Wafaie Fawzi's research while affiliated with University of Massachusetts Boston and other places
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Publications (846)
Introduction
Adolescence is a critical time for growth and development, but this age group is often neglected in research and development of nutrition interventions. Despite recommendations from the WHO to provide nutrient supplements to adolescents, evidence remains scarce on the most effective supplementation strategy. This study aims to compare...
Introduction:
WHO guidelines on iron supplementation among children call for further research to identify the optimal schedule, duration, dose and cosupplementation regimen.
Methods:
A systematic review and meta-analysis of randomised controlled trials was undertaken. Randomised controlled trials providing ≥30 days of oral iron supplementation v...
Background
Adolescent population Global Diet Quality Score (GDQS) is uncommon in low-income settings. Though Global Diet Quality Score is a good measure of dietary diversity, it has not been used in assessing nutritional outcomes among adolescents. Therefore, the aim of this study is to assess school-attending adolescents stunting and thinness stat...
Background:
There is abundant evidence showing that iron deficiency is closely linked with delayed brain development, worse school performance, and behavioral abnormalities. However, evidence on the impact of iron supplementation among children and adolescents in low- and middle-income countries (LMICs) has been inconsistent. This study aims to ex...
The COVID-19 pandemic has had serious negative health and economic impacts in sub-Saharan Africa.
Continuous monitoring of these impacts is crucial to formulate interventions to minimize the consequences of COVID-19.
This study surveyed 2,829 adults in urban and rural sites among five sub-Saharan African countries: Burkina Faso,
Ethiopia, Nigeria,...
Background
Sub-Saharan Africa faces prolonged COVID-19 related impacts on economic activity, livelihoods, nutrition, and food security, with recovery slowed down by lagging vaccination progress.
Objective
This study investigated the economic impacts of COVID-19 on food prices, consumption and dietary quality in Burkina Faso, Ethiopia, Ghana, Nigeri...
Importance:
Approximately 1 in 4 women experience intimate partner violence (IPV) or nonpartner sexual violence during their lifetime. Mothers exposed to IPV are more likely to experience depressive symptoms and to discipline their children harshly, which may affect their children's socioemotional development; however, there is limited evidence on...
The provision of high-quality antenatal care (ANC) is important for preventing maternal and newborn mortality and morbidity, but only around half of pregnant women in Tanzania attended four or more ANC visits in 2019. Although there is emerging evidence on the benefit of community health worker (CHW) interventions on ANC uptake, few large-scale pra...
Background Continuous monitoring of the pandemic’s impact on health service provision and mental health, COVID-19 perceptions, and compliance with prevention measures among health care providers (HCPs) can help with mitigating the pandemic’s negative effects.
Methods A computer-assisted telephone interviewing (CATI) survey was conducted among 1499...
Purpose
Whether anemia type modifies the risk of pregnancy and newborn outcomes and the effectiveness of iron supplementation is unclear. We examined the association of iron deficiency anemia (IDA) and non-iron deficiency anemia (NIDA) on the risks of these outcomes and the extent to which anemia type modifies the impact of prenatal iron supplement...
Purpose
This multi-country survey assessed the levels and the determinants of the impacts of the pandemic on education and mental health among adolescents in sub-Saharan Africa and the potential factors that may exacerbate these adverse impacts.
Methods
A phone survey was conducted among adolescents in nine diverse areas in Burkina Faso, Ethiopia,...
The African continent has some of the world’s lowest COVID-19 vaccination rates. While the limited availability of vaccines is a contributing factor, COVID-19 vaccine hesitancy among health care providers (HCP) is another factor that could adversely affect efforts to control infections on the continent. We sought to understand the extent of COVID-1...
COVID-19 vaccine hesitancy among adolescents poses a challenge to the global effort to control the pandemic. This multi-country survey aimed to assess the prevalence and determinants of COVID-19 vaccine hesitancy among adolescents in sub-Saharan Africa between July and December 2021. The survey was conducted using computer-assisted telephone interv...
Background
Nutritional conditions during pregnancy may influence the epigenetic development of an individual and consequently their later-life risk of noncommunicable disease (NCD). Improving nutrition for pregnant females may therefore serve the dual purpose of directly improving pregnancy outcomes and preventing NCDs in the next generation.
Obje...
Background
Environmental enteric dysfunction (EED) may contribute to adverse birth outcomes in low-resource settings. We examined the associations of EED biomarkers with birth outcomes in pregnant women living with human immunodeficiency virus in Dar es Salaam, Tanzania.
Methods
We performed a cohort study of 706 HIV-infected pregnant women. Mater...
Background
Gestational weight gain (GWG) below or above the Institute of Medicine (IOM) recommendations has been associated with adverse perinatal outcomes. Few studies have examined the effect of prenatal nutrient supplementations on GWG in low- and middle-income countries (LMICs).
Objectives
To investigate the effects of multiple micronutrient s...
There is growing evidence that home vegetable gardening interventions improve food security and nutrition outcomes at the family level. Sustainability of many of these community interventions remain a challenge. This study assessed factors influencing the sustainability of homestead vegetable production intervention in Rufiji district, Tanzania, on...
Background: Since its first case of COVID-19 on March 13, 2020 and Ethiopia has exerted efforts to curb the spread of the Coronavirus disease 2019 (COVID-19) without imposing a nationwide lockdown. Globally, COVID-19 related disruptions and mitigation measures have impacted livelihoods and food systems, nutrition, as well as access and use of healt...
BACKGROUND: India has the highest prevalence of multidrug-resistant TB (MDR-TB) globally. Vitamin D deficiency is potentially an important risk factor for MDR-TB.
METHODS : We conducted a case-control study of 90 newly diagnosed adult MDR-TB cases, 180 household controls and 82 non-household controls in Mumbai, India. Serum 25-hydroxyvitamin D (25(...
Background:
The influence of inflammation on iron status among people living with HIV (PLWHIV) has not been well explored. We evaluated the trajectory of iron status among PLWHIV during the first year of highly active antiretroviral therapy (HAART), compared alternative approaches for inflammation correction, and assessed the associations of iron...
Introduction
Presently, there are few population-level strategies to address SARS-CoV-2 infection except preventive measures such as vaccination. Micronutrient deficiency, particularly vitamin D and zinc deficiency, has been associated with dysregulated host responses, and may play an important role in COVID-19.
Methods and analysis
We have design...
Background:
The school presents an ideal environment to positively impact the long-term health and nutrition outcomes of early adolescents, who are at risk of obesity and anemia.
Methods:
In this cross-sectional survey, we described differences in weight and anemia by sociodemographic, diet and physical activity indicators among 1059 students ag...
Background
The prevalence of adverse birth outcomes is highest in resource-limited settings such as sub-Saharan Africa. Maternal consumption of diets with adequate nutrients during pregnancy may protect against these adverse outcomes.
Objective
To determine the association between maternal dietary animal source foods (ASF) consumption and the risk...
Background
Low birth weight (LBW), including preterm birth (PTB) and small for gestational age (SGA), contributes a significant global health burden. We aimed to summarise current evidence on the effect of preconception and periconception interventions on LBW, SGA and PTB.
Methods
In this systematic review and meta-analysis, we searched PubMed, Em...
OBJECTIVES
To assess effects of supplementation with 3 or more micronutrients (multiple micronutrients; MMN) compared to no MMN in human milk-fed preterm and low birth weight (LBW) infants.
RESULTS
Data on a subgroup of 414 preterm or LBW infants from 2 randomized controlled trials (4 reports) were included. The certainty of evidence ranged from l...
Introduction
Secondary schools have the transformative potential to advance adolescent nutrition and provide a unique entry point for nutrition interventions to reach adolescents and their families and communities. Integrated school nutrition interventions offer promising pathways towards improving adolescent nutrition status, food security and bui...
Plain language summary Pregnancy is a critical lifetime event for both mother and the offspring, with implications in short-term and long-term health consequences. Gestational weight gain (GWG) is an important modifiable factor for pregnancy outcomes related to infant body size and weight and prematurity. Countries in sub-Saharan Africa (SSA) have...
Objectives
Environmental enteric dysfunction (EED), a subclinical state of intestinal inflammation, may contribute to poor fetal growth in low-resource settings. Pregnant women living with HIV may be particularly susceptible to effects of EED, given their increased risk of infections and adverse birth outcomes. We sought to explore the associations...
Objectives
Environmental enteric dysfunction (EED), a subclinical state of intestinal inflammation, may contribute to poor growth in children in low-resource settings, but validated biomarkers are lacking. Multiplex assays, such as the 11-plex Micronutrient and EED Assessment Tool (MEEDAT), hold promise due to their ability to capture multiple doma...
Objectives
Hypertension is a growing problem in Ethiopia; large representative surveys are needed to elucidate the burden of raised blood pressure and regional differences.
Methods
A population-based cross-sectional survey including 2,520 women and 1,054 men aged 15–49 years was carried out in six regions of Ethiopia (Addis Ababa, Afar, Amhara, Or...
Background
Combination antiretroviral therapy (cART) initiation during pregnancy reduces the risk of perinatal HIV transmission; however, studies have suggested that there may be unintended adverse consequences on birth outcomes for selected cART regimens.
Methods
We analyzed adverse birth outcomes among a prospective cohort of 1307 pregnant women...
UNSTRUCTURED
Background: Two billion people in low- and middle-income countries (LMICs) are deficient in key nutrients. Nutritional deficiencies worsen during pregnancy, causing adverse outcomes for the mother and the fetus, with consequences after pregnancy. These effects may be mitigated by providing micronutrient supplementation to women during...
Background
Two billion people in low- and middle-income countries (LMICs) are deficient in key nutrients. Nutritional deficiencies worsen during pregnancy, causing adverse outcomes for the mother and the fetus, with consequences after pregnancy. These effects may be mitigated by providing micronutrient supplementation to women during pregnancy and...
Introduction:
Gestational weight gain (GWG) is associated with fetal and newborn health; however, data from sub-Saharan Africa are limited.
Methods:
We used data from a prenatal micronutrient supplementation trial among a cohort of HIV-negative pregnant women in Dar es Salaam, Tanzania to estimate the relationships between GWG and newborn outcom...
Background
Antenatal multiple micronutrient supplementation (MMS) with iron, folic acid, and other micronutrients might improve birth outcomes, but it is not currently universally recommended by WHO.
Methods
In this observational cohort study, we surveyed pregnancies for adverse birth outcomes at eight hospitals from July, 2014, to July, 2018, and...
COVID-19 vaccine hesitancy among adolescents poses a challenge to the global effort to control the pandemic. This multi-country survey aimed to assess the levels and determinants of COVID-19 vaccine hesitancy among adolescents in sub-Saharan Africa between July and December 2021. The survey was conducted using computer-assisted telephone interviewi...
Objective
This study investigated associations between types and food sources of protein with overweight/obesity and underweight in Ethiopia.
Design
We conducted a cross-sectional dietary survey using a non-quantitative food frequency questionnaire. Linear regression models were used to assess associations between percent energy intake from total,...
Background
There is growing evidence that home vegetable gardening interventions improve food security and nutrition outcomes at the family level. This study assessed factors influencing the sustainability of homestead vegetable production intervention in Rufiji district, Tanzania, one year after the cessation of external support.
Methods
This was...
Background
Vaccines may induce non-specific effects on survival and health outcomes, in addition to protection against targeted pathogens or disease. Observational evidence suggests that infant Baccillus Calmette-Guérin (BCG) vaccination may provide non-specific survival benefits, while diphtheria-tetanus-pertussis (DTP) vaccination may increase th...
Homestead food production (HFP) programs may improve diet and nutrition outcomes by increasing availability of nutrient dense foods such as vegetables and supporting livelihoods. We conducted a pair-matched cluster-randomized controlled trial to investigate whether vegetable home gardens could improve women’s dietary diversity, household food secur...
Background:
Observational studies suggest that blood concentrations of 25-hydroxyvitamin D (25(OH)D) are associated with morbidity, viral suppression, and mortality among adults living with HIV.
Objective:
We evaluated the effect of cholecalciferol (vitamin D3) supplementation on the risk of HIV disease progression, HIV-1 viral suppression, como...
Background:
Observational studies suggest that vitamin D deficiency among people living with HIV is associated with a greater risk of disease progression and death. Low levels of vitamin D in pregnancy are also associated with poor fetal and infant growth. Therefore, vitamin D supplementation may improve clinical outcomes for pregnant women living...
This study aimed to examine associations of dietary quality and diversity among reproductive-aged women with overweight and obesity. We conducted a cross-sectional study in the Health and Demographic Surveillance System of the Dar es Salaam Urban Cohort Study (DUCS) in Tanzania. A random sample of 1004 non-pregnant women was selected from the DUCS...
Small-scale chicken production holds great potential as a nutrition-sensitive strategy in low-income settings, due to its potential for improving income, increasing the consumption of nutritious foods (including eggs and meat), and empowering women. This study sought to evaluate the impacts of and to identify challenges and solutions for a nutritio...
Objective: School absenteeism and grade retention are associated with various life-course problems. In this study, we examined school absenteeism and grade retention in Ethiopian adolescents, as well as factors associated with them. Methods: We analyzed data from 1200 adolescents (aged 10- 14 years) from 20 public primary schools in Addis Ababa, Et...
Background
Adolescence is a critical period of maturation when nutrient needs are high, especially among adolescents entering pregnancy. Using individual-level data from 140,000 participants, we examined socioeconomic, nutrition, and pregnancy and birth outcomes for adolescent mothers (10–19 years) compared to older mothers in low and middle-income...
Background:
Anaemia is common among HIV-infected children and iron supplementation is prescribed routinely for the prevention and management of anaemia among children. Limited evidence suggests iron supplementation may have adverse effects among HIV-infected populations. We aimed to estimate the effect of iron supplement use on mortality, disease...
Background:
In many regions of the world, little is known about meal structures, meal patterns, and nutrient intake because the collection of quantitative dietary intake is expensive and labor-intensive.
Objectives:
We describe the development and field feasibility of a tablet-based Tanzania 24-h recall tool (TZ-24hr-DR) and dietary intakes coll...
Background:
Stunting affects a quarter of children under five, yet little is known about the accuracy of caregivers' perceptions regarding their child's linear growth. Most existing quantitative research on this topic has been conducted in high income countries and has examined perceptions of children's weight rather than height.
Objectives:
In...
Most low- and middle-income countries present suboptimal intakes of calcium during pregnancy and high rates of mortality due to maternal hypertensive disorders. Calcium supplementation during pregnancy is known to reduce the risk of these disorders and associated complications, including preeclampsia, maternal morbidity, and preterm birth, and is,...
Background
Gestational weight gain (GWG) is a modifiable risk factor associated with adverse birth outcomes. Studies have shown that the provision of multiple micronutrient supplements to pregnant women reduces the risk of low birthweight. However, the effect of multiple micronutrient supplements on GWG has been understudied.
Objectives
We examine...
Healthy maternal diets during pregnancy are an important protective factor for pregnancy-related outcomes, including gestational weight gain (GWG) and birth outcomes. We prospectively examined the associations of maternal dietary diversity and diet quality, using Minimum Dietary Diversity for Women (MDD-W) and Prime Diet Quality Score (PDQS), with...
This study examined whether child diet and mother–child interactions mediated the effects of a responsive stimulation and nutrition intervention delivered from 2009 to 2012 to 1324 children aged 0–24 months living in rural Pakistan. Results showed that the intervention improved children's cognitive, language and motor development through child diet...
Objective:
We examined lifestyle factors with midlife weight change according to history of gestational diabetes mellitus (GDM) in a large longitudinal female cohort.
Research design and methods:
In the Nurses' Health Study II, we categorized changes in lifestyle within 4-year periods and estimated their associations with concurrent changes in b...
School enrolment rates have increased globally, making the school environment a unique setting to promote healthy nutrition and eating outcomes among early adolescents. In this cross-sectional study, we describe the food and health environment of junior secondary schools in Ouagadougou (Burkina Faso, West Africa). We evaluated the food and health e...
Background
Hypertensive disorders of pregnancy are important causes of maternal morbidity and mortality, as well as preterm birth, the leading cause of death for children under 5 years globally. The World Health Organization currently recommends that pregnant women receive high-dose calcium supplementation (1500–2000 mg elemental calcium) for preve...
Background
Decision making process for Official Development Assistance (ODA) for healthcare sector in low-income and middle-income countries involves multiple agencies, each with their unique power, priorities and funding mechanisms. This process at country level has not been well studied.
Methods
This paper developed and applied a new framework t...
Background
Dietary folate inadequacy is one the most common micronutrient deficiencies that cause neural tube defect (NTD) among infants in Sub-Saharan African countries. This study aims to determine the dietary intake of folate among women of reproductive age (WRA) of Kersa, Eastern Ethiopia.
Methods
A cross-sectional study took place among volun...
Contributions of Universities to the efforts during the Covid-19 pandemic in emerging economies
Inflammation may adversely affect early human brain development. We aimed to assess the role of maternal nutrition and infections on cord blood inflammation. In a pregnancy cohort in Sylhet, Bangladesh, we enrolled 251 consecutive pregnancies resulting in a term livebirth from July 2016–March 2017. Stillbirths, preterm births, and cases of neonatal...
Background
Nutritionally inadequate diets in Ethiopia contribute to a persisting national burden of adult undernutrition, while the prevalence of noncommunicable diseases (NCDs) is rising.
Objectives
To evaluate performance of a novel Global Diet Quality Score (GDQS) in capturing diet quality outcomes among Ethiopian adults.
Methods
We scored the...
Background
We have developed a simple and globally applicable tool, the Global Diet Quality Score (GDQS), to measure diet quality.
Objectives
To test the utility of the GDQS, we examined the associations of the GDQS with weight change and risk of obesity in US women.
Methods
Health, lifestyle, and diet information were collected from women (n = 6...
Background
The global diet quality score (GDQS) is a simple, standardized metric appropriate for population-based measurement of diet quality globally.
Objectives
We aimed to operationalize data collection by modifying the quantity of consumption cutoffs originally developed for the GDQS food groups and to statistically evaluate the performance of...
Background
The double burdens of under- and overnutrition are changing the health of individuals and the economic and disease burdens in China. Poor diet plays an important role; however, a valid and easily operationalized metric that could capture the full range of characteristics of the diet that are relevant to both under- and overnutrition is l...
Background
Key nutrient deficits remain widespread throughout sub-Saharan Africa (SSA) whereas noncommunicable diseases (NCDs) now cause one-third of deaths. Easy-to-use metrics are needed to track contributions of diet quality to this double burden.
Objectives
We evaluated comparative performance of a novel food-based Global Diet Quality Score (G...
Background
The prevalence of type 2 diabetes has increased substantially in India over the past 3 decades. Undiagnosed diabetes presents a public health challenge, especially in rural areas, where access to laboratory testing for diagnosis may not be readily available.
Objectives
The present work explores the use of several machine learning and st...
Background
Poor diet quality is a major driver of both classical malnutrition and noncommunicable disease (NCD) and was responsible for 22% of adult deaths in 2017. Most countries face dual burdens of undernutrition and NCDs, yet no simple global standard metric exists for monitoring diet quality in populations and population subgroups.
Objectives...