Identification of Cis-regulatory Elements of Butyrophilin Gene of the Mammary Gland

Butyrophilin subfamily 1 member A1 is a highly expressed gene in  mammary gland of all mammals during lactation. It is found to be the major integral protein in the milk fat globule membrane. Its interactions with other membrane elements and soluble proteins of the mammary  epithelial cells regulate the secretion of milk fat. In order to reveal any shared cis-acting elements, the human butyrophilin subfamily 1member A1 5’-flanking genomic sequence was analyzed and compared with four mammals comprising of a rodent and three primates, viz., Mus musculus, and Pan troglodytes, Pongo obelli, and Macaca mulata, and three other mammary specific human milk genes using publicly available  bioinformatics tools. Prior to a multiple sequence analysis, low complexityDNA sequences were masked using CENSOR. The multiple sequence  analysis revealed nine highly conserved regions of similarities in the 5’- flanking region of butyrophilin genes across species. Consensus putative transcription factor binding sites were identified using MatInspector and compared with SiteGA results. They were subsequently examined for the expression in the mammary gland as well as for their occurrence in the previously identified region of homology. Finally, CCCTCbinding factor (CTCF) and nuclear receptor subfamily 2 - factor (NR2F) were identifiedat a similar distance from the transcription start site in the 5’- flanking region of butyrophilin gene across the species. However, the exact  interaction of these transcription factors with the butyrophilin gene is not known, which needs further investigation

Utilization of Deworming Drugs and Its Individual and Community Level Predictors among Pregnant Married Women in Cameroon: A Multilevel Modeling

Background. Although deworming pregnant women is one of the strategies to reduce parasites (roundworms and hookworms) causing anemia and related perinatal and maternal complications, utilization of deworming medication among pregnant women in Cameroon is suboptimal. Comprehensive assessment of individual, household (including women’s autonomy), and community-level factors associated with utilization of deworming medication has not been done so far. Therefore, we investigated the individual/household and community-level factors associated with deworming among pregnant married women in Cameroon. Methods. Our study was limited to pregnant women because they have a greater risk due to increased chances of anemia. We used data from the 2018/19 Cameroon Demographic and Health Survey. Analysis on 5,013 pregnant married women was carried out using multilevel logistic regression. Odds ratios with a 95% confidence interval (CI) were reported. Results. Our findings showed that about 29.8% of pregnant married women received deworming medications. The individual/household level predictors of deworming medications utilization identified in this study were women’s educational level, wealth quintile, and skilled antenatal care. Distance to health facility and region were identified as community-level predictors of deworming medications utilization. Higher odds of receiving deworming medication occurred among educated and wealthier pregnant married women as well as among pregnant married women who had skilled antenatal care or lived in the south region, whereas lower odds were observed among pregnant married women living in the north region. Conclusion. Access to education and economic empowerment of pregnant married women in remote areas and the north region should be the primary focus of the Cameroon government to enhance deworming coverage in the country

Determining Prevalence of Anemia and Its Associated Factors in Cameroon: A Multilevel Analysis.

BackgroundAnemia constitutes a major public health concern, which is associated with maternal and perinatal mortality. In low- and middle-income countries, the burden of anemia is profoundly high. Cameroon, as one of the low- and middle-income countries, has a disproportionate anemia burden. Factors associated with anemia prevalence are largely unknown in Cameroon. Hence, we determined the prevalence of anemia and its individual/household and community-level factors among adult women in Cameroon.MethodsWe derived data from the 2018 Cameroon Demographic and Health Survey for analysis in this study. Using the Stata version 14 software, univariate multilevel logistic regression analysis was used to select variables that had significant association with anemia at p ResultsA total of 6,809 women aged 15-49 years were involved in this study with a mean age 30 ± 11.87 years. Approximately two-fifths of women were anemic. Of them, 0.8% were severely anemic, while 17.4% and 21.5% were moderately and mildly anemic, respectively. Current employment status (yes AOR = 0.77, 95% CI; 0.61-0.96) and parity (1-2 children AOR = 0.61, 95% CI; 0.44-0.86) were the main individual level factors associated with anemia, whereas region (Douala region AOR = 2.65, 95% CI; 1.61-4.36, North-West region AOR = 0.53, 95% CI; 0.28-0.99) was the community-level factor associated with anaemia.ConclusionEmpowerment of women through employment opportunities as well as focusing special attention in region where high prevalence of anemia could be crucial to decrease the burden of anemia and related maternal and perinatal mortality in the country

Utilization of deworming medication and its associated factors among pregnant married women in 26 sub-Saharan African countries: a multi-country analysis

Background Deworming is one of the strategies to reduce the burden of anemia among pregnant women. Globally, pregnant women in sub-Saharan Africa are more affected by anemia. Therefore, this study examined both the coverage and demographic, socioeconomic, and women empowerment-related factors associated with the utilization of deworming medication among pregnant married women in sub-Saharan Africa. Methods We used data from the most recent Demographic and Health Surveys of 26 countries in sub-Saharan Africa conducted between 2010 and 2019. Using Stata version-14 software, analysis was done on 168,910 pregnant married women. Bivariate and multivariable logistic regression analyses were conducted to examine the factors associated with the utilization of deworming medication. The results were presented using adjusted odds ratios (aORs) at 95% confidence intervals (CIs). Results The pooled results showed that about 50.7% (95% CI 48.2–53.3%) of pregnant married women in the studied countries took deworming medications, and this varied from as high as 84.1% in Sierra Leone to as low as 2% in Angola. Regarding sub-regional coverage, the highest and lowest coverages were seen in East Africa (67.6%, 95% CI 66.0–69.1%) and West Africa (24.3%, 95% CI 22.4–26.4%) respectively. We found higher odds of utilization of deworming medication among older pregnant married women (aOR=1.93, 95% CI 1.32–2.84), women with educated husbands (aOR=1.40, 95% CI 1.11–1.77), wealthier women (aOR=3.12, 95% CI 1.95–4.99), women exposed to media (aOR=1.46, 95% CI 1.18–1.80), and those who had four or more antenatal care visits (aOR=1.51, 95% CI 1.24–1.83). Conclusions Enhancing women’s education, disseminating information about maternal healthcare services through mass media, and ensuring that women from economically disadvantaged households benefit from national economic growth can be considered as deworming medication improvement strategies in sub-Saharan Africa. Moreover, providing more attention to adolescents or young pregnant women and increasing the number of antenatal care visits could be considered to increase deworming uptake among pregnant married women

Does Birth Interval Matter in Under-Five Mortality? Evidence from Demographic and Health Surveys from Eight Countries in West Africa

In sub-Saharan Africa (SSA), every 1 in 12 children under five dies every year compared with 1 in 147 children in the high-income regions. Studies have shown an association between birth intervals and pregnancy outcomes such as low birth weight, preterm birth, and intrauterine growth restriction. In this study, we examined the association between birth interval and under-five mortality in eight countries in West Africa. A secondary analysis of the Demographic and Health Survey (DHS) data from eight West African countries was carried out. The sample size for this study comprised 52,877 childbearing women (15-49 years). A bivariate logistic regression analysis was carried out and the results were presented as crude odds ratio (cOR) and adjusted odds ratios (aOR) at 95% confidence interval (CI). Birth interval had a statistically significant independent association with under-five mortality, with children born to mothers who had >2 years birth interval less likely to die before their fifth birthday compared to mothers with ≤2 years birth interval [cOR = 0:56; CI = 0:51 − 0:62], and this persisted after controlling for the covariates [aOR = 0:55; CI = 0:50 − 0:61]. ]. The country-specific results showed that children born to mothers who had >2 years birth interval were less likely to die before the age of five compared to mothers with ≤2 years birth interval in all the eight countries. In terms of the covariates, wealth quintile, mother’s age, mother’s age at first birth, partner’s age, employment status, current pregnancy intention, sex of child, size of child at birth, birth order, type of birth, and contraceptive use also had associations with under-five mortality. We conclude that shorter birth intervals are associated with higher under-five mortality. Other maternal and child characteristics also have associations with under-five mortality. Reproductive health interventions aimed at reducing under-five mortality should focus on lengthening birth intervals. Such interventions should be implemented, taking into consideration the characteristics of women and their childre

Time trends, geographical, socio-economic, and gender disparities in neonatal mortality in Burundi: evidence from the demographic and health surveys, 2010-2016.

BackgroundProgrammatic and research agendas surrounding neonatal mortality are important to help countries attain the child health related 2030 Sustainable Development Goal (SDG). In Burundi, the Neonatal Mortality Rate (NMR) is 25 per 1000 live births. However, high quality evidence on the over time evolution of inequality in NMR is lacking. This study aims to address the knowledge gap by systematically and comprehensively investigating inequalities in NMR in Burundi with the intent to help the country attain SDG 3.2 which aims to reduce neonatal mortality to at least as low as 12 per 1000 live births by 2030.MethodsThe Burundi Demographic and Health Survey (BDHS) data for the periods of 2010 and 2016 were used for the analyses. The analyses were carried out using the WHO's HEAT version 3.1 software. Five equity stratifiers: economic status, education, residence, sex and subnational region were used as benchmark for measuring NMR inequality with time over 6 years. To understand inequalities from a broader perspective, absolute and relative inequality measures, namely Difference, Population Attributable Risk (PAR), Ratio, and Population Attributable Fraction (PAF) were calculated. Statistical significance was measured by computing corresponding 95% Confidence Intervals (CIs).ResultsNMR in Burundi in 2010 and 2016 were 36.7 and 25.0 deaths per 1000 live births, respectively. We recorded large wealth-driven (PAR = -3.99, 95% CI; - 5.11, - 2.87, PAF = -15.95, 95% CI; - 20.42, - 11.48), education related (PAF = -6.64, 95% CI; - 13.27, - 0.02), sex based (PAR = -1.74, 95% CI; - 2.27, - 1.21, PAF = -6.97, 95% CI; - 9.09, - 4.86), urban-rural (D = 15.44, 95% CI; 7.59, 23.29, PAF = -38.78, 95% CI; - 45.24, - 32.32) and regional (PAR = -12.60, 95% CI; - 14.30, - 10.90, R = 3.05, 95% CI; 1.30, 4.80) disparity in NMR in both survey years, except that urban-rural disparity was not detected in 2016. We found both absolute and relative inequalities and significant reduction in these inequalities over time - except at the regional level, where the disparity remained constant during the study period.ConclusionLarge survival advantage remains to neonates of women who are rich, educated, residents of urban areas and some regions. Females had higher chance of surviving their 28th birthday than male neonates. More extensive work is required to battle the NMR gap between different subgroups in the country

Association between Attitude towards Wife Beating and Childhood Diarrhea: A Demographic and Health Survey-Based Study in 25 Sub-Saharan African Countries.

BackgroundChildhood diarrhea remains a major public health problem in sub-Saharan Africa (SSA). Women empowerment reduces child mortality, and wife beating attitude is one of the indicators of women empowerment. There is a dearth of evidence about wife beating attitudes and childhood diarrhea in SSA. Therefore, the present study aimed to examine the association between attitude towards wife beating and diarrhea among under-five children.MethodsWe used Demographic and Health Surveys from 25 countries in SSA that were conducted between 2010 and 2020. Using Stata version 14 software, we carried out the analysis on 153,864 children under five. Bivariate and multivariate logistic regression analyses were applied, and the results were presented using adjusted odd ratios (aOR) at 95% confidence interval (CI).ResultsThe pooled results show that 71.4% of married women disagreed with wife beating. About 20.5% of under-five children of married women had diarrhea. Childhood diarrhea varied from highest prevalence in Chad (27.9%) to the lowest prevalence in Sierra-Leone (8.5%). The study showed lower odds of diarrhea among children of married women who disagreed with wife beating (aOR = 0.66 95% CI; 0.54-0.80) compared to children of married women who agreed with wife beating. Moreover, the study results show that women's age (35-39 years-aOR = 0.48, 95% CI; 0.31-0.74, 40-44 years-aOR = 0.57, 95% CI; 0.35-0.93, 45-49 years-aOR = 0.35, 95% CI; 0.16-0.79) was negatively associated with childhood diarrhea, while husband's education (primary school-aOR = 1.36, 95% CI; 1.05-1.77), parity (ever born 3-4 children-aOR = 1.36, 95% CI; 1.09-1.70, and 5+ children-aOR = 1.56, 95% CI; 1.14-2.12), and religion (Muslim-aOR = 3.56, 95% CI; 1.44-8.83) were positively associated with diarrhea among under-five children.ConclusionsThe study shows association between women attitude towards wife beating and childhood diarrhea. Therefore, empowering women, especially young women by increasing awareness about domestic violence, their rights, and empowering them through education and economic advancement need to be considered in order to reduce childhood diarrhea. Moreover, fertility control or birth spacing and working closely with religious leaders are important factors to consider in reducing childhood diarrhea

Individual-, household-, and community-level factors associated with pregnant married women's discriminatory attitude towards people living with HIV in sub-Saharan Africa: A multicountry cross-sectional study.

Background and Aims Discriminatory attitude towards people living with human immunodeficiency virus (HIV) remains a major problem in the prevention and treatment of HIV in sub-Sahara Africa (SSA). Understanding the multiple factors linked to discriminatory attitude towards people living with HIV/AIDS (PLWHA) in SSA is necessary for developing appropriate interventions. This study aimed at investigating the individual, household, and community-level factors associated with pregnant married women's discriminatory attitude towards people living with HIV/AIDS. Methods We used data from the Demographic and Health Surveys of 12 sub-Saharan African countries conducted between 2015 and 2019. Data on 17 065 pregnant married women were analyzed. Bivariate (chi-squared test) and multivariable multilevel logistic regression analyses were applied to investigate the factors associated with discriminatory attitude towards PLWHA. The results were reported as adjusted odds ratio (aOR) at 95% confidence interval (CI). Results The mean age of participants was 31.2 ± 8.5. The prevalence of discriminatory attitude towards PLWHA was 36.2% (95% CI: 33.4%-39.1%). Individual/household-level factors associated with discriminatory attitude towards PLWHA were women's educational level (secondary school-aOR = 0.49, 95% CI: 0.26-0.93), husband's educational level (higher education-aOR = 0.35, 95% CI: 0.16-0.76), decision-making power (yes-aOR = 0.51, 95% CI: 0.38-0.69), wife-beating attitude (disagreement with wife beating-aOR = 0.58, 95% CI: 0.43-0.79), and religion (Muslim-aOR = 1.92, 95% CI: 1.22-3.04). Community socioeconomic status (medium-aOR = 0.61, 95% CI: 0.41-0.93) was the only community-level factor associated with discriminatory attitude towards PLWHA. Conclusion More than one-third of pregnant married women in SSA had discriminatory attitude towards PLWHA. Women's educational level, husband's educational level, decision-making power, wife-beating attitude, religion, and community socio-economic status were associated with discriminatory attitude towards PLWHA. To lessen the prevalence of discriminatory attitude towards PLWHA, considering these significant factors is needed. Therefore, governments and other stakeholders in the respective countries need to increase education coverage. Moreover, empowering women through education and economy is crucial. Finally, working with religious leaders to increase awareness about HIV and discriminatory attitude towards PLWHA should also be a priority in SSA

Predictors of skilled birth attendance among married women in Cameroon: further analysis of 2018 Cameroon Demographic and Health Survey

Background In Cameroon, maternal deaths remain high. The high maternal deaths in the country have been attributed to the low utilization of maternal healthcare services, including skilled birth attendance. This study examined the predictors of skilled birth services utilization among married women in Cameroon. Methods Data from the 2018 Cameroon Demographic and Health Survey was analyzed on 7881 married women of reproductive age (15–49 years). Both bivariate and multivariable logistic regression analyses were carried out to determine the predictors of skilled childbirth services. The results were presented with crude odds ratio (cOR) and adjusted odds ratio (aOR) and 95% confidence interval (CI). Results The coverage of skilled birth attendance among married women of reproductive age in Cameroon was 66.2%. After adjusting for potential confounders, media exposure (aOR = 1.46, 95% CI: 1.11–1.91), higher decision making (aOR = 1.88, 95% CI: 1.36–2.59), maternal education (aOR = 2.38, 95% CI; 1.65–3.42), place of residence (aOR = 0.50, 95% CI; 0.33–0.74), religion (aOR = 0.55, 95% CI; 0.35–0.87), economic status (aOR = 5.16, 95% CI; 2.58–10.30), wife beating attitude (aOR = 1.32, 95% CI; 1.05–1.65), parity (aOR = 0.62, 95% CI; 0.41–0.93) and skilled antenatal care (aOR = 14.46, 95% CI; 10.01–20.89) were found to be significant predictors of skilled birth attendance. Conclusions This study demonstrates that social, economic, regional, and cultural factors can act as barriers to skilled childbirth services utilization in Cameroon. Interventions that target women empowerment, antenatal care awareness and strengthening are needed, especially among the rural poor, to reduce barriers to care seeking. Maternal healthcare services utilization interventions and policies in Cameroon need to focus on specific equity gaps that relate to socio-economic status, maternal education, and the economic empowerment of women. Such policies and interventions should also aim at reducing geographical barriers to access to maternal healthcare services, including skilled birth attendance. Due to the presence of inequities in the use of skilled birth attendance services, programs aimed at social protection and empowerment of economically disadvantaged women are necessary for the achievement of the post-2015 targets and the Sustainable Development Goals

Individual/Household and Community-Level Factors Associated with Child Marriage in Mali: Evidence from Demographic and Health Survey

Background. Child marriage is a major public health problem globally, and the prevalence remains high in sub-Saharan African countries, including Mali. There is a dearth of evidence about factors associated with child marriage in Mali. Hence, this studyaimed at investigating the individual/household and community-level factors associated with child marriage among women in Mali. Methods. Using data from the 2018 Mali Demographic and Health Survey, analysis was done on 8,350 women aged 18-49 years. A Chi-square test was used to select candidate variables for the multilevel multivariable logistic regression models. Fixed effects results weree xpressed as adjusted odds ratios (aOR) at 95% confidence intervals (CI). Stata version 14 software was used for the analysis. Results. The results showed that 58.2% (95% CI; 56.3%-60.0%) and 20.3% (95%; 19.0%-21.6%) of women aged 18-49 years were married before their 18th and 15th birthday, respectively. Educational status of women (higher education: , 95% CI; 0.14-0.44), their partner’s/husband’s educational status (higher education: , 95% CI; 0.47-0.87), women’s occupation (professional, technical, or managerial: , 95% CI; 0.33-0.77), family size (five and above: , 95% CI; 1.03-1.30), and ethnicity (Senoufo/Minianka: , 95% CI; 0.58-0.92) were the identified individual/household level factors associated with child marriage, whereas region (Mopti: , 95% CI; 0.19-0.39) was the community level factor associated with child marriage. Conclusions. This study has revealed a high prevalence of child marriage in Mali. To reduce the magnitude of child marriage in Mali, enhancing policies and programs that promote education for both girls and boys, creating employment opportunities, improving the utilization of family planning services, and sensitizing girls and parents who live in regions such as Kayes on the negative effects of child marriage is essential. Moreover, working with community leaders so as to reduce child marriage in the Bambara ethnic communities would also be beneficial