Community-based malaria control programme in Tigray Region, Northern Ethiopia: Results of a mortality survey of rural under-five children

Abstract: A mortality survey of children under five years of age was undertaken in Tigray Region, in rural areas covered by a community-based malaria control programme. A multistage cluster sampling technique was used to define the sample. Trained Malaria Control Programme personnel conducted interviews in 4660 households. Total under-five population sampled was 7335, in which 190 deaths were reported in one year. Median duration of illness before death was 14 days, mean age at death 1.5 years, and 53% of those who died were male. Forty five percent died without being taken to a Community Health Worker (CHW) or to a health facility before death, and 92% of the deaths occurred at home. Overall, 12% of deaths were reported by families due to fever or malaria. Death rate (age 0-4) was 25.9%. Estimated age specific mortality rate (age 0-4) was 26.3%, underfive mortality rate (U5MR) was 163%, and malaria-specific mortality rate based on lay reporting was 3.3%. Two districts were found to have very high mortality with estimated U5MRs of 372% and 290%. Based on these findings, increased efforts are being made in the Community-Based Malaria Control Programme to educate families about the importance of early diagnosis and treatment and the use of CHW services for ill children. Areas for investigating the determinants of the marked district mortality differentials are discussed. [Ethiop. J. Health Dev. 1998;12(3):203-211

In situ deposition of polyaniline onto sisal fibers and removal efficiency for chromium (VI) from aqueous solution: Structure and adsorption studies

In the present study, polyaniline was coated on the surface of sisal fibers through in situ oxidative polymerization which was further characterized using FT‐IR, UV‐Vis, XRD, SEM and EDX instruments. The composite was tested to remove hexavalent chromium Cr(VI) from simulated wastewater on batch experimentas a function of contact time, solution pH, particle size, adsorbent dose and adsorbate dose. Peaks in the range of 1480‐1580 cm‐1 from FT‐IR spectra confirmed polyaniline is rich in amino polyfunctionalities. Another peak at 1160 cm‐1 proved introduction of polyaniline in the doped state. An EDX spectrum exhibits a characteristic peak of C, N, O and Cl atoms that verify deposition of polyaniline on the surface of sisal fibers. It was observed that adsorption of Cr(VI) is highly susceptible to pH change with the adsorption removal of 93.1% achieved at pH 4. Studies on adsorption reaction revealed adsorption process followed pseudo second orderkinetics confirming chemisorption as a rate determining step. The isotherm data were suitably fitted tothe Langmuir model with maximum adsorption capacity (qm) of 17.86 mg/g when all adsorption variables were optimized

Neighbourhood Open Spaces : Co-production and Spatial Transformation in Addis Ababa

The open spaces of a city are its lungs. They are places for people to exercise and carry out social activities, they influence the water cycle, and have considerable impact on air quality. In the developed world, companies are attracted to locations that offer well-designed, well-managed public spaces and these in turn attract customers, employees, and services (Byrne and Sipe 2010) . The presence of green parks, squares, gardens, and other public spaces in urban areas have therefore become vital marketing tools. Well-planned areas with green open spaces offer benefits to the local economy in terms of raising real-estate prices (ibid. ) . Open spaces facilitate social communication, relaxation and recreation, and promote trade and tourism (Thompson 2002) . Open spaces are among a city’s most valuable assets that are threatened by rapid urban transformation. Protecting these open spaces and maintaining sustainable...peerReviewe

Fortified balanced energy-protein supplementation, maternal anemia, and gestational weight gain : a randomized controlled efficacy trial among pregnant women in rural Burkina Faso

Background Anemia and suboptimal gestational weight gain (GWG) are associated with adverse maternal and birth outcomes. Limited research indicates that balanced energy-protein (BEP) supplements reduce the incidence of inadequate GWG. Objectives We assessed the efficacy of a micronutrient-fortified BEP supplement on the secondary outcomes of anemia, GWG, GWG rate, and GWG in relation to the Institute of Medicine (IOM)'s recommendations, as compared with an iron-folic acid (IFA) tablet. Methods We conducted a randomized controlled trial in Burkina Faso, among pregnant women (15-40 y old) enrolled at <21 weeks of gestation. Women received either BEP and IFA (intervention) or IFA (control). Hemoglobin (g/dL) concentrations were measured at baseline and the third antenatal care visit (ANC), whereas maternal weight was measured at baseline and all subsequent similar to 7-weekly ANCs. GWG (kg) was calculated as a woman's last weight measurement (at similar to 36 weeks of gestation) minus weight at enrollment, whereas GWG rate (kg/wk) was GWG divided by the time between the first and last weight measurements. GWG adequacy (%) was computed as GWG divided by the IOM's recommendation. Binary outcomes included severely inadequate, inadequate, and excessive GWG. Statistical analyses followed the intention-to-treat principle. Linear regression and probability models were fitted for the continuous and binary outcomes, respectively, adjusting for baseline measurements. Results Women in the BEP group tended to have higher, but nonsignificantly different, GWG (0.28 kg; 95% CI: -0.05, 0.58 kg; P = 0.099). Furthermore, there were no significant differences in prenatal anemia prevalence, GWG rate, GWG adequacy, or incidence of inadequate or excessive GWG. Findings were robust to model adjustments and complete case and per protocol analyses. Conclusions This trial does not provide evidence that fortified BEP supplementation reduces maternal anemia or increases GWG, as compared with IFA. In conjunction with the small, but positive, effects of maternal BEP supplementation on birth outcomes, our findings warrant the investigation of additional biochemical and postnatal outcomes. This trial was registered at clinicaltrials.gov as NCT03533712

Multiple mycotoxin exposure during pregnancy and risks of adverse birth outcomes : a prospective cohort study in rural Ethiopia

Introduction: Mycotoxin exposure during pregnancy has been associated with adverse birth outcomes in low- and middle-income countries. The evidence, however, is inconsistent and mainly limited to the assessment of a single mycotoxin. We assessed biomarkers of exposure to multiple mycotoxins during pregnancy and their associations with adverse birth outcomes in rural Ethiopia. Methods: We analyzed data from 579 pregnant women between 8 and 24 weeks of completed gestation enrolled in a prospective cohort study. Serum mycotoxin concentrations were determined using liquid chromatography coupled with tandem mass spectrometry. Multivariable linear probability models, adjusted for potential confounding factors and multiple comparisons, were fitted to assess the associations between mycotoxin exposure and small for gestational age and preterm birth. We applied principal component analysis to reduce the dimensionality of biomarker data from several taxonomic mycotoxin groups. Results: All pregnant women were co-exposed to at least five mycotoxins, and one pregnant woman was co-exposed to 27 mycotoxins. Fumonisins (FB), i.e., FB2, FB3, FB1, and tenuazonic acid were the most frequently identified mycotoxins in 98.8, 95.3, 93.3, and 81.4% of the samples respectively. Deoxynivalenol was detected in 38.7%, nivalenol in 50.1%, ochratoxin a in 67.9%, and zearalenone in 50.9% of the serum samples. After adjustment, we found no statistically significant (all P >= 0.05) associations between mycotoxin exposures and birth outcomes. Conclusions: Despite our study providing no evidence for relationships between mycotoxin biomarkers and adverse birth outcomes, our findings do indicate an extensive presence of multiple mycotoxin exposure among pregnant women. Public health policies and nutrition-sensitive interventions must ensure exposure to mycotoxins is reduced in rural Ethiopia

Chronic aflatoxin exposure during pregnancy is associated with lower fetal growth trajectories : a prospective cohort from the Butajira Nutrition, Mental Health, and Pregnancy (BUNMAP) Study in rural Ethiopia

Background Aflatoxins are toxic secondary metabolites produced by Aspergillus fungi, which are ubiquitously present in the food supplies of low- and middle-income countries. Studies of maternal aflatoxin exposure and fetal outcomes are mainly focused on size at birth and the effect on intrauterine fetal growth has not been assessed. Objectives In the present study, we examined the association between chronic aflatoxin exposure during pregnancy and fetal growth trajectories in a rural setting in Ethiopia. Methods In a prospective cohort study, we enrolled 492 pregnant females, with a singleton pregnancy and before 28 wk of gestation. Serum aflatoxin B-1-lysine concentration was measured using LC-tandem MS. Three rounds of ultrasound measurements were conducted to estimate fetal weight at mean +/- SD gestational age weeks of 19.1 +/- 3.71, 28.5 +/- 3.51, and 34.5 +/- 2.44. Estimated fetal weight was expressed in centiles using the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) reference. We fitted a multivariable linear mixed-effects model to estimate the rate of fetal growth between aflatoxin-exposed (i.e., aflatoxin B-1-lysine concentration above or equal to the limit of detection) and unexposed mothers in the study. Results Mothers had a mean +/- SD age of 26.0 +/- 4.58 y. The median (25th, 75th percentile) serum aflatoxin B-1-lysine concentration was 12.6 (0.93, 96.9) pg/mg albumin, and aflatoxin exposure was observed in 86.6% of maternal blood samples. Eighty-five percent of the females enrolled provided at least 2 ultrasound measurements for analysis. On average, the aflatoxin-exposed group had a significantly lower change over time in fetal weight-for-gestational-age centile than the unexposed group (ss = -0.92; 95% CI: -1.77, -0.06 centiles/week; P = 0.037). Conclusions Chronic maternal aflatoxin exposure is associated with lower fetal growth over time. Our findings emphasize the importance of nutrition-sensitive strategies to mitigate dietary aflatoxin exposure and adopting food safety measures in low-income settings, in particular during the fetal period of development

Green synthesis of Co-doped ZnO via the accumulation of cobalt ion onto Eichhornia crassipes plant tissue and the photocatalytic degradation efficiency under visible light

Nowadays, water pollution is a major concern to the globe. For this reason, various research works has been done to access pure water thereby minimizing the effect of pollutants. In this work, the cobalt doped ZnO (Co-doped ZnO) via the accumulation of cobalt ion onto Eichhornia crassipes plant tissue for different days and combined with zinc precursor was synthesized. The resulting catalyst powder samples were characterized by Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), X-Ray photoelectron spectroscopy (XPS), field emission scanning electron microscopy (FE-SEM), and Ultraviolet–vis (UV–vis) spectroscopy, and microwave plasma atomic emission spectrometer (MP-AES). The catalysts were also tested for the photocatalytic degradation of methylene blue (MB) in the presence of H _2 O _2 under visible light irradiation. The best catalytic activity was gained by the 8th-days accumulation of cobalt ion onto the Eichhornia crassipes plant tissue and 99.6% of the dye was degraded within 45 min. However, 69.6, 65.7, 73.6, and 94.8% of MB dye was degraded by 1, 2, 4, and 6 days accumulations. Hence, removal of toxic heavy metal by using Eichhornia crassipes plant and recycling in the wastewater treatment gain is highly appreciated. Moreover, the Co-doped ZnO photocatalysts could enhance the photocatalytic activities due to suppressing of the electron and hole recombination and the porosity of the catalysts resulted from the Eichhornia crassipes plant after calcination

A Multi-Omics and Human Biomonitoring Approach to Assessing the Effectiveness of Fortified Balanced Energy–Protein Supplementation on Maternal and Newborn Health in Burkina Faso: A Study Protocol

Fortified balanced energy–protein (BEP) supplementation is a promising intervention for improving maternal health, birth outcomes and infant growth in low- and middle-income countries. This nested biospecimen sub-study aimed to evaluate the physiological effect of multi-micronutrient-fortified BEP supplementation on pregnant and lactating women and their infants. Pregnant women (15–40 years) received either fortified BEP and iron–folic acid (IFA) (intervention) or IFA only (control) throughout pregnancy. The same women were concurrently randomized to receive either a fortified BEP supplement during the first 6 months postpartum in combination with IFA for the first 6 weeks (i.e., intervention) or the postnatal standard of care, which comprised IFA alone for 6 weeks postpartum (i.e., control). Biological specimens were collected at different timepoints. Multi-omics profiles will be characterized to assess the mediating effect of BEP supplementation on the different trial arms and its effect on maternal health, as well as birth and infant growth outcomes. The mediating effect of the exposome in the relationship between BEP supplementation and maternal health, birth outcomes and infant growth were characterized via biomonitoring markers of air pollution, mycotoxins and environmental contaminants. The results will provide holistic insight into the granular physiological effects of prenatal and postnatal BEP supplementation