Per Ashorn
Biographic Data
| ID | 5463012 |
|---|---|
| NAME | Per Ashorn |
| GIVEN NAMES | Per |
| FAMILY NAME | Ashorn |
| SIGNATURE | ASHORN P |
| AFFILIATIONS | Tampere University |
| ORCID | 0000-0003-2311-2593 |
| VERIFIED | Yes |
| TOTAL WORKS | 58 |
| TOTAL CITATIONS | 31 |
| AUTHOR COUNT | 58 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2000 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 4 |
A single dose of azithromycin versus placebo for malaria in infants: A cluster-randomized trial
Azithromycin mass drug administration (MDA) has been shown to promote child survival in high mortality settings. Azithromycin has antimalarial effects, and one possible mechanism behind mortality reduction with azithromycin may be reduction in malaria. We aimed to test the effect of a single dose of azithromycin on malaria prevalence and parasite load in infants. This malaria substudy was part of a large double-blinded cluster-randomized clinical…
Haemoglobin concentration thresholds that discriminate functional outcomes among children aged 6–30 months in eight countries: A pooled analysis of individual participant data
Introduction The WHO cut-offs to define anaemia among children (haemoglobin, Hb <105 g/L in 6–23 months and <110 g/L in 24–59 months) are based on the distribution of Hb concentrations in a healthy population. Our objective was to identify Hb values that best discriminate functional outcomes among children aged 6–30 months. Methods We used previously compiled datasets from an individual participant data meta-analysis of effects of small quantity …
Global assessment of childhood growth monitoring: Cross-sectional survey of national policies and practices
Background: Monitoring children's growth is crucial in paediatric care for early identification of health issues, with the World Health Organization (WHO) advocating for its practice throughout childhood. However, the focus and implementation of growth monitoring vary globally, reflecting different health priorities and practices. Methods: We conducted a global, cross-sectional, questionnaire-based survey, targeted at representatives of the minis…
Infants less than 6 months of age at risk of poor growth and development: Evidence gaps identified during WHO guideline development
box The 2023 WHO guideline on wasting and nutritional oedema includes four recommendations and four good practice statements on the management of infants less than 6 months of age at risk of poor growth and development, prioritising this vulnerable yet often neglected group
Prevention of wasting and nutritional oedema: Evidence gaps identified during WHO guideline development
box Inclusion of prevention in the 2023 WHO guideline on wasting and nutritional oedema is a significant and timely addition, aligning with the global development goal of reducing current wasting prevalence from 6
Is rotavirus aetiology in young children with acute diarrhoea associated with sociodemographic and clinical factors, including rotavirus vaccination status? A secondary cross-sectional analysis of the…
INTRODUCTION: One of the leading causes of global child mortality continues to be diarrhoea where rotavirus contributed to about 24% of deaths among all diarrhoeal deaths, mostly in low-income and middle-income countries. Rotavirus vaccination programmes have contributed to the reduction of mortality from 24% to 19% in rotavirus infections among hospitalised children, but the burden of rotaviral diarrhoea remains high, especially in settings with…
Eye-tracking measures of oculomotor speed and control as markers of cognitive ability in Malawian adolescent population: Secondary analysis of a randomized controlled trial
Processing speed and response control are fundamental properties of brain function and potential markers of cognitive ability. This study, a secondary analysis of a randomized controlled trial, examined whether eye-tracking measures of saccadic reaction time and gaze control are associated with an established cognitive ability test, Raven’s coloured progressive matrices (CPM), among 13-year-old rural Malawian adolescents (1003 participants, 50.3%…
Guidance on sexual, reproductive, maternal, newborn, child and adolescent health in humanitarian and fragile settings: A scoping review
INTRODUCTION: Progress related to sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH) has stalled. COVID-19, conflict and climate change threaten to reverse decades of progress and to ensure the health and well-being of vulnerable populations in humanitarian and fragile settings (HFS) going forward, there is a need for tailored guidance for women, children and adolescents (WCA). This review seeks to map and appraise cur…
Characteristics and outcomes of children 2–23 months of age with prolonged diarrhoea: A secondary analysis of data from the ‘Antibiotics for Children with Diarrhea’ trial
Background: Approximately 12% of all diarrhoeal episodes last for 7-13 days. As such, they are termed prolonged diarrhoea, and are associated with over two-thirds of all diarrhoeal deaths. Due to a lack of robust data, we aimed to evaluate a comparative background characteristics of young children with acute and prolonged diarrhoea, and their outcomes at day 90 follow-up. Methods: We performed a secondary analysis of data from the Antibiotics for…
Exploring Adolescent girls’ Food-Talk in Kathmandu Valley, Nepal: A Qualitative Study
This study aimed to analyze how adolescent girls residing in Kathmandu valley, Nepal, talk about food within the context of their everyday experiences. We conducted 10 in-depth and four focus group interviews. Qualitative thematic analysis based on the constructivist paradigm was used to organize the interviews. The Utilitarian domain contained health statements using biomedical language and lay theories on health. Hedonic talk emphasized the tas…
Prevalence of morbidity symptoms among pregnant and postpartum women receiving different nutrient supplements in Ghana and Malawi: A secondary outcome analysis of two randomised controlled trials
Little is known about the impact of small-quantity lipid-based nutrient supplements (SQ-LNSs) on maternal morbidity. This secondary outcome analysis aimed to compare morbidity symptoms among women in two trials evaluating the efficacy of SQ-LNSs. From enrolment (≤20-week gestation) to 6 months postpartum, Ghanaian (n = 1320) and Malawian (n = 1391) women were assigned to consume daily: 60 mg iron and 400 μg folic acid until childbirth and placebo…
Association between asymptomatic infections and linear growth in 18–24‐month‐old Malawian children
Inadequate diet and frequent symptomatic infections are considered major causes of growth stunting in low-income countries, but interventions targeting these risk factors have achieved limited success. Asymptomatic infections can restrict growth, but little is known about their role in global stunting prevalence. We investigated factors related to length-for-age Z-score (LAZ) at 24 months by constructing an interconnected network of various infec…
Provision of small‐quantity lipid‐based nutrient supplements does not improve intestinal health among rural Malawian children
Lipid-based nutrient supplements (LNS) have been found to improve child growth and reduce child mortality. However, the mechanistic pathways for these improvements warrant exploration. One potential pathway is linked to improvement in intestinal health. Our study aimed to test a hypothesis that small-quantity LNS (SQ-LNS) could reduce the levels of intestinal inflammation, repair and permeability of children. As intestinal health markers we measu…
Effect of community‐initiated kangaroo mother care on breastfeeding performance in low birthweight infants: A randomized clinical trial
This individually randomized trial was conducted to estimate the effect of promoting community-initiated kangaroo mother care (ciKMC) in low birthweight (LBW) infants on infant breastfeeding performance. It was designed as a substudy within a larger primary trial on ciKMC and infant survival. Five hundred fifty stable LBW mother-infant dyads (1500-2250 g) who provided consent, were consecutively enroled for breastfeeding performance assessment. T…
Association between prenatal provision of lipid‐based nutrient supplements and caesarean delivery: Findings from a randomised controlled trial in Malawi
In populations with a high prevalence of childhood and adolescent undernutrition, supplementation during pregnancy aiming at improving maternal nutritional status and preventing fetal growth restriction might theoretically lead to cephalopelvic disproportion and delivery complications. We investigated whether the prenatal provision of small-quantity lipid-based nutrient supplements (SQ-LNS) was associated with an increased risk of caesarean secti…
Lack of Associations between Environmental Exposures and Environmental Enteric Dysfunction among 18-Month-Old Children in Rural Malawi
Environmental enteric dysfunction (EED) is common and contributes to linear growth faltering (stunting) and mortality among children in low-resource settings. A few studies on the environmental causes of EED have been conducted but the exact exposures that cause or predispose children to EED are context-specific and not clear. This study aimed to assess associations between selected environmental exposures and EED markers among 620 18-month-old c…
Preventive small-quantity lipid-based nutrient supplements reduce severe wasting and severe stunting among young children: An individual participant data meta-analysis of randomized controlled trials
Including SQ-LNSs in preventive interventions to promote healthy child growth and development is likely to reduce rates of severe wasting and stunting. This meta-analysis was registered at www.crd.york.ac.uk/PROSPERO as CRD42019146592.
Association of maternal prenatal selenium concentration and preterm birth: A multicountry meta-analysis
BACKGROUND: Selenium (Se), an essential trace mineral, has been implicated in preterm birth (PTB). We aimed to determine the association of maternal Se concentrations during pregnancy with PTB risk and gestational duration in a large number of samples collected from diverse populations. METHODS: Gestational duration data and maternal plasma or serum samples of 9946 singleton live births were obtained from 17 geographically diverse study cohorts. …
Setting research priorities for sexual, reproductive, maternal, newborn, child and adolescent health in humanitarian settings
Data needs, effective intervention strategies and approaches, as well as greater efficiency and quality during delivery of care in humanitarian settings were prioritized. The findings from this research provide guidance for researchers, program implementers, as well as donor agencies on SRMNCAH research priorities in humanitarian settings. A global research agenda could save the lives of those who are at greatest risk and vulnerability as well as…
Consumption of multiple micronutrients or small-quantity lipid-based nutrient supplements containing iodine at the recommended dose during pregnancy, compared with iron and folic acid, does not affect…
Objectives: Inadequate iodine intake during pregnancy increases the risk of neonatal morbidity and mortality. We aimed to evaluate whether prenatal supplements containing iodine affect urinary iodine concentrations (UIC) of pregnant women in Malawi. Design: A randomised controlled trial. Pregnant women ( n 1391) were assigned to consume 60 mg/d Fe and 400 μg/d folic acid (IFA) or 18 vitamins and minerals including 250 μg/d iodine (MMN) or 20 g/d …
Small-quantity lipid-based nutrient supplements for children age 6–24 months: A systematic review and individual participant data meta-analysis of effects on developmental outcomes and effect modifier…
Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child growth: An individual participant data meta-analysis of randomized controlled trials
Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child anemia and micronutrient status: An individual participant data meta-analysis of randomized contr…
The availability of global guidance for the promotion of women’s, newborns’, children’s and adolescents’ health and nutrition in conflicts
BACKGROUND: Significant global gains in sexual, reproductive, maternal, newborn, child and adolescent health and nutrition (SRMNCAH&N) will be difficult unless conflict settings are adequately addressed. We aimed to determine the amount, scope and quality of publically available guidance documents, to characterise the process by which agencies develop their guidance and to identify gaps in guidance on SRMNCAH&N promotion in conflicts. METHODS: We…
Lipid-based nutrient supplements and all-cause mortality in children 6–24 months of age: A meta-analysis of randomized controlled trials
Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child growth: An individual participant data meta-analysis of randomized controlled trials
Preventive small-quantity lipid-based nutrient supplements reduce severe wasting and severe stunting among young children: An individual participant data meta-analysis of randomized controlled trials
Including SQ-LNSs in preventive interventions to promote healthy child growth and development is likely to reduce rates of severe wasting and stunting. This meta-analysis was registered at www.crd.york.ac.uk/PROSPERO as CRD42019146592.
Feeding patterns and behaviors during home supplementation of underweight Malawian children with lipid-based nutrient supplements or corn-soy blend
The way caregivers use supplementary food for undernourished children and integrate it into feeding patterns may influence the benefits achieved by supplementation. We studied feeding patterns and behaviors in 170 underweight 6-17-month-olds who received either lipid-based nutrient supplements (LNS) (n=85) or corn-soy blend (CSB) (n=85) during a 12-week intervention trial in southern Malawi. Observational data were collected during one 11h home v…
Malawian mothers’ attitudes towards the use of two supplementary foods for moderately malnourished children
Seasonal variation in the dietary sources of energy for pregnant women in Lungwena, rural Malawi
We conducted a nutritional survey to describe monthly variation in food consumption among subsistence farmers in Malawi, Southeastern Africa. Of special interest was the identification of foods whose intake changes contributed most to the seasonal fluctuation of overall energy intake. For this purpose, dietary intakes of 593 pregnant women were analysed with 24‐h recall methodology. Mean daily energy intakes varied from 1520 kcal/woman in Februar…
Feeding patterns of underweight children in rural Malawi given supplementary fortified spread at home
Fortified spread (FS), containing dry food particles embedded in edible fat, offers a convenient means for nutrition rehabilitation. To describe how caregivers feed FS to their undernourished children at home, and how FS use affects other feeding patterns, we conducted a longitudinal observational study in rural Malawi. Sixteen 6- to 17-month-old underweight children (weight-for-age z-score < -2.0; -3.0 < weight-for-height z-score < 0) received F…
Supplementary feeding with fortified spread among moderately underweight 6–18‐month‐old rural Malawian children
We aimed to analyse growth and recovery from undernutrition among moderately underweight ambulatory children receiving micronutrient-fortified maize-soy flour (Likuni Phala, LP) or ready-to-use fortified spread (FS) supplementary diet. One hundred and seventy-six 6-18-month-old individuals were randomized to receive 500 g LP or 350 g FS weekly for 12 weeks. Baseline and end of intervention measurements were used to calculate anthropometric gains …
Malawian mothers’ attitudes towards the use of two supplementary foods for moderately malnourished children
Feeding patterns and behaviors during home supplementation of underweight Malawian children with lipid-based nutrient supplements or corn-soy blend
The way caregivers use supplementary food for undernourished children and integrate it into feeding patterns may influence the benefits achieved by supplementation. We studied feeding patterns and behaviors in 170 underweight 6-17-month-olds who received either lipid-based nutrient supplements (LNS) (n=85) or corn-soy blend (CSB) (n=85) during a 12-week intervention trial in southern Malawi. Observational data were collected during one 11h home v…
Acceptability of three novel lipid-based nutrient supplements among Malawian infants and their caregivers: Acceptability of three novel LNS products
We tested the acceptability of three new lipid-based nutrient supplements (LNSs) in two independent phases among 18 8-12-month-old healthy rural Malawians and their caregivers. In phase 1, acceptability was assessed by offering three new LNSs in random order, and an LNS already determined to be acceptable, Nutributter(®), each added to 30 g of warm maize porridge over three consecutive days. In phase 2, infants from each village were provided one…
Developmental outcomes among 18‐month‐old Malawians after a year of complementary feeding with lipid‐based nutrient supplements or corn‐soy flour
The major aim of this trial was to compare the development of 18-month-old infants who received complementary feeding for 1 year either with lipid-based nutrient supplements or micronutrient fortified corn-soy porridge. Our secondary aim was to determine the socio-economic factors associated with developmental outcomes in the same population. A total of 163 six-month-old rural Malawian children were enrolled in a randomized controlled trial where…
The validity of a structured interactive 24‐hour recall in estimating energy and nutrient intakes in 15‐month‐old rural Malawian children
This study aimed to compare the nutritional intake values among 15-month-old rural Malawian children obtained by weighed food record (WFR) with those obtained by modified 24-hour recall (mod 24-HR), and to develop algorithm for adjusting mod 24-HR values so as to predict mean intake based on WFRs. The study participants were 169 15-month-old children who participated in a clinical trial. Food consumption on one day was observed and weighed (estab…
Responsive feeding and child interest in food vary when rural Malawian children are fed lipid‐based nutrient supplements or local complementary food
Caregiver and child behaviours during feeding have been used to measure responsiveness, which has been recognised as important for child growth and development. The aims of this study were to understand how caregiver and child behaviours differ when feeding lipid-based nutrient supplements (LNS) vs. local complementary food and to detect associations between behaviours and child interest in food. Sixteen moderately underweight 6-17-month-old Mala…
Nicaraguan Migration and the Prevalence of Adolescent Childbearing in Costa Rica
An effectiveness trial showed lipid-based nutrient supplementation but not corn–soya blend offered a modest benefit in weight gain among 6- to 18-month-old underweight children in rural Malawi
Objective To determine if supplementation with corn–soya blend (CSB) or lipid-based nutrient supplement (LNS) improved the weight gain of moderately underweight infants and children when provided through the national health service. Design A randomised, controlled, assessor-blinded clinical trial. Infants and children were randomised to receive for 12 weeks an average daily ration of 71 g CSB or 43 g LNS, providing 1188 kJ and 920 kJ, respectivel…
Risk of childhood undernutrition related to small-for-gestational age and preterm birth in low- and middle-income countries
BACKGROUND: Low- and middle-income countries continue to experience a large burden of stunting; 148 million children were estimated to be stunted, around 30-40% of all children in 2011. In many of these countries, foetal growth restriction (FGR) is common, as is subsequent growth faltering in the first 2 years. Although there is agreement that stunting involves both prenatal and postnatal growth failure, the extent to which FGR contributes to stu…
Effect of complementary feeding with lipid‐based nutrient supplements and corn–soy blend on the incidence of stunting and linear growth among 6‐ to 18‐month‐old infants and children in rural M alawi
Low nutritional value of complementary foods is associated with high incidence of childhood growth stunting in low-income countries. This study was done to test a hypothesis that dietary complementation with lipid-based nutrient supplements (LNS) promotes linear growth and reduces the incidence of severe stunting among at-risk infants. A total of 840 6-month-old healthy infants in rural Malawi were enrolled to a randomised assessor-blinded trial.…
Considerations in developing lipid‐based nutrient supplements for prevention of undernutrition: Experience from the I nternational L ipid‐ B ased N utrient S upplements ( iLiNS ) P roject
The International Lipid-Based Nutrient Supplements (iLiNS) Project began in 2009 with the goal of contributing to the evidence base regarding the potential of lipid-based nutrient supplements (LNS) to prevent undernutrition in vulnerable populations. The first project objective was the development of acceptable LNS products for infants 6-24 months and for pregnant and lactating women, for use in studies in three countries (Burkina Faso, Ghana and…
Postnatal growth velocity and overweight in early adolescents: A comparison of rural and urban African boys and girls
OBJECTIVES: To compare growth velocity of two African child cohorts and examine the relationship between postnatal growth velocity in infancy/early childhood and the risk of overweight/stunting in early adolescence. METHODS: The study used data from two child cohorts from urban (Birth to Twenty Cohort, South Africa) and rural (Lungwena Child Survival Study, Malawi) African settings. Mixed effect modelling was used to derive growth and peak growth…
Impact of lipid‐based nutrient supplements and corn–soy blend on energy and nutrient intake among moderately underweight 8–18‐month‐old children participating in a clinical trial
Nutrition interventions have an effect on growth, energy and nutrient intake, and development, but there are mixed reports on the effect of supplementation of energy-dense foods on dietary intake. This substudy aimed at assessing the effect of supplementation with corn-soy blend (CSB) or lipid-based nutrient supplement (LNS) on energy and nutrient intake in moderately underweight children participating in a clinical trial. A total of 188 children…
Factors associated with breast milk intake among 9–10‐month‐old M alawian infants
Exclusive breastfeeding is recommended during the first 6 months of life; thereafter, continued breastfeeding along with nutritious complementary foods is recommended. Continued breastfeeding contributes a substantial proportion of nutrient needs and promotes healthy growth and development, but the quantity of breast milk consumed may be highly variable and little is known about the factors associated with breast milk intake after 6 months of age…
Nutrient supplementation may adversely affect maternal oral health – a randomised controlled trial in rural M alawi
Nutritional supplementation during pregnancy is increasingly recommended especially in low-resource settings, but its oral health impacts have not been studied. Our aim was to examine whether supplementation with multiple micronutrients (MMN) or small-quantity lipid-based nutrient supplements affects dental caries development or periodontal health in a rural Malawian population. The study was embedded in a controlled iLiNS-DYAD trial that enrolle…
Feeding behaviors during home‐based treatment of moderate acute malnutrition using corn‐soy blends or lipid‐based nutrient supplements
Feeding behaviors have an important impact on children's nutritional status and are essential to consider when implementing nutrition programs. The objective of this study was to explore and compare feeding behaviors related to supplementary feeding with corn‐soy blends (CSB) and lipid‐based nutrient supplements (LNS) based on best practice feeding behaviors. The study was conducted as part of a randomized controlled trial assessing the effective…
Maternal plasma cholesterol and duration of pregnancy: A prospective cohort study in Ghana
Low plasma cholesterol may be associated with preterm birth; however, results are mixed and limited primarily to high-income countries. Our objective was to determine whether maternal plasma lipid concentrations are associated with pregnancy duration. We performed a nested cohort (n = 320) study of pregnant Ghanaian women enrolled in a randomized controlled trial. Total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipopr…
Height gain after two‐years‐of‐age is associated with better cognitive capacity, measured with Raven's coloured matrices at 15‐years‐of‐age in Malawi
Stunting is a measure of chronic undernutrition, and it affects approximately 160 million children worldwide. Cognitive development of stunted children is compromised, but evidence about the association between height gain in late childhood and adolescent cognitive capacity is scarce. We aimed to determine the association between height gains at different ages, including late childhood, and cognitive capacity at 15-years-of-age. We conducted a pr…
The impact of maternal diet fortification with lipid‐based nutrient supplements on postpartum depression in rural Malawi: A randomised‐controlled trial
Perinatal depression is highly prevalent in low-and-middle-income countries and has been linked to poor child health. Suboptimal maternal nutrition may be a risk factor for perinatal depression. In this randomised-controlled trial conducted in rural Malawi, we set out to test the hypothesis that women taking a fatty acid-rich lipid-based nutrient supplement (LNS) would have fewer depressive symptoms postpartum than those taking iron-folate (IFA) …
Impact of small‐quantity lipid‐based nutrient supplement on hemoglobin, iron status and biomarkers of inflammation in pregnant Ghanaian women
We examined hemoglobin (Hb, g/L), iron status (zinc protoporphyrin, ZPP, μmol/mol heme, and transferrin receptor, TfR, mg/L) and inflammation (C-reactive protein, CRP and alpha-1 glycoprotein, AGP) in pregnant Ghanaian women who participated in a randomized controlled trial. Women (n = 1320) received either 60 mg Fe + 400-μg folic acid (IFA); 18 micronutrients including 20-mg Fe (MMN) or small-quantity lipid-based nutrient supplements (SQ-LNS, 11…
Provision of Lipid-Based Nutrient Supplements from Age 6 to 18 Months Does Not Affect Infant Development Scores in a Randomized Trial in Malawi
Investigating Preterm Care at the Facility Level: Stakeholder Qualitative Study in Central and Southern Malawi
Medicine (49 works) · Child Nutrition and Water Access (40 works) · Internal Medicine (37 works) · Pediatrics (24 works) · Environmental health (21 works) · Child Nutrition and Feeding Issues (17 works) · Pregnancy (17 works) · Randomized controlled trial (14 works) · Micronutrient (13 works) · Population (13 works)