A systematic review of non-antibiotic measures for the prevention of urinary tract infections in pregnancy

Background: Urinary tract infections (UTIs) are common in pregnancy and account for the highest proportion of primary care antibiotic prescriptions issued to pregnant women in the UK. It is well known that antibiotic use is associated with increased antimicrobial resistance and therefore measures to minimise antibiotic use for UTI prevention have been studied. The efficacy and safety of these measures in pregnancy have not been addressed and therefore the aim of this study was to systematically review the literature to identify and evaluate potential measures to prevent UTIs in pregnant women. Methods: Ten databases (EMBASE, AMED, BNI, CINAHL, Medline, PubMed, PsycINFO, Cochrane Trials, Scopus and Science Direct) were systematically searched in July 2017 for studies reporting non-antibiotic measures to prevent UTIs in pregnancy. The terms (“urinary tract infection”or UTI or bacteriuria or cystitis) AND (prevention) AND (pregnan*) were used. The quality of the publications was appraised using the Critical Appraisal Skills Programme (CASP) checklists for cohort study, case-control study and randomised controlled trial. The results were synthesised using a textual narrative approach. Results: Search results yielded 3276 publications and after reviewing titles and removing duplicates, 57 full text articles were assessed for eligibility and eight were included in the review. Five different approaches (hygiene measures, cranberry juice, immunisation, ascorbic acid and Canephron® N) have been identified, all of which are reported to be safe in pregnancy. Conclusion: The quality of the evidence varied considerably and only hygiene measures were supported by evidence to be recommended in practice. Future work needs to concentrate on strengthening the evidence base through improved design and reporting of studies with a focus on immunisation, ascorbic acid and Canephron® N

Oil and Cocoa in the Political Economy of Ghana-EU Relations: Whither Sustainable Development?

Oil and cocoa represent strategic export commodities for the Ghanaian economy, prioritised within the Ghana Shared Growth and Development Agenda. This article examines these sectors in the context of Ghana’s relations with the European Union (EU). Notably, the EU constitutes the most important market for Ghanaian exports. The European Commission, moreover, has pledged to tangibly assist private sector development in Ghana, with particular reference to the UN Sustainable Development Goals (SDGs). Through its focus on oil and cocoa, the article problematises certain aspects of EU aid and trade interventions with respect to normative SDG development pledges