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การวิเคราะห์มิติทางสังคมของการท่องเที่ยวเชิงการแพทย์, ณัฐดนยา ทิพยจารุโภคา

Chulalongkorn University Theses and Dissertations (Chula ETD)

งานวิจัยนี้เป็นการวิจัยเชิงคุณภาพ โดยมีวัตถุประสงค์เพื่อศึกษา วิเคราะห์ เพื่อทำความเข้าใจการท่องเที่ยวเชิงการแพทย์ในมิติทางสังคม สำรวจประเด็นสำคัญ และผลกระทบที่เกิดขึ้นแล้วและอาจจะเกิดขึ้นทางด้านสังคม สุขภาพ ที่อาจจะมาจากการส่งเสริมการท่องเที่ยวเชิงการแพทย์ โดยผู้วิจัยได้กำหนดระเบียบวิธีการวิจัยหรือกระบวนวิธีการวิจัยประกอบไปด้วยการศึกษาและวิเคราะห์ข้อมูลจากเอกสารและการสัมภาษณ์บุคคลจำนวน 20 คน จากนั้นจึงนำข้อมูลที่ได้มาวิเคราะห์เชิงเนื้อหาและเขียนรายงานผลงานวิจัยในลักษณะเชิงพรรณนา ผลการศึกษาพบว่า จากวิกฤตเศรษฐกิจในปี พ.ศ.2540 โรงพยาบาลเอกชนต้องหาโอกาสใหม่ๆ ทดแทนการรายได้จากกลุ่มลูกค้าที่เป็นคนไทย จึงได้หันไปหากลุ่มลูกค้าจากต่างประเทศซึ่งเป็นประเทศที่มีกำลังซื้อสูง ต่อมารัฐบาลประสบปัญหาขาดดุลเดินสะพัดติดต่อกันหลายปี จึงได้มีการกำหนดนโยบายการพัฒนาประเทศไทยให้เป็นศูนย์กลางสุขภาพของเอเชีย โดยไทยมีการท่องเที่ยวเป็นทุนเดิมอยู่แล้ว มีกลุ่มสถานพยาบาลเอกชนที่ได้รับมาตรฐานด้านการบริการด้านสุขภาพหลายแห่ง ด้วยจุดแข็งเหล่านี้ จึงพัฒนาแผนและนโยบายเพื่อการเป็นศูนย์กลางสุขภาพ (Medical hub) ในระดับเอเชีย ซึ่งส่วนใหญ่จะถูกมองไปในด้านของผลดีด้านเศรษฐกิจรายได้กำไรที่เพิ่มขึ้นของประเทศ จึงมีประเด็นว่าผลกระทบการท่องเที่ยวเชิงการแพทย์นั้นมักจะไม่ได้รับการพิจารณาอย่างถี่ถ้วนเมื่อมีการผลักดันนโยบายนี้ ดังนั้น การศึกษามิติทางสังคมของการท่องเที่ยวเชิงการแพทย์ได้สำรวจประเด็นสำคัญไว้ดังนี้ 1. แนวคิดและนิยามของการท่องเที่ยวเชิงการแพทย์ (Medical Tourism) และนักท่องเที่ยวเชิงการแพทย์ (Medical Tourists) 2. ผลกระทบต่ออัตรากำลังบุคลากรทางการแพทย์และอัตราค่ารักษาพยาบาล 3. ผลกระทบจากโลกาภิวัตน์และกระบวนการทำให้เป็นสินค้า 4. มาตรฐานคุณภาพโรงพยาบาล 5. ผลกระทบด้านการแพร่กระจายปัญหาการแพร่กระจายของเชื้อดื้อยา และโรคติดต่อที่ระบาดครั้งใหญ่ ซึ่งประเด็นเหล่านี้เป็นสิ่งสำคัญ ในอีกมุมหนึ่ง การท่องเที่ยวเชิงการแพทย์มีส่วนที่ทำให้การรักษาพยาบาลในยุคปัจจุบันเปรียบเสมือนเป็นสินค้าชนิดหนึ่งที่รองรับนักท่องเที่ยวต่างชาติและกลุ่มคนที่มีฐานะด้านการเงิน เรื่องนี้จึงมีความซับซ้อนและต้องทำความเข้าใจจากหลายแง่มุม และจำเป็นอย่างยิ่งที่ควรจะมีการศึกษาพิจารณาจากแง่มุมที่ไม่ได้มีการพูดถึงมากนัก ทั้งในเรื่องของคำนิยามและความหมายของการท่องเที่ยวเชิงการแพทย์และนักท่องเที่ยวเชิงการแพทย์ ปรากฏการณ์โลกาภิวัตน์ตามกระแสเสรีนิยมใหม่ซึ่งทำให้เรื่องการท่องเที่ยวเชิงการแพทย์โยงใยได้กับข้อถกเถียงเรื่องความเป็นธรรมทางสังคมที่เกิดขึ้นจากการส่งเสริมธุรกิจและอุตสาหกรรมนี้ การทำความเข้าใจที่ชัดเจนขึ้นจะนำไปสู่การสร้างแนวทางการเสริมความเป็นธรรมด้านสุขภาพและการกระจายผลประโยชน์ให้สังคมโดยรวมได้ต่อไป

Small Area Estimates Of Poverty In Region Iii, Caesar B. Cororaton, Arlene B. Inocencio, Alellie B. Sobreviñas, Emmanuel Dc. Barnedo

DLSU Business & Economics Review

Official estimates of the Philippine Statistical Authority (PSA) poverty incidence prior to 2018 are reliable up to the regional level as these are consistent with the sampling domain of the data used for estimation. Below this level, the PSA poverty estimates are unreliable because of very large sampling errors. The high level of unreliability makes the estimates less useful for poverty policy targeting. This paper addresses this concern by combining the Family Income and Expenditure Survey (FIES) and the Census of Population and Housing (CPH) data and using an increasingly accepted technique for small area estimation (SAE). We estimate the …

Using Community-Based Screening To Quantify The Relationship Between Hiv And Hypertension In A Rural South African Community, Jessica Ainooson

Public Health Theses

Background: Over the past three decades, the prevalence of hypertension has increased in sub-Saharan Africa, paralleling the HIV/AIDS epidemic. The aim of this study is to assess the relationship between HIV status and elevated blood pressure in a rural South African community. Methods: A secondary analysis was conducted from a community-based screening program providing TB/HIV/blood pressure/glucose screening in the rural sub-district of Msinga, KwaZulu-Natal, South Africa from 2011 - 2017. Descriptive analyses were used to characterize the frequency of measured and self-reported hypertension, HIV status, and sociodemographic variables. Multivariable logistic regressions were used to estimate the relationship between HIV status …

Association Between Rheumatoid Arthritis Severity And Mental Health In A Prevalent Cohort Of American Adults, 2013-2022, Nicole-Anne Ballesteros

Public Health Theses

Objective/Purpose: The severity of rheumatoid arthritis and its association with depression and anxiety among a prevalent cohort of American adults has been neither well-researched nor backed by real-world data. This investigation seeks to test the hypothesis that there is an association between disease severity and the aforementioned psychological conditions, both of which are commonly observed in patients with rheumatoid arthritis.

Methods: Real-world data from OM1 Inc.’s rheumatoid arthritis registry (2013-2022) was used for this analysis. Disease severity (low, medium, and high), categorized using disease activity scores, was the main exposure, while depression and anxiety were the study’s two primary outcomes. …

Identification And Correction Of Normalized Deviance In Healthcare Systems To Prevent Healthcare-Associated Infections And Improve Patient Outcomes, Elliana Sophia Barbell

Public Health Theses

Introduction: In healthcare, normalized deviance is characterized by the steady transition away from standard practice toward variations in practice behaviors. This deviation presents minorly at first and is accepted to save time and increase efficiency. However, initial evaluations of innocuity do not represent actual safety. While the deviant practice may not cause immediate patient harm, its alignment with additional system weak points has the potential to lead to poor patient outcomes, including the development of healthcare-associated infections (HAI). One behavior that may influence HAI development and patient outcomes is hair removal during preoperative skin preparation.Methods: An observational study of hair …

Adverse Childhood Experiences & Breastfeeding - Pakistan, Paola Bojorquez-Ramirez

Public Health Theses

Rationale: Prior studies have found that a history of adverse childhood experiences (ACEs) is associated with breastfeeding, but the evidence is inconsistent. Despite low and middle income countries (LMICs) carrying a disproportionate amount of poor maternal and infant health outcomes, little research has assessed the relative impact of ACEs on breastfeeding initiation and exclusive breastfeeding in LMICs.Objective: The study investigates whether maternal ACEs are associated with breastfeeding initiation and exclusive breastfeeding at 3 and 6 months postpartum among a cohort of women from rural Pakistan. Methods: The cross-sectional analysis included 869 women 18-45 years of age from the Bachpan Cohort …

Caregiver Experiences Of Social Need And Promotion Of Support In The Pediatric Setting: A Qualitative Study, Meghan Patricia Casey

Public Health Theses

Children are vulnerable to the long-term health impacts of unmet family needs within social determinants of health like income, food security, housing, and transportation. Efforts have grown to recognize and respond to these challenges in the pediatric setting through social needs screening and other interventions. Previous research has extensively described the pediatric provider perspective on this work. However, less is known about how caregivers experience interactions surrounding social needs in the healthcare setting and which factors may influence these perceptions. To address these gaps in knowledge, this qualitative study examined semi-structured interviews of 20 caregivers who participated in a pediatric …

United States Immigration Law As A Social Determinant Of Health: A Mixed-Methods Systematic Review, Natalia Castellanos González

Public Health Theses

Background: Rapidly changing immigration policies and anti-immigrant rhetoric have impacted the services available and the health outcomes of undocumented immigrants. Research focusing on the health of noncitizens usually employs a cultural frameworks approach, focusing on individual behaviors or outcomes rather than structural barriers and limitations. This analysis is not adequate for explaining the origins of community-level and structural inequities, and there are existing gaps in research documenting the ways in which policies and changes impact immigrants’ health-seeking behaviors and overall health. Methods: This thesis employed a mixed methods-mixed research synthesis approach to carry out a systematic review. Article selection followed …

Proximity And Parental Interaction: Examining The Relationship Between Proximity Data And Mother-Infant Interaction Among Mothers With And Without Depression, Paige Farrenkopf

Public Health Theses

Background: There is a lack of data on response behaviors among young mothers in low- and middle-income countries. Emerging passive sensing technology has been increasingly allowing researchers to collect this type of day-to-day behavioral data.

Methods: We administered PHQ-9 depression surveys and the Observation of Maternal-Child Interaction (OMCI) measure to young mothers between the ages of 15-25 in the Chitwan region of Nepal, and conducted key informant interviews with all mothers selected for participation.

Results: Among 54 mother-infant dyads, we found that there was no statistically significant correlation between maternal responsiveness and proximity. When we stratified participant groups by depression …

Challenges And Prospects: Reducing U.S. Methane Emissions Via Red Macroalgae (Asparagopsis Taxiformis) Feed Additives To Inhibit Enteric Methane Production From Ruminant Livestock, Rebecca Gillman

Public Health Theses

Approximately 27% of U.S. methane emissions are emitted by the agriculture sector annually, primarily by ruminant livestock as a GHG enteric fermentation bi-product (EPA, 2022). This proposed intervention explores the feasibility of scaling up use of anti-methanogenic ruminant feed additives, to directly reduce U.S. agricultural methane emissions at the source. A careful review of in vitro, in vivo and small-scale pilot studies revealed that the potent, anti-methanogenic bioactive compounds in red macroalgae (Asparagopsis Taxiformis) can both safely and effectively inhibit methanogenesis during enteric fermentation, resulting in up to 90% reduction in methane emissions without adverse risk or consequence to animal …

Oiremos: The Development, Implementation, And Evaluation Of A Holistic Health Curriculum For A Hispanic Youth Enrichment Program, Margaret Cavendish Kellogg

Public Health Theses

In the spring of 2021, as the Covid-19 pandemic continued to exacerbate health inequities and virtual learning dragged on, I developed and implemented an educational health-promotion intervention for a small group of Hispanic youth in collaboration with a New Haven Latinx social services non-profit, Junta for Progressive Action. The bilingual, culturally-responsive health curriculum wove together engaging activities related to physical, emotional, mental, social, and community health, promoting participants’ socio-emotional learning and equipping them with destigmatizing vocabulary and skills they could use to advocate for their needs. The curriculum was grounded in social and behavioral theories and was informed by participants’ …

Patient Experience During The Covid-19 Pandemic At Smilow Cancer Hospital At Yale-New Haven, Danielle Marie Kline

Public Health Theses

Background: The COVID-19 pandemic has sidelined many elective, as well as non-elective, procedures designed to improve patients’ care experience. Oncology patients are at higher risk of developing and dying from COVID-19 and experience greater difficulties accessing and affording healthcare, compared to patients without cancer.

Objective: To explore the trends in patient experience of outpatient oncology patients in relation to the COVID-19 pandemic.

Methods: We utilized the additional comments section of the Press Ganey survey to ask respondents (n=12,514) about their experiences utilizing care. The survey was administered after each patient visit and analyzed quarterly from January 2020 to February 2021: …

Factors Associated With Failure To Complete Multi-Dose Vaccine Series Among U.S. Children Ages 19–35 Months, National Immunization Survey-Child, 2019, Sarah Yukari Michels

Public Health Theses

Background: Most early childhood immunizations require 3-4 doses to achieve optimal disease protection. Failure to complete multi-dose vaccine series is an important driver of undervaccination. Our objective was to evaluate factors associated with starting but not completing all multi-dose series in the combined 7-vaccine series.

Methods: Using 2019 National Immunization Survey-Child data, U.S. children ages 19-35 months with provider verified vaccination data were classified in one of three vaccination patterns: (1) completed the combined 7-vaccine series, (2) missing ≥1 vaccine series (i.e., selective vaccination), or (3) all series initiated, but did not complete all multi-dose series (i.e., missing ≥1 dose(s)). …

A Qualitative Analysis Of Paternal Perspectives On Breastfeeding Support Among Black Fathers In Connecticut, Jasmine Teresa Rios

Public Health Theses

Background: Despite the persistence of racial and ethnic disparities in breastfeeding in which Black mothers breastfeed at lower rates, little is known about Black fathers’ experiences with breastfeeding and breastfeeding support services (e.g., maternity hospital-based care, lactation specialty care). This thesis reports Black fathers’ perceptions of breastfeeding, influencers of breastfeeding, and breastfeeding support services in Connecticut using a qualitative, community-based participatory approach.Methods: The study’s focus group guide was co-developed with community partners and adapted from the Barrier Analysis Tool to identify breastfeeding facilitators, barriers, and service improvement areas. Per study design, all participants were fathers to a child under three …

Navigating A Patchwork Maze: Individuals’ Experience Of Administrative Burden When Accessing Homeless Assistance Services, Leah Robinson

Public Health Theses

Despite significant efforts to address the issue of homelessness in the United States over the past several decades, over 500,000 individuals still experience homelessness on any given night. A large portion of this persistent and high rate of homelessness can likely be attributed to the shortage of affordable housing options, the eviction crisis, and limited financial support for rental assistance found throughout the country. However, administrative burdens may also contribute to the high rate of homelessness being seen.Our study explores this question by examining 28 individuals’ experience of administrative burden when navigating the landscape of homeless assistance services in New …

Evaluating Associations Between Pesticide Use And Kidney Function In The Biomarkers Of Exposure And Effect In Agriculture (Beea) Study: Using Cluster Models To Group Farmers With Similar Pesticide Use, Thomas Shao

Public Health Theses

Pesticides are commonly used in agrarian areas to control for certain forms of undesirable plant or animal life. The widespread use of pesticides and the variety of chemicals that make up this class pose adverse health effects to those exposed to pesticides. Farmers often use multiple pesticides, and their use is often correlated with other pesticides. However, analyses typically examine each pesticide individually and mixture analysis is not as heavily considered. To further evaluate the exposure of pesticide usage, hierarchical clustering methods were used to identify similar questionnaire response patterns. This technique has been used to quantify homogenous exposure estimates …

Occupational And Socioeconomic Risk Factors Of Noise-Induced Hearing Loss, Rongcan Sun

Public Health Theses

Hazardous noise (>85 dBA) is among the most common occupational exposures and responsible for the majority of noise-induced hearing loss. Noise-induced hearing loss impacts many aspects of a person’s life, including workplace safety, daily routine, economic consequences, and quality of life. However, studies on the relationship between occupational noise exposure and hearing loss were usually done in specific industries rather than the general population. In addition, studies focused on associations between socioeconomic factors and hearing loss rarely take the type of occupation into consideration. In this study, we aim to evaluate both occupational noise exposure and socioeconomic status as …

Nutrition And Hookworm Infection: A Causal Analysis Of The Literature, Mengting Su

Public Health Theses

Hookworm infection is one of the neglected tropical diseases, particularly in low and middle-income countries, but we know relatively little about causal evidence related to malnutrition. This is mainly due to the relatively small research community compared to those investigating the impact of hookworm infection on host nutritional status and disease complications. Causal inference is critical in epidemiology and biomedical research because it can be a powerful tool in enlightening prevention efforts and developing etiology models. The application of causal criteria to address complex epidemiological research questions is indeed helpful in proposing more interventions to improve the health and well-being …

Association Between Household Chaos And Childhood Overweight-Obesity: A Cross-Sectional Study Among Young Samoan Children, Ruiyan Michelle Wang

Public Health Theses

AbstractObjective: Household chaos – sustained disorganization, disorder, and hurriedness in the home setting – has been shown to be associated with a variety of adverse health effects for children. The present study examines the relationship of household chaos with childhood overweight and obesity among Samoan children aged 5 to 12 years. Additionally, the present study explores characteristics of the home environment that may be captured by the household chaos measure. Methods: This analysis uses data from the third wave (2019-2020) of data collection in the Ola Tuputupua’e cohort study. Height and weight were used to construct the childhood overweight/obesity outcome …

Musculoskeletal Outcomes Among Older Adults Following Hospitalization For Covid-19: A Pilot Study, Clara Ming Hei Wong

Public Health Theses

Background Older individuals are at high risk for musculoskeletal impairment following hospitalization due to decreased neuromuscular function and bone mineral density (BMD) arising from illness itself, and external factors such as immobilization and changes in nutritional status. To address the knowledge gap regarding the longitudinal impact of COVID-19 on musculoskeletal outcomes, this thesis aimed to study the relationship between COVID-19 severity and physical functional, incidence of falls and fractures in older adults. Secondarily, in a subset of patients we examined the relationship between COVID-19 severity and osteoporosis- and sarcopenia-related measures. Methods This study analyzed data from the VALIANT study and …

Quantitative Real-Time Pcr Assays For The Detection Of Leptospira, Alice Zhao

Public Health Theses

Leptospirosis is an infectious zoonotic disease caused by bacteria of the genus Leptospira. The genus is comprised of 40 pathogenic species divided among P1 (19) and P2 (21). Leptospirosis incurs a disproportionately large burden of disease in urban slum regions of developing countries that lack adequate sewage disposal, water treatment, and sanitation infrastructure. While P1 species have been identified in cases of human infection, it is unclear if all Leptospira species are capable of infecting humans, especially P2 species. Among P1 species, L. interrogans has been described as the most frequent specie to cause disease in both animals and humans, …

Per- And Polyfluoroalkyl Substances (Pfass) In Household Dust From North China: Occurrence, Contribution, And Human Exposure, Yakun Zhou

Public Health Theses

Measurements and analysis of an emerging contaminant of poly- and perfluoroalkyl substances (PFAS) and adverse health effects associated with PFAS have received increasing attention around the world. In this study, 64 participants’ household dust were collected in Jinan, China during September 2018 and January 2019, conducted as part of the Biomarkers of Air Pollutants Exposure in the Chinese aged 60-69 (China BAPE) study. Concentrations and composition profiles of 7 individual PFASs were determined and estimated daily intakes of PFASs via dust ingestion for children and adults were calculated. By using a dimension reduction method − principal component analysis (PCA) and …

The Nexus Of Climate Change, Biodiversity, And Food Security: A Brazil Case Study, Andrew M. Berger

Dissertations and Theses

What is referred to as climate change today is the rapid warming of the climate, largely from human actions, and the effects that come with that warming. One study published by the United States Department of Agriculture (USDA) in 2021 argues that, “human-induced emissions of greenhouse gases have caused increases in global average temperatures, changes in precipitation timing and intensity, rising sea levels, and many other changes.” A Food and Agriculture Organization (FAO) study found that when looking at the number of countries exposed to climate extremes in five year periods from 2000 to 2020, the number of countries “exposed …

Youth Musicians’ Executive Functioning And Its Impact On Emotional And Behavioral Health, Michael A. Tate

Dissertations and Theses

A growing body of neuroscience literature shows that music promotes brain development, as learning a music instrument involves multiple brain regions and neurocognitive systems. In partnership with a non-profit organization with a mission to strengthen New York City communities through music education programs, this study aimed to evaluate the effects of music training on children’s executive functioning (EF), as well as emotional and behavioral outcomes. We hypothesized that (i) children’s EF would develop more rapidly with exposure to the program; (ii) the intensity of practice would be associated with rate of growth of children’s EF, emotion regulation and behavior; (iii) …

Early Risk Factors For School-Age Adhd And Irritability: The Roles Of Prenatal Risk, Intrusive Parenting Style During Preschool And Caregiver-Child Attachment Quality., Ashley M. Rainford

Dissertations and Theses

ADHD is a highly impairing neurodevelopmental disorder and the family context provides a critical early environment where children’s risk for the disorder may be heightened or reduced. A parent’s style, that is their approach to interacting and guiding the child may provide children with warmth and security, or elicit fear, distrust and disappointment, both of which in turn impact behavior. However, the parent-child relationship is not unidirectional; it is dynamic. Children with high ADHD-like behaviors have greater difficulty relating to and interacting with their caregivers, while caregivers become increasingly stressed and show greater hostility and less warmth in their parenting. …

Covid-19 Vaccine Related Anxiety Partially Mediates The Association Between Covid-19 Related Anxiety And Student Adjustment To College During The Pandemic, Hanh Nguyen

Dissertations and Theses

The COVID-19 pandemic caused severe disruptions to the education of millions of college students, who were forced to adapt to sudden changes in living and learning environments. In this study, we sought to investigate two different dimensions of anxiety that were specific to the pandemic – COVID-19 related anxiety and COVID-19 vaccine anxiety – hoping to pinpoint the relationship between these two variables and students’ ability to adapt to college. Specifically, using cross sectional survey data during three semester waves (Spring 2021, Fall 2021, and Spring 2022) we hypothesized (1) a decreasing trend across time in both COVID-19 related anxiety …

Impact Of Percutaneous Transluminal Intervention On Vascular Hypoxia And The Role Of Micro-Calcifications On Atherosclerotic Plaque Rupture, Andrea Corti

Dissertations and Theses

Atherosclerotic disease is initiated by cholesterol build-up beneath the endothelium, which evolves into a fibroatheroma, a lipid-rich plaque covered by a fibrous cap. Many of these plaques are considered as vulnerable, as they grow to occlude the luminal section of the artery (chronically stenotic) or become mechanically unstable with a higher chance of rupturing (rupture-prone). On one hand, chronically stenotic vulnerable plaques are symptomatic lesions that are often treated with Percutaneous Transluminal Intervention (PTI). Unfortunately, approximately 10% of PTI procedures are followed by severe Neointima Hyperplasia (NH), which causes a new occlusion and failure of the implant. A significant precursor …

Joint Laughter Between Patient And Therapist: Exploring The Function Of These Moments And Their Relationship To The Working Alliance In Short-Term Psychotherapy, Molly Rappaport

Dissertations and Theses

Laughter emerges in infancy and reflects mutually aroused and regulated positive affect within the caregiver-infant relationship and repeated cycles of shared, co-regulated positive arousal have been shown to play a critical role in fueling secure attachment bond formation and laying the groundwork for the infant’s capacity for affect regulation (Schore, 2003). Throughout life, laughter continues to function as an attachment behavior with the possibility of promoting interpersonal closeness or creating distance. Attitudes toward the role of laughter in psychotherapy vary among psychodynamically-oriented clinicians and research has mostly focused on the kinds of humor and interventions that provoke laughter rather than …

The Enduring Role Of Conflict In The Perpetuation Of Famine: Advancing 'The Right To Adequate Food' For Sustainable Peace, Robert M. Bane

Dissertations and Theses

The present thesis evaluates developments and trends in global conflict dynamics, global systems of governance, and global hunger. Together, the thesis investigates and upholds the notion that famine is a ‘man-made’ phenomenon and explains how famine persists in a world abundant with food. Through analysis and research the following is found: the occurrence of global conflict is accelerating alongside an increase in the severity of organized violence dynamics; global authoritarianism is expanding presenting a threat to global freedoms and liberal democracy; as these trends are occurring, world hunger is steadily on the rise reflecting a significant backsliding of progress achieved …

One-Carbon Metabolism In Children With Marasmus And Kwashiorkor, Thaddaeus May, Bethany De La Haye, Gabrielle Nord, Kevin Klatt, Kevin Stephenson, Sara Adams, Lucy Bollinger, Neil Hanchard, Erland Arning, Teodoro Bottiglieri, Kenneth Maleta, Mark Manary, Farook Jahoor

Children’s Nutrition Research Center Staff Publications

BACKGROUND: Kwashiorkor is a childhood syndrome of edematous malnutrition. Its precise nutritional precipitants remain uncertain despite nine decades of study. Remarkably, kwashiorkor's disturbances resemble the effects of experimental diets that are deficient in one-carbon nutrients. This similarity suggests that kwashiorkor may represent a nutritionally mediated syndrome of acute one-carbon metabolism dysfunction. Here we report findings from a cross-sectional exploration of serum one-carbon metabolites in Malawian children.

METHODS: Blood was collected from children aged 12-60 months before nutritional rehabilitation: kwashiorkor (N = 94), marasmic-kwashiorkor (N = 43) marasmus (N = 118), moderate acute malnutrition (N = 56) and controls (N = …