Postnatal probiotic supplementation can prevent and optimize treatment of childhood asthma and atopic disorders: a systematic review of randomized controlled trials

Background: Although several randomized controlled trials (RCTs) published over the past 5 years show that prenatal or postnatal probiotics may prevent or optimize the treatment of childhood asthma and atopic disorders, findings from the systematic reviews and meta-analyses of these studies appear inconsistent. More recent RCTs have focused on postnatal probiotics, and linked specific probiotic strains to better disease outcomes. Objective: This systematic review aimed to determine if postnatal probiotics are as effective as prenatal probiotics in preventing or treating childhood asthma and atopic disorders. Methods: We searched the PubMed, Medline, Google Scholar, and EMBASE databases for RCTs published within the past 5 years (from 2017 to 2022). We included only full-text RCTs on human subjects published in or translated into the English language. We retrieved relevant data items with a preconceived data-extraction form and assessed the methodological quality of the selected RCTs using the Cochrane Collaboration's tool for assessing the risk of bias in randomized trials. We qualitatively synthesized the retrieved data to determine any significant differences in study endpoints of the probiotic and placebo groups. Results: A total of 1,320 participants (688 and 632 in the probiotic and placebo groups) from six RCTs were investigated. One RCT showed that early Lactobacillus rhamnosus GG (LGG) led to a reduction in the cumulative incidence rate of asthma. Another study demonstrated that mixed strains of Lactobacillus paracasei and Lactobacillus fermentum could support clinical improvement in children with asthma while one trial reported a significant reduction in the frequency of asthma exacerbations using a mixture of Ligilactobacillus salivarius and Bifidobacterium breve. Three trials showed that a combination of LGG and Bifidobacterium animalis subsp lactis, Lactobacillus rhamnosus alone, and a probiotic mixture of Lactobacillus LOCK strains improved clinical outcomes in children with atopic dermatitis and cow-milk protein allergy. Conclusions: Postnatal strain-specific probiotics (in single or mixed forms) are beneficial in preventing and treating atopic dermatitis and other allergies. Similarly, specific strains are more effective in preventing asthma or improving asthma outcomes. We recommend more interventional studies to establish the most useful probiotic strain in these allergic diseases

The Role of HIV/AIDS Prevention Campaigns on HIV Related Behavioural Changes in Ibadan, Nigeria

This study examined the impact of sources of AIDS education on HIV-related behavioural changes, and its implications for HIV prevention and service delivery in Nigeria. We analysed cross-sectional data obtained from a structured face-to-face interview with 1,373 respondents aged 15-50, who have ever had sex in Ibadan, Nigeria. Knowledge of HIV/AIDS, its route of transmission and prevention strategies was high.  About 20 % of the respondents were exposed to the AIDS prevention campaigns. A majority reported sexual behavioral changes, which included restriction of sex partners, use of condoms, sexual abstinence and avoidance of casual sex. Thirty-nine percent took some steps to reduce risk of infection by avoiding transfusion with unscreened blood and testing for HIV status.  Using multiple logistic regressions, the factors affecting the reported changes were identified. The application of health belief model shows that the model cannot wholly explain the changes in behavior. The role of female powerlessness in safer sex decision-making is noted. Despite the limitations of the study, the need for a sustained AIDS prevention campaign is stressed. The implications of the study for AIDS programs and research are highlighted

Community involvement in obstetric emergency management in rural areas: a case of Rukungiri district, Western Uganda

<p>Abstract</p> <p>Background</p> <p>Maternal mortality is a major public health problem worldwide especially in low income countries. Most causes of maternal deaths are due to direct obstetric complications. Maternal mortality ratio remains high in Rukungiri district, western Uganda estimated at 475 per 100,000 live births. The objectives were to identify types of community involvement and examine factors influencing the level of community involvement in the management of obstetric emergencies.</p> <p>Methods</p> <p>We conducted a descriptive study during 2nd to 28th February 2009 in rural Rukungiri district, western Uganda. A total of 448 heads of households, randomly selected from 6/11 (54.5%) of sub-counties, 21/42 (50.0%) parishes and 32/212 (15.1%) villages (clusters), were interviewed. Data were analysed using STATA version 10.0.</p> <p>Results</p> <p>Community pre-emergency support interventions available included community awareness creation (sensitization) while interventions undertaken when emergency had occurred included transportation and referring women to health facility. Community support programmes towards health care (obstetric emergencies) included establishment of community savings and credit schemes, and insurance schemes. The factors associated with community involvement in obstetric emergency management were community members being employed (AOR = 1.91, 95% CI: 1.02 - 3.54) and rating the quality of maternal health care as good (AOR = 2.22, 95% CI: 1.19 - 4.14).</p> <p>Conclusions</p> <p>Types of community involvement in obstetric emergency management include practices and support programmes. Community involvement in obstetric emergency management is influenced by employment status and perceived quality of health care services. Policies to promote community networks and resource mobilization strategies for health care should be implemented. There is need for promotion of community support initiatives including health insurance schemes and self help associations; further community sensitization by empowered community based resource persons rather than health workers and improvement in quality of health care can contribute towards effective management of obstetric complications.</p

Birth preparedness and complication readiness among the women beneficiaries of selected rural primary health centers of Dakshina Kannada district, Karnataka, India.

INTRODUCTION: Birth preparedness and complication readiness (BPCR) is a strategy to promote timely use of skilled maternal and neonatal care during childbirth. According to World Health Organization, BPCR should be a key component of focused antenatal care. Dakshina Kannada, a coastal district of Karnataka state, is categorized as a high-performing district (institutional delivery rate >25%) under the National Rural Health Mission. However, a substantial proportion of women in the district experience complications during pregnancy (58.3%), childbirth (45.7%), and postnatal (17.4%) period. There is a paucity of data on BPCR practice and the factors associated with it in the district. Exploring this would be of great use in the evidence-based fine-tuning of ongoing maternal and child health interventions. OBJECTIVE: To assess BPCR practice and the factors associated with it among the beneficiaries of two rural Primary Health Centers (PHCs) of Dakshina Kannada district, Karnataka, India. METHODS: A facility-based cross-sectional study was conducted among 217 pregnant (>28 weeks of gestation) and recently delivered (in the last 6 months) women in two randomly selected PHCs from June -September 2013. Exit interviews were conducted using a pre-designed semi-structured interview schedule. Information regarding socio-demographic profile, obstetric variables, and knowledge of key danger signs was collected. BPCR included information on five key components: identified the place of delivery, saved money to pay for expenses, mode of transport identified, identified a birth companion, and arranged a blood donor if the need arises. In this study, a woman who recalled at least two key danger signs in each of the three phases, i.e., pregnancy, childbirth, and postpartum (total six) was considered as knowledgeable on key danger signs. Optimal BPCR practice was defined as following at least three out of five key components of BPCR. OUTCOME MEASURES: Proportion, Odds ratio, and adjusted Odds ratio (adj OR) for optimal BPCR practice. RESULTS: A total of 184 women completed the exit interview (mean age: 26.9±3.9 years). Optimal BPCR practice was observed in 79.3% (95% CI: 73.5-85.2%) of the women. Multivariate logistic regression revealed that age >26 years (adj OR = 2.97; 95%CI: 1.15-7.7), economic status of above poverty line (adj OR = 4.3; 95%CI: 1.12-16.5), awareness of minimum two key danger signs in each of the three phases, i.e., pregnancy, childbirth, and postpartum (adj OR = 3.98; 95%CI: 1.4-11.1), preference to private health sector for antenatal care/delivery (adj OR = 2.9; 95%CI: 1.1-8.01), and woman's discussion about the BPCR with her family members (adj OR = 3.4; 95%CI: 1.1-10.4) as the significant factors associated with optimal BPCR practice. CONCLUSION: In this study population, BPCR practice was better than other studies reported from India. Healthcare workers at the grassroots should be encouraged to involve women's family members while explaining BPCR and key danger signs with a special emphasis on young (<26 years) and economically poor women. Ensuring a reinforcing discussion between woman and her family members may further enhance the BPCR practice

Pregnancy termination in sub-Saharan Africa: the need for refined data

PURPOSE: This study examines the levels and pattern of, as well as the factors associated with, pregnancy termination in seventeen Sub-Sahara African countries. METHODS: The 2000 round of demographic and health survey (DHS) data sets for the countries are used. The study population are women aged 15-49 who have ever been exposed to the risk of pregnancy and interviewed during the surveys. Univariate analysis is done to examine the distribution of the women. Bivariate analysis of selected background, contraceptive, sexual behaviour and fertility variables by having ever had a terminated pregnancy are also carried out. Lastly, multivariate logistic regression models are fitted to examine the magnitude of associated variables while controlling for others. RESULTS: the associated factors vary from country to country. However, age and marital status are associated with and are critical predictors of having ever had a terminated pregnancy in all the countries. For example, the odds of having ever had a terminated pregnancy is about 54 and 32 times (for currently and formerly married women, respectively) that of those that have never married in Rwanda. CONCLUSION: This study has come up with findings that provoke more thinking and research on the topic of pregnancy termination and to reproductive health in general. This is because ‘ever had a terminated pregnancy’ as used in the DHS context made no distinction between the three different pathways through which a pregnancy may not result into a live birth. Key Words: Abortion; Stillbirths; Pregnancy termination; Sub- Saharan Africa

Predictors of Unintended Pregnancy Among South African Youth

Although unintended pregnancy is recognized as a major public health problem in South Africa, studies on it have been limited and at local level. Using the 1998 South African Demographic and Health Survey (SADHS) data set, this study examined the distribution of and factors associated with unintended pregnancy among South African youth. Analysis was based on a sub-sample of 1, 395 women aged 15-24 who were interviewed during the survey and who had pregnancy at the time of and/or three years preceding the survey. Univariate, bivariate and multivariate methods of analysis were employed. The results show a high level of unintended pregnancy with only 29% of the pregnancies wanted. The level of unintended pregnancy varies by region and some socio-economic variables. Five critical predictors of unintended pregnancy among South African youth were identified. These are: age group, region, marital status, education and relationship to the last sexual partner. The findings of this study have implications for reproductive health policies and programmes in designing appropriate national programmes for reducing the incidence of unintended pregnancy among South African youth. The need for further research into this area using triangulated methodology is recommended. Eastern African Social Sciences Review Vol. 23 (1) 2007: pp. 61-8

EFFECT OF DIFFERENT DOUGH IMPROVERS ON THE PROXIMATE COMPOSITION, MINERALS, VITAMINS AND SENSORY PROPERTIES OF WHEAT BREAD

Abstract Comparative evaluation of bread made from wheat flour using five different dough improvers was evaluated. The improvers were ascorbic acid, EDC-2000, (etheylen

Verbal marital conflict and male domination in the family as risk factors of intimate partner violence

A systematic review was performed to analyse the characteristics and quality of the studies that consider the relationship between verbal marital conflict and/or male domination in the family and violent behaviour by men towards their partner. Only 11 articles were identified between 1986 and 2006. Most of them find a positive association between male domination in the family and/or verbal marital conflict and violence towards the woman in the couple. However, limitations such as misclassification bias, recall bias, selection bias, external validity and the problem of consistency (overestimation of effect) were acknowledged by authors of this studies. In eight of the 11 studies reviewed, preventive measures or interventions to deal with the problem were recommended. More and better empirical evidence is required in order to provide suitable measures to address the issue of verbal marital conflict and male domination and its influence on IPV.Valencian School for Health Studies (Grant–Intimate partner violence against women. Causes, determinants and risk factor for evidence-based policies), and the Network for Research on Gender and Health