Dietary Diversity Score during Pregnancy is Associated with Neonatal Low Apgar Score : A Hospital-Based Cross-Sectional Study

Background: Apgar score is an established index of neonatal well-being and development. Nutrition during pregnancy is an accepted risk factor for neonatal low Apgar score. Objective: To investigate the association between dietary diversity score and low Apgar score. Methods: This was a hospital based cross-sectional study. The study participants were 420 mothers who delivered and were attending the postnatal clinic at the Cape Coast Metropolitan Hospital. Mothers' dietary information during pregnancy was assessed with a food frequency questionnaire. In reference to the FAOs women's Dietary Diversity Score (DDS), the subjects were categorized into low, medium or high DDS. The primary outcome was Apgar score. Apgar scores <5 were classified as low. Results: The mean age (+/- standard deviation, SD) of subjects was 26.7 +/- 5.7 years with a range of 17 to 45 years. The prevalence of low Apgar score among the study population was 16.9%. Majority of the study participants had a low DDS in relation to low Apgar score whereas 7.5% had high DDS. After adjusting for potential confounding factors, the odds of low Apgar score in the low DDS group was three times higher than those who had high DDS (Adjusted odds ratio, AOR= 3.10, 95% confidence interval, CI=1.23-4.48). Conclusion: Dietary diversity score during pregnancy was associated with a low Apgar score in the study area. The results of this study reinforce the significance of adequate nutrition during pregnancy in the study area.Peer reviewe

An evaluation of COVID-19 surveillance system in New Juaben South Municipality of Ghana: a cross-sectional study

Introduction:&nbsp;among others, the objectives of Ghana’s COVID-19 surveillance system are to rapidly detect, test, isolate and manage cases, to monitor trends in COVID-19 deaths and to guide the implementation and adjustment of targeted control measures. We therefore aimed to examine the operations of the COVID-19 surveillance system in New Juaben South Municipality, describe its attributes and explore whether its objectives were being met. Methods:&nbsp;we utilized a mixed method descriptive study design to evaluate the COVID-19 surveillance system in the New Juaben South Municipality of the Eastern Region of Ghana. Desk review and key informant interviews were carried out from 1st&nbsp;February to 31st&nbsp;March 2021 to measure nine surveillance system attributes as an approximation of its performance using the CDC’s 2013 updated surveillance system guidelines. Results:&nbsp;while the COVID-19 surveillance system in New Juaben South (NJS) was highly representative of its population, it was rated ‘moderate’ for its stability, flexibility, sensitivity and acceptability. The system was however characterized by a low performance on data quality, simplicity, timeliness and predictive value positive. The sensitivity and predictive value positive (PVP) of the system were 55.6% and 31.3% respectfully. Conclusion:&nbsp;while the surveillance system is only partially meeting its objectives, it is useful in the COVID-19 response in New Juaben South Municipality. System performance could improve with stigma reduction especially among health care workers, timely testing and simplification of surveillance forms and software

The Conundrum of Low COVID-19 Mortality Burden in sub-Saharan Africa: Myth or Reality?

The burden of coronavirus disease (COVID-19) in sub-Saharan Africa (SSA) has been substantially lower compared to other regions of the world. Extensive morbidity and mortality were not observed among countries in SSA during the first wave of the COVID-19 pandemic. To explain this phenomenon, several hypotheses have been formulated, including the low median age of the population in most SSA countries, lack of long-term care facilities, cross-protection from other local coronaviruses, insufficient testing and reporting resulting in an undercounting of COVID-related deaths, genetic risk factors, or the benefit of early lockdowns that were extensive in many SSA countries. Early lockdowns in SSA have been some of the strictest and resulted in devastating economic and social consequences and increased mortality from other health-related problems including maternal deaths. We review the literature and rationale supporting the various hypotheses that have been put forward to account for relatively low hospitalization and death rates for COVID-19 in SSA. We conclude that the strongest evidence would support the demographic age structure with a very low median age as the primary factor in leading to the low mortality seen in the first wave of the pandemic. The impact of new variants of concern in SSA raises the risk of more severe waves. Nevertheless, furthering the understanding of the underlying explanations for the low morbidity and mortality seen across SSA countries may allow the adoption of unique strategies for limiting the spread of COVID-19 without the need for stringent lockdowns

Do dietary practices and household environmental quality mediate socioeconomic inequalities in child undernutrition risk in West Africa?

We investigated the relationship between socioeconomic status and child undernutrition in West Africa (WA), and further examined the mediating role of dietary practices (measured as Minimum Dietary Diversity [MDD], Minimum Meal Frequency [MMF], and Minimum acceptable diet [MAD]) and household environmental quality (HEQ) in the observed relationship. Thirteen countries were included in the study. We leveraged the most recent Demographic and Health Surveys datasets ranging from 2010 to 2019. Poisson regression model with robust standard errors was used to estimate prevalence ratios and their corresponding 95% CIs. Structural Equation Modelling was used to conduct the mediation analysis. West Africa. 132,448 under-five children born within five years preceding the survey were included. Overall, 32.5%, 8.2%, 20.1% and 71.7% of WA children were stunted, wasted, underweight and anaemic, respectively. Prevalence of undernutrition decreased with increasing maternal education and household wealth (Trend p-values < 0.001). Secondary or higher maternal education and residence in rich households were associated with statistically significant decrease in the prevalence of stunting, wasting, underweight and anaemia among children in WA. MAD was found to mediate the association of low maternal education and poor household wealth with childhood stunting and underweight by 35.9% to 44.5%. MDD, MMF and HEQ did not mediate the observed relationship. The study findings enables an evaluation and improvement of existing intervention strategies through a socioeconomic lens to help address the high burden of child undernutrition in WA and other developing regions

UNBOUND

UNBOUND showcases the graduating class from the fashion design school at Fanshawe College. We are pleased to present Unbound 2017! Our 11th Unbound theme embraces the concept of Craft and Machine , a blend of couturier techniques with technology. Unbound describes the creative spirit and achievements of our eighteen emerging Canadian fashion designers. Unbound 2017 is a professional collaboration between Fanshawe College, community and professionals in the fashion industry. As you turn the pages, admire their accomplishments - the results of three years of passion, hard work, and dedication.https://first.fanshawec.ca/famd_design_fashiondesign_unbound/1004/thumbnail.jp

Secular trends in low birth weight and child undernutrition in West Africa : evidence from complex nationwide surveys, 1985–2019

Objective: We present prevalence estimates and secular trends of stunting, wasting, underweight, and anaemia among children under 5 years of age and low birth weight (LBW) over the period 1985–2019 in West Africa (WA). Design: Analysis of Demographic and Health Survey (DHS) and World Bank data. DerSimonian–Laird random effect model with the Knapp–Hartung adjustment to the standard error was used to derive overall prevalence estimates. We used fixed effect ordinary least square regression models with cluster robust standard error to conduct time trends analyses. Setting: West Africa. Participants: Children aged 0 to 59 months. Results: Three distinct periods (1986–1990, 1993–1996 and 1997–2000) of sharp increases in prevalence of all outcomes was observed. After the year 2000, prevalence of all outcomes except LBW started to decline with some fluctuations. LBW prevalence showed a steady increase after 2000. We observed a decline in prevalence of stunting (β = –0·20 %; 95 % CI –0·43 %, 0·03 %), log-wasting (β = –0·02 %; 95 % CI –0·02 %, –0·01 %), log-underweight (β = –0·02 %; 95 % CI –0·03 %, –0·01 %) anaemia (β = –0·44; 95 % CI –0·55 %, –0·34 %), and an increase in LBW (β = 0·06 %; 95 % CI –0·10 %, 0·22 %) in WA over the period. Pooled prevalence of stunting, wasting, underweight, anaemia and LBW in WA for the period 1985–2019 was 26·1 %, 16·4 %, 22·7 %, 76·2 % and 11·3 %, respectively. Conclusions: Child undernutrition prevalence varied greatly between countries and the year cohorts. We observed marginal reductions in prevalence of all outcomes except anaemia where the reductions were quite striking and LBW where an increase was noted. There is the need for more rigorous and sustained targeted interventions in WA