Changes in growth, body composition, and zinc indexes were evaluated after 25 wk in a double-blind zinc-supplementation study of 162 periurban Guatemalan children aged 81.5 +/- 7.0 mo (mean +/- SD). Children receiving the zinc supplement (10 mg Zn/d as amino acid chelate) for 90.1 +/- 9.2 d had higher mean fasting plasma zinc (16.2 +/- 2.9 vs 14.9 +/- 2.1 mumol/L, P < 0.01), a greater increase in median triceps skinfold Z score (0.50 vs 0.38, P < 0.05), and a smaller deficit in median midarm circumference (MAC) Z score (-0.03 vs -0.20, P < 0.05) compared with the placebo group. Initial hair zinc classified as < 1.68 and > 1.68 mumol/g was the only laboratory variable that explained some of the variance in final Z scores of midarm-muscle area (P < 0.05) and MAC (P < 0.01). Children responded to the zinc supplement with changes in indexes of body composition rather than growth.

BackgroundViolence against women by their male intimate partners (IPV) during pregnancy may lead to negative pregnancy outcomes. We examined the role of IPV as a potential risk factor for miscarriage in Guatemala. Our objectives were: (1) To describe the magnitude and pattern of verbal, physical and sexual violence by male intimate partners in the last 12 months (IPV) in a sample of pregnant Guatemalans; (2) To evaluate the influence of physical or sexual IPV on miscarriage as a pregnancy outcome.MethodsAll pregnant women reporting to the maternity of a major tertiary care public hospital in Guatemala City from June 1st to September 30th, 2006 were invited to participate in this cross-sectional study. The admitting physician assessed occurrence of miscarriage, defined as involuntary pregnancy loss up to and including 28 weeks gestation. Data on IPV, social and demographic characteristics, risk behaviours, and medical history were collected by interviewer-administered questionnaire. Laboratory testing was performed for HIV and syphilis. The relationship between IPV and miscarriage was assessed through multivariable logistic regression.ResultsIPV affected 18% of the 1897 pregnant Guatemalan women aged 15-47 in this sample. Verbal IPV was most common (16%), followed by physical (10%) and sexual (3%) victimisation. Different forms of IPV were often co-prevalent. Miscarriage was experienced by 10% of the sample (n = 190). After adjustment for potentially confounding factors, physical or sexual victimisation by a male intimate partner in the last 12 months was significantly associated with miscarriage (ORadj 1.1 to 2.8). Results were robust under a range of analytic assumptions.ConclusionsPhysical and sexual IPV is associated with miscarriage in this Guatemalan facility-based sample. Results cohere well with findings from population-based surveys. IPV should be recognised as a potential cause of miscarriage. Reproductive health services should be used to screen for spousal violence and link to assistance.

In a study of periurban Guatemalan school-children (89 males, 73 females) aged 81.5 +/- 7.0 mo (mean +/- SD), height, weight, arm circumference, and triceps-skinfold-thickness (TSF) measurements were examined in relation to plasma and hair zinc concentrations, plasma and red blood cell alkaline phosphatase activities, recognition thresholds for salt (RTS), delayed-cutaneous hypersensitivity response to seven recall skin test antigens, and cognitive measures. Children were stunted [median height-for-age (HA) Z score -1.49] but not wasted [median weight-for-height (WH) Z score 0.20], with median midarm muscle area (MAMA) and midarm-fat area (MAFA) Z scores of -0.57 and -0.35, respectively. Of the children, 63.5% of males and 44.1% of females had hair zinc < 1.68 mumol/g (P < 0.05); 12.3% of males and 1.5% of females had plasma zinc < 10.71 mumol/L (P < 0.05). Children with hair zinc < 1.68 mumol/g had higher (P < 0.05) medians for WA Z and WH Z scores, RTS, and phytic acid intake than did those with hair zinc > or = 1.68 mumol/g. Zinc status explained some of the variance in growth (HA, WA, and WH Z scores), body composition (MAFA Z scores), and taste acuity. Suboptimal zinc status arose partly from diets low in readily available zinc.

One hundred thirty children (65-95 mo old) from a low-socioeconomic neighborhood of Guatemala City participated in a randomized, double-blind, controlled trial of zinc supplementation. One group received 10 mg Zn/d (n = 65) and the other group received a placebo (n = 65); 90 +/- 9.2 doses were given over 120-150 d. Stools were examined for prevalence and intensity of helminths and prevalence of protozoa at the beginning and end of the study. The initial prevalence was 42% for helminths and 18% for protozoa, with no differences between groups. Mebendazole was administered to all children, and protozoal infections were treated specifically at the beginning of the study. The reinfection rates were 17% (11 of 65) for helminths and 12.3% (8 of 65) for protozoa in the zinc group and 15% (10 of 65) and 10.7% (7 of 65), respectively, in the placebo group (P > 0.05). Analysis by specific parasites revealed no treatment effect. We conclude that neither plasma or hair zinc status nor oral zinc supplementation had an effect on parasite status in children.

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