Risks of aflatoxin exposure among adolescents in boarding schools in Kilimanjaro region, Tanzania

2021 ◽  
pp. 1-16
Author(s):  
C. Nicholaus ◽  
H.D. Martin ◽  
A. Matemu ◽  
J. Kimiywe ◽  
N. Kassim

School feeding in low-income countries is dominated by cereals and legumes, which are susceptible to aflatoxin contamination but are usually not assessed for aflatoxins. A cross sectional study was conducted to assess aflatoxin exposure among adolescents through consumption of school meals in Kilimanjaro region. Food frequency questionnaires and 24 h dietary recalls were used to collect information on food consumption. At least four samples of common food used in school meals were collected. A deterministic approach was used to estimate the dietary aflatoxin exposure. High Performance Liquid chromatography (HPLC) was used to analyse presence of aflatoxin contamination. Results showed that, maize based food and beans were consumed on daily basis. The intake of maize flour and dehulled maize ranged from 17.5 to 738.2 g and 28.2 to 272 g per person per day respectively. Furthermore, consumption of beans and rice were in the range of 121.1 to 595.2 g and 15.7 to 42.2 g per person per day respectively. Total aflatoxins ranged 0.20-438.53 μg/kg (median 2.30 μg/kg). The highest contamination range (0.59-438.53 μg/kg) was in maize while the lowest (0.20-3.41 μg/kg) was found in rice. Similarly, the highest aflatoxin B1 (AFB1) concentration (35.88 μg/kg) was in dehulled maize while the lowest (0.44 μg/kg) was in rice. The highest dietary exposure to total aflatoxins and AFB1 due to consumption of maize ranged from 0.70 to 973.45 ng/kg/bodyweight (bw)/day, and from 0.05-81.06 ng/kg/bw/day, respectively. This pronounced risk of exposure to aflatoxins might have been contributed by a monotonous maize based diet in boarding schools. These findings call for institutions immediate interventions, such as the use of appropriate storage technologies, sorting, cleaning and winnowing in order to remove damaged grains, thereby reducing the risk of dietary exposure to aflatoxins. Likewise, the relevant ministries should consider food diversification and routine risk assessments of the susceptible crops throughout the value chain as a long-term intervention plan at policy level.

2020 ◽  
Vol 1 ◽  
pp. 5
Author(s):  
Audu Onyemocho ◽  
Agwa Moses ◽  
Aboh Kisani ◽  
Omole Namben Victoria ◽  
Anejo-Okopi Joseph

Objective: Rabies, one of the oldest and fatal infectious diseases known to human race, is transmitted by infected dogs. The global target of zero dog-mediated rabies human deaths has been set for 2030; however, the realization of this goal poses challenges in most low-income countries where rabies is endemic due to weak surveillance. Dogs have been increasingly deployed for domestic uses over the years, especially for security purposes. This study assessed the assessment of knowledge and practice of vaccination of dogs against rabies by dog owners. Materials and Methods: A cross-sectional community-based study was employed to study 400 dog owners in Makurdi metropolis through multistage sampling techniques. Sighting of valid dog vaccination card was used as criteria for current vaccination. Bivariate analysis was carried out to establish the relationship between the respondent knowledge of rabies and dog vaccination with significant value set at P < 0.05. Results: The mean age of the respondents was 31 (Â ± 0.8) years, majority of them had tertiary and secondary education (40.0% and 39.0%, respectively), 26.0% were traders, and 50.0% were married. Overall, 73.0% of the respondents had good knowledge score, 61.0% had seen at least a rabid dog in their life time, and 74.0% have a history of dog vaccination, but evidence of up to date vaccination of dogs by owners was seen in only 18.0% of all the vaccination cards sighted. The relationship between the educational status of the respondents, their knowledge score, and their dog vaccination was statistically significant (P < 0.05). Conclusion: Knowledge of rabies among dog owners in Makurdi was good, but the practice of dog vaccination was poor. Educational status was a good predictor of practice. Awareness campaign on dog vaccination should be strengthened and adequate measures should be put in place at the veterinary hospitals in Makurdi for vaccination of dogs.


2019 ◽  
Vol 34 (13) ◽  
pp. 842-850
Author(s):  
Emmanuel Segnon Sogbossi ◽  
Damienne Houekpetodji ◽  
Toussaint G. Kpadonou ◽  
Yannick Bleyenheuft

Cerebral palsy is a common cause of pediatric motor disability. Although there are increasing amounts of data on the clinical profile of children with cerebral palsy in high-income countries, corresponding information about low-income countries and developing countries is lacking. Therefore, we aimed to describe the clinical spectrum of cerebral palsy in children in Benin, a representative West African low-income country. Our cross-sectional observational study included 114 children with cerebral palsy recruited from community-based rehabilitation centers and teaching hospitals (median age: 7 years, range 2-17; sex: 66% male). Data were collected through review of medical records and interviews with children’s mothers. Assessment included risk factors, clinical subtypes according to the Surveillance of CP in Europe criteria, severity of motor outcome scored by the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System, comorbidities, and school attendance. We recorded a high prevalence of intrapartum adverse events. Seventeen percent of children had postneonatal cerebral palsy, with cerebral malaria being the most common cause. Most children were severely affected (67.5% as bilateral spastic; 54.4% as GMFCS IV or V), but severity declined substantially with age. Only 23% of the children with cerebral palsy had attended school. Poor motor outcomes and comorbidities were associated with school nonattendance. These results suggest that intrapartum risk factors and postnatal cerebral malaria in infants are opportune targets for prevention of cerebral palsy in Sub-Saharan low-income countries.


2010 ◽  
Vol 16 (2) ◽  
pp. 5 ◽  
Author(s):  
Dominic Ignatius Ukpong ◽  
Festus Abasiubong

<p><strong>Background.</strong> The burden of mental illness is particularly severe for people living in low-income countries. Negative attitudes towards the mentally ill, stigma experiences and discrimination constitute part of this disease burden.</p><p><strong>Objective.</strong> The aim of this study was to investigate knowledge of possible causes of mental illness and attitudes towards the mentally ill in a Nigerian university teaching hospital population.</p><p><strong>Method.</strong> A cross-sectional descriptive study of a convenience sample of 208 participants from the University of Uyo Teaching Hospital, Uyo, Nigeria, using the Community Attitudes towards the Mentally Ill (CAMI) scale. Information was also obtained on beliefs about possible causes of mental illness. <strong></strong></p><p><strong>Results.</strong> The respondents held strongly negative views about the mentally ill, mostly being authoritarian and restrictive in their attitudes and placing emphasis on custodial care. Even though the respondents appeared to be knowledgeable about the possible role of psychosocial and genetic factors in the causation of mental illness, 52.0% of them believed that witches could be responsible, 44.2% thought mental illness could be due to possession by demons, and close to one-third (30%) felt that it could be a consequence of divine punishment.</p><p><strong>Conclusions.</strong> Stigma and discrimination against the mentally ill are widespread even in a population that is expected to be enlightened. The widespread belief in supernatural causation is likely to add to the difficulties of designing an effective anti-stigma psycho-educational programme. There is a need in Nigeria to develop strategies to change stigma attached to mental illness at both institutional and community levels.</p>


Author(s):  
Md Hasanuzzaman ◽  
Md Hafizur Rahman ◽  
Md Shafiqul Islam Khan ◽  
Musammet Rasheda Begum ◽  
Farjana Alam ◽  
...  

Background: Over 200 million under-five-children born in low-income countries are at risk of not reaching their development potential and infectious diseases are the leading cause of development deficits in these regions.Methods: A cross-sectional study was conducted to investigate personal and household hygiene practices among 154 mothers and their association with the incidence of infectious diseases among 167 children aged 6 months to 59 months in Patuakhali district, Bangladesh.Results: Only 13.6% of the mothers had proper hand washing knowledge. Besides, 14% and 53.9% of the mothers washed their hands with soap and only with water respectively before feeding their child. About 68.2% of mothers prepared food on the ground and half (49.5%) of the toilet did not have a hand washing location beside it. The risk of childhood infectious disease was significantly associated with hand washing of mothers before feeding a child (OR: 2.3, 95% CI: 1.5-4.1, p<0.05) and hand washing of child before eating (OR: 3.4, 95% CI: 1.8-5.7, p<0.05).Conclusions: Hand washing agents were inadequate and compliance to hand washing was poor. Therefore, the continuous focus is needed on the mother's awareness construction to increase the compliance to hand washing practice among mothers as well as their child with soap, especially during child feeding.


Author(s):  
Giovana Z. Mazo ◽  
Felipe Fank ◽  
Pedro S. Franco ◽  
Bruna da Silva Vieira Capanema ◽  
Franciele da Silva Pereira

The objective was to analyze the impact of social isolation on moderate physical activity and factors associated with sedentary behavior of older adults during the COVID-19 pandemic. This was a cross-sectional study involving 111 older adults (aged 71.0 ± 6.87 years). The data were collected at two time points: in November 2019 and in June 2020. There was a decline in moderate physical activity when the minutes/week were compared before and during social isolation (p < .001). Sedentary behavior was associated with the condition of living alone. Older adults who lived alone were 3.29 times more likely to spend 4 hr or more in sedentary behavior than those who lived with a partner (95% confidence interval [1.01, 10.74]). Government agencies must establish PA-related health promotion strategies, especially in developing and low-income countries. Therefore, home exercises need to be encouraged to prevent the consequences of this pandemic period.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Demelash Wachamo ◽  
Yadessa Tegene ◽  
Abdisa Tibeso ◽  
Assefa Washo

Background. Young people are challenged with sexual and reproductive health (SRH) problems due to limited access to services and information. It contributes a high burden of sexually transmitted disease, unsafe abortion, and premature mortality, especially in low-income countries like Ethiopia. Hence, this study aimed at assessing the SRH service utilization and associated factors among college students at West Arsi Zone in Oromia region, Ethiopia. Methods. Institutional-based cross-sectional study was conducted among 519 randomly selected college students from January 01, 2019, up to April 30, 2019. Data were collected through self-administered pretested questionnaires. Data entry and analysis for descriptive and logistic regression models were performed by using SPSS (version 23). The result was declared as statistically significant at p < 0.05. Results. The utilization of at least one SRH service in the last twelve months was seen in 304 (58.6%) students. Mainly information and counseling (81.3%), voluntary testing and counseling for HIV (80.6%), condom service (37.2%), pregnancy test (35.5%), family planning services (33.2%), and abortion care services (26.0%) were most frequently utilized. The students’ aged between 20 and 24 years [AOR = 2.05, 95% CI: 1.38–3.06], female students [AOR = 1.92, 95% CI: 1.30–2.82], those not living with family [AOR = 1.54, 95% CI: 1.05–2.26], those who discussed about SRH with family/friends [AOR = 1.92, 95% CI: 1.31–2.82], and those who participated in school clubs [AOR = 1.75, 95% CI: 1.19, 2.58] more frequently used SRH service compared with their counterparts. Conclusions. The utilization of SRH services was low when compared with other studies and needs improvements to tackle RH-related problems. It requires pertinent health education and the SRH club at higher educational institutions is crucial.


2019 ◽  
Vol 11 (8) ◽  
pp. 2353
Author(s):  
Soohyeon Kim ◽  
Jungho Baek ◽  
Eunnyeong Heo

This study is to investigate whether the multifaceted roles of democracy have a positive relationship with environmental quality. Using a panel data of 132 high- and low-income countries from 2014 to 2016, a random effect (RE) model is analyzed in comparison with cross-sectional analysis. To pursue the current research thoroughly, five elements of democracy that encompass the aspects of democratic institutions (election system, civil liberties, and government function) and the aspects of democratic culture (political participation and political culture) are selected. We find that elements of democracy are positively correlated with the environment in high-income countries. In low-income countries, on the other hand, it is found that the role of democracy in explaining the environmental quality appears to be very weak; only the effect of government function positively relates with the environment.


2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Calista Nicholaus ◽  
Haikael D. Martin ◽  
Neema Kassim ◽  
Athanasia O. Matemu ◽  
Judith Kimiywe

A cross-sectional study was conducted to assess dietary practices, nutrient adequacy, and nutrition status among 164 adolescents aged between 16 and 19 years in boarding secondary schools in the Kilimanjaro region. In-depth interviews and a survey guided by a semistructured and structured questionnaire, including 24-hour recall and food frequency questionnaire techniques, were used to collect information. Nutrition status was assessed using anthropometric measurements and hemoglobin levels. WHO AnthroPlus software and NutriSurvey software were used to analyze anthropometry and dietary data, respectively. Diet in boarding schools was monotonous comprising mainly of cereal-legume meal with low intake of animal sources, fruits, and vegetables. Mean intake of energy, vitamin C, iron, calcium, and zinc was 1392 kcal, 24.8 mg, 9.2 mg, 134.5 mg, and 4.3 mg, respectively, which were below the Recommended Daily Allowance. The average carbohydrate, fat, and protein intake of 471.9 g, 73.7 g, and 80.7 g, respectively, were slightly higher than the Recommended Daily Allowance in both sexes. Male had a significantly higher intake of protein and carbohydrates (P<0.001). Female had a significantly (P<0.001) high intake of fat compared to male adolescents. Overall, 23.1% of the adolescents were anaemic, 25% were overweight, and 6.1% were obese. Boarding secondary schools’ diet is monotonous and are inadequate in key micronutrients, iron, zinc, calcium, and vitamin C. There is a coexistence of undernutrition and overnutrition among adolescents in boarding schools. Therefore, monitoring adolescents’ dietary intake and nutrition status is a key in preventing adolescents’ malnutrition in the short term and diet-related diseases in the long term.


BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e023013 ◽  
Author(s):  
Deogratius Bintabara ◽  
Keiko Nakamura ◽  
Kaoruko Seino

ObjectiveThis study was performed to explore the factors associated with accumulation of multiple problems in accessing healthcare among women in Tanzania as an example of a low-income country.DesignPopulation-based cross-sectional survey.SettingNationwide representative data for women of reproductive age obtained from the 2015–2016 Tanzania Demographic and Health Survey were analysed.Primary outcome measuresA composite variable, ‘problems in accessing healthcare’, with five (1-5) categories was created based on the number of problems reported: obtaining permission to go to the doctor, obtaining money to pay for advice or treatment, distance to a health facility and not wanting to go alone. Respondents who reported fewer or more problems placed in lower and higher categories, respectively.ResultsA total of 13 266 women aged 15–49 years, with a median age (IQR) of 27 (20–36) years were interviewed and included in the analysis. About two-thirds (65.53%) of the respondents reported at least one of the four major problems in accessing healthcare. Furthermore, after controlling for other variables included in the final model, women without any type of health insurance, those belonging to the poorest class according to the wealth index, those who had not attended any type of formal education, those who were not employed for cash, each year of increasing age and those who were divorced, separated or widowed were associated with greater problems in accessing healthcare.ConclusionThis study indicated the additive effects of barriers to healthcare in low-income countries such as Tanzania. Based on these results, improving uptake of health insurance and addressing social determinants of health are the first steps towards reducing women’s problems associated with accessing healthcare.


2018 ◽  
Vol 16 (3) ◽  
pp. 302-306 ◽  
Author(s):  
Mona Sharma ◽  
Saurya Dhungel ◽  
Sujata Niroula ◽  
Manan Karki

Background: Labour analgesia, though practiced worldwide, is not very popular in low-income countries. The aim of the study was to assess the awareness, attitude, acceptance, and reasons for hindrance of labour analgesia among patients visiting a tertiary care center in the capital cityMethods: It was a cross sectional study conducted in Obstetrics and Gynecology outpatient department of Kathmandu Medical College Teaching Hospital in the month of August 2017. All pregnant patients presenting for antenatal checkup was included. Data was collected based on a questionnaire after informed consent. Statistical analysis was done in SPSS version 20 and results were expressed in frequencies and percentage.Results: Total of 270 pregnant women participated in the study. Out of these forty-four (16.3%) patients were aware about labour analgesia. The acceptance rate was high (72.2%). Majority (84.6%) had no problem with expenditure associated with labour analgesia.Conclusions: Despite low awareness about painless delivery among the antenatal women, the acceptance rate is high.


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