15 research outputs found

    Understanding Drivers of Stunting Reduction in Nigeria from 2003 to 2018: a Regression Analysis

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    Nigeria is a high burden country for stunting. Stunting reduction has been slow and characterized by unequal progress across the 36 states and federal capital territory of the country. This study aimed to assess the changes in prevalence of stunting and growth determinants from 2003 to 2018, identify factors that predicted the change in stunting, and project future stunting prevalence if these predicted determinants improve. Trend and linear decomposition analyses of growth outcomes and determinants were conducted using 2003, 2008, 2013, and 2018 Nigeria Demographic and Health Survey data. Pooled data included 57,507 children 0 to 59 months old. Findings show that stunting and severe stunting significantly reduced from 43 to 37% and 23% to 17%, respectively (p < 0.001), between 2003 and 2018. Disturbingly, height-for-age z-scores at birth significantly decreased, indicating risks of potential future stunting increase. Improvements in nine stunting determinants (maternal body mass index, maternal height, ≥ 4 antenatal care visits, health facility delivery, reduced child illnesses, asset index, maternal education, paternal education, and preceding birth interval) predicted stunting reductions in children 0–59 months. Few of these nine determinants improved in subpopulations with limited stunting progress. Intra-sectoral and multisectoral coordination were potentially inadequate; 12% of children had received all of three selected health sector interventions along a continuum of care and 6% had received all of six selected multisector interventions. Forward looking projections suggest that increased efforts to improve the nine predictors of stunting change can reduce under-five stunting in Nigeria to ≤ 27% in the short term.Bill and Melinda Gates Foundatio

    Détermination De La Dose Optimale D'engrais Minéral 15-15-15 Sur Cinq (05) Variétés De Maïs Doux (Zea Mays L. ssp. saccharata) Au Sénégal

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    The objective of this study is to assess the response of five varieties of sweet maize namely, Prime plus (V1), Shy 1036 (V2), Colombus (V3), GSS (V4), and JKMH-45 (V5) to three different doses of NPK (15-15-15) fertilizer: F1 (normal dose), F2 (75% of the normal dose) and F3 (125% of the normal dose). An experimental design in Fisher blocs with 15 treatments was established at the ISRA/CRA experimental station in Saint Louis (Senegal). The results have shown that 30 days after sowing (DAS), the varieties Colombus, GSS and JKMH-45 have had the highest heights with 32.75 cm, 31.85 cm and 31.46 cm, respectively with the F2 dose. The variety JKMH-45 has a greater height of the upper ear (89.39 cm) at 60 DAS and valorizes better the F2 dose (75% of the normal dose). The F3 dose increases less the plant’s height. A non-significant difference was observed among the 5 varieties used regarding the precocity. The variety V2 or Shy 1036 developed ears at first, but is not precocious compared to the variety V1 that not only shows earlier anthesis but also an appearance of darker hairs. The variety JKMH-45, although presenting darker hairs after the variety Prime plus, is the latest variety, earing at 57 DAS and with male and female anthesis appearing at 59 DAS and 63 DAS. This study can constitute a basic criterion in differentiating the sweet maize varieties in Senegal. It would also allow more financial saving on inputs and contribute to the maximization ofproduction if the choice of the variety is well done

    The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

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    INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

    Evidence mapping of wasting programs and their impact along the continuum of care in low- and middle-income countries: A rapid review of the research evidence

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    Wasting, also known as acute malnutrition, is a major health problem requiring urgent attention in low- and middle-income countries (LMICs). Wasting is defined as low weight-for-height. According to the World Health Organization (WHO), it often indicates a recent and severe weight loss and usually occurs when a person has not had food of adequate quality and/or quantity and/or they have had frequent or prolonged illnesses.Non-PRIFPRI1; CRP4; 2 Promoting Healthy Diets and Nutrition for all; Transform Nutrition West AfricaPHND; A4NHCGIAR Research Program on Agriculture for Nutrition and Health (A4NH

    Cartographie des données probantes sur les programmes de réduction de l’émaciation et leur impact le long du continuum de soins, dans les pays à revenu faible ou intermédiaire : revue rapide des résultats de recherche

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    L’émaciation ou la malnutrition aiguë est un problème de santé majeur nécessitant une attention urgente dans les pays à revenu faible ou intermédiaire (PRFI). L’émaciation se définit comme un faible rapport poids/taille et/ou un faible périmètre brachial. Selon l’Organisation mondiale de la santé (OMS), elle indique souvent une perte de poids récente importante et se produit habituellement lorsqu’une personne n’a pas une alimentation suffisante en quantité et/ou en qualité et/ou a souffert de maladies fréquentes ou prolongées. La prise en charge de 2 Cartographie des données probantes sur les programmes de réduction de l’émaciation et leur impact le long du continuum de soins l’émaciation est vitale, dans la mesure où les enfants émaciés sont exposés à un risque accru de maladie et de décès.Non-PRIFPRI1; CRP4; 2 Promoting Healthy Diets and Nutrition for all; Transform Nutrition West AfricaPHND; A4NHCGIAR Research Program on Agriculture for Nutrition and Health (A4NH

    Effectiveness and implementation analysis of interventions to improve exclusive and early initiation of breastfeeding in West Africa

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    Transform Nutrition West Africa has identified key priorities for future action in the West Africa region. It has done so in consultation with stakeholders, including researchers, NGOs, members of civil society and the private sector, and representatives from government, the United Nations, and donor agencies. Consultations involved capturing, documenting, and learning from implementation experiences, and accelerating equitable program coverage of mother, infant, and young child interventions at scale. Stakeholders specifically identified the need for contextualization and implementation of interventions to promote breastfeeding.Non-PRIFPRI1; CRP4; 2 Promoting Healthy Diets and Nutrition for all; Transform Nutrition West AfricaPHND; A4NHCGIAR Research Program on Agriculture for Nutrition and Health (A4NH

    How Denmark, England, Estonia, France, Germany, and the USA pay for variable, specialized and low volume care: A cross-country comparison of in-patient payment systems

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    Background: Diagnosis-related group (DRG)-based hospital payment can potentially be inadequately low (or high) for highly variable, highly specialized, and/or low volume care. DRG-based payment can be combined with other payment mechanisms to avoid unintended consequences of inadequate payment. The aim of this study was to analyze these other payment mechanisms for acute inpatient care across six countries (Germany, Denmark, England, Estonia, France, the United States [Medicare]). Methods: Information was collected about elements excluded from DRG-based payment, the rationale for exclusions, and payment mechanisms complementing DRG-based payment. A conceptual framework was developed to systematically describe, visualise and compare payment mechanisms across countries. Results: Results show that the complexity of exclusion mechanisms and associated additional payment components differ across countries. England and Germany use many different additional mechanisms, while there are only few exceptions from DRG-based payment in the Medicare program in the United States. Certain areas of care are almost always excluded (eg, certain areas of cancer care or specialized pediatrics). Denmark and England use exclusion mechanisms to steer service provision for highly complex patients to specialized providers. Conclusion: Implications for researchers and policy-makers include: (1) certain areas of care might be better excluded from DRG-based payment; (2) exclusions may be used to incentivize the concentration of highly specialized care at specialized institutions (as in Denmark or England); (3) researchers may apply our analytical framework to better understand the specific design features of DRG-based payment systems.PRIFPRI3; 5 Strengthening Institutions and Governance; ISIPHN
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