Pub Date : 2018-04-22eCollection Date: 2018-01-01DOI: 10.1017/gheg.2018.4
D C Parra, L F Gomez, L Iannotti, D Haire-Joshu, A K Sebert Kuhlmann, R C Brownson
Background: The aim of this study was to establish the association of maternal, family, and contextual correlates of anthropometric typologies at the household level in Colombia using 2005 Demographic Health Survey (DHS/ENDS) data.
Methods: Household-level information from mothers 18-49 years old and their children <5 years old was included. Stunting and overweight were assessed for each child. Mothers were classified according to their body mass index. Four anthropometric typologies at the household level were constructed: normal, underweight, overweight, and dual burden. Four three-level [households (n = 8598) nested within municipalities (n = 226), nested within states (n = 32)] hierarchical polytomous logistic models were developed. Household log-odds of belonging to one of the four anthropometric categories, holding 'normal' as the reference group, were obtained.
Results: This study found that anthropometric typologies were associated with maternal and family characteristics of maternal age, parity, maternal education, and wealth index. Higher municipal living conditions index was associated with a lower likelihood of underweight typology and a higher likelihood of overweight typology. Higher population density was associated with a lower likelihood of overweight typology.
Conclusion: Distal and proximal determinants of the various anthropometric typologies at the household level should be taken into account when framing policies and designing interventions to reduce malnutrition in Colombia.
{"title":"Multilevel correlates of household anthropometric typologies in Colombian mothers and their infants.","authors":"D C Parra, L F Gomez, L Iannotti, D Haire-Joshu, A K Sebert Kuhlmann, R C Brownson","doi":"10.1017/gheg.2018.4","DOIUrl":"https://doi.org/10.1017/gheg.2018.4","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to establish the association of maternal, family, and contextual correlates of anthropometric typologies at the household level in Colombia using 2005 Demographic Health Survey (DHS/ENDS) data.</p><p><strong>Methods: </strong>Household-level information from mothers 18-49 years old and their children <5 years old was included. Stunting and overweight were assessed for each child. Mothers were classified according to their body mass index. Four anthropometric typologies at the household level were constructed: normal, underweight, overweight, and dual burden. Four three-level [households (<i>n</i> = 8598) nested within municipalities (<i>n</i> = 226), nested within states (<i>n</i> = 32)] hierarchical polytomous logistic models were developed. Household log-odds of belonging to one of the four anthropometric categories, holding 'normal' as the reference group, were obtained.</p><p><strong>Results: </strong>This study found that anthropometric typologies were associated with maternal and family characteristics of maternal age, parity, maternal education, and wealth index. Higher municipal living conditions index was associated with a lower likelihood of underweight typology and a higher likelihood of overweight typology. Higher population density was associated with a lower likelihood of overweight typology.</p><p><strong>Conclusion: </strong>Distal and proximal determinants of the various anthropometric typologies at the household level should be taken into account when framing policies and designing interventions to reduce malnutrition in Colombia.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2018-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gheg.2018.4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36193137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-04-06eCollection Date: 2018-01-01DOI: 10.1017/gheg.2018.1
S A Quaderi, J R Hurst
Chronic respiratory diseases receive little attention and funding in comparison with other major causes of global morbidity and mortality [1]. Chronic obstructive pulmonary disease (COPD) is a major public health problem. COPD is the end result of a susceptible lung being exposed to sufficient environmental stimulus. Caused principally by tobacco smoking and household air pollution (HAP), COPD is a silent killer in lowand middle-income countries (LMICs): an estimated 328 million people have COPD worldwide [2], and in 15 years, COPD is expected to become the leading cause of death [3]. The relentless decline in lung function that characterises COPD is associated with progressive symptoms and functional impairment, with susceptibility to respiratory infections called ‘exacerbations’. Exacerbations are responsible for much of the morbidity and mortality. COPD has a significant impact on quality of life for those living with the condition, and on local economies for those affected, those caring for the affected and health services. A population literally struggling for breath is, in consequence, unproductive. The majority of cases of chronic lung disease are preventable. Exposure reduction initiatives must focus on tobacco control, and cook-stove interventions: either cleaner fuel (ideally), or better ventilation (at the least). Awareness campaigns and health programmes have the potential to revolutionise the diagnosis and management of COPD and COPD exacerbations, improving quality of life and health service cost and burden. LMICs face unique challenges in managing COPD, including sub-optimal and diverse primary care systems which present challenges with diagnosis and management, especially during exacerbations. A better understanding of how to prevent, diagnose and manage COPD in both rural and urban settings would make a real difference in countries of need. Two important aspects to consider when addressing the global economic burden of COPD are that of underdiagnosis and comorbidities [4]. Firstly, COPD remains underdiagnosed in many jurisdictions [5]. Studies included in reviews focusing on the global economic burden of COPD are all based on diagnosed COPD, and a simple multiplication of these values by the number of COPD patients to calculate the overall economic burden of COPD will underestimate the contribution of undiagnosed COPD [5]. Secondly, COPD is known to be associated with a significant number of comorbid conditions, and estimating costs that are directly attributable to COPD fails to consider the burden of such comorbidities [4]. Adjusting for comorbidities by calculating excess costs with an appropriate comparison group can provide a better opportunity, but even this results in an underestimation of the costs of the comorbidities [6–8].
{"title":"The unmet global burden of COPD.","authors":"S A Quaderi, J R Hurst","doi":"10.1017/gheg.2018.1","DOIUrl":"https://doi.org/10.1017/gheg.2018.1","url":null,"abstract":"Chronic respiratory diseases receive little attention and funding in comparison with other major causes of global morbidity and mortality [1]. Chronic obstructive pulmonary disease (COPD) is a major public health problem. COPD is the end result of a susceptible lung being exposed to sufficient environmental stimulus. Caused principally by tobacco smoking and household air pollution (HAP), COPD is a silent killer in lowand middle-income countries (LMICs): an estimated 328 million people have COPD worldwide [2], and in 15 years, COPD is expected to become the leading cause of death [3]. The relentless decline in lung function that characterises COPD is associated with progressive symptoms and functional impairment, with susceptibility to respiratory infections called ‘exacerbations’. Exacerbations are responsible for much of the morbidity and mortality. COPD has a significant impact on quality of life for those living with the condition, and on local economies for those affected, those caring for the affected and health services. A population literally struggling for breath is, in consequence, unproductive. The majority of cases of chronic lung disease are preventable. Exposure reduction initiatives must focus on tobacco control, and cook-stove interventions: either cleaner fuel (ideally), or better ventilation (at the least). Awareness campaigns and health programmes have the potential to revolutionise the diagnosis and management of COPD and COPD exacerbations, improving quality of life and health service cost and burden. LMICs face unique challenges in managing COPD, including sub-optimal and diverse primary care systems which present challenges with diagnosis and management, especially during exacerbations. A better understanding of how to prevent, diagnose and manage COPD in both rural and urban settings would make a real difference in countries of need. Two important aspects to consider when addressing the global economic burden of COPD are that of underdiagnosis and comorbidities [4]. Firstly, COPD remains underdiagnosed in many jurisdictions [5]. Studies included in reviews focusing on the global economic burden of COPD are all based on diagnosed COPD, and a simple multiplication of these values by the number of COPD patients to calculate the overall economic burden of COPD will underestimate the contribution of undiagnosed COPD [5]. Secondly, COPD is known to be associated with a significant number of comorbid conditions, and estimating costs that are directly attributable to COPD fails to consider the burden of such comorbidities [4]. Adjusting for comorbidities by calculating excess costs with an appropriate comparison group can provide a better opportunity, but even this results in an underestimation of the costs of the comorbidities [6–8].","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2018-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gheg.2018.1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36193135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-02-05eCollection Date: 2018-01-01DOI: 10.1017/gheg.2017.15
S J Clark, J Wakefield, T McCormick, M Ross
Traditionally health statistics are derived from civil and/or vital registration. Civil registration in low- to middle-income countries varies from partial coverage to essentially nothing at all. Consequently the state of the art for public health information in low- to middle-income countries is efforts to combine or triangulate data from different sources to produce a more complete picture across both time and space - data amalgamation. Data sources amenable to this approach include sample surveys, sample registration systems, health and demographic surveillance systems, administrative records, census records, health facility records and others. We propose a new statistical framework for gathering health and population data - Hyak - that leverages the benefits of sampling and longitudinal, prospective surveillance to create a cheap, accurate, sustainable monitoring platform. Hyak has three fundamental components: Data amalgamation: A sampling and surveillance component that organizes two or more data collection systems to work together: (1) data from HDSS with frequent, intense, linked, prospective follow-up and (2) data from sample surveys conducted in large areas surrounding the Health and Demographic Surveillance System (HDSS) sites using informed sampling so as to capture as many events as possible;Cause of death: Verbal autopsy to characterize the distribution of deaths by cause at the population level; andSocioeconomic status (SES): Measurement of SES in order to characterize poverty and wealth. We conduct a simulation study of the informed sampling component of Hyak based on the Agincourt HDSS site in South Africa. Compared with traditional cluster sampling, Hyak's informed sampling captures more deaths, and when combined with an estimation model that includes spatial smoothing, produces estimates of both mortality counts and mortality rates that have lower variance and small bias.
{"title":"Hyak mortality monitoring system: innovative sampling and estimation methods - proof of concept by simulation.","authors":"S J Clark, J Wakefield, T McCormick, M Ross","doi":"10.1017/gheg.2017.15","DOIUrl":"10.1017/gheg.2017.15","url":null,"abstract":"<p><p>Traditionally health statistics are derived from civil and/or vital registration. Civil registration in low- to middle-income countries varies from partial coverage to essentially nothing at all. Consequently the state of the art for public health information in low- to middle-income countries is efforts to combine or triangulate data from different sources to produce a more complete picture across both time and space - <i>data amalgamation</i>. Data sources amenable to this approach include sample surveys, sample registration systems, health and demographic surveillance systems, administrative records, census records, health facility records and others. We propose a new statistical framework for gathering health and population data - Hyak - that leverages the benefits of sampling and longitudinal, prospective surveillance to create a cheap, accurate, sustainable monitoring platform. Hyak has three fundamental components: <i>Data amalgamation</i>: A sampling and surveillance component that organizes two or more data collection systems to work together: (1) data from HDSS with frequent, intense, linked, prospective follow-up and (2) data from sample surveys conducted in large areas surrounding the Health and Demographic Surveillance System (HDSS) sites using informed sampling so as to capture as many events as possible;<i>Cause of death</i>: Verbal autopsy to characterize the distribution of deaths by cause at the population level; and<i>Socioeconomic status (SES)</i>: Measurement of SES in order to characterize poverty and wealth. We conduct a simulation study of the informed sampling component of Hyak based on the Agincourt HDSS site in South Africa. Compared with traditional cluster sampling, Hyak's informed sampling captures more deaths, and when combined with an estimation model that includes spatial smoothing, produces estimates of both mortality counts and mortality rates that have lower variance and small bias.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2018-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gheg.2017.15","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36193134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-31eCollection Date: 2018-01-01DOI: 10.1017/gheg.2017.18
M Toyama, F Diez-Canseco, P Busse, I Del Mastro, J J Miranda
Background: The aim of this study was to design and develop a set of, short message service (SMS) to promote specialized mental health care seeking within the framework of the Allillanchu Project.
Methods: The design phase consisted of 39 interviews with potential recipients of the SMS, about use of cellphones, and perceptions and motivations towards seeking mental health care. After the data collection, the research team developed a set of seven SMS for validation. The content validation phase consisted of 24 interviews. The participants answered questions regarding their understanding of the SMS contents and rated its appeal.
Results: The seven SMS subjected to content validation were tailored to the recipient using their name. The reminder message included the working hours of the psychology service at the patient's health center. The motivational messages addressed perceived barriers and benefits when seeking mental health services. The average appeal score of the seven SMS was 9.0 (SD±0.4) of 10 points. Participants did not make significant suggestions to change the wording of the messages.
Conclusions: Five SMS were chosen to be used. This approach is likely to be applicable to other similar low-resource settings, and the methodology used can be adapted to develop SMS for other chronic conditions.
{"title":"Design and content validation of a set of SMS to promote seeking of specialized mental health care within the Allillanchu Project.","authors":"M Toyama, F Diez-Canseco, P Busse, I Del Mastro, J J Miranda","doi":"10.1017/gheg.2017.18","DOIUrl":"10.1017/gheg.2017.18","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to design and develop a set of, short message service (SMS) to promote specialized mental health care seeking within the framework of the Allillanchu Project.</p><p><strong>Methods: </strong>The design phase consisted of 39 interviews with potential recipients of the SMS, about use of cellphones, and perceptions and motivations towards seeking mental health care. After the data collection, the research team developed a set of seven SMS for validation. The content validation phase consisted of 24 interviews. The participants answered questions regarding their understanding of the SMS contents and rated its appeal.</p><p><strong>Results: </strong>The seven SMS subjected to content validation were tailored to the recipient using their name. The reminder message included the working hours of the psychology service at the patient's health center. The motivational messages addressed perceived barriers and benefits when seeking mental health services. The average appeal score of the seven SMS was 9.0 (SD±0.4) of 10 points. Participants did not make significant suggestions to change the wording of the messages.</p><p><strong>Conclusions: </strong>Five SMS were chosen to be used. This approach is likely to be applicable to other similar low-resource settings, and the methodology used can be adapted to develop SMS for other chronic conditions.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2018-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36193133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-23eCollection Date: 2018-01-01DOI: 10.1017/gheg.2017.17
E Mekonnen, E Bekele, C M Stein
Background: Infection by Mycobacterium tuberculosis (Mtb) is a necessary but not sufficient cause for tuberculosis (TB). Although numerous studies suggest human genetic variation may influence TB pathogenesis, there is a conspicuous lack of replication, likely due to imprecise phenotype definition. We aimed to replicate novel findings from a Ugandan cohort in Ethiopian populations.
Method: We ascertained TB cases and household controls (n = 292) from three different ethnic groups. Latent Mtb infection was determined using Quantiferon to develop reliable TB progression phenotypes. We sequenced exonic regions of TICAM2 and NOD1.
Result: Significant novel associations were observed between two variants in NOD1 and TB: rs751770147 [unadjusted p = 7.28 × 10-5] and chr7:30477156(T), a novel variant, [unadjusted p = 1.04 × 10-4]. Two SNPs in TICAM2 were nominally associated with TB, including rs2288384 [unadjusted p = 0.003]. Haplotype-based association tests supported the SNP-based results.
Conclusion: We replicated the association of TICAM2 and NOD1 with TB and identified novel genetic associations with TB in Ethiopian populations.
{"title":"Novel polymorphisms in <i>TICAM2</i> and <i>NOD1</i> associated with tuberculosis progression phenotypes in Ethiopian populations.","authors":"E Mekonnen, E Bekele, C M Stein","doi":"10.1017/gheg.2017.17","DOIUrl":"10.1017/gheg.2017.17","url":null,"abstract":"<p><strong>Background: </strong>Infection by <i>Mycobacterium tuberculosis</i> (<i>Mtb</i>) is a necessary but not sufficient cause for tuberculosis (TB). Although numerous studies suggest human genetic variation may influence TB pathogenesis, there is a conspicuous lack of replication, likely due to imprecise phenotype definition. We aimed to replicate novel findings from a Ugandan cohort in Ethiopian populations.</p><p><strong>Method: </strong>We ascertained TB cases and household controls (<i>n</i> = 292) from three different ethnic groups. Latent <i>Mtb</i> infection was determined using Quantiferon to develop reliable TB progression phenotypes. We sequenced exonic regions of <i>TICAM2</i> and <i>NOD1</i>.</p><p><strong>Result: </strong>Significant novel associations were observed between two variants in <i>NOD1</i> and TB: rs751770147 [unadjusted <i>p</i> = 7.28 × 10<sup>-5</sup>] and chr7:30477156(T), a novel variant, [unadjusted <i>p</i> = 1.04 × 10<sup>-4</sup>]. Two SNPs in <i>TICAM2</i> were nominally associated with TB, including rs2288384 [unadjusted <i>p</i> = 0.003]. Haplotype-based association tests supported the SNP-based results.</p><p><strong>Conclusion: </strong>We replicated the association of <i>TICAM2</i> and <i>NOD1</i> with TB and identified novel genetic associations with TB in Ethiopian populations.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2018-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36193132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01Epub Date: 2018-05-08DOI: 10.1017/gheg.2018.7
Kenneth Ekoru, Elizabeth H Young, David G Dillon, Deepti Gurdasani, Nathan Stehouwer, Daniel Faurholt-Jepsen, Naomi S Levitt, Nigel J Crowther, Moffat Nyirenda, Marina A Njelekela, Kaushik Ramaiya, Ousman Nyan, Olanisun O Adewole, Kathryn Anastos, Caterina Compostella, Joel A Dave, Carla M Fourie, Henrik Friis, Iolanthe M Kruger, Chris T Longenecker, Dermot P Maher, Eugene Mutimura, Chiratidzo E Ndhlovu, George Praygod, Eric W Pefura Yone, Mar Pujades-Rodriguez, Nyagosya Range, Mahmoud U Sani, Muhammad Sanusi, Aletta E Schutte, Karen Sliwa, Phyllis C Tien, Este H Vorster, Corinna Walsh, Dickman Gareta, Fredirick Mashili, Eugene Sobngwi, Clement Adebamowo, Anatoli Kamali, Janet Seeley, Liam Smeeth, Deenan Pillay, Ayesha A Motala, Pontiano Kaleebu, Manjinder S Sandhu
Background: Anti-retroviral therapy (ART) regimes for HIV are associated with raised levels of circulating triglycerides (TG) in western populations. However, there are limited data on the impact of ART on cardiometabolic risk in sub-Saharan African (SSA) populations.
Methods: Pooled analyses of 14 studies comprising 21 023 individuals, on whom relevant cardiometabolic risk factors (including TG), HIV and ART status were assessed between 2003 and 2014, in SSA. The association between ART and raised TG (>2.3 mmol/L) was analysed using regression models.
Findings: Among 10 615 individuals, ART was associated with a two-fold higher probability of raised TG (RR 2.05, 95% CI 1.51-2.77, I2=45.2%). The associations between ART and raised blood pressure, glucose, HbA1c, and other lipids were inconsistent across studies.
Interpretation: Evidence from this study confirms the association of ART with raised TG in SSA populations. Given the possible causal effect of raised TG on cardiovascular disease (CVD), the evidence highlights the need for prospective studies to clarify the impact of long term ART on CVD outcomes in SSA.
{"title":"HIV treatment is associated with a two-fold higher probability of raised triglycerides: Pooled Analyses in 21 023 individuals in sub-Saharan Africa.","authors":"Kenneth Ekoru, Elizabeth H Young, David G Dillon, Deepti Gurdasani, Nathan Stehouwer, Daniel Faurholt-Jepsen, Naomi S Levitt, Nigel J Crowther, Moffat Nyirenda, Marina A Njelekela, Kaushik Ramaiya, Ousman Nyan, Olanisun O Adewole, Kathryn Anastos, Caterina Compostella, Joel A Dave, Carla M Fourie, Henrik Friis, Iolanthe M Kruger, Chris T Longenecker, Dermot P Maher, Eugene Mutimura, Chiratidzo E Ndhlovu, George Praygod, Eric W Pefura Yone, Mar Pujades-Rodriguez, Nyagosya Range, Mahmoud U Sani, Muhammad Sanusi, Aletta E Schutte, Karen Sliwa, Phyllis C Tien, Este H Vorster, Corinna Walsh, Dickman Gareta, Fredirick Mashili, Eugene Sobngwi, Clement Adebamowo, Anatoli Kamali, Janet Seeley, Liam Smeeth, Deenan Pillay, Ayesha A Motala, Pontiano Kaleebu, Manjinder S Sandhu","doi":"10.1017/gheg.2018.7","DOIUrl":"10.1017/gheg.2018.7","url":null,"abstract":"<p><strong>Background: </strong>Anti-retroviral therapy (ART) regimes for HIV are associated with raised levels of circulating triglycerides (TG) in western populations. However, there are limited data on the impact of ART on cardiometabolic risk in sub-Saharan African (SSA) populations.</p><p><strong>Methods: </strong>Pooled analyses of 14 studies comprising 21 023 individuals, on whom relevant cardiometabolic risk factors (including TG), HIV and ART status were assessed between 2003 and 2014, in SSA. The association between ART and raised TG (>2.3 mmol/L) was analysed using regression models.</p><p><strong>Findings: </strong>Among 10 615 individuals, ART was associated with a two-fold higher probability of raised TG (RR 2.05, 95% CI 1.51-2.77, I<sup>2</sup>=45.2%). The associations between ART and raised blood pressure, glucose, HbA1c, and other lipids were inconsistent across studies.</p><p><strong>Interpretation: </strong>Evidence from this study confirms the association of ART with raised TG in SSA populations. Given the possible causal effect of raised TG on cardiovascular disease (CVD), the evidence highlights the need for prospective studies to clarify the impact of long term ART on CVD outcomes in SSA.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5985947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36205100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-10eCollection Date: 2017-01-01DOI: 10.1017/gheg.2017.11
C Newman, P K Chama, M Mugisha, C W Matsiko, V Oketcho
The paper distils results from a review of relevant literature and two gender analyses to highlight reasons for gender imbalances in senior roles in global health and ways to address them. Organizations, leadership, violence and discrimination, research and human resource management are all gendered. Supplementary materials from gender analyses in two African health organizations demonstrate how processes such as hiring, deployment and promotion, and interpersonal relations, are not 'gender-neutral' and that gendering processes shape privilege, status and opportunity in these health organizations. Organizational gender analysis, naming stereotypes, substantive equality principles, special measures and enabling conditions to dismantle gendered disadvantage can catalyze changes to improve women's ability to play senior global health roles in gendered organizations. Political strategies and synergies with autonomous feminist movements can increase women's full and effective participation and equal opportunities. The paper also presents organizational development actions to bring about more gender egalitarian global health organizations.
{"title":"Reasons behind current gender imbalances in senior global health roles and the practice and policy changes that can catalyze organizational change.","authors":"C Newman, P K Chama, M Mugisha, C W Matsiko, V Oketcho","doi":"10.1017/gheg.2017.11","DOIUrl":"10.1017/gheg.2017.11","url":null,"abstract":"<p><p>The paper distils results from a review of relevant literature and two gender analyses to highlight reasons for gender imbalances in senior roles in global health and ways to address them. Organizations, leadership, violence and discrimination, research and human resource management are all gendered. Supplementary materials from gender analyses in two African health organizations demonstrate how processes such as hiring, deployment and promotion, and interpersonal relations, are not 'gender-neutral' and that gendering processes shape privilege, status and opportunity in these health organizations. Organizational gender analysis, naming stereotypes, substantive equality principles, special measures and enabling conditions to dismantle gendered disadvantage can catalyze changes to improve women's ability to play senior global health roles in gendered organizations. Political strategies and synergies with autonomous feminist movements can increase women's full and effective participation and equal opportunities. The paper also presents organizational development actions to bring about more gender egalitarian global health organizations.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2017-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36193697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-27eCollection Date: 2017-01-01DOI: 10.1017/gheg.2017.16
N Sallah, T Carstensen, K Wakeham, R Bagni, N Labo, M O Pollard, D Gurdasani, K Ekoru, C Pomilla, E H Young, S Fatumo, G Asiki, A Kamali, M Sandhu, P Kellam, D Whitby, I Barroso, R Newton
Epstein Barr virus (EBV) infects 95% of the global population and is associated with up to 2% of cancers globally. Immunoglobulin G (IgG) antibody levels to EBV have been shown to be heritable and associated with developing malignancies. We, therefore, performed a pilot genome-wide association analysis of anti-EBV IgG traits in an African population, using a combined approach including array genotyping, whole-genome sequencing and imputation to a panel with African sequence data. In 1562 Ugandans, we identify a variant in human leukocyte antigen (HLA)-DQA1, rs9272371 (p = 2.6 × 10-17) associated with anti-EBV nuclear antigen-1 responses. Trans-ancestry meta-analysis and fine-mapping with European-ancestry individuals suggest the presence of distinct HLA class II variants driving associations in Uganda. In addition, we identify four putative, novel, very rare African-specific loci with preliminary evidence for association with anti-viral capsid antigen IgG responses which will require replication for validation. These findings reinforce the need for the expansion of such studies in African populations with relevant datasets to capture genetic diversity.
{"title":"Whole-genome association study of antibody response to Epstein-Barr virus in an African population: a pilot.","authors":"N Sallah, T Carstensen, K Wakeham, R Bagni, N Labo, M O Pollard, D Gurdasani, K Ekoru, C Pomilla, E H Young, S Fatumo, G Asiki, A Kamali, M Sandhu, P Kellam, D Whitby, I Barroso, R Newton","doi":"10.1017/gheg.2017.16","DOIUrl":"10.1017/gheg.2017.16","url":null,"abstract":"<p><p>Epstein Barr virus (EBV) infects 95% of the global population and is associated with up to 2% of cancers globally. Immunoglobulin G (IgG) antibody levels to EBV have been shown to be heritable and associated with developing malignancies. We, therefore, performed a pilot genome-wide association analysis of anti-EBV IgG traits in an African population, using a combined approach including array genotyping, whole-genome sequencing and imputation to a panel with African sequence data. In 1562 Ugandans, we identify a variant in <i>human leukocyte antigen</i> (<i>HLA</i>)-<i>DQA1</i>, rs9272371 (<i>p</i> = 2.6 × 10<sup>-17</sup>) associated with anti-EBV nuclear antigen-1 responses. Trans-ancestry meta-analysis and fine-mapping with European-ancestry individuals suggest the presence of distinct <i>HLA</i> class II variants driving associations in Uganda. In addition, we identify four putative, novel, very rare African-specific loci with preliminary evidence for association with anti-viral capsid antigen IgG responses which will require replication for validation. These findings reinforce the need for the expansion of such studies in African populations with relevant datasets to capture genetic diversity.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2017-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10661052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-27eCollection Date: 2017-01-01DOI: 10.1017/gheg.2017.14
G D Pule, E R Chimusa, K Mnika, K Mhandire, E Kampira, C Dandara, A Wonkam
Partial carrier-resistance to Plasmodium falciparum malaria conferred by the sickle cell (HbS) mutation has resulted in the local amplification and positive selection of sickle cell disease (SCD) in malaria-endemic regions and particularly in sub-Saharan Africa (SSA). The present study investigated the β-globin gene haplotypes, and selected malaria-associated variants among three cohorts of Bantu-speaking individuals from Malawi, Zimbabwe and South Africa compared with reports with data from others SSA populations. The data suggest a south-ward frequency decrease of malaria-associated variants in SSA linked to the evolutionary dynamics of various African populations' genomes through selective pressure of malaria. These selected genomics differences, positive selection of SCD in malaria-endemic regions among 'Bantus' from various part of Africa emphasise the evidence of the dissociation between genetics, anthropology and culture. The present study also showed a relatively prevalent Benin haplotype, which is mostly found in West Africa, among Southern African Blacks and very low Bantu haplotype, which could suggest a major migration route, of Southern Africa Bantu, along the African west coast, post-occurrence of the Sickle cell mutation, which date remain to be fully elucidated.
{"title":"Beta-globin gene haplotypes and selected Malaria-associated variants among black Southern African populations.","authors":"G D Pule, E R Chimusa, K Mnika, K Mhandire, E Kampira, C Dandara, A Wonkam","doi":"10.1017/gheg.2017.14","DOIUrl":"https://doi.org/10.1017/gheg.2017.14","url":null,"abstract":"<p><p>Partial carrier-resistance to <i>Plasmodium falciparum</i> malaria conferred by the sickle cell (<i>HbS</i>) mutation has resulted in the local amplification and positive selection of sickle cell disease (SCD) in malaria-endemic regions and particularly in sub-Saharan Africa (SSA). The present study investigated the <i>β</i>-globin gene haplotypes, and selected malaria-associated variants among three cohorts of Bantu-speaking individuals from Malawi, Zimbabwe and South Africa compared with reports with data from others SSA populations. The data suggest a south-ward frequency decrease of malaria-associated variants in SSA linked to the evolutionary dynamics of various African populations' genomes through selective pressure of malaria. These selected genomics differences, positive selection of SCD in malaria-endemic regions among 'Bantus' from various part of Africa emphasise the evidence of the dissociation between genetics, anthropology and culture. The present study also showed a relatively prevalent Benin haplotype, which is mostly found in West Africa, among Southern African Blacks and very low Bantu haplotype, which could suggest a major migration route, of Southern Africa Bantu, along the African west coast, post-occurrence of the Sickle cell mutation, which date remain to be fully elucidated.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2017-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gheg.2017.14","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36193696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-10-11eCollection Date: 2017-01-01DOI: 10.1017/gheg.2017.13
F Debnath, T Bhatnagar, L Sundaramoorthy, M Ponnaiah
Background: Competency of peripheral health workers in the detection and management of common syndromic conditions is crucial as they are the first point of contact for the majority of the Indian population.
Methods: We measured the competency of auxiliary nurse midwives (ANMs), and factors associated with inadequate competency, in the detection and management of common conditions-diarrhoea, acute respiratory tract infection, fever, malaria-through a cross-sectional study using condition specific validated clinical vignettes and structured questionnaires.
Results: Out of 272 selected ANMs, 68% (95% CI 62-74%) were adequately competent. Factors independently associated with inadequate competency were unavailability of essential drugs in preceding month [adjusted odds ratio (AOR) = 1.95; 95% CI 1.1-3.5] and ever trained in integrated management of childhood illness (AOR = 2.4; 95% CI 1.4-4.1).
Conclusion: More than two third of the peripheral health workers were adequately competent to detect and manage common conditions. Ensuring uninterrupted drug availability and improved quality in service trainings might facilitate competency levels.
背景:外围卫生工作者在发现和管理常见综合征方面的能力至关重要,因为他们是大多数印度人口的第一接触点。方法:我们测量了辅助护士助产士(ANMs)的能力,以及与能力不足相关的因素,在检测和管理常见疾病(腹泻、急性呼吸道感染、发烧、疟疾)方面,通过一项横断面研究,使用特定疾病的验证临床小插曲和结构化问卷。结果:在选定的272名护士中,68% (95% CI 62-74%)胜任。与胜任力不足独立相关的因素是前一个月基本药物供应不足[调整优势比(AOR) = 1.95;(95% CI 1.1-3.5)并接受过儿童疾病综合管理方面的培训(AOR = 2.4;95% ci 1.4-4.1)。结论:超过三分之二的外围卫生工作者有足够的能力发现和管理常见疾病。确保不间断的药物供应和提高服务培训的质量可能有助于提高能力水平。
{"title":"Competency of peripheral health workers in detection & management of common syndromic conditions under surveillance, North 24 Parganas, West Bengal, India, 2016: a cross-sectional study.","authors":"F Debnath, T Bhatnagar, L Sundaramoorthy, M Ponnaiah","doi":"10.1017/gheg.2017.13","DOIUrl":"https://doi.org/10.1017/gheg.2017.13","url":null,"abstract":"<p><strong>Background: </strong>Competency of peripheral health workers in the detection and management of common syndromic conditions is crucial as they are the first point of contact for the majority of the Indian population.</p><p><strong>Methods: </strong>We measured the competency of auxiliary nurse midwives (ANMs), and factors associated with inadequate competency, in the detection and management of common conditions-diarrhoea, acute respiratory tract infection, fever, malaria-through a cross-sectional study using condition specific validated clinical vignettes and structured questionnaires.</p><p><strong>Results: </strong>Out of 272 selected ANMs, 68% (95% CI 62-74%) were adequately competent. Factors independently associated with inadequate competency were unavailability of essential drugs in preceding month [adjusted odds ratio (AOR) = 1.95; 95% CI 1.1-3.5] and ever trained in integrated management of childhood illness (AOR = 2.4; 95% CI 1.4-4.1).</p><p><strong>Conclusion: </strong>More than two third of the peripheral health workers were adequately competent to detect and manage common conditions. Ensuring uninterrupted drug availability and improved quality in service trainings might facilitate competency levels.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2017-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/gheg.2017.13","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36193695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}