Last data update: Jul 01, 2024. (Total: 47134 publications since 2009)
Records 1-14 (of 14 Records) |
Query Trace: Sullivan KM [original query] |
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Bioabsorption and effectiveness of long-lasting permethrin-treated uniforms over three months among North Carolina outdoor workers
Sullivan KM , Poffley A , Funkhouser S , Driver J , Ross J , Ospina M , Calafat AM , Beard CB , White A , Balanay JA , Richards S , Dyer M , Mather TN , Meshnick S . Parasit Vectors 2019 12 (1) 52 BACKGROUND: Vector-borne diseases are an important cause of morbidity and mortality in the USA. Effective, convenient prevention methods are needed. Long-lasting permethrin-impregnated (LLPI) clothing can prevent tick bites, however, additional information is needed on the real-world effectiveness and safety of this preventative measure. METHODS: In this pilot study, we recruited state and county park employees from North Carolina to wear LLPI uniforms for three months during the summer of 2016. We collected spot urine samples for biomonitoring of permethrin metabolites at one week, one month and three months after first use of the LLPI uniform. Following three months of wear, we collected pants and socks and analyzed them for permethrin content and mortality to ticks and mosquitoes. RESULTS: Thirteen park employees were included in the analysis. Bioactive amounts of permethrin remained in all clothing swatches tested, although there was great variability. Tick mortality was high, with 78% of pant and 88% of sock swatches having mean knockdown percentages >/= 85%. In contrast, mosquito mortality was low. Over the study period, the absorbed dosage of permethrin averaged < 4 mug/kg/d of body weight based on measurements of three metabolites. CONCLUSIONS: LLPI clothing retained permethrin and bioactivity against ticks after three months of use in real-world conditions. The estimated absorbed dosage of permethrin was well below the U.S. EPA level of concern, suggesting that LLPI clothing can be used safely by outdoor workers for tick bite prevention. |
Vitamin D status and associated factors of deficiency among Jordanian children of preschool age
Nichols EK , Khatib IM , Aburto NJ , Serdula MK , Scanlon KS , Wirth JP , Sullivan KM . Eur J Clin Nutr 2014 69 (1) 90-5 BACKGROUND/OBJECTIVES: Vitamin D deficiency in children remains a global concern. Although literature exists on the vitamin D status and its risk factors among children in the Middle East, findings have yielded mixed results, and large, representative community studies are lacking. SUBJECTS/METHODS: In a nationally representative survey of 1077 Jordanian children of preschool age (12-59 months) in Spring 2010, we measured 25(OH)D3 concentrations by liquid chromatography-tandem mass spectrometry and calculated prevalence ratios for deficiency associated with various factors. RESULTS: Results showed 19.8% (95% confidence interval (CI): 16.4-23.3%) deficiency (<12 ng/ml) and 56.5% (95% CI: 52.0-61.0%) insufficiency (<20 ng/ml). In adjusted models, prevalence of deficiency was higher for females compared with males (prevalence ratio (PR)=1.74, 95% CI: 1.22-2.47, P=0.002) and lower for children 24-35 months of age (PR=0.64, 95% CI: 0.44-0.92, P=0.018) compared with children 12-23 months of age. In rural areas, there was no difference in prevalence of vitamin D deficiency between those whose mothers had/did not have vitamin D deficiency (P=0.312); however, in urban areas, prevalence of vitamin D deficiency was 3.18 times greater among those whose mothers were vitamin D deficient compared with those whose mothers were not deficient (P=0.000). CONCLUSIONS: Vitamin D deficiency and insufficiency pose significant public health problems in Jordanian children with female children disproportionately affected. Strong associations between vitamin D status in children and urban residency and maternal vitamin D status suggest that the behaviors related to sun exposure in urban mothers likely also affect the sun exposure and thus vitamin D status of their children. |
Micronutrient status in Jordan: 2002 and 2010
Serdula MK , Nichols EK , Aburto NJ , Masa'd H , Obaid B , Wirth J , Tarawneh M , Barham R , Hijawi B , Sullivan KM . Eur J Clin Nutr 2014 68 (10) 1124-8 BACKGROUND/OBJECTIVES: Two national surveys were conducted in Jordon in 2002 and 2010 to investigate the micronutrient status in women and children. To determine the prevalence of anemia, iron and folate deficiency among women and children in 2010 and compare with the prevalence of anemia and iron deficiency in 2002. SUBJECTS/METHODS: A nationally representative survey was conducted in 2002 (1023 women, 15-49 years of age; 1059 children, 12-59 months of age) and a second survey in 2010 (2035 women; 940 children). Venous blood samples were used to measure hemoglobin, ferritin and red blood cell folate (the latter on a subsample of 393 women). RESULTS: Among women in 2010, the prevalence of folate deficiency and insufficiency was 13.6% and 82.9%, respectively. Geometric mean serum ferritin was higher in 2010 compared with 2002 (21.3 ng/ml vs 18.3, P=0.01); there was no significant change in the prevalence of iron deficiency (35.1% vs 38.7%, P=0.17), iron deficiency anemia (19.1% vs 20.0%, P=0.61) or anemia (29.2% vs 29.3%, P=0.96). Among children, a significantly lower prevalence was observed in 2010 compared with 2002 for iron deficiency (13.7% vs 26.2% P<0.001) and iron deficiency anemia (4.8% vs 10.1%, P<0.001); a nonsignificant lower prevalence was observed for anemia (16.6% vs 20.2%, P=0.09). CONCLUSIONS: In 2010, approximately one of seven women was folate deficient and six out of seven were folate insufficient for the prevention of neural tube defects. Between 2002 and 2010, significant improvement was observed in the prevalence of iron deficiency in children, but not in women. |
Obese women less likely to have low serum ferritin, Nicaragua
Wendt AS , Jefferds ME , Perrine CG , Halleslevens P , Sullivan KM . Public Health Nutr 2014 18 (4) 1-6 OBJECTIVE: To examine the association between overweight and obesity and serum ferritin among women of reproductive age (15-49 years) in Nicaragua, considering the effect of alpha1-acid glycoprotein (AGP), a marker of inflammation. DESIGN: We analysed data from the 2004-05 Nicaraguan Integrated Surveillance System for Nutrition Interventions. Three logistic regression models were analysed with low serum ferritin (<15 mug/l) as the dependent variable: (i) overweight or obese status and covariates; (ii) model 1 plus AGP; and (iii) model 1 restricted to only women with normal AGP levels (≤1.0 g/l). SETTING: Nicaragua. SUBJECTS: Included in this analysis were 832 non-pregnant mother/caregivers (15-49 years) surveyed in 2004-2005. RESULTS: In the sample, prevalence of overweight and obesity was 31.8 % and 19.2 %, respectively, and 27.6 % had low serum ferritin. In model 1, the adjusted OR of low serum ferritin was 0.74 (95 % CI 0.52, 1.05) for overweight women and 0.42 (95 % CI 0.26, 0.65) for obese women. In model 2, AGP was significantly independently associated with low serum ferritin (adjusted OR=0.56, 95 % CI 0.34, 0.92) while the adjusted OR for overweight and obesity were largely unchanged. Excluding women with elevated AGP did not appreciably affect the relationship between overweight or obesity and low serum ferritin (model 3). CONCLUSIONS: Overall, in this population of reproductive-age women, obese women were less likely to have low serum ferritin levels, and this was independent of inflammation as measured by AGP. |
Nutritional status of young children with inherited blood disorders in western Kenya
Tsang BL , Sullivan KM , Ruth LJ , Williams TN , Suchdev PS . Am J Trop Med Hyg 2014 90 (5) 955-962 ![]() To determine the association between a range of inherited blood disorders and indicators of poor nutrition, we analyzed data from a population-based, cross-sectional survey of 882 children 6-35 months of age in western Kenya. Of children with valid measurements, 71.7% were anemic (hemoglobin < 11 g/dL), 19.1% had ferritin levels < 12 mug/L, and 30.9% had retinol binding protein (RBP) levels < 0.7 mumol/L. Unadjusted analyses showed that compared with normal children, alpha+-thalassemia trait individuals had a higher prevalence of anemia (82.3% versus 66.8%, P = 0.001), but a lower prevalence of low RBP (20.5% versus 31.4%, P = 0.024). In multivariable analysis, alpha+-thalassemia trait remained associated with anemia (adjusted odds ratio [aOR] = 1.8, P = 0.004) but not with low RBP (aOR = 0.6, P = 0.065). Among young Kenyan children, alpha+-thalassemia is associated with anemia, whereas G6PD deficiency, haptoglobin 2-2, and HbS are not; none of these blood disorders are associated with iron deficiency, vitamin A deficiency, or poor growth. |
Comparison of population iodine estimates from 24-hr urine and timed spot urine samples
Perrine CG , Cogswell ME , Swanson CA , Sullivan KM , Chen TC , Carriquiry A , Dodd KW , Caldwell K , Wang CY . Thyroid 2013 24 (4) 748-57 BACKGROUND: Median urine iodine concentration (UIC; microg/L) in spot urine samples is recommended for monitoring population iodine status. Other common measures are iodine:creatinine ratio (I/Cr; microg/g) and estimated 24-hr urine iodine excretion (UIE; I/Cr*predicted 24-hr Cr; microg/d). Despite different units, these measures are often used interchangeably, and it is unclear how they compare with the reference standard 24-hr UIE. METHODS: Volunteers aged 18-39y collected all their urine samples for 24-hours (n=400); voids from morning, afternoon, evening, overnight, and a composite 24-h sample were analyzed for iodine. We calculated median observed 24-hr UIE and 24-hr UIC, and spot UIC, I/Cr, and 2 measures of estimated UIE calculated using predicted 24-hr Cr from published estimates by Kesteloot & Joosens (varies by age and sex) and published equations by Mage (varies by age, sex, race, and anthropometric measures). We examined mean differences and relative difference across iodine excretion levels using Bland-Altman plots. RESULTS: Median 24-hr UIE was 173.6 microg/d and 24-hr UIC was 144.8 microg/L. From timed spot urine samples, estimates were UIC: 147.3-156.2 microg/L, I/Cr: 103.6-114.3 microg/g, estimated 24-hr UIE (Kesteloot & Joosens): 145.7-163.3 microg/d, and estimated 24-hr UIE (Mage): 176.5-187.7 microg/d. Iodine measures did not vary consistently by timing of spot urine collection. Compared with observed 24-hr UIE, on average, estimated (Mage) 24-hr UIE was not significantly different, while estimated 24-hr UIE (Kesteloot& Joosens) was significantly different for some race/sex groups. Compared with 24-hr UIC, on average, spot UIC did not differ. CONCLUSIONS: Estimates of UIC, I/Cr, and estimated 24h-hr UIE (I/Cr*predicted 24-hr Cr) from spot urine samples should not be used interchangeably. Estimated 24-hr UIE, where predicted 24-hr Cr varies by age, sex, race, and anthropometric measures and was calculated with prediction equations using data from the sample, was more comparable to observed 24-hr UIE than when predicted 24-hr Cr was from published estimates from a different population. However, currently no cutoffs exist to interpret population estimated 24-hr UIE values. |
Monitoring the iodine status of pregnant women in the United States
Sullivan KM , Perrine CG , Pearce EN , Caldwell KL . Thyroid 2013 23 (4) 520-1 Assuring adequate iodine nutrition is an important public health task. In this letter, we describe the iodine status of pregnant women in the United States and discuss the ability to monitor iodine status and trends. The iodine status of pregnant women in the United States has been of concern to some groups, and in October 2006, the Public Health Committee of the American Thyroid Association (ATA) recommended daily iodine supplementation during pregnancy and lactation in the United States and Canada (1). In October 2011, the ATA Taskforce on Thyroid Disease during Pregnancy and Postpartum endorsed daily oral iodine supplementation during pregnancy and lactation in North America and added women planning on becoming pregnant to this recommendation (2). | In cross-sectional surveys, the iodine status of a population is usually assessed through the analysis of casual (or spot) urine specimens for urinary iodine concentration (UIC). A single spot UIC should not be used as an indicator of an individual’s iodine status, because the UIC can vary widely within an individual throughout the day and as well as day-to-day (3). König et al. state that to estimate an individual’s iodine status requires ten repeat spot or 24-hour urine collections (3). Therefore, while a single spot urine specimen is not useful for classifying an individual’s iodine status, the median urinary iodine has been used to assess the iodine status of a population. The World Health Organization (WHO) has formulated criteria to assist in interpreting median urinary iodine levels (4). For pregnant women, a median UIC of < 150 μg/L is classified as insufficient iodine intake, 150–249 μg/L as adequate, 250–499 μg/L as above requirements, and ≥500 μg/L as excessive, in terms of the amount of iodine required to prevent iodine deficiency. |
Determinants of anemia among preschool children in rural, western Kenya
Foote EM , Sullivan KM , Ruth LJ , Oremo J , Sadumah I , Williams TN , Suchdev PS . Am J Trop Med Hyg 2013 88 (4) 757-64 ![]() Although anemia in preschool children is most often attributed to iron deficiency, other nutritional, infectious, and genetic contributors are rarely concurrently measured. In a population-based, cross-sectional survey of 858 children 6-35 months of age in western Kenya, we measured hemoglobin, malaria, inflammation, sickle cell, alpha-thalassemia, iron deficiency, vitamin A deficiency, anthropometry, and socio-demographic characteristics. Anemia (Hb < 11 g/dL) and severe anemia (Hb < 7 g/dL) prevalence ratios (PRs) for each exposure were determined using multivariable modeling. Anemia (71.8%) and severe anemia (8.4%) were common. Characteristics most strongly associated with anemia were malaria (PR: 1.7; 95% confidence interval [CI] = 1.5-1.9), iron deficiency (1.3; 1.2-1.4), and homozygous alpha-thalassemia (1.3; 1.1-1.4). Characteristics associated with severe anemia were malaria (10.2; 3.5-29.3), inflammation (6.7; 2.3-19.4), and stunting (1.6; 1.0-2.4). Overall 16.8% of anemia cases were associated with malaria, 8.3% with iron deficiency, and 6.1% with inflammation. Interventions should address malaria, iron deficiency, and non-malarial infections to decrease the burden of anemia in this population. |
Summary of an NIH workshop to identify research needs to improve the monitoring of iodine status in the United States and to inform the DRI
Swanson CA , Zimmermann MB , Skeaff S , Pearce EN , Dwyer JT , Trumbo PR , Zehaluk C , Andrews KW , Carriquiry A , Caldwell KL , Egan SK , Long SE , Bailey RL , Sullivan KM , Holden JM , Betz JM , Phinney KW , Brooks SP , Johnson CL , Haggans CJ . J Nutr 2012 142 (6) 1175S-85S The Office of Dietary Supplements (ODS) at the NIH sponsored a workshop on May 12-13, 2011, to bring together representatives from various NIH institutes and centers as a first step in developing an NIH iodine research initiative. The workshop also provided an opportunity to identify research needs that would inform the dietary reference intakes for iodine, which were last revised in 2001. Iodine is required throughout the life cycle, but pregnant women and infants are the populations most at risk of deficiency, because iodine is required for normal brain development and growth. The CDC monitors iodine status of the population on a regular basis, but the status of the most vulnerable populations remains uncertain. The NIH funds very little investigator-initiated research relevant to iodine and human nutrition, but the ODS has worked for several years with a number of other U.S. government agencies to develop many of the resources needed to conduct iodine research of high quality (e.g., validated analytical methods and reference materials for multiple types of samples). Iodine experts, scientists from several U.S. government agencies, and NIH representatives met for 2 d to identify iodine research needs appropriate to the NIH mission. |
Vitamin D status and determinants of deficiency among non-pregnant Jordanian women of reproductive age
Nichols EK , Khatib IM , Aburto NJ , Sullivan KM , Scanlon KS , Wirth JP , Serdula MK . Eur J Clin Nutr 2012 66 (6) 751-6 BACKGROUND/OBJECTIVES: Vitamin D deficiency, a risk factor for osteomalacia and osteoporosis, is a re-emerging health problem globally. While sunlight is an important vitamin D source, previous investigations among women whose culture encourages skin covering have been small, not nationally representative, or both. We investigated serum 25-hydroxyvitamin D (25(OH)D(3)) status and factors associated with deficiency in a nationally representative survey of 2013 Jordanian women of reproductive age in Spring 2010. SUBJECTS/METHODS: We measured 25(OH)D(3) concentrations by liquid chromatography-tandem mass spectrometry and calculated prevalence ratios for deficiency associated with skin covering and other factors. RESULTS: Results showed 60.3% (95% CI: 57.1-63.4%) deficiency (<12 ng/ml) and 95.7% (95% CI: 94.4-96.8%) insufficiency (<20 ng/ml) among women. Prevalence of deficiency was 1.60 times higher for women who covered with a scarf/hijab (95% CI: 1.06-2.40, P=0.024) and 1.87 times higher for women who wore full cover, or a niqab (95% CI: 1.20-2.93, P=0.006), compared with the women who did not wear a scarf/hijab or niqab. Compared with rural women completing at least secondary education, prevalence of deficiency was 1.30 times higher for urban women of the same education level (95% CI: 1.08-1.57, P=0.006), 1.18 times higher for urban women completing less than secondary education (95% CI: 0.98-1.43, P=0.09), and 0.66 times lower for rural women completing less than secondary education (95% CI: 0.52-0.84, P=0.001). CONCLUSION: Vitamin D deficiency and insufficiency pose significant public health problems in Jordanian women. Prevalence of deficiency is significantly higher among urban women and among women who cover with a scarf/hijab or niqab. (European Journal of Clinical Nutrition advance online publication, 14 March 2012; doi:10.1038/ejcn.2012.25.) |
Some subgroups of reproductive age women in the United States may be at risk for iodine deficiency
Perrine CG , Herrick K , Serdula MK , Sullivan KM . J Nutr 2010 140 (8) 1489-94 Consuming an adequate amount of iodine during pregnancy is critical for fetal neurologic development. Even a mild deficiency can impair cognitive ability. Important sources of iodine in the United States include dairy products and iodized salt. Although the U.S. population has traditionally been considered iodine sufficient, median urinary iodine concentrations (UIC) have decreased 50% since the 1970s. We analyzed 2001-2006 NHANES data from urine iodine spot tests for pregnant (n = 326), lactating (n = 53), and nonpregnant, nonlactating (n = 1437) women of reproductive age (15-44 y). We used WHO criteria to define iodine sufficiency (median UIC: 150-249 microg/L among pregnant women; >or=100 microg/L among lactating women; and 100-199 microg/L among nonpregnant, nonlactating women). The iodine status of pregnant women was borderline sufficient (median UIC = 153 microg/L; 95% CI = 105-196), while lactating (115 microg/L; 95% CI = 62-162) and nonpregnant, nonlactating (130 microg/L; 95% CI = 117-140) women were iodine sufficient. Dairy product consumption was an important contributor to iodine status among both pregnant and nonpregnant, nonlactating women, and those who do not consume dairy products may be at risk for iodine deficiency. Although larger samples are needed to confirm these findings, these results raise concerns about the iodine status of pregnant women and women of reproductive age who are not consuming dairy products. Iodine levels among U.S. women should be monitored, particularly among subgroups at risk for iodine deficiency. |
The impact of transient hypothyroidism on the increasing rate of congenital hypothyroidism in the United States
Parks JS , Lin M , Grosse SD , Hinton CF , Drummond-Borg M , Borgfeld L , Sullivan KM . Pediatrics 2010 125 Suppl 2 S54-63 The reported incidence rate of primary congenital hypothyroidism (CH) has been increasing in the United States over the past 2 decades. We have considered the possibility that the inclusion of cases of transient hypothyroidism has inflated the reported incidence rate of CH. Assessing the effects of cases of transient hypothyroidism on the incidence rate is problematic, because the definitions, diagnostic criteria, and differentiation from transient hyperthyrotropinemia vary widely among state newborn screening programs. Among the 4 etiologies for transient hypothyroidism (maternal thyrotropin receptor-blocking antibodies, exposure to maternal antithyroid medications, iodine deficiency, and iodine excess), there is little evidence of increases in the incidence rate from thyrotropin receptor-blocking antibodies. Exposure to antithyroid drugs could contribute significantly to the incidence rate of transient CH, given the high estimated incidence of active maternal hyperthyroidism. Iodine deficiency or excess in the United States seems unlikely to have contributed significantly to the incidence rate of CH, because the secular trend toward lower iodine intake among women of reproductive age in the 1980s and 1990s seems to have plateaued, and perinatal iodine exposure has presumably declined as a result of recommendations to discontinue using iodine-containing disinfectants. Although the female-to-male sex ratio among newborns with thyroid agenesis or dysgenesis (the most common causes of CH) is typically 2:1, analysis of the sex ratio of newborns diagnosed with presumed CH in the United States suggests that a substantial proportion might have transient hypothyroidism or hyperthyrotropinemia, because the sex ratio has been well below the expected 2:1 ratio. Combined ultrasonography and (123)I scintigraphy of the thyroid gland are effective tools for identifying cases of thyroid agenesis and dysgenesis and can help to differentiate cases of transient hypothyroidism from true CH. Imaging is also a vital component in evaluating children who, at 3 years of age, undergo a trial of discontinuation of levothyroxine treatment to test for persistence of hypothyroidism. Ultimately, thyroid gland imaging, in conjunction with long-term follow-up studies that appropriately assess and report whether there was permanence of hypothyroidism, will be necessary to address the true incidence rate of CH and any contribution to the observed rate by transient cases of hypothyroidism or hyperthyrotropinemia. |
U.S. maternally linked birth records may be biased for Hispanics and other population groups
Leiss JK , Giles D , Sullivan KM , Mathews R , Sentelle G , Tomashek KM . Ann Epidemiol 2010 20 (1) 23-31 PURPOSE: We sought to advance understanding of linkage error in U.S. maternally linked datasets and how the error might affect results of studies based on the linked data. METHODS: North Carolina birth and fetal death records for 1988-1997 were maternally linked (n=1,030,029). The maternal set probability, defined as the probability that all records assigned to the same maternal set do in fact represent events to the same woman, was used to assess differential maternal linkage error across race/ethnic groups. RESULTS: Maternal set probabilities were lower for records specifying Asian or Hispanic race/ethnicity, suggesting greater maternal linkage error for these sets. The lower probabilities for Hispanics were concentrated in women of Mexican origin who were not born in the United States. CONCLUSIONS: Differential linkage error may be a source of bias in studies that use U.S. maternally linked datasets to make comparisons between Hispanics and other groups or among Hispanic subgroups. Methods to quantify and adjust for this potential bias are needed. |
Use of supplements with and without iodine in women of childbearing age in the United States
Gregory CO , Serdula MK , Sullivan KM . Thyroid 2009 19 (9) 1019-20 The iodine status of women of childbearing age in the United States has declined dramatically over the last 25 years (1,2). In fact, using criteria from the World Health Organization, certain subgroups may be classified as iodine deficient (3). Given this dramatic decline in iodine status and the critical role of iodine in fetal neurologic development, in October 2006 the American Thyroid Association recommended iodine supplementation for all pregnant and lactating women in the United States and Canada (4). | We were interested in determining the percentage of women of childbearing age in the United States taking supplements and the percentage taking supplements containing iodine. We looked at data from the National Health and Nutrition Examination Survey (NHANES) for the years 2001–2006. NHANES is a stratified, multistage survey that provides a representative sample of the noninstitutionalized U.S. population (5). Information collected includes the use of any vitamins, minerals, or other dietary supplements within the previous 30 days. Product names are obtained and are compared to a database containing information including vitamin and mineral content. | The reported use of any supplement and use of a supplement containing iodine within the previous 30 days is presented in Table 1 for nonpregnant women of childbearing age (15‱44 years) and pregnant and lactating women. Less than half of nonpregnant women were taking any supplement compared to three fourths of pregnant women and two thirds of lactating women. Only one fifth of nonpregnant and pregnant women and 15% of lactating women were taking a supplement that contained iodine. Although the prevalence of supplement use was much higher among pregnant and lactating women compared to nonpregnant women, the prevalence of taking a supplement containing iodine was similarly low among all groups. This indicates that a lower percentage of supplements consumed by pregnant and lactating women contained iodine compared to supplements consumed by nonpregnant women (26% and 22%, vs. 47%, respectively). |
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