WHO Reference Research Articles

Nutritional Status of Children in the PROFISEM Intervention Zone: Logone Occidental and Wadi-Fira in Chad

In Chad, as in most sub-Saharan African countries, the nutritional situation remains a major concern, and is an underlying cause of many other health problems. The aim of this study is to assess the nutritional status of children aged 6 to 59 months in the provinces of Logone Occidental and Wadi-Fira, in order to contribute to a better management of nutritional problems. The study was carried out between August 16 and October 10, 2022, and involved 207 children aged 6 to 59 months in Wadi-Fira, and 63 aged 6 to 59 months in Logone Occidental. Data collection was carried out using a questionnaire and measurements to collect data on the children's socio-demographic characteristics and anthropometry. Analysis of the children's nutritional status was based on the z-score of nutritional indices and edema according to 2006 WHO references. Analysis of the results showed that the prevalence of global acute malnutrition is 18.84%, chronic malnutrition affects 30.9% and underweight affects 32.9% of children in Wadi Fira. In Logone Occidental, about 1/10 child (9.20%) suffers from acute malnutrition, 33.6% from chronic malnutrition and 22.8% from underweight. In Wadi-Fira, the nutritional situation is considered critical, with more than one child on 15 suffering from global or moderate acute malnutrition. In Logone Occidental, the nutritional situation is precarious for both forms of acute malnutrition. The nutritional situation in both provinces needs a reinforcement of current actions in the fight against malnutrition.

Assessing the carcinogenic and non-carcinogenic health risks of metals in the drinking water of Isfahan, Iran

Metals are significant contributors to water pollution, posing serious threats to human health. This study aims to assess the carcinogenic and non-carcinogenic health risks associated with metals in Isfahan drinking water. Eighty water samples were randomly collected from the city's distribution network between January and March 2020–2021. Inductively coupled plasma Optical Emission Spectrometry was used to measure toxic metals, namely Pb, Cr, Cd, Ni, and As concentrations. Results revealed that the mean concentration of Ni (70.03 µg/L) exceeded the WHO reference value (70 µg/L), while the other metals were below the standard values. The average chronic daily intake order of toxic metals was Ni > Cr > Pb > As > Cd. Non-carcinogenic risk assessment through hazard quotient (HQ) and hazard index (HI) demonstrated that both THI for adults (HQingestion + HQdermal = 4.02E−03) and THI for children (HIingestion + HIdermal = 3.83E−03) were below the acceptable limit (less than 1). This indicated no non-carcinogenic risk to residents through water ingestion or dermal exposure. However, findings indicated that the ingestion route was the primary exposure pathway, with HQ values for ingestion exceeding HQ values for dermal adsorption. Carcinogenic risk assessment showed that the risk associated with As metal exceeded the acceptable limit (1 × 10−6). Therefore, implementing treatment improvement programs and appropriate control measures is essential to safeguard the health of Isfahan City residents.

Assessment of indoor radon distribution and seasonal variation within the Kpando Municipality of Volta Region, Ghana.

This study uses CR-39 radon detectors to examine radon distributions, seasonal indoor radon variations, correction factors, and the influence of building materials and characteristics on indoor radon concentration in 120 dwellings. The study also determines the spatial distribution of radon levels using the ArcGIS geostatistical method. Radon detectors were exposed in bedrooms from April to July (RS), August to November (DS); December to March (HS), and January-December (YS) from 2021 to 2022. The result for the radon levels during the weather seasons were; 32.3 to 190.1 Bqm-3 (80.9 ± 3.2 Bq/m3) for (RS), 30.8 to 151.4 Bqm-3 (68.5 ± 2.7 Bqm-3) for HS and 24.8 to 112.9 Bqm-3(61.7 ± 2.1 Bqm-3) for DS, and 25.2 to 145.2 Bq/m3 (69.4 ± 2.7 Bqm-3). The arithmetic mean for April to July season was greater than August to November. The correction factors associated with this study ranged from 0.9 to 1.2. The annual effective dose (AE) associated with radon data was varied from 0.6 to 4.04 mSv/y (1.8 ± 0.1 mSv/y). The April to July period which was characterized by rains recorded the highest correlation coefficient and indoor radon concentration. Distribution and radon mapping revealed radon that the exposure to the occupant is non-uniformly spread across the studied dwellings. 15.4% of the studied data exceeded WHO reference values of 100 Bq/m3. The seasonal variation, dwelling age, and building materials were observed to have a substantial impact on the levels of radon concentration within the buildings.

Clinical care of childhood sexual abuse: a systematic review and critical appraisal of guidelines from European countries

The clinical management of Child sexual abuse (CSA) demands specialised skills from healthcare professionals due to its sensitivity, legal implications, and serious physical health and mental health effects. Standardised, comprehensive clinical practice guidelines (CPGs) may be pivotal. In this systematic review, we examined existing CSA national CPGs (NCPGs) from European countries to assess their quality and reporting. We systematically searched six international databases and multiple grey literature sources, reporting by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Eligible guidelines were CSA guidance from national health agencies or societies in 34 COST Action 19106 Network Countries (CANC), published between January 2012 and November 2022. Two independent researchers searched, screened, reviewed, and extracted data. NCPGs were compared for completeness with reference WHO 2017 and 2019 guidelines. We used the Appraisal of Guidelines for Research and Evaluation (AGREE II) to appraise quality and reporting. PROSPERO: CRD42022320747. Of 2919 records identified by database searches, none met inclusion criteria. Of 4714 records identified by other methods, 24 NCPGs from 17 (50%) of CANC countries were included. In 17 (50%) of eligible countries, no NCPGs were found. Content varied significantly within and between countries. NCPGs lacked many components in state-of-the art clinical practice compared to WHO reference standards, particularly in safety and risk assessment, interactions with caregivers, and mental health interventions. Appraisal by AGREE II revealed shortcomings in NCPG development, regarding scientific rigour, stakeholder involvement, implementation and evaluation. A notable number of European countries lack an NCPG; existing NCPGs often fall short. The healthcare response to CSA in Europe requires a coordinated approach to develop and implement high-quality CPGs. We advocate for a multidisciplinary team to develop a pan-European CSA guideline to ensure quality care for survivors. Funding was provided by the International Centre for Missing and Exploited Children.

Prevalence, inequality and associated factors of overweight/obesity among Bangladeshi adolescents aged 15-19 years.

The objective of the current study was to estimate the prevalence and associated factors of overweight/obesity among Bangladeshi adolescents aged 15-19 y and to identify whether wealth-related inequality exists for overweight/obesity among Bangladeshi older adolescents. We analyzed publicly available national representative secondary data from the 2019-2020 Bangladesh Adolescent Health and Wellbeing Survey. This cross-sectional survey was carried out among 18 249 adolescents aged 15-19 y regardless of their marital status using a two-stage stratified sampling technique (the data of 9128 eligible adolescents were included in this analysis). The WHO reference population for body mass index-for-age (1+Z score) was considered as overweight/obesity. We found that girls had significantly (p<0.05) higher prevalence of overweight/obesity (11.63%) than boys (8.25%); however, their biological sex as well their age were not significantly associated with higher odds of overweight/obesity. Those who were in their higher grade (grade 11 and higher) in the school and had been exposed to media were more likely (1.67 and 1.39 times, respectively) to be overweight/obesity compared with primary grade (0-5) and those who experienced no media exposure, respectively. Inequality analysis revealed that adolescents belonging to wealthy households had significantly higher rates of overweight/obesity than those in poorer households (concentration index=0.093). The study exhibited the multifaceted nature of overweight/obesity among Bangladeshi older teenagers, revealing that their school grade, exposure to media content and wealth-related inequality emerged as significant contributing factors. The findings underscore the urgent need for targeted interventions and public health strategies to address the escalating burden of overweight and obesity in this age group.

P437 Feasibility study of a Point-of-Care assay for rapid determination of anti-TNFα biologics in capillary blood

Abstract Background Inflammatory bowel disease (IBD) patients benefit from therapeutic drug monitoring and personalized adjustment of anti-TNFα drugs such as adalimumab (ADL) and infliximab (IFX). Commercially available rapid assays allow the fast and easy measurement of ADL and IFX. Unfortunately, most ADL and IFX in-vitro diagnostic assays rely on serum as analyte matrix. This is a critical hurdle in point-of-care (POC) analysis, as it requires laboratory professionals, additional laboratory instruments and is time consuming. Therefore, two recently developed rapid tests for the determination of ADL and IFX that only require capillary blood (CB) or EDTA whole blood (WB) without further treatment are tested in a POC setup at three different study sites. The primary aim of this study is to demonstrate matrix equivalency of CB and EDTA WB compared to serum as reference. Methods This observational study was performed at three sites. Two sites in Switzerland, Clarunis Basel and Kantonsspital Baselland, and one site in France, Centre Hospitalier Universitaire de Saint-Étienne. Sample analysis was performed by healthcare professionals at the study sites with the established Quantum Blue® serum rapid tests and the newly developed capillary blood applications. Blood samples from patients under infliximab therapy were collected directly before infusion (trough level of drug). Samples from adalimumab-treated patients were collected irrespective of the injection schedule. In total, up to 100 IBD patients are anticipated in the study, 50 under infliximab therapy and 50 treated with adalimumab. This work evaluated the interim outcome after the analysis of 29 ADL and 18 IFX patients. Results Bland-Altmann analysis revealed a good agreement of CB and EDTA WB compared to serum for both IFX and ADL sample sets. The mean bias for the biologic’s trough level analysed in CB and compared to serum was 5.2% for IFX and -11.7% for ADL. Passing-Bablok analysis for CB versus serum resulted in a slope of 0.92 and an intercept at 0.08 for IFX and a slope of 0.86 and an intercept at -0.063 for ADL. A comparison of EDTA WB compared to serum revealed a mean bias of 7.8% for IFX and 7.4% for ADL. Passing-Bablok analysis for EDTA WB versus serum resulted in a slope of 1.00 and an intercept at 0.00 for IFX and a slope of 1.00 and an intercept at 0.30 for ADL. Conclusion The newly developed rapid Quantum Blue® assays for the determination of infliximab and adalimumab in capillary blood and EDTA whole blood are very well comparable to the analysis of either biologic in serum. This study furthermore demonstrated the assays are well suited to be used in a POC setting, such as infusion centres, rather than in a laboratory. Both assays are standardized to WHO reference material.

Comparison of international height and BMI-for-age growth references and their correlation with adiposity in Brazilian schoolchildren.

This study verified the diagnostic accuracy of the nutritional status classified by the international height and BMI references of the World Health Organization (WHO) (WHO/2007), International Obesity Task Force (IOTF/2012) and MULT (2023). The data pool was composed by 22737 subjects aged five to 16 years from the Santos and Porto Alegre surveys. A correlation matrix between the z-scores of the BMI references and the skinfold measurements was calculated through the Pearson correlation coefficient (r), and the subject's nutritional status was classified according to the international growth references. The accuracy for diagnosing obesity was performed separately by sex and using the 95th percentile of the triceps and subscapular skinfold sum, while Lin's concordance coefficient, Bland-Altman method and the Cohen's Kappa coefficient (Kappa) were used to verify the concordance and reliability among the BMI references. The correlation matrix showed a high positive correlation among the BMI z-scores (r ≥ 0·99) and among the skinfold measurements (r ≥ 0·86). The prevalence of stunting was higher when applying the MULT reference (3·4 %) compared with the WHO reference (2·3 %). The Bland-Altman plots showed the lowest critical difference (CD) between the height references of WHO and MULT (CD = 0·22). Among the BMI references, the WHO obesity percentile presented lower performance than MULT for boys, presenting a lower +LR value (WHO = 6·99/MULT 18 years = 10·99; 19 years = 8·99; 20 years = 8·09) for the same -LR values (0·04). Therefore, MULT reference holds promise as a valuable tool for diagnosing childhood obesity, particularly when considering sex differences. This enhances its suitability for assessing the nutritional status of Brazilian schoolchildren.

Eruption of first permanent molar among a group of Iraqi children in relation to nutritional status

Background/Aim: The timing of a tooth's eruption can be affected by a variety of factors. The nutritional status has an impact on the development of a child's body. The purpose of the study was to analyse the number of children aged 6 to 9 in an Iraqi Arab population who had erupted permanent first molars and to examine how nutritional status affected the timing and level of emergence. Methods: A total of 330 boys and girls, in first grade elementary school, made up the sample. First molars that had erupted were noted, along with the level of the eruption. Each child's nutritional status was evaluated by recording their height and weight and body mass index (BMI) value was compared to the 2007 WHO reference. Results: Girls had higher number of erupted molars than boys did and a correlation between the number of erupted teeth and nutritional condition existed, with a higher mean number of erupted molars in obese children. Conclusion: BMI had an impact on the timing of the eruption of permanent first molars, a result that was primarily observed in females.

Patterns, Potential Teratogenicity, and Associated Factors of Drugs Prescribed to Pregnant Women Attending Antenatal Care Units in Debre Tabor Comprehensive Specialized Hospital, Debre Tabor, Northwest Ethiopia

Background: About 80% of pregnant women use at least one medication during their pregnancy period. Many drugs that are not allowed to be used during pregnancy (from FDA Pregnancy Categories D and X) were used. Irrational use of these drugs during pregnancy may result in different birth defects, as explained by thalidomide and diethylstilbestrol’s tragedy. Knowledge of drug utilization and associated factors that affect the pattern is important to enhance rational prescribing. But information about prescription patterns and associated factors among pregnant women is scarce in the Debre Tabor area and generally in Ethiopia.Objective: This study was aimed at assessing drug prescription patterns, potential teratogenicity, and associated factors among pregnant women attending the antenatal care unit at Debre Tabor Comprehensive Specialized Hospital, Debre Tabor, Northwest Ethiopia.Methods: A retrospective cross‐sectional study design was performed on 359 pregnant women attending antenatal care units from June 01, 2022, to August 30, 2022, in the hospital. Necessary data were obtained through a questionnaire by reviewing the medical charts of the women. Analysis of the data was performed using SPSS Version 23. The association of the independent variables to medication use was assessed using multivariate logistic regression. A p value of less than 0.05 was considered significant.Results: Most of the study participants (325/359) were married (90.5%). From a total of 359 participants, 350 (97.5%) were prescribed with drugs. About 64% (385/602) of the prescribed medications were iron and vitamins. The most commonly prescribed medications are iron and folic acid combination (340/602, 56.5%), albendazole (48/602, 8%), mebendazole (37/602, 6.1%), omeprazole (33/602, 5.5%), followed by amoxicillin (32/602, 5.3%). The majority (79.3%) of the drugs were from FDA Pregnancy Categories A and B. Prescribed drug utilization was more probable in women who first visited the facility at their second (AOR = 2.91, 95% CI [1.12–6.64]) and third trimesters (AOR = 4.32, 95% CI [1.37–6.81]), had chronic illness (AOR = 7.54, 95% CI [2.34–14.68]), and live in rural areas (AOR = 2.47, 95% CI [1.56–8.43]).Conclusion: The study revealed that the prescription pattern in the hospital is in line with the WHO reference. Age, gravidity, number of ANC visits, first visit to the facility, presence of chronic illness, educational status, and residency were significantly associated with prescription drug use in pregnant mothers. But still, some pregnant women received drugs that may have teratogenicity risk (FDA Category C).

Efficacy and safety of praziquantel treatment against Schistosoma mansoni infection among pre-school age children in southern Ethiopia

BackgroundPreventive chemotherapy with a single dose of praziquantel given to an all-at-risk population through mass drug administration is the cornerstone intervention to control and eliminate schistosomiasis as a public health problem. This intervention mainly targets school age children, and pre-school age children (pre-SAC) are excluded from receiving preventive chemotherapy, partly due to scarcity of data on praziquantel treatment outcomes.MethodsWe conducted active efficacy and safety surveillance of praziquantel treatment among 240 Schistosoma mansoni-infected pre-SAC who received a single dose of praziquantel (40 mg/kg) in southern Ethiopia. The study outcomes were egg reduction rates (ERR) and cure rates (CRs) four weeks after treatment using the Kato–Katz technique and treatment-associated adverse events (AEs) that occurred within 8 days post-treatment.ResultsThe overall ERR was 93.3% (WHO reference threshold ≥ 90%), while the CR was 85.2% (95% CI = 80.0–89.5%). Baseline S. mansoni infection intensity was significantly associated with CRs, 100% among light infected than moderate (83.4%) or heavy (29.4%) infected children. An increase of 100 in baseline S. mansoni egg count per gram of stool resulted in a 26% (95% CI: 17%, 34%) reduction in the odds of cure. The incidence of experiencing at least one type of AE was 23.1% (95% CI: 18.0%, 29.0%). Stomachache, diarrhea, and nausea were the most common AEs. AEs were mild-to-moderate grade and transient. Pre-treatment moderate (ARR = 3.2, 95% CI: 1.69, 6.14) or heavy infection intensity (ARR = 6.5, 95% CI: 3.62, 11.52) was a significant predictor of AEs (p < 0.001). Sex, age, or soil-transmitted helminth coinfections were not significant predictors of CR or AEs.ConclusionsSingle-dose praziquantel is tolerable and effective against S. mansoni infection among pre-SAC, and associated AEs are mostly mild-to-moderate and transient. However, the reduced CR in heavily infected and AEs in one-fourth of S. mansoni-infected pre-SAC underscores the need for safety and efficacy monitoring, especially in moderate-to-high infection settings. Integrating pre-SACs in the national deworming programs is recommended to accelerate the elimination of schistosomiasis as a public health problem.

Determinants of Anishinabeck infant and early childhood growth trajectories in Northwestern Ontario, Canada: a cohort study

BackgroundThe Developmental Origins of Health and Disease (DOHaD) paradigm emphasizes the significance of early life factors for the prevention of chronic health conditions, like type 2 diabetes (T2DM) and obesity, which disproportionately affect First Nations communities in Canada. Despite increasing DOHaD research related to maternal health during pregnancy, early childhood growth patterns, and infant feeding practices with many populations, data from First Nations communities in Canada are limited. In partnership with Sandy Lake First Nation, the aims of this project were to characterize birthweights and growth patterns of First Nations infants/children over the first 6 years of life and to study the impact of maternal and infant social and behavioral factors on birthweight and growth trajectories.MethodsWe recruited 194 families through community announcements and clinic visits. Infant/child length/height and weight were measured at 1 and 2 weeks; 1, 2, 6, 12, and 18 months; and 2, 3, 4, 5 and 6 years. Maternal and infant/child questionnaires captured data about health, nutrition, and social support. Weight-for-Age z-score (WAZ), Height-for-Age z-score (HAZ), and BMI-for-Age z-score (BAZ) were calculated using WHO reference standards and trajectories were analyzed using generalized additive models. Generalized estimating equations and logistic regression were used to determine associations between exposures and outcomes.ResultsWAZ and BAZ were above the WHO mean and increased with age until age 6 years. Generalized estimating equations indicated that WAZ was positively associated with age (0.152; 95% CI 0.014, 0.29), HAZ was positively associated with birthweight (0.155; 95% CI 0.035, 0.275), and BAZ was positively associated with caregiver’s BMI (0.049; 95% CI 0.004, 0.090). There was an increased odds of rapid weight gain (RWG) with exposure to gestational diabetes (OR: 7.47, 95% CI 1.68, 46.22). Almost 70% of parents initiated breastfeeding, and breastfeeding initiation was modestly associated with lower WAZ (-0.18; 95% CI -0.64, 0.28) and BAZ (-0.23; 95% CI -0.79, 0.34).ConclusionsThis work highlights early life factors that may contribute to T2DM etiology and can be used to support community and Indigenous-led prevention strategies.

Semen Cryopreservation to Expand Male Fertility in Cancer Patients: Intracase Evaluation of Semen Quality.

To preserve male fertility after diagnosis of any kind of cancer, a prompt assessment of the semen quality and an appropriate semen cryopreservation must be performed before radio-chemotherapy starts. The present work aims to evaluate the semen parameters at diagnosis of different cancer patients before cryopreservation and after thawing. Testicular tumors and lymphomas are among the most common cancers in younger patients, and while chemotherapy significantly increases patients' survival, it can epigenetically alter the semen fluid, resulting in temporary or permanent infertility. We analyzed data from the database of the Gamete Cryopreservation Center (Annunziata Hospital, CS; Italy) in the period of 2011-2020 from a cohort of 254 cancer patients aged 18-56 years. The evaluation was performed in a blind manner and anonymously recovered; the main parameters referring to semen quality were assessed in accordance with the WHO guidelines and decision limits (6th edition; 2021). The cancer types were as follows: testis cancers (TC; n = 135; 53.1%), hematological cancers (HC; n = 76; 29.9%), and other types of cancer (OC; n = 43; 17%). Comparing TC vs. HC (P1) and vs. OC (P2), TC had the worst semen quality: sperm number/mL (P1 = 0.0014; P2 = 0.004), total motility (P1 = 0.02; P2 = 0.07), progressive motility (P1 = 0.04; P2 = 0.05), viability (P1 = 0.01; P2 = 0.02), and percentage of atypical morphology (P1 = 0.05; P2 = 0.03). After semen thawing, viability and progressive motility recovery lowered, accounting for 46.82% and 16.75%, respectively, in the whole cohort; similarly, in the subgroups ascribed to TC, they showed the lowest recovery. Strong correlation existed between pre- and post-cryopreservation viability and progressive motility in the whole cohort (p < 0.001) and in the TC subgroup (p < 0.05). All cancer subgroups, to significantly different extents, had semen findings below the WHO reference values, suggesting diverse sperm susceptibilities to different cancers and cryodamage. Cancer and associated treatments epigenetically affect patients' semen quality, meaning cryopreservation should be considered a useful personalized prerogative for any kind of cancer in a timely manner.

Evaluation of the Radon Levels in the Groundwater Wells of Qatar: Radiological Risk Assessment

The objective of this work is to give a holistic overview of the groundwater quality in Qatar in terms of its radon levels and provide a radiological risk assessment of elevated radon levels on human health. This study covered the analysis of groundwater collected from various locations throughout Qatar and maps using ArcGIS followed by a radiological risk assessment of radon in Qatar. There is no extensive study reported to investigate radon activity levels in groundwater across Qatar and their health effects. The radon level measurements of the Qatari groundwater ranged between 2.7 ± 0.2 and 60.7 ± 13.4 Bq/L with a mean value of 20.6 Bq/L, which is greater than the US EPA’s maximum contamination level (11 Bq/L). About 65% of the studied samples exceeded the US EPA’s MCL guidelines. The mean total annual effective dose due to radon inhalation and ingestion was 0.056 mSv/y, which is below the WHO reference level of 0.1 mSv/y. The radon radiological risk study through inhalation and ingestion clearly revealed that the contribution of the inhalation dose was higher than the ingestion dose.

Association between Hidradenitis Suppurativa and Abnormalities in Semen Parameters and Sexual Function: A Pilot Study.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease affecting patients of reproductive age. Although HS shares risk factors with male infertility, only 1 epidemiological study has evaluated this association. To further evaluate this potential association, findings on semen and hormonal analysis, testicular ultrasound, and the International Index of Erectile Function (IIEF-15) were compared between 28 men attending a tertiary HS clinic during the period April 2019 to April 2021, and 44 healthy controls, spouses of infertile women undergoing semen evaluation before in vitro fertilization. Patients with HS were divided based on the absence or presence of gluteal and genital lesions. Patients with HS were younger than controls (median 27 vs 34 years, p < 0.0004) and had a higher proportion of smokers (86% vs 33%, p < 0.0001). Semen parameters in patients with gluteal-genital lesions, specifically those with severe scrotal involvement necessitating surgery, were lower than the WHO reference values and significantly lower than in patients without gluteal-genital lesions and controls. Erectile dysfunction was reported by 93% of patients with HS. These findings suggest that spermatogenesis and sexual function may be impaired in young men with HS. Therefore, multidisciplinary management of HS should include their evaluation to identify patients who might benefit from semen cryopreservation and sexual treatment.

Abstract 14218: Trends in Prevalence of Hypertension and Untreated Hypertension Before and During the COVID-19 Pandemic Period in Japan

Background: To examine influence of the COVID-19 pandemic on blood pressure in a general population, trends in prevalence of hypertension and untreated hypertension before and during the COVID-19 pandemic period were examined. Methods: We studied subjects aged 40 to 79 who had the annual health checkup offered to adult citizens of Moriguchi city, Osaka, Japan from 2015 to 2022. Sex-specific age-standardized prevalence rates of hypertension (systolic blood pressure (BP) &gt; 140 mmHg, diastolic BP &gt; 90 mmHg, or receiving antihypertensives) and those of untreated hypertension to the WHO reference population with 95% confidence intervals (CI) were calculated. Statistically significant difference was determined by 95% CI compared to the 95% CI of the prevalence of 2015. Results: Number of subjects and trends in prevalence of hypertension and untreated hypertension with 95% CI are presented in the figure. From 2015 to 2019 (before the COVID-19 pandemic period) prevalence of hypertension and untreated hypertension did not change both in men and women. However, from 2020 to 2022 (during the COVID-19 pandemic period), prevalence of hypertension and untreated hypertension significantly increased compared to 2015, except for prevalence of hypertension in women in 2020 and that of untreated hypertension in men in 2022. Conclusions: During the COVID-19 pandemic period, higher prevalence of hypertension and untreated hypertension was observed in a general population in Japan.

Lipidomics profiles of human spermatozoa: insights into capacitation and acrosome reaction using UPLC-MS-based approach.

Lipidomics elucidates the roles of lipids in both physiological and pathological processes, intersecting with many diseases and cellular functions. The maintenance of lipid homeostasis, essential for cell health, significantly influences the survival, maturation, and functionality of sperm during fertilization. While capacitation and the acrosome reaction, key processes before fertilization, involve substantial lipidomic alterations, a comprehensive understanding of the changes in human spermatozoa's lipidomic profiles during these processes remains unknown. This study aims to explicate global lipidomic changes during capacitation and the acrosome reaction in human sperm, employing an untargeted lipidomic strategy using ultra-performance liquid chromatography-mass spectrometry (UPLC-MS). Twelve semen specimens, exceeding the WHO reference values for semen parameters, were collected. After discontinuous density gradient separation, sperm concentration was adjusted to 2 x 106 cells/ml and divided into three groups: uncapacitated, capacitated, and acrosome-reacted. UPLC-MS analysis was performed after lipid extraction from these groups. Spectral peak alignment and statistical analysis, using unsupervised principal component analysis (PCA), bidirectional orthogonal partial least squares discriminant analysis (O2PLS-DA) analysis, and supervised partial least-squares-latent structure discriminate analysis (PLS-DA), were employed to identify the most discriminative lipids. The 1176 lipid peaks overlapped across the twelve individuals in the uncapacitated, capacitated, and acrosome-reacted groups: 1180 peaks between the uncapacitated and capacitated groups, 1184 peaks between the uncapacitated and acrosome-reacted groups, and 1178 peaks between the capacitated and acrosome-reacted groups. The count of overlapping peaks varied among individuals, ranging from 739 to 963 across sperm samples. Moreover, 137 lipids had VIP values > 1.0 and twenty-two lipids had VIP > 1.5, based on the O2PLS-DA model. Furthermore, the identified twelve lipids encompassed increases in PI 44:10, LPS 20:4, LPA 20:5, and LPE 20:4, and decreases in 16-phenyl-tetranor-PGE2, PC 40:6, PS 35:4, PA 29:1, 20-carboxy-LTB4, and 2-oxo-4-methylthio-butanoic acid. This study has been the first time to investigate the lipidomics profiles associated with acrosome reaction and capacitation in human sperm, utilizing UPLC-MS in conjunction with multivariate data analysis. These findings corroborate earlier discoveries on lipids during the acrosome reaction and unveil new metabolites. Furthermore, this research highlights the effective utility of UPLC-MS-based lipidomics for exploring diverse physiological states in sperm. This study offers novel insights into lipidomic changes associated with capacitation and the acrosome reaction in human sperm, which are closely related to male reproduction.

Nutritional status assessment using anthropometry and evaluation of school canteen menus in Tanzania

Abstract Background According to the FAO, an estimated 767.9 million people faced hungry in 2021. To improve food sovereignty, it is necessary to investigate eating habits and assess the actual level of malnutrition. The study took place in two private schools, one primary and one secondary school in the Rukwa region, one of the poorest in Tanzania, with a human development index of 0.467. Methods Height and weight were measured from March to June 2022 on a sample of 235 students (52% male, age 9.9 ± 2.6) from the primary school and 297 (61% male, age 16.9 ± 2.8) from the secondary school. The menus of the canteens were evaluated by weighing the ingredients cooked for one week and dividing the estimated nutrients for each student attending the canteen, then comparing them with the EFSA Dietary Reference Values. Results The BMI by age of children from 5 to 19 years was compared with the WHO reference data for growth. 72.7% of primary school students were in the 50th percentile and 27.7% in the 15th percentile, while 68.7% of secondary school students were in the 50th percentile and 25.4% in the 15th percentile. The menu evaluation showed that carbohydrates provide 79.6% of the diet's energy, while lipids only 10.58%. Vitamin intake was particularly low for B7 (3.05μg), B12 (0.155μg), A (149.21μg), D (0.04μg) and K (0.57μg). Among the minerals, the greatest deficiencies are Calcium (290mg), Magnesium (39.95mg) Iodine (18.63µg), Copper (0.20mg), Selenium (1.38µg) and Manganese (0.46mg). Conclusions The results show that children and adolescents are growing less than recommended and malnutrition affects the youngest. The meals in the two canteens show a shortage of several nutrients, easily attributable to the low consumption of fruit and animal products. Although the situation appears critical, it should be emphasised that the schools surveyed were private, while in public schools the catering service does not exist, often condemning students to a single evening meal. Key messages • In a rural context of Tanzania, children and adolescents are growing less than recommended and malnutrition affects the youngest. • A low intake of vitamins and minerals was detected in two school canteens in Tanzania.

Microbisporicin (NAI-107) protects Galleria mellonella from infection with Neisseria gonorrhoeae.

Due to the increasing incidence of antibiotic-resistant bacterial pathogens, the need for the development of alternative compounds is of utmost importance. Bacteriocins are considered a promising alternative to antibiotics. In this study, we determined the in vitro activities of 65 bacteriocins from the PARAGEN collection along with microbisporicin (NAI-107) against 14 WHO reference isolates of Neisseria gonorrhoeae, one isolate of Neisseria meningitidis, and four commensal Neisseria spp. The initial screening of the bacteriocins was carried out using a spot-on-lawn assay wherein 12 bacteriocins (12/66) showed a zone of inhibition against the WHO-P N. gonorrhoeae isolate. Four bacteriocins (4/12), Garvicin KS (GarKS) (ABC), lacticin (lcn) Q, lcn Z, and NAI-107, demonstrated higher activity, and minimum inhibitory concentrations (MICs) using agar dilutions were determined for 19 Neisseria spp. GarKS (ABC), lcn Q, and lcn Z had an MIC range of 4-16 µg/mL, whereas NAI-107 had an MIC range of <0.25 to 2 µg/mL. Using an in vivo Galleria mellonella model, we determined the efficacy of GarKS (ABC), lcn Z, and NAI-107. GarKS (ABC) and lcn Z displayed no in vivo toxicity but showed no in vivo activity against WHO-P N. gonorrhoeae. In contrast, NAI-107 was as effective as ceftriaxone and significantly increased the survival rate of WHO-P N. gonorrhoeae-infected G. mellonella larvae. In conclusion, NAI-107 exhibited potent in vitro and in vivo activities against N. gonorrhoeae. To our knowledge, this is the first study to demonstrate that NAI-107 possesses anti-gonococcal activity in vivo. IMPORTANCE We screened 66 bacteriocins to see if they exhibited anti-gonococcal activity. We found 12 bacteriocins with anti-gonococcal effects, and 4 bacteriocins showed higher anti-gonococcal activity. Three bacteriocins, lacticin Z, lacticin Q, and Garvicin KS (ABC), showed in vitro anti-gonococcal activity but no in vivo inhibitory effects against the Neisseria gonorrhoeae (WHO-P) isolate. On the other hand, NAI-107 showed in vivo anti-gonococcal activity. The findings suggest that NAI-107 is a promising alternative to treat gonorrhea infections.

Implications of the South African National Drug Policy on prescribing patterns: a case study of the Limpopo province

BackgroundThe South African National Drug Policy (SA-NDP) was introduced to promote rational medicine use (RMU). This study evaluates the quality of prescribing in the public healthcare sector in South Africa's Limpopo province following the World Health Organization's (WHO) rational prescribing standards. In addition, the prescribing practices in South Africa were compared to other African countries.MethodsA prospective cross-sectional survey of patients' prescriptions was conducted in Limpopo, South Africa, from October to December 2018. Findings were compared with the WHO reference values (WHO-RV), and the International Network of Rational Use of Drugs (IRDP) tool was used to measure the degree of rational prescribing. The optimal IRDP value was defined as 1. Study findings were compared with results from a previous study conducted in Limpopo and studies from Ethiopia and Eritrea.ResultsSix hundred prescriptions were reviewed. The mean (SD) age was 43.9 ± 24.4 years (females = 56.5%). The average number of drugs prescribed (4.3, IRDP = 0.47) was higher than the WHO-RV (< 2). Generic prescribing (43%, IRDP = 0.43) and medicines prescribed from the essential medicines list (EML) (90%, IRDP = 0.90) were less than the WHO-RV (100%, respectively). Antibiotics (28%, IRDP = 1) and the number of injections prescribed (8%, IRDP = 1) were below the WHO-RV (< 30% and < 20%, respectively). The number of medicines prescribed was higher compared to previous years (4.3 vs. 3.4). Antibiotic prescribing declined (28% vs. 63.4%). Generic prescribing (43% vs. 41.7%) and medicines prescribed from the EML (90% vs. 93.1%) did not improve. A higher number of medicines were prescribed in this study compared to Ethiopia (1.7) and Eritrea (1.8), and a lower number of antibiotics were prescribed compared to Ethiopia (58.2%) and Eritrea (54.5%). Generic prescribing was low compared to Ethiopia (95.6%) and Eritrea (94.9%). All studies showed reduced injection prescribing (6.6–15.9%) and similar prescribing from the EML (90–95%).ConclusionsThere is an increased potential for drug-drug and adverse reactions with the increased number of prescribed medicines; however, the patient's clinical needs may warrant using multiple medicines. There is a need for generic prescribing to reduce medicine expenditure.

P‐CB‐2 | Amotosalen/UVA Treatment of Platelet and Plasma Components using the INTERCEPT Blood Systems to Inactivate WHO Reference Bacterial Strains

P‐CB‐2 | Amotosalen/UVA Treatment of Platelet and Plasma Components using the INTERCEPT Blood Systems to Inactivate WHO Reference Bacterial Strains