Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4 (62.3 (55.1�70.8) million) to 6.4 (58.3 (47.6�70.7) million), but is predicted to remain above the World Health Organization�s Global Nutrition Target of <5 in over half of LMICs by 2025. Prevalence of overweight increased from 5.2 (30 (22.8�38.5) million) in 2000 to 6.0 (55.5 (44.8�67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic. © 2020, The Author(s)

Author Correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017 (Nature Medicine, (2020), 26, 5, (750-759), 10.1038/s41591-020-0807-6)

An amendment to this paper has been published and can be accessed via a link at the top of the paper. © 2020, The Author(s)

Author Correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017 (Nature Medicine, (2020), 26, 5, (750-759), 10.1038/s41591-020-0807-6)

An amendment to this paper has been published and can be accessed via a link at the top of the paper. © 2020, The Author(s)

Detection of Plasmodium falciparum chloroquine resistance transporter (PfCRT) mutant gene amongst malaria-infected pregnant women in Calabar, Nigeria

Chemotherapy is the mainstay in malaria control and management. For some time, chloroquine (CQ) was a drug of choice for the treatment of malaria. It was effective against all forms of malaria, cheap and readily available. The increased resistance of malaria parasites to CQ led to widespread abandonment of the drug in African and Asian countries on the prompting of the World Health Organization. Currently, artemisinin-based combination therapy is the gold standard for the treatment of malaria. This study investigates the presence of the Plasmodium falciparum Chloroquine Resistance Transporter (PfCRT) mutant gene, a molecular marker responsible for CQ resistance in malaria parasites. A total of 369 pregnant women were microscopically screened for malaria infection using thin and thick blood films stained with Giemsa. Subsequently, malaria parasite DNA was extracted from the blood of malaria positive participants. The PfCRT gene was amplified using Polymerase Chain Reaction (PCR). A Restriction Fragment Length Polymorphism analysis of the gene was performed to confirm mutant forms. The results showed that 251 (68.0%) of the participants had Plasmodium falciparum in their blood. Molecular examination revealed the presence of PfCRT mutant genes in 28% of the study population. Notwithstanding the decline in the prevalence of PfCRT T76 mutation since the antimalarial policy change in Nigeria, the 28% prevalence recorded in this study is considered high after ten years of the withdrawal of CQ in the treatment of uncomplicated malaria

Economic evaluations of digital health interventions for the management of musculoskeletal disorders: a systematic review and meta-analysis

Background: Musculoskeletal disorders (MSDs) are widespread in many countries and its huge burden has necessitated innovative approaches such as digital health interventions. However, no study has evaluated the findings of cost-effectiveness of these interventions. Objective: This study was aimed to synthesise the cost-effectiveness of digital health interventions for people with MSDs. Methods: Electronic databases including Medline, AMED, CIHAHL, PsycINFO, Scopus, Web of Science, and Centre for Review and Dissemination were searched for cost-effectiveness of digital health published between inception to June 2022 following the Systematic Reviews and Meta-Analysis guideline (PRISMA). References of all retrieved articles were checked for relevant studies. Quality appraisal of the included studies was done using the Quality of Health Economic Studies (QHES) instrument. Results were presented using a narrative synthesis and random effects meta-analysis. Results: Ten studies from six countries met the inclusion criteria. Using QHES, we found that the mean score of the overall quality of the included studies was 82.5. Included studies were on non-specific chronic low back pain (n = 4), chronic pain (n = 2), knee and hip osteoarthritis (n = 3) and Fibromyalgia (n = 1). The economic perspectives adopted in the included studies were societal (n = 4), societal and healthcare (n = 3) and healthcare (n = 3). Of the ten included studies 5 (50%) of them used quality-adjusted life years as the outcome measures. Except one study, all the included studies reported that digital health interventions were cost effective compared to the control group. In a random effects meta-analysis (n = 2), the pooled disability and Quality-Adjusted Life-Year (QALY) were (-0.176 95% CI -0.317 to -0.035, p = 0.014) and (3.855 95% CI 2.023 to 5.687, p < 0. 001), respectively. The meta-analysis (n = 2) for the costs were in favour of the digital health intervention compared to control (-USD417.52 95% CI -522.01 to – 313.03). Conclusion: Studies indicate that digital health interventions are cost-effective for people with MSDs. The findings suggest that digital health intervention could help improve access to treatment for patients with MSDs and as a result improving their health outcomes. Clinicians and policy makers should consider the use of these interventions for patients with MSDs

Clinical and economic burden of low back pain in low- and middle-income countries: a systematic review

Objectives: Low back pain (LBP) is the leading cause of disability and work absenteeism globally, and it poses significant clinical and economic burden to individuals, health systems and the society. This study aimed to synthesise the clinical and economic burden of LBP in Low- and Middle-Income Countries (LMICs). Methods: A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed. PubMed, Medline, CINAHL, PsycINFO, AMED, Embase and Scopus databases were systematically searched for studies that examined the clinical and economic burden of LBP in LMICs, published from inception to December 10, 2021. Only studies with clearly stated methodologies and published in English were eligible for review. Results: Nine studies met the inclusion criteria and were reviewed. Of these, three of them were clinical burden studies. The mean Newcastle–Ottawa quality assessment scale (NOS) score of the included studies was 4, with an average from 3 to 6. The included studies were conducted in Argentina, Brazil, China, Ethiopia, Nigeria, and Republic of Serbia. The rates of hospitalisation due to LBP ranged between 13.4% to 18.7%. Due to variation of methodological approaches, the reported cost estimates were inconsistent across the studies. A total cost of US$2.2 billion per population and US$1226.25 per patient were reported annually due to LBP. Conclusion: This systematic literature review suggests that LBP is associated with significantly high rates of hospitalisation and costs. As LBP is an important threat to the population, health professionals and policymakers are to put in place appropriate programmes to reduce the clinical and economic burden associated with LBP and improve the health outcomes of individuals with this condition in LMICs