An Explorative Study into the Aetiology of Developmental Dysplasia of the Hip Using Targeted Urine Metabolomics.

Developmental dysplasia of the hip (DDH) is the most prevalent congenital musculoskeletal disorder, yet its cause remains unknown. Adequate nutrient provision and coordinated electron exchange (redox) processes are critical for foetal growth and tissue development. This novel study sought to explore specific biochemical pathways in skeletal development for potential involvement in the aetiology of DDH. Spot urine samples were collected from infants, aged 13-61 days, with and without DDH. Ion chromatography-mass spectrometry was used to quantify thiosulphate, sulphate, nitrate, and phosphate, whilst nitrite was quantified using high-performance liquid chromato-graphy. Thiobarbituric acid reactive substances (TBARS) were measured as markers of lipid peroxidation. Creatinine and osmolality were determined by a 96-well plate assay and micro-osmometer to potentially normalise values for renal function, lean body mass, and hydration status. Urine samples were analysed from 99 babies: 30 with DDH and 69 age-matched non-DDH controls. Thiosulphate, TBARS, and creatinine concentrations differed between the DDH group and the controls (p = 0.025, 0.015, and 0.004 respectively). Urine osmolality was significantly lower in DDH compared to the controls (p = 0.036), indicative of the production of a more diluted urine in DDH infants. Following adjustment for osmolality, significant differences became apparent in urinary sulphate levels in DDH (p = 0.035) whereas all other parameters were similar between the groups. This is the first study to assess the potential role of these inorganic anions in DDH. The higher levels of sulphate found in infants with DDH suggests either enhanced intake from milk, increased endogenous formation, or impaired renal reabsorption. This investigation demonstrates the power of urine metabolomics and highlights the importance of normalisation for hydration status to disentangle developmental disorders. Our results strongly suggest that DDH is a systemic disease associated with altered uptake, formation, or handling of sulphate. There is potential for new opportunities in the prevention or treatment of DDH via nutritional intervention.

Community Health Education for Health Crisis Management: The Case of COVID-19 in Cameroon.

The current coronavirus disease 2019 (COVID-19) pandemic has led Cameroon's government to implement public health measures aimed at preventing its spread. This paper investigates how community health education on the virus was being carried out, what gaps exist and what further action could be taken. A survey instrument was used to gather data among a total of 179 Cameroonians recruited via opportunistic and snowball sampling methods. According to our findings, gaps exist. These include the need for adequate community health education on COVID-19, maximising multilingualism and indigenous cultural assets and disbanding misconceptions on the pandemic, as well as stigmatisation. The paper culminates by underlining the significance of an integrated approach to confront the pandemic. This approach captures the need to frame but also firm up community health education architecture on COVID-19 that captures inputs from different stakeholders, including indigenous knowledge holders, for collective wellbeing.

Outcomes of children aged 6-59 months with severe acute malnutrition at the GADO Outpatient Therapeutic Center in Cameroon.

OBJECTIVE: We aimed to assess outcomes [rates of recovery, default, case fatality; rate of weight gain and rate of Mean Upper Arm Circumference (MUAC) gain] of children aged 6-59 months with severe acute malnutrition (SAM) at the Outpatient Therapeutic Center at Gado Refugee Camp, Cameroon, in relation to international standards. We retrospectively analysed files of 254 children with SAM aged 6-59 months admitted from April 2015 to August 2016. RESULTS: 72.8% got discharged as recovered, 0.8% died and none defaulted. 26.8% got referred to stabilization center, mostly for poor weight gain (44.1%). Mean rate of weight gain was 4.4 g/kg/day and MUAC gain 0.3 mm/cm/day; median duration of treatment 44.5 days. Amongst those with marasmus, kwashiorkor and marasmic kwashiorkor, median duration of stay was 48, 24.5 and 36.3 days (p = 0.002); recovery rates were similar 73, 71.4, 71.4% respectively (p = 0.7); Median rates of weight gain, 4.4, 6.7 and 8.1 g/kg/day (p = 0.05). 49 children had been incorrectly diagnosed and treated as SAM. International Standards were met in terms of case fatality rate and default rate but not rates of recovery and weight gain. Separate gender charts must be used to calculate weight for height z scores as combined charts cause significant errors.