International Journal of Environmental Research and Public Health, 2022
Poor knowledge and management of menstruation impacts girls’ school attendance and academic perfo... more Poor knowledge and management of menstruation impacts girls’ school attendance and academic performance. This paper aims to explore how menstrual hygiene management practices and related factors influence school absenteeism and drop-out among primary and secondary school girls in rural Gambia. Mixed-method studies were conducted among students and key informants from 19 schools from July 2015–December 2017. Focus group discussions, in-depth interviews, cross-sectional surveys, menstrual diaries, and school water, sanitation and hygiene (WASH) facility observations were used. Key findings from the interviews were that menstrual pain, cultural beliefs, fear of peers knowing menstrual status, and poor school WASH facilities led to school absenteeism, however, they had no impact on school drop-out. Of the 561 girls surveyed, 27% reported missing at least one school day per month due to menses. Missing school during the most recent menstrual period was strongly associated with menstrual ...
Tool to assess infant feeding, socioeconomic status and water/hygiene/sanitation conditions (PDF ... more Tool to assess infant feeding, socioeconomic status and water/hygiene/sanitation conditions (PDF 291 kb)
Focus group discussion interview guidelines (Guidelines developed by the team for boys and girls)... more Focus group discussion interview guidelines (Guidelines developed by the team for boys and girls). (DOCX 45 kb)
In depth interview guidelines (Guidelines developed by the team for mothers, teachers and boys). ... more In depth interview guidelines (Guidelines developed by the team for mothers, teachers and boys). (DOCX 28 kb)
Questionnaire (Questionnaire Tool used to collect the cross-sectional data among adolescent girls... more Questionnaire (Questionnaire Tool used to collect the cross-sectional data among adolescent girls developed by the team in this study) (DOCX 199 kb)
Objectives Neonatal sepsis, a major cause of death amongst infants in sub-Saharan Africa, is ofte... more Objectives Neonatal sepsis, a major cause of death amongst infants in sub-Saharan Africa, is often gut derived. Impairments in immunity and the gut barrier in sick neonates allow colonisation by opportunistic pathogens such as Enterobacteriaceae to progress to blood stream infection. Colonisation by Enterobacteriaceae producing extended spectrum beta-lactamase (ESBL) or carbapenemase enzymes is particularly problematic and can lead to antimicrobial-resistant (AMR) or untreatable infections. We sought to explore the rates of colonisation by ESBL or carbapenemase producers and their genotypes in two neonatal units (NNUs) in West and East Africa. Methods Stool and rectal swab samples were taken at multiple timepoints from newborns admitted to the NNUs at the University College Hospital, Ibadan, Nigeria and the Jaramogi Oginga Odinga Teaching and Referral Hospital, Kisumu, western Kenya. Samples were tested for ESBL and carbapenemase genes using a previously validated qPCR assay with hi...
We assessed the effect of COVID-19 lockdown on deliveries and neonatal admissions according to ge... more We assessed the effect of COVID-19 lockdown on deliveries and neonatal admissions according to gestation in Lagos, Nigeria. During lockdown (April–June 2020), there was a marked fall of about 50% in in-hospital deliveries and admissions to the neonatal wards for both in and outborn infants compared with prelockdown (January–March 2020) and a comparison period (April–June 2019). However, the proportion of preterm infants was broadly similar in each period. Lockdown markedly reduced hospital deliveries and healthcare-seeking for sick newborns but did not influence the overall proportion of preterm births among in-house deliveries and outborn neonatal admissions.
Objective To describe the patient population, priority diseases and outcomes in newborns admitted... more Objective To describe the patient population, priority diseases and outcomes in newborns admitted <48 hours old to neonatal units in both Kenya and Nigeria. Study design In a network of seven secondary and tertiary level neonatal units in Nigeria and Kenya, we captured anonymised data on all admissions <48 hours of age over a 6-month period. Results 2280 newborns were admitted. Mean birthweight was 2.3 kg (SD 0.9); 57.0% (1214/2128) infants were low birthweight (LBW; <2.5kg) and 22.6% (480/2128) were very LBW (VLBW; <1.5 kg). Median gestation was 36 weeks (interquartile range 32, 39) and 21.6% (483/2236) infants were very preterm (gestation <32 weeks). The most common morbidities were jaundice (987/2262, 43.6%), suspected sepsis (955/2280, 41.9%), respiratory conditions (817/2280, 35.8%) and birth asphyxia (547/2280, 24.0%). 18.7% (423/2262) newborns died; mortality was very high amongst VLBW (222/472, 47%) and very preterm infants (197/483, 40.8%). Factors independen...
Growth faltering associated with undernutrition in early childhood is endemic in sub- Saharan Afr... more Growth faltering associated with undernutrition in early childhood is endemic in sub- Saharan Africa. Worldwide, over 3 million child deaths annually are attributed to foetal growth restriction, underweight, stunting, wasting, suboptimal breastfeeding and micronutrient deficiencies. Survivors suffer adverse health and socio-economic outcomes. Although rates of stunting have halved worldwide, progress in sub-Saharan Africa has been slow. The prevalence of wasting has not shifted. This work aimed to describe secular trends of growth faltering in early childhood and the hormone correlates of malnourished children during nutritional rehabilitation in rural Gambia. Also, to explore factors associated with severe wasting in infancy. Firstly, secular trends of growth faltering among under 2’s from three rural Gambian villages were described using routinely collected clinic anthropometry data. Over the past four decades, rates of stunting and underweight halved, but significant growth falte...
International Journal of Environmental Research and Public Health, 2022
Poor knowledge and management of menstruation impacts girls’ school attendance and academic perfo... more Poor knowledge and management of menstruation impacts girls’ school attendance and academic performance. This paper aims to explore how menstrual hygiene management practices and related factors influence school absenteeism and drop-out among primary and secondary school girls in rural Gambia. Mixed-method studies were conducted among students and key informants from 19 schools from July 2015–December 2017. Focus group discussions, in-depth interviews, cross-sectional surveys, menstrual diaries, and school water, sanitation and hygiene (WASH) facility observations were used. Key findings from the interviews were that menstrual pain, cultural beliefs, fear of peers knowing menstrual status, and poor school WASH facilities led to school absenteeism, however, they had no impact on school drop-out. Of the 561 girls surveyed, 27% reported missing at least one school day per month due to menses. Missing school during the most recent menstrual period was strongly associated with menstrual ...
Tool to assess infant feeding, socioeconomic status and water/hygiene/sanitation conditions (PDF ... more Tool to assess infant feeding, socioeconomic status and water/hygiene/sanitation conditions (PDF 291 kb)
Focus group discussion interview guidelines (Guidelines developed by the team for boys and girls)... more Focus group discussion interview guidelines (Guidelines developed by the team for boys and girls). (DOCX 45 kb)
In depth interview guidelines (Guidelines developed by the team for mothers, teachers and boys). ... more In depth interview guidelines (Guidelines developed by the team for mothers, teachers and boys). (DOCX 28 kb)
Questionnaire (Questionnaire Tool used to collect the cross-sectional data among adolescent girls... more Questionnaire (Questionnaire Tool used to collect the cross-sectional data among adolescent girls developed by the team in this study) (DOCX 199 kb)
Objectives Neonatal sepsis, a major cause of death amongst infants in sub-Saharan Africa, is ofte... more Objectives Neonatal sepsis, a major cause of death amongst infants in sub-Saharan Africa, is often gut derived. Impairments in immunity and the gut barrier in sick neonates allow colonisation by opportunistic pathogens such as Enterobacteriaceae to progress to blood stream infection. Colonisation by Enterobacteriaceae producing extended spectrum beta-lactamase (ESBL) or carbapenemase enzymes is particularly problematic and can lead to antimicrobial-resistant (AMR) or untreatable infections. We sought to explore the rates of colonisation by ESBL or carbapenemase producers and their genotypes in two neonatal units (NNUs) in West and East Africa. Methods Stool and rectal swab samples were taken at multiple timepoints from newborns admitted to the NNUs at the University College Hospital, Ibadan, Nigeria and the Jaramogi Oginga Odinga Teaching and Referral Hospital, Kisumu, western Kenya. Samples were tested for ESBL and carbapenemase genes using a previously validated qPCR assay with hi...
We assessed the effect of COVID-19 lockdown on deliveries and neonatal admissions according to ge... more We assessed the effect of COVID-19 lockdown on deliveries and neonatal admissions according to gestation in Lagos, Nigeria. During lockdown (April–June 2020), there was a marked fall of about 50% in in-hospital deliveries and admissions to the neonatal wards for both in and outborn infants compared with prelockdown (January–March 2020) and a comparison period (April–June 2019). However, the proportion of preterm infants was broadly similar in each period. Lockdown markedly reduced hospital deliveries and healthcare-seeking for sick newborns but did not influence the overall proportion of preterm births among in-house deliveries and outborn neonatal admissions.
Objective To describe the patient population, priority diseases and outcomes in newborns admitted... more Objective To describe the patient population, priority diseases and outcomes in newborns admitted <48 hours old to neonatal units in both Kenya and Nigeria. Study design In a network of seven secondary and tertiary level neonatal units in Nigeria and Kenya, we captured anonymised data on all admissions <48 hours of age over a 6-month period. Results 2280 newborns were admitted. Mean birthweight was 2.3 kg (SD 0.9); 57.0% (1214/2128) infants were low birthweight (LBW; <2.5kg) and 22.6% (480/2128) were very LBW (VLBW; <1.5 kg). Median gestation was 36 weeks (interquartile range 32, 39) and 21.6% (483/2236) infants were very preterm (gestation <32 weeks). The most common morbidities were jaundice (987/2262, 43.6%), suspected sepsis (955/2280, 41.9%), respiratory conditions (817/2280, 35.8%) and birth asphyxia (547/2280, 24.0%). 18.7% (423/2262) newborns died; mortality was very high amongst VLBW (222/472, 47%) and very preterm infants (197/483, 40.8%). Factors independen...
Growth faltering associated with undernutrition in early childhood is endemic in sub- Saharan Afr... more Growth faltering associated with undernutrition in early childhood is endemic in sub- Saharan Africa. Worldwide, over 3 million child deaths annually are attributed to foetal growth restriction, underweight, stunting, wasting, suboptimal breastfeeding and micronutrient deficiencies. Survivors suffer adverse health and socio-economic outcomes. Although rates of stunting have halved worldwide, progress in sub-Saharan Africa has been slow. The prevalence of wasting has not shifted. This work aimed to describe secular trends of growth faltering in early childhood and the hormone correlates of malnourished children during nutritional rehabilitation in rural Gambia. Also, to explore factors associated with severe wasting in infancy. Firstly, secular trends of growth faltering among under 2’s from three rural Gambian villages were described using routinely collected clinic anthropometry data. Over the past four decades, rates of stunting and underweight halved, but significant growth falte...
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