Assessment of the knowledge, attitude and practice of health care workers in Fako Division on post exposure prophylaxis to blood borne viruses: a hospital based cross-sectional study

Introduction: accidental exposure to blood and body fluid presents a serious public health concern, especially among healthcare workers (HCW) and constitutes a risk of transmission of blood borne viruses. Infections acquired through occupational exposure are largely preventable through strict control measures such as the use of safe devices, proper waste disposal, immunization and prompt management of exposures including the use of Post Exposure Prophylaxis. This study aimed to assess the knowledge, attitude and practice of healthcare workers on post exposure prophylaxis and also determine the factors influencing reporting of occupational exposures among HCW in Fako Division, Cameroon. Methods: this was a hospital based cross-sectional study conducted from February 2016 to July 2016 involving the administration of questionnaires to 216 health care workers in Fako division. Data collected was analyzed with SPSS version 22 and results presented as percentages and tables. Pearson chi-square test was used to determine statistically significant relationship between different factors with reporting of occupational exposures among health care workers in Fako division. Results: a high proportion of participants 125(58%) had poor knowledge on Post Exposure Prophylaxis and 131(60.6%) of participants proved to have a positive attitude towards post exposure prophylaxis. 50.9% (110/216) of all participants had at least one occupational exposure with a low uptake 19.1(21/110) of Post Exposure Prophylaxis recorded among participants who were exposed. There was a statistically significant relationship between years of experience (p-value = 0.006, CI= 0.151-0.745) and category of health care worker (p-value= 0.022, CI=0.314-14.215) with reporting of occupational exposure (p-value< 0.05). Conclusion: this study recorded among participants a poor knowledge on post exposure prophylaxis and poor practice though a majority of study participants had possitive attitude towards PEP. Therefore, a formal training for all health care workers on post exposure prophylaxis to blood borne viruses, strict monitoring and evaluation of health care worker's adherence to standard precautions, adequate reporting of exposures and uptake of post exposure prophylaxis is recommended

A cross-sectional survey on the prevalence of anaemia and malnutrition in primary school children in the Tiko Health District, Cameroon

Introduction: anaemia and malnutrition are common health problems in developing countries with children being the most vulnerable. They have negative impacts on human performance, growth and development, in children, both as cause and consequences of disease. Although annual mass deworming and nutrition supplement strategies have been implemented in the Tiko Health District (THD), no study has been carried out to determine the prevalence of anaemia and malnutrition. The aim of this study was therefore designed to determine the prevalence of anaemia and malnutrition among primary school children aged 5-15 years in the Tiko Health District. Methods: a cross-sectional study was carried out in 10 randomly selected schools in the THD and a total of 400 school children were enrolled in the study. Body weight and height were measured using an electronic weighing scale and stadiometer respectively. Anthropometric indices: Height-for-Age Z scores (HAZ), Weight-for-Age Z scores (WAZ) and Body Mass Index-for-Age Z scores (BMIAZ) were analyzed and compared with WHO Growth Reference Standards using WHO Anthroplus software. Hemoglobin levels were determined using Urit-12 Haemoglobinometer and anaemia defined as Hemoglobin (Hb) < 11g/dl. Data analysis was done using the SPSS software. Results: the overall prevalence of malnutrition was 9.25%, prevalence of stunting 7.5% with 0.8% being severely stunted. The prevalence of wasting was 1% and underweight 0.7%. The overall prevalence of anaemia was 5%. Parents occupation and the absence of toilet were statistically associated with anaemia (P = 0.04 and P = 0.003). Age, floor type, absence of toilet and BMI were significantly associated with malnutrition (P = 0.00, P = 0.01, P = 0.02 and P = 0.003). Conclusion: this study revealed a low prevalence of malnutrition and anaemia which could be attributed to the deworming and nutrition supplement strategies which have been implemented

Mild-to-Moderate Kidney Dysfunction and Cardiovascular Disease: Observational and Mendelian Randomization Analyses

BACKGROUND: End-stage renal disease is associated with a high risk of cardiovascular events. It is unknown, however, whether mild-to-moderate kidney dysfunction is causally related to coronary heart disease (CHD) and stroke. METHODS: Observational analyses were conducted using individual-level data from 4 population data sources (Emerging Risk Factors Collaboration, EPIC-CVD [European Prospective Investigation into Cancer and Nutrition-Cardiovascular Disease Study], Million Veteran Program, and UK Biobank), comprising 648 135 participants with no history of cardiovascular disease or diabetes at baseline, yielding 42 858 and 15 693 incident CHD and stroke events, respectively, during 6.8 million person-years of follow-up. Using a genetic risk score of 218 variants for estimated glomerular filtration rate (eGFR), we conducted Mendelian randomization analyses involving 413 718 participants (25 917 CHD and 8622 strokes) in EPIC-CVD, Million Veteran Program, and UK Biobank. RESULTS: There were U-shaped observational associations of creatinine-based eGFR with CHD and stroke, with higher risk in participants with eGFR values 105 mL·min-1·1.73 m-2, compared with those with eGFR between 60 and 105 mL·min-1·1.73 m-2. Mendelian randomization analyses for CHD showed an association among participants with eGFR 105 mL·min-1·1.73 m-2. Results were not materially different after adjustment for factors associated with the eGFR genetic risk score, such as lipoprotein(a), triglycerides, hemoglobin A1c, and blood pressure. Mendelian randomization results for stroke were nonsignificant but broadly similar to those for CHD. CONCLUSIONS: In people without manifest cardiovascular disease or diabetes, mild-to-moderate kidney dysfunction is causally related to risk of CHD, highlighting the potential value of preventive approaches that preserve and modulate kidney function

Mild-to-Moderate Kidney Dysfunction and Cardiovascular Disease: Observational and Mendelian Randomization Analyses

BACKGROUND: End-stage renal disease is associated with a high risk of cardiovascular events. It is unknown, however, whether mild-to-moderate kidney dysfunction is causally related to coronary heart disease (CHD) and stroke. METHODS: Observational analyses were conducted using individual-level data from 4 population data sources (Emerging Risk Factors Collaboration, EPIC-CVD [European Prospective Investigation into Cancer and Nutrition-Cardiovascular Disease Study], Million Veteran Program, and UK Biobank), comprising 648 135 participants with no history of cardiovascular disease or diabetes at baseline, yielding 42 858 and 15 693 incident CHD and stroke events, respectively, during 6.8 million personyears of follow-up. Using a genetic risk score of 218 variants for estimated glomerular filtration rate (eGFR), we conducted Mendelian randomization analyses involving 413 718 participants (25917 CHD and 8622 strokes) in EPIC-CVD, Million Veteran Program, and UK Biobank. RESULTS: There were U-shaped observational associations of creatinine-based eGFR with CHD and stroke, with higher risk in participants with eG FR values 105 mL.min(-1).1.73 m(-2), compared with those with eG FR between 60 and 105 mL.min(-1).1.73 m(-2). Mendelian randomization analyses for CHD showed an association among participants with eGFR 105 mL.min(-1).1.73 m(-2). Results were not materially different after adjustment for factors associated with the eGFR genetic risk score, such as lipoprotein(a), triglycerides, hemoglobin Alc, and blood pressure. Mendelian randomization results for stroke were nonsignificant but broadly similar to those for CHD. CONCLUSIONS: In people without manifest cardiovascular disease or diabetes, mild-to-moderate kidney dysfunction is causally related to risk of CHD, highlighting the potential value of preventive approaches that preserve and modulate kidney function

Additional file 1: of Increased body mass index may be associated with greater risk of end-stage renal disease in whites compared to blacks: a nested case–control study

Sensitivity analysis: predicted probabilities of incident ESRD for whites and blacks, plotted against BMI at age 21 between 18.5 and 35 kg/m 2 . BMI at age 21 was modeled using restricted cubic splines with 4 knots and excluding persons with BMI < 18.5 or > 35 kg/m2. The predicted probabilities of incident ESRD computed from multivariable logistic models were plotted against BMI at age 21. There is a monotonic increase in the probability of ESRD in both whites and blacks but the difference in slopes between the curves appears even greater than in Fig. 1. (PNG 61 kb

The Effect of Caloric Restriction and Aerobic Exercise on Serum FGF-23 in Patients with Moderate to Severe CKD

BACKGROUND Chronic kidney disease (CKD) is associated with elevated serum fibroblast growth factor 23 (FGF23) which correlates with increased cardiovascular risk. Prior data suggest serum FGF23 is also associated with increased adiposity. We tested the hypothesis that an intervention involving caloric restriction and aerobic exercise to reduce body weight would reduce serum FGF23 in patients with moderate to severe CKD. METHODS We performed a secondary analysis of data from a 2Χ2 factorial randomized trial enrolling 103 participants randomized to receive combined caloric restriction and aerobic exercise, caloric restriction alone, aerobic exercise alone, or usual care. Enrollees were persons with a median estimated glomerular filtration rate (eGFR) of 40.5 ml/min/1.73m2 (IQR: 30.3, 56.2). Measurements of Serum FGF23 (using C-terminal ELISA assay) and serum phosphate were obtained at baseline and month 4. Changes in serum FGF23 between baseline and month 4 across intervention arms were examined using analysis of covariance with robust standard errors. RESULTS After adjustment for baseline differences, serum FGF23 levels fell by 20.6% [95%CI: 0.4, 36.7, p = 0.047] more in the combined intervention arm compared to usual care. Further adjustment for baseline serum phosphate attenuated the relative difference in serum FGF23 decline between the combined intervention arm and usual care [percent change = -18.6, 95% CI: -35.3, 2.9; p = 0.10]. Caloric restriction or exercise alone did not demonstrate significantly greater decline in serum FGF23 compared to usual care. The median values of change in serum phosphate between baseline and month 4 among participants in the combined intervention and diet-only arms were -0.15 and 0.05 mg/dl whereas the exercise and usual care arms experienced no change in serum phosphate. Neither intervention arm showed a significantly greater percent change in serum phosphate from baseline to month 4 compared to usual care. CONCLUSION A combined 4-month calorie restriction and aerobic exercise intervention led to significant reductions in serum FGF23. The magnitude of serum FGF23 reduction appeared to be influenced in part by baseline serum phosphate levels while the latter remained relatively unchanged at the end of the trial. Funding Other NIH Suppor

A cross-sectional survey on the prevalence of anaemia and malnutrition in primary school children in the Tiko Health District, Cameroon

INTRODUCTION: Anaemia and malnutrition are common health problems in developing countries with children being the most vulnerable. They have negative impacts on human performance, growth and development, in children, both as cause and consequences of disease. Although annual mass deworming and nutrition supplement strategies have been implemented in the Tiko Health District (THD), no study has been carried out to determine the prevalence of anaemia and malnutrition. The aim of this study was therefore designed to determine the prevalence of anaemia and malnutrition among primary school children aged 5-15 years in the Tiko Health District. METHODS: A cross-sectional study was carried out in 10 randomly selected schools in the THD and a total of 400 school children were enrolled in the study. Body weight and height were measured using an electronic weighing scale and stadiometer respectively. Anthropometric indices: Height-for-Age Z scores (HAZ), Weight-for-Age Z scores (WAZ) and Body Mass Index-for-Age Z scores (BMIAZ) were analyzed and compared with WHO Growth Reference Standards using WHO Anthroplus software. Hemoglobin levels were determined using Urit-12 Haemoglobinometer and anaemia defined as Hemoglobin (Hb) < 11g/dl. Data analysis was done using the SPSS software. Results: The overall prevalence of malnutrition was 9.25%, prevalence of stunting 7.5% with 0.8% being severely stunted. The prevalence of wasting was 1% and underweight 0.7%. The overall prevalence of anaemia was 5%. Parents occupation and the absence of toilet were statistically associated with anaemia (P = 0.04 and P = 0.003). Age, floor type, absence of toilet and BMI were significantly associated with malnutrition (P = 0.00, P = 0.01, P = 0.02 and P = 0.003). CONCLUSION: This study revealed a low prevalence of malnutrition and anaemia which could be attributed to the deworming and nutrition supplement strategies which have been implemented.http://www.panafrican-med-journal.compm2020School of Health Systems and Public Health (SHSPH

High tissue-sodium associates with systemic inflammation and insulin resistance in obese individuals.

BACKGROUND AND AIMS: High sodium intake is associated with obesity and insulin resistance, and high extracellular sodium content may induce systemic inflammation, leading to cardiovascular disease. In this study, we aim to investigate whether high tissue sodium accumulation relates with obesity-related insulin resistance and whether the pro-inflammatory effects of excess tissue sodium accumulation may contribute to such association. METHODS AND RESULTS: In a cross-sectional study of 30 obese and 53 non-obese subjects, we measured insulin sensitivity determined as glucose disposal rate (GDR) using hyperinsulinemic euglycemic clamp, and tissue sodium content using (23)Na magnetic resonance imaging. Median age was 48 years, 68% were female and 41% were African American. Median (interquartile range) BMI was 33 (31.5, 36.3) and 25 (23.5, 27.2) kg/m2 in the obese and non-obese individuals, respectively. In obese individuals, insulin sensitivity negatively correlated with muscle (r=-0.45, p=0.01) and skin sodium (r=-0.46, p=0.01). In interaction analysis among obese individuals, tissue sodium had a greater effect on insulin sensitivity at higher levels of high-sensitivity C-reactive protein (p-interaction= 0.03 and 0.01 for muscle and skin Na+, respectively) and interleukin-6 (p-interaction= 0.024 and 0.003 for muscle and skin Na+, respectively). In interaction analysis of the entire cohort, the association between muscle sodium and insulin sensitivity was stronger with increasing levels of serum leptin (p-interaction=0.01). CONCLUSIONS: Higher muscle and skin sodium are associated with insulin resistance in obese patients. Whether high tissue sodium accumulation has a mechanistic role in the development of obesity-related insulin resistance through systemic inflammation and leptin dysregulation remains to be examined in future studies. Clinicaltrials.gov registration: NCT02236520