scholarly journals Drivers of stunting reduction in Ethiopia: a country case study

2020 ◽  
Vol 112 (Supplement_2) ◽  
pp. 875S-893S
Author(s):  
Hana Tasic ◽  
Nadia Akseer ◽  
Seifu H Gebreyesus ◽  
Anushka Ataullahjan ◽  
Samanpreet Brar ◽  
...  
Keyword(s):  
Parental Education ◽  
Health Workers ◽  
Health Concern ◽  
Demographic And Health Surveys ◽  
Global Public Health ◽  
Access To Health Services ◽  
Open Defecation ◽  
Chronic Undernutrition ◽  
Policies And Programs ◽  
Change In Mean

ABSTRACT Background Chronic undernutrition in children continues to be a global public health concern. Ethiopia has documented a significant decline in the prevalence of childhood stunting, a measure of chronic undernutrition, over the last 20 y. Objectives The aim of this research was to conduct a systematic assessment of the determinants that have driven child stunting reduction in Ethiopia from 2000 to 2016, focused on the national, community, household, and individual level. Methods This study employed both quantitative and qualitative methods. Specifically, a systematic literature review, retrospective quantitative data analysis using Demographic and Health Surveys from 2000–2016, qualitative data collection and analysis, and analyses of key nutrition-specific and -sensitive policies and programs were undertaken. Results National stunting prevalence improved from 51% in 2000 to 32% in 2016. Regional variations exist, as do pro-rich, pro-urban, and pro-educated inequalities. Child height-for-age z score (HAZ) decomposition explained >100% of predicted change in mean HAZ between 2000 and 2016, with key factors including increases in total consumable crop yield (32% of change), increased number of health workers (28%), reduction in open defecation (13%), parental education (10%), maternal nutrition (5%), economic improvement (4%), and reduced diarrhea incidence (4%). Policies and programs that were key to stunting decline focused on promoting rural agriculture to improve food security; decentralization of the health system, incorporating health extension workers to improve rural access to health services and reduce open defecation; multisectoral poverty reduction strategies; and a commitment to improving girls’ education. Interviews with national and regional stakeholders and mothers in communities presented improvements in health service access, women and girls’ education, improved agricultural production, and improved sanitation and child care practices as drivers of stunting reduction. Conclusions Ethiopia's stunting decline was driven by both nutrition-specific and -sensitive sectors, with particular focus on the agriculture sector, health care access, sanitation, and education.

scholarly journals Drivers of stunting reduction in Nepal: a country case study

2020 ◽  
Vol 112 (Supplement_2) ◽  
pp. 844S-859S
Author(s):  
Kaitlin Conway ◽  
Nadia Akseer ◽  
Raj Kumar Subedi ◽  
Samanpreet Brar ◽  
Basudev Bhattarai ◽  
...  
Keyword(s):  
Poverty Reduction ◽  
Parental Education ◽  
Maternal Nutrition ◽  
Health Workers ◽  
Decomposition Analysis ◽  
Health Concern ◽  
Maternal And Newborn Health ◽  
Demographic And Health Surveys ◽  
Access To Health Services ◽  
Nutrition Sensitive

ABSTRACT Background Chronic child malnutrition represents a serious global health concern. Over the last several decades, Nepal has seen a significant decline in linear growth stunting – a physical manifestation of chronic malnutrition – despite only modest economic growth and significant political instability. Objective This study aimed to conduct an in-depth assessment of the determinants of stunting reduction in Nepal from 1996 to 2016, with specific attention paid to national-, community-, household-, and individual-level factors, as well as relevant nutrition-specific and -sensitive initiatives rolled out within the country. Methods Using a mixed-methods approach, 4 types of inquiry were employed: 1) a systematic review of published peer-reviewed and gray literature; 2) retrospective quantitative data analyses using Demographic and Health Surveys from 1996 to 2016; 3) a review of key nutrition-specific and -sensitive policies and programs; and 4) retrospective qualitative data collection and analyses. Results Mean height-for-age z-scores (HAZ) improved by 0.94 SDs from 1996 to 2016. Subnational variation and socioeconomic inequalities in stunting outcomes persisted, with the latter widening over time. Decomposition analysis for children aged under 5 y explained 90.9% of the predicted change in HAZ, with key factors including parental education (24.7%), maternal nutrition (19.3%), reduced open defecation (12.3%), maternal and newborn health care (11.5%), and economic improvement (9.0%). Key initiatives focused on decentralizing the health system and mobilizing community health workers to increase accessibility; long-standing nationwide provision of basic health interventions; targeted efforts to improve maternal and child health; and the prioritization of nutrition-sensitive initiatives by both government and donors. National and community stakeholders and mothers at village level highlighted a mixture of poverty reduction, access to health services, improved education, and increased access to water, sanitation, and hygiene as drivers of stunting reduction. Conclusions Improvements in both nutrition-specific and nutrition-sensitive sectors have been critical to Nepal's stunting decline, particularly in the areas of poverty reduction, health, education, and sanitation.

scholarly journals Preventing Childhood Obesity in Primary Schools: A Realist Review from UK Perspective

2021 ◽  
Vol 18 (24) ◽  
pp. 13395
Author(s):  
Sharea Ijaz ◽  
James Nobles ◽  
Laura Johnson ◽  
Theresa Moore ◽  
Jelena Savovic ◽  
...  
Keyword(s):  
Childhood Obesity ◽  
Primary Schools ◽  
Parental Education ◽  
Cochrane Review ◽  
Realist Review ◽  
Health Concern ◽  
Global Public Health ◽  
Programme Theory ◽  
School Based ◽  
School Based Interventions

Childhood obesity is a global public health concern. While evidence from a recent comprehensive Cochrane review indicates school-based interventions can prevent obesity, we still do not know how or for whom these work best. We aimed to identify the contextual and mechanistic factors associated with obesity prevention interventions implementable in primary schools. A realist synthesis following the Realist And Meta-narrative Evidence Syntheses–Evolving Standards (RAMESES) guidance was with eligible studies from the 2019 Cochrane review on interventions in primary schools. The initial programme theory was developed through expert consensus and stakeholder input and refined with data from included studies to produce a final programme theory including all of the context-mechanism-outcome configurations. We included 24 studies (71 documents) in our synthesis. We found that baseline standardised body mass index (BMIz) affects intervention mechanisms variably as a contextual factor. Girls, older children and those with higher parental education consistently benefitted more from school-based interventions. The key mechanisms associated with beneficial effect were sufficient intervention dose, environmental modification and the intervention components working together as a whole. Education alone was not associated with favourable outcomes. Future interventions should go beyond education and incorporate a sufficient dose to trigger change in BMIz. Contextual factors deserve consideration when commissioning interventions to avoid widening health inequalities.

COVID-19: A Review on Epidemiology, Clinical Features and Possible Potential Drugs Based on Available Case Studies

Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Kirtikumar C. Badgujar ◽  
Dipak V. Patil ◽  
Dipak V. Dhangar ◽  
Vikrant P. Patil ◽  
Ashish B. Badgujar
Keyword(s):  
Public Health ◽  
Case Studies ◽  
Clinical Features ◽  
Health Workers ◽  
Case Reports ◽  
World Health ◽  
Health Concern ◽  
Global Public Health ◽  
The World ◽  
Novel Coronavirus

: The emerging novel coronavirus disease 2019 has caused global outbreak and major public health concern. The World Health Organization (WHO) has announced a coronavirus disease outbreak a pandemic with a global public health emergency of international concern. As of now, 12th April 2020 almost 18,37,404 cases has been confirmed globally (in 209 countries) with almost 1,13,274 fatalities. This increasing number has created anxiety throughout the world which has severely affected the whole world culture, societies, behavioural pattern, peace and economics. At present, research on novel coronavirus is in the preliminary stage. There is no vaccine or specific antiviral to treat coronavirus disease. Also, very few case studies are available; hence it has become difficult to treat and to control this pandemic situation. In view of this, the present systematic review is done to highlight epidemiology clinical features, radiographic characteristics and potential drugs based on available clinical case reports. Biomarkers for early diagnosis and impact of age, sex, pre-existing comorbidity on COVID-19 is also discussed. Further this paper also outlines various possible antiviral chemical drug agents that can be potential and promising to treat this coronavirus disease 2019. This review may be helpful for medical practitioner, public health workers and government authorities to manage and deal with novel coronavirus disease 2019.

SARS-COV2 virus and Coronavirus disease (COVID-19)

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 977-982
Author(s):  
Mohamed J. Saadh ◽  
Bashar Haj Rashid M ◽  
Roa’a Matar ◽  
Sajeda Riyad Aldibs ◽  
Hala Sbaih ◽  
...  
Keyword(s):  
Close Contact ◽  
Antiviral Agents ◽  
Health Concern ◽  
The Novel ◽  
Global Public Health ◽  
Fatal Disease ◽  
Mild Disease ◽  
Life Threatening ◽  
Novel Coronavirus

SARS-COV2 virus causes Coronavirus disease (COVID-19) and represents the causative agent of a potentially fatal disease that is of great global public health concern. The novel coronavirus (2019) was discovered in 2019 in Wuhan, the market of the wet animal, China with viral pneumonia cases and is life-threatening. Today, WHO announces COVID-19 outbreak as a pandemic. COVID-19 is likely to be zoonotic. It is transmitted from bats as intermediary animals to human. Also, the virus is transmitted from human to human who is in close contact with others. The computerized tomographic chest scan is usually abnormal even in those with no symptoms or mild disease. Treatment is nearly supportive; the role of antiviral agents is yet to be established. The SARS-COV2 virus spreads faster than its two ancestors, the SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV), but has lower fatality. In this article, we aimed to summarize the transmission, symptoms, pathogenesis, diagnosis, treatment, and vaccine to control the spread of this fatal disease.

scholarly journals Wasting and Associated Factors among Children under 5 Years in Five South Asian Countries (2014–2018): Analysis of Demographic Health Surveys

2021 ◽  
Vol 18 (9) ◽  
pp. 4578
Author(s):  
Nidhi Wali ◽  
Kingsley E. E. Agho ◽  
Andre M. N. Renzaho
Keyword(s):  
South Asia ◽  
South Asian ◽  
Health Surveys ◽  
Associated Factors ◽  
Common Factor ◽  
Household Wealth ◽  
Health Concern ◽  
Demographic And Health Surveys ◽  
Asian Countries ◽  
Sampling Weights

Child wasting continues to be a major public health concern in South Asia, having a prevalence above the emergency threshold. This paper aimed to identify factors associated with wasting among children aged 0–23 months, 24–59 months, and 0–59 months in South Asia. A weighted sample of 564,518 children aged 0–59 months from the most recent demographic and health surveys (2014–2018) of five countries in South Asia was combined. Multiple logistic regression analyses that adjusted for clustering and sampling weights were used to examine associated factors. Wasting prevalence was higher for children aged 0–23 months (25%) as compared to 24–59 months (18%), with variations in prevalence across the South Asian countries. The most common factor associated with child wasting was maternal BMI [adjusted odds ratio (AOR) for 0–23 months = 2.02; 95% CI: (1.52, 2.68); AOR for 24–59 months = 2.54; 95% CI: (1.83, 3.54); AOR for 0–59 months = 2.18; 95% CI: (1.72, 2.77)]. Other factors included maternal height and age, household wealth index, birth interval and order, children born at home, and access to antenatal visits. Study findings suggest need for nutrition specific and sensitive interventions focused on women, as well as adolescents and children under 2 years of age.

scholarly journals CO0005 C-C CHEMOKINE RECEPTOR TYPE 5 AND ITS LIGANDS CCL4, 8 AND 11 CAN LINK COVID-19, RHEUMATOID ARTHRITIS AND HYDROXYCHLOROQUINE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 213.3-214
Author(s):  
M. Y. Hachim ◽  
S. Hannawi
Keyword(s):  
Rheumatoid Arthritis ◽  
Mechanism Of Action ◽  
Immune Cells ◽  
Health Concern ◽  
Healthy Controls ◽  
Global Public Health ◽  
Ccr5 Expression ◽  
Disease Modifying Drugs ◽  
Link Type ◽  
Disease Modifying

Background:Coronavirus disease (COVID-19) caused by SARS-COV2 represents an unprecedented global public health concern with a particular burden on patients with chronic diseases and those on immune-modulating drugs. It is especially worrisome to patients with rheumatoid arthritis (RA) who are on immune suppression regimens[1]. On the other side, many reports showed and recommended the use of some Disease-Modifying Drugs commonly used to treat rheumatic diseases like hydroxychloroquine. However, the general understanding of COVID-19 characteristics in this population and the mechanism of action of these drugs in COVID-19 is still unknown[2].Objectives:Explore publicly available transcriptomic dataset of patients infected with SARS-COV2 compared to uninfected to identify differentially expressed genes (DEGs) related to the immune system that might be pathogenic in RA synovium. Then explore the effect of Disease-Modifying Drugs on their local expression that might give hints about their possible mechanism of action.Methods:RNAseq dataset (GSE147507) were retrieved using the Gene Expression Omnibus (GEO) and used to identify DEGs between infected and uninfected lung samples using BioJupies tools [3]. The DEGs were explored for common pathways using Metascape online tool (http://metascape.org) [10], as shown in figure (1). The chemokines genes were filtered out, and their common receptor (CR) was identified. The immune cells that express a higher level of the identified receptor were explored using DICE project tool (https://dice-database.org/). The expression of CR was searched in a microarray dataset (GSE77298) of synovial biopsies of RA and healthy controls. RNAseq dataset (GSE97165) of synovial biopsies taken from 19 early RA patients at baseline and after six months of Triple Disease-Modifying Anti-rheumatic drugs (tDMARD; methotrexate, sulfasalazine, and hydroxychloroquine) treatment.Results:84 DEGs were identified between uninfected and COVID-19 infected lung samples. These DEGs were enriched in pathways specific to (response to the virus, response to interferon, leukocyte activation, and chemotaxis). Interestingly, SARS-COV-2 infected lungs express more CCL4, CCL8, and CCL11; the three ligands shared the same receptor, which is CCR5. Top immune cells that express CCR5 were CD4 T memory T reg cells, Th17, Th1, and monocytes. CCR5 was significantly upregulated in RA compared to healthy controls synovium (p=0.04) and was dramatically downregulated after six months of tDMARD treatment (p=0.004), as shown in figure (2).Conclusion:Using publicly available transcriptomic datasets properly highlighted the possible beneficiary effect of DMARDs in patients with COVID-19, which can block CCR5 rich immune cells recruitment.References:[1]Favalli, E.G., et al.,COVID-19 infection and rheumatoid arthritis: Faraway, so close!Autoimmun Rev, 2020. 19(5): p. 102523.[2]Gianfrancesco, M.A., et al.,Rheumatic disease and COVID-19: initial data from the COVID-19 Global Rheumatology Alliance provider registries.The Lancet Rheumatology, 2020. 2(5): p. e250-e253.[3]Torre, D., A. Lachmann, and A. Ma’ayan,BioJupies: Automated Generation of Interactive Notebooks for RNA-Seq Data Analysis in the Cloud.Cell Systems, 2018. 7(5): p. 556-561.e3.Figure 1.Flowchart of transcriptomic analysisFigure 2.(A) Top immune cells that express CCR5 (B) CCR5 expression in synovial biopsies of RA and control (C) CCR5 expression at baseline and after 6 months of tDMARD treatment.Disclosure of Interests:None declared

scholarly journals Optimized and Non-Optimized Personal Protective Equipment Use during the COVID-19 Pandemic in Thailand: A National Cross-Sectional Survey in a Resource-Limited Setting

2021 ◽  
Vol 15 ◽  
pp. 117863022110135
Author(s):  
Visal Moolasart ◽  
Weerawat Manosuthi ◽  
Varaporn Thienthong ◽  
Uajai Jaemsak ◽  
Winnada Kongdejsakda ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Negative Pressure ◽  
Symptom Severity ◽  
Univariate Analysis ◽  
Education Level ◽  
Health Concern ◽  
Protective Equipment ◽  
Global Public Health ◽  
Cross Sectional ◽  
Infection Control Program

Introduction: Coronavirus disease (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-COV2). COVID-19 is highly contagious, potentially fatal, and a global public health concern. Combining optimized personal protective equipment (PPE) use and hand hygiene is the best strategy for preventing COVID-19 in health care workers (HCWs). Methods: We conducted a national cross-sectional web-based survey of HCWs in the infection control program (IPC) in Thailand between May 5, 2020 and May 15, 2020. The primary objective was the prevalence of optimized PPE use amongst HCWs. The secondary objective was identification of the independent predictors of optimized PPE use. Results: We received a response from 46% of HCWs (756/1650), and all those who responded were nurse or HCWs who were registered in the IPC network. Five HCWs were excluded because of missing data, and 751 were included in the final analysis. The prevalences of PPE use were 22% (168/751) for optimized PPE use, 78% (583/751) for non-optimized PPE use, 35% (263/751) for PPE overuse, and 43% (320/751) for PPE underused. In univariate analysis, optimized PPE use was significantly associated with age, education level, knowledge of appropriate negative pressure room selection, and knowledge of apparently milder symptom severity in children than adults. In multivariate analysis, independent predictors of optimized PPE use were knowledge of appropriate negative pressure room selection (aOR = 1.95, 95% CI = 1.18-3.22), the difference in symptom severity between children and adults (aOR = 0.55, 95% CI = 0.37-0.81), and education level (aOR = 1.54, 95% CI = 1.04-2.27). Conclusion: The prevalence of optimized PPE use amongst HCWs was 22%. Independent predictors of optimized PPE use were COVID-19 knowledge-based factors and education level. Therefore, the continued education training program should be implemented to ensure maintenance of appropriate practices during the COVID-19 pandemic.

scholarly journals Probiotics as a Possible Strategy for the Prevention and Treatment of Allergies. A Narrative Review

Foods ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 701
Author(s):  
Aroa Lopez-Santamarina ◽  
Esther Gonzalez Gonzalez ◽  
Alexandre Lamas ◽  
Alicia del Carmen Mondragon ◽  
Patricia Regal ◽  
...  
Keyword(s):  
Allergic Diseases ◽  
Urban Environments ◽  
Probiotic Bacteria ◽  
Health Concern ◽  
Global Public Health ◽  
Cytokine Release ◽  
Public Health Concern ◽  
Beneficial Effects ◽  
Opportunistic Bacteria

Allergies are an increasing global public health concern, especially for children and people living in urban environments. Allergies impair the quality of life of those who suffer from them, and for this reason, alternatives for the treatment of allergic diseases or reduction in their symptoms are being sought. The main objective of this study was to compile the studies carried out on probiotics as a possible therapy for allergies. The most studied allergies on which probiotics have been shown to have a beneficial effect are rhinitis, asthma, and atopic dermatitis. Most studies have studied the administration of Lactobacillus and Bifidobacterium spp. in children and have shown beneficial effects, such as a reduction in hyperreactivity and inflammation caused by allergens and a decrease in cytokine release, among other beneficial effects. In the case of children, no clear beneficial effects were found in several studies, and the potential risk from the use of some opportunistic bacteria, such as probiotics, seems controversial. In the studies that reported beneficial results, these effects were found to make allergy symptoms less aggressive, thus reducing morbidity in allergy sufferers. The different effects of the same probiotic bacteria on different patients seem to reinforce the idea that the efficacy of probiotics is dependent on the microbial species or strain, its derived metabolites and byproducts, and the gut microbiota eubiosis of the patient. This study is relevant in the context of allergic diseases, as it provides a broader understanding of new alternatives for the treatment of allergies, both in children, who are the main sufferers, and adults, showing that probiotics, in some cases, reduce the symptoms and severity of such diseases.

scholarly journals Evolution and Population Structure of Salmonella enterica Serovar Newport

2010 ◽  
Vol 192 (24) ◽  
pp. 6465-6476 ◽  
Author(s):  
Vartul Sangal ◽  
Heather Harbottle ◽  
Camila J. Mazzoni ◽  
Reiner Helmuth ◽  
Beatriz Guerra ◽  
...  
Keyword(s):  
Population Structure ◽  
North America ◽  
Salmonella Enterica ◽  
Health Concern ◽  
Global Public Health ◽  
Multiple Sequence ◽  
Monophyletic Lineage ◽  
Population Structures ◽  
Paratyphi B ◽  
Multiple Drugs

ABSTRACT Salmonellosis caused by Salmonella enterica serovar Newport is a major global public health concern, particularly because S. Newport isolates that are resistant to multiple drugs (MDR), including third-generation cephalosporins (MDR-AmpC phenotype), have been commonly isolated from food animals. We analyzed 384 S. Newport isolates from various sources by a multilocus sequence typing (MLST) scheme to study the evolution and population structure of the serovar. These were compared to the population structure of S. enterica serovars Enteritidis, Kentucky, Paratyphi B, and Typhimurium. Our S. Newport collection fell into three lineages, Newport-I, Newport-II, and Newport-III, each of which contained multiple sequence types (STs). Newport-I has only a few STs, unlike Newport-II or Newport-III, and has possibly emerged recently. Newport-I is more prevalent among humans in Europe than in North America, whereas Newport-II is preferentially associated with animals. Two STs of Newport-II encompassed all MDR-AmpC isolates, suggesting recent global spread after the acquisition of the bla CMY-2 gene. In contrast, most Newport-III isolates were from humans in North America and were pansusceptible to antibiotics. Newport was intermediate in population structure to the other serovars, which varied from a single monophyletic lineage in S. Enteritidis or S. Typhimurium to four discrete lineages within S. Paratyphi B. Both mutation and homologous recombination are responsible for diversification within each of these lineages, but the relative frequencies differed with the lineage. We conclude that serovars of S. enterica provide a variety of different population structures.

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