Influencing factors of unmet needs for child spacing among selected countries experiencing high maternal-mortality in sub-Saharan Africa

Background: Maternal complication and death have implicated unintended pregnancy. The indicator for measuring the risk of unintended pregnancy is unmet need for family planning (FP). It is necessary to explore the current situation of unmet need for child spacing (UNCS) as well as its influencing factors among countries that are experiencing high maternal mortality ratio. We aimed to unveil the prevalence of UNCS and its associated factors in Nigeria, Liberia and Sierra Leone.Methods: We analysed the data from DHS phase VII survey, a cross- sectional study conducted from year 2017 to 2018 across several countries. Total records of 25,539, 5,553, and 10,050 were extracted for Nigeria, Liberia and Sierra Leone respectively. Explored variables were UNCS, demographic characteristics and husband’s partners profile. Data was analysed using SPSS version 25. Descriptive statistics, test of association (chi-square) and binary logistic regression were used during the data analysis (α0.05).Results: UNCS was high in Nigeria (15.9%), Liberia (22.5%) and Sierra Leone (21.9%). In Nigeria, Liberia and Sierra Leone, 40%, 37% and 49.1% were uneducated respectively. The proportion of married women were 89% in Nigeria, 32% in Liberia and 70.2% in Sierra Leone. Also, female headship of household (OR: 1.29, 95%CI: 1.09-1.54) was associated with UNCS relative to male headship of household.Conclusions: UNCS was high in the three countries. Factors like educational status of women, age, as well as women as head of the households should be given much attention in the efforts to reduce UNCS as identified in this study

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance.

Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times and more-regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and illuminate the distinct dispersal dynamics of variants of concern-particularly Alpha, Beta, Delta, and Omicron-on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve while the continent faces many emerging and reemerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Influencing factors of unmet needs for child spacing among selected countries experiencing high maternal-mortality in sub-Saharan Africa

Background: Maternal complication and death has been implicated in unintended pregnancy. The indicator for measuring the risk of unintended pregnancy is unmet need for family planning (FP). It is necessary to explore the current situation of unmet need for child spacing (UNCS) as well as its influencing factors among countries that are experiencing high maternal mortality ratio. We aimed to unveil the prevalence of UNCS and its associated factors in Nigeria, Liberia and Sierra Leone.Methods: We analysed the data from DHS phase VII survey, a cross- sectional study conducted from year 2017 to 2018 across several countries. Total records of 25,539, 5,553, and 10,050 were extracted for Nigeria, Liberia and Sierra Leone respectively. Explored variables were UNCS, demographic characteristics and husband’s partners profile. Data was analysed using SPSS version 25. Descriptive statistics, test of association (chi-square) and binary logistic regression were used during the data analysis (α0.05).Results: UNCS was high in Nigeria (15.9%), Liberia (22.5%) and Sierra Leone (21.9%). In Nigeria, Liberia and Sierra Leone, 40%, 37% and 49.1% were uneducated respectively. The proportion of married women were 89% in Nigeria, 32% in Liberia and 70.2% in Sierra Leone. Also, female headship of household (OR: 1.29, 95%CI: 1.09-1.54) was associated with UNCS relative to male headship of household.Conclusions: UNCS was high in the three countries. Factors like educational status of women, age, as well as women as head of the households should be given much attention in the efforts to reduce UNCS as identified in this study.</jats:p

Body composition of Kwara state basketball players - implications for peak performance: Body composition of Kwara state basketball players - implications for peak performance

This study was carried out to evaluate the body composition of Basketball players in Kwara State, Nigeria. Physical characteristics of age, height and weight, the percentage body fat, fat mass, fat free mass and muscle mass were measured using standardized methods. Purposive sampling technique was used to select the participants made up of twelve (12) junior and fifteen (15) senior male basketball players. Portable Bathroom-type Hanson, scale (model B1801) was used to measure weight in kilogrammes, Holtain Stadiometre for height in centimetres and Slim-guide Skinfold callipers (model MI 48170, U.S.A). One-way ANOVA was used to analyse the difference in physical characteristics of the participants; t-test was used to determine difference in the body composition of the senior and junior basketball players. Significant difference was found in the body composition. The senior team had significantly higher fat free muscle mass and less fat and percentage body fat (4.69) that was too low for continuous vigorous intensity workout. However, there were no significant differences in the fat mass and fat free mass; while significant difference was found in percent body fat, BMI and muscle mass of both the senior and junior teams. This implies that the senior team has better musculature than the junior team. It was concluded that there is need for nutritional intervention and carbohydrate loading prior to performance to meet up the energy demand for daily training programme and during performance in order to improve performance ability of the senior basketball players

Body composition of Kwara state basketball players - implications for peak performance

This study was carried out to evaluate the body composition of Basketball players in Kwara State, Nigeria. Physical characteristics of age, height and weight, the percentage body fat, fat mass, fat free mass and muscle mass were measured using standardized methods. Purposive sampling technique was used to select the participants made up of twelve (12) junior and fifteen (15) senior male basketball players. Portable Bathroom-type Hanson, scale (model B1801) was used to measure weight in kilogrammes, Holtain Stadiometre for height in centimetres and Slim-guide Skinfold callipers (model MI 48170, U.S.A). One-way ANOVA was used to analyse the difference in physical characteristics of the participants; t-test was used to determine difference in the body composition of the senior and junior basketball players. Significant difference was found in the body composition. The senior team had significantly higher fat free muscle mass and less fat and percentage body fat (4.69) that was too low for continuous vigorous intensity workout. However, there were no significant differences in the fat mass and fat free mass; while significant difference was found in percent body fat, BMI and muscle mass of both the senior and junior teams. This implies that the senior team has better musculature than the junior team. It was concluded that there is need for nutritional intervention and carbohydrate loading prior to performance to meet up the energy demand for daily training programme and during performance in order to improve performance ability of the senior basketball players.</jats:p

Risk factors of anemia among selected countries experiencing higher rate of under-5 mortality in sub-Saharan Africa: a three-way interaction model

Background: Over 1.8 million under-five mortality could be avoided each year if anemia is dealt with. No adequate information on the determinants of anemia among the sub-Saharan countries experiencing a higher after prevalence under-5 mortality. This study identified the risk factors of anemia among three sub-Saharan countries (Benin, Guinea and Nigeria).Methods: A total of 24137 records from the 2018 demographic and health survey. The outcome variable was anemia status (Anemic=1, not anemic=0). Measures of effects (AOR) were assessed using binary logistic regression and random-effect generalized linear model. Stata MP 16 was used for the data analysis.Results: Anemia was found to be common among children in Nigeria (ENREF 59.4%), Benin (58.2%), and Guinea (46.0%). Children (&lt;6 months) had higher risk of anemia (AOR: 1.20, 95% CI: 1.05-1.37). Intake of drugs for the treatment of intestinal parasites during pregnancy was found to be protective against anemia in Nigeria (AOR: 0.85, 95% CI: 0.89-0.97) and Guinea (AOR: 0.76, 95% CI: 0.63-0.91). Main cooking fuel: Kerosene (AOR: 1.32, 95% CI: 1.05-1.65) and firewood (AOR: 1.46, 95% CI: 1.17-1.81) were associated with a higher risk of anemia.Conclusions: Children of younger age (&lt;6 months) deserve priority attention in the battle against anemia. Intake of drugs for intestinal parasites during pregnancy presents a potentially impactful strategy for anemia prevention among under-5 children in addition to routine deworming and treatments. Also, rural residents, users of kerosene and firewood as main cooking fuel, and users of unprotected well as main source of drinking water needs attention in the awareness and campaigns against under-5 anemia.</jats:p