Effect of Chronic Arsenic Exposure on Malnutrition of Under Five Children

Study Overview
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Brief Summary
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Early life malnutrition is associated with later life health problems, Particularly Stunting, which is a height-for-age Z score less than -2 standard deviation of World Health Organization median.Underweight is weight-for-age Z score less than -2 standard deviation of World Health Organization median. Wasting is weight -for- height Z score less than -2 standard deviation of World Health Organization median.

Detailed Description
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prevalence of under-five stunting, wasting and underweight are 21% and , 8% and 6% respectively in Egyptian Demographic Health Survey 2014. The main risk factors for growth restriction in children are maternal under nutrition during pregnancy, lack of exclusive breastfeeding, inappropriate complementary feeding and micronutrient intake and high prevalence of enteric infections. However, other environmental exposures may also play a role in growth restriction . High concentrations of Arsenic, lead and cadmium in placenta are associated with poor fetal out come and low birth weight. Arsenic crosses the placenta causing suppression of insulin-Like Growth Factor 1. When breastfeeding is exclusive, infants are unlikely to be exposed to Arsenic by other routes of exposure such as external foods, drinking water and foods made at home using Arsenic contaminated water. Rational of the study. Improvement of under-five nutritional status is a global target. Although the exposure to arsenic has increased globally, it's impact on nutritional status has seldom been investigated.

Official Title
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Effect of Chronic Arsenic Exposure on Malnutrition Among Under-five Children Attending Assiut University Children Hospital

Conditions
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Malnutrition, Child, Arsenic Poisoning Chronic

Intervention / Treatment
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* Diagnostic Test: arsenic exposure


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: female children from 2 to 5 years Exclusion Criteria: Severely ill children other than severely malnourished. Children with congenital anomaly. Relatives.

Ages Eligible for Study
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Minimum Age: 2 Years
Maximum Age: 5 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| malnourished under five children<br>children from 2 to 5 years with malnutrition | Diagnostic Test: arsenic exposure<br>* analysis of hair samples for Arsenic using Agilent graphite tube atomizer 120<br>|
| well nourished under five children<br>children from 2 to 5 years without malnutrition | Diagnostic Test: arsenic exposure<br>* analysis of hair samples for Arsenic using Agilent graphite tube atomizer 120<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Chronic Arsenic Exposure of Under Five Children | Hair samples collected from participating children will be analyzed for Arsenic using Agilent graphite tube atomizer (GTA) 120 | one year | 
| weight measurement | weight in kilograms will be measured to all participating children | one year | 
| height measurement | height in meters will be measured to all participating children | one year |