Iron deficiency, with or without anemia, remains a major public health concern among young children in Myanmar. While iron supplementation is widely recommended, its potential adverse effects on growth and gut microbiota warrant investigation, particularly in contexts of poor complementary feeding. To assess the effects of iron supplementation, with or without complementary feeding recommendations (CFRs), on micronutrient status, linear growth and gut microbiota composition among Myanmar children aged 12-23 months, a 24-week randomized controlled trial was conducted in Ayeyarwady Region of Myanmar. Fourteen clusters (villages/wards) were randomized to receive CFRs or not, and children within the clusters were randomized to receive daily aqueous iron or placebo, creating four arms: Placebo (n = 104), CFR (n = 112), Fe (n = 105) and CFRFe (n = 112) totalling 433 children. All intervention groups (CFR, Fe, CFRFe) improved haemoglobin and reduced anaemia risk compared with Placebo (AOR = 0.31 (0.15-0.62), 0.15 (0.07-0.32), 0.14 (0.07-0.31), respectively). CFR and CFRFe also improved zinc status. However, iron-alone (Fe) increased the stunting risk (AOR= 2.74 (1.04-7.23)), while CFRFe did not. No significant effects were observed on gut microbiota composition. Aqueous iron supplementation may impair linear growth when diets are not optimized; combining supplements with optimized complementary feeding may support healthier outcomes. This article is part of the theme issue 'Biological, biomedical and environmental drivers of stunting'.
BACKGROUND:Using Global Burden of Disease (GBD) 2021 data, we quantified the global, regional, and national burdens and trends of lower respiratory infections (LRIs) attributable to smoking and secondhand smoke exposure from 1990 to 2021. Our findings aim to inform evidence-based strategies for more effective prevention and control. METHODS:Based on the GBD 2021, we analyzed age-standardized mortality rates (ASMRs) and age-standardized disability-adjusted life year rates (ASDRs) across the 204 countries and territories. We then evaluated trends using estimated annual percentage changes (EAPCs). The temporal evolution of the disease burden, its relationship with the sociodemographic index (SDI), and the independent effects of population growth, ageing, and epidemiological changes were examined. Additionally, cross-national inequality analyses and projections of the disease burden through 2050 were conducted. RESULTS:In 2021, the global ASMR for LRIs attributable to smoking was 2.32 per 100,000 people, with an ASDR of 52.04 per 100,000 person-years. For secondhand smoke, the ASMR was 2.01 per 100,000 people, with an ASDR of 88.26 per 100,000 person-years. In the 5 SDI regions, the burden of LRIs attributable to smoking was most severe in the low-middle SDI, whereas the burden attributable to secondhand smoke was most significant in the low SDI. Furthermore, the burden of LRIs attributable to both smoking and secondhand smoke was especially pronounced in countries such as Lesotho and the Solomon Islands. The smoking-attributable LRIs burden increased with age, whereas the burden of secondhand smoke exposure was notably high in children under 5 years of age. Forecast analyses predict a significant decrease in the ASMR and ASDR for LRIs attributable to smoking and secondhand smoke exposure from 2022 to 2050. CONCLUSION:Despite a global decline in the burden of LRIs attributable to smoking and secondhand smoke, significant inequalities persist. Future tobacco control must be targeted to high-risk regions and populations, particularly children under 5 years old exposed to secondhand smoke and older adults affected by both smoking and secondhand smoke, in order to further reduce the burden of LRIs.
Building on our previous report of high prevalence of soil-transmitted helminth (STH) infections among Myanmar schoolchildren (Aung et al., Infectious Diseases of Poverty, 2022), we conducted additional molecular screening of archival stool samples from the same cohort in Phyu Township, Bago Region, to investigate additional helminth infections. We also report finding of other helminths by Kato-Katz in the previous study that were not previously published. Stool samples utilised in this study were collected in 2016 and the DNA extracted in 2017 and kept stored at -20°C until further molecular characterisation in this study in 2025. Using quantitative PCR (qPCR), we detected Schistosoma DNA in two of 264 samples, Strongyloides stercoralis DNA in twelve, and Ancylostoma ceylanicum in eleven. Although sequencing of the Schistosoma-positive samples was unsuccessful, the molecular evidence aligns with other recent reports suggesting emerging or cryptic transmission of schistosomiasis in Myanmar. The epidemiology of schistosomiasis in the region remains poorly defined, highlighting the need for targeted snail surveys, environmental DNA (eDNA) monitoring, and host sampling to confirm transmission foci. This study demonstrates the added value of molecular diagnostics for complementing traditional parasitological methods and guiding surveillance and control strategies in areas of emerging endemicity.
Protollin, a nasal adjuvant, was evaluated in a randomized double-blind phase 1 study of 16 early Alzheimer’s disease (AD) patients to determine safety and to assess its immunomodulatory effects. In a double-blind dose escalation study, subjects received nasal Protollin at doses of 0.1 mg, 0.5 mg, 1.0 mg, and 1.5 mg or placebo twice over a two-week period. Treatment was well-tolerated with minimal side effects. Transcriptomic and single-cell analyses demonstrated that prior to treatment, AD blood monocytes had downregulation of phagocytosis-related genes and an increased pro-inflammatory signature. These AD monocyte abnormalities were reversed by nasal Protollin beginning at a dose of 1.0 mg. Protollin induced a robust phagocytic gene signature, including upregulation of CD36, ITGAL, LYST, and FCGR1A. A similar phagocytic signature was observed in brain-infiltrating amyloid-clearing monocytes in an APP Tg mouse model treated with nasal Protollin. Protollin treatment decreased the expression of costimulatory molecules on monocytes and decreased CD8 + T cell activation and cytotoxicity. Our results provide the basis for a phase 2 study of nasal Protollin in subjects with AD in which nasal Protollin at a dose of 1.0 mg will be administered weekly over 6 months to modulate peripheral immunity and clear amyloid from the brain. ClinicalTrials.gov registration no NCT07187141.
Background: Unhealthy dietary habits and physical inactivity among university students are common across the world, predisposing them to obesity and its comorbidities. Nutritional literacy (NL), which plays an important role in the formation of these behaviors, is unexplored. This study was conducted to investigate the relationship of nutritional literacy with dietary and lifestyle practices among university students in Abha, Saudi Arabia. Methods: A cross-sectional descriptive study was carried out on 385 students of King Khalid University (KKU) by convenient sampling. Information was collected between March and May 2024 using an online research form, which includes socio-demographics, the Nutrition Literacy Self-Assessment Short Form (NL-SF12), and the Dietary and Lifestyle Habits Questionnaire (DLHQ). Descriptive statistics were calculated, and Pearson's correlation and multiple regression models were applied, at significance level of p < 0.05. Results: Highest levels of NL were found in the knowledge (M = 4.31, SD = 0.74) and understanding sections (M = 4.08, SD = 0.70), compared to using skills (M = 3.56, SD = 0.96). The average (M) meal pattern was irregular, M = 2.41, SD = 0.92, fruits and vegetable consumption was moderate (sweets intake and fast food intake frequent (soft drink intake also typical of the sample quantity being: M = 2.23, SD = 0.77). Lifestyle behaviors included high screen time, eating during sedentary periods, and moderate sports participation. NL was significantly correlated with dietary habits (r = 0.624, p = 0.005), but less so with lifestyle habits (r = 0.524, p = 0.063). Positive predictors included education, income, sleep, and age; negative predictors were smoking, chronic illness, and higher BMI. Conclusion: The KKU students had satisfactory nutritional literacy, but weak application of their theoretical knowledge in terms of poor dietary and lifestyle practices. The present study is a valuable addition to the literature through focusing on actual application of nutritional literacy factors among university students in the Saudi context. Designed interventions that target practical food skills, mindful eating/social dining and regular physical activity are necessary to assist consumers in making healthy decisions and curtail the long-term burden of NCDs. These results provide pragmatic direction for universities and public health policymakers to develop specific, evidence-based programs that meet the needs of students living these realities.
