Assessing the burden and risk factors of sudden infant death syndrome (SIDS) and other sleep related infant deaths in Africa: a case study of Zambia

BACKGROUND: In wealthier countries, sudden infant death syndrome (SIDS) is consistently mentioned as a leading preventable cause of infant mortality. However, in Africa, little is known about SIDS. The general view in the Global Health community is that SIDS is not a significant cause of infant mortality in low resource settings. But is this assumption correct? It seems illogical that SIDS would only be confined to high-income settings. An alternative hypothesis is that we are in a situation where SIDS in Africa has historically not been a priority area for research. Consequently, we may have fallen into the common trap where the absence of evidence is misconstrued as evidence of absence. The focus of this thesis is to challenge these assumptions. METHODS: We do this in stages. First, we present results of a systematic review of published studies about SIDS in Africa. Second, we analyze a recently collected unique data set consisting of verbal autopsy data from the next of kin of several hundred deceased infants to attempt to quantify the burden of apparent SIDS deaths. Third, we assess the burden of canonical risk factors for SIDS using prospectively collected survey data. And fourth, we analyze individual attitudes, knowledge, and experience with SIDS collected via focus groups and in-depth interviews to better understand awareness of SIDS and its risk factors, and the potential that these could be modified. RESULTS: The systematic review confirmed that SIDS is poorly studied in Africa. Most of the research on SIDS in Africa comes from South Africa. The incidence of SIDS was high, with reported incidence rates of between 3.01 to 3.70 per 1000 live births in South Africa compared to 0.3 per 1000 live births in the U.S. Bedsharing and prone/lateral sleeping were universally prevalent in countries where these were assessed. In Zambia, 7.4% of decedent infants who died at home died suddenly and unexpectedly, with 5.4% presumably dying of SIDS. In surveys, nearly all infants (89.5%) shared a bed with an adult during sleep, and nearly two-thirds slept (73%) in the lateral position. Infants rarely slept in the recommended supine/back position. In focus group discussions, mothers indicated that they felt the supine sleep position posed an aspiration risk to the infant. Most cited health care workers and experienced women in the community as sources of information on sleep practices. CONCLUSION: Contrary to the prevailing view of SIDS in low to middle-income countries, in Africa and Zambia specifically, SIDS may be a significant cause of infant mortality, but it is going unrecognized or unreported. Public health interventions in Africa and Zambia are overlooking SIDS as an important cause of infant mortality. Interventions to prevent SIDS, such as laying the infant to sleep on the back, are low cost and will be worthwhile in reducing the high infant mortality rates in these settings

Employee Motivation on the Organisational Growth of Printing Industry in the Kumasi Metropolis

The printing industry is supposed to be a major contributor to Ghana’s development through employment creation and the enhancement of information to the general public. The main purpose of the study was to assess employee motivation on the printing industry within Kumasi Metropolis. The study employed both the quantitative and qualitative surveys on the printing industries within the given study area with emphasis on general printing technology which has been in existence for more than three decades. The survey was intended to get employees on their responses on what they feel are the best factors that could motivate them for their self-actualisation and also meet organizational goals. The study set to identify the most ranked factor(s) among several motivated factors which existed in the sector and it emerged that Job satisfaction was the most ranked factor from the empirical findings. Keywords: Motivation, Employee Satisfaction, Performance, Organisational Goals and Industr

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Linkages Between the Curriculum of Institutions Offering Clothing and Textiles and Their Allied Industry

There is a need for a link between the curricular of the clothing and textiles institutions and the professional practice in the industry. However, there seems to be a vacuum in the literature regarding the extent to which the curricular of the clothing and textiles institutions are linked to what their allied industry does. The purpose of this article was to examine the relevance of the curriculum of the clothing and textiles institutions to the large-scale clothing and textiles industries, from the perspectives of respondents. The study is expected to promote establishment of collaboration and linkages between Clothing and Textiles institutions and industry. Action research and multiple case study approach were employed for this qualitative research. The researchers used purposive sampling to select respondents. Face-to-face interview, with semi-structured interview guide and observation were used to collect data for the study. The sample size was twenty-two respondents taken from industry and academia. The outcome of the study showed the following: varied perception about relevance of curriculum to the expectations of the industry, non-existence of some relevant skills in the curricula, different industrial attachment practices, non-involvement of the industry in curriculum development and review, inadequate facilities. The following conclusion resulted from the analysis of the study: Curriculum of the institutions is largely perceived to be relevant but requires some updates; inadequate facilities/equipment in the institutions for student training. Keywords: Curriculum, industry, clothing and textiles, institutions, training. DOI: 10.7176/JEP/12-3-14 Publication date: January 31st 2021

Evaluating the higher national diploma industrial art programme of tamale technical university in Ghana: Curriculum versus implementation

AbstractIn Ghana’s Polytechnics/Technical Universities, the Higher National Diploma (HND) programmes are ran to provide the country with its middle-skilled manpower base in science, engineering, technology, commerce and art for socio-economic development. However, the HND Industrial Art Programme of Tamale Technical University begun in 2008/2009 academic year and has since run up-to-date with options in Painting and Decorating (P/D), Leatherwork, Textiles and Ceramics without any form of evaluation to ascertain its impact in the country despite the numerous calls from stakeholders. Therefore, the study sought to examine the impact of the HND Industrial Art Programme of Tamale Technical University on the Art Industry in Ghana. To conduct the study, the main objective was to evaluate the scope and content of the curriculum of the HND Industrial Art Programme with reference to its implementation in the University. The Concurrent Triangulation Mixed-Method research design involving both qualitative (case study, document and descriptive analysis) and quantitative research were adopted to undertake the research. Questionnaire, interview and observation guides were relied as tools to collect data for the study. A sample population of 223 (present students: 57, graduates: 137, lecturers/technicians: 13 and industrial attachment supervisors: 16) was selected using purposive, random and snowball sampling techniques. From the study, the major finding is that, the curricula of the programme’s options provided students with knowledge and skills required in their respective industries as conceived by the Department. Nonetheless, with time and advancement in technology as being noted in the industry, some of the courses require review to catch up with industry standards. The findings from the study have implication on the training of students in the Country. It is therefore recommended that appropriate steps should be taken in conjunction with relevant stakeholders to have a holistic review of the curriculum to make it relevant

Assessment of the potential of charred briquettes of sawdust, rice and coconut husks: Using water boiling and user acceptability tests

Charred briquettes production is a sustainable way of producing cooking fuel from waste. Unsustainable harvesting of wood for fuel production has contributed immensely to the rapid deforestation in Ghana. This study determined the potential of charred briquettes of sawdust, rice and coconut husks in meeting cooking energy needs of households. In a further step, the acceptability of biomass users in the study to replace their current fuels with charred briquettes was established. The calorific value of the charred briquettes was found to be 24.69 MJ/kg. The highest combustion efficiency of briquettes was determined as 34.7% when a multi-feed gasifier stove (MFGS) was used. There were 14% and 80% reduction in particulate matter and carbon monoxide emissions, respectively when briquettes was used instead of charcoal in the MFGS. The analysis of the production cost of briquettes revealed that 1 kg of briquettes should be sold at Gh¢ 2.48 in order to make a 10% profit. The user acceptability survey indicated that about 40% of respondents are ready to patronize briquettes should it be sold at Gh¢ 2.48. This study established that briquette is a suitable replacement for wood and charcoal, if its full potential is harnessed and the energy utilization efficiency of biomass (sawdust, rice and coconut husts) briquettes is confirmed

Digital Device Use, Computer Vision Syndrome, and Sleep Quality among an African Undergraduate Population

Background. The purpose of the study was to determine the prevalence of computer vision syndrome (CVS) and poor sleep quality among university students and assess the relationship between digital device usage, CVS, and sleep quality. Methods. A cross-sectional study including undergraduate students was conducted in Ghana between January–March 2020. Information on digital device use and CVS symptoms was collected using a structured questionnaire. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Logistic regression was used to determine the relationship between CVS and digital device use behavior, and linear regression analysis was used to explore the association between sleep quality and digital device use behavior. Statistical significance was set at p < 0.05. Results. Mean (SD) age of participants was 20.95 (1.68) years and most (54.97%) of them were females. The prevalence of CVS was 64.36%. Factors associated with CVS included hours of digital device use per day (OR = 4.1, p < 0.001), years of digital device use (OR = 3.0, p < 0.001), adjustment of digital device screen contrast to the surrounding brightness (OR = 1.95, p = 0.014), and presence of glare (OR = 1.79, p = 0.048). Prevalence of poor sleep quality was 62.43%. There was a significant association between poor sleep quality and number of years participants had used a digital device (p = 0.015) and the number of hours they used a digital device per day (p = 0.005). Conclusion. There is a high prevalence of both CVS and poor sleep quality among undergraduate students in Ghana. This represents a significant public health issue that needs attention

Adaptation of the Wound Healing Questionnaire universal-reporter outcome measure for use in global surgery trials (TALON-1 study): mixed-methods study and Rasch analysis

BackgroundThe Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation.MethodsThis was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling and measurement properties of the WHQ. Finally, qualitative and quantitative data were triangulated using a modified, exploratory, instrumental design model.ResultsIn the qualitative phase, 10 structured interviews and six focus groups took place with a total of 47 investigators across six countries. Themes related to comprehension, response mapping, retrieval, and judgement were identified with rich cross-cultural insights. In the quantitative phase, an exploratory Rasch model was fitted to data from 537 patients (369 excluding extremes). Owing to the number of extreme (floor) values, the overall level of power was low. The single WHQ scale satisfied tests of unidimensionality, indicating validity of the ordinal total WHQ score. There was significant overall model misfit of five items (5, 9, 14, 15, 16) and local dependency in 11 item pairs. The person separation index was estimated as 0.48 suggesting weak discrimination between classes, whereas Cronbach's α was high at 0.86. Triangulation of qualitative data with the Rasch analysis supported recommendations for cross-cultural adaptation of the WHQ items 1 (redness), 3 (clear fluid), 7 (deep wound opening), 10 (pain), 11 (fever), 15 (antibiotics), 16 (debridement), 18 (drainage), and 19 (reoperation). Changes to three item response categories (1, not at all; 2, a little; 3, a lot) were adopted for symptom items 1 to 10, and two categories (0, no; 1, yes) for item 11 (fever).ConclusionThis study made recommendations for cross-cultural adaptation of the WHQ for use in global surgical research and practice, using co-produced mixed-methods data from three continents. Translations are now available for implementation into remote wound assessment pathways