Examining ethnic differences in age at sexual debut among adolescent girls in the Gambia

Whether age at sexual debut is influenced by adolescents’ ethnicity has not been examined in the Gambia. The aim of this study was to assess ethnic differences in age at sexual debut among girls in 24 rural Gambian settlements. A cross-sectional household survey of 181 respondents aged (10-19 years) was conducted among girls belonging to the three main ethnic groups (Mandinka, Fula and Wolof). Descriptive statistics and ordinal logistic regression were used to show the onset of sexual intercourse and describe the patterns of sexual debut by ethnic group among respondents. All the analyses were conducted in Stata 12.0. The study findings showed that the lowest median age at sexual debut is among Mandinka and Wolof girls (14 years). The results of ordinal logistic regression indicate that girls in the Mandinka and Wolof ethnic groups are approximately 20% less likely to initiate sex at an early age than girls in the Fula ethnic group. On the other hand, girls with more than 1 year of education are less likely to initiate sex at an early age than those with less than 1 year of education. It was also found that girls who live with their mothers are 71% less likely to have an early sexual debut than those who do not. These findings suggest ethnic differences in age at sexual debut among girls in the Gambia. The findings also highlight the importance of female education and living with a mother in reducing the chances of early sexual debut among adolescent girls

Examining ethnic differences in age at sexual debut among adolescent girls in the Gambia

Whether age at sexual debut is influenced by adolescents’ ethnicity has not been examined in the Gambia. The aim of this study was to assess ethnic differences in age at sexual debut among girls in 24 rural Gambian settlements. A cross-sectional household survey of 181 respondents aged (10-19 years) was conducted among girls belonging to the three main ethnic groups (Mandinka, Fula and Wolof). Descriptive statistics and ordinal logistic regression were used to show the onset of sexual intercourse and describe the patterns of sexual debut by ethnic group among respondents. All the analyses were conducted in Stata 12.0. The study findings showed that the lowest median age at sexual debut is among Mandinka and Wolof girls (14 years). The results of ordinal logistic regression indicate that girls in the Mandinka and Wolof ethnic groups are approximately 20% less likely to initiate sex at an early age than girls in the Fula ethnic group. On the other hand, girls with more than 1 year of education are less likely to initiate sex at an early age than those with less than 1 year of education. It was also found that girls who live with their mothers are 71% less likely to have an early sexual debut than those who do not. These findings suggest ethnic differences in age at sexual debut among girls in the Gambia. The findings also highlight the importance of female education and living with a mother in reducing the chances of early sexual debut among adolescent girls.   La question de savoir si l’âge au début des rapports sexuels est influencé par l’origine ethnique des adolescents n’a pas été examinée en Gambie. Le but de cette étude était d'évaluer les différences ethniques d'âge au début de la relation sexuelle parmi les filles de 24 établissements ruraux gambiens. Une enquête transversale auprès des ménages auprès de 181 répondants âgés de 10 à 19 ans a été menée auprès de filles appartenant aux trois principaux groupes ethniques (mandinka, peul et wolof). Des statistiques descriptives et une régression logistique ordinale ont été utilisées pour montrer le début des rapports sexuels et décrire les modèles de débuts sexuels par groupe ethnique parmi les répondants. Toutes les analyses ont été menées dans Stata 12.0. Les résultats de l'étude ont montré que l'âge médian le plus bas au début des rapports sexuels est celui des filles mandingues et wolof (14 ans). Les résultats de la régression logistique ordinale indiquent que les filles des groupes ethniques mandinka et wolof sont environ 20% moins susceptibles d'avoir des relations sexuelles à un âge précoce que les filles du groupe peul. En revanche, les filles ayant plus d'un an d'éducation sont moins susceptibles d'avoir des relations sexuelles à un âge précoce que celles ayant moins d'un an d'éducation. Il a également été constaté que les filles qui vivent avec leur mère sont 71% moins susceptibles d'avoir des débuts sexuels précoces que celles qui n'en ont pas. Ces résultats suggèrent des différences ethniques d'âge au début des rapports sexuels parmi les filles en Gambie. Les résultats soulignent également l'importance de l'éducation des femmes et de la vie avec une mère pour réduire les chances de débuts sexuels précoces chez les adolescentes &nbsp

An objective tropical Atlantic sea surface temperature gradient index for studies of south Amazon dry-season climate variability and change

Future changes in meridional sea surface temperature (SST) gradients in the tropical Atlantic could influence Amazon dry-season precipitation by shifting the patterns of moisture convergence and vertical motion. Unlike for the El Niño-Southern Oscillation, there are no standard indices for quantifying this gradient. Here we describe a method for identifying the SST gradient that is most closely associated with June–August precipitation over the south Amazon. We use an ensemble of atmospheric general circulation model (AGCM) integrations forced by observed SST from 1949 to 2005. A large number of tropical Atlantic SST gradient indices are generated randomly and temporal correlations are examined between these indices and June–August precipitation averaged over the Amazon Basin south of the equator. The indices correlating most strongly with June–August southern Amazon precipitation form a cluster of near-meridional orientation centred near the equator. The location of the southern component of the gradient is particularly well defined in a region off the Brazilian tropical coast, consistent with known physical mechanisms. The chosen index appears to capture much of the Atlantic SST influence on simulated southern Amazon dry-season precipitation, and is significantly correlated with observed southern Amazon precipitation

Sexual and reproductive health of adolescents and young people in the Gambia: a systematic review

Introduction: in Gambia, adolescents and young people make up 32% of the national population. Observations indicate that this population group lacks access to quality information and services on sexual and reproductive health. This systematic review explored sexual and reproductive health indicators for adolescents and young people in Gambia. Methods: published studies on sexual and reproductive health indicators were searched in PubMed, Google Scholar and African Journals Online. Moreover, national reference documents containing relevant in-country data on adolescents and young people's sexual and reproductive health were also collected and reviewed. Search terms for published studies focused on modern contraceptive and sexually transmitted infections (STIs) prevalence rates, availability and accessibility to sexual and reproductive health (SRH) services and satisfaction levels with SRH services among adolescents and young people (aged 10-24 years). Results: the review showed that contraceptive prevalence rates among adolescents and young people in Gambia ranged from 7% to 9%. Reasons for low contraceptive prevalence among adolescents and young people included limited knowledge and access to sexual and reproductive health information and services, provider attitudes, stigma, shame, lack of money and cultural and religious misconceptions associated with contraception. Overall, the review found limited information on STI prevalence among adolescents and young people, with only a single published study reporting a prevalence rate of 8.4%. In addition, inadequate counseling and complaints related to physical environmentprocess of providing sexual and reproductive health services and information were significant factors associated with satisfaction with SRH services among adolescents and young people. Conclusion: this review provides important baseline data that may be useful for policymakers and program managers to improve adolescents and young people's sexual and reproductive health in Gambia

Fighting COVID-19 in The Gambia: Efforts, Challenges, and way Forward

On March 11, 2020, the novel coronavirus disease (COVID-19) was declared a pandemic of global magnitude. Since then, nations have instituted response measures to curtail the rapid spread and propagation of the virus. This Letter to the Editor provides a brief assessment of the measures and challenges facing The Gambia’s COVID-19 response and suggests some policy and practical recommendations that can be used by policymakers and implementers to address the COVID-19 situation in The Gambia. It is based on a narrative review of existing literature on the COVID-19 response in The Gambia, as well as on the authors’ opinion as researchers supporting the COVID-19 response efforts in The Gambia

Association between proton pump inhibitor therapy and clostridium difficile infection: a contemporary systematic review and meta-analysis.

Abstract Introduction Emerging epidemiological evidence suggests that proton pump inhibitor (PPI) acid-suppression therapy is associated with an increased risk of Clostridium difficile infection (CDI). Methods Ovid MEDLINE, EMBASE, ISI Web of Science, and Scopus were searched from 1990 to January 2012 for analytical studies that reported an adjusted effect estimate of the association between PPI use and CDI. We performed random-effect meta-analyses. We used the GRADE framework to interpret the findings. Results We identified 47 eligible citations (37 case-control and 14 cohort studies) with corresponding 51 effect estimates. The pooled OR was 1.65, 95% CI (1.47, 1.85), I2 = 89.9%, with evidence of publication bias suggested by a contour funnel plot. A novel regression based method was used to adjust for publication bias and resulted in an adjusted pooled OR of 1.51 (95% CI, 1.26–1.83). In a speculative analysis that assumes that this association is based on causality, and based on published baseline CDI incidence, the risk of CDI would be very low in the general population taking PPIs with an estimated NNH of 3925 at 1 year. Conclusions In this rigorously conducted systemic review and meta-analysis, we found very low quality evidence (GRADE class) for an association between PPI use and CDI that does not support a cause-effect relationship

Research priorities to reduce the impact of COVID-19 in low- and middle-income countries

publishedVersio

The Paris Commune in the British socialist imagination, 1871–1914

This article is concerned with manifestations of the memory of the Paris Commune in Britain in the decades after 1871. It is about how the Commune was incorporated into the mythology, the canon, of British socialism, and how the memory of the Commune furnished British socialism with powerful and useful symbols. In highlighting the ways in which the events of 1871 captured the British socialist imagination, what follows shows how, despite its oft-emphasised insularity, British socialism was made through the incorporation and appropriation of both native and foreign ideas, symbols, and traditions. The powerful mythologies and symbolism associated with the Commune were taken up by socialists in Britain, and highlight an important intersection between British and French political cultures in the late nineteenth and early twentieth centuries

Research priorities to reduce the impact of COVID-19 in low- and middle-income countries.

BackgroundThe COVID-19 pandemic has caused disruptions to the functioning of societies and their health systems. Prior to the pandemic, health systems in low- and middle-income countries (LMIC) were particularly stretched and vulnerable. The International Society of Global Health (ISoGH) sought to systematically identify priorities for health research that would have the potential to reduce the impact of the COVID-19 pandemic in LMICs.MethodsThe Child Health and Nutrition Research Initiative (CHNRI) method was used to identify COVID-19-related research priorities. All ISoGH members were invited to participate. Seventy-nine experts in clinical, translational, and population research contributed 192 research questions for consideration. Fifty-two experts then scored those questions based on five pre-defined criteria that were selected for this exercise: 1) feasibility and answerability; 2) potential for burden reduction; 3) potential for a paradigm shift; 4) potential for translation and implementation; and 5) impact on equity.ResultsAmong the top 10 research priorities, research questions related to vaccination were prominent: health care system access barriers to equitable uptake of COVID-19 vaccination (ranked 1st), determinants of vaccine hesitancy (4th), development and evaluation of effective interventions to decrease vaccine hesitancy (5th), and vaccination impacts on vulnerable population/s (6th). Health care delivery questions also ranked highly, including: effective strategies to manage COVID-19 globally and in LMICs (2nd) and integrating health care for COVID-19 with other essential health services in LMICs (3rd). Additionally, the assessment of COVID-19 patients' needs in rural areas of LMICs was ranked 7th, and studying the leading socioeconomic determinants and consequences of the COVID-19 pandemic in LMICs using multi-faceted approaches was ranked 8th. The remaining questions in the top 10 were: clarifying paediatric case-fatality rates (CFR) in LMICs and identifying effective strategies for community engagement against COVID-19 in different LMIC contexts.InterpretationHealth policy and systems research to inform COVID-19 vaccine uptake and equitable access to care are urgently needed, especially for rural, vulnerable, and/or marginalised populations. This research should occur in parallel with studies that will identify approaches to minimise vaccine hesitancy and effectively integrate care for COVID-19 with other essential health services in LMICs. ISoGH calls on the funders of health research in LMICs to consider the urgency and priority of this research during the COVID-19 pandemic and support studies that could make a positive difference for the populations of LMICs