ETD Collection

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    Growth patterns in a cohort of very low birth weight infants in Johannesburg: a retrospective review
    (2010-08-24) Mackay, Cheryl Anne
    INTRODUCTION: Improved survival of VLBW infants is raising several management issues. An example is that of growth and growth monitoring. AIM OF THE STUDY: To assess the growth of a cohort of VLBW infants born at CMJAH from term CGA to 20 months CGA. METHODS: A retrospective chart review was conducted on 139 VLBW infants (birth weight ≤ 1500g) born at CMJAH between 1 July 2006 and 28 February 2007. RESULTS: Comparison with a term growth reference showed initial growth failure followed by gradual catch up growth but with persistent deficits in length for age. Comparison with international VLBW references showed similar growth for weight and head circumference for age but with deficits in length for age. Growth parameters of the study sample were similar to those of other South African VLBW infants. CONCLUSION: Growth and growth monitoring in VLBW infants is complicated by characteristic growth patterns, high associated morbidity, controversies surrounding ideal growth and lack of an ideal growth reference. Significant deficits in length for age in the study sample may have been due to the large proportion of infants born SGA and the high prevalence of stunting in South African children. Current recommendations for growth monitoring of VLBW infants include the use of a VLBW reference up to two years CGA followed by a term growth reference thereafter
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    The association between post-weaning dietary patterns at age 1 and growth at age 2, from the Birth-to-Twenty cohort study, South Africa
    (2010-04-19T10:21:30Z) Gitau, Tabither Muthoni
    Introduction Malnutrition remains the major cause of child mortality and an essential component in child development and future productivity of the child in the world. With the increasing prevalence of undernutrition, micronutrient deficiencies, and over nutrition in South Africa, it calls for interventions which will help reduce malnutrition since child‟s growth is partly dependant on their diet. This study aimed at determining the association between post-weaning dietary patterns at age one and growth at age two among children from the Birth-To-Twenty cohort in Johannesburg, South Africa. Specific objectives: To describe dietary intake patterns (Diet Diversity Score and Food Variety Score) growth at age one and two among boys and girls in BT20, the prevalence of malnutrition (Stunting, wasting and underweight) among boys and girls in BT20, and to determine the association between dietary patterns at age one and growth at age two. Hypothesis There is no association between post-weaning dietary patterns at age one and growth at age two in the Birth-To-Twenty Cohort study. Study design: Prospective longitudinal study. Setting; Birth-To-Twenty Cohort study Johannesburg, South Africa. Inclusion criteria –Must have complete data on dietary questionnaires and growth data at age two. Data Collection data was collected on following variables; dietary patterns, socio-economic status, growth (height and weight), complimentary feeding, birthweight and gestational age. Anthropometric data (height and weight) was collected at age one and two. Food frequencies questionnaires were used for data collection. Data Analysis STATA 10 was used for data cleaning and analysis. Descriptive and inferential analysis was carried out. Multiple regression analysis was used to assess the association between outcome variable (growth at age 2) and dietary patterns at age 1(12months) and growth at age 2 (24months), and dietary patterns at age 1 controlling for confounders. P-values were calculated to test for v statistical significance at 5% significance level. Results: Ninety six percent of the infants were introduced to solid foods when they were less than 6 months. The Food Variety Score (FVS) was 32.4 and 32.6 for boys and girls respectively; Diet Diversity Score (DDS) was 9.7 and 9.8 for boys and girls respectively. A proportion of 20.5% (n=164) infants were underweight at birth, the prevalence of stunting among the boys rose from 8% at year one to 19% at year two, wasting demonstrated a slight increase from 5% to 8%, underweight too showed a sharp increase from 11% to 25%. Among the girls stunting prevalence increased from 6% at year one to 20% at year 2, wasting slightly rose from 3% to 4% and underweight from 6% to 11%. There was 7.7% (n=35) catch up growth and 20.7% (n=94) catch down with regard to stunting. A proportion of 3.3% (n=15) infants had catch up for weight-for-height and 5.5% (n=25) had a catch down growth. 3.7% (n=17) had catch up growth with regard to weight-for- age and 11.2% (n=51) had catch down growth. Birthweight, underweight and stunting at age one, gender and ethnicity were associated with growth at age two. There was no association between dietary patterns at age one and growth at age two. Conclusion: Diet diversity is good within Soweto and consequently food diversity is not associated with infant growth, however other factors such as macronutrient intake and morbidity maybe important in the Soweto context. Inappropriate feeding practices such as feeding the infant with high sugar diet, high fat and refined foods should be addressed so as to curb the increasing catch down growth at age two. Introduction of solid foods at less than 6 months of age should also be addressed; this can be done by emphasising that exclusive breastfeeding in community health programs for the first 6 months.
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    Growth performance and digestibility in exocrine pancreatic insufficient pigs supplemented with a pancreatic enzyme preparation
    (2009-05-26T08:05:21Z) Donaldson, Janine
    Exocrine pancreatic insufficiency (EPI) is a major complication of cystic fibrosis. Conventional treatment involves the replacement of pancreatic enzymes and intake of a low fat diet. However, contrary to previous therapeutic strategies, a high fat diet may be beneficial in EPI patients. The present study investigated the effects of dietary supplementation with Creon 10 000 a pancreatic enzyme preparation, in conjunction with a high-fat diet, on growth performance, digestibility and absorption of fat in a pig model of EPI by the surgical ligation of the pancreatic duct in 6 male pigs (Swedish Landrace X Yorkshire X Hampshire). Following surgery, and for the duration of the experimental period, pigs were fed a high fat diet (twice daily). The experimental period lasted for 15 days during which blood, urine and faecal samples were collected. In the last 7 days of the experimental period (days 8-14), Creon 10 000 was included in the high fat meals. Urine and faecal samples were analysed for dry matter, crude protein and fat content. Plasma was used to assess the lipaemic index and the plasma lipid profiles. Treatment with Creon 10 000 significantly increased body mass (P = 0.016) and the digestibility of dry matter, crude protein as well as the co-efficient of fat absorption were also significantly improved following treatment (P<0.05). Creon 10 000 improved the lipaemic index values and significant changes in plasma free fatty acid and triglyceride concentrations were observed but not in cholesterol or high and low density lipoproteins. This study supports previous reports that the administration of pancreatic enzyme preparations together with a high fat meal is a beneficial strategy for the nutritional management of EPI.
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    Elucidation of the aerobic respiratory chains in mycobacteria
    (2006-10-27T07:51:11Z) Matsoso, Limenako
    The aerobic respiratory chain of mycobacteria consists of at least two branches, a cytochrome c branch terminating in an aa3-type cytochrome c oxidase, and a quinol branch terminating in cytochrome bd oxidase. The structure and function of the former branch, leading from the menaquinone-menaquinol pool to the cytochrome bc1 complex and terminating in the aa3-type cytochrome c oxidase, was characterized in Mycobacterium smegmatis. Allelic exchange mutants of M. smegmatis in the bc1 complex (ΔqcrCAB::hyg) and in subunit II of the aa3-type cytochome c oxidase (ΔctaC::hyg) were constructed and analyzed for growth, and gene expression using lacZ reporter assays and genome expression profiling by DNA microarray. Both mutants were found to be profoundly growth impaired. Disruption of this pathway resulted in an adaptation of the respiratory network that is characterized by a marked up-regulation of cydAB, which encodes the bioenergetically less-efficient and microaerobically induced cytochrome bd-type menaquinol oxidase that is required for the growth of M. smegmatis under O2-limiting conditions. Other adaptations to re-routing of the electron flux through the branch terminating in the bd-type oxidase were revealed by comparative expression profiling of the bc1-deficient mutant and its parental wild type strain using a partialgenome microarray of M. smegmatis that is enriched in essential genes. The majority of the genes up-regulated in the mutant are involved in intermediary metabolism and respiration. Also induced were several genes including, uspL and a homologue of Rv1592c, which were previously shown to be up-regulated by hypoxia in M. smegmatis (uspL) and M. tuberculosis (uspL and Rv1592). The cytochrome bc1-aa3 branch is required for growth of M. smegmatis under aerobic conditions and its disruption results in growth attenuation and up-regulation of cytochrome bd oxidase.