TB STIGMA – MEASUREMENT GUIDANCE

TB is the most deadly infectious disease in the world, and stigma continues to play a significant role in worsening the epidemic. Stigma and discrimination not only stop people from seeking care but also make it more difficult for those on treatment to continue, both of which make the disease more difficult to treat in the long-term and mean those infected are more likely to transmit the disease to those around them. TB Stigma – Measurement Guidance is a manual to help generate enough information about stigma issues to design and monitor and evaluate efforts to reduce TB stigma. It can help in planning TB stigma baseline measurements and monitoring trends to capture the outcomes of TB stigma reduction efforts. This manual is designed for health workers, professional or management staff, people who advocate for those with TB, and all who need to understand and respond to TB stigma

Engaging community health workers in maternal and infant death identification in Khayelitsha, South Africa : a pilot study

CITATION: Igumbor, J., et al. 2020. Engaging community health workers in maternal and infant death identification in Khayelitsha, South Africa : a pilot study. Pregnancy and Childbirth, 20:736, doi:10.1186/s12884-020-03419-4.Background: Engaging community health workers in a formalised death review process through verbal and social autopsy has been utilised in different settings to estimate the burden and causes of mortality, where civil registration and vital statistics systems are weak. This method has not been widely adopted. We piloted the use of trained community health workers (CHW) to investigate the extent of unreported maternal and infant deaths in Khayelitsha and explored requirements of such a programme and the role of CHWs in bridging gaps. Methods: This was a mixed methods study, incorporating both qualitative and quantitative methods. Case identification and data collection were done by ten trained CHWs. Quantitative data were collected using a structured questionnaire. Qualitative data were collected using semi-structured interview guides for key informant interviews, focus group discussions and informal conversations. Qualitative data were analysed thematically using a content analysis approach. Results: Although more than half of the infant deaths occurred in hospitals (n = 11/17), about a quarter that occurred at home (n = 4/17) were unreported. Main causes of deaths as perceived by family members of the deceased were related to uncertainty about the quality of care in the facilities, socio-cultural and economic contexts where people lived and individual factors. Most unreported deaths were further attributed to weak facilitycommunity links and socio-cultural practices. Fragmented death reporting systems were perceived to influence the quality of the data and this impacted on the number of unreported deaths. Only two maternal deaths were identified in this pilot study. Conclusions: CHWs can conduct verbal and social autopsy for maternal and infant deaths to complement formal vital registration systems. Capacity development, stakeholder’s engagement, supervision, and support are essential for a community-linked death review system. Policymakers and implementers should establish a functional relationship between community-linked reporting systems and the existing system as a starting point. There is a need for more studies to confirm or build on our pilot findings.https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-03419-4Publisher's versio

Neonatal cranial ultrasound abnormalities in LBW infants: Relation to cognitive outcomes at age six

bjective: To assess the independent relation of neonatal cranial ultrasound (US) abnormalities in low birth weight (LBW) infants to cognitive outcomes at 6 years of age.Design: Prospective cohort study.Sample and Methods: Six-year follow-up data were obtained on a regional birth cohort of LBW infants (\u3c 2 kg) systematically screened as neonates with serial US. US abnormalities were dichotomized into isolated germinal matrix/intraventricular hemorrhage (GM/IVH) and parenchymal lesions/ventricular enlargement (PL/VE). Global cognitive outcomes (mental retardation, borderline intelligence, and normal intelligence) and selected specific cognitive abilities were assessed at 6 years of age with standardized instruments. Multivariate techniques were used to assess the effects of US independent of maternal social disadvantage at birth and other perinatal and neonatal risk factors.Results: The sample as a whole had a significantly elevated rate of mental retardation (MR; 5%), almost all moderate to profound in severity. PL/VE was independently related to MR (odds ratio [OR], 65.8; confidence interval [CI], 19.1 to 22.4) and borderline intelligence (OR, 3.7; CI, 1.3 to 10.8); isolated GM/IVH was more modestly related to MR (OR, 4.6; CI, 1.2 to 18.6) but not related to borderline intelligence. Approximately half of the cases of MR were attributable to PL/VE independent of other factors. Of non-US factors, the number of days receiving mechanical ventilation increased the risk for MR. Maternal social disadvantage increased the risk for borderline intelligence but not MR. Among children of normal intelligence, those with PL/VE, but not isolated GM/IVH, performed more poorly than those without US abnormalities on tests of visual perceptual organization but not on tests of language, memory, or quantitative skills.Conclusion: Prevention of white matter injury would substantially improve cognitive outcomes for LBW infants

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms

Predictors of sexual risk behaviour among adolescents from low socioeconomic settings in South Africa

Includes bibliographical references.The HIV epidemic continues to be a public health concern with evidence indicating that in South Africa, the epidemic is being driven largely by new infections in adolescents. Behavioural change is key to successful prevention strategies. This study sets out to determine the prevalence and predictors of sexual risk behaviours among adolescents aged 12-18 from low socioeconomic settings in South Africa with the aim of informing future prevention interventions

Environmentally sustainable food: an analysis of consumer practices and their diffusion in France

Purpose This aim of this study is to identify the ways of helping public authorities bring about change to environmentally sustainable household food practices. Design/methodology/approach The authors identified the practices involved in this concept from the consumer perspective and measured their diffusion among French households. The analyses were conducted following two successive data collection campaigns comprising 571 and 501 respondents in France. The methodology involved two complementary scaling techniques: factor analysis and item response theory. Findings The results show that consumers understand sustainable food through five food practices: buying and cooking products with sustainable attributes, anti-waste storage, self-production, plant protein consumption and anti-waste cooking. Originality/value The findings suggest that while at the individual level people appear to have incorporated anti-waste practices into their daily lives, at the household level, there is still work to be done for improving diets and stimulating the production of home-grown food. It is also worth noting that the emerging vision typically involves sustainable foods that are organic, locally grown, seasonal, based on fair trade and packaging-free

Enhancing a peer supporter intervention for young mothers living with HIV in Malawi, Tanzania, Uganda, and Zambia: Adaptation and co-development of a psychosocial component

Young mothers living with HIV (YMHIV) experience heightened risks to their mental health, as their transition to adulthood is marked by social stigma, health and socioeconomic challenges. Targeted psychosocial interventions may improve the mental health of YMHIV; however, no evidence-based interventions have been developed for this group. Peer support models, more common for youth living with HIV, show promise as a design to reach YMHIV in a non-stigmatising way. This manuscript describes the process of adapting and co-developing an evidence-based psychosocial component (Boost) of a larger intervention called Ask-Boost-Connect-Discuss. Peer supporters in Malawi, Tanzania, Uganda, and Zambia used ABCD to guide group sessions with YMHIV. The research team partnered with an implementing partner, Paediatric-Adolescent Treatment Africa, to undertake this work in three phases: 1) formative research, 2) content adaptation and development, and 3) consultation, refinement, and modification. YMHIV (n = 4), peer supporters (n = 21), and technical advisors (n = 4) were engaged as co-developers, shaping the resulting Boost intervention component at each phase. Peer support models may effectively reach young mothers, and consultation, co-creation, and integration with existing programming can offer rich insights to inform these models. We discuss the implications and promise of this approach

Performance de mesure de la composition en acides gras de la bavette de flanchet par spectroscopie proche infrarouge

The aim of the study was to test the prediction performance of the fatty acid (FA) composition of beef (Rectusabdominis, RA) with a NIRS (near infrared spectroscopy) equipment. In order to have a representative database ofFrench beef FA composition, 364 RA were sampled on carcasses from different rearing systems (dairy or beef ; youngbulls, cows, steers or heifers ; pasture, hay or corn silage with or without extruded linseed concentrates). FAcomposition was assessed using gas chromatography and spectra were measured at wavelengths between 400 and2500nm. The results show that NIRS accurately predicts several individual FA (16:0, 18:1d9cis) and FA groups (totalsaturated, monounsaturated FA) (RPD>2.0). For other FA and especially polyunsaturated fatty acids (PUFA) n-6 or n-3, the performances should still be improved for quantitative purposes