Years In sub-Saharan Africa Research Articles

Measuring rising heat and flood risk along the belt-and-road initiative

China’s global infrastructure financing flagship, the Belt and Road Initiative (BRI) encompasses countries hosting over 60% of the global population and one-third of worldwide GDP. It is based mainly on long-term loans that will mature decades into the future, and timely repayments are only possible if they remain commercially viable. But despite its vast global scope, little is known about the climate risks that could imperil the operations of BRI projects over the next few decades, and, consequently, threaten their long-term sustainability. We narrow this gap by estimating the impacts of future climate change on 217 BRI projects across 70 countries and 9 sectors in two dimensions. First, the effects of increased heat stress on human physical work capacity are calculated using the wet bulb globe temperature and an assessment of the workload for each selected BRI project. Second, the potential structural damages from more frequent flooding incidents are measured by return period (RP), where a shorter RP signals heightened risk. Both have direct impacts on human productivity and infrastructural integrity, which are essential to maintaining the operational viability and financial stability of BRI projects. We compared projected changes on both measures for the mid- and late-twentieth centuries (2041–2060 and 2081–2100) to the historical baseline (1981–2010). We found that BRI projects face escalating vulnerability to climatic risks on both counts. The results underscore a broad variance across different future carbon emission scenarios measured under the Shared Socioeconomic Pathways (including SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5). BRI’s aggregated climatic risks are substantially elevated under a high carbon emission scenario compared to a low emission scenario. By the end of the twentieth century, labor workability under SSP3-7.0 (31%) could potentially decrease three times more compared to SSP1-2.6 (10%). Under an intermediate-emission scenario (SSP2-4.5), floods with a historical return period of 10 years could have a return period of 5 years in the future. Significantly hampering the utilization and economic return generation potential of infrastructure projects. In addition, regional geography contributes to risk heterogeneity, with 100-year floods occurring every 15 years in South Asia and every 24 years in Sub-Saharan Africa. Such climate risk implications, potentially overlooked by development financiers, represent significant risks to the sustenance of the BRI, estimated to be worth $1 trillion.

Bacteriological profile of meningitis in children aged 3 months to 15 years in sub-Saharan Africa: About a systematic review and critical reading of the literature

Objective : Bacterial meningitis is a serious, urgent, debilitating and fatal disease. It is therefore necessary to have data on bacterial epidemiology and the profile of sensitivity to antibiotics on which the emergency treatment protocol could be based. The objective of this study was to identify the bacteriological profile of meningitis in children aged 3 months to 15 years in sub-Saharan Africa by conducting a systematic review of recent literature.Methods : This is a systematic review of the literature for which we visited free databases including PubMed, Cochrane, Medline, Google scholar and PMC Free. The key words used were: bacterial meningitis, Sub-Saharan Africa, Acute bacterial meningitis; Culture; Gram stain; Incidence, meningitis; pneumococcus; Haemophilus influenzae. Our research considered articles conducted in sub-Saharan Africa, of all languages, and published since 2004. In total, the search generated 48 studies, which after applying the criteria mentioned above, only 7 studies were retained.Results : This systematic review showed that the bacterial flora during meningitis in children aged between 3 months to 15 years is essentially dominated by Streptococcus pneumonia in the majority with a weighted frequency of 42.9% (35.2-47. 4) and significant heterogeneity between different authors (p < 0.001). This was followed by Haemophilus influenzae with a weighted frequency of 13.8% (11.3-18.1). Escherichia coli and meningococci were observed in a small proportion. The germs identified were more sensitive to cefotaxime, ceftriaxone, then to amoxicillin, gentamicin and oxacillin.Conclusion : Studies are necessary to regularly revisit the bacterial flora during meningitis in children in order to adapt the treatment according to the antibiogram and for probabilistic antibiotic therapy to be based on research results, because this flora bacterial infection varies from one period to another and from one country to another.

Prevalence and impact of primary headaches among students aged 8-12 years in Sub-Saharan Africa: Cameroon experience.

The present study aimed to investigate the prevalence and impact of primary headache among students aged 8-12 years in the city of Douala (Cameroon). From January to May 2022, a cross-sectional study was conducted in 52 primary schools randomly selected from five districts in the city of Douala. The study population consisted of primary school students in level III classes. The diagnosis of primary headache was made according to the International Classification of Headache Disorders, 3rd ed (ICHD-3) criteria and the paediatric version of the HARDSHIP questionnaire was used for recruitment. In total, 2056 students participated of whom 55.9% (n = 1149) were female, with a median age of 11 years. The prevalence of headache in the last 12 months was 85.7% (n = 1762), that of migraine was 26.1% (n = 536) and that of tension-type headache (TTH) was 15.1% (n = 311). Regarding the impact of primary headaches, 176 (32.8%) migraineurs reported absenteeism from school compared to 70 (22.5%) students with TTH (p = 0.03) and 309 (57.6%) migraineurs had a break in their activities compared to 147 (47.3%) students with TTH (p < 0.01). Primary headaches are common among students aged 8-12 years in the city of Douala. They are responsible for a considerable impact on children and their family, particularly for migraineurs.

Intimate partner violence and childhood health outcomes in 37 sub-Saharan African countries: an analysis of demographic health survey data from 2011 to 2022

Understanding the contribution of intimate partner violence (IPV) to childhood health outcomes (eg, morbidity and mortality) is crucial for improving child survival in sub-Saharan Africa. This comprehensive study aimed to explore the associations between maternal exposure to physical, sexual, or emotional violence and adverse childhood health outcomes in sub-Saharan Africa. We analysed Demographic Health Survey datasets from 37 sub-Saharan African countries from 2011 to 2022. A generalised linear mixed model was used to examine the associations between maternal physical violence, sexual violence, or emotional violence, and early childhood health outcomes (eg, acute respiratory infection, diarrhoea, undernutrition, and child mortality). A random effects meta-analysis was used to calculate pooled odds ratios (ORs) for adverse childhood health outcomes. The odds of undernutrition and mortality were 55% and 58% higher among children younger than 5 years born to mothers who were exposed to physical and sexual violence, respectively. 238 060 children younger than 5 years were included. Children whose mothers experienced physical violence (adjusted OR 1·33, 95% CI 1·29-1·42), sexual violence (1·47, 1·34-1·62), emotional violence (1·39, 1·32-1·47), or a combination of emotional and sexual violence (1·64, 1·20-2·22), or a combination of all the three forms of violence (1·88, 1·62-2·18) were associated with an increased odds of developing diarrhoeal disease. Similarly, children whose mothers experienced physical violence (1·43, 1·28-1·59), sexual violence (1·47, 1·34-1·62), emotional violence (1·39, 1·32-1·47), or a combination of emotional and sexual violence (1·48, 1·16-1·89), or a combination of all three forms of violence (1·66, 1·47-1·88) were positively associated with symptoms of acute respiratory infection. We found a strong link between maternal exposure to IPV and health outcomes for children younger than 5 years in sub-Saharan Africa, with minor variations across countries. To address childhood morbidity and mortality attributed to IPV, interventions need to be tailored for specific countries. Burkina Faso, Burundi, Chad, Comoros, Gabon, Liberia, Nigeria, Sierra Leone, South Africa, and Uganda should be priority nations. None.

Evaluating the impact of the global evidence, local adaptation (GELA) project for enhancing evidence-informed guideline recommendations for newborn and young child health in three African countries: a mixed-methods protocol

BackgroundPoverty-related diseases (PRD) remain amongst the leading causes of death in children under-5 years in sub-Saharan Africa (SSA). Clinical practice guidelines (CPGs) based on the best available evidence are key to strengthening health systems and helping to enhance equitable health access for children under five. However, the CPG development process is complex and resource-intensive, with substantial scope for improving the process in SSA, which is the goal of the Global Evidence, Local Adaptation (GELA) project. The impact of research on PRD will be maximized through enhancing researchers and decision makers’ capacity to use global research to develop locally relevant CPGs in the field of newborn and child health. The project will be implemented in three SSA countries, Malawi, South Africa and Nigeria, over a 3-year period. This research protocol is for the monitoring and evaluation work package of the project. The aim of this work package is to monitor the various GELA project activities and evaluate the influence these may have on evidence-informed decision-making and guideline adaptation capacities and processes. The specific project activities we will monitor include (1) our ongoing engagement with local stakeholders, (2) their capacity needs and development, (3) their understanding and use of evidence from reviews of qualitative research and, (4) their overall views and experiences of the project.MethodsWe will use a longitudinal, mixed-methods study design, informed by an overarching project Theory of Change. A series of interconnected qualitative and quantitative data collections methods will be used, including knowledge translation tracking sheets and case studies, capacity assessment online surveys, user testing and in-depth interviews, and non-participant observations of project activities. Participants will comprise of project staff, members of the CPG panels and steering committees in Malawi, South Africa and Nigeria, as well as other local stakeholders in these three African countries.DiscussionOngoing monitoring and evaluation will help ensure the relationship between researchers and stakeholders is supported from the project start. This can facilitate achievement of common goals and enable researchers in South Africa, Malawi and Nigeria to make adjustments to project activities to maximize stakeholder engagement and research utilization. Ethical approval has been provided by South African Medical Research Council Human Research Ethics Committee (EC015-7/2022); The College of Medicine Research and Ethics Committee, Malawi (P.07/22/3687); National Health Research Ethics Committee of Nigeria (01/01/2007).

Pooled prevalence and associated factors of teenage pregnancy among women aged 15 to 19 years in sub-Saharan Africa: evidence from 2019 to 2022 demographic and health survey data

BackgroundTeenage pregnancy is becoming one of the most common social and public health problems worldwide, with the highest prevalence in sub-Saharan Africa. Health risks and adverse outcomes of pregnancy and childbirth among adolescent girls are the commonest cause of the global burden of maternal morbidity and mortality. This study is intended to determine the pooled prevalence and determinants of teenage pregnancy in sub-Saharan Africa using the most recent demographic and health survey data (2019–2022).MethodsA cross-sectional study was conducted using data from the most recent demographic and health surveys of four countries (Kenya, Tanzania, Gabon, and Cameroon) in sub-Saharan Africa conducted between 2019 and 2022. A total weighted sample of 12,829 teenagers aged 15 to 19 years was included in the study. Data extracted from demographic and health survey data sets were cleaned, recorded, and analyzed using STATA/SE version 14.0 statistical software. Multilevel mixed-effects logistic regression was used to determine the factors associated with the dependent variable. Finally, variables with a p-value ≤ 0.05 and an adjusted odds ratio with a 95% confidence interval were declared statistically significant.ResultsThe pooled prevalence of teenage pregnancy among women aged 15 to 19 years was 18.15% (95% CI: 17.49, 18.83). Teenage pregnancy was positively associated with the respondent’s age [AOR = 2.97; 95% CI (2.55, 3.46)], educational status [AOR = 2.21; 95% CI (1.62, 3.03)] and [AOR = 1.80; 95% CI (1.54, 2.12)], wealth status [AOR = 2.61; 95% CI (2.12, 3.22)] and [AOR = 1.65; 95% CI (1.33, 2.05)], relation to the household head [AOR = 2.09; 95% CI (1.60, 2.72)], and unmet need for contraception [AOR = 14.3; 95% CI (11.5, 17.8)]. On the other hand, it was negatively associated with marital status [AOR = 0.08; 95% (0.07, 0.10)], working status [AOR = 0.75; 95% CI (0.64, 0.88)], age at first sex [AOR = 0.68; 95% CI (0.58, 0.80)], contraceptive use [AOR = 0.25; 95% CI (0.20, 0.30)], contraceptive knowledge [AOR = 0.27; 95% CI (0.19, 0.40)], and community contraceptive utilization [AOR = 0.85; 95% CI (0.73, 0.99)].ConclusionIn the current study, one out of six young women aged 15 to 19 experienced teenage pregnancy. Therefore, addressing unmet needs for family planning, improving women’s educational status, and giving special attention to teenagers with low educational and economic status are recommended.

Differences across the lifespan between females and males in the top 20 causes of disease burden globally: a systematic analysis of the Global Burden of Disease Study 2021

Sex and gender shape health. There is a growing body of evidence focused on comprehensively and systematically examining the magnitude, persistence, and nature of differences in health between females and males. Here, we aimed to quantify differences in the leading causes of disease burden between females and males across ages and geographies. We used the Global Burden of Disease Study 2021 to compare disability-adjusted life-year (DALY) rates for females and males for the 20 leading causes of disease burden for individuals older than 10 years at the global level and across seven world regions, between 1990 and 2021. We present absolute and relative differences in the cause-specific DALY rates between females and males. Globally, females had a higher burden of morbidity-driven conditions with the largest differences in DALYs for low back pain (with 478·5 [95% uncertainty interval 346·3-632·8] more DALYs per 100 000 individuals among females than males), depressive disorders (348·3 [241·3-471·0]), and headache disorders (332·9 [48·3-731·9]), whereas males had higher DALY rates for mortality-driven conditions with the largest differences in DALYs for COVID-19 (with 1767·8 [1581·1-1943·5] more DALYs per 100 000 among males than females), road injuries (1012·2 [934·1-1092·9]), and ischaemic heart disease (1611·8 [1405·0-1856·3]). The differences between sexes became larger over age and remained consistent over time for all conditions except HIV/AIDS. The largest difference in HIV/AIDS was observed among those aged 25-49 years in sub-Saharan Africa with 1724·8 (918·8-2613·7) more DALYs per 100 000 among females than males. The notable health differences between females and males point to an urgent need for policies to be based on sex-specific and age-specific data. It is also important to continue promoting gender-sensitive research, and ultimately, implement interventions that not only reduce the burden of disease but also achieve greater health equity. Bill & Melinda Gates Foundation.

Determinants of iron-rich food deficiency among children under 5 years in sub-Saharan Africa: a comprehensive analysis of Demographic and Health Surveys

BackgroundIron deficiency is a major public health problem that affects the physical and cognitive development of children under 5 years of age (under-5 children) in sub-Saharan Africa (SSA). However, the...

Effects of Moderate Acute Malnutrition Treatment and HIV-Exposure on Body Composition among Children Under Five Years in SubSaharan Africa: A systematic review

Background: Malnutrition poses a global threat to Childhood growth and survival. Coupled with HIV exposure and infection, under-nutrition risk is greatly increased. Infection with HIV results in Acquired Immune Deficiency Syndrome which increases the body’s nutrient requirements and may significantly affect the body composition parameters. This study aimed to review data from published articles to identify the changes in body composition among children under five in sub-Saharan Africa as a result of Moderate Acute Malnutrition (MAM) and HIV exposure&#x0D; Materials And Methods: We conducted a systematic review of published articles on body composition, moderate acute malnutrition treatment and HIV exposure among children under five years. Data was searched from PubMed, Ovid-MedLine, Google Scholar, Cochrane Central Register of Controlled Trials and EMBASE. The review was done as per Cochrane reviews and Preferred Reporting Items for Systematic Reviews and MetaAnalyses guidelines (PRISMA). The articles were then screened for suitability of inclusion and analysis.&#x0D; Results: A total of 1,505 records were identified; 520 articles from PubMed, 535 from Medline and 430 from EMBASE. On the first screening step, 755 duplicate records were removed. Screening the articles by abstract and title led to the elimination of 717 records. Further, 88 records were excluded due to a lack of full-text articles, not related to the topic, no prospective studies and the wrong age group (above five years). We finally ended up with 9 articles that were included for review.&#x0D; Conclusions: There is an interrelationship between MAM treatment, HIV Exposure and body composition. Treatment of MAM using standard ready-to-use supplemental foods and locally produced specialized nutritious formulas improves the body composition parameters of children under five years. HIV-exposed infected children exhibit poorer body composition parameters than HIV-exposed uninfected and HIV-unexposed uninfected children.

Impact of health system strengthening interventions on child survival in sub-Saharan Africa: a systematic review protocol

BackgroundStrengthening healthcare systems is a practical approach to enhance healthcare delivery and services. Although there has been a rise in the number of health systems strengthening (HSS) interventions in sub-Saharan Africa (SSA), there is limited evidence on the causal effect of these activities on child survival. Furthermore, the findings reported so far have been varied, and how they relate to each other remains unclear. This systematic review study aims to assess all available evidence to understand the impact of HSS activities on child survival in SSA.MethodsWe developed a search strategy to retrieve all relevant studies from electronic databases such as PubMed/MEDLINE, Web of Science, and African Journals Online. We will use a combination of search terms such as “under-five mortality,” “child mortality,” “infant mortality,” “neonatal mortality,” “child survival,” and “health systems strengthening.” The review will include studies that establish a causal relationship between HSS interventions and child survival. This will include studies with designs such as randomized controlled trials and quasi-experimental and methods like difference-in-difference. Two reviewers will independently screen all citations, abstracts, and full-text data and a third reviewer will act as a tiebreaker in case of disagreements. The primary outcome of interest is the impact of HSS activities on under-five survival. We will evaluate the quality of each study using the Bradford Hill criteria for causation.DiscussionOur systematic review will identify and evaluate all relevant evidence that establishes a causal relationship between HSS activities and the survival of children under five years in SSA. The review’s findings regarding the impact of HSS activities on child survival could be of significant interest to the donor community and policy actors in the region. We also anticipate that the review’s conclusions could serve as a valuable guide for the development of future health system interventions and strategies in SSA.Systematic review registrationPROSPERO CRD42022333913.

Clinical breast exam training using tactually accurate computer simulation among healthcare providers in ghana

BackgroundThe incidence and prevalence of breast cancer continue to grow each year in sub-Saharan Africa. With limited access to diagnostic testing in this resource-limited area, clinical breast exams are a priority. Diversity in clinical breast exam skills contributes to misdiagnosis and delayed diagnosis of breast cancer. Computer-based simulation improves clinical breast exam skills and has the potential to improve patient outcomes. ObjectivesThis study aimed to evaluate the effectiveness of tactually accurate computer simulation on participants’ clinical breast exam competence, confidence, and intent to perform clinical breast exams in their practice. MethodsThis was a retrospective study design analyzing MammaCare® training data and web-based survey data from 34 healthcare providers, including midwives, nurses, physician assistants, and medical officers, employed at five clinics in Ghana. ResultsParticipants demonstrated clinical breast exam skill competence. With each successive training module, the participants increased palpation coverage of breast tissue and decreased the number of false positive lumps identified as well as accurately identified true positive lumps. Participants reported increased confidence and intent to perform clinical breast exams and inquire about risk factors and symptoms patients may be experiencing. ConclusionsClinical breast exam skills training using tactually accurate computer simulation was effective and appropriate for practicing healthcare providers. The training may promote enhanced screening practices and early detection of breast cancer.

Assessment of Consent Comprehension Among Kenyan Adolescents, Young Adults, and Parents: Comparison of Enhanced and Standard Consenting Procedures

PurposeYouth aged 15–19 years and parents of minors aged 15–17 years in sub-Saharan Africa are under-represented in empirical consent research. Thus, knowledge is limited concerning the adequacy of consent procedures and need for strategies to improve consent comprehension among these groups. We assessed comprehension following standard consent procedures and evaluated an enhanced procedure among Kenyan youth and parents. MethodsParticipants were adolescents aged 15–17 years (n = 273), their parents (n = 196), and young adults aged 18–19 years (n = 196). We used a quasi-experimental cohort design to implement standard and enhanced (single condition: extended discussion, test/feedback) consent procedures. Participants completed a 21-item informed consent comprehension assessment instrument. ResultsAfter standard consent procedures, mean comprehension scores were 11.36, 13.64, and 13.43 (score range: 0–21) among adolescents, young adults, and parents, respectively. About 6.2% of adolescents, 19.6% of young adults, and 21.4% of parents answered ≥ 80% of the questions correctly. After the enhanced procedures, comprehension scores (15.87 adolescents, 17.81 young adults, and 16.77 parents) and proportions answering ≥ 80% of the questions correctly (44.9% adolescents, 76.8% young adults, and 64.3% parents) increased significantly. Regression analysis indicated statistically significant differences (p < .001) in comprehension scores between the enhanced and standard groups (β = 3.87 adolescents, β = 4.03 young adults, and β = 3.60 parents) after controlling for sociodemographic factors. DiscussionEnhancing consent procedures with extended discussions, quizzes, and additional explanation where understanding is inadequate is a promising approach for improving comprehension. However, poorer comprehension among adolescents compared to young adults and parents underscores the need for research to identify additional approaches to improve understanding.

Female-controlled dual protection methods: Prevalence, predictors, experiences and perceptions among young women living with HIV in northern Uganda-A mixed-method study protocol.

The use of dual protection methods among young women living with HIV (YWLHIV) aged 15-24 years in sub-Saharan Africa (SSA) is poorly researched despite the double risk of unintended pregnancy and HIV. Even more scanty is literature on the use of female-controlled dual protection methods. We propose to determine the female-controlled dual protection prevalence, and the predictors among YWLHIV in northern Uganda. The study will also explore the YWLHIV's experiences and perceptions regarding the female-controlled dual protection methods. This study will employ a mixed-methods design. The study area will be Lira district and Lira city located in northern Uganda. The setting for recruitment of participants will be the public health facility-based anti-retroviral therapy (ART) clinics. These ART clinics serves a total of about 1,771 YWLHIV. A sample of 425 YWLHIV will be selected by stratified random sampling from the ART clinic registers. The three strata of interest will be the YWLHIV attending the ART clinic at referral hospitals, health centers level IV (primary healthcare centers), and health centers level III (dispensaries). The primary outcome will be the use of the female-controlled dual protection methods. The outcome will be measured by asking the YWLHIV 'what methods under their control as YWLHIV do they use to protect against both unintended pregnancy and HIV during sexual intercourse with their male partners.' The questionnaire also has measures for the unintended pregnancy, HIV status, and the potential predictors. Qualitative component of the study will be in-depth interviews of the participants about their experiences and perceptions regarding the female-controlled dual protection methods. Data collection was still ongoing at the time of first submission of this study protocol to the journal (14th March 2023). The Statistical Package for Social Sciences (SPSS) version 23.0 will be used for the statistical analyses. Descriptive statistics, bivariate and multivariate regression analyses will be used to establish the prevalence, associated factors and the predictors of the outcome respectively. The statistical significance level of 5% and 95% confidence interval will be considered. In-depth interviews will be manually analyzed using a thematic analysis approach for codes, themes, and categories.

Prevalence of female genital mutilation and associated factors among daughters aged 0-14 years in sub-Saharan Africa: a multilevel analysis of recent demographic health surveys.

Female genital mutilation (FGM) is a harmful traditional practice involving the partial or total removal of external genitalia for non-medical reasons. Despite efforts to eliminate it, more than 200 million women and girls have undergone FGM, and 3 million more undergo this practice annually. Tracking the prevalence of FGM and identifying associated factors are crucial to eliminating the practice. This study aimed to determine the prevalence of FGM and associated factors among daughters aged 0-14 years. The most recent Demographic Health Survey Data (DHS) datasets from sub-Saharan African countries were used for analysis. A multilevel modified Poisson regression analysis model was applied to identify factors associated with FGM. Data management and analysis were performed using STATA-17 software, and the pooled prevalence and adjusted odds ratio (AOR) with a 95% confidence interval (CI) were reported. Statistical significance was set at p ≤ 0.05. The study included a weighted sample of 123,362 participants. The pooled prevalence of FGM among daughters aged 0-14 years in sub-Saharan Africa was found to be 22.9% (95% CI: 16.2-29.6). The daughter's place of birth (AOR = 0.54, 95% CI: 0.48-0.62), mother's age (AOR = 1.72, 95% CI: 1.4-2.11), father's education (AOR = 0.92, 95% CI: 0.87-0.98), mother's perception about FGM (AOR = 0.42, 95% CI: 0.35-0.48), FGM as a religious requirement (AOR = 1.23, 95% CI: 1.12-1.35), mother's age at circumcision (AOR = 1.11, 95% CI: 1.01-1.23), residing in rural areas (AOR = 1.12, 95% CI: 1.05-1.19), and community literacy level (AOR = 0.90, 95% CI: 0.83-0.98) were factors associated with FGM. The high prevalence of FGM among daughters aged 0-14 years in sub-Saharan Africa indicates the need for intensified efforts to curb this practice. Addressing the associated factors identified in this study through targeted interventions and policy implementation is crucial to eradicate FGM and protect the rights and well-being of girls.

Insecticidal activity and repellent potential of ocimum gratissimum on tribolium castaneum

Background: Using botanicals for pest control has become very popular in recent years in sub-Saharan Africa and other parts of the world. These botanicals are recognized to offer protection against insect pests thanks to the natural components inherent in them. Some of these chemicals may work independently or in concert to create a desired result that lead to health challenge. Objectives: This study was aimed at evaluating the toxicity and repellent potential of Ocimum gratissimum on Tribolium castaneum. Methodology: The different concentrations 20% (200 mg/mL), 10% (100 mg/mL), 5% (50 mg/mL), 2.5% (25 mg/mL), and 1.25% (12.5mg/mL) of the oil extracts including control with acetone only were selected and tested to determine the LD50 value and LD90 value. Repellent activity contained in the essential oil was done using standard method. Result: Mortality increased in accordance with increase in concentration of O. gratissimum. The highest and lowest doses of O. gratissimum, 200 mg/ml and 12.5 mg/ml (P&lt;0.05, P=0.009), caused mortalities of 90% and 43.3% respectively. The log-probit regression analysis showed that the LD50 and LD90 for this plant extract were 18.60 mg/mL and 175.99 mg/mL respectively. Conclusion: The present study has evidently shown that O.gratissimum oil have insecticidal activity. O.gratissimum oil extract also serve as good toxicant and repellent agents in the treatment of Tribolium castaneum during storage.

Elevated blood pressure among adolescents in sub-Saharan Africa: a systematic review and meta-analysis

More people from sub-Saharan Africa aged between 20 years and 60 years are affected by end-organ damage due to underlying hypertension than people in high-income countries. However, there is a paucity of data on the pattern of elevated blood pressure among adolescents aged 10-19 years in sub-Saharan Africa. We aimed to provide pooled estimates of high blood pressure prevalence and mean levels in adolescents aged 10-19 years across sub-Saharan Africa. In this systematic review and meta-analysis, we searched PubMed, Google Scholar, African Index Medicus, and Embase to identify studies published from Jan 1, 2010, to Dec 31, 2021. To be included, primary studies had to be observational studies of adolescents aged 10-19 years residing in sub-Saharan African countries reporting the pooled prevalence of elevated blood pressure or with enough data to compute these estimates. We excluded studies on non-systemic hypertension, in African people not living in sub-Saharan Africa, with participant selection based on the presence of hypertension, and with adult cohorts in which we could not disaggregate data for adolescents. We independently extracted relevant data from individual studies using a standard data extraction form. We used a random-effects model to estimate the pooled prevalence of elevated blood pressure and mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels overall and on a sex-specific basis. This study is registered with PROSPERO (CRD42022297948). We identified 2559 studies, and assessed 81 full-text studies for eligibility, of which 36 studies comprising 37 926 participants aged 10-19 years from ten (20%) of 49 sub-Saharan African countries were eligible. A pooled sample of 29 696 adolescents informed meta-analyses of elevated blood pressure and 27 155 adolescents informed meta-analyses of mean blood pressure. Sex data were available from 26 818 adolescents (14 369 [53·6%] were female and 12 449 [46·4%] were male) for the prevalence of elevated blood pressure and 23 777 adolescents (12 864 [54·1%] were female and 10 913 [45·9%] were male) for mean blood pressure. Study quality was high, with no low-quality studies. The reported prevalence of elevated blood pressure ranged from 4 (0·2%) of 1727 to 1755 (25·1%) of 6980 (pooled prevalence 9·9%, 95% CI 7·3-12·5; I?=99·2%, pheterogeneity<0·0001). Mean SBP was 111 mm Hg (95% CI 108-114) and mean DBP was 68 mm Hg (66-70). 13·4% (95% CI 12·9-13·9; pheterogeneity<0·0001) of male participants had elevated blood pressure compared with 11·9% (11·3-12·4; pheterogeneity<0·0001) of female participants (odds ratio 1·04, 95% CI 0·81-1·34; pheterogeneity<0·0001). To our knowledge, this systematic review and meta-analysis is the first systematic synthesis of blood pressure data specifically derived from adolescents in sub-Saharan Africa. Although many low-income countries were not represented in our study, our findings suggest that approximately one in ten adolescents have elevated blood pressure across sub-Saharan Africa. Accordingly, there is an urgent need to improve preventive heart-health programmes in the region. None.

Neural tube defects as a cause of death among stillbirths, infants, and children younger than 5 years in sub-Saharan Africa and southeast Asia: an analysis of the CHAMPS network

Neural tube defects are common birth defects resulting in severe morbidity and mortality; they can largely be prevented with periconceptional maternal intake of folic acid. Understanding the occurrence of neural tube defects and their contribution to mortality in settings where their burden is highest could inform prevention and health-care policy. We aimed to estimate the mortality attributed to neural tube defects in seven countries in sub-Saharan Africa and southeast Asia. This analysis used data from the Child Health and Mortality Prevention Surveillance (CHAMPS) network and health and demographic surveillance systems from South Africa, Mozambique, Bangladesh, Kenya, Mali, Ethiopia, and Sierra Leone. All stillbirths and infants and children younger than 5 years who died, who were enrolled in CHAMPS, whose families consented to post-mortem minimally invasive tissue sampling (MITS) between Jan 1, 2017, and Dec 31, 2021, and who were assigned a cause of death by a determination of cause of death panel as of May 24, 2022, were included in this analysis, regardless the cause of death. MITS and advanced diagnostic methods were used to describe the frequency and characteristics of neural tube defects among eligible deaths, identify risk factors, and estimate the mortality fraction and mortality rate (per 10 000 births) by CHAMPS site. Causes of death were determined for 3232 stillbirths, infants, and children younger than 5 years, of whom 69 (2%) died with a neural tube defect. Most deaths with a neural tube defect were stillbirths (51 [74%]); 46 (67%) were neural tube defects incompatible with life (ie, anencephaly, craniorachischisis, or iniencephaly) and 22 (32%) were spina bifida. Deaths with a neural tube defect were more common in Ethiopia (adjusted odds ratio 8·09 [95% CI 2·84-23·02]), among female individuals (4·40 [2·44-7·93]), and among those whose mothers had no antenatal care (2·48 [1·12-5·51]). Ethiopia had the highest adjusted mortality fraction of deaths with neural tube defects (7·5% [6·7-8·4]) and the highest adjusted mortality rate attributed to neural tube defects (104·0 per 10 000 births [92·9-116·4]), 4-23 times greater than in any other site. CHAMPS identified neural tube defects, a largely preventable condition, as a common cause of death among stillbirths and neonatal deaths, especially in Ethiopia. Implementing interventions such as mandatory folic acid fortification could reduce mortality due to neural tube defects. Bill & Melinda Gates Foundation.

Assessing the combined effect of household cooking fuel and urbanicity on acute respiratory symptoms among under-five years in sub-Saharan Africa

BackgroundThis study sought to investigate the association between urbanicity (rural-urban residency), the use of solid biomass cooking fuels and the risk of Acute Respiratory Infections (ARIs) among children under the age of 5 in sub-Saharan Africa (SSA). MethodsCross-sectional data from the most recent surveys of the Demographic and Health Survey Program conducted in 31 sub-Saharan African countries were pooled for the analysis. The outcome variables, cough and rapid short breath were derived from questions that asked mothers if their children under the age of 5 suffered from cough and short rapid breath in the past two weeks preceding the survey. To examine the associations, multivariable negative log-log regression models were fitted for each outcome variable. ResultsHigher odds ratios of cough occurred among children in urban households that use unclean cooking fuel (aOR = 1.05 95% CI = 1.01, 1.08). However, lower odds ratios were observed for rural children in homes that use clean cooking fuel (aOR = 0.93 95% CI = 0.87, 0.99) relative to children in urban homes using clean cooking fuel. We also found higher odds ratios of short rapid breaths among children in rural households that use unclean cooking fuel compared with urban residents using clean cooking fuel (aOR = 1.12 95% CI = 1.08, 1.17). ConclusionUrbanicity and the use of solid biomass fuel for cooking were associated with an increased risk of symptoms of ARIs among children under five years in SSA. Thus, policymakers and stakeholders need to design and implement strategies that minimize children’s exposure to pollutants from solid biomass cooking fuel. Such interventions could reduce the burden of respiratory illnesses in SSA and contribute to the realization of Sustainable Development Goal 3.9, which aims at reducing the number of diseases and deaths attributable to hazardous chemicals and pollution of air, water and soil.

Moderate-to-Severe Diarrhea and Stunting Among Children Younger Than 5 Years: Findings From the Vaccine Impact on Diarrhea in Africa (VIDA) Study

Stunting affects >20% of children <5 years old worldwide and disproportionately impacts underserved communities. The Vaccine Impact on Diarrhea in Africa (VIDA) Study examined the association between an episode of moderate-to-severe diarrhea (MSD) and the risk of subsequent stunting in children <5 years living in 3 sub-Saharan African countries. In this prospective, matched, case-control study among children <5 years, data were collected over 36 months from 2 groups. "Children with MSD" visited a health center within 7 days of illness onset experiencing ≥3 loose stools/day plus sunken eyes, poor skin turgor, dysentery, intravenous rehydration, or hospitalization. "Children without MSD" were enrolled from the community within 14 days of the index MSD child; they were diarrhea-free during the previous 7 days and were matched to the index case by age, sex, and residence. Using generalized linear mixed-effects models, we estimated the effect of an MSD episode on odds of being stunted, defined as height-for-age z-scores <-2, at a follow-up visit 2-3 months post-enrollment. The proportion of stunting at enrollment was similar when 4603 children with MSD and 5976 children without MSD were compared (21.8% vs 21.3%; P = .504). Among children not stunted at enrollment, those with MSD had 30% higher odds of being stunted at follow-up than children without MSD after controlling for age, sex, study site, and socioeconomic status (adjusted OR: 1.30; 95% CI: 1.05-1.62: P = .018). Children <5 years in sub-Saharan Africa without stunting experienced an increased likelihood of stunting during 2-3 months following an episode of MSD. Strategies for control of early childhood diarrhea should be integrated into programs intended to reduce childhood stunting.

Stunting Following Moderate-to-Severe Diarrhea Among Children Aged &amp;lt;5 Years in Africa Before and After Rotavirus Vaccine Introduction: A Comparison of the Global Enteric Multicenter Study and the Vaccine Impact on Diarrhea in Africa (VIDA) Study

Studies conducted before rotavirus vaccine introduction found that moderate-to-severe diarrhea (MSD) in children aged <5 years was associated with stunting at follow-up. It is unknown whether the reduction in rotavirus-associated MSD following vaccine introduction decreased the risk of stunting. The Global Enteric Multicenter Study (GEMS) and the Vaccine Impact on Diarrhea in Africa (VIDA) study, two comparable matched case-control studies, were conducted during 2007-2011 and 2015-2018, respectively. We analyzed data from 3 African sites where rotavirus vaccine was introduced after GEMS and before starting VIDA. Children with acute MSD (<7 days onset) were enrolled from a health center and children without MSD (diarrhea-free for ≥7 days) were enrolled at home within 14 days of the index MSD case. The odds of being stunted at a follow-up visit 2-3 months after enrollment for an episode of MSD was compared between GEMS and VIDA using mixed-effects logistic regression models controlling for age, sex, study site, and socioeconomic status. We analyzed data from 8808 children from GEMS and 10 579 from VIDA. Among those who were not stunted at enrollment in GEMS, 8.6% with MSD and 6.4% without MSD became stunted during the follow-up period. In VIDA, 8.0% with MSD and 5.5% children without MSD developed stunting. An episode of MSD was associated with higher odds of being stunted at follow-up compared with children without MSD in both studies (adjusted odds ratio [aOR], 1.31; 95% confidence interval [CI]: 1.04-1.64 in GEMS and aOR, 1.30; 95% CI: 1.04-1.61 in VIDA). However, the magnitude of association was not significantly different between GEMS and VIDA (P = .965). The association of MSD with subsequent stunting among children aged <5 years in sub-Saharan Africa did not change after rotavirus vaccine introduction. Focused strategies are needed for prevention of specific diarrheal pathogens that cause childhood stunting.