Socioeconomic inequalities and HIV testing during antenatal care in high- medium- and low-conflict intensity countries in sub-saharan Africa

Understanding HIV testing determinants in different settings is vital to reducing new infections. This study assessed HIV testing rates during antenatal care (ANC) in seven sub-Saharan African countries designated as high, medium, low or no conflict intensity settings. We ranked and plotted concentration curves for HIV testing by socioeconomic inequality and determined their concentration indices (CCI). Testing for HIV during ANC was highest in Zimbabwe (95.7%) and lowest in Sudan (3.6%). Countries with medium and high conflict intensity experienced higher HIV testing inequality (CCI=0.38) than countries with low or no conflict (CCI=0.15). Low HIV testing rates were associated with no education, rural areas, poorest wealth index quintiles and home birth, which demonstrate that determinants of HIV testing during ANC in conflict-affected areas are complex and context-based. Programme implementation and policymakers must acknowledge these complexities and local contexts in their program designs and planning

Promoting healthy gender relationships in secondary schools through a mixed netball competition

Context: Gender-based violence is a widespread problem with significant impacts. Young people are identified as a priority group: as targets for change, and agents of change in violence prevention strategies. By increasing knowledge; providing opportunities to discuss issues in a supportive environment; challenging attitudes about roles and expectations; and providing skills to challenge sexism, harassment, and gender-based discrimination; we hope to prevent gender-based violence. Objectives: • Increase adolescent awareness to recognise the early warning signs of relationship and gender-based violence and the multiple factors that enable it; • Provide students the opportunity to practice and implement skills to take bystander action to prevent or intercede in situations of relationship and gender-based violence Process: Students participated in workshops exploring consent, gender equity, the role of the bystander and the impact of attitudes and behaviours on enabling or preventing the incidence of gender-based violence. These workshops were followed by a mixed round robin netball competition. Analysis: Interviews and surveys were conducted to measure baseline of students’ knowledge and confidence to intervene and impact of the workshops and netball competition. Outcomes: 75 surveys were completed. 66.2% reported learning about early signs of unhealthy relationships. 55.6% would only act if it was safe to. Some participants were unable to transfer class-based learning to the netball competition. Evidence showed students were surprised and strongly impacted by the data provided. Presumptions cannot be made that information is available and known to most. Efforts to raise awareness of the statistics on violence against women needs to continue

Plant-derived foods for the Attenuation of allergic airway inflammation

Asthma is an allergy-mediated inflammatory disease characterised by infiltration of the airway with mast cells, lymphocytes, and eosinophils. The disease is induced by co-ordination of T-helper cell type 2 (Th2) cytokines and inflammatory signal molecules. Fruits and vegetables are a rich source of polyphenolic bioactive compounds, which have been observed to have health-promoting properties when consumed by humans. In particular, fruit-derived proanthocyanins and anthocyanins have been found to attenuate lung inflammation. Epidemiological studies have revealed correlations between fruit consumption and a lower prevalence of respiratory symptoms and lower incidence of non-specific lung diseases. In this review we summarise the current understanding of the pathophysiologic mechanism(s) involved in the development of allergic airway disease. We also review evidence of the beneficial effects of plant-derived foods, their components and metabolites in allergic airway inflammation arising from in vitro and rodent studies, epidemiological studies and human intervention trials. The mechanism, biological relevance and functional benefits, such as immune modulation (e.g. reduction in cytokine and eotaxin production), antioxidant ability, tissue remodelling and tight junction function are also discussed. © 2014 Bentham Science Publishers

Blackcurrant anthocyanins modulate CCL11 secretion and suppress allergic airway inflammation

CCL11, a chemokine, is linked to the early development of airways eosinophilia in allergic asthma. Therefore, CCL11 production is a target for abrogating eosinophilic-driven airway inflammation. Blackcurrants are high in compounds that regulate inflammation, particularly anthocyanins. In this study, we investigated the effect of oral blackcurrant supplementation on allergen-induced eosinophilia and CCL11 production; we also profiled key compounds in blackcurrants that were linked to this effect. Ten milligram per kilogram (total anthocyanins) of a commercially available, anthocyanin-rich New Zealand "Ben Ard" blackcurrant extract ("Currantex 30") attenuated ovalbumin-induced inflammation, eosinophilia (by 52.45 ± 38.50%), and CCL11 production (by 48.55 ± 28.56%) in a mouse model of acute allergic lung inflammation. Ten blackcurrant polyphenolic extracts were also found to suppress CCL11 secretion by stimulated human lung epithelial cells in vitro. Correlation analysis identified potential blackcurrant polyphenolic anthocyanin constituents specifically delphinidins and cyanidins, involved in CCL11 suppression. Our findings show oral supplementation with New Zealand blackcurrant is effective in reducing lung inflammation, and highlight the potential benefit of developing cultivars with specific polyphenolic profiles for the creation of functional foods with desirable biological activity

Racial disparities in COVID-19 pandemic cases, hospitalisations, and deaths: A systematic review and meta-analysis

Background: People from racial minority groups in western countries experience disproportionate socioeconomic and structural determinants of health disadvantages. These disadvantages have led to inequalities and inequities in health care access and poorer health outcomes. We report disproportionate disparities in prevalence, hospitalisation, and deaths from COVID-19 by racial minority populations. Methods: We conducted a systematic literature search of relevant databases to identify studies reporting on prevalence, hospitalisations, and deaths from COVID-19 by race groups between 01 January 2020 – 15 April 2021. We grouped race categories into Blacks, Hispanics, Whites and Others. Random effects model using the method of DerSimonian and Laird were fitted, and forest plot with respective ratio estimates and 95% confidence interval (CI) for each race category, and subgroup meta-regression analyses and the overall pooled ratio estimates for prevalence, hospitalisation and mortality rate were presented. Results: Blacks experienced significantly higher burden of COVID-19: prevalence ratio 1.79 (95% confidence interval (CI)=1.59-1.99), hospitalisation ratio 1.87 (95% CI=1.69-2.04), mortality ratio 1.68 (95% CI=1.52-1.83), compared to Whites: prevalence ratio 0.70 (95% CI = 0.0.64-0.77), hospitalisation ratio 0.74 (95% CI=0.65-0.82), mortality ratio 0.82 (95% CI=0.78-0.87). Also, Hispanics experienced a higher burden: prevalence ratio 1.78 (95% CI=1.63-1.94), hospitalisation ratio 1.32 (95% CI=1.08-1.55), mortality ratio 0.94 (95% CI=0.84-1.04) compared to Whites. A higher burden was also observed for Other race groups: prevalence ratio 1.43 (95% CI=1.19-1.67), hospitalisation ratio 1.12 (95% CI=0.89-1.35), mortality ratio 1.06 (95% CI=0.89-1.23) compared to Whites. The disproportionate burden among Blacks and Hispanics remained following correction for publication bias. Conclusions: Blacks and Hispanics have been disproportionately affected by COVID-19. This is deeply concerning and highlights the systemically entrenched disadvantages (social, economic, and political) experienced by racial minorities in western countries; and this study underscores the need to address inequities in these communities to improve overall health outcomes

Effects of potato fiber and potato-resistant starch on biomarkers of colonic health in rats fed diets containing red meat

The effects of red meat consumption with and without fermentable carbohydrates on indices of large bowel health in rats were examined. Sprague-Dawley rats were fed cellulose, potato fiber, or potato-resistant starch diets containing 12% casein for 2 wk, then similar diets containing 25% cooked beef for 6 wk. After week 8, cecal and colonic microbiota composition, fermentation end-products, colon structure, and colonocyte DNA damage were analyzed. Rats fed potato fiber had lower Bacteroides-Prevotella-Porphyromonas group compared to other diet groups. Colonic Bifidobacterium spp. and/or Lactobacillus spp. were higher in potato fiber and potato-resistant starch diets than in the cellulose diet. Beneficial changes were observed in short-chain fatty acid concentrations (acetic, butyric, and propionic acids) in rats fed potato fiber compared with rats fed cellulose. Phenol and p-cresol concentrations were lower in the cecum and colon of rats fed potato fiber. An increase in goblet cells per crypt and longer crypts were found in the colon of rats fed potato fiber and potato-resistant starch diets. Fermentable carbohydrates had no effect on colonic DNA damage. Dietary combinations of red meat with potato fiber or potato-resistant starch have distinctive effects in the large bowel. Future studies are essential to examine the efficacy of different types of nondigestible carbohydrates in maintaining colonic health during long-term consumption of high-protein diets. Practical Application: Improved understanding of interactions between the food consumed and gut microbiota provides knowledge needed to make healthier food choices for large bowel health. The impact of red meat on large bowel health may be ameliorated by consuming with fermentable dietary fiber, a colonic energy source that produces less harmful by-products than the microbial breakdown of colonic protein for energy. Developing functional red meat products with fermentable dietary fiber could be one way to promote a healthy and balanced macronutrient diet. © 2012 Institute of Food Technologists®

Blackcurrant cultivar polyphenolic extracts suppress CCL26 secretion from alveolar epithelial cells

Eosinophil recruitment to the airways is a characteristic feature of allergic asthma. Eotaxins are potent chemokines that regulate the recruitment of eosinophils to sites of inflammation. Of these, CCL26 is linked to persistent eosinophil recruitment in the later phase of an allergic response. We evaluated the effectiveness of 10 different blackcurrant cultivar polyphenolic extracts in suppressing CCL26 secretion in stimulated human alveolar epithelial cells. Correlation analysis to identify the potential blackcurrant composition constituent(s) involved in CCL26 suppression and the effects of the four major anthocyanins present in blackcurrants to validate results was conducted. All blackcurrant polyphenolic extracts suppressed CCL26 secretion by lung alveolar cells; however, differential efficacy was observed, which was attributed to their cultivar-specific polyphenolic composition profiles. We identified that the ratio of concentrations of delphinidin glycosides to cyanidin glycosides in the blackcurrant cultivars was an important determinant in influencing CCL26 suppression in lung cells. Our findings support the potential use of blackcurrants or blackcurrant-derived foods/ingredients in managing lung inflammation and the development of specific cultivars as functional foods/ingredients with beneficial biological activities. This journal is © the Partner Organisations 2014

Dietary combination of potato resistant starch and red meat up-regulates genes involved in colonic barrier function of rats

In a recent study, we have shown the favourable colonic effects of potato fibre and potato resistant starch through increased proliferation of bifidobacteria, lactobacilli or elevated short‐chain fatty acids (SCFAs) levels in rats fed a red meat‐based diet (Paturi et al., 2012c). Our hypothesis was that these changes in the microbiota and their metabolism may have positively influenced gene expression in the colon, given that beneficial bacteria such as bifidobacteria and lactobacilli are capable of enhancing the intestinal epithelial cell functions. Therefore, in the present study, we set out to investigate how the consumption of fermentable fibres, alongside a red meat diet affected the expression of genes involved in various protective mechanisms in the colon of rats

HIV/AIDS knowledge and attitudes among women of child-bearing age in South Sudan: Findings from a household survey

This study assessed the determinants that shape HIV knowledge and attitudes among South Sudanese women by analysing a Multiple Indicator Cluster Survey collected from 9,061 women in 9,369 households. Generalised linear mixed model regression was performed. Fifty percent of respondents were aware of HIV/AIDS, with 21% and 22% exhibiting good knowledge and positive attitudes towards people with HIV/AIDS, respectively. When controlled for individual and community-level variables, younger women (AOR=1.28, 95% CI: 1.01-162), women with primary (AOR=2.19; 95% CI: 1.86-2.58) and secondary (AOR=4.48; 95% CI: 3.38-5.93) education, and those living in urban areas (AOR=1.40; 95% CI: 1.12-1.76) had significantly good knowledge. Women in the richer (AOR=1.60; 95% CI: 1.08-2.36) and the richest (AOR=2.02; 95% CI: 1.35-3.02) wealth quintiles had significant positive attitudes towards people with HIV/AIDS. Well-designed social and behavioural campaigns targeting uneducated women and those living in rural and remote settings will enhance knowledge of perceived risk, awareness, and ability to carry out preventive behaviours