain compared with the plain githeri and control groups (P< 0·05). The meat group showed the least increase in TSF and MAFA of all groups. These findings have implications for increasing micronutrient intake and lean body mass in primary schoolchildren consuming vegetarian diets.

Grillenberger, M; Murphy SP; BNO, Neumann CG;, Neumann CG;, Bwibo NO. "High prevalence of inadequate iron intake in rural Kenyan school children.". 2013.
2012
Long JK, Murphy SP, Weiss RE, Nyerere S, Bwibo NO, Neumann CG. "Meat and milk intakes and toddler growth: a comparison feeding intervention of animal-source foods in rural Kenya." Public Health Nutr. 2012;15(6):1100-7. AbstractMeat and milk intakes and toddler growth

To examine the effects of animal-source foods on toddler growth.

2011
Omwami EM, Neumann C, Bwibo NO. "Effects of a school feeding intervention on school attendance rates among elementary schoolchildren in rural Kenya." Nutrition. 2011;27(2):188-93. Abstracteffects_of_a_school_feeding_intervention.pdf

A randomized controlled school feeding intervention offered an opportunity to determine whether school feeding resulted in improved school attendance among elementary schoolchildren in a rural district of Kenya.

2009
Gewa CA, Weiss RE, Bwibo NO, Whaley S, Sigman M, Murphy SP, Harrison G, Neumann CG. "Dietary micronutrients are associated with higher cognitive function gains among primary school children in rural Kenya." Br. J. Nutr.. 2009;101(9):1378-87. Abstractdietary_micronutrients.pdf

With the exception of iodine and Fe, there is still very limited information on the effect of micronutrients on cognitive function, especially among school-age children. The present analysis evaluates the relationship between dietary Fe, Zn and B vitamins (B12, B6, folate and riboflavin) and gains in cognitive test scores among school children in rural Kenya. Data for the present study were obtained from The Child Nutrition Kenya Project, a 2-year longitudinal, randomised controlled feeding intervention study using animal source foods. Dietary nutrient values were based on monthly and bimonthly 24 h recall data collected during the study period. In longitudinal regression analyses, available Fe, available Zn, vitamin B12 and riboflavin showed significant relationships with improved cognitive test scores, after controlling for confounders such as energy intake, school, socio-economic status and morbidity. Available Fe intake was associated with significantly higher gains in Raven's Coloured Progressive Matrices test scores over time. Available Zn intake was associated with significantly higher gains in digit span-total test scores over time, while vitamin B12 and riboflavin intakes were each associated with significantly higher gains in digit span-forward test scores over time. This analysis demonstrates the influence of improved dietary micronutrient status on school children's cognitive function.

2008
Neumann CG, Bwibo NO, Siekmann JH, McLean ED, Browdy B, Drorbaugh N. "Comparison of blood smear microscopy to a rapid diagnostic test for in-vitro testing for P. falciparum malaria in Kenyan school children.". 2008. Abstractcomparison_of_blood_smear_microscopy.pdfWebsite

OBJECTIVE:
To compare the diagnostic performance of microscopy using Giemsa-stained thick and thin blood smears to a rapid malaria dipstick test (RDT) in detecting P. falciparum malaria in Kenyan school children.
DESIGN:
Randomised, controlled feeding intervention trial from 1998-2001.
SETTING:
Rural Embu district, Kenya. The area is considered endemic for malaria, with four rainy seasons per year. Chloroquine resistance was estimated in 80% of patients. Children had a spleen rate of 45%.
SUBJECTS:
A sample of 515 rural Kenyan primary school children, aged 7-11 years, who were enrolled in a feeding intervention trial from 1998-2001.
MAIN OUTCOME MEASURES:
Percent positive and negative P. falciparum malaria status, sensitivity, specificity and positive and negative predictive values of RDT
RESULTS:
For both years, the RDT yielded positive results of 30% in children compared to microscopy (17%). With microscopy as the "gold standard", RDT yielded a sensitivity of 81.3% in 1998 and 79.3% in 2000. Specificity was 81.6% in 1998 and 78.3% in 2000. Positive predictive value was 47.3% in 1998 and 42.6% in 2000, and negative predictive value was 95.6% in 1998 and 94.9% in 2000.
CONCLUSION:
Rapid diagnostic testing is a valuable tool for diagnosis and can shorten the interval for starting treatment, particularly where microscopy may not be feasible due to resource and distance limitations

O PROFBWIBONIMROD. "Dietary micronutrients are associated with higher cognitive function gains among primary school children in rural Kenya. Gewa CA, Weiss RE, Bwibo NO, Whaley S, Sigman M, Murphy SP, Harrison G, Neumann CG.Br J Nutr. 2008 Sep 30:1-10. [Epub ahead of print].". In: Br J Nutr. 2008 Sep 30:1-10. [Epub ahead of print]. Anim. Hlth. Prod. Afr. 2008; 2008. AbstractDietary micronutrients.pdf

With the exception of iodine and Fe, there is still very limited information on the effect of micronutrients on cognitive function, especially among school-age children. The present analysis evaluates the relationship between dietary Fe, Zn and B vitamins (B12, B6, folate and riboflavin) and gains in cognitive test scores among school children in rural Kenya. Data for the present study were obtained from The Child Nutrition Kenya Project, a 2-year longitudinal, randomised controlled feeding intervention study using animal source foods. Dietary nutrient values were based on monthly and bimonthly 24 h recall data collected during the study period. In longitudinal regression analyses, available Fe, available Zn, vitamin B12 and riboflavin showed significant relationships with improved cognitive test scores, after controlling for confounders such as energy intake, school, socio-economic status and morbidity. Available Fe intake was associated with significantly higher gains in Raven's Coloured Progressive Matrices test scores over time. Available Zn intake was associated with significantly higher gains in digit span-total test scores over time, while vitamin B12 and riboflavin intakes were each associated with significantly higher gains in digit span-forward test scores over time. This analysis demonstrates the influence of improved dietary micronutrient status on school children's cognitive function.

2007
O PROFBWIBONIMROD. "Designing snacks to address micronutrient deficiencies in rural Kenyan schoolchildren. J Nutr . 2007 Apr; 137 ( 4 ): 1093-6 . Review. PMID: 17374685 [PubMed - indexed for MEDLINE] Murphy SP, Gewa C, Grillenberger M, Bwibo NO, Neumann CG.". In: J Nutr . 2007 Apr; 137 ( 4 ): 1093-6 . Review. PMID: 17374685 [PubMed - indexed for MEDLINE]. Anim. Hlth. Prod. Afr. 2008; 2007. Abstractdesigning_snacks_to_address_micronutrient.pdf

University of Hawaii, Honolulu, HI 96813, USA. suzanne@crch.hawaii.edu

Three snacks were designed to improve nutrient intakes among school-age children living in rural Kenya. Snacks containing animal-source foods (milk and meat) provided more nutrients than an equicaloric vegetarian snack. The vegetarian snack provided extra vitamin A (primarily from fortified cooking fat; the milk snack was rich in calcium, vitamin A, and vitamin B-12; and the meat snack supplied vitamin B-12, iron, and zinc. When changes in intakes from baseline to the feeding period were compared across the 4 groups, total energy intake increased the most for children in the meat group and the least for children in the control group. Differences in energy intakes across the 3 feeding groups were primarily caused by decreases in home intake for the vegetarian and milk snack groups. It is important to evaluate the change in home intakes as well as intakes from the foods provided by the study when evaluating the effect of feeding programs on nutrient adequacy.

PMID: 17374685 [PubMed - indexed for MEDLINE]

O PROFBWIBONIMROD. "Low plasma vitamin B-12 in Kenyan school children is highly prevalent and improved by supplemental animal source foods. J Nutr . 2007 Mar; 137 ( 3 ): 676-82 . PMID: 17311959 [PubMed - indexed for MEDLINE] McLean ED, Allen LH, Neumann CG, Peerson JM, Siekm.". In: J Nutr . 2007 Mar; 137 ( 3 ): 676-82 . Anim. Hlth. Prod. Afr. 2008; 2007. Abstractlow_plasma_vitamin_b-12.pdf

Department of Nutritional Biology, University of California, Davis, CA 95616, USA.

The high prevalence of vitamin B-12 deficiency in many regions of the world is becoming recognized as a widespread public health problem, but it is not known to what extent this deficiency results from a low intake of the vitamin or from its malabsorption from food. In rural Kenya, where a previous study identified a high prevalence of inadequate vitamin B-12 intakes, this study examined whether plasma vitamin B-12 concentrations were associated with dietary sources of the vitamin at baseline and could be increased by supplementation with animal source foods (ASF). The 4 experimental groups in 503 school children were: 1) control (no food provided); 2) githeri (a maize and bean staple with added oil); 3) githeri + meat (githeri + minced beef); or 4) githeri + milk (githeri + milk). Feedings were isocaloric. Dietary data were collected at baseline, and biochemical data at baseline and after 1 and 2 y of feeding. Baseline plasma vitamin B-12 concentration was 193.6 +/- 105.3 pmol/L and correlated with % energy from ASF (r = 0.308, P < 0.001). The odds ratio for low plasma vitamin B-12 (<148 pmol/L), which occurred in 40% of children, was 6.28 [95% CI: 3.07-12.82] for the lowest vs. highest ASF intake tertile (P < 0.001). Feeding ASF (meat or milk) greatly reduced the prevalence of low plasma vitamin B-12 (P < 0.001). The high prevalence of low plasma vitamin B-12 concentrations in these children is predicted by a low intake of ASF, and supplemental ASF improves vitamin B-12 status.

PMID: 17311959 [PubMed - indexed for MEDLINE]

O PROFBWIBONIMROD. "Meat supplementation improves growth, cognitive, and behavioral outcomes in Kenyan children. J Nutr . 2007 Apr; 137 ( 4 ): 1119-23 . PMID: 17374691 [PubMed - indexed for MEDLINE] Neumann CG, Murphy SP, Gewa C, Grillenberger M, Bwibo NO.". In: J Nutr . 2007 Apr; 137 ( 4 ): 1119-23 . Anim. Hlth. Prod. Afr. 2008; 2007. Abstractmeat_supplementation_improves_growth.pdf

Department of Community Health Sciences, School of Public Health, University of California, Los Angeles, CA 90095, USA. cneumann@mednet.ucla.edu

A randomized, controlled school feeding study was conducted in rural Embu District, Kenya to test for a causal link between animal-source food intake and changes in micronutrient nutrition and growth, cognitive, and behavioral outcomes. Twelve primary schools were randomly assigned to 1 of 4 groups. Children in Standard I classes received the local plant-based dish githeri as a midmorning school snack supplemented with meat, milk, or fat added to equalize energy content in all feedings. The Control children received no feedings but participated in data collection. Main outcome measures assessed at baseline and longitudinally were 24-h food intake recall, anthropometry, cognitive function, physical activity, and behaviors during school free play. For cognitive function, the Meat group showed the steepest rate of increase on Raven's Progressive Matrices scores and in zone-wide school end-term total and arithmetic test scores. The Plain githeri and Meat groups performed better over time than the Milk and Control groups (P < 0.02-0.03) on arithmetic tests. The Meat group showed the greatest increase in percentage time in high levels of physical activity and in initiative and leadership behaviors compared with all other groups. For growth, in the Milk group only younger and stunted children showed a greater rate of gain in height. The Meat group showed near doubling of upper midarm muscle area, and the Milk group a smaller degree of increase. This is the first randomized, controlled feeding study to examine the effect of meat- vs. milk- vs. plant-based snacks on functional outcomes in children.

PMID: 17374691 [PubMed - indexed for MEDLINE]

O PROFBWIBONIMROD, N PROFWEREFREDRICK. "Neonatal nutrition and later outcomes of very low birth weight infants at Kenyatta national hospital Afr Health Sci. 2007 June; 7 (2) : 108.". In: Afr Health Sci. Anim. Hlth. Prod. Afr. 2008; 2007. Abstractneonatal_nutrition.pdf

Extensive research in developed countries has established that very low birth weight (VLBW) infants are particularly vulnerable to the effects of early nutritional deficiencies. There is, however, little information from poor countries on the long-term effects of these deficiencies in such infants.

Determine the association between neonatal feeding regimens and post-discharge morbidity/ mortality and neurological abnormalities at the age of two years for a cohort of VLBW infants.

One hundred and seventy five VLBW infants were recruited over a consecutive period of one year and followed up to the age of two years corrected for gestation. With neonatal feeding regimes as the exposure variable, post-discharge re-hospitalization, mortality and Saigal and Rosenbaum's functional disability assessment scores were compared as the outcome variables.

O PROFBWIBONIMROD. "The potential of increased meat intake to improve iron nutrition in rural Kenyan schoolchildren. Int J Vitam Nutr Res . 2007 May; 77 ( 3 ): 193-8 . PMID: 18214020 [PubMed - indexed for MEDLINE] Grillenberger M, Murphy SP, Neumann CG, Bwibo NO, Verhoef H,.". In: Int J Vitam Nutr Res . 2007 May; 77 ( 3 ): 193-8 . Anim. Hlth. Prod. Afr. 2008; 2007. Abstractthe_potential_of_increased_meat_intake_to_improve_iron_nutrition.pdf

Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.

Schoolchildren in developing countries often have inadequate intakes of iron, due primarily to poor bioavailability. Increasing meat in the diet could improve both the amount of iron consumed and its availability. The effect of increases in intakes of meat and ascorbic acid on absorbed iron was investigated by theoretically modifying the habitual diet of rural Kenyan schoolchildren. The projected changes in the amount of absorbed iron and prevalence of inadequate iron intakes were calculated for 78 children (6-9 years of age). The prevalence of inadequate iron intakes decreased from 77% to 54% through the theoretical addition of 50 g beef or 100 mg ascorbic acid and to 23% through the addition of both to dinner each day. To reduce the prevalence of inadequate iron intake to 5%, the addition of 100 g meat plus 150 mg ascorbic acid would be necessary. The combined addition of meat and ascorbic acid to a meal has the potential to reduce the projected prevalence of inadequate iron intakes among these schoolchildren.

PMID: 18214020 [PubMed - indexed for MEDLINE]

2006
Bwibo NO;, Acham JM. "Health education in Kenya- an overview.". 2006.
Grillenberger M;, Neumann CG;, Murphy SP;, Bwibo NO. "Impact of supplementation with animal source foods on morbidity of rural Kenyan school children.". 2006.
Grillenberger M;, Neumann CG;, Murphy SP;, Bwibo NO;, Weiss RE;, Jiang L;, Hautvast JG;, West CE. "Intake of micronutrients high in animal-source foods is associated with better growth in rural Kenyan school children.". 2006. Abstractintake_of_micronutrients_high_in_animal-source_foods.pdf

Observational studies have shown that children in developing countries consuming diets containing high amounts of bioavailable nutrients, such as those found in animal-source foods, grow better. The present study investigated which specific nutrients from the diet of Kenyan school children predicted their growth. The children (n 544, median age 7 years) participated in a 2-year long food supplementation study with animal-source foods. Height gain during the intervention period was positively predicted by average daily intakes of energy from animal-source foods, haem Fe, preformed vitamin A, Ca and vitamin B12. Weight gain was positively predicted by average daily intakes of energy from animal-source foods, haem Fe, preformed vitamin A, Ca and vitamin B12. Gain in mid-upper-arm muscle area was positively predicted by average daily intakes of energy from animal-source foods and vitamin B12. Gain in mid-upper-arm fat area was positively predicted by average daily intakes of energy from animal-source foods. Gain in subscapular skinfold thickness was not predicted by any of the nutrient intakes. Negative predictors of growth were total energy and nutrients that are contained in high amounts in plant foods. The study shows that growth was positively predicted by energy and nutrients that are provided in high amounts and in a bioavailable form in meat and milk, and their inclusion into the diets of children in developing countries should be part of all food-based programmes in order to improve micronutrient status and growth

O PROFBWIBONIMROD, N PROFWEREFREDRICK. "Early growth of very low birth weight infants. East Afr Med J. 2006 Mar;83(3):84-9. Were FN, Bwibo NO.". In: East Afr Med J. 2006 Mar;83(3):84-9. Anim. Hlth. Prod. Afr. 2008; 2006. Abstract

Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, P.O. Box 20956-00202, Nairobi, Kenya. BACKGROUND: Early growth in very low birth weight (VLBW) infants has been found predictive of their later outcomes. This has led to increased interest in establishing measures to optimise such growth. In facilities without the resources required to undertake long-term audits for all the high risk infants they graduate, these growth parameters may also be used as selection criteria for those meriting such follow up reducing costs. OBJECTIVES: To describe early growth patterns among a cohort of VLBW infants and determine some of the factors associated with poor growth among them. DESIGN: Cross section survey. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: One hundred and seventy five neonatal survivors. RESULTS: Of the 175 infants recruited, the male/female ratio was 4:6, sixty four (36.6%) were intrauterine growth retarded while significant illnesses during the neonatal period were reported in 109 (62.3%). Forty seven percent of the infants had been fed on exclusive breast milk, 33% on mixed feeds while 20% received exclusive preterm formula. The mean neonatal weight gain for the whole cohort was 13.5 (3.9) g/kg/day, length of 0.34 (0.11) cm/week and head circumference of 0.32 (0.71) cm/week. By term only 33 (18.9%), 37 (21.1%) and 48 (28%) had reached the expected (the 3rd percentile) weight, length and head circumference respectively. Sixty percent of the infants gained weight at <15 g/kg/day while 70% and 78% grew in head circumference and length at < 0.5 cm/week respectively. At term weight, head and linear growth faultering were recorded in 81%, 72% and 79% respectively. The factors that were associated with better growth at this stage included feeding on preterm formula (P < 0.001) and absence of neonatal morbidity (P < 0.001). Infants who were appropriate for gestational age at birth also had better catch up growth at term compared to those born small for gestation (P < 0.001) but their neonatal growth itself was not significantly better. CONCLUSION: The mean neonatal growth in all anthropometric measures was less than expected and by the time of their expected delivery, less than 30% of these infants had reached the 3rd percentile of the expected measurement in all the three growth parameters. Choice of milk and neonatal morbidity influenced these growth patterns. RECOMMENDATIONS: Routine fortification of mother's milk or addition of preterm formula and reorganised care of sick newborns is recommended to improve early growth. PMID: 16771104 [PubMed - indexed for MEDLINE]

O PROFBWIBONIMROD. "Grillenberger M, Neumann CG, Murphy SP, Bwibo NO, Weiss RE, Jiang L, Hautvast JG, West CE.Intake of micronutrients high in animal-source foods is associated with better growth in rural Kenyan school children. Br J Nutr. 2006 Feb;95(2):379-90.". In: Br J Nutr. 2006 Feb;95(2):379-90. Anim. Hlth. Prod. Afr. 2008; 2006. Abstract

Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, P.O. Box 20956-00202, Nairobi, Kenya. BACKGROUND: Early growth in very low birth weight (VLBW) infants has been found predictive of their later outcomes. This has led to increased interest in establishing measures to optimise such growth. In facilities without the resources required to undertake long-term audits for all the high risk infants they graduate, these growth parameters may also be used as selection criteria for those meriting such follow up reducing costs. OBJECTIVES: To describe early growth patterns among a cohort of VLBW infants and determine some of the factors associated with poor growth among them. DESIGN: Cross section survey. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: One hundred and seventy five neonatal survivors. RESULTS: Of the 175 infants recruited, the male/female ratio was 4:6, sixty four (36.6%) were intrauterine growth retarded while significant illnesses during the neonatal period were reported in 109 (62.3%). Forty seven percent of the infants had been fed on exclusive breast milk, 33% on mixed feeds while 20% received exclusive preterm formula. The mean neonatal weight gain for the whole cohort was 13.5 (3.9) g/kg/day, length of 0.34 (0.11) cm/week and head circumference of 0.32 (0.71) cm/week. By term only 33 (18.9%), 37 (21.1%) and 48 (28%) had reached the expected (the 3rd percentile) weight, length and head circumference respectively. Sixty percent of the infants gained weight at <15 g/kg/day while 70% and 78% grew in head circumference and length at < 0.5 cm/week respectively. At term weight, head and linear growth faultering were recorded in 81%, 72% and 79% respectively. The factors that were associated with better growth at this stage included feeding on preterm formula (P < 0.001) and absence of neonatal morbidity (P < 0.001). Infants who were appropriate for gestational age at birth also had better catch up growth at term compared to those born small for gestation (P < 0.001) but their neonatal growth itself was not significantly better. CONCLUSION: The mean neonatal growth in all anthropometric measures was less than expected and by the time of their expected delivery, less than 30% of these infants had reached the 3rd percentile of the expected measurement in all the three growth parameters. Choice of milk and neonatal morbidity influenced these growth patterns. RECOMMENDATIONS: Routine fortification of mother's milk or addition of preterm formula and reorganised care of sick newborns is recommended to improve early growth. PMID: 16771104 [PubMed - indexed for MEDLINE]

O PROFBWIBONIMROD, N PROFWEREFREDRICK. "Two year neurological outcomes of Very Low Birth Weight infants. East Afr Med J. 2006 May;83(5):243-9. Were FN, Bwibo NO.". In: East Afr Med J. 2006 May;83(5):243-9. Anim. Hlth. Prod. Afr. 2008; 2006. Abstract

Department of Nutritional Biology, University of California, Davis, CA 95616, USA.

The high prevalence of vitamin B-12 deficiency in many regions of the world is becoming recognized as a widespread public health problem, but it is not known to what extent this deficiency results from a low intake of the vitamin or from its malabsorption from food. In rural Kenya, where a previous study identified a high prevalence of inadequate vitamin B-12 intakes, this study examined whether plasma vitamin B-12 concentrations were associated with dietary sources of the vitamin at baseline and could be increased by supplementation with animal source foods (ASF). The 4 experimental groups in 503 school children were: 1) control (no food provided); 2) githeri (a maize and bean staple with added oil); 3) githeri + meat (githeri + minced beef); or 4) githeri + milk (githeri + milk). Feedings were isocaloric. Dietary data were collected at baseline, and biochemical data at baseline and after 1 and 2 y of feeding. Baseline plasma vitamin B-12 concentration was 193.6 +/- 105.3 pmol/L and correlated with % energy from ASF (r = 0.308, P < 0.001). The odds ratio for low plasma vitamin B-12 (<148 pmol/L), which occurred in 40% of children, was 6.28 [95% CI: 3.07-12.82] for the lowest vs. highest ASF intake tertile (P < 0.001). Feeding ASF (meat or milk) greatly reduced the prevalence of low plasma vitamin B-12 (P < 0.001). The high prevalence of low plasma vitamin B-12 concentrations in these children is predicted by a low intake of ASF, and supplemental ASF improves vitamin B-12 status.

PMID: 17311959 [PubMed - indexed for MEDLINE]

2005
O PROFBWIBONIMROD. "Sigman M, Whaley SE, Neumann CG, Bwibo N, Guthrie D, Weiss RE, Liang LJ, Murphy SP.Diet quality affects the playground activities of Kenyan children. Food Nutr Bull. 2005 Jun;26(2 Suppl 2):S202-12.". In: Food Nutr Bull. 2005 Jun;26(2 Suppl 2):S202-12. Anim. Hlth. Prod. Afr. 2008; 2005. Abstract

Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, P.O. Box 20956-00202, Nairobi, Kenya. BACKGROUND: Early growth in very low birth weight (VLBW) infants has been found predictive of their later outcomes. This has led to increased interest in establishing measures to optimise such growth. In facilities without the resources required to undertake long-term audits for all the high risk infants they graduate, these growth parameters may also be used as selection criteria for those meriting such follow up reducing costs. OBJECTIVES: To describe early growth patterns among a cohort of VLBW infants and determine some of the factors associated with poor growth among them. DESIGN: Cross section survey. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: One hundred and seventy five neonatal survivors. RESULTS: Of the 175 infants recruited, the male/female ratio was 4:6, sixty four (36.6%) were intrauterine growth retarded while significant illnesses during the neonatal period were reported in 109 (62.3%). Forty seven percent of the infants had been fed on exclusive breast milk, 33% on mixed feeds while 20% received exclusive preterm formula. The mean neonatal weight gain for the whole cohort was 13.5 (3.9) g/kg/day, length of 0.34 (0.11) cm/week and head circumference of 0.32 (0.71) cm/week. By term only 33 (18.9%), 37 (21.1%) and 48 (28%) had reached the expected (the 3rd percentile) weight, length and head circumference respectively. Sixty percent of the infants gained weight at <15 g/kg/day while 70% and 78% grew in head circumference and length at < 0.5 cm/week respectively. At term weight, head and linear growth faultering were recorded in 81%, 72% and 79% respectively. The factors that were associated with better growth at this stage included feeding on preterm formula (P < 0.001) and absence of neonatal morbidity (P < 0.001). Infants who were appropriate for gestational age at birth also had better catch up growth at term compared to those born small for gestation (P < 0.001) but their neonatal growth itself was not significantly better. CONCLUSION: The mean neonatal growth in all anthropometric measures was less than expected and by the time of their expected delivery, less than 30% of these infants had reached the 3rd percentile of the expected measurement in all the three growth parameters. Choice of milk and neonatal morbidity influenced these growth patterns. RECOMMENDATIONS: Routine fortification of mother's milk or addition of preterm formula and reorganised care of sick newborns is recommended to improve early growth. PMID: 16771104 [PubMed - indexed for MEDLINE]

2004
O PROFBWIBONIMROD. "Neumann CG, Gewa C, Bwibo NO.Child nutrition in developing countries. Pediatr Ann. 2004 Oct;33(10):658-74.". In: Pediatr Ann. 2004 Oct;33(10):658-74. Anim. Hlth. Prod. Afr. 2008; 2004. Abstract

Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, P.O. Box 20956-00202, Nairobi, Kenya. BACKGROUND: Early growth in very low birth weight (VLBW) infants has been found predictive of their later outcomes. This has led to increased interest in establishing measures to optimise such growth. In facilities without the resources required to undertake long-term audits for all the high risk infants they graduate, these growth parameters may also be used as selection criteria for those meriting such follow up reducing costs. OBJECTIVES: To describe early growth patterns among a cohort of VLBW infants and determine some of the factors associated with poor growth among them. DESIGN: Cross section survey. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: One hundred and seventy five neonatal survivors. RESULTS: Of the 175 infants recruited, the male/female ratio was 4:6, sixty four (36.6%) were intrauterine growth retarded while significant illnesses during the neonatal period were reported in 109 (62.3%). Forty seven percent of the infants had been fed on exclusive breast milk, 33% on mixed feeds while 20% received exclusive preterm formula. The mean neonatal weight gain for the whole cohort was 13.5 (3.9) g/kg/day, length of 0.34 (0.11) cm/week and head circumference of 0.32 (0.71) cm/week. By term only 33 (18.9%), 37 (21.1%) and 48 (28%) had reached the expected (the 3rd percentile) weight, length and head circumference respectively. Sixty percent of the infants gained weight at <15 g/kg/day while 70% and 78% grew in head circumference and length at < 0.5 cm/week respectively. At term weight, head and linear growth faultering were recorded in 81%, 72% and 79% respectively. The factors that were associated with better growth at this stage included feeding on preterm formula (P < 0.001) and absence of neonatal morbidity (P < 0.001). Infants who were appropriate for gestational age at birth also had better catch up growth at term compared to those born small for gestation (P < 0.001) but their neonatal growth itself was not significantly better. CONCLUSION: The mean neonatal growth in all anthropometric measures was less than expected and by the time of their expected delivery, less than 30% of these infants had reached the 3rd percentile of the expected measurement in all the three growth parameters. Choice of milk and neonatal morbidity influenced these growth patterns. RECOMMENDATIONS: Routine fortification of mother's milk or addition of preterm formula and reorganised care of sick newborns is recommended to improve early growth. PMID: 16771104 [PubMed - indexed for MEDLINE]

2003
O PROFBWIBONIMROD. "Bwibo NO, Neumann CG.The need for animal source foods by Kenyan children. J Nutr. 2003 Nov;133(11 Suppl 2):3936S-3940S. Review.". In: J Nutr. 2003 Nov;133(11 Suppl 2):. Anim. Hlth. Prod. Afr. 2008; 2003. Abstract

Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, P.O. Box 20956-00202, Nairobi, Kenya. BACKGROUND: Early growth in very low birth weight (VLBW) infants has been found predictive of their later outcomes. This has led to increased interest in establishing measures to optimise such growth. In facilities without the resources required to undertake long-term audits for all the high risk infants they graduate, these growth parameters may also be used as selection criteria for those meriting such follow up reducing costs. OBJECTIVES: To describe early growth patterns among a cohort of VLBW infants and determine some of the factors associated with poor growth among them. DESIGN: Cross section survey. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: One hundred and seventy five neonatal survivors. RESULTS: Of the 175 infants recruited, the male/female ratio was 4:6, sixty four (36.6%) were intrauterine growth retarded while significant illnesses during the neonatal period were reported in 109 (62.3%). Forty seven percent of the infants had been fed on exclusive breast milk, 33% on mixed feeds while 20% received exclusive preterm formula. The mean neonatal weight gain for the whole cohort was 13.5 (3.9) g/kg/day, length of 0.34 (0.11) cm/week and head circumference of 0.32 (0.71) cm/week. By term only 33 (18.9%), 37 (21.1%) and 48 (28%) had reached the expected (the 3rd percentile) weight, length and head circumference respectively. Sixty percent of the infants gained weight at <15 g/kg/day while 70% and 78% grew in head circumference and length at < 0.5 cm/week respectively. At term weight, head and linear growth faultering were recorded in 81%, 72% and 79% respectively. The factors that were associated with better growth at this stage included feeding on preterm formula (P < 0.001) and absence of neonatal morbidity (P < 0.001). Infants who were appropriate for gestational age at birth also had better catch up growth at term compared to those born small for gestation (P < 0.001) but their neonatal growth itself was not significantly better. CONCLUSION: The mean neonatal growth in all anthropometric measures was less than expected and by the time of their expected delivery, less than 30% of these infants had reached the 3rd percentile of the expected measurement in all the three growth parameters. Choice of milk and neonatal morbidity influenced these growth patterns. RECOMMENDATIONS: Routine fortification of mother's milk or addition of preterm formula and reorganised care of sick newborns is recommended to improve early growth. PMID: 16771104 [PubMed - indexed for MEDLINE]

O PROFBWIBONIMROD. "The impact of dietary intervention on the cognitive development of Kenyan school children. J Nutr . 2003 Nov; 133 ( 11 Suppl 2 ): 3965S-3971S . PMID: 14672297 [PubMed - indexed for MEDLINE] Whaley SE, Sigman M, Neumann C, Bwibo N, Guthrie D, Weiss RE, Alb.". In: J Nutr . 2003 Nov; 133 ( 11 Suppl 2 ): 3965S-3971S . Anim. Hlth. Prod. Afr. 2008; 2003. Abstract

Department of Psychiatry and Psychology, Neuropsychiatric Institute, University of California, Los Angeles, CA, USA. swhaley@mednet.ucla.edu

Previous observational studies in developing countries have suggested that diet quality, particularly increased animal source food (ASF) consumption, is positively associated with child cognitive development. This report presents findings from a study in rural Kenya, designed to test the impact of three different diets on the cognitive development of school children. Twelve schools with a total of 555 Standard 1 children (equivalent to U.S. Grade 1) were randomized to one of four feeding interventions: Meat, Milk, Energy or Control (no feeding). Feeding continued for seven school terms (21 mo), and cognitive tests were administered before the commencement of feeding and during every other term of feeding. Hierarchical linear random effects models and associated methods were used to examine the effects of treatment group on changes in cognitive performance over time. Analyses revealed that children receiving supplemental food with meat significantly outperformed all other children on the Raven's Progressive Matrices. Children supplemented with meat, and children supplemented with energy, outperformed children in the Control group on tests of arithmetic ability. There were no group differences on tests of verbal comprehension. Results suggest that supplementation with animal source food has positive effects on Kenyan children's cognitive performance. However, these effects are not equivalent across all domains of cognitive functioning, nor did different forms of animal source foods produce the same beneficial effects. Implications of these findings for supplementation programs in developing countries are discussed.

PMID: 14672297 [PubMed - indexed for MEDLINE]

O PROFBWIBONIMROD. "Kenyan school children have multiple micronutrient deficiencies, but increased plasma vitamin B-12 is the only detectable micronutrient response to meat or milk supplementation. J Nutr . 2003 Nov; 133 ( 11 Suppl 2 ): 3972S-3980S . PMID: 14672298 [PubMed -.". In: J Nutr . 2003 Nov; 133 ( 11 Suppl 2 ): 3972S-3980S . Anim. Hlth. Prod. Afr. 2008; 2003. Abstract

Program in International Nutrition, University of California, Davis, CA 95616, USA.

Animal source foods (ASF) can provide micronutrients in greater amounts and more bioavailable forms compared to plant source foods, but their intake is low in many poor populations. However, the impact of ASF on micronutrient status of undernourished populations has not been assessed. Supplemental meat (60-85 g/d), milk (200-250 mL/d) or energy (isocaloric with the meat and milk, 240-300 kcal/d) were randomly assigned to 555 undernourished school children aged 5-14 y in a rural malaria-endemic area of Kenya, at one school meal daily for one school year. Blood and stool samples were collected at baseline and after 1 y to assess stool parasites, malaria, hemoglobin, serum or plasma C-reactive protein, ferritin, iron, zinc, copper, vitamin B-12, folate and retinol, and erythrocyte riboflavin. At baseline, there was a high prevalence of micronutrient deficiencies (iron, zinc, vitamins A and B-12 and riboflavin), yet plasma ferritin was low in few children, and none had low serum copper. At the end of the year of supplementation, plasma vitamin B-12 concentrations were significantly increased in children fed the Meat or Milk meal; prevalence of severe plus moderate deficiency fell from 80.7% at baseline to 64.1% in the Meat group and from 71.6 to 45.1% in the Milk group, respectively. No significant improvement was observed in the status of other micronutrients compared to the Energy and Control groups, although malaria and other infections may have obscured effects. Supplementation with small amounts of meat or milk reduced the high prevalence of vitamin B-12 deficiency in these children.

PMID: 14672298 [PubMed - indexed for MEDLINE]

O PROFBWIBONIMROD. "Murphy SP, Gewa C, Liang LJ, Grillenberger M, Bwibo NO, Neumann CG.School snacks containing animal source foods improve dietary quality for children in rural Kenya. J Nutr. 2003 Nov;133(11 Suppl 2):3950S-3956S.". In: J Nutr. 2003 Nov;133(11 Suppl 2):3950S-3956S. Anim. Hlth. Prod. Afr. 2008; 2003. Abstract

Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, P.O. Box 20956-00202, Nairobi, Kenya. BACKGROUND: Early growth in very low birth weight (VLBW) infants has been found predictive of their later outcomes. This has led to increased interest in establishing measures to optimise such growth. In facilities without the resources required to undertake long-term audits for all the high risk infants they graduate, these growth parameters may also be used as selection criteria for those meriting such follow up reducing costs. OBJECTIVES: To describe early growth patterns among a cohort of VLBW infants and determine some of the factors associated with poor growth among them. DESIGN: Cross section survey. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: One hundred and seventy five neonatal survivors. RESULTS: Of the 175 infants recruited, the male/female ratio was 4:6, sixty four (36.6%) were intrauterine growth retarded while significant illnesses during the neonatal period were reported in 109 (62.3%). Forty seven percent of the infants had been fed on exclusive breast milk, 33% on mixed feeds while 20% received exclusive preterm formula. The mean neonatal weight gain for the whole cohort was 13.5 (3.9) g/kg/day, length of 0.34 (0.11) cm/week and head circumference of 0.32 (0.71) cm/week. By term only 33 (18.9%), 37 (21.1%) and 48 (28%) had reached the expected (the 3rd percentile) weight, length and head circumference respectively. Sixty percent of the infants gained weight at <15 g/kg/day while 70% and 78% grew in head circumference and length at < 0.5 cm/week respectively. At term weight, head and linear growth faultering were recorded in 81%, 72% and 79% respectively. The factors that were associated with better growth at this stage included feeding on preterm formula (P < 0.001) and absence of neonatal morbidity (P < 0.001). Infants who were appropriate for gestational age at birth also had better catch up growth at term compared to those born small for gestation (P < 0.001) but their neonatal growth itself was not significantly better. CONCLUSION: The mean neonatal growth in all anthropometric measures was less than expected and by the time of their expected delivery, less than 30% of these infants had reached the 3rd percentile of the expected measurement in all the three growth parameters. Choice of milk and neonatal morbidity influenced these growth patterns. RECOMMENDATIONS: Routine fortification of mother's milk or addition of preterm formula and reorganised care of sick newborns is recommended to improve early growth. PMID: 16771104 [PubMed - indexed for MEDLINE]

O PROFBWIBONIMROD. "Neumann CG, Bwibo NO, Murphy SP, Sigman M, Whaley S, Allen LH, Guthrie D, Weiss RE, Demment MW.Animal source foods improve dietary quality, micronutrient status, growth and cognitive function in Kenyan school children: background, study design and baselin.". In: J Nutr. 2003 Nov;133(11 Suppl 2):3941S-3949S. Anim. Hlth. Prod. Afr. 2008; 2003. Abstract

Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, P.O. Box 20956-00202, Nairobi, Kenya. BACKGROUND: Early growth in very low birth weight (VLBW) infants has been found predictive of their later outcomes. This has led to increased interest in establishing measures to optimise such growth. In facilities without the resources required to undertake long-term audits for all the high risk infants they graduate, these growth parameters may also be used as selection criteria for those meriting such follow up reducing costs. OBJECTIVES: To describe early growth patterns among a cohort of VLBW infants and determine some of the factors associated with poor growth among them. DESIGN: Cross section survey. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: One hundred and seventy five neonatal survivors. RESULTS: Of the 175 infants recruited, the male/female ratio was 4:6, sixty four (36.6%) were intrauterine growth retarded while significant illnesses during the neonatal period were reported in 109 (62.3%). Forty seven percent of the infants had been fed on exclusive breast milk, 33% on mixed feeds while 20% received exclusive preterm formula. The mean neonatal weight gain for the whole cohort was 13.5 (3.9) g/kg/day, length of 0.34 (0.11) cm/week and head circumference of 0.32 (0.71) cm/week. By term only 33 (18.9%), 37 (21.1%) and 48 (28%) had reached the expected (the 3rd percentile) weight, length and head circumference respectively. Sixty percent of the infants gained weight at <15 g/kg/day while 70% and 78% grew in head circumference and length at < 0.5 cm/week respectively. At term weight, head and linear growth faultering were recorded in 81%, 72% and 79% respectively. The factors that were associated with better growth at this stage included feeding on preterm formula (P < 0.001) and absence of neonatal morbidity (P < 0.001). Infants who were appropriate for gestational age at birth also had better catch up growth at term compared to those born small for gestation (P < 0.001) but their neonatal growth itself was not significantly better. CONCLUSION: The mean neonatal growth in all anthropometric measures was less than expected and by the time of their expected delivery, less than 30% of these infants had reached the 3rd percentile of the expected measurement in all the three growth parameters. Choice of milk and neonatal morbidity influenced these growth patterns. RECOMMENDATIONS: Routine fortification of mother's milk or addition of preterm formula and reorganised care of sick newborns is recommended to improve early growth. PMID: 16771104 [PubMed - indexed for MEDLINE]

O PROFBWIBONIMROD. "Whaley SE, Sigman M, Neumann C, Bwibo N, Guthrie D, Weiss RE, Alber S, Murphy SP. he impact of dietary intervention on the cognitive development of Kenyan school children. J Nutr. 2003 Nov;133(11 Suppl 2):3965S-3971S.". In: J Nutr. 2003 Nov;133(11 Suppl 2):3965S-3971S. Anim. Hlth. Prod. Afr. 2008; 2003. Abstract

Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, P.O. Box 20956-00202, Nairobi, Kenya. BACKGROUND: Early growth in very low birth weight (VLBW) infants has been found predictive of their later outcomes. This has led to increased interest in establishing measures to optimise such growth. In facilities without the resources required to undertake long-term audits for all the high risk infants they graduate, these growth parameters may also be used as selection criteria for those meriting such follow up reducing costs. OBJECTIVES: To describe early growth patterns among a cohort of VLBW infants and determine some of the factors associated with poor growth among them. DESIGN: Cross section survey. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: One hundred and seventy five neonatal survivors. RESULTS: Of the 175 infants recruited, the male/female ratio was 4:6, sixty four (36.6%) were intrauterine growth retarded while significant illnesses during the neonatal period were reported in 109 (62.3%). Forty seven percent of the infants had been fed on exclusive breast milk, 33% on mixed feeds while 20% received exclusive preterm formula. The mean neonatal weight gain for the whole cohort was 13.5 (3.9) g/kg/day, length of 0.34 (0.11) cm/week and head circumference of 0.32 (0.71) cm/week. By term only 33 (18.9%), 37 (21.1%) and 48 (28%) had reached the expected (the 3rd percentile) weight, length and head circumference respectively. Sixty percent of the infants gained weight at <15 g/kg/day while 70% and 78% grew in head circumference and length at < 0.5 cm/week respectively. At term weight, head and linear growth faultering were recorded in 81%, 72% and 79% respectively. The factors that were associated with better growth at this stage included feeding on preterm formula (P < 0.001) and absence of neonatal morbidity (P < 0.001). Infants who were appropriate for gestational age at birth also had better catch up growth at term compared to those born small for gestation (P < 0.001) but their neonatal growth itself was not significantly better. CONCLUSION: The mean neonatal growth in all anthropometric measures was less than expected and by the time of their expected delivery, less than 30% of these infants had reached the 3rd percentile of the expected measurement in all the three growth parameters. Choice of milk and neonatal morbidity influenced these growth patterns. RECOMMENDATIONS: Routine fortification of mother's milk or addition of preterm formula and reorganised care of sick newborns is recommended to improve early growth. PMID: 16771104 [PubMed - indexed for MEDLINE]

2002
2001
2000
1997
O PROFBWIBONIMROD. "Bwibo N O Child Abuse and Neglect, Chapter 27 In: child Health .". In: AMREF. Anim. Hlth. Prod. Afr. 2008; 1997. Abstract

Department of Psychiatry and Psychology, Neuropsychiatric Institute, University of California, Los Angeles, CA, USA. swhaley@mednet.ucla.edu

Previous observational studies in developing countries have suggested that diet quality, particularly increased animal source food (ASF) consumption, is positively associated with child cognitive development. This report presents findings from a study in rural Kenya, designed to test the impact of three different diets on the cognitive development of school children. Twelve schools with a total of 555 Standard 1 children (equivalent to U.S. Grade 1) were randomized to one of four feeding interventions: Meat, Milk, Energy or Control (no feeding). Feeding continued for seven school terms (21 mo), and cognitive tests were administered before the commencement of feeding and during every other term of feeding. Hierarchical linear random effects models and associated methods were used to examine the effects of treatment group on changes in cognitive performance over time. Analyses revealed that children receiving supplemental food with meat significantly outperformed all other children on the Raven's Progressive Matrices. Children supplemented with meat, and children supplemented with energy, outperformed children in the Control group on tests of arithmetic ability. There were no group differences on tests of verbal comprehension. Results suggest that supplementation with animal source food has positive effects on Kenyan children's cognitive performance. However, these effects are not equivalent across all domains of cognitive functioning, nor did different forms of animal source foods produce the same beneficial effects. Implications of these findings for supplementation programs in developing countries are discussed.

PMID: 14672297 [PubMed - indexed for MEDLINE]

1995
O PROFBWIBONIMROD. "Bwibo NO. Breastfeeding: past, present and future. East Afr Med J. 1995 Mar;72(3):145-6.". In: East Afr Med J. 1995 Mar;72(3):145-6. Anim. Hlth. Prod. Afr. 2008; 1995. Abstract

Department of Psychiatry and Psychology, Neuropsychiatric Institute, University of California, Los Angeles, CA, USA. swhaley@mednet.ucla.edu

Previous observational studies in developing countries have suggested that diet quality, particularly increased animal source food (ASF) consumption, is positively associated with child cognitive development. This report presents findings from a study in rural Kenya, designed to test the impact of three different diets on the cognitive development of school children. Twelve schools with a total of 555 Standard 1 children (equivalent to U.S. Grade 1) were randomized to one of four feeding interventions: Meat, Milk, Energy or Control (no feeding). Feeding continued for seven school terms (21 mo), and cognitive tests were administered before the commencement of feeding and during every other term of feeding. Hierarchical linear random effects models and associated methods were used to examine the effects of treatment group on changes in cognitive performance over time. Analyses revealed that children receiving supplemental food with meat significantly outperformed all other children on the Raven's Progressive Matrices. Children supplemented with meat, and children supplemented with energy, outperformed children in the Control group on tests of arithmetic ability. There were no group differences on tests of verbal comprehension. Results suggest that supplementation with animal source food has positive effects on Kenyan children's cognitive performance. However, these effects are not equivalent across all domains of cognitive functioning, nor did different forms of animal source foods produce the same beneficial effects. Implications of these findings for supplementation programs in developing countries are discussed.

PMID: 14672297 [PubMed - indexed for MEDLINE]

O PROFBWIBONIMROD. "R.N. Musoke, Care of the newborn. Chapter 2 in Primary Health Care. A manual for medical students and other health workers Ed. K. Mukelabai, N.O. Bwibo, F.E. Onyango, Second edition 1995, UNICEF.". In: manual for medical students and other health workers Ed. K. Mukelabai, N.O. Bwibo, F.E. Onyango, Second edition 1995, UNICEF. Anim. Hlth. Prod. Afr. 2008; 1995. Abstract

Department of Psychiatry and Psychology, Neuropsychiatric Institute, University of California, Los Angeles, CA, USA. swhaley@mednet.ucla.edu

Previous observational studies in developing countries have suggested that diet quality, particularly increased animal source food (ASF) consumption, is positively associated with child cognitive development. This report presents findings from a study in rural Kenya, designed to test the impact of three different diets on the cognitive development of school children. Twelve schools with a total of 555 Standard 1 children (equivalent to U.S. Grade 1) were randomized to one of four feeding interventions: Meat, Milk, Energy or Control (no feeding). Feeding continued for seven school terms (21 mo), and cognitive tests were administered before the commencement of feeding and during every other term of feeding. Hierarchical linear random effects models and associated methods were used to examine the effects of treatment group on changes in cognitive performance over time. Analyses revealed that children receiving supplemental food with meat significantly outperformed all other children on the Raven's Progressive Matrices. Children supplemented with meat, and children supplemented with energy, outperformed children in the Control group on tests of arithmetic ability. There were no group differences on tests of verbal comprehension. Results suggest that supplementation with animal source food has positive effects on Kenyan children's cognitive performance. However, these effects are not equivalent across all domains of cognitive functioning, nor did different forms of animal source foods produce the same beneficial effects. Implications of these findings for supplementation programs in developing countries are discussed.

PMID: 14672297 [PubMed - indexed for MEDLINE]

1993
O PROFBWIBONIMROD. "Child battering in Nairobi, Kenya. East Afr Med J . 1993 Nov; 70 ( 11 ): 688-92 . PMID: 8033769 [PubMed - indexed for MEDLINE] Sumba RO, Bwibo NO.". In: East Afr Med J . 1993 Nov; 70 ( 11 ): 688-92 . Anim. Hlth. Prod. Afr. 2008; 1993. Abstract

Department of Psychiatry, Faculty of Medicine, University of Nairobi, Kenya.

A survey of battered children was carried out at Kenyatta National Hospital, Nairobi between 1st May 1989 and 30th April 1990. Twenty eight cases were identified and compared with twenty six controls, matched for age and sex. The battered children were likely to be aged between three and four years, with slight male predominance. The abusing parents tended to live in crowded environments, were younger in age, less educated and were less likely to be practising contraception. They were relatively new migrants to Nairobi and were socially isolated. The socio-economic and cultural issues are discussed.

PMID: 8033769 [PubMed - indexed for MEDLINE]

 

O PROFBWIBONIMROD. "Children and accidents. Epidemiology and prevention. Trop Geogr Med . 1993; 45 ( 5 ): 223-6 . No abstract available. PMID: 8279063 [PubMed - indexed for MEDLINE] Bwibo NO.". In: Trop Geogr Med . 1993; 45 ( 5 ): 223-6 . Anim. Hlth. Prod. Afr. 2008; 1993. Abstract

No abstract available

1992
O PROFBWIBONIMROD. "Medical illness in school-age Kenyans in relation to nutrition, cognition, and playground behaviors. J Dev Behav Pediatr . 1992 Dec; 13 ( 6 ): 392-8 . PMID: 1469106 [PubMed - indexed for MEDLINE] Neumann C, McDonald MA, Sigman M, Bwibo N.". In: J Dev Behav Pediatr . 1992 Dec; 13 ( 6 ): 392-8. Anim. Hlth. Prod. Afr. 2008; 1992. Abstract

Department of Public Health, University of California, Los Angeles 90024-1772.

Because medical illness is associated with malnutrition, it might contribute to the poor outcomes seen in malnourished children. This study explored relations between frequency of mild illness and development in 133 mild-to-moderately malnourished school-age Kenyan children. Morbidity information was collected for one year. Concurrent assessments of cognitive status and playground behaviors were obtained. Nutritional and environmental variables were also assessed. Girls with more reported days of mild illness performed less well on developmental measures than did their healthier female peers. They were less cognitively advanced, and, on the playground, girls with more mild illness were less active, happy, and social. Furthermore, relations between frequency of mild illness and playground behaviors (but not cognitive score) in the girls remained statistically significant when other variables, such as socioeconomic status, parental literacy, food intake, and anthropometry, were considered. For the boys, frequency of mild illness was not related to cognition or play behaviors.

PMID: 1469106 [PubMed - indexed for MEDLINE]

O PROFBWIBONIMROD. "Protein energy malnutrition: current status. East Afr Med J . 1992 Aug; 69 ( 8 ): 413-4 . No abstract available. PMID: 1396204 [PubMed - indexed for MEDLINE] Bwibo NO.". In: East Afr Med J . 1992 Aug; 69 ( 8 ): 413-4 . Anim. Hlth. Prod. Afr. 2008; 1992. Abstract

No abstract available

1991
Opinya GN;, Bwibo NO;, Valderhaug J;, Birkeland JM;, Lökken P. "Intake of fluoride and excretion in mothers' milk in a high fluoride (9 ppm) area in Kenya.". 1991.
O PROFBWIBONIMROD. "Prediction of cognitive competence in Kenyan children from Toddler nutrition, family characteristics and abilities. J Child Psychol Psychiatry . 1991 Jan; 32 ( 2 ): 307-20 . PMID: 1903401 [PubMed - indexed for MEDLINE] Sigman M, McDonald MA, Neumann C, Bw.". In: J Child Psychol Psychiatry . 1991 Jan; 32 ( 2 ): 307-20 . Anim. Hlth. Prod. Afr. 2008; 1991. Abstract

Department of Psychiatry, University of California, Los Angeles.

This study explored the extent to which cognitive competence in 5-yr old Kenyan children was associated with earlier nutritional factors, family conditions and toddler characteristics. Food intake during the 18th-30th mths and physical stature at 30 mths were associated with cognitive skills at 5 yrs. Measures of family background, abilities of the child as a toddler and current schooling were also associated with cognitive abilities at 5 yrs. These variables influenced development independently, so that later cognitive competence was best predicted by a combination of earlier nutritional, family and toddler characteristics.

PMID: 1903401 [PubMed - indexed for MEDLINE]

O PROFBWIBONIMROD. "Relationships between morbidity and development in mildly to moderately malnourished Kenyan toddlers. Pediatrics . 1991 Nov; 88 ( 5 ): 934-42 . PMID: 1945634 [PubMed - indexed for MEDLINE] Neumann C, McDonald MA, Sigman M, Bwibo N, Marquardt M.". In: Pediatrics . 1991 Nov; 88 ( 5 ): 934-42 . Anim. Hlth. Prod. Afr. 2008; 1991. Abstract

University of California, Los Angeles.

This study explored the extent to which morbidity in 110 mildly to moderately malnourished Kenyan toddlers was associated with developmental outcomes. Morbidity information was collected from the 18th to 30th months. Concurrent assessments of vocalization, play, and performance on the Bayley scales were obtained. At 5 years, a follow-up battery of cognitive tests was administered. Female toddlers who suffered more illness generally performed less well on developmental measures than their healthier female peers. These children vocalized and played less and performed less well on the Bayley Mental scales at 30 months and on the cognitive battery at 5 years. For the boys, development was largely independent of morbidity. Morbidity was related to patterns of care giving for both boys and girls, but it was not associated with socioeconomic status or food intake. However, girls who were ill more often were shorter and lighter. Relations between morbidity and development in the girls remained statistically significant when other variables, which were also related to development (such as care giving, socioeconomic status, parental IQ and literacy, food intake, and anthropometry) were considered. This suggests that morbidity, in these female toddlers, had an effect on development above and beyond other variables typically associated with malnutrition.

PMID: 1945634 [PubMed - indexed for MEDLINE]

1990
O PROFBWIBONIMROD. "N. O Bwibo Diarrhoea including Oral Dehydration Therapy. Chapter 28 In: Health care of women and Children in Developing countries.Editors: Helen Wallace and Kanti Girii third Party Publishing Company Oakland, California 1990. Pg. 327-333.". In: Helen Wallace and Kanti Girii third Party Publishing Company Oakland, California. Anim. Hlth. Prod. Afr. 2008; 1990. Abstract

Department of Psychiatry, University of California, Los Angeles.

This study explored the extent to which cognitive competence in 5-yr old Kenyan children was associated with earlier nutritional factors, family conditions and toddler characteristics. Food intake during the 18th-30th mths and physical stature at 30 mths were associated with cognitive skills at 5 yrs. Measures of family background, abilities of the child as a toddler and current schooling were also associated with cognitive abilities at 5 yrs. These variables influenced development independently, so that later cognitive competence was best predicted by a combination of earlier nutritional, family and toddler characteristics.

PMID: 1903401 [PubMed - indexed for MEDLINE]

1989
Chunge CN, Ngige S, Bwibo CR, Mulega PC, Kilonzo JF, Kibati F, Owate J. "A rapid staining technique for Leishmania parasites in splenic aspirate smears.". 1989. Abstract

A quick and suitable method for staining Leishmania donovani and other blood protozoa is described. The method, which could have wide applications, is a modification of Field's staining technique as used for malaria parasites. It uses the same stains in a different order. The method has been tried on smears containing malaria and trypanosomes, and the results were good. It is very cheap and requires no special apparatus or training

O PROFBWIBONIMROD. "Cognitive abilities of Kenyan children in relation to nutrition, family characteristics, and education. Child Dev . 1989 Dec; 60 ( 6 ): 1463-74 . PMID: 2515042 [PubMed - indexed for MEDLINE] Sigman M, Neumann C, Jansen AA, Bwibo N.". In: Child Dev . 1989 Dec; 60 ( 6 ): 1463-74 . Anim. Hlth. Prod. Afr. 2008; 1989. Abstract

Department of Psychiatry, UCLA Medical School 90024.

The purpose of this study was to determine whether nutritional factors, family characteristics, and the duration of schooling were associated with cognitive and attentional capacities in children growing up in rural Kenya. Food intake was measured by direct observation and weighment twice monthly over the course of a year. Families were characterized in terms of socioeconomic status and the literacy of the parents. Children who were better nourished had higher composite scores on a test of verbal comprehension and the Raven's matrices. Better-nourished females were more attentive during classroom observations than malnourished female schoolchildren. Family characteristics and duration of school participation were associated with cognitive abilities for both boys and girls. For the children considered as a group, cognitive scores were best predicted by a combination of factors including duration of schooling, food intake, physical stature, and SES.

PMID: 2515042 [PubMed - indexed for MEDLINE]

O PROFBWIBONIMROD. "Relationship between nutrition and development in Kenyan toddlers. J Pediatr . 1989 Sep; 115 ( 3 ): 357-64 . PMID: 2769494 [PubMed - indexed for MEDLINE] Sigman M, Neumann C, Baksh M, Bwibo N, McDonald MA.". In: J Pediatr . 1989 Sep; 115 ( 3 ): 357-64 . Anim. Hlth. Prod. Afr. 2008; 1989. Abstract

Department of Psychiatry, University of California, Los Angeles School of Medicine 90024-1759.

The relationship between mild to moderate malnutrition, as measured by food intake and anthropometric status, and developmental outcome was explored in 110 Kenyan toddlers. Developmental outcome was assessed at 30 months of age by the Bayley Mental and Motor scales and by evaluation of play behaviors. Verbalization and play during months 15 to 30 were also evaluated. Family background and home rearing conditions were assessed, and these variables were separated from the correlations between nutrition and outcome by partial correlation methods. Food intake was related to anthropometric status, play behaviors, and total amount of verbalization and play even when the potentially confounding effects of certain family background and home rearing variables were covaried. Food intake was not related to Bayley Mental and Motor scores, but measures of length and weight were, even when family background and home rearing variables were held constant. Mild to moderate malnutrition does appear to affect the child's development adversely even when other environmental characteristics, which also relate to development, are considered.

PMID: 2769494 [PubMed - indexed for MEDLINE]

O PROFBWIBONIMROD. "A study of the efficacy and safety of albendazole (Zentel) in the treatment of intestinal helmenthiasis in Kenyan children less than 2 years of age. East Afr Med J . 1989 Mar; 66 ( 3 ): 197-202 . PMID: 2591328 [PubMed - indexed for MEDLINE] Pamba HO, Bwib.". In: East Afr Med J . 1989 Mar; 66 ( 3 ): 197-202 . Anim. Hlth. Prod. Afr. 2008; 1989. Abstract

One hundred children comprising of 57 males and 43 females aged between 8 and 24 months entered the study. 46 children had single and 54 children had multiple helminth infections. All children received albendazole 200 mg (10 ml) suspension as a single dose. Albendazole proved very effective and safe in the treatment of single and multiple helminth infections in children under 2 years of age, achieving cure rates of 100% in both Ascaris lumbricoides and Necator americanus respectively, 83% in Trichuris trichiura and 66% in Hymenolepis nana. Treatment of polyparasitism appears to be of benefit in improving nutritional status using haemoglobin concentrations as an index.

PMID: 2591328 [PubMed - indexed for MEDLINE]

1988
Murphy S;, Marquardt M;, Carter E;, Bwibo NO. "Impact of acute morbidity on food intake in rural Kenyan toddlers.". 1988.
O PROFBWIBONIMROD. "Analysis of false positive HIV-1 serologic testing in Kenya. Diagn Microbiol Infect Dis . 1988 Mar; 9 ( 3 ): 179-85 . PMID: 2840237 [PubMed - indexed for MEDLINE] Kuhls TL, Nishanian PG, Cherry JD, Shen JP, Neumann CG, Stiehm ER, Ettenger RB, Bwibo NO, Ko.". In: Diagn Microbiol Infect Dis . 1988 Mar; 9 ( 3 ): 179-85 . Anim. Hlth. Prod. Afr. 2008; 1988. Abstract

Department of Pediatrics, UCLA School of Medicine.

Sera of 95 mothers and 129 children from Nairobi, Kenya, collected in 1976, and of 466 adults and 193 children of Embu District, Kenya, collected in 1984 and 1985, were analyzed for the presence of human immunodeficiency virus type 1 (HIV-1) antibodies. Although no HIV-1 seropositivity was demonstrated by western blot analysis in both study groups, 7% of Nairobi mothers and 10% of adult females from Embu District had false positive results by enzyme immunoassay (EIA) compared with less than 1% seroreactivity rates observed in adult males and children. False positive results were not due to simian T lymphotropic virus type III (STLV-IIIAGM)/human T lymphotropic virus type IV (HTLV-IV) seropositivity. Sixty-one percent of the HIV-1 EIA reactive sera could not be explained by cytotoxic activity to lymphocytes bearing the HLA-DR4 or HLA-DQw3 phenotype. We conclude that false positive HIV EIA tests are frequently encountered in East Africa. Seroprevalence rates in rural Africa must be interpreted with caution due to the decreased specificity of HIV EIAs.

PMID: 2840237 [PubMed - indexed for MEDLINE]

O PROFBWIBONIMROD. "Bwibo N O and Health Service (chapter 11 pp 154 .". In: Publishers . Anim. Hlth. Prod. Afr. 2008; 1988. Abstract

One hundred children comprising of 57 males and 43 females aged between 8 and 24 months entered the study. 46 children had single and 54 children had multiple helminth infections. All children received albendazole 200 mg (10 ml) suspension as a single dose. Albendazole proved very effective and safe in the treatment of single and multiple helminth infections in children under 2 years of age, achieving cure rates of 100% in both Ascaris lumbricoides and Necator americanus respectively, 83% in Trichuris trichiura and 66% in Hymenolepis nana. Treatment of polyparasitism appears to be of benefit in improving nutritional status using haemoglobin concentrations as an index.

PMID: 2591328 [PubMed - indexed for MEDLINE]

O PROFBWIBONIMROD. "Bwibo N O and Ndombi I O Nutrition in Sickness; Chapter VI In: Feeding the Child including recipes Editors: R.K. Oniango, Nimrod O Bwibo, Isiye O Ndombi, Kama O Rogo. Publishers .". In: Publishers . Anim. Hlth. Prod. Afr. 2008; 1988. Abstract

One hundred children comprising of 57 males and 43 females aged between 8 and 24 months entered the study. 46 children had single and 54 children had multiple helminth infections. All children received albendazole 200 mg (10 ml) suspension as a single dose. Albendazole proved very effective and safe in the treatment of single and multiple helminth infections in children under 2 years of age, achieving cure rates of 100% in both Ascaris lumbricoides and Necator americanus respectively, 83% in Trichuris trichiura and 66% in Hymenolepis nana. Treatment of polyparasitism appears to be of benefit in improving nutritional status using haemoglobin concentrations as an index.

PMID: 2591328 [PubMed - indexed for MEDLINE]

1987
O PROFBWIBONIMROD, SAMSON PROFMEMEJULIUS. "Into Africa. The telemedicine links between Canada, Kenya and Uganda. C.M.A.J. Vol. 136, 398-400, 1987. House M., Koegh E., Hillman D., Bwibo N.O., Meme J. S., Wafula E., Macleods, McCollough N.". In: C.M.A.J. Vol. 136, 398-400, 1987. Anim. Hlth. Prod. Afr. 2008; 1987. Abstract

Department of Pediatrics, UCLA School of Medicine.

Sera of 95 mothers and 129 children from Nairobi, Kenya, collected in 1976, and of 466 adults and 193 children of Embu District, Kenya, collected in 1984 and 1985, were analyzed for the presence of human immunodeficiency virus type 1 (HIV-1) antibodies. Although no HIV-1 seropositivity was demonstrated by western blot analysis in both study groups, 7% of Nairobi mothers and 10% of adult females from Embu District had false positive results by enzyme immunoassay (EIA) compared with less than 1% seroreactivity rates observed in adult males and children. False positive results were not due to simian T lymphotropic virus type III (STLV-IIIAGM)/human T lymphotropic virus type IV (HTLV-IV) seropositivity. Sixty-one percent of the HIV-1 EIA reactive sera could not be explained by cytotoxic activity to lymphocytes bearing the HLA-DR4 or HLA-DQw3 phenotype. We conclude that false positive HIV EIA tests are frequently encountered in East Africa. Seroprevalence rates in rural Africa must be interpreted with caution due to the decreased specificity of HIV EIAs.

PMID: 2840237 [PubMed - indexed for MEDLINE]

O PROFBWIBONIMROD. "Medical curriculum in a developing country. East Afr Med J . 1987 Oct; 64 ( 10 ): 697-709 . No abstract available. PMID: 3507316 [PubMed - indexed for MEDLINE] Bwibo NO.". In: East Afr Med J . 1987 Oct; 64 ( 10 ): 697-709 . Anim. Hlth. Prod. Afr. 2008; 1987. Abstract

No abstract available

1986
1985
O PROFBWIBONIMROD. "Birthweights of infants of teenage mothers in Nairobi. Acta Paediatr Scand Suppl . 1985; 319 : 89-94 . PMID: 3868931 [PubMed - indexed for MEDLINE] Bwibo NO.". In: Acta Paediatr Scand Suppl . 1985; 319 : 89-94 . Anim. Hlth. Prod. Afr. 2008; 1985. Abstract

Teenage pregnancies lower average birthweight. In the NBS, teenage mothers had significantly lower average birthweight of 2 920 +/- 553 g compared with 3 133 +/- 533 g among women in the general population. A high rate of LBW on the infants of the teenage mothers was the significant factor in lowering the average birthweight. In both NBS and the PMHS the incidence of LBW 18% and 15% respectively as well as the rate of preterm delivery of 24% and 23% respectively were high. In PMHS although the numbers were small, the incidence of LBW was high (13%) in the 14-year-olds and in the 15-year-olds it was 4.8% which was much lower than that for 17- and 18-year-olds. In a large series in Nigeria the incidence of LBW was 27% in mothers aged less than 15 years, 26% in mothers aged 15-19, 20% in those aged 20-24 and least (18%) in the 25-29 year age group. Many unfavourable socioeconomic circumstances and lack of adequate antenatal supervision contribute to these high rates. Some of the teenage mothers-particularly the very young, below 16 years-are physically immature and are still growing children themselves. Their nutrient intake is shared between their own growth needs and those of their foetuses. In the Nigerian study, administration of folic acid and iron together with antimalarials to pregnant mothers resulted in increased maternal height as well as foetal growth, thus stressing the importance of nutritional care for the teenage mothers.

PIP: Teenage pregnancies lower average birth weight. In the Nairobi Birth Survey (NBS), teenage mothers had significantly lower average birth weight of 2920 +or- 553 gm compared with 3133 +or- 533 gm among women in the general population. A high rate of low birth weight (LBW) in those infants born to teenage mothers was the significant factor in lowering that figure. In both the NBS and the Pumwani Maternity Hospital Study (PMHS), the incidence of LBW was 18% and 15%, respectively, and the rate of preterm delivery 24% and 23%, respectively. In the PMHS, although the numbers were small, the incidence of LBW was high (13%) in the 14-year-old group and it was 4.8% in the 15-year-old group; these figures were much lower than those for ages 17 and 18. In a large series in Nigeria, the incidence of LBW was 27% in mothers aged less than 15, 26% in mothers aged 15-19, 20% in those aged 20-24, and least (18%) in those 25-29. Many unfavorable socioeconomic circumstances and lack of adequate antenatal supervision contribute to these high rates. Some teenage mothers–particularly those under age 16–are physically immature and are themselves still growing. Their nutrient intake is shared between their own growth needs and those of their fetuses. In the Nigerian study, administration of folic acid and iron together with antimalarials to pregnant mothers resulted in increased maternal height as well as fetal growth, thus stressing the importance of nutritional care for teenage mothers. author's modified

PMID: 3868931 [PubMed - indexed for MEDLINE]

O PROFBWIBONIMROD. "N .O Bwibo Tuberculosis: Chapter 14 In: child Health in Tropics Editor: D B Jelliffee, fifth Edition pp 135-147. Edward Arnold Publishers, 1985.". In: Edward Arnold Publishers. Anim. Hlth. Prod. Afr. 2008; 1985. Abstract

No abstract available

1984
O PROFBWIBONIMROD. "Haemoglobin A1C in children with sickle cell disease. East Afr Med J . 1984 Jan; 61 ( 1 ): 32-4 . No abstract available. PMID: 6745138 [PubMed - indexed for MEDLINE] Juma FD, Gitau W, Bwibo NO, Gachoka C.". In: East Afr Med J . 1984 Jan; 61 ( 1 ): 32-4 . Anim. Hlth. Prod. Afr. 2008; 1984. Abstract

Despite the high frequency of sickle cell disease in Europe, the disease is poorly managed. Critical periods are the hospital stays during which the anaesthesiologist plays an important role. Understanding the molecular basis of polymerization processes of haemoglobin S can help to avoid triggering a crisis. Differentiation of the various haemoglobin phenotypes helps to estimate the individual perioperative risk. Knowledge of the patient's history and the actual haemoglobin S level facilitates general anaesthesia, surgery and postoperative care. Damage to liver, spleen, eyes, bones, lung and central nervous system increases the perioperative risk. Preoperative preparation includes early admission, intravenous volume substitution, continuing pain therapy and prophylactic antibiotic medication. General anaesthesia seems to be better for patients with a high-risk profile rather than regional anaesthesia. Careful perioperative and postoperative monitoring should allow hypoxaemia, hypovolaemia, hypothermia, acidosis and overtransfusion to be avoided. Effective pain therapy includes a combination of opioids with peripherally acting analgesia.

O PROFBWIBONIMROD. "Gonadotropin excretion during puberty in malnourished children. J Pediatr . 1984 Aug; 105 ( 2 ): 325-8 . PMID: 6431069 [PubMed - indexed for MEDLINE] Kulin HE, Bwibo N, Mutie D, Santner SJ.". In: J Pediatr . 1984 Aug; 105 ( 2 ): 325-8 . Anim. Hlth. Prod. Afr. 2008; 1984. Abstract

p6nadotropins were measured by radioimmunoassay of urine samples from 285 privileged Nairobi adolescents and from 238 rural peripubertal Kenyan boys and girls who had had moderate malnutrition during childhood. Gonadotropins were reduced at all ages in the rural adolescents, but pubertal stage-matched comparisons showed no differences between children of the two study areas in middle or late phases of sexual maturity. These results document the pattern of gonadotropin changes in an environment of reduced caloric intake and confirm the presumed hypothalamic-pituitary origin of the delayed adolescence that occurs under such circumstances.

PMID: 6431069 [PubMed - indexed for MEDLINE]

1983
1982
O PROFBWIBONIMROD. "Hematopathological observations in Kenyan children with sickle cell anemia in the first decade of life. Am J Pediatr Hematol Oncol . 1982 Summer; 4 ( 2 ): 182-6 . PMID: 6180653 [PubMed - indexed for MEDLINE] Kasili EG, Bwibo NO.". In: Am J Pediatr Hematol Oncol . 1982 Summer; 4 ( 2 ): 182-6 . Anim. Hlth. Prod. Afr. 2008; 1982. Abstract

This paper reviews clinicopathological and hematological manifestations of sickle cell anemia as seen in Kenyan children in the first decade of life. The information is based on a study of 447 patients. The findings are similar to those that are well documented from America, West Africa, and other parts of Africa. However, local variations and complications such as malnutrition and topical infections that may affect prognosis are high-lighted.

O PROFBWIBONIMROD. "Clinical aspects of sickle cell disease in Nairobi children. Am J Pediatr Hematol Oncol . 1982 Summer; 4 ( 2 ): 187-90 . PMID: 6956242 [PubMed - indexed for MEDLINE] Bwibo NO, Kasili EG.". In: Am J Pediatr Hematol Oncol . 1982 Summer; 4 ( 2 ): 187-90 . Anim. Hlth. Prod. Afr. 2008; 1982. Abstract

Children with sickle cell disease in Nairobi come from tribes living in malarial regions of Kenya. The clinical presentation and complications of this disease are described. The symptoms at onset are nonspecific but the typical features that follow are easy to recognize. Cardiac murmurs and persistently enlarged spleen in older children pose diagnostic challenges. Poor appetite and failure to thrive are common; so are school absenteeism due to crises and infection. The use of white blood cell counts to determine the presence of infection during crises is described.

PMID: 6956242 [PubMed - indexed for MEDLINE]

O PROFBWIBONIMROD. "The effect of chronic childhood malnutrition on pubertal growth and development. Am J Clin Nutr . 1982 Sep; 36 ( 3 ): 527-36 . PMID: 7113957 [PubMed - indexed for MEDLINE] Kulin HE, Bwibo N, Mutie D, Santner SJ.". In: Am J Clin Nutr . 1982 Sep; 36 ( 3 ): 527-36. Anim. Hlth. Prod. Afr. 2008; 1982. Abstract

Pubertal growth and development were compared in 342 privileged, urban children and 347 impoverished rural adolescents from Kenya. Measurements of height, weight, upper arm circumference, and triceps skinfolds revealed marked differences between the two study groups just before the onset of sexual maturation. These differences were also found in the early stages of puberty but notable catch-up was evident throughout the later period of the maturational process. Early stages of sexual maturity were delayed by 3 yr in malnourished boys with a 2.1-yr lag in the age of onset of menarche in rural girls. Derived estimates of body fat as well as direct anthropometry revealed that the onset of puberty is not size related under the circumstances of chronic childhood malnutrition.

PMID: 7113957 [PubMed - indexed for MEDLINE]

O PROFBWIBONIMROD, MASIBO PROFWAFULAEZEKIEL. "Serological determination of prevalence of congenital syphilis in two hospitals in Kenya. East Afr Med J . 1982 Nov; 59 ( 11 ): 750-3 . No abstract available. PMID: 6764198 [PubMed - indexed for MEDLINE] Wafula EM, Bwibo NO.". In: East Afr Med J . 1982 Nov; 59 ( 11 ): 750-3 . Anim. Hlth. Prod. Afr. 2008; 1982. Abstract

No abstract available.

1981
O PROFBWIBONIMROD. "N. O Bwibo Haematological Diseases in Tropics In: Paediatrics Practice in Developing countries. Editor: G.J Ebrahim, MacMilla Press Ltd 1981 London pp 239-256.". In: MacMilla Press Ltd. Anim. Hlth. Prod. Afr. 2008; 1981. Abstract

This paper reviews clinicopathological and hematological manifestations of sickle cell anemia as seen in Kenyan children in the first decade of life. The information is based on a study of 447 patients. The findings are similar to those that are well documented from America, West Africa, and other parts of Africa. However, local variations and complications such as malnutrition and topical infections that may affect prognosis are high-lighted.

PMID: 6180653 [PubMed - indexed for MEDLINE]

1980
O PROFBWIBONIMROD. "N .O Bwibo Nutrition and Child Health in Kenya In: Paediatrics .". In: Pitman Medical Publishers 1980, pp 177-184. Anim. Hlth. Prod. Afr. 2008; 1980. Abstract

No abstract available.

1979
O PROFBWIBONIMROD. "Tuberculous meningitis–diagnostic problems. East Afr Med J . 1979 Dec; 56 ( 12 ): 646-50 . No abstract available. PMID: 544261 [PubMed - indexed for MEDLINE] Bwibo NO.". In: East Afr Med J . 1979 Dec; 56 ( 12 ): 646-50 . Anim. Hlth. Prod. Afr. 2008; 1979. Abstract

No abstract available

1978
1977
O PROFBWIBONIMROD. "Bwibo N.O, Kasili EG, Oduori ML: Childhood Leukaemia in Kenya. In: tumours in Early Life .". In: Edited by L Seven with Pwerugia Quadrennial international Conferences in Cancer Rome. Anim. Hlth. Prod. Afr. 2008; 1977. Abstract

No abstract available.

O PROFBWIBONIMROD. "Congenital biliary atresia. East Afr Med J . 1977 Oct; 54 ( 10 ): 535-8 . No abstract available. PMID: 608421 [PubMed - indexed for MEDLINE] Ongeri SK, Bwibo NO, Kinuthia D.". In: East Afr Med J . 1977 Oct; 54 ( 10 ): 535-8 . Anim. Hlth. Prod. Afr. 2008; 1977. Abstract

No abstract available.

1976
Stamm O, Latscha U, Janecek P, Campana A. "Development of a special electrode for continuous subcutaneous pH measurement in the infant scalp." Am. J. Obstet. Gynecol.. 1976;124(2):193-5. Abstract

Using a combined special glass electrode it is possible to monitor pH ratios and pH variation in the subcutaneous tissue of the infant scalp continuously. Tests on a normal sample of newborn babies immediately after birth showed a significant correlation between tissue pH and capillary blood pH, with the trend of pH variation being broadly similar in both measurement media.

O'Day DH. "Acid protease activity during germination of microcysts of the cellular slime mold Polysphondylium pallidum." J. Bacteriol.. 1976;125(1):8-13. Abstract

Extracts of dormant microcysts of Polysphondylium pallidum demonstrate pH optima for the hydrolysis of casein at 3.5 and 6.0. During germination the intracellular pH 6.0 caseinolytic specific activity does not change significantly. The pH 6.0 protease is also active on azo-albumin, revealing the same developmental pattern with this substrate. Both acid protease activities are excreted during the germination process. Addition of purified nonspecific protease to cultures speeds up germination, suggesting that the excreted protease may play a role in removal of the microcyst wall. When cycloheximide is added to cultures, complete germination (emergence) is stopped whereas the pH 6.0 protease activity still accumulates to between 50 and 60% of the maximum control activity. Although this suggests that post-translational controls might mediate the accumulation of a portion of the pH 6.0 protease increase, mixing and dilution experiments with cell extracts do not reveal the differential presence of soluble activators or inhibitors of this activity at different developmental stages. The presence of tightly bound enzyme-inhibitor complexes for protease B in dormant microcysts has not been ruled out and is currently under study.

Chern CJ, Beutler E. "Biochemical and electrophoretic studies of erythrocyte pyridoxine kinase in white and black Americans." Am. J. Hum. Genet.. 1976;28(1):9-17. Abstract

The mean PNK activity in red blood cells from black subjects was only about 40% of that in whites. Among 51 whites examined, one was found to have enzyme deficiency. The estimated gene frequencies for PNKH (the common allele in whites which codes for higher enzyme activity) and PNKL (the common allele in blacks which codes for lower enzyme activity) were .35 and .65, respectively, for black donors, and .81 and .19, respectively, for white donors, The variant enzyme in persons with enzyme deficiency was associated with an increased rate of degradation in red cells during aging. No other biochemical or electrophoretic differences were detected.

Jacob JS, McDonald HS. "Diving bradycardia in four species of North American aquatic snakes." Comp Biochem Physiol A Comp Physiol. 1976;53(1):69-72.
Share JB. "Review of drug treatment for Down's syndrome persons." Am J Ment Defic. 1976;80(4):388-93. Abstract

A review of drug treatment for Down's syndrome individuals was presented. Drugs used to modify behavior, as well as drugs used with the goal of affecting cognitive processes, were discussed. Some observations were offered as to the effectiveness of past and current drugs on Down's syndrome and some methodological problems relating to drug studies presented. There have not been any drugs that have demonstrated remarkable improvement in the status of Down's syndrome individuals that have been widely accepted as effective.

Bland RD, Clarke TL, Harden LB. "Rapid infusion of sodium bicarbonate and albumin into high-risk premature infants soon after birth: a controlled, prospective trial." Am. J. Obstet. Gynecol.. 1976;124(3):263-7. Abstract

We conducted a controlled, prospective trial to evaluate the effectiveness of rapidly infusing sodium bicarbonate (NaHCO3) and salt-poor albumin into high-risk, premature infants in the first 2 hours of life. Fifty-three infants, randomized into one of four treatment groups, received 8 ml. per kilogram of a solution containing either (A) glucose in water, (B) salt-poor albumin, (C) NaHCO3, or (D) a combination of albumin and NaHCO3. After the initial infusion, the babies received no colloid or alkali solutions until 4 hours of age. We managed them supportively with warmth, appropriate oxygen administration, isotonic fluid infusion, and close monitoring. Among the infants who received alkali, 14 of 26 acquired the respiratory distress syndrome (RDS), 11 died, and four had intracranial hemorrhage. Among babies who received no alkali, RDS occurred in 11 of 27, 5 died, and none had intracranial hemorrhage. These results do not support the common practice of rapidly infusing NaHCO3 into high-risk, premature infants, and they suggest that the early management of such infants needs renewed critical evaluation.

1975
Ostashevskiĭ II, Sungurov IA, Volchkov VA. "[Light scattering by cell suspensions in normal conditions and exposed to external factors]." Biofizika. 1975;20(5):853-8. Abstract

The characteristics of light scattering of cell suspensions in norm (pH 7,2, t=20degreesC) and upon external influences (change of pH and increase of tdegree). The turbidity tauapproximatelylambda-n and n=0,2--0,3 for cells in norm. After cell damage n increases. Dependence of n correlates with the increase of some injured cells determined by eozin test. Alterations of light scattering after cell damage were connected with the increase of deposit of intercellular structure in general scattering.

Akamatsu N, Nakajima H, Ono M, Miura Y. "Increase in acetyl CoA synthetase activity after phenobarbital treatment." Biochem. Pharmacol.. 1975;24(18):1725-7.
Thornton JA, Harrison MJ. "Letter: Duration of action of AH8165." Br J Anaesth. 1975;47(9):1033.
Hunter AL, Klaassen CD. "Biliary excretion of colchicine in newborn rats." Drug Metab. Dispos.. 1975;3(6):530-5. Abstract

The 24-hr LD50 of colchicine in newborn rats is 0.24 mg/kg, which is about 1/10 that observed in the adult. The 24-hr LD50 of colchicine was relatively constant in rats over 25 days of age. In an attempt to determine the mechanism of the increased sensitivity of the newborn rat to the toxic action of colchicine, the distribution of 3H after the administration of 3H-colchicine (0.1 mg/kg) was measured in 10- and 35-day-old rats. The concentration of 3H was higher in all tissues of the newborn than the adult after ip administration, suggesting an immaturity in the pathway for colchicine elimination. After iv administration, radioactivity disappeared much more slowly from the plasma of the newborn rat than from the adult. This was due to a lower capacity of the liver of the newborn to concentrate colchicine and to excrete it into the bile. Development of the hepatic excretory mechanism responsible for excretion of colchicine occurred at the same age as did the increase in LD50. These results suggest that colchicine is more toxic in the newborn because the drug remains in the body for a longer time due to immaturity of the liver excretory process.

Roskoski R, Lim CT, Roskoski LM. "Human brain and placental choline acetyltransferase: purification and properties." Biochemistry. 1975;14(23):5105-10. Abstract

Choline acetyltransferase (EC 2.3.1.6) catalyzes the biosynthesis of acetylcholine according to the following chemical equation: acetyl-CoA + choline in equilibrium to acetylcholine + CoA. In addition to nervous tissue, primate placenta is the only other animal source which contains appreciable acetylcholine and its biosynthetic enzyme. Human brain caudate nucleus and human placental choline acetyltransferase were purified to electrophoretic homogeneity using ion-exchange and blue dextran-Sepharose affinity chromatography. The molecular weights determined by Sephadex G-150 gel filtration and sodium dodecyl sulfate gel electrophoresis are 67000 plus or minus 3000. N-Ethylmaleimide, p-chloromercuribenzoate, and dithiobis(2-nitrobenzoic acid) inhibit the enzyme. Dithiothreitol reverses the inhibition produced by the latter two reagents. The pKa of the group associated with N-ethylmaleimide inhibition is 8.6 plus or minus 0.3. A chemically competent acetyl-thioenzyme is isolable by Sephadex gel filtration. The enzymes from the brain and placenta are thus far physically and biochemically indistinguishable.

Hirano H, Higashi K, Sakamoto Y. "DNA polymerase in nuceoli isolated from Ehrlich ascites tumor cells." Biochem. Biophys. Res. Commun.. 1975;67(2):518-24.
Alekseeva IG, Lapina GP, Tulovskaia ZD, Izmaĭlova VN. "[Structure formation in interphase adsorption layers of lysozyme at liquid boundaries]." Biofizika. 1975;20(4):566-9. Abstract

In connection with the modelling of biomembranes regularities of the formation and development of interphase adsorption layers of lysozyme at liquid borders under different conditions and depending on the nature of carbohydrate phase were investigated by the determination of mechanical characteristics of such layers. The investigations carried out showed that the most solid layers appeared under the conditions which assured the formation of the maximum number of intermolecular bonds (which in a common case is performed with maximum disorderlinesss of the macromolecules which get at the interphase).

Mier PD, van den Hurk JJ. "Lysosomal hydrolases of the epidermis. I. Glycosidases." Br. J. Dermatol.. 1975;93(1):1-10. Abstract

Seven distinct glycosidases (EC 3.2) have been characterized in guinea-pig epidermis. Their properties indicate them to be of lysosomal origin. The 'profile' of the epidermal glycosidases is significantly different from that reported for whole skin, the activities of beta-galactosidase and beta-acetylglucosaminidase being very high and those of the remaining enzymes relatively low in epidermis.

Wrightstone RN, Smith LL, Wilson JB, Vella F, Huisman TH. "Some physicochemical properties of hemoglobin-manitoba (alpha2 102Ser replaced by Arg (G9) beta2)." Biochim. Biophys. Acta. 1975;412(2):283-7. Abstract

Hb-Manitoba was discovered in 1970 [1] in a Canadian family of British origin. Recently we observed the same variant in a second family, and found that the oxy-derivative of Hb-Manitoba is slightly unstable at 65 degrees C, dissociates less readily at alkaline pH than does Hb-A, and forms asymmetric hybrids with other hemoglobins which are readily detectable by electrophoresis.

Schwabbauer ML. "Use of the latent image technique to develop and evaluate problem-solving skills." Am J Med Technol. 1975;41(12):457-62. Abstract

This project involved designing, developing and evaluating a simulation module, utilizing the latent image technique. The general topic chosen for this simulation was the laboratory characterization of anemias. Target learner populations included medical technology students, physician assistant students, and pathology residents. Members of all three groups participated in the evaluation of the module and responded to its use in varied settings.

Conway CM. "Editorial: "Old lamps for new"." Br J Anaesth. 1975;47(8):811-2.
Kersten E. "6th International Symposium on Maritime Medicine 1974." Bull Inst Marit Trop Med Gdynia. 1975;26(2):131-2.
Di Ferrante N, Leachman RD, Angelini P, Donnelly PV, Francis G, Almazan A, Segni G, Franzblau C, Jordan RE. "Ehlers-Danlos type V (X-linked form): a lysyl oxidase deficiency." Birth Defects Orig. Artic. Ser.. 1975;11(6):31-7.
O PROFBWIBONIMROD. "Varieties of malnutrition. Kenya Nurs J . 1975 Dec; 4 ( 2 ): 38-40 . No abstract available. PMID: 1044874 [PubMed - indexed for MEDLINE] Bwibo NO.". In: Kenya Nurs J . 1975 Dec; 4 ( 2 ): 38-40 . Anim. Hlth. Prod. Afr. 2008; 1975. Abstract

No abstract available.

1973
1972
1971
Bwibo NO. "Whooping cough in Uganda.". 1971.
O PROFBWIBONIMROD. "Bwibo NO.Congenital syphilis. East Afr Med J. 1971 Apr;48(4):185-91.". In: East Afr Med J. 1971 Apr;48(4):185-91. Anim. Hlth. Prod. Afr. 2008; 1971. Abstract

No abstract available.

O PROFBWIBONIMROD. "Clinical significance of strongyloides in African children. J Trop Med Hyg . 1971 Apr; 74 ( 4 ): 79-81 . No abstract available. PMID: 5574874 [PubMed - indexed for MEDLINE] Bwibo NO.". In: J Trop Med Hyg . 1971 Apr; 74 ( 4 ): 79-81 . Anim. Hlth. Prod. Afr. 2008; 1971. Abstract

No abstract available

O PROFBWIBONIMROD. "Iron nutrition in infancy. East Afr Med J . 1971 Dec; 48 ( 12 ): 741-3 . No abstract available. PMID: 5148607 [PubMed - indexed for MEDLINE] Bwibo NO.". In: East Afr Med J . 1971 Dec; 48 ( 12 ): 741-3 . Anim. Hlth. Prod. Afr. 2008; 1971. Abstract

No abstract available

O PROFBWIBONIMROD. "The role of neonatal infection in neonatal and childhood mortality. J Trop Pediatr Environ Child Health . 1971 Sep; 17 ( 3 ): 89-90 . No abstract available. PMID: 5210143 [PubMed - indexed for MEDLINE] Bwibo NO.". In: J Trop Pediatr Environ Child Health . 1971 Sep; 17 ( 3 ): 89-90 . Anim. Hlth. Prod. Afr. 2008; 1971. Abstract

No abstract available.

1970
O PROFBWIBONIMROD. "Bwibo NO. Common causes of death in children at Mulago Hospital, Kampala, Uganda. Clin Pediatr (Phila). 1970 Nov;9(11):691-4.". In: Clin Pediatr (Phila). 1970 Nov;9(11):691-4. Anim. Hlth. Prod. Afr. 2008; 1970. Abstract

No abstract available

O PROFBWIBONIMROD. "Congenital pyloric stenosis in African infants. Report of 19 cases in Uganda. Bwibo NO. East Afr Med J. 1970 Jul;47(7):377-82.". In: East Afr Med J. 1970 Jul;47(7):377-82. Anim. Hlth. Prod. Afr. 2008; 1970. Abstract

No abstract available

O PROFBWIBONIMROD. "Renal tuberculosis. A case report. Trop Geogr Med. 1970 Sep;22(3):377-80. Bwibo NO.". In: Trop Geogr Med. 1970 Sep;22(3):377-80. Anim. Hlth. Prod. Afr. 2008; 1970. Abstract

No abstract available

O PROFBWIBONIMROD. "Sclerema neonatorum (a study of 16 cases in the special care unit, Mulago Hospital, Kampala). East Afr Med J. 1970 Jan;47(1): Bwibo NO, Anderson BT.". In: East Afr Med J. 1970 Jan;47(1):. Anim. Hlth. Prod. Afr. 2008; 1970. Abstract

No abstract available

O PROFBWIBONIMROD. "Waardenburgs syndrome in an African child. Hum Hered . 1970; 20 ( 1 ): 19-22 . No abstract available. PMID: 5444872 [PubMed - indexed for MEDLINE] Bwibo NO, Mkono MD.". In: Hum Hered . 1970; 20 ( 1 ): 19-22 . Anim. Hlth. Prod. Afr. 2008; 1970. Abstract

No abstract available

1969

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