Determination of optimal cut-off values for waist circumferences used for the diagnosis of the metabolic syndrome among Batswana adults (ELS 32).

BACKGROUND: To date, no definitive waist circumference (WC) cut-off values for abdominal obesity (AO) have been established for sub-Saharan Africa, including Botswana. Therefore, the classification of AO among these populations is based on European values. For accurate diagnosis of the metabolic syndrome (MetS), cut-off values reflective of the population investigated must be used. OBJECTIVE: The study was an attempt to determine optimal cut-off values for AO among Batswana adults. METHODS: The receiver operating characteristic curve was used to determine the optimal cut-off values for predicting at least two other risk factors of the MetS. Data were used from a descriptive cross-sectional study employing a complex multi-stage cluster sampling. Demographic and anthropometric measurements (weight and height, waist and hip circumferences), blood pressure, and blood glucose, triglycerides, high-density lipoprotein cholesterol and total cholesterol levels were collected from 384 men and 416 women in Gaborone and the surrounding villages. RESULTS: The ability of waist circumference to predict at least two other risk factors of the MetS gave cut-off values of ≥ 91.0 cm (sensitivity 69.1% and specificity of 90.8%, area under the curve 0.85) for men and ≥ 82.3 cm (sensitivity of 88.6% and specificity of 58.9%, area under the curve of 0.76) for women. CONCLUSIONS: There is a difference between the cut-off values for Europeans with those determined for Batswana adults. Inconsistencies in cut-off values used have the potential for undesirable consequences for cardiovascular risk stratification and prioritisation of preventative strategies for AO and the MetS. The need to determine population-, ethnic- and gender-based cut-off values for AO for Batswana adults has never been more paramount.

Phenotypic resistance of indigenous goat breeds to infection with Haemonchus contortus in northwestern Nigeria.

Two studies at the National Animal Production Research Institute (NAPRI), Zaria, Nigeria, compared Red Sokoto (RS), Sahelian (SG), and West African Dwarf (WAD) goats after experimental or natural infection with Haemonchus contortus. In the first study, 20 RS, 17 SG, and 14 WAD kids were challenged at 6 months of age with 5000 L3 larvae of H. contortus. Fecal egg counts (FEC), packed cell volumes (PCV), and body weights (BW) were recorded 0, 28, 35, and 42 days after infection. The FEC and PCV were affected only by time of measurement. In the second study, 322 RS and 97 SG kids were produced at NAPRI over 3 years, weaned at 4 to 6 months of age, dewormed, returned to contaminated pastures, and evaluated 28 and 35 days later. Effects of breed, year, breed × time interaction, and breed × year interaction were observed for PCV and BW; FEC was only affected by time of measurement, year and breed × year interaction. The FEC were larger and PCV were smaller on day 35 compared to day 28 and in year 2 compared to years 1 and 3. The SG kids were notably smaller than RS kids in year 2, with higher FEC and lower PCV, but FEC were larger for RS kids in years 1 and 3. Differences in parasite resistance among these Nigerian goat breeds were therefore small and likely reflected underlying differences in growth, development, and disease history.

Building locally relevant ethics curricula for nursing education in Botswana.

AIM: The goal of this multi-institutional collaboration was to develop an innovative, locally relevant ethics curriculum for nurses in Botswana. BACKGROUND: Nurses in Botswana face ethical challenges that are compounded by lack of resources, pressures to handle tasks beyond training or professional levels, workplace stress and professional isolation. Capacity to teach nursing ethics in the classroom and in professional practice settings has been limited. METHODS: A pilot curriculum, including cases set in local contexts, was tested with nursing faculty in Botswana in 2012. RESULTS: Thirty-three per cent of the faculty members indicated they would be more comfortable teaching ethics. A substantial number of faculty members were more likely to introduce the International Council of Nurses Code of Ethics in teaching, practice and mentoring as a result of the training. Based on evaluation data, curricular materials were developed using the Code and the regulatory requirements for nursing practice in Botswana. A web-based repository of sample lectures, discussion cases and evaluation rubrics was created to support the use of the materials. DISCUSSION: A new master degree course, Nursing Ethics in Practice, has been proposed for fall 2015 at the University of Botswana. The modular nature of the materials and the availability of cases set within the context of clinical nurse practice in Botswana make them readily adaptable to various student academic levels and continuing professional development programmes. CONCLUSION: The ICN Code of Ethics for Nursing is a valuable teaching tool in developing countries when taught using locally relevant case materials and problem-based teaching methods. IMPLICATIONS FOR NURSING: The approach used in the development of a locally relevant nursing ethics curriculum in Botswana can serve as a model for nursing education and continuing professional development programmes in other sub-Saharan African countries to enhance use of the ICN Code of Ethics in nursing practice.

Body image dissatisfaction is increased in male and overweight/obese adolescents in Botswana.

INTRODUCTION: The purpose of this study was to examine linkages between obesity, physical activity, and body image dissatisfaction, with consideration of socioeconomic status (SES) and urbanization in adolescents in Botswana. MATERIALS AND METHODS: A nationally representative, cross-sectional survey in 707 secondary school students included measured height and weight to determine overweight (OW) or obesity (OB) using World Health Organization standards; physical activity (PA) using the International Physical Activity Questionnaire; and body image satisfaction using the Body Ideals Questionnaire. SES was described by private school versus public school attendance. RESULTS AND DISCUSSION: OW/OB students felt farther from ideal and greater dissatisfaction with their weight and body proportions than optimal weight students. Boys felt greater difference from ideal and more dissatisfaction with muscle tone, chest size, and strength than girls. Lower SES students and those from rural villages had more minutes of PA than higher SES or urban students. In this rapidly developing African country, these trends reflect the nutrition transition and offer opportunity to motivate OW/OB students and boys for PA as a health promotion obesity prevention behavior. CONCLUSIONS: As urbanization and improved SES are desirable and likely to continue, the public health system will be challenged to prevent obesity while preserving a healthy body image.

Association between socioeconomic status indicators and obesity in adolescent students in Botswana, an African country in rapid nutrition transition.

OBJECTIVE: The purpose of this study was to examine two separate socioeconomic status (SES) indicators of obesity in Botswana, an African country that has experienced rapid economic development and where the prevalence of human immunodeficiency virus/acquired immune deficiency syndrome is high. METHODS: We conducted a nationally representative, cross-sectional study of 707 adolescent secondary school students in Botswana. Measured height and weight were used to compute World Health Organization age- and sex-specific body mass index z-scores. SES was described by private vs. public school attendance and a survey of assets/facilities within the home. RESULTS: Overall, private school students and those with more assets had a higher prevalence of overweight and obesity than public school students (private: 27.1%, 95% confidence interval [CI]: 20.4-34.5; public: 13.1%, 95% CI: 9.8-16.8) and those with fewer assets (more assets: 20.0%, 95% CI: 16.0-24.4; fewer assets: 11.2%, 95% CI: 6.6-16.9). CONCLUSIONS: Public health interventions in developing countries may need to be targeted differently to low or high SES individuals in order to treat already high obesity rates in higher SES groups and to prevent the development of obesity in lower SES communities undergoing economic transition.