scholarly journals Multiple and complex links between babyWASH and stunting: an evidence synthesis

2020 ◽  
Vol 10 (4) ◽  
pp. 786-805
Author(s):  
Amy Waller ◽  
Monica Lakhanpaul ◽  
Samuel Godfrey ◽  
Priti Parikh
Keyword(s):  
Evidence Synthesis ◽  
Behavioural Change ◽  
Field Trials ◽  
Sub Saharan Africa ◽  
Mixed Data ◽  
Biological Mechanisms ◽  
Transmission Cycle ◽  
Sanitation And Hygiene ◽  
Sub Saharan ◽  
Randomised Controlled

Abstract Studies have shown linkages between water, sanitation and hygiene (WASH) and stunting in children under 2 years in sub-Saharan Africa. WASH interventions have been shown to reduce stunting rates; however, the biological mechanisms and socio-economic influences responsible for this trend remain poorly understood. This paper reviews the literature regarding these links, and the efficacy of both general WASH interventions and those targeted at children in their first 1,000 days, known as babyWASH, for stunting reduction. Fifty-nine papers published between 2008 and 2019 were reviewed, retrieved from Science Direct, Scopus and Web of Science databases, comprising field trials and data analysis, and literature and systematic reviews. Key findings showed that stunting is directly attributed to diarrhoea, environmental enteric dysfunction and undernutrition although a more comprehensive understanding of these biological mechanisms is necessary. Interventions to interrupt the faecal transmission cycle proved to effectively reduce stunting rates, particularly improved sanitation facilities to reduce open defaecation, increased proximity to water and widespread behavioural change. Methodologies should move away from randomised controlled trials towards selected contexts, mixed data collection methods and inclusion of broader social, cultural and environmental conditions. Improved cross-sectoral collaboration is encouraged, particularly to ensure the complexity of social and contextual factors is fully considered.

scholarly journals Cash Transfers and Child Nutrition: Evidence from sub-Saharan Africa

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Oladayo Nathaniel Awojobi
Keyword(s):  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Child Nutrition ◽  
Cash Transfers ◽  
Cash Transfer ◽  
Sub Saharan Africa ◽  
Controlled Trials ◽  
Sub Saharan ◽  
Randomised Controlled ◽  
Nutritional Outcomes

This paper summarises the arguments and counterarguments within the scientific discussion on cash transfers and child nutrition. The main purpose of the research is to assess the effectiveness of cash transfers in improving nutritional outcomes in vulnerable children in sub-Saharan Africa. Systematisation of the literary sources indicates that studies have justified cash transfer as social-income support that addresses a vital social determinant of health (income) for children in low-and-middle-income countries. The methodological basis of this study is a systematic review that searched a wide range of academic and grey literature databases, including PubMed, Cochrane Library and Google Scholar. This study included cluster-randomised controlled trials (R.C.T.s), randomised controlled trials, quasi-experimental studies, mixed-methods studies, and non-randomised cluster trials. Studies included in this systematic review were screened for their eligibility. The systematic review uses the Cochrane data collection form to extract data from the included studies. It was not feasible to statistically combine the results of the studies due to the heterogeneity of most of the studies. Preferably, the review employs a narrative synthesis to present the estimated effects of cash transfers on children’s nutritional outcomes. The systematic review presents the results of data synthesis, of which eleven studies met the inclusion criteria. Overall, the evidence from the systematic review indicates that cash transfer programmes targeted at children effectively improve anthropometric and nutritional outcomes. Further research is needed to spell out the multiple pathways to how cash transfers improve children’s nutritional outcomes. Moreover, this systematic review shows the importance of cash transfers in improving child nutrition. Policymakers should continue to employ institutional mechanisms to strengthen the nutritional status of children, especially the vulnerable ones since cash transfer intervention is a temporary measure.

scholarly journals PO 8719 INTRODUCING A NEW AFRICA MENINGITIS NETWORK – A NORTH-SOUTH COLLABORATION

2019 ◽  
Vol 4 (Suppl 3) ◽  
pp. A63.1-A63
Author(s):  
Mosepele Mosepele ◽  
Cecilia Kanyama ◽  
David Meya ◽  
Fiona Cresswell ◽  
Timothee Chammard ◽  
...  
Keyword(s):  
Treatment Strategies ◽  
Sub Saharan Africa ◽  
High Dose ◽  
Diagnostic Strategies ◽  
Cns Infections ◽  
Study Protocols ◽  
Sub Saharan ◽  
Novel Treatment Strategies ◽  
Set Up ◽  
Randomised Controlled

BackgroundCentral nervous system infections, including meningitis, continue to cause significant morbidity in Africa. HIV has contributed to the epidemiology of CNS infections in this setting. Notable advances in the study of CNS infections by several groups have demonstrated the utility of new diagnostic strategies and impact of novel treatment strategies. However, efforts to coordinate meningitis research in Africa, and between Africa and the rest of the world remain very limited.MethodsIn a bid to promote a coordinated study of CNS infections across Africa, and in collaboration with other meningitis groups globally, the researchers of the AMBITION study (High Dose Ambisome on a Fluconazole Backbone for Cryptococcal Meningitis Induction Therapy in Sub-saharan Africa: A Randomised Controlled Non-inferiority Trial) are leveraging the EDCTP support for the AMBITION trial to set up an Africa Meningitis Trials Network.ResultsThe Africa Meningitis Trials Network (AMNET) was launched in Malawi in early 2018. Main achievements since the launch of the network, include an internal review of meningitis research across network sites and launch of the network website. The network also has two study protocols pending ethics review at all sites. These studies will provide much needed information on resources available for meningitis care, research and provide a baseline epidemiology of meningitis in Africa.ConclusionAMNET provides a rare opportunity for investigators interested in meningitis research to leverage the ongoing AMBITION trial to conduct Africa-wide preliminary research on meningitis. The network is recruiting additional members in Africa and globally to collaborate on meningitis research, and also apply for research funding to support meningitis work. Anyone interested in knowing more about the network should contact the AMNET communications officer, Ms Phum’lani Machao, [email protected]

scholarly journals Evidence for pulmonary rehabilitation in chronic respiratory diseases in sub-Saharan Africa: a systematic review

2020 ◽  
Vol 24 (10) ◽  
pp. 991-999
Author(s):  
F. M. Bickton ◽  
C. Fombe ◽  
E. Chisati ◽  
J. Rylance
Keyword(s):  
Pulmonary Rehabilitation ◽  
Respiratory Diseases ◽  
Sub Saharan Africa ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Chronic Respiratory Diseases ◽  
Exercise Regimen ◽  
Home Based ◽  
Sub Saharan ◽  
Randomised Controlled

BACKGROUND: Pulmonary rehabilitation (PR) is a highly effective non-pharmacological treatment for patients with chronic respiratory diseases.OBJECTIVE: To synthesise the evidence for PR practice and efficacy in sub-Saharan Africa.METHODS: We searched in PubMed and Scopus for relevant studies and scanned reference lists of relevant studies from these databases for additional studies. Articles meeting the inclusion criteria were included. Pre-determined data were extracted independently by two reviewers. A narrative synthesis approach was used in the interpretation of findings.RESULTS: Six studies were included, totalling 275 participants. Indications for PR were chronic obstructive pulmonary disease, asthma, pulmonary tuberculosis and post-tuberculosis lung disease. Programmes ran for 6–12 weeks, universally incorporated exercise, and variously used home-based and hospital-based delivery models. All were interventional studies, of which two were randomised controlled trials, and primarily reported pulmonary function and exercise tolerance endpoints. Evidence for individualising the exercise regimen was available in three studies.CONCLUSIONS: There is limited evidence on PR design and efficacy in sub-Saharan Africa, but available data support its use in a variety of chronic respiratory conditions. Future studies should report core outcome sets and their individualised exercise and education regimens.

scholarly journals Water, sanitation and hygiene (WASH) in sub-Saharan Africa and associations with undernutrition, and governance in children under five years of age: a systematic review

2020 ◽  
pp. 1-28 ◽  
Author(s):  
D. J. Momberg ◽  
B. C. Ngandu ◽  
L. E. Voth-Gaeddert ◽  
K. Cardoso Ribeiro ◽  
J. May ◽  
...  
Keyword(s):  
Systematic Review ◽  
Water Source ◽  
The State ◽  
Sub Saharan Africa ◽  
Human Right ◽  
Poor Child ◽  
Child Undernutrition ◽  
Sanitation And Hygiene ◽  
Health Related ◽  
Sub Saharan

Abstract Associations between different forms of malnutrition and environmental conditions, including water, sanitation and hygiene (WASH), may contribute towards persistently poor child health, growth and cognitive development. Experiencing poor nutrition in utero or during early childhood is furthermore associated with chronic diseases later in life. The primary responsibility for provision of water and sanitation, as a basic service and human right, lies with the State; however, a number of stakeholders are involved. The situation is most critical in sub-Saharan Africa (SSA), where, in 2015, 311 million people lacked a safe water source, and >70% of SSA populations were living without adequate sanitation. The aim of this paper was to conduct a systematic review to investigate the state of literature concerned with WASH and its association with nutritional status, and governance in children from birth to 5 years of age in SSA. Articles were sourced from PubMed Central, Science Direct and ProQuest Social Science databases published between 1990 and 2017. The PRISMA Statement was utilised and this systematic review is registered with PROSPERO (CRD42017071700). The search terms returned 15,351 articles for screening, with 46 articles included. This is indicative of a limited body of knowledge; however, the number of publications on this topic has been increasing, suggesting burgeoning field of interest. Targeted research on the governance of WASH through the identification of the various role players and stakeholders at various levels, while understanding the policy environment in relation to particular health-related outcomes is imperative to address the burden of child undernutrition.

scholarly journals Efficacy of a cry1Ab Gene for Control of Maruca vitrata (Lepidoptera: Crambidae) in Cowpea (Fabales: Fabaceae)

2020 ◽  
Vol 113 (2) ◽  
pp. 974-979
Author(s):  
Prince C Addae ◽  
Mohammad F Ishiyaku ◽  
Jean-Batiste Tignegre ◽  
Malick N Ba ◽  
Joseph B Bationo ◽  
...  
Keyword(s):  
Insect Pests ◽  
Field Trials ◽  
Genetically Engineered ◽  
Maruca Vitrata ◽  
Sub Saharan Africa ◽  
High Dose ◽  
Cry1ab Protein ◽  
Cry1ab Gene ◽  
Pod Borer ◽  
Sub Saharan

Abstract Cowpea [Vigna unguiculata (L) Walp.] is an important staple legume in the diet of many households in sub-Saharan Africa. Its production, however, is negatively impacted by many insect pests including bean pod borer, Maruca vitrata F., which can cause 20–80% yield loss. Several genetically engineered cowpea events that contain a cry1Ab gene from Bacillus thuringiensis (Bt) for resistance against M. vitrata were evaluated in Nigeria, Burkina Faso, and Ghana (West Africa), where cowpea is commonly grown. As part of the regulatory safety package, these efficacy data were developed and evaluated by in-country scientists. The Bt-cowpea lines were planted in confined field trials under Insect-proof netting and artificially infested with up to 500 M. vitrata larvae per plant during bud formation and flowering periods. Bt-cowpea lines provided nearly complete pod and seed protection and in most cases resulted in significantly increased seed yield over non-Bt control lines. An integrated pest management strategy that includes use of Bt-cowpea augmented with minimal insecticide treatment for protection against other insects is recommended to control pod borer to enhance cowpea production. The insect resistance management plan is based on the high-dose refuge strategy where non-Bt-cowpea and natural refuges are expected to provide M. vitrata susceptible to Cry1Ab protein. In addition, there will be a limited release of this product until a two-toxin cowpea pyramid is released. Other than South African genetically engineered crops, Bt-cowpea is the first genetically engineered food crop developed by the public sector and approved for release in sub-Saharan Africa.

scholarly journals Data-driven analyses of behavioral strategies to eliminate cysticercosis in sub-Saharan Africa

2021 ◽  
Vol 15 (3) ◽  
pp. e0009234
Author(s):  
Laura A. Skrip ◽  
Veronique Dermauw ◽  
Pierre Dorny ◽  
Rasmané Ganaba ◽  
Athanase Millogo ◽  
...  
Keyword(s):  
Behavioral Interventions ◽  
Human Exposure ◽  
Taenia Solium ◽  
Public Health Problem ◽  
Sub Saharan Africa ◽  
P Value ◽  
Behavioral Strategies ◽  
Sanitation And Hygiene ◽  
Neurological Morbidity ◽  
Sub Saharan

Background The multi-host taeniosis/cysticercosis disease system is associated with significant neurological morbidity, as well as economic burden, globally. We investigated whether lower cost behavioral interventions are sufficient for local elimination of human cysticercosis in Boulkiemdé, Sanguié, and Nayala provinces of Burkina Faso. Methodology/Principal findings Province-specific data on human behaviors (i.e., latrine use and pork consumption) and serological prevalence of human and pig disease were used to inform a deterministic, compartmental model of the taeniosis/cysticercosis disease system. Parameters estimated via Bayesian melding provided posterior distributions for comparing transmission rates associated with human ingestion of Taenia solium cysticerci due to undercooking and human exposure to T. solium eggs in the environment. Reductions in transmission via these pathways were modeled to determine required effectiveness of a market-focused cooking behavior intervention and a community-led sanitation and hygiene program, independently and in combination, for eliminating human cysticercosis as a public health problem (<1 case per 1000 population). Transmission of cysticerci due to consumption of undercooked pork was found to vary significantly across transmission settings. In Sanguié, the rate of transmission due to undercooking was 6% higher than that in Boulkiemdé (95% CI: 1.03, 1.09; p-value < 0.001) and 35% lower than that in Nayala (95% CI: 0.64, 0.66; p-value < 0.001). We found that 67% and 62% reductions in undercooking of pork consumed in markets were associated with elimination of cysticercosis in Nayala and Sanguié, respectively. Elimination of active cysticercosis in Boulkiemdé required a 73% reduction. Less aggressive reductions of 25% to 30% in human exposure to Taenia solium eggs through sanitation and hygiene programs were associated with elimination in the provinces. Conclusions/Significance Despite heterogeneity in effectiveness due to local transmission dynamics and behaviors, education on the importance of proper cooking, in combination with community-led sanitation and hygiene efforts, has implications for reducing morbidity due to cysticercosis and neurocysticercosis.

scholarly journals An Overview of Cholera Epidemiology: A Focus on Africa; with a Keen Interest on Nigeria

2020 ◽  
pp. 1-17
Author(s):  
Tarh, Jacqueline Ebob
Keyword(s):  
Local Government ◽  
Task Force ◽  
Case Fatality ◽  
Sub Saharan Africa ◽  
Polluted Water ◽  
The People ◽  
Sanitation And Hygiene ◽  
The World ◽  
Sub Saharan ◽  
Sanitary Conditions

Cholera is still a problem in the world today. A huge population of deaths due to cholera disease still occur in Sub-Saharan Africa (Nigeria most especially), Asia, the Americas and other developing countries, where approximately 1.7 billion inhabitants are still served by faecally polluted water sources. Approximately, 2.4 billion inhabitants of these areas of the world lack the majorly required sanitary conditions of living. Legros, asserts that, as of 2019, about forty-seven countries of the globe, are still affected by cholera. Raw or undercooked, contaminated seafood, serves as a vehicle for the transmission (especially to non-endemic areas). A Case Fatality Rate of 4.87% was recorded from 34 Local Government Areas of Bauchi, Borno, Kaduna, Kano and Zamfara state in Nigeria by the 34th week, in 2018, while 298 confirmed cases and 38 deaths (CFR 1.5%) were recorded from three Local Government Areas in two States (Adamawa & Borno) by Epidemiological week 41 in 2019. Cholera in some cases is regarded as a “disease of the poor” because the populations most affected are those that cannot afford to provide the basic health facilities for themselves. For example, waste management systems, and good accommodation with toilet facilities (the living and health conditions of the people) are wanting. In 2017, A Global Roadmap to 2030 was launched by the Global Task Force on Cholera Control (GTFCC Ending Cholera) to decrease the death rate due to cholera by 90%. By so doing, the disease can be eradicated from at least half of the 47 cholera-affected countries. The objectives of this roadmap are: to fortify health systems, water, sanitation and hygiene (WASH), and to coordinate different ways by which cholera can be controlled in these countries by 2030 (ensuring early detection and prompt response to contain outbreaks). This review aimed to understand the epidemiology of cholera in Nigeria, Africa and the world at large, to access the level of spread, management and preventive measures so far implemented in the endemic regions.

scholarly journals INFLUENCE OF DIETARY INTAKES, ‘WASH’ AND DIARRHEAL MORBIDITY ON STUNTING AMONG CHILDREN BELOW FIVE YEARS IN NAKURU COUNTY: A CASE STUDY OF KAPTEMBWO AND MILIMANI, KENYA

2020 ◽  
Vol 1 (2) ◽  
Author(s):  
Daniel Matoke Ayienda ◽  
Muthuka J. Kyalo ◽  
Job O. Mapesa ◽  
Lawrence Mugambi ◽  
Eglah J. Kiplagat
Keyword(s):  
Descriptive Analysis ◽  
Sub Saharan Africa ◽  
Eastern Africa ◽  
Dietary Intakes ◽  
Risk Of Death ◽  
Sanitation And Hygiene ◽  
Significant Difference ◽  
Sub Saharan ◽  
Adult Earnings ◽  
High Level

Stunting is the most prevalent and pervasive form of under nutrition worldwide. In 2019, an estimate of 144 million (21.3%) of children under the age of 5 years are stunted globally. In sub-Saharan Africa, 34% of children fewer than 5 years are stunted and the burden of stunting is most prevalent in the Eastern Africa region with 37% (FAO, 2017). In Kenya, out of a total of 7 million under 5 years, 1.82 million (26%) children are suffering from stunting; out of which 11.4% are severely stunted. Stunting is associated with greater risk of death from infectious diseases in childhood, poorer cognition, poorer educational outcomes and lower adult earnings. The study population was a total of 314 children aged 0-59 months. Data was collected using survey CTO questionnaire. Use of pesticides, hygiene practices and sanitation (human waste disposal), hand washing practices, water sources and means of water treatment were examined and adequately described in relation to EED and stunting. Survey CTO programme was installed in tablets and or smart phones, in which a questionnaire with closed ended questions was programmed and used to collect a no-paper work data. The Survey CTO programmed questionnaire only allowed the researcher to key in a response for one question before moving to the next question. Data was analyzed using SPSS version 22 software. Descriptive analysis was done using SPSS while regression was done using STATA. There was no significant difference in dietary intakes between children in Kaptembwo and Milimani, and that the dietary intakes in both Milimani and Kaptembwo were adequate and balanced. Out of 202 children sampled in Kaptembwo, 40.59% had experienced diarrhea in the last four weeks to data collection while out of 112 children sampled in Milimani, only 17% had experienced diarrhea in the last four weeks. In spite of the same dietary intakes in Kaptembwo and Milimani, stunting is high in Kaptembwo than in Milimani. Out of a total of 314 children sampled, 25% were stunted in Kaptembwo, while only 3.33% were stunted in Milimani. Diarrhea increases loss of dietary nutrients thereby making the nutrients required for growth inadequate. High level of stunting in Kaptembwo is associated with poor environmental conditions (poor sanitation and hygiene) which contribute to diarrhea. Diarrhea could be key contributor to Environmental Enteric Dysfunction (EED), which is too a contributor to stunting. It is recommended that residents of Kaptembwo and Milimani are educated on the importance of good sanitation and hygiene in order to curb diarrhea, which is a contributor to the development of EED. In the same spirit, understand the importance of proper use of pesticides. Experimental research was done in the same area involving the use of biological markers for EED. <p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/edu_01/0720/a.php" alt="Hit counter" /></p>

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