Medicine and Health Sciences Commons^™

Cultural Adaptation Of An Innovative Reproductive Health Assessment Tool For Dementia Research In Africa: Insights From The Fember-Africa Study, Alice Moraa Ondieki, Anne Njogu, Cynthia I Sabel Smith, Edna Bosire, Karen Blackmon, Harrison Kaleli, Jasmit Shah, Rachel Maina, Sheila Waa, Chinedu Momoh

Brain and Mind Institute

Background: Dementia research accounts for only 0.1% of all research in Africa,making it the lowest among all low- and middle-income country (LMIC) regions. Thedevelopment and adaptation of biological and psychosocial measures in ethnicallyand culturally diverse populations remain limited but are essential for culturallyinformed research. This is particularly critical for examining sex- and gender-basedvulnerabilities to Alzheimer’s disease and related dementias (ADRD), including factorssuch as reproductive health and fertility.

Method: We conducted a thorough review of our clinical and health questionnaires forcultural relevance and sensitivity through a series (n = 3) of focus groups discussions.These focus groups included a diverse range of …

Vitality Tracking In Kenyan Adults Using Wearable Devices And Ecological Momentary Assessments, Karen Blackmon, Benard Alaka, Catherine Onyancha, Litha Musili, Raechel Kamau, Cyprian Mostert, Mansoor Saleh, Zul Merali, Chinedu Momoh, Thomas Thesen

Brain and Mind Institute

Background: Vitality is essential to healthy aging but is elusive to define and measure.Dynamic capture of fluctuations in vitality can uncover abnormal trajectories thatcould be a harbinger of frailty in older adults. Yet, these fluctuations are missed bystatic and/or sparse sampling strategies. To address the need for dynamic and high-density capture of vitality in older adults, we developed a passive sensing and activeprobing digital platform using wearable devices and smartphones. We deployed thisparadigm in older Kenyan adults and evaluated its potential for use in research on thedynamics of accelerated aging.

Method: Cognitively unimpaired (CU) Kenyan adults ≥ 35 years of …

Predicting Accelerated And Delayed Aging In Global Settings: Biobehavioral Age Gaps And The Role Of Global Exposomes, Hernan Hernandez, Hernando Santamaria-Garcia, Sebastian Moguilne, Agustina Legaz, Pavel Prado, Jhosmary Cuadros, Liset Gonzalez, Cyprian Mostert, Chinedu Momoh, Zul Merali

Brain and Mind Institute

Background: Global health challenges like aging and dementia are shaped bysocioeconomic disparities, environmental factors, and social determinants of health.We developed a behavioral age gap (BAG), measuring the difference between expectedbehavioral age and chronological age

Method: We utilized a cross-sectional sample (n = 161,981) comprising countriesfrom Latin America, Europe, Asia, and Africa. Behavioral age was estimated usinga Gradient Boosting Regressor with 10-fold cross-validation, incorporating multiplerisk factors (hypertension, diabetes, heart disease, female sex, visual impairment andhearing impairment) and protective factors (cognition, functional ability, education)associated with healthy aging. BAG was calculated as the difference between predictedand chronological age, and adjusted gaps were derived …

A Retrospective Analysis Of Relapse Rates And Medication Compliance In Bipolar I And Bipolar Ii Disorders: A Comparative Study, Nasir Mehmood, Qudsia Tariq

Pakistan Journal of Neurological Sciences (PJNS)

Background and objective:

Bipolar disorder is a chronic, serious mental health condition characterized by mood episodes, and medication non-compliance is a significant predictor of relapse. The objective of this study was to investigate the relapse rates and medication compliance in patients with bipolar I and II disorders.

Methods:

This retrospective observational study was conducted at Karwan-e-Hayat Institute for Mental Health Care, Karachi, Pakistan. Medical records of 377 patients diagnosed with bipolar I or bipolar II disorder between July 2019 and June 2022 were retrieved from the Hospital Management System (HMS). Diagnosis was confirmed using DSM-IV criteria. Medication compliance was assessed …

Clinical Phenotypes Of Motor Neurone Disease In A Kenyan Hospital-Based Population, Effie Nailah Kamadi, Jasmit Shah, Juzar Hooker, Thomas Jenkins, Dilraj Sokhi

Internal Medicine, East Africa

Background: Motor neurone disease (MND) presentation is globally heterogenous and data on the clinical phenotype in Sub-Saharan Africa (SSA) is scarce. We sought to address this by describing the profile of MND patients in a Kenyan hospital-based population.

Methods: The medical charts of all adult MND patients assessed in the facility between January 2010 and December 2023 were retrospectively reviewed. The biographical data and clinical features of these patients were captured from their electronic and manual health records and statistical analysis performed.

Results: In total, 160 patients had their data analyzed. The male to female ratio was 1.76:1. The median …

Multinational Transfusion Practices And Outcomes In Haematology Patients Admitted To The Intensive Care Unit, Caroline Schaap, Laurens Oomen, Senta Raasveld, Jimmy Schenk, Sanne De Bruin, Merijn Reuland, Claudia Oord, Jan Bakker, Maurizio Cecconi, Marcus Lance

Anaesthesiology, East Africa

Background and Objectives The number of critically ill patients with haematological conditions is increasing, yet transfusion practices in this population remain poorly defined. This study aimed to compare transfusion strategies in critically ill patients with versus without haematological conditions.

Study Design and Methods This international, prospective observational substudy of the International Point Prevalence Study of Intensive Care Unit [ICU] Transfusion Practices (InPUT) evaluated transfusion use in ICU patients with and without haematological conditions, including benign or malignant diseases or a history of stem cell transplantation. Outcomes included use of red blood cells (RBCs), platelets, plasma, haemostatic interventions, transfusion indications and …

Gut Bacterial Dysbiosis In Pediatric Severe Malaria Associates With Post-Discharge Mortality, Olivia Bednarski, Sawyer Lehman, David Mzinza, Caroline Kazinga, Ruth Namazzi, Robert Opoka, Jie Ren, Tuan Tran, Terrie Taylor, Karl Seydel

Paediatrics and Child Health, East Africa

Gut microbiota have been implicated in severe malaria in murine models, but their contribution to the pathogenesis of severe malaria in children is unknown. Here we show through analysis of gut bacteria in stool samples from two separate African studies enrolling children with severe malaria, and children from local communities, that children with severe malaria have gut bacteria dysbiosis. Among children with severe malaria, there is increased abundance of Enterobacteriaceae that associates with multiple clinical complications of severe malaria. Moreover, increased abundance of Escherichia coli was a predictor of post-discharge mortality. Metagenome analysis identify elevated metabolic pathways and genes supporting …

Neonatal Unit Human Resources: Coverage For Six Cadres And Trends For Staff-To-Baby Ratios In 65 Neonatal Units Implementing With Nest360 In Kenya, Malawi, Nigeria, And Tanzania, Rebecca Penzias, Eric Ohuma, Opeyemi Odedere, Olabisi Dosunmu, George Okello, Hannah Mwaniki, Robert Tillya, Josephine Shabani, Vincent Ochieng, Ekran Rashid, William Macharia

Paediatrics and Child Health, East Africa

Background: Implementing small and sick newborn care (SSNC) requires skilled health workers; however, there is a shortage, adversely impacting patient outcomes and health worker wellbeing. There are limited data and no cur‑ rent World Health Organization (WHO) standards for staftobaby ratios in neonatal units in low and middleincome countries (LMICs) to inform policy, planning, and investment.

Methods: In 65 neonatal units (36 in Malawi, 13 in Kenya, 7 in Tanzania, and 9 in Nigeria), a health facility assessment (HFA) for SSNC and governmentled quality improvement (QI) processes were implemented. Stafng data were col‑ lated from baseline HFA (Sept 2019–March 2021) …

Oesophageal Cancer And Its Associated Factors Among Patients Attending Surgical And Oncology Clinics At Garissa County Referral Hospital, Kenya: A Case-Control Study, Abdi Bashir, Moses Ngari, Berrick Otieno, Makorani Y’Dhidha-A-Mjidho, Osman Abdullahi, Symon Kariuki

Institute for Human Development, East Africa

Background Oesophageal cancer (EC) is a common cause of cancer mortality. Evidence on the burden, risk factors and treatment outcomes is limited in low-income and middle-income countries. This study aimed to describe the features of EC cases and determine associated factors among patients attending surgical and oncology clinics in Garissa County Referral Hospital (GCRH).

Methods We conducted a case–control study in which cases were patients with EC and positive histological confirmation and controls were patients admitted to GCRH for other diseases. Data on exposures were extracted from patient files. Data on tobacco and alcohol use were based on current or …

Liquid Biopsies Of Lung Cancer And Next Generation Sequencing At Sub-Saharan Africa Sites (Lungs@Africa), Nadia Ghazali, Catherine Brown, Trevor Pugh, Rayjean Hung, Kelechi Okonta, Mansoor Saleh, Shahin Sayed, Richard Khanyile, Zodwa Dlamini

Pathology, East Africa

Introduction: There is a lack of genomic and epidemiologic data regarding lung cancer in Sub-Saharan Africa. Liquid biopsy is a non-invasive and scalable approach for molecular profiling. This pilot study aims to determine the prevalence of actionable genetic alterations (AGAs) of non-small cell lung cancer (NSCLC) using liquid biopsy while establishing a liquid biopsy testing pipeline in Sub-Saharan Africa.

Methods: This is a prospective, cohort study at three sites: Aga Khan University Cancer Centre in Nairobi, Kenya; University of Port Harcourt Teaching Hospital in Port Harcourt, Nigeria; and Steve Biko Academic Hospital, University of Pretoria in Pretoria, South …

Cabotegravir And Rilpivirine For Treatment Of Hiv Infection In Africa: Week 96 Results From The Phase 3b Randomized, Open-Label, Noninferiority Cares Trial, Cissy Kityo, Ivan Mambule, Joseph Musaazi, Simiso Sokhela, Henry Mugerwa, Henry Mugerwa, Ibrahim Yawe, Fiona Cresswell, Abraham Siika, Reena Shah

Internal Medicine, East Africa

Evaluation of the durable efficacy and safety of long-acting injectable therapy for HIV is needed in African populations. In a multicenter, open-label phase 3b trial, 512 African adults with HIV-1, stable on first-line oral therapy, with screening plasma viral load (VL) < 50 copies ml−1 and without past virologic failure were randomized (1:1) to continue oral therapy or switch to cabotegravir (600 mg) and rilpivirine (900 mg) intramuscular injections every 8 weeks (optional 4-week oral lead-in). VL was monitored every 24 weeks. Here the primary outcome for our analysis up to 96 weeks was VL < 50 copies ml−1, using the Food and Drug Administration snapshot algorithm (noninferiority margin 10%) in the intention-to-treat exposed population. At 96 weeks, 247/255 (97%) in the long-acting group and 250/257 (97%) in the oral therapy group had VL < 50 copies ml−1 (difference −0.4%; 95% confidence interval −3.1% to 2.0%), demonstrating noninferiority. Adverse events of severity grade ≥3 occurred in 41/255 (16%) in the long-acting group and in 22/257 (9%) in the oral therapy group, mostly considered unrelated to the study drug; only one treatment-related adverse event in the long-acting group led to a decision to discontinue treatment (injection-site abscess). Cabotegravir and rilpivirine long-acting therapy produced durable virologic suppression, met the prespecified noninferiority endpoint compared with oral therapy and demonstrated an acceptable safety and tolerability profile. Long-acting therapy may be considered for use in African treatment programs. PACTR registration: 202104874490818.

Detection Of Left Ventricular Thrombus In Newly Diagnosed Heart Failure Patients: Diagnostic Accuracy Of 2d Transthoracic Echocardiography Compared With Cardiac Mri In A Kenyan Cohort, Barbara Karau, Nadeem Kassam, Mohamed Varwani, Jeilan Mohamed, Kevin Ombati, James Orwa, Mzee Ngunga

Internal Medicine, East Africa

Background Left ventricular thrombus (LVT) is a recognized complication of severe left ventricular (LV) systolic dysfunction. While cardiac magnetic resonance (CMR) Imaging is considered the gold standard due to its high sensitivity and specificity for detecting LVT, its availability remains limited in Sub-Saharan Africa. In contrast, 2D transthoracic echocardiography (TTE) is more accessible and commonly used in clinical practice. This study aimed to determine the incidence of LVT in patients with a left ventricular ejection fraction (LVEF) of less than 35% from any etiology, and to compare the diagnostic accuracy of TTE against CMR for its detection.

Methods This prospective, …

Implementation And Evaluation Of Infection Prevention And Control Training In Sub-Saharan Africa, David Odada, James Ndai, Ruth Thuku, Philip Adebayo

Internal Medicine, East Africa

No abstract provided.

Enhancing Food Security Sustainability Through Digital Information Extension Services In Rural Uganda: Maize Postharvest Evidence-Based Strategies, Jackline Estomihi Kiwelu, Patrick Ngulube

Libraries

Background Postharvest losses caused by poor drying and storage practices lead to maize waste, reduced food availability, unsafe food due to aflatoxin contamination, and income loss for farmers. This exacerbates food insecurity and threatens the livelihoods of rural communities. Leveraging digital solutions to provide quality maize postharvest handling information is critical to mitigating these challenges.

Objective This study examined maize postharvest handling extension information services provided by rural agricultural extension officers in selected districts of Uganda, focusing on how evidence-based practices supported by information sources, expert knowledge, and ICT infrastructure ensure the quality and relevance of the information delivered.

Methods …

Associations Of Estrogen With Modifiable And Non-Modifiable Risk Factors For Dementia: A Narrative Review, Sarah Gregory, Katie Bridgeman, Hannah Darwin, Mariapaola Barbato, Laura Booi, Anna Serrat, Antonella Chadha, Francesca Farina, Natalie Jenkins, Beverly Cheserem

Brain and Mind Institute

Female sex is associated with higher incidence and risk of dementia. Estrogen may rep-resent one important mechanism contributing to the increase in incidence rates. In thisreview, we synthesize narratively the evidence for associations between estrogen—across the life course from menarche to menopause, estrogen-containing hormonalcontraception and hormone replacement therapies, and pregnancy—with potentialmodifiable risk factors for dementia. These include education, hearing loss, traumaticbrain injury, hypertension, alcohol use, obesity, smoking, depression, physical inactiv-ity, diabetes, low-density lipoprotein (LDL) cholesterol, social isolation, air pollution,and untreated visual loss, as well as apolipoprotein E ε4. In addition, evidence is sum-marized for associations with sleep, diet, and stress. …

Examining Gender And Ethnic Disparities In Scientific Authorship To Promote A Culture Of Equity, Diversity And Inclusion At A University School Of Public Health, Paula Christen, Julia Michalow, Tristan Naidoo, Hillary Topazian, Sabine An Elsland, Abeer Arif, Marc Baguelin, Gemma Clunie, Sarah Essilfie-Quaye, Chinedu Momoh

Brain and Mind Institute

In public health research, diverse perspectives are vital to identify biases that homogenous teams might miss. Since publication metrics influence career progression, we investigated publication rate disparities within a School of Public Health. We analysed 18 322 peer-reviewed publications by 513 affiliated researchers between 2014 and 2023 using multivariable regression models and network analysis to assess the impact of gender, ethnicity, job level and centrality in the School’s research network on publication rates. We found a persistent gender gap in publication rates across job levels and ethnicities, with men publishing more than women (incidence rate ratio 1.30, 95% confidence interval …

Acceptability, Feasibility And Preliminary Evaluation Of The Who Caregiver Skills Training For Children With Developmental Disabilities In Rural And Urban Kenya, Amina Abubakar, Eva Mwangome, Paul Mwangi, Vibian Angweny, Martha Kombe, Rachel Mapenzi, Patricia Kipkemoi, Patricia Kipkemoi, Beatrice Mkubwa, Silas Onyango

Institute for Human Development, East Africa

Background Interventions to improve the developmental outcomes of children with developmental disabilities (DDs) in low-resourced settings such as Kenya are limited. The WHO caregiver skills training (CST) was developed to address social and communication needs of children with DDs through caregiver-mediated engagement strategies. This study investigated CST’s acceptability, feasibility and evaluated its effect on behavioural, communication and quality of life outcomes for children with DDs and their caregivers in Kenya.

Methods The settings were rural Kilifi and Korogocho informal settlement in Nairobi, Kenya. A sequential mixed-methods design consisting of three phases. First, CST materials translation to Swahili, stakeholder consultations and …

Kenya’S Path To Universal Health Coverage: Insights From Policy And Practice, Evaline Chepchirchir Langat, Paul Ward, Hailay Gesesew, Lillian Mwanri

Centre of Excellence in Women and Child Health

Background Universal health coverage (UHC) is a globally endorsed commitment aimed at ensuring equitable access to affordable healthcare services. Kenya's journey toward UHC has been marked by significant reforms, including the 2018 pilot phase and ongoing implementation phase (2020–2030). Using qualitative insights from policymakers and practitioners, this study explored Kenya’s progress, challenges, and opportunities to achieve UHC.

Methods Key informant interviews were conducted with 44 stakeholders across seven counties in Kenya. Data were collected in English using a semi-structured interview guide, audio-recorded with consent, and transcribed verbatim. Thematic analysis, guided by the WHO health system framework, identified achievements, challenges, and …

Age-Specific Distribution Of Cervical Precancer And Cancer Among Women Living With Hiv Across Seven Countries: A Systematic Review And An Individual Patient Data Meta-Analysis, Shona Dalal, Karin Sundström, Ronaldo Silva, Katayoun Taghavi, Helen Cejtin, Michael Chung, Sharon Greene, Smita Joshi, Helen Kelly, Elkanah Orang'o

Obstetrics and Gynaecology, East Africa

Background Women living with HIV have an elevated risk for cervical cancer, present earlier, and have more recurrent human papillomavirus (HPV) infections compared with women without HIV. To update WHO recommendations on screening and treatment to prevent cervical cancer, we aimed to identify whether women living with HIV should be screened for cervical cancer at a specific age, the optimal screening interval following a negative cervical screen, and the screening interval following treatment.

Methods We conducted a systematic literature review on cervical cancer and HIV by searching MEDLINE, Embase, CENTRAL, the Cochrane Library, and clinical trial registries covering Jan 1, …

Small For Gestational Age Subgroups Have Differential Morbidity, Growth, And Neurodevelopment At Age 2: The Interbio-21st Newborn Study, Aris Papageorghiou, María Restrepo-Méndez, Rose Mcgready, Fernando Barros, Francois Nosten, Shama Munim, R. Ochieng, Rachel Craik, Hellen Barsosio, James Berkley

Paediatrics and Child Health, East Africa

BACKGROUND: Small for gestational age is a complex perinatal syndrome associated with increased neonatal morbidity, mortality, and impaired childhood growth and neurodevelopment. Current classifications rely primarily on birthweight, which does not capture the heterogeneity of the condition nor predict long-term health outcomes. Here we aim to identify and characterize distinct small for gestational age subgroups and assess their neonatal and early childhood health trajectories.

OBJECTIVE: To refine the classification of small for gestational age by identifying subgroups based on maternal, fetal, and environmental factors and evaluating their associations with neonatal morbidity, growth, and neurodevelopment at age 2.

STUDY …

The Children's Hospitals In Africa Mapping Project (Champ) Survey: Facilities, Equipment, Supplies, Infrastructure, And Capacity To Respond To Emergencies, Vinayak Bhardwaj, Lawrence Stanberry, Philip Larussa, Wilmot James, Maitry Mahida, Aimable Kanyamuhunga, Atnafu Tekleab, Augustine Omoigberale, Crispen Ngwenya, Pauline Samia

Paediatrics and Child Health, East Africa

The Children’s Hospitals in Africa Mapping Project (CHAMP) survey was developed and implemented to assess the capabilities of some of the best resourced sub-Saharan African hospitals serving children. The aim was to evaluate hospital facilities, infrastructure, equipment, supplies, services, staffing, and readiness to care for children amid public health emergencies. This report analysed a subset of survey questions that characterised the hospitals and assessed facilities, equipment, supplies, infrastructure and capacity to respond to emergencies and outbreaks. Twenty-four sites were recruited. Twenty hospitals from 15 countries completed the survey from 2018 to 2019. This portion of the CHAMP study identified issues …

Implementation Of The Multicountry Who Covid-19 Pregnancy Cohort Study: Challenges And Lessons Learned During The Pandemic, Maria Costa, Renato Souza, Jose Cecatti, Sami Gottlieb, Marie Delnord, Soe Soe Thwin, Ndema Habib, Marleen Temmerman, Ingrid Gichere, Beth Maina

Obstetrics and Gynaecology, East Africa

Introduction A generic research protocol was developed for a prospective cohort study to allow systematic, harmonized data collection of the impact of SARS-CoV-2 infection and vaccination during pregnancy on maternal, obstetric, and neonatal outcomes across different settings. This article describes the study conception, development, implementation, challenges, and key lessons learned within study sites across the world.

Methods The protocol was implemented in 43 facilities in 10 countries during the pandemic, involving consecutive recruitment of over 16,000 pregnant or postpartum women. We evaluated selection of study sites, ethical approvals, staff recruitment and training, recruitment and follow-up, and incorporation of new elements …

Neonatal Unit Human Resources: Coverage For Six Cadres And Trends For Staff-To-Baby Ratios In 65 Neonatal Units Implementing With Nest360 In Kenya, Malawi, Nigeria, And Tanzania, Rebecca Penzias, Eric Ohuma, Opeyemi Odedere, Olabisi Dosunmu, George Okello, Hannah Mwaniki, Robert Tillya, Vincent Ochieng, Ekran Rashid, William Macharia

Paediatrics and Child Health, East Africa

Background Implementing small and sick newborn care (SSNC) requires skilled health workers; however, there is a shortage, adversely impacting patient outcomes and health worker well-being. There are limited data and no current World Health Organization (WHO) standards for staff-to-baby ratios in neonatal units in low- and middle-income countries (LMICs) to inform policy, planning, and investment.

Methods In 65 neonatal units (36 in Malawi, 13 in Kenya, 7 in Tanzania, and 9 in Nigeria), a health facility assessment (HFA) for SSNC and government-led quality improvement (QI) processes were implemented. Staffing data were collated from baseline HFA (Sept 2019–March 2021) and mid-2023 …

Food Insecurity Is Associated With Depressive And Anxiety Symptoms Among Caregivers Of Young Children In Arid And Semi-Arid Regions Of Kenya: A Cross-Sectional Study, Esther Chongwo, Daisy Chelangat, Eunice Njoroge, Barack Aoko, Martha Kaniala, Moses Wesala, Phillis Magoma, Joyce Marangu, Margaret Kabue, Daniel Rabok

Institute for Human Development, East Africa

Introduction: This study fills a critical gap by assessing the prevalence and association between food insecurity and depressive and anxiety symptoms among caregivers of young children in Kenya's arid and semi-arid lands (ASALs).

Methods: A cross-sectional design was used to collect data from caregivers of children aged 0–3 years from Lamu, Isiolo and Turkana Counties (N = 446). Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 scales were used to assess depressive and anxiety symptoms, respectively. We also administered the Household Food Insecurity Access Scale, alongside sociodemographic and health-related questionnaires.

Results: The mean caregiver age was 29.37 years …

Safety Of Spinal Anaesthesia In The East African Population: Assessment Of Spinal Cord Termination Level At And Above L2 Vertebra In Adults, David Nekyon, Sheila Waa, Samuel Gitau, David Odaba

Anaesthesiology, East Africa

Background While spinal anaesthesia is a widely used technique, failure to accurately identify the L3-L4 intervertebral space (IVS) during the procedure may expose a patient to a needlestick injury to the spinal cord.

Objectives This study aimed to determine the proportion of Conus Medullaris Terminations (CMT) at or above the L2 vertebra in a black East African population and identify any age or gender-based variations.

Methodology A prospective observational study of lumbar spine MRI was conducted on 331 patients who had no vertebral deformities or prior spine surgeries. Two radiologists assessed the CMT level by consensus, referencing the nearest vertebral …

Identifying Sex- And Gender-Specific Endocrinological, Lifestyle, Psychosocial, And Socio-Cultural Targets For Alzheimer's Disease Prevention In Africans: The Female Brain Health And Endocrine Research In Africa (Fember-Africa) Project, Chinedu Momoh, Benard Aliwa, Lukoye Atwoli, Karen Blackmon, Edna Bosire, Samuel Gitau, Harrison Kaleli, Ciru Kamanda, Linda Khakali, Rachel Maina, Peter Mativo, Sylvia Mbugua, Zul Merali, Kendi Muchungi, Anne Njogu, Douglas Nyankira, Alice Ondieki, Catherine Onyancha, Stanely Onyango, Jasmit Shah, Sheena Shah, Cynthia Smith, Dilraj Sokhi, Sheila Waa, Thomas Thesen

Brain and Mind Institute

Dementia rates are rising globally, with the burden increasing most rapidly in low- tomiddle-income countries. Despite this, research into Alzheimer’s disease and relateddementias (ADRD) among African populations remains limited, with existing modelsbased on Western cohorts that overlook sex-, gender-, and ancestry-specific factors.The Female Brain Health and Endocrine Research in Africa (FemBER-Africa) project,hosted at the Brain and Mind Institute, Aga Khan University, Kenya, will establish adeeply phenotyped cohort of 250 African individuals across the ADRD spectrum. Itwill assess sex-specific risk factors linked to ethnicity, lifestyle, and endocrinologicalvariables using fluid-based biomarkers (blood and saliva), neuroimaging (magneticresonance imaging and positron emission tomography), and …

Prevalence And Determinants Of Nomophobia Among Healthcare Workers In Nepal: A Cross-Sectional Study, Prakash Banjade, Asmita Itani, Munish Sharma, Reena Shah, Jasmit Shah, Aakansha Singh, Rahul Kashyap, Salim Surani

Brain and Mind Institute

Introduction: Nomophobia, the fear of being without a mobile phone, has become a significant concern in the current digital age. Healthcare professionals rely heavily on mobile devices for communication and information access. This cross-sectional study aimed to assess the prevalence and determinants of nomophobia among healthcare workers in Nepal.

Methods: A modified Nomophobia Questionnaire (NMP-Q) was used to determine nomophobia scores. Demographic characteristics such as age, gender, race, type of smartphone, hours spent on a smartphone, and type of medical specialty were considered to evaluate nomophobia in diverse groups of healthcare workers. Summary statistics were presented as frequencies …

Evaluating The Impact Of Alcohol On Dementia: Evidence From 13 Developing Countries, Cyprian Mostert

Brain and Mind Institute

Background: The 2024 Lancet Commission on Dementia Prevention identified alcoholconsumption as a risk factor contributing to a global increase in dementia cases by onepercent.

Method: We used a panel VAR model to analyze the impact of alcohol consumption ondementia prevalence in 13 developing countries with different alcohol tax systems.

Result: In countries with progressive alcohol tax systems, an increase in taxes onbeer and spirits leads to a 10 percent reduction in per capita alcohol consumption.This decline corresponds to a 4 percent reduction in dementia prevalence within fouryears. In countries with hybrid alcohol tax systems, a combination of alcohol bansand tax …

Small For Gestational Age Subgroups Have Differential Morbidity, Growth, And Neurodevelopment At Age 2: The Interbio-21st Newborn Study, Aris T. Papageorghiou, María C. Restrepo-Ménde, Rose Mcgready, Fernando C. Barros, Francois Nosten, Shama Munim, Roseline Ochieng, Rachel Craik, Hellen C. Barsosio, Zulfiqar Ahmed Bhutta

Department of Obstetrics & Gynaecology

Background: Small for gestational age is a complex perinatal syndrome associated with increased neonatal morbidity, mortality, and impaired childhood growth and neurodevelopment. Current classifications rely primarily on birthweight, which does not capture the heterogeneity of the condition nor predict long-term health outcomes. Here we aim to identify and characterize distinct small for gestational age subgroups and assess their neonatal and early childhood health trajectories.
Objective: To refine the classification of small for gestational age by identifying subgroups based on maternal, fetal, and environmental factors and evaluating their associations with neonatal morbidity, growth, and neurodevelopment at age 2.
Study design: Prospective …

Plasma Biomarkers In Neuropsychiatric Syndromes: A Narrative Review, Zahinoor Ismail, Dylan X Guan, Ganesh Babulal, James Bateman, Marc Cantillon, Byron Creese, Fabrizia D'Antonio, Corinne Fischer, Jennifer Gatchel, Chinedu Momoh

Brain and Mind Institute

Neuropsychiatric symptoms (NPS) are common features of neurodegenerative disease (NDD) but are relatively understudied compared to cognition, especially regarding biomarkers. Further, emerging evidence describes the utility of systematic assessment of NPS across the cognitive continuum, even in advance of dementia. In this narrative review, we discuss the role of plasma biomarkers in relation to NPS across the cognitive continuum of unimpaired, subjective cognitive decline, mild cognitive impairment, and dementia. While Alzheimer's disease is the primary focus, vascular, Lewy body, and frontotemporal dementia etiologies are also discussed. Literature searches included NPS and dementia-related search terms with additional literature identified based on …