Anemia in children aged 6 to 59 months attending a quaternary health facility in Maputo, Mozambique

Abstract Background Globally, anemia prevails as a public health issue, being also a concern in Mozambique, where about two-thirds of children 6-59 months of age are affected by anemia. We carried out this study to estimate anemia prevalence and evaluate structural determinants and hematological parameters association among children aged 6 to 59 months attending pediatric inpatient and outpatient services in a Quaternary Health Facility in Maputo City Province, Mozambique. Methods From August 2021 to January 2022, we conducted a cross-sectional study at the ‘Maputo Central Hospital’ where we collected data from 397 inpatients or outpatients who attended pediatric consultations. The cut-off values for anemia were: mild (10g/dL≤Hb≤10.9g/dL), moderate (7g/dL≤Hb≤9.9g/dL), severe (Hb < 7.0g/dL). We used SPSS 28.0 software to perform descriptive analyses and Chi-Square tests. Results Our preliminary findings show that the total rate of positive cases was 30.0% moderate anemia (119/397), 23.9% mild anemia (95/397), and 7.3% severe anemia (29/397). Anemia frequencies were higher in male patients unregarding the type (54.2% moderate, 62.1% mild, 67.9% severe). Anemia prevalence was higher among children aged 24-59 months (41.2% moderate, 47.4% mild, 51.7% severe; p < 0.05). The rate of all anemia types was higher in children from rural areas and Maputo City province relative to those from urban areas and other country provinces. The level of education of the child's companion to the consultations was associated with anemia (p ≤ 0,05), with higher rates observed in secondary level education. We observed no association between iron or serum ferritin values to anemia. Key messages • Children aged 24-59 months, children from rural areas, and who are male are more vulnerable to suffering anemia than their peers, thus needing more monitoring during their growth. • Nutritional-anemia-specific interventions targeting the first 1000 days of life may be helpful to its reduction in children.

Childhood obesity is a public health crisis. Even though appetite traits in infancy were associated with childhood adiposity, whether early weight gain can influence later appetite has not been researched. Our aim was to prospectively examine the bidirectional association between growth and appetite traits during the first year of life. We followed up 450 healthy term infants for 12 months (m). Appetite traits at 4 weeks (wk), 6m and 12m were assessed using the Baby and Child Eating Behaviour Questionnaires. Infant feeding, anthropometric, socioeconomic and demographic data were also collected. Infant weight-for-age z-scores (WFAZ) were calculated using the WHO 2006 growth reference. Growth was assessed as conditional WFAZ change (cWFAZc) by saving the residuals from linear regression models of WFAZ at each successive time point versus WFAZ at the earlier time point. Multivariable linear regression was used to analyse bidirectional associations between cWFAZc (0-4wk, 4wk-6m, 6-12m) and appetite traits Enjoyment of Food (EF), Food Responsiveness (FR), Satiety Responsiveness (SR) and Slowness in Eating (SE) at 4wk, 6m and 12m. All models were adjusted for relevant confounders. At 4wk, SR score was associated with lower (b:-0.16; 95% CI:-0.28,-0.03), and FR score with higher (b:0.10; 95% CI:0.01,0.19) cWFAZc from 4wk to 12m. SR score at 6m was inversely associated with cWFAZc from 6-12m (b:-0.09; 95% CI:-0.16,-0.01). Conversely, higher cWFAZc between 4wk-6m was associated with higher EF (b:0.10; 95% CI:0.01,0.19) and FR (b:0.16; 95% CI:0.04,0.29) scores at 12m. cWFAZc between 6m-12m was inversely associated with SR at 12m (b:-0.18; 95% CI:-0.35,-0.01). Our results suggest that the growth acceleration hypothesis, where faster growth in infancy leads to later obesity, may be mediated by an up-regulation of appetite traits at 12m. This highlights the public health importance of avoiding growth acceleration in infancy as a way to curb the childhood obesity epidemic.

Key messages:
Weight gain in early infancy impacts appetite regulation in the first year of life and up-regulation of appetite traits at 12 months predisposes to childhood obesity. Avoiding growth acceleration in infancy can decrease the risk for childhood obesity.

Background:
Research shows that anxiety is connected to a variety of mental health outcomes, and that it is widespread among the population. In the light of the great personal and societal costs of obesity and eating disorders, we want to understand the connection between anxiety and different dimensions of eating behaviors that have a strong empirical link with negative eating-related health outcomes.

Methods:
We used data from the population-based LIFE-Adult-Study (n = 5019) to analyze the connection between anxiety (GAD-7) and the three dimensions of eating behaviors: Cognitive Restraint, Disinhibition, and Hunger (FEV, German version of the Three-Factor-Eating-Questionnaire). We controlled for sociodemographic variables, smoking, physical activity, personality, and social support.

Conclusions:
There is an empirical connection between anxiety and two factors of eating behavior, i.e., Disinhibition and Hunger. If future research strengthens the assumption of a causal direction from anxiety to those factors, interventions that help individuals to better regulate and cope with anxiety, could be one potential pathway to reducing eating disorders and obesity in the population.

Key messages:
There is a significant connection between anxiety and eating behavior.
Interventions that address anxiety could reduce problematic eating-related health outcomes like eating disorders and obesity.

11.D. Workshop: Depression comorbidity in prediabetes and diabetes: evaluating risk factors and outcomes
Abstract citation ID: ckac129.699 Organised by: Tuebingen University (Germany) Chair persons: Norbert Schmitz (Germany) Contact: norbert.schmitz@med.uni-tuebingen.de Depression is a common comorbidity in prediabetes and diabetes. Evidence for the interaction of depression and behavioural and biological risk factors for (pre-) diabetes and diabetes-related outcomes will be presented and discussed using longitudinal data from the Lifelines Cohort, the Canadian Longitudinal Study on Aging, and the Cartagene study. In addition, digital phenotyping will be discussed as an alternative approach for the assessment of mobility and behaviour in people with diabetes. Key messages: Behavioural, psychosocial and biological risk factors might increase the risk of poor diabetes outcomes in a synergistic way. Prevention program for diabetes and diabetes realted outcomes should focus on behavioural, psychosocial and biological risk factors simultaneously.