Nathalie Lambrecht

All Publications

• Effect of a Homestead Food Production and Food Hygiene Intervention on Biomarkers of Environmental Enteric Dysfunction in Children Younger Than 24 Months in Rural Bangladesh: A Cluster-Randomized Controlled Trial AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE Mueller-Hauser, A. A., Huda, T., Sobhan, S., Lambrecht, N. J., Waid, J. L., Wendt, A. S., Ali, S., Rahman, M., Gabrysch, S. 2023; 109 (5): 1166-1176

  Abstract

  Poor sanitation and hygiene practices and inadequate diets can contribute to environmental enteric dysfunction (EED). We evaluated the impact of a combined homestead food production and food hygiene intervention on EED biomarkers in young children in rural Bangladesh. The analysis was conducted within the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) cluster-randomized trial in Sylhet, Bangladesh. The FAARM trial enrolled 2,705 married women and their children younger than 3 years of age in 96 settlements (geographic clusters): 48 intervention and 48 control. The 3-year intervention (2015-2018) included training on gardening, poultry rearing, and improved nutrition practices and was supplemented by an 8-month food hygiene behavior change component, implemented from mid-2017. We analyzed data on 574 children age 0 to 24 months with multilevel linear regression. We assessed fecal myeloperoxidase (MPO), neopterin (NEO), and alpha-1-antitrypsin (AAT) as biomarkers of EED, and serum C-reactive protein (CRP) and alpha-1-acid glycoprotein (AGP) as biomarkers of systemic inflammation, using ELISA. There was no intervention effect on NEO, AAT, CRP, and AGP concentrations, but, surprisingly, MPO levels were increased in children of the intervention group (0.11 log ng/mL; 95% CI, 0.001-0.22). This increase was greater with increasing child age and among intervention households with poultry that were not kept in a shed. A combined homestead food production and food hygiene intervention did not decrease EED in children in our study setting. Small-scale poultry rearing promoted by the intervention might be a risk factor for EED.

  View details for DOI 10.4269/ajtmh.23-0153

  View details for Web of Science ID 001130915100007

  View details for PubMedID 37783459

  View details for PubMedCentralID PMC10622486

• Effect of a Homestead Food Production Program on the Prevalence of Diarrhea and Acute Respiratory Infection in Children in Sylhet, Bangladesh: A Cluster-Randomized Controlled Trial AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE Lambrecht, N. J., Mueller-Hauser, A. A., Sobhan, S., Schmidt, W., Huda, T., Waid, J. L., Wendt, A. S., Kader, A., Gabrysch, S. 2023; 109 (4): 945-956

  Abstract

  Diarrhea and respiratory illness are leading causes of mortality and morbidity among young children. We assessed the impact of a homestead food production intervention on diarrhea and acute respiratory infection (ARI) in children in Bangladesh, secondary outcomes of the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) cluster-randomized trial. The trial enrolled 2,705 married women and their children 3 years or younger in 96 rural settlements (geographic clusters) in Sylhet Division, Bangladesh. The intervention promoted home gardening and poultry rearing alongside child nutrition and health counseling over 3 years (2015-2018). An 8-month food hygiene behavior change component using emotional drivers was delivered beginning in mid-2017. Caregiver-reported diarrhea and symptoms of ARI in the week preceding the survey were recorded every 2 months. We analyzed 32,460 observations of 3,276 children over 4 years and found that 3.9% of children had diarrhea and 3.4% had an ARI in the prior 7 days. There was no overall effect of the intervention on 7-day diarrhea period prevalence (odds ratio [OR], 0.92; 95% CI, 0.71-1.19), diarrhea point prevalence (OR, 1.03; 95% CI, 0.78-1.36), or 7-day ARI period prevalence (OR, 1.18; 95% CI, 0.88-1.60). There was no impact on diarrhea severity or differences in health-seeking behaviors. Our findings suggest that this homestead food production program was insufficient to reduce morbidity symptoms among children in a rural setting. More comprehensive water, sanitation, and hygiene measures, and behavioral recommendations may be needed to achieve impacts on child health.

  View details for DOI 10.4269/ajtmh.23-0152

  View details for Web of Science ID 001163653600014

  View details for PubMedID 37580032

  View details for PubMedCentralID PMC10551083

• Thalassemia and hemoglobinopathy prevalence in a community-based sample in Sylhet, Bangladesh ORPHANET JOURNAL OF RARE DISEASES Wendt, A. S., Brintrup, J., Waid, J. L., Kader, A., Lambrecht, N. J., Gabrysch, S. 2023; 18 (1): 192

  Abstract

  Inherited blood disorders affect 7% of the population worldwide, with higher prevalences in countries in the "thalassemia belt," which includes Bangladesh. Clinical management options for severely affected individuals are expensive; thus, targeted government policies are needed to support prevention and treatment programs. In Bangladesh, there is a lack of data, in particular community-based estimates, to determine population prevalence. This study aims to estimate the prevalence of a wide range of hemoglobinopathies and their associations with anemia in a community-based sample of women and young children in rural Sylhet, Bangladesh.Capillary blood samples from 900 reproductive-aged women and 395 children (aged 6-37 months) participating in the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) trial in two sub-districts of Habiganj, Sylhet Division, Bangladesh were analyzed for alpha thalassemia, beta thalassemia, and other hemoglobinopathies. We examined the association of each inherited blood disorder with hemoglobin concentration and anemia using linear and logistic regression.We identified at least one inherited blood disorder in 11% of women and 10% of children. Alpha thalassemia was most prevalent, identified in 7% of women and 5% of children, followed by beta thalassemia and hemoglobin E in 2-3%. We also identified cases of hemoglobin S and hemoglobin D in this population. Having any of the identified inherited blood disorders was associated with lower hemoglobin values among non-pregnant women, largely driven by alpha and beta thalassemia. Pregnant women with beta thalassemia were also more likely to have lower hemoglobin concentrations. Among children, we found weak evidence for a relationship between hemoglobinopathy and lower hemoglobin concentrations.We found a high prevalence of alpha thalassemia among both women and children in rural Sylhet, Bangladesh-higher than all other identified hemoglobinopathies combined. Community-based estimates of alpha thalassemia prevalence in Bangladesh are scarce, yet our findings suggest that alpha thalassemia may comprise the majority of inherited blood disorders in some regions of the country. We recommend that future research on inherited blood disorders in Bangladesh include estimates of alpha thalassemia in their reporting for public health awareness and to facilitate couples  counseling.

  View details for DOI 10.1186/s13023-023-02821-3

  View details for Web of Science ID 001029400500001

  View details for PubMedID 37468973

  View details for PubMedCentralID PMC10355052

• Wild foods contribute to women's higher dietary diversity in India NATURE FOOD Cheek, J., Lambrecht, N. J., den Braber, B., Akanchha, N., Govindarajulu, D., Jones, A. D., Chhatre, A., Rasmussen, L. 2023; 4 (6): 476-+

  Abstract

  Wild foods, from forests and common lands, can contribute to food and nutrition security. Most previous studies have established correlations between wild food consumption and children's dietary diversity in Africa, but other groups and geographic contexts remain understudied. Here a rigorous quasi-experimental method was combined with monthly interval data to assess the contribution of wild foods to women's diets. We collected 24 h diet recall data monthly, from November 2016 to November 2017, from 570 households in East India. We found that wild foods contributed positively to diets, especially in June and July (when consumption of wild foods was highest). Women who consumed wild foods had higher average dietary diversity scores (13% and 9% higher in June and July, respectively) and were more likely to consume nutrient-dense, dark-green leafy vegetables than those who did not. Our results underscore the importance of policies that increase knowledge of wild foods and protect people's rights to access forests and other common lands for improved nutrition.

  View details for DOI 10.1038/s43016-023-00766-1

  View details for Web of Science ID 001018578900015

  View details for PubMedID 37349564

  View details for PubMedCentralID 8761519

• Limiting red meat availability in a university food service setting reduces food-related greenhouse gas emissions by one-third CLIMATIC CHANGE Lambrecht, N. J., Hoey, L., Bryan, A., Heller, M., Jones, A. D. 2023; 176 (6)

  View details for DOI 10.1007/s10584-023-03543-y

  View details for Web of Science ID 000987153400001

• Impact of a Homestead Food Production program on poultry rearing and egg consumption: A cluster-randomized controlled trial in Bangladesh MATERNAL AND CHILD NUTRITION Lambrecht, N. J., Waid, J. L., Wendt, A. S., Sobhan, S., Kader, A., Gabrysch, S. 2023; 19 (3): e13505

  Abstract

  Women and children in Bangladesh face high levels of micronutrient deficiencies from inadequate diets. We evaluated the impact of a Homestead Food Production (HFP) intervention on poultry production, as a pathway outcome, and women's and children's egg consumption, as secondary outcomes, as part of the Food and Agricultural Approaches to Reducing Malnutrition cluster-randomized trial in Sylhet division, Bangladesh. The 3-year intervention (2015-2018) promoted home gardening, poultry rearing, and nutrition counseling. We randomly allocated 96 clusters to intervention (48 clusters; 1337 women) or control (48 clusters; 1368 women). Children < 3 years old born to participants were enrolled during the trial. We analyzed poultry production indicators, measured annually, and any egg consumption (24-h recall), measured every 2-6 months for women and their children. We conducted intention-to-treat analyses using mixed-effects logistic regression models with repeat measures, with minimal adjustment to increase precision. Poultry ownership increased by 16% points (pp) and egg production by 13 pp in the final intervention year. The intervention doubled women's odds of egg consumption in the final year (Odds Ratio [OR]: 2.31, 95% CI: 1.68-3.18), with positive effects sustained 1-year post-intervention (OR: 1.58, 95% CI: 1.16-2.15). Children's odds of egg consumption were increased in the final year (OR: 3.04, 95% CI: 1.87-4.95). Poultry ownership was associated with women's egg consumption, accounting for 12% of the total intervention effect, but not with children's egg consumption. Our findings demonstrate that an HFP program can have longer-term positive effects on poultry production and women's and children's diets.

  View details for DOI 10.1111/mcn.13505

  View details for Web of Science ID 000955721900001

  View details for PubMedID 36961298

  View details for PubMedCentralID PMC10262892

• Spatiotemporal variation in risk of Shigella infection in childhood: a global risk mapping and prediction model using individual participant data LANCET GLOBAL HEALTH Badr, H. S., Colston, J. M., Nguyen, N. H., Chen, Y., Burnett, E., Ali, S., Rayamajhi, A., Satter, S. M., Trang, N., Eibach, D., Krumkamp, R., May, J., Adegnika, A., Manouana, G., Kremsner, P., Chilengi, R., Hatyoka, L., Debes, A. K., Ateudjieu, J., Faruque, A. G., Hossain, M., Kanungo, S., Kotloff, K. L., Mandomando, I., Nisar, M., Omore, R., Sow, S. O., Zaidi, A. M., Lambrecht, N., Adu, B., Page, N., Platts-Mills, J. A., Mavacala Freitas, C., Pelkonen, T., Ashorn, P., Maleta, K., Ahmed, T., Bessong, P., Bhutta, Z. A., Mason, C., Mduma, E., Olortegui, M. P., Yori, P., Lima, A. M., Kang, G., Humphrey, J., Ntozini, R., Prendergast, A. J., Okada, K., Wongboot, W., Langeland, N., Moyo, S. J., Gaensbauer, J., Melgar, M., Freeman, M., Chard, A. N., Thongpaseuth, V., Houpt, E., Zaitchik, B. F., Kosek, M. N. 2023; 11 (3): E373-E384

  Abstract

  Diarrhoeal disease is a leading cause of childhood illness and death globally, and Shigella is a major aetiological contributor for which a vaccine might soon be available. The primary objective of this study was to model the spatiotemporal variation in paediatric Shigella infection and map its predicted prevalence across low-income and middle-income countries (LMICs).Individual participant data for Shigella positivity in stool samples were sourced from multiple LMIC-based studies of children aged 59 months or younger. Covariates included household-level and participant-level factors ascertained by study investigators and environmental and hydrometeorological variables extracted from various data products at georeferenced child locations. Multivariate models were fitted and prevalence predictions obtained by syndrome and age stratum.20 studies from 23 countries (including locations in Central America and South America, sub-Saharan Africa, and south and southeast Asia) contributed 66 563 sample results. Age, symptom status, and study design contributed most to model performance followed by temperature, wind speed, relative humidity, and soil moisture. Probability of Shigella infection exceeded 20% when both precipitation and soil moisture were above average and had a 43% peak in uncomplicated diarrhoea cases at 33°C temperatures, above which it decreased. Compared with unimproved sanitation, improved sanitation decreased the odds of Shigella infection by 19% (odds ratio [OR]=0·81 [95% CI 0·76-0·86]) and open defecation decreased them by 18% (OR=0·82 [0·76-0·88]).The distribution of Shigella is more sensitive to climatological factors, such as temperature, than previously recognised. Conditions in much of sub-Saharan Africa are particularly propitious for Shigella transmission, although hotspots also occur in South America and Central America, the Ganges-Brahmaputra Delta, and the island of New Guinea. These findings can inform prioritisation of populations for future vaccine trials and campaigns.NASA, National Institutes of Health-The National Institute of Allergy and Infectious Diseases, and Bill & Melinda Gates Foundation.

  View details for DOI 10.1016/S2214-109X(22)00549-6

  View details for Web of Science ID 000942696000001

  View details for PubMedID 36796984

  View details for PubMedCentralID PMC10020138

• Associations of bacterial enteropathogens with systemic inflammation, iron deficiency, and anemia in preschool-age children in southern Ghana PLOS ONE Lambrecht, N. J., Bridges, D., Wilson, M. L., Adu, B., Eisenberg, J. S., Folson, G., Baylin, A., Jones, A. D. 2022; 17 (7): e0271099

  Abstract

  Anemia remains a pervasive public health problem among preschool-age children in Ghana. Recent analyses have found that anemia in Ghanaian children, particularly in Southern regions, is largely attributable to infectious causes, rather than nutritional factors. Infections with enteropathogens can reduce iron absorption and increase systemic inflammation, but few studies have examined direct links between enteropathogens and anemia. This study investigated associations between detection of individual bacterial enteropathogens and systemic inflammation, iron deficiency, and anemia among 6- to 59-month-old children in Greater Accra, Ghana. Serum samples were analyzed from a cross-sectional sample of 262 children for concentrations of hemoglobin (Hb), biomarkers of systemic inflammation [C-reactive protein (CRP) and α-1-acid glycoprotein (AGP)], and biomarkers of iron status [serum ferritin (SF) and serum transferrin receptor (sTfR)]. Stool samples were analyzed for ten bacterial enteropathogens using qPCR. We estimated associations between presence of each enteropathogen and elevated systemic inflammation (CRP > 5 mg/L and AGP > 1 g/L), iron deficiency (SF < 12 μg/L and sTfR > 8.3 mg/L) and anemia (Hb < 110 g/L). Enteropathogens were detected in 87% of children's stool despite a low prevalence of diarrhea (6.5%). Almost half (46%) of children had anemia while one-quarter (24%) had iron deficiency (low SF). Despite finding no associations with illness symptoms, Campylobacter jejuni/coli detection was strongly associated with elevated CRP [Odds Ratio (95% CI): 3.49 (1.45, 8.41)] and elevated AGP [4.27 (1.85, 9.84)]. Of the pathogens examined, only enteroinvasive Escherichia coli/Shigella spp. (EIEC/Shigella) was associated with iron deficiency, and enteroaggregative Escherichia coli (EAEC) [1.69 (1.01, 2.84)] and EIEC/Shigella [2.34 (1.15, 4.76)] were associated with anemia. These results suggest that certain enteroinvasive pathogenic bacteria may contribute to child anemia. Reducing exposure to enteropathogens through improved water, sanitation, and hygiene practices may help reduce the burden of anemia in young Ghanaian children.

  View details for DOI 10.1371/journal.pone.0271099

  View details for Web of Science ID 000844536800114

  View details for PubMedID 35802561

  View details for PubMedCentralID PMC9269377

• Ruminant-Related Risk Factors are Associated with Shiga Toxin-Producing<i> Escherichia</i><i> coli</i> Infection in Children in Southern Ghana AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE Lambrecht, N. J., Wilson, M. L., Bridges, D., Eisenberg, J. S., Adu, B., Baylin, A., Folson, G., Jones, A. D. 2022; 106 (2): 513-522

  Abstract

  Livestock can provide benefits to low-income households, yet may expose children to zoonotic enteropathogens that cause illness and negative long-term health outcomes. The aim of this cross-sectional study was to determine whether livestock-related risk factors, including animal ownership, exposure to animal feces, and consumption of animal-source foods, were associated with bacterial zoonotic enteropathogen infections in children 6-59 months old in Greater Accra, Ghana. Stool samples from 259 children and 156 household chickens were analyzed for atypical enteropathogenic Escherichia coli (aEPEC), Campylobacter jejuni/coli (C. jejuni/coli), Salmonella, and Shiga toxin-producing Escherichia coli (STEC) using quantitative polymerase chain reaction (qPCR). aEPEC, C. jejuni/coli, STEC, and Salmonella were detected in 45.6%, 11.6%, 4.3%, and 0.8% of children's stool samples, respectively. In adjusted logistic regression models, household ownership of goats or sheep was associated with STEC detection in children (odds ratio [95% confidence interval]: 4.30 [1.32, 14.08]), as were positive detection of STEC in chicken feces (7.85 [2.54, 24.30]) and frequent consumption of fresh cow's milk (3.03 [1.75, 5.24]). No livestock-related risk factors were associated with aEPEC or C. jejuni/coli infection in children. Our findings suggest that ruminant ownership in southern Ghana may expose children to STEC through household fecal contamination and foodborne routes. The lack of association between livestock risk factors and the more commonly detected pathogens, aEPEC and C. jejuni/coli, warrants further research, particularly to help explain how animal-keeping and sanitation practices affect transmission of fecal pathogens that were highly prevalent in chicken feces.

  View details for DOI 10.4269/ajtmh.21-0550

  View details for Web of Science ID 000751813200024

  View details for PubMedID 34844207

  View details for PubMedCentralID PMC8832919

• Maternal Overweight and Obesity during Pregnancy Are Associated with Neonatal, but Not Maternal, Hepcidin Concentrations JOURNAL OF NUTRITION Jones, A. D., Shi, Z., Lambrecht, N. J., Jiang, Y., Wang, J., Burmeister, M., Li, M., Lozoff, B. 2021; 151 (8): 2296-2304

  Abstract

  Overweight or obesity among pregnant women may compromise maternal and neonatal iron status by upregulating hepcidin.This study determined the association of 1) maternal and neonatal iron status with maternal and neonatal hepcidin concentrations, and 2) maternal prepregnancy weight status with maternal and neonatal hepcidin concentrations.We examined hematologic data from 405 pregnant women and their infants from the placebo treatment group of a pregnancy iron supplementation trial in rural China. We measured hepcidin, serum ferritin (SF), soluble transferrin receptor (sTfR), and high-sensitivity C-reactive protein in maternal blood samples at mid-pregnancy and in cord blood at delivery. We used regression analysis to examine the association of maternal prepregnancy overweight or obese status with maternal hepcidin concentration in mid-pregnancy and cord hepcidin concentrations. We also used path analysis to examine mediation of the association of maternal prepregnancy overweight or obese status with maternal iron status by maternal hepcidin, as well as with neonatal hepcidin by neonatal iron status.Maternal iron status was positively correlated with maternal hepcidin at mid-pregnancy (SF: r = 0.63, P < 0.001; sTfR: r = -0.37, P < 0.001). Neonatal iron status was also positively correlated with cord hepcidin (SF: r = 0.61, P < 0.001; sTfR: r = -0.39, P < 0.001). In multiple linear regression models, maternal prepregnancy overweight or obese status was not associated with maternal hepcidin at mid-pregnancy but was associated with lower cord hepcidin (coefficient = -0.21, P = 0.004). Using path analysis, we observed a significant indirect effect of maternal prepregnancy overweight or obese status on cord hepcidin, mediated by neonatal iron status.In both pregnant women and neonates, hepcidin was responsive to iron status. Maternal prepregnancy overweight status, with or without including obese women, was associated with lower cord blood hepcidin, likely driven by lower iron status among the neonates of these mothers.

  View details for DOI 10.1093/jn/nxab133

  View details for Web of Science ID 000731834300026

  View details for PubMedID 33979838

  View details for PubMedCentralID PMC8349130

• Weight bias among public health trainees PUBLIC HEALTH NUTRITION Sonneville, K. R., Rose, K. L., Lambrecht, N. J., Barry, M. R., Weeks, H. M., Leung, C. W. 2021; 24 (6): 1566-1569

  Abstract

  To explore explicit beliefs about the controllability of obesity and the internalisation of negative weight-related stereotypes among public health trainees.Cross-sectional online survey assessing explicit beliefs about the controllability of obesity using the Beliefs About Obese Persons Scale (BAOP) and internalisation of weight bias using the Modified Weight Bias Internalization Scale (WBIS-M). Bivariate associations between BAOP and WBIS-M scores and demographic characteristics were examined using t tests or ANOVA with post hoc Tukey's tests.School of Public Health at a large, Midwestern University.Public health students (n 322).Relative to students who identified as male, those who identified as female had a stronger belief that obesity is not within the control of the individual (P = 0·03), yet had more internalisation of weight bias (P < 0·01). Greater weight bias internalisation was also seen among students who perceived themselves to be of a higher weight status (P < 0·001) and those who were at risk for food insecurity (P < 0·01).Public health trainees may be more attuned to the complexities of weight relative to trainees in other health-related fields, but are still susceptible to internalisation of negative weight-related stereotypes.

  View details for DOI 10.1017/S1368980020004097

  View details for Web of Science ID 000637103100039

  View details for PubMedID 33168123

  View details for PubMedCentralID PMC10195483

• Perceptions and beliefs about anaemia: A qualitative study in three agroecological regions of Ghana MATERNAL AND CHILD NUTRITION Awuah, R., Colecraft, E. K., Wilson, M. L., Adjorlolo, L., Lambrecht, N. J., Nyantakyi-Frimpong, H., Jones, A. D. 2021; 17 (4): e13181

  Abstract

  Little evidence exists concerning perceptions of anaemia in Ghanaian communities, which limits understanding of how to potentially improve health in settings with high anaemia prevalence. We explored lay perceptions of anaemia to understand local knowledge and beliefs and to provide an opportunity to inform interventions. A cross-sectional, qualitative study was conducted in selected communities in three regions of Ghana with high prevalence of anaemia. Forty-eight focus group discussions (FGDs) were conducted with adolescent girls, adult women of reproductive age and adult men (16 FGDs for each demographic group). Participants across the three demographic groups generally described anaemia as inadequate blood in the body and reported that poor diet, heat, alcohol intake, physiological factors and diseases such as malaria were the main causes of anaemia. Consequences of anaemia mentioned in the FGDs included dizziness, weight loss, loss of appetite and weakness. Prevention of anaemia was perceived to result from improved diet, avoidance of exposure to heat and improved sanitation to avoid diseases. The findings suggest that despite areas of convergence between lay and biomedical knowledge on the causes, consequences and prevention of anaemia, the burden of anaemia remains high in the study regions. This highlights a disconnect between local knowledge of anaemia and the health and nutrition behaviours needed to reduce its incidence. Effective interventions can be developed with and for communities that build upon existing knowledge while filling remaining knowledge gaps or misconceptions.

  View details for DOI 10.1111/mcn.13181

  View details for Web of Science ID 000634318700001

  View details for PubMedID 33780144

  View details for PubMedCentralID PMC8476426

• Associations between livestock ownership and lower odds of anaemia among children 6-59 months old are not mediated by animal-source food consumption in Ghana MATERNAL AND CHILD NUTRITION Lambrecht, N. J., Wilson, M. L., Baylin, A., Folson, G., Naabah, S., Eisenberg, J. S., Adu, B., Jones, A. D. 2021; 17 (3): e13163

  Abstract

  Livestock ownership may mitigate anaemia among young children by providing access to animal-source foods (ASFs) yet exacerbate anaemia by exposing children to animal-source pathogens. This study aimed to assess the association between household livestock ownership and child anaemia and examine whether this relationship is mediated by child ASF consumption or by child morbidity and inflammation. We conducted a cross-sectional study of 470 children aged 6-59 months in Greater Accra, Ghana. Child blood samples were analysed for haemoglobin concentration, iron status biomarkers and inflammatory biomarkers. Caregivers were asked about the child's frequency of ASF consumption in the past 3 months. Livestock ownership was categorized into five typologies to distinguish households by the number and combinations of species owned. In adjusted logistic regression, children from households in Type 5, owning cattle, small livestock (goats, sheep or pigs) and poultry, had lower odds of anaemia compared with those in Type 1, owning no livestock (OR [95% CI]: 0.32 [0.14, 0.71]). Although children from households that owned poultry were more likely to consume chicken meat, and children from households with cattle were more likely to drink cow's milk, consumption of these ASFs did not mediate the observed association between livestock ownership and child anaemia. There were no associations between livestock ownership and children's symptoms of illness or inflammation. Further research is needed to understand how ownership of certain livestock species, or a greater diversity of livestock species, may be associated with the risk of child anaemia, including the role of dietary and income-based pathways.

  View details for DOI 10.1111/mcn.13163

  View details for Web of Science ID 000623245000001

  View details for PubMedID 33645904

  View details for PubMedCentralID PMC8189243

• The Role of Iron in the Susceptibility of Neonatal Mice to <i>Escherichia coli</i> K1 Sepsis JOURNAL OF INFECTIOUS DISEASES Michels, K. R., Lambrecht, N. J., Lv, W., Schaller, M. A., Lukacs, N. W., Bermick, J. R. 2019; 220 (7): 1219-1229

  Abstract

  Sepsis from Escherichia coli expressing the K1 antigen is a leading cause of death in neonates. In a murine model, E. coli K1 grew rapidly in the peritoneal cavity of neonatal mice, causing fatal disease. In contrast, adult mice cleared the infection. Neonatal mice mounted a rapid and equivalent antimicrobial immune response compared to adult mice. Interestingly, peritoneal fluid from neonatal mice contained significantly more total iron than that of adult mice, which was sufficient to support enhanced E. coli growth. Transient iron overload in adult mice infected with E. coli resulted in 100% mortality. Maternal diet-induced mild iron deficiency decreased offspring peritoneal iron, decreased bacterial growth, and conferred protection against sepsis. Taken together, neonatal susceptibility to E. coli K1 sepsis is enhanced by a localized excess of peritoneal iron that allows for unchecked bacterial growth. Targeting this excess iron may provide a new therapeutic target in human patients.

  View details for DOI 10.1093/infdis/jiz282

  View details for Web of Science ID 000490986500019

  View details for PubMedID 31136646

  View details for PubMedCentralID PMC7325330

• Assessing the Impact of Animal Husbandry and Capture on Anemia among Women and Children in Low- and Middle-Income Countries: A Systematic Review ADVANCES IN NUTRITION Lambrecht, N. J., Wilson, M. L., Jones, A. D. 2019; 10 (2): 331-344

  Abstract

  Animal husbandry and capture (AHC) may mitigate anemia among women and children by supplying a source of micronutrient-rich animal source foods (ASF), yet may concurrently increase exposure to anemia-inducing pathogens such as Plasmodium spp., helminths, and enteropathogens. We conducted a systematic literature review to assess the relation between AHC and anemia among women of reproductive age, school-aged children, and children aged <5 y in low- and middle-income countries (LMICs). We used a 2-stage screening process, in which 1 reviewer searched 4 databases (PubMed, Web of Science, EMBASE, and Global Health) with predetermined search terms for relevant articles. Two reviewers then independently screened studies using a priori exclusion criteria, yielding a total of 23 articles included in the final review. We evaluated evidence from observational studies assessing animal-dependent livelihoods and livestock ownership, and interventions that promoted livestock and fish production. We found little consistency in anemia outcomes across the several AHC exposures and population groups. Poultry production interventions had modest benefits on anemia among women and children, although whether these improvements were a result of increased ASF consumption, or a result of the combined treatment study design could not be determined. Observational studies identified chicken ownership, and no other livestock species, as a risk factor for anemia among young children. However, there was limited evidence to evaluate pathways underlying these associations. Studies tended to rely on self-reported fever and diarrhea to assess illness, and no study directly assessed linkages between AHC, pathogen burden, and anemia. Thus, there is insufficient evidence to conclude whether AHC improves or worsens anemia among women and children in LMICs. Given the current interest in promoting animal production among low-income households, future studies with robust measures of livestock ownership, ASF consumption, pathogen burden, and anemia status are needed to understand the nuances of this complex and potentially contradictory relation.

  View details for DOI 10.1093/advances/nmy080

  View details for Web of Science ID 000469512800012

  View details for PubMedID 30854553

  View details for PubMedCentralID PMC6416043

• Livestock ownership is associated with higher odds of anaemia among preschool-aged children, but not women of reproductive age in Ghana MATERNAL AND CHILD NUTRITION Jones, A. D., Colecraft, E. K., Awuah, R. B., Boatemaa, S., Lambrecht, N. J., Adjorlolo, L., Wilson, M. L. 2018; 14 (3): e12604

  Abstract

  Livestock ownership may influence anaemia through complex and possibly contradictory mechanisms. In this study, we aimed to determine the association of household livestock ownership with anaemia among women aged 15-49 years and children aged 6-59 months in Ghana and to examine the contribution of animal source foods (ASFs) to consumption patterns as a potential mechanism mediating this association. We analysed data on 4,441 women and 2,735 children from the 2014 Ghana Demographic and Health Survey and 16,772 households from the Ghana Living Standards Survey Round 6. Haemoglobin measurements were used to define anaemia (non-pregnant women: <120 g/L; children: <110 g/L). Child- and household-level ASF consumption data were collected from 24-hour food group intake and food consumption and expenditure surveys, respectively. In multiple logistic regression models, household livestock ownership was associated with anaemia among children (OR, 95% CI: 1.5 [1.1, 2.0]), but not women (1.0 [0.83, 1.2]). Household ownership of chickens was associated with higher odds of anaemia among children (1.6 [1.2, 2.2]), but ownership of other animal species was not associated with anaemia among women or children. In path analyses, we observed no evidence of mediation of the association of household livestock ownership with child anaemia by ASF consumption. Ownership of livestock likely has limited importance for consumption of ASFs among young children in Ghana and may in fact place children at an increased risk of anaemia. Further research is needed to elucidate if and how pathogen exposure associated with livestock rearing may underlie this increased risk of anaemia.

  View details for DOI 10.1111/mcn.12604

  View details for Web of Science ID 000436544400020

  View details for PubMedID 29608248

  View details for PubMedCentralID PMC6055803

• Neonatal monocytes exhibit a unique histone modification landscape CLINICAL EPIGENETICS Bermick, J. R., Lambrecht, N. J., denDekker, A. D., Kunkel, S. L., Lukacs, N. W., Hogaboam, C. M., Schaller, M. A. 2016; 8: 99

  Abstract

  Neonates have dampened expression of pro-inflammatory cytokines and difficulty clearing pathogens. This makes them uniquely susceptible to infections, but the factors regulating neonatal-specific immune responses are poorly understood. Epigenetics, including histone modifications, can activate or silence gene transcription by modulating chromatin structure and stability without affecting the DNA sequence itself and are potentially modifiable. Histone modifications are known to regulate immune cell differentiation and function in adults but have not been well studied in neonates.To elucidate the role of histone modifications in neonatal immune function, we performed chromatin immunoprecipitation on mononuclear cells from 45 healthy neonates (gestational ages 23-40 weeks). As gestation approached term, there was increased activating H3K4me3 on the pro-inflammatory IL1B, IL6, IL12B, and TNF cytokine promoters (p < 0.01) with no change in repressive H3K27me3, suggesting that these promoters in preterm neonates are less open and accessible to transcription factors than in term neonates. Chromatin immunoprecipitation with massively parallel DNA sequencing (ChIP-seq) was then performed to establish the H3K4me3, H3K9me3, H3K27me3, H3K4me1, H3K27ac, and H3K36me3 landscapes in neonatal and adult CD14+ monocytes. As development progressed from neonate to adult, monocytes lost the poised enhancer mark H3K4me1 and gained the activating mark H3K4me3, without a change in additional histone modifications. This decreased H3K4me3 abundance at immunologically important neonatal monocyte gene promoters, including CCR2, CD300C, ILF2, IL1B, and TNF was associated with reduced gene expression.These results provide evidence that neonatal immune cells exist in an epigenetic state that is distinctly different from adults and that this state contributes to neonatal-specific immune responses that leaves them particularly vulnerable to infections.

  View details for DOI 10.1186/s13148-016-0265-7

  View details for Web of Science ID 000384470900001

  View details for PubMedID 27660665

  View details for PubMedCentralID PMC5028999