Influencing factors of unmet needs for child spacing among selected countries experiencing high maternal-mortality in sub-Saharan Africa

Background: Maternal complication and death have implicated unintended pregnancy. The indicator for measuring the risk of unintended pregnancy is unmet need for family planning (FP). It is necessary to explore the current situation of unmet need for child spacing (UNCS) as well as its influencing factors among countries that are experiencing high maternal mortality ratio. We aimed to unveil the prevalence of UNCS and its associated factors in Nigeria, Liberia and Sierra Leone.Methods: We analysed the data from DHS phase VII survey, a cross- sectional study conducted from year 2017 to 2018 across several countries. Total records of 25,539, 5,553, and 10,050 were extracted for Nigeria, Liberia and Sierra Leone respectively. Explored variables were UNCS, demographic characteristics and husband’s partners profile. Data was analysed using SPSS version 25. Descriptive statistics, test of association (chi-square) and binary logistic regression were used during the data analysis (α0.05).Results: UNCS was high in Nigeria (15.9%), Liberia (22.5%) and Sierra Leone (21.9%). In Nigeria, Liberia and Sierra Leone, 40%, 37% and 49.1% were uneducated respectively. The proportion of married women were 89% in Nigeria, 32% in Liberia and 70.2% in Sierra Leone. Also, female headship of household (OR: 1.29, 95%CI: 1.09-1.54) was associated with UNCS relative to male headship of household.Conclusions: UNCS was high in the three countries. Factors like educational status of women, age, as well as women as head of the households should be given much attention in the efforts to reduce UNCS as identified in this study

Design of Mixing Station for Alternative Gaseous Fuels

Úkolem diplomové práce je navrhnout potrubní rozvod plynů do směšovací stanice a následně i navrhnout samotnou směšovací stanici. V textové části je nejprve vytvořena rešerše týkající se využívání technických a topných plynů v praxi. Na tuto část postupně navazují specifikace plynů, které se budou dopravovat do směšovací stanice. Ve výpočtové části se práce prostřednictvím výpočtových vztahů zabývá složením směsného plynu, fyzikálními vlastnostmi jednotlivých plynů i samotného plynu směsného, přičemž jsou vypočteny a navrženy potrubní tratě jednotlivých plynů směřujících do směšovací stanice. Konstrukční část práce se zabývá návrhem směšovací stanice a směšovací komory, ve které se jednotlivé plyny mísí. Grafická část práce obsahuje schémata jednotlivých potrubních tratí a směšovací stanice, 3D model směšovací komory a výkres směšovací komory.The task of the diploma thesis is to design the pipeline distribution of gases to the mixing station and then design the mixing station itself. In the text part is first created a search regarding the use of technical and heating gases in practice. This part is followed by the gas specifications that will be transported to the mixing station. In the computational part, the work with the help of calculation relations deals with the composition of the mixed gas, the physical properties of the individual gases and the mixing gas itself, and the pipelines of the individual gases leading to the mixing station are calculated and designed. The construction part deals with the design of the mixing station and the mixing chamber, in which the individual gases are mixed. The graphical part of the thesis contains diagrams of individual pipeline lines and mixing stations, a 3D model of the mixing chamber and a drawing of the mixing chamber.361 - Katedra energetikyvýborn

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

Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times and more-regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and illuminate the distinct dispersal dynamics of variants of concern-particularly Alpha, Beta, Delta, and Omicron-on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve while the continent faces many emerging and reemerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

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

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

Assessment of complementary feeding practices among care givers in Ilorin, Kwara State.

Background: Appropriate feeding practices are of fundamental importance for the survival, growth and development of any child. Objectives: The aim of this study was to assess feeding practices of mothers in Ilorin, Kwara State. Methodology: A total of 210 nursing mothers and caregivers for children aged 6 to 36 months were studied. Data collection was with a structured questionnaire and data was analyzed using SPSS version 14.0. Results: Thirty eight (18%) of the mothers interviewed practiced exclusive breast feeding. Ninety (42.8%) of the respondents introduced complementary diets between 4-6 months while 24 (11.4%) introduced it before 4 months. Reasons for the introduction included “inadequacy of breast milk alone” 102(48.6%), “lack of sufficient breast milk” 24(11.4%) and “advice from health workers” 37(17.4%). Rice was the first complementary food introduced in 72(34.3%). The use of feeding bottles was reported in 67(31.9%). Conclusion: The rate of EBF practice was low, there was early introduction of inadequately nutritious complementary feeds and use of feeding bottles was also found to be common. We recommend the need for continuous education on appropriate feeding practices for children by health workers to mothers and caregiver. Key words: complementary feeding ; practices; caregive

THE USE OF PSYCHOACTIVE DRUGS AMONG STREET LADIES IN ABA METROPOLIS OF NIGERIA: AN ASSESSMENT OF PUBLIC HEALTH IMPLICATIONS

Introduction: The use of psychoactive drugs among ladies is engaged in on an alarming increase in the postmodern Nigerian society, as it remains one of the public health and social vices that affects the contemporary human community.&#x0D; Purpose: The objectives of this study were to identify the drugs mostly abused and to determine the risk behaviours they engage in when under the influence of psychoactive drugs.&#x0D; Methodology: This study adopted a cross-sectional approach involving the use of oral interview and a semi- structured questionnaire as the instrument of data collection. This involved 20 interviewees in simple random selection. The data collected were analyzed using a descriptive statistics and statistical test of significance and results presented in charts.&#x0D; Findings: Major findings in this study attest to the fact that the mostly abused psychoactive drugs are Cigarette, Indian hemp, tramadol and codeine, cocaine. The use of psychoactive drugs is precursory to mental health challenges, depression, and behavioural abnormalities among younger women. The risk behaviours engaged when under the influence of these psychoactive drugs are aggressiveness/ ready to fight, unrestricted sexual activities, desire for more drug use. Consequently, the study findings maintain that the perpetration of heinous crimes that are carried out in the society cannot be independent of the influence of drugs, since the abused psychoactive drugs alter the normal function of the brain thus affecting the mental health of the user.&#x0D; Contribution to theory, practice and policy: Therefore, public health education and promotion with a focus on dissuading the unrestricted circulation and abuse of psychoactive drugs, especially among Aba young ladies is perceived profitable.&#x0D; Conclusion and Recommendation: Community awareness regarding drug and substance among women and constant checkmating of the activities of street girls should be carried out.</jats:p