A cross-sectional study on the co-occurrence of infectious diseases, malnutrition and cardio-metabolic risk factors

In sub-Saharan Africa, infectious diseases and malnutrition constitute the main health problems in children, while adolescents and adults are increasingly facing cardio-metabolic conditions. Among adolescents as the largest population group in this region, we investigated the co-occurrence of infectious diseases, malnutrition and cardio-metabolic risk factors (CRFs), and evaluated demographic, socio-economic and medical risk factors for these entities. In a cross-sectional study among 188 adolescents in rural Ghana, malarial infection, common infectious diseases and Body Mass Index were assessed. We measured ferritin, C-reactive protein, retinol, fasting glucose and blood pressure. Socio-demographic data were documented. We analyzed the proportions (95% confidence interval, CI) and the co-occurrence of infectious diseases (malaria, other common diseases), malnutrition (underweight, stunting, iron deficiency, vitamin A deficiency [VAD]), and CRFs (overweight, obesity, impaired fasting glucose, hypertension). In logistic regression, odds ratios (OR) and 95% CIs were calculated for the associations with socio- demographic factors. In this Ghanaian population (age range, 14.4–15.5 years; males, 50%), the proportions were for infectious diseases 45% (95% CI: 38–52%), for malnutrition 50% (43–57%) and for CRFs 16% (11–21%). Infectious diseases and malnutrition frequently co-existed (28%; 21–34%). Specifically, VAD increased the odds of non-malarial infectious diseases 3-fold (95% CI: 1.03, 10.19). Overlap of CRFs with infectious diseases (6%; 2–9%) or with malnutrition (7%; 3–11%) was also present. Male gender and low socio-economic status increased the odds of infectious diseases and malnutrition, respectively. Malarial infection, chronic malnutrition and VAD remain the predominant health problems among these Ghanaian adolescents. Investigating the relationships with evolving CRFs is warranted

Adolescent health in rural Ghana: A cross-sectional study on the co-occurrence of infectious diseases, malnutrition and cardio-metabolic risk factors.

In sub-Saharan Africa, infectious diseases and malnutrition constitute the main health problems in children, while adolescents and adults are increasingly facing cardio-metabolic conditions. Among adolescents as the largest population group in this region, we investigated the co-occurrence of infectious diseases, malnutrition and cardio-metabolic risk factors (CRFs), and evaluated demographic, socio-economic and medical risk factors for these entities. In a cross-sectional study among 188 adolescents in rural Ghana, malarial infection, common infectious diseases and Body Mass Index were assessed. We measured ferritin, C-reactive protein, retinol, fasting glucose and blood pressure. Socio-demographic data were documented. We analyzed the proportions (95% confidence interval, CI) and the co-occurrence of infectious diseases (malaria, other common diseases), malnutrition (underweight, stunting, iron deficiency, vitamin A deficiency [VAD]), and CRFs (overweight, obesity, impaired fasting glucose, hypertension). In logistic regression, odds ratios (OR) and 95% CIs were calculated for the associations with socio-demographic factors. In this Ghanaian population (age range, 14.4-15.5 years; males, 50%), the proportions were for infectious diseases 45% (95% CI: 38-52%), for malnutrition 50% (43-57%) and for CRFs 16% (11-21%). Infectious diseases and malnutrition frequently co-existed (28%; 21-34%). Specifically, VAD increased the odds of non-malarial infectious diseases 3-fold (95% CI: 1.03, 10.19). Overlap of CRFs with infectious diseases (6%; 2-9%) or with malnutrition (7%; 3-11%) was also present. Male gender and low socio-economic status increased the odds of infectious diseases and malnutrition, respectively. Malarial infection, chronic malnutrition and VAD remain the predominant health problems among these Ghanaian adolescents. Investigating the relationships with evolving CRFs is warranted

Adolescent health in rural Ghana: A cross-sectional study on the co-occurence of infectious diseases, malnutrition and cardio-metabolic risk factors

For the last 25 years, an epidemiologic transition has taken place in sub-Saharan Africa. While infectious diseases and malnutrition slowly decline and thus, still constitute main public health threats, cardio-metabolic diseases are on the rise as major contributors to the burden of disease. In Ghana, both groups of diseases co-occur at the country level, within households and at the individual level. However, among adolescents as one of the largest population groups in this region, the occurrence of such entities has hardly been described. Therefore, the present study aimed at investigating the proportions of infectious diseases, malnutrition and cardio-metabolic risk factors (CRFs) among teenagers in Ghana, and at evaluating demographic, socio-economic and medical risk factors for these conditions. In a cross-sectional analysis including 188 adolescents in rural Ghana, the single proportions (95% confidence interval, CI) and the co-occurrence of infectious diseases (malaria, other common diseases), malnutrition (underweight, stunting, iron deficiency, vitamin A deficiency), and CRFs (overweight, obesity, impaired fasting glucose, hypertension) were determined. In questionnaire-based interviews, we collected socioeconomic data and self-reported health status. Body weight, -height, -temperature and blood pressure were measured for each individual. From venous blood samples Plasmodium species, plasma concentrations of ferritin, C-reactive protein, retinol, and fasting plasma glucose were analyzed. Anthropometric measures and blood pressure values were compared to age- and sex-specific reference data to detect underweight, stunting, overweight, obesity as well as hypertension, respectively. In logistic regression models, odds ratios (OR) and 95% CIs were calculated for the associations of sociodemographic and medical factors with disease status. In this Ghanaian population (age range, 14.4-15.5 years; males, 50%), the proportions were for infectious diseases 45% (95% CI: 38-52%), for malnutrition 50% (43-57%) and for CRFs 16% (11-21%). Infectious diseases and malnutrition frequently coexisted (28%; 21-34%). Overlap of CRFs with infectious diseases (6%; 2-9%) or with malnutrition (7%; 3-11%) was also present. The former mainly comprised hypertension plus malarial infection (n=8/11), while the latter was largely attributable to overweight or obesity plus vitamin A deficiency (n=7/13). Male gender and low socio-economic status increased the odds of infectious diseases and malnutrition, respectively. Malarial infection, chronic malnutrition and VAD remain the predominant health problems among these Ghanaian adolescents. Regarding CRFs, already at this young age, obesity and hypertension evolve. Investigating the interrelations of infection, malnutrition, and CRFs is warranted.In Subsahara-Afrika vollzieht sich in den letzten 25 Jahren ein epidemiologischer Wandel. Während Infektionskrankheiten und Mangelernährung weiterhin die vorrangigen Gesundheitsprobleme bilden und ihr Anteil in der Public Health-Belastung nur langsam abnimmt, steigt die Belastung durch kardio-metabolische Erkrankungen rapide. Demnach liegt in Ghana eine Doppelbelastung durch beide Erkrankungsgruppen vor, die sich auf Bevölkerungsebene, innerhalb einer Familie und bei Einzelpersonen zeigt. Jedoch ist dieses Phänomen kaum erforscht für Jugendliche – eine der größten Bevölkerungsgruppen in dieser Region. Daher hatte die vorliegende Studie die Ziele, die Häufigkeit von Infektionskrankheiten, Mangelernährung und kardio-metabolischen Risikofaktoren unter Jugendlichen in Ghana zu bestimmen sowie demografische, sozioökonomische und klinische Risikofaktoren für deren Auftreten zu analysieren. ..

Clinical and anthropometric characteristics of 188 rural Ghanaian adolescents.

<p>Clinical and anthropometric characteristics of 188 rural Ghanaian adolescents.</p

Venn diagram for the co-occurrences of infectious diseases, malnutrition and cardio-metabolic risk factors in 188 adolescents in rural Ghana.

<p>Data are presented as proportions of the total study population. Infectious diseases comprise malarial infection <i>plus</i> diagnoses of and symptoms compatible with another infectious disease; malnutrition comprises underweight, stunting, iron deficiency and vitamin A deficiency; cardio-metabolic risk factors comprise overweight, obesity, impaired fasting glucose and hypertension.</p

Socio-demographic characteristics of 188 rural Ghanaian adolescents.

<p>Socio-demographic characteristics of 188 rural Ghanaian adolescents.</p

Proportions of infectious diseases, malnutrition and cardio-metabolic risk factors in 188 adolescents in rural Ghana.

<p>Error bars indicate 95% confidence intervals. dark grey = infectious diseases, comprise malarial infection <i>plus</i> diagnoses of and symptoms compatible with another infectious disease; light grey = malnutrition, comprises underweight, stunting, iron deficiency and vitamin A deficiency; white = cardio-metabolic risk factors, comprise overweight, obesity, impaired fasting glucose and hypertension.</p

Associations of demographic, socio-economic and medical factors with infectious diseases, malnutrition and CRFs.

<p>Associations of demographic, socio-economic and medical factors with infectious diseases, malnutrition and CRFs.</p

Preserved Self-Evaluation in Amnesia Supports Access to the Self through Introspective Computation

International audienceEncounters with new people result in the extraction and storage in memory of both their external features, allowing us to recognize them later, and their internal traits, allowing us to better control our current interactions with them and anticipate our future ones. Just as we extract, encode, store, retrieve and update representations of others so, too, do we process representations of ourselves. These representations, which rely on declarative memory, may be altered or cease to be accessible in amnesia. Nonetheless, studies of amnesic patients have yielded the surprising observation that memory impairments alone do not prevent patients from making accurate trait self-judgments. In this review, we discuss prevailing explanations for preserved self-evaluation in amnesia and propose an alternative one, based on the concept of introspective computation. We also consider molecular and anatomical aspects of brain functioning that potentially support introspective computation. In this review, we discuss the literature on the representations people have of themselves, focusing on representations of self-personality traits. The latter are usually assessed using self-evaluation tasks, where participants are provided with a list of traits and asked to rate their self-descriptiveness. Self-evaluation on a set of traits involves retrieving personal information from semantic as well as episodic memory. Surprisingly, studies have shown that patients with semantic and/or episodic memory impairments are still able to provide accurate trait self-judgments. In this paper, we review these clinical cases, as well as possible explanations for preserved self-evaluation in amnesia provided in the literature. In a different section, we describe an alternative cognitive operation that we called introspective computation that may be used to judge the self-descriptiveness of personality traits. This mental operation, which does not rely on personal knowledge stored in long-term memory, may allow patients to provide accurate judgments of their personality traits despite their amnesia. We also discuss cognitive operations, including introspective computation, used in self-evaluation tasks, and their possible impairments in patients unaware of their personality changes