Public Health Commons^™

Substance Use Among Healthcare Professionals: A Cross-Sectional Study In Kenya, Jasmit Shah, Cynthia Smith, Cyprian Mostert, Linda Khakali, Zul Merali, Sayed Karar

Brain and Mind Institute

Substance use among healthcare professionals, including alcohol, tobacco, marijuana, benzodiazepines etc., is a rising concern. The immensity of substance use is not yet clear, though recently, studies conducted on medical students and physician trainees show that 10% to 15% of all healthcare professionals misuse drugs at some point in their career, and that 6% to 8% of physicians have a substance use disorder. Substance use has a direct impact on relationships, physical health, and job performance, and is associated with depression, burnout, and decreased career satisfaction. The aim of this study was to shed light on the prevalence of substance …

Supraclavicular Nodal Metastasis At Primary Staging Of Prostate Cancer Using 18f-Psma-1007 Pet/Ct, Samuel Gitau, Jasmit Shah, William Olwit, Saeed Samnakay, Manel Haj Mansour, Khalid Makhdomi

Brain and Mind Institute

Background: The most common sites of metastasis in prostate cancer are bone, pelvic and retroperitoneal lymph nodes, liver and lungs. This study aimed to evaluate the prevalence of supraclavicular nodal metastasis in newly diagnosed prostate cancer using 18F-PSMA-1007 PET/CT which has hitherto been understudied.

Methods: 18F-PSMA-1007 PET/CT examinations performed at our institution between June 2020 and June 2022 for primary staging of prostate cancer were reviewed to identify supraclavicular nodal metastasis from prostate cancer. Data variables included age, stage of disease, PSA level, Gleason score and ISUP/WHO grade group and how these compare with the presence of supraclavicular …

Molecular Profile Of Non-Small Cell Lung Cancer In A Predominantly Black African Population In Kenya: A Single Institution Review, Sitna Mwanzi, Shahin Sayed, Swati Das, Jonathan Wawire, Jasmit Shah, Asim Jamal Shaikh

Haematology and Oncology, East Africa

Targeted therapies for patients with non-small cell lung cancer (NSCLC) have significantly improved the outcomes for patients with oncogenic driver mutations. Testing for epidermal growth factor receptor (EGFR) mutations, anaplastic lymphoma kinase (ALK) rearrangement, c-ros oncogene 1 (ROS1) rearrangement and programmed death ligand 1 (PDL 1) testing are now highly recommended for all patients with NSCLC. There are clear geographical differences in the rate of driver mutations with higher EGFR mutation rates in the Asian population in comparison to the Caucasian population. Little is known about the rate of oncogenic driver mutations in predominantly Black African populations like those living …

Global Burden Of Metabolic Dysfunction-Associated Steatosis Liver Disease, 2010 To2021, Gong Feng, Giovanni Targher, Christopher D. Byrne, Yusuf Yilmaz, Vincent Wai-Sun Wong, Cosmas Rinaldi Adithya Lesmana, Leon A. Adams, Jerome Boursier, George Papatheodoridis, Christopher Opio

Internal Medicine, East Africa

Background & Aims :This study used the Global Burden of Disease data (2010–2021) to analyze the rates and trends of point prevalence, annual incidence, and years lived with disability (YLDs) for metabolic dysfunction-associated steatotic liver disease (MASLD) in 204 countries.

Methods :Total numbers and age-standardized rates per 100,000 population for MASLD prevalence, annual incidence, and YLDs were compared across regions and countries by age, sex, and sociodemographic index (SDI). Smoothing spline models were used to evaluate the relationship between the burden of MASLD and SDI. Estimates were reported with uncertainty intervals (UI).

Results: Globally, in 2021, the age-standardized rates per …

Social Media In Advancing Equity And Collaboration In Rheumatology: The Cordiality Review, Ihsane Hmamouchi, Nelly Ziade, Adewale Adebajo, Latika Gupta, Puja Mehta, Angela Migowa, Elena Nikiphorou, Noelle A. Rolle, Didem Saygin, Namrata Singh

Pathology, East Africa

Social media has transformed communication in academia and medicine, offering stakeholders innovative avenues for knowledge exchange and collaboration. The CORDIALITY review (soCial media fOR aDvancing equIty And coLlaboration In rheumaTologY) examines the impact of social media on education and information dissemination, patient education and empowerment, networking and mentorship, and research collaboration within rheumatology, when effectively used. In this narrative review, we consider the opportunities as well as the challenges related to each of these facets of social media use. With a focus on inequities faced globally, we give particular consideration to disparities by gender as they relate to the rheumatology …

Community Engagement Approaches And Lessons Learned: A Case Study Of The Precise Pregnancy Cohort Study In Kenya, Onesmus Wanje, Angela Koech, Maggie Woo Kinshella, Grace Mwashigadi, Alice Kombo, Grace Maitha, Nathan Barreh, Hiten D. Mistry, Marianne Vidler, Rachel Craik

Centre of Excellence in Women and Child Health

Community engagement (CE) has been recommended as an important ethical consideration for health research to enhance informed consent and exchange knowledge between researchers and community members. The purpose of this paper is to describe how CE was developed and delivered for the PRECISE prospective pregnancy cohort study in Kenya. PRECISE enrolled pregnant women in antenatal care, followed them up to the postpartum period, and collected data and biological samples to enable the study of placental disorders in sub-Saharan Africa. Initially CE was aimed at informing the community about the study, establishing communitywide acceptance of the research and addressing concerns about …

Seroprevalence And Associated Factors For Hepatitis B And Hepatitis C Viral Infection Among Patients With Diabetes Mellitus In Northern Tanzania, Doreen T. Eliah, Nyasatu G. Chamba, Abid M. Sadiq, Amos Mwasamwaja, Faustini C. Kimondo, Cuthbert D. Matay, Eliada B. Nziku, Tumaini E. Mirai, Ibrahim Ali Ibrahim Muhina, Fuad H. Said

Internal Medicine, East Africa

Background: The coexistence of viral hepatitis with diabetes mellitus (DM) significantly escalates the risk of severe outcomes. This study aimed to determine the seroprevalence and associated factors of hepatitis B (HBV) and hepatitis C (HCV) viral infections among DM patients in northern Tanzania.

Materials and methods: Conducted between February 2023 and May 2023, this hospital-based cross-sectional study enrolled 189 patients with DM from the Diabetic Clinic of Kilimanjaro Christian Medical Centre. A structured questionnaire captured relevant clinical information, and plasma blood sample was assessed for hepatitis B surface antigen and anti-hepatitis C antibody seropositivity. Data analysis employed SPSS v26, and …

Prevalence And Correlates Of Depressive And Anxiety Symptoms Among Pregnant Women From An Urban Informal Settlement In Nairobi, Kenya: A Community-Based Cross-Sectional Study, Stephen Mulupi, Amina Abubakar, Moses Nyongesa, Vibian Angweny, Margaret Kabue, Paul Mwangi, Rachel Odhiambo, Joyce Marangu, Eunice Njoroge, Mercy Mokaya, Emmanuel Obulemire, Eunice Ombech, Kofi Marfo

Institute for Human Development, East Africa

Purpose: Previous research, largely from the Global North, reports high rates of common mental health disorders among women in the antenatal period, but there is paucity of such data in contexts like Kenya. This study investigated the prevalence and correlates of depressive and anxiety symptoms among pregnant women in an urban informal settlement in Kenya’s capital – Nairobi.

Method: An analysis of baseline cross-sectional data from a pilot cluster randomized trial of an integrated early childhood development programme. Participants were pregnant women in their third pregnancy trimester (N = 249), residing in an urban informal settlement in Nairobi County. Mental …

Air Pollution Exposures In Early Life And Brain Development In Children (Abc): Protocol For A Pregnancy Cohort Study, Sarah Benki-Nugent, Faridah H. Were, Anne M Riederer, Michael Gatari, Cj Karr, Edmund Yw Seto, Beatrice C. Mutai, Susan Wamithi, Brent R. Collett, John Kinuthia

Paediatrics and Child Health, East Africa

Introduction Air pollution is linked with poor neurodevelopment in high-income countries. Comparable data are scant for low-income countries, where exposures are higher. Longitudinal pregnancy cohort studies are optimal for individual exposure assessment during critical windows of brain development and examination of neurodevelopment. This study aims to determine the association between prenatal ambient air pollutant exposure and neurodevelopment in children aged 12, 24 and 36 months through a collaborative, capacity-enriching research partnership.

Methods and analysis This observational cohort study is based in Nairobi, Kenya. Eligibility criteria are singleton pregnancy, no severe pregnancy complications and maternal age 18 to 40 years. At …

Outcomes Of Pregnant Icu Patients With Severe Covid-19 Pneumonia In Qatar During The Three Waves Of The Covid-19 Pandemic: A Retrospective Cohort Study, Layla J.M Kily, Sohel M.G Ahmed, Tamam A.K.M Alhusban, Mohammed J. Orompurath, Marcus Lance, Mogahed I.H Hussein, Salwa M. Abuyaqoub, Huda A. Saleh, Eynas Abdalla, Santhosh Gopalakrishnan

Anaesthesiology, East Africa

Introduction: Pregnant women are considered a high-risk group for COVID-19 infection/pneumonia as they are known to be more vulnerable to viral infections. They require close monitoring and appropriate timely intervention to minimize the impact on both the mother and the fetus. Although the more prevalent Omicron variant led to fewer severe infections and fewer intensive care unit (ICU) admissions globally during the third wave, the effect on pregnant women and pregnancy outcomes was unknown. The vaccination campaign was thoroughly established by the third wave of the pandemic in Qatar. This retrospective descriptive cohort study investigates the characteristics, hospital stay, interventions, …

The Case For An International Severity Of Illness Scoring System, Alexander Tracy, Jorge Ibrain Figueira Salluh, Eirik Alnes Buanes, Dave A. Dongelmans, Stefano Finazz, Bharath Kumar Tirupakuzhi Vijayaraghavan, Nazir Lone, David Pilcher, Matti Reinikainen, Wangari Siika

Anaesthesiology, East Africa

Severity of illness scores in the critical care context have evolved to serve multiple functions. These scores enable risk-adjusted outcomes to be benchmarked for the assessment of intensive care unit (ICU) performance, inform resource allocation, and enable the characterization of disease severity. Numerous illness severity scores have been developed to optimize calibration at the national level, but few studies have examined the international application of such scores.()

The COVID-19 pandemic demonstrated the value of benchmarking outcomes across heterogeneous populations and across various health care systems. Severity of illness scores were widely used to describe trial populations, assess treatment effects and …

Procalcitonin-Guided Duration Of Antibiotic Treatment In Children Hospitalised With Confirmed Or Suspected Bacterial Infection In The Uk (Batch): A Pragmatic, Multicentre, Open-Label, Two-Arm, Individually Randomised, Controlled Trial, Cherry-Ann Waldron, Philip Pallmann, Simon Schoenbuchner, Debbie Harris, Lucy Brookes-Howell, Céu Mateus, Jolanta Bernatoniene, Katrina Cathie, Saul N. Faust, Helen Nabwera

Centre of Excellence in Women and Child Health

Background Procalcitonin is a rapid response biomarker specific for bacterial infection, which is not routinely used in the UK National Health Service. We aimed to assess whether using a procalcitonin-guided algorithm would safely reduce the duration of antibiotic therapy compared with usual care, in which C-reactive protein is the commonly used biomarker.

Methods The BATCH trial was a pragmatic, multicentre, open-label, parallel, two-arm, individually randomised, controlled trial conducted in 15 hospitals in England and Wales. Children aged 72 h to 18 years who were admitted to hospital and were being treated with intravenous antibiotics for suspected or confirmed bacterial infection …

Interventions To Prevent And Manage Infections In Pregnancy, Rahima Yasin, Li Jiang, Jai K. Das, Zulfiqar Ahmed Bhutta

Institute for Global Health and Development

Background: Care interventions aimed at preventing and treating maternal infections during the gestational period are of paramount importance. Timely immunizations, screening strategies, and management of maternal infections reduce the risk of complications for the developing fetus and play a pivotal role in improving neonatal outcomes.
Summary: We aim to summarize evidence for a total of thirteen interventions, pertaining to the prevention and treatment of maternal infections during the antenatal period, from Every Newborn Series published in The Lancet 2014. We identified the most recent systematic reviews, extracted data from each review, and conducted a sub-group meta-analysis for low-income countries and …

Intersection Between Individual, Household, Environmental And System Level Factors In Defining Risk And Resilience For Children In Kenya’S Asal: A Qualitative Study, Esther Chongwo, Barack Aoko, Martha Kaniala, Moses Wesala, Phillis Magoma, Eunice Njoroge, Susan Nyamanya, Joyce Marangu, Anil Khamis, Amina Abubakar

Institute for Human Development, East Africa

Introduction: Children growing up in arid and semi-arid regions of Sub-Saharan Africa (SSA) face heightened risks, often resulting in poor developmental outcomes. In Kenya, the arid and semi-arid lands (ASAL) exhibit the lowest health and developmental indicators among children. Despite these risks, some children grow up successfully and overcome the challenges. However, there is limited comprehensive data on sources of risks and resilience in these children, particularly research that incorporates community perspectives and indigenous knowledge. Systematic documentation of factors influencing child outcomes is crucial for understanding the overall burden, informing policy and implementing targeted interventions. This study aimed at …

Academic Proficiency In Ugandan Children With Sickle Cell Anemia: A Cross-Sectional Study, Robert Opoka, Shubaya Kasule Naggayi, Paul Bangirana, Simple Ouma, Betty Nyangoma, Annet Birabwa, Grace Nambatya, Maxencia Kabatabaazi, Ann Jacqueline Nakitende, Dennis Kalibbala

Paediatrics and Child Health, East Africa

Introduction: Academic proficiency is crucial for advancing learning goals, school advancement, and future economic security. Children with sickle cell anemia (SCA) in sub-Saharan Africa (SSA) may be at risk of disease-associated learning difficulties. Limited data exist on this topic among school-age children in the region. We aimed to assess academic proficiency in a sample of children with SCA in Uganda compared with unaffected controls.

Methods: This cross-sectional study was conducted in Kampala, Uganda. Participants were school-going children with SCA, aged 6–12 years, attending Mulago Hospital SCA Clinic, and age-matched sibling controls without SCA. Academic proficiency was assessed by the Wide …

Educational Interventions To Improve Pediatric Emergency Care: A Qualitative Assessment Of The Perspectives Of African Healthcare Workers, Emily A. Hartford, Chris A. Rees, Isaac Kihurani, Raana Hussain, Elena Seifert, Alexis Schmid, Tigist Bacha, Carol C. Chen, Megan L. Schultz

Paediatrics and Child Health, East Africa

Pediatric emergency care (PEC) training for health care workers (HCWs) is commonly offered in the form of short courses. This study gathers the perspectives of HCWs from eight African countries on how to best deliver and implement short training courses in PEC. This is a qualitative study using semi-structured key informant (KI) interviews. Utilizing the African Federation for Emergency Medicine (AFEM) member list serve, we identified African HCWs who had previous experience participating in and/or delivering short training courses in PEC. From this cohort, four interviewers were selected. These interviewers all received training in qualitative interviewing and then each recruited …

Incidence Of Bleeding And Performance Of The Precise-Dapt Score In Predicting Bleeding In Patients On Dual Antiplatelet Therapy After Treatment For Acute Coronary Syndrome In Kenya, Peter Mugo, Jeilan Mohamed, Miriam Msunza, James Orwa, Mzee Ngunga

Internal Medicine, East Africa

Introduction: Dual Antiplatelet Therapy (DAPT) plays an important role in the secondary prevention of ischemic events after treatment for acute coronary syndrome (ACS). The long-term use of DAPT is associated with an increased risk of bleeding, which affects morbidity and mortality. Risk stratification scores have been developed to predict this risk and provide a balance against the risk of ischemic events. The aim of this study was to determine the incidence of bleeding in a cohort of patients in Kenya on DAPT and assess the performance of the PRECISE-DAPT Score in predicting the risk of bleeding.

Methods: This was a …

The Female Brain Health And Endocrine Research In Africa Study (Fember-Africa): Identifying Endocrinological, Lifestyle, Psychosocial And Socio-Cultural Targets For Alzheimer’S Disease Prevention In Women Of African Ancestry, Chinedu Momoh, Rachel Maina, Edna Bosire, Linda Khakali, Sarah Gregory, Karen Blackmon, Thomas Thesen, Samuel Gitau, Anne Njogu, Cynthia Smith, Sylvia Mbugua, Sheila Waa, Jasmit Shah, Kendi Muchungi, Zul Merali

Brain and Mind Institute

Background The Global Dementia Action Plan 2017-2025 specifies key targets, with an emphasis on building research infrastructure and capability across the Global South. However, to date, only 0.1% of total research in Africa constitutes dementia research, the lowest volume of all LMIC regions. Several biomarker and risk models of the preclinical and prodromal stages of Alzheimer’s disease (AD) are proposed as optimal junctures for disease prevention, yet they ignore the influence of biological sex/gender on cognitive and disease processes, despite female sex/gender constituting a major AD modifier. Similarly, the application of these models in ethno-racial and culturally diverse cohorts is …

Challenges And Opportunities Of Universal Health Coverage In Africa: A Scoping Review, Evaline Chepchirchir Langat, Paul Ward, Hailay Gesesew, Lillian Mwanri

Centre of Excellence in Women and Child Health

Background: Universal health coverage (UHC) is a global priority, with the goal of ensuring that everyone has access to high-quality healthcare without suffering financial hardship. In Africa, most governments have prioritized UHC over the last two decades. Despite this, the transition to UHC in Africa is seen to be sluggish, with certain countries facing inertia. This study sought to examine the progress of UHC-focused health reform implementation in Africa, investigating the approaches utilized, the challenges faced, and potential solutions.

Method: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, we scoped the literature …

Efficacy Of Probiotics For Treatment Of Acute Or Persistent Diarrhoea In Children From Birth Till 10 Years: Systematic Review And Meta-Analysis, Anmol Minaz, Ridwa Alam, Uswa Jiwani, Khadija Vadsaria, Ahmad Khan, Aqsa Ishaq, Samar Sultan, Marium Mohsin, Ashraf Sharif, Yasir Bin Nisar, Jai K. Das, Sajid Bashir Soofi, Shabina Ariff

Centre of Excellence in Women and Child Health

Background: Numerous studies have investigated the efficacy of probiotics in treating acute and persistent diarrhoea. However, probiotics have not been established as a recommended management option for diarrhoeal illness by the World Health Organization (WHO). Therefore, we conducted a systematic review of randomised controlled trials to assess the efficacy of probiotics for the management of acute and persistent diarrhoea in children.
Methods: A systematic search on PubMed, CINAHL, Wiley Cochrane Library, Scopus, Clinicaltrials.gov, and WHO International Clinical Trials Registry Platform (ICTRP) was performed. All studies published in the year 2000 and onwards that assessed the use of probiotics in the …

Low-Osmolarity Oral Rehydration Solution For Childhood Diarrhoea: A Systematic Review And Meta-Analysis, Mustafa Bin Ali Zubairi, Syeda Kanza Naqvi, Ayesha Arshad Ali, Ashraf Sharif, Rehana Abdus Salam, Zain Hasnain, Sajid Bashir Soofi, Shabina Ariff, Yasir Bin Nisar, Jai K. Das

Institute for Global Health and Development

Background: Oral rehydration solution (ORS) is crucial in the management of diarrhoea. Until the early 2000s, the standard formulation of glucose-based ORS with a total osmolarity of 311 mmol/L was being used for this purpose. However, due to concerns about sodium levels and cases of hypernatremia, a low-osmolarity ORS solution (LORS) with an osmolarity of 245mmol/L or less was developed to replace the standard ORS. With this systematic review, we aimed to assess the effectiveness of LORS compared to standard ORS for the treatment of acute and persistent diarrhoea.
Methods: We comprehensively searched PubMed, CINAHL, the Cochrane Library, ClinicalTrials.gov, the …

Antibiotics For Acute Watery Or Persistent With Or Without Bloody Diarrhoea In Children: A Systematic Review And Meta-Analysis, Syeda Kanza Naqvi, Mustafa Bin Ali Zubairi, Ayesha Arshad Ali, Ashraf Sharif, Rehana Abdus Salam, Zain Hasnain, Sajid Bashir Soofi, Shabina Ariff, Yasir Bin Nisar, Jai K. Das

Institute for Global Health and Development

Background: The use of antibiotics in the treatment of acute and persistent watery diarrhoea has long been a subject of contention. While the advantages of using antimicrobials are acknowledged, concerns remain regarding potential adverse effects and antibiotic resistance. Therefore, we conducted a systematic review and meta-analysis to assess the efficacy of antibiotics compared to placebos for the treatment of diarrhoea.
Methods: We searched PubMed, CINAHL, the Cochrane Library, ClinicalTrials.gov, the World Health Organization (WHO) International Clinical Trials Registry Platform, and Scopus from inception until 20 July 2023 for studies published after the year 2000 assessing antibiotics vs placebo in acute …

Zinc Supplementation For Acute And Persistent Watery Diarrhoea In Children: A Systematic Review And Meta-Analysis, Ayesha Arshad Ali, Syeda Kanza Naqvi, Zain Hasnain, Mustafa Bin Ali Zubairi, Ashraf Sharif, Rehana Abdus Salam, Sajid Bashir Soofi, Shabina Ariff, Yasir Bin Nisar, Jai K. Das

Institute for Global Health and Development

Background: Zinc is a micronutrient that plays a role in immune system strengthening and regulation of intestinal epithelial cells, and can reduce the duration and severity of diarrhoea. We conducted a systematic review of randomised controlled trials (RCTs) to assess the effectiveness of zinc compared to no zinc for the management of acute and persistent diarrhoea in children.
Methods: We searched PubMed, the Cochrane Library, Scopus, CINAHL, ClinicalTrials.gov, and World Health Organization (WHO) International Clinical Trials Registry Platform from inception until 31 July 2023 for studies published from year 2000 onwards that assessed the use of zinc in the management …

Engaging Fathers(To-Be): A Pilot Study On The Adaptation And Programme Experience Of Sms4baba Intervention In Kenya’S Informal Settlements, Vibian Angweny, Richard Fletcher, Paul Mwangi, Margaret Kabue, Rachel Odhiambo, Stephen Mulupi, Emmanuel Obulemire, Eunice Njoroge, Eunice Ombech, Mercy Mokaya, Moses Wesala, Joyce Marangu, Amina Abubakar

Institute for Human Development, East Africa

Background Engaging fathers(to-be) can improve maternal, newborn, and child health outcomes. However, father-focused interventions in low-resource settings are under-researched. As part of an integrated early childhood development pilot cluster randomised trial in Nairobi’s informal settlements, this study aimed to test the feasibility of a text-only intervention for fathers (SMS4baba) adapted from one developed in Australia (SMS4dads).

Methods A multi-phased mixed-methods study, which included an exploratory qualitative phase and pre-post evaluation of the adapted SMS4baba text-only intervention was conducted between 2019 and 2022. Three focusgroup discussions (FGDs) with 19 fathers were conducted at inception to inform SMS4baba content development; two post-pilot …

High Yield Of Congenital Hypothyroidism Among Infants Attending Children Hospital, Nairobi, Kenya. Facility Based Study In The Absence Of Newborn Screening, Menbere Kahssay, Thomas Ngwiri

Paediatrics and Child Health, East Africa

Objectives: Congenital hypothyroidism (CHT) is a treatable cause of intellectual disability. Late diagnosis and delayed initiation of treatment leads to irreversible neurodevelopmental and intellectual disability. Thus, newborn screening is crucial. However, 71 % of babies are born in an area with no established newborn screening program and Kenya is not an exception. We aimed to determine the incidence of CHT, developmental outcomes of patients in the absence of newborn screening.

Methods: A retrospective data of subjects who met the inclusion criteria, newborn and infants from 3 days to 2 years whose thyroid function test (TFT) was undertaken during well baby …

Factors Associated With Tuberculosis Drug Resistance Among Presumptive Multidrug Resistance Tuberculosis Patients Identified In A Drtb Surveillance Study In Western Kenya, Albert Okumu, James Orwa, Ruth Sitati, Isaiah Omondi, Ben Odhiambo, Jeremiah Ogoro, George Oballa, Benjamin Ochieng, Steve Wandiga, Collins Ouma

Population Health, East Africa

Multidrug-resistant tuberculosis (MDR-TB) is caused by M. tuberculosis (Mtb) with resistance to the first-line anti-TB medicines isoniazid (INH) and rifampicin (RIF). In Western Kenya, there is reported low prevalence of drug resistant strains among HIV tuberculosis patients, creating a need to determine factors associated with drug resistance patterns among presumptive MDR-TB patients. To determine factors associated with drug resistance patterns among presumptive MDR-TB patients in western Kenya. Three hundred and ninety (3 9 0) sputum sample isolates from among presumptive multidrug TB patients, were analyzed for TB drug resistance as per Ministry of Health (MoH) TB program diagnostic …

Effectiveness Of Enhanced Care For Treatment Of Acute Or Persistent Diarrhea In Malnourished Children Aged 0 Months To 10 Years: A Systematic Review, Ridwa Alam, Khadija Vadsaria, Ahmad Khan, Uswa Jiwani, Aqsa Ishaq, Anmol Minaz, Ashraf Sharif, Jai K. Das, Sajid Bashir Soofi, Shabina Ariff

Centre of Excellence in Women and Child Health

Background: Diarrhea poses a significant public health challenge, particularly affecting children under five. The link between malnutrition and diarrhea is well established, with diarrhea being a primary cause of malnutrition in young children and malnutrition exacerbating the severity of diarrhea. While the World Health Organization (WHO) recommends a comprehensive approach to both diarrhea and malnutrition management, including oral rehydration, continuous feeding, zinc supplementation, and antibiotics for specific strains, it does not adequately address the complex needs of malnourished children with diarrhea who may benefit from enhanced care in the form of follow-up and monitoring beyond initial treatment. We aimed to …

A Time-Stratified, Case–Crossover Study Of Heat Exposure And Perinatal Mortality From 16 Hospitals In Sub-Saharan Africa, Claudia Hanson, Jeroen De Bont, Kristi Sidney Annerstedt, Maria Del Rosario Alsina, Federica Nobile, Nathalie Roos, Peter Waiswa, Andrea Pembe, Jean-Paul Dossou, Claudia Hanson, Hussein Kidanto

Brain and Mind Institute

Growing evidence suggests that extreme heat events affect both pregnant women and their infants, but few studies are available from sub-Saharan Africa. Using data from 138,015 singleton births in 16 hospitals in Benin, Malawi, Tanzania and Uganda, we investigated the association between extreme heat and early perinatal deaths, including antepartum and intrapartum stillbirths, and deaths within 24 h after birth using a time-stratified case–crossover design. We observed an association between an increase from the 75th to the 99th percentile in mean temperature 1 week (lag 0–6 d) before childbirth and perinatal mortality (odds ratio (OR) = 1.34 (95% confidence interval …

Association Of Chronic Malnutrition, And Not Anemia, With Cognitive Development In Ethiopian Schoolchildren: A Cross-Sectional Study, Befikadu Tariku Gutema, Muluken Bekele Sorrie, Sifray Batire, Tadiwos Hailu Zewdie, Bruno Levecke, Amina Abubakar, Stefaan De Henauw, Souheila Abbeddou

Institute for Human Development, East Africa

This study assesses the associations between nutritional statusand cognitive development of schoolchildren. A unit increase inheight-for-age Z-score was associated with 0.12 SD, 0.08 SD and0.12 SD increase in standardized digit span, Raven’s coloredprogressive metrics, and performance index of visual searchtask, respectively. A unit increase in body-mass-index-for-ageZ-score was associated with 0.11 SD increase in standardizeddigit span. Hemoglobin concentration was not associated withany of the cognitive outcomes. Chronic malnutrition was asso-ciated with cognitive development in schoolchildren while thin-ness and hemoglobin concentrations were associated withselected or no cognitive outcomes, respectively.

Community Perspectives Of Heat And Weather Warnings For Pregnant And Postpartum Women In Kilifi, Kenya, Adelaide Lusambili, Veronique Filippi, Britt Nakstad, Julian Natukunda, Cathryn Birch, John Marsham, Nathalie Roos, Peter Khaemba, Sari Kovats

Institute for Human Development, East Africa

Background: Extreme weather is a recognised risk factor for stillbirth and preterm birth, disrupts women’s access to healthcare during pregnancy and childbirth, and negatively affects the care of newborns. Reliable and accessible heat and weather warning systems are key in alerting individuals to undertake protective measures. There is a notable gap in understanding how women and caregivers in rural East Africa perceive and utilize weather information. We investigated community members’ heat and weather warning information-seeking behaviour, identified available sources, assessed their reliability and utility, and examined their influence on behaviour.

Settings: Our research was conducted in rural Kilifi County in …