Determinants of iron-rich food deficiency among children under 5 years in sub-Saharan Africa: a comprehensive analysis of Demographic and Health Surveys.

BACKGROUND: Iron deficiency is a major public health problem that affects the physical and cognitive development of children under 5 years of age (under-5 children) in sub-Saharan Africa (SSA). However, the factors associated with the limited consumption of iron-rich foods in the region are poorly understood. OBJECTIVE: This study examined the prevalence and determinants of iron-rich food deficiency among under-5 children in 26 SSA countries. DESIGN: This nationally representative quantitative study employed pooled data from Demographic and Health Surveys conducted between 2010 and 2019. METHODS: Representative samples comprising 296 850 under-5 children from the various countries were used. Bivariate and multivariate logistic regression models were used to determine the associations between the lack of iron-rich food uptake and various sociodemographic factors. RESULT: The overall prevalence of iron-rich food deficiency among the children in the entire sample was 56.75%. The prevalence of iron-rich food deficiency varied widely across the 26 countries, ranging from 42.76% in Congo Democratic Republic to 77.50% in Guinea. Maternal education, particularly primary education (OR 0.62, 95% CI 0.57 to 0.68) and higher education (OR 0.58, 95% CI 0.52 to 0.64), demonstrated a reduced likelihood of iron-rich food deficiency in the sample. Likewise, paternal education, with both primary education (OR 0.69, 95% CI 0.63 to 0.75) and higher education (OR 0.66, 95% CI 0.60 to 0.73) showed decreased odds of iron-rich food deficiency. Postnatal visits contributed significantly to reducing the odds of iron-rich food deficiency (OR 0.90, 95% CI 0.83 to 0.95), along with antenatal visits, which also had a positive impact (OR 0.84, 95% CI 0.74 to 0.95). Finally, residents in rural areas showed slightly higher odds of iron-rich food deficiency (OR 1.12, 95% CI 1.10 to 1.28). CONCLUSION: Based on the findings, interventions targeting iron-food deficiency in the SSA region should take into strong consideration the key determinants highlighted in this study.

Determinants of intention to conceal tuberculosis status among family members: an analysis of seven Sub-Saharan African countries.

BACKGROUND: Tuberculosis (TB) remains a significant public health burden in Sub-Saharan Africa (SSA), accounting for about 25% of global TB cases. In several communities, TB diagnosis, treatment, and control have become a critical challenge, largely due to the intention to conceal TB status among family members. It is therefore crucial to understand the factors associated with the intentions to conceal TB status among family members in SSA. METHODS: This quantitative study utilised data from the most recent Demographic and Health Surveys (DHS). The objective was to examine the factors associated with the intention to conceal the TB status of family members. The sample consisted of 58,849 individuals aged 10 years or older from seven SSA countries. Binary logistic regression was employed to assess the associations between TB status concealment and various socio-demographic and economic variables. RESULTS: The overall prevalence of TB status concealment intentions for the seven countries was 28.0% (95% CI: 27.6-28.4). Malawi and Eswatini accounted for the highest (47.3%) and lowest (3.0%) prevalence of TB concealment intentions respectively. TB status concealment intentions decreased with increasing age (p < 0.001). Living in rural areas was associated with lower odds of intending to conceal the TB of family members compared to living in urban areas (aOR = 0.92; p = 0.008). Higher education levels were associated with lower odds of TB status concealment intentions (aOR = 0.50; p < 0.001) compared to lower education levels. As participants wealth index increased, the odds of TB status concealment intentions decreased (aOR = 0.83; p < 0.001). Country of residence also showed significant associations with individuals in Ghana (aOR = 4.51; p < 0.001), Lesotho (aOR = 2.08; p < 0.001), Malawi (aOR = 4.10; p < 0.001), Namibia (aOR = 4.40; p < 0.001), and Sao-Tome and Principe (aOR = 5.56; p < 0.001) showing higher odds of TB status concealment intentions compared to Eswatini. CONCLUSIONS: The findings conclude that several social determinants of health, including age, urbanicity, education, and wealth contribute to TB status concealment intentions for family members. Considering these factors is important for designing targeted interventions to improve TB control in the sample. In light of the unavailability of cultural variables in the dataset, future research can leverage qualitative approaches to conduct a more comprehensive exploration of the cultural factors linked to TB status concealment intentions in the population.

Prevalence and factors associated with undernutrition among children under the age of five years in Benin.

BACKGROUND: Benin ranks as one of the countries in the world with an alarmingly high prevalence of stunting, wasting, and underweight in children under five years. However, limited studies have examined the factors associated with the prevalence of these undernutrition indicators among children under five years in the country. This study aimed to fill this research gap by examining the prevalence rates and factors associated with stunting, wasting, and underweight among this specific population of interest. METHODS: This quantitative study utilised data from the most recent Benin Demographic and Health Survey (BDHS) conducted in 2017-18. The survey employed a nationally representative cross-sectional design and utilised a two-stage stratified cluster sampling technique to select participants. The study included a sample of 13,589 children under the age of five years. The main analytical approach employed was binary logistic regression, which was used to explore the associations between undernutrition (the combined outcome variable representing stunting, wasting, and underweight) and various socio-demographic factors. RESULTS: The combined prevalence of stunting, wasting, and underweight among children under five years in Benin during the 2017-18 survey period was 14.95%. Several factors were significantly associated with these indicators of undernutrition, including female gender (AOR = 0.71, 95% CI = 0.59-0.85), birth weight of 4.1 kg and over (AOR = 0.26, 95% CI = 0.14-0.48), multiple births (AOR = 3.22, 95% CI = 2.11-4.91), and a child's experience of diarrhoea (AOR = 1.76, 95% CI = 1.40-2.20). Furthermore, the prevalence of these undernutrition indicators was higher among children whose mothers had lower levels of education (AOR = 0.82, 95% CI = 0.01-0.42) and were unmarried (AOR = 0.67, 95% CI = 0.49-0.93). CONCLUSIONS: This present study confirms that undernutrition rates are elevated in Benin and are closely linked to perinatal factors such as birth weights and multiple births, postnatal health conditions including diarrheal episodes, and socio-demographic determinants such as a child's gender, maternal education level, and marital status. Therefore, there is the need to consider specific modifiable factors, such as low birth weight, episodes of child diarrhoea, and maternal education as priority targets for child nutrition interventions in Benin.

Work-related respiratory health conditions among construction workers: a systematic narrative review.

BACKGROUND: Emerging evidence in both developed and developing countries indicate that occupational health hazards and diseases among construction workers constitute a significant public health challenge. While occupational health hazards and conditions in the construction sector are diverse, a burgeoning body of knowledge is emerging about respiratory health hazards and diseases. Yet, there is a notable gap in the existing literature in terms of comprehensive syntheses of the available evidence on this topic. In light of this research gap, this study systematically reviewed the global evidence on occupational health hazards and related respiratory health conditions among construction workers. METHODS: Using meta-aggregation, guided by the Condition (respiratory health conditions), Context (construction industry) and Population (construction workers) (CoCoPop) framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, literature searches were conducted on Scopus, PubMed, Web of Science and Google Scholar for relevant studies on respiratory health conditions affecting construction workers. Four eligibility criteria were used in scrutinising studies for inclusion. The quality of the included studies was assessed based on Joanna Briggs Institute's Critical Appraisal tool, while the reporting of the results was guided by the Synthesis Without Meta-analysis guidelines. RESULTS: From an initial pool of 256 studies from the various databases, 25 studies published between 2012 and October 2022 were identified as meeting the inclusion criteria. In all, 16 respiratory health conditions were identified, with cough (ie, dry and with phlegm), dyspnoea/breathlessness and asthma emerging as the top three respiratory conditions among construction workers. The study identified six overarching themes of hazards that are associated with respiratory health conditions among construction workers. These hazards include exposure to dust, respirable crystalline silica, fumes, vapours, asbestos fibres and gases. Smoking and extended period of exposure to the respiratory hazard were found to increase the risk of contracting respiratory diseases. CONCLUSIONS: Our systematic review indicates that construction workers are exposed to hazards and conditions that have adverse effects on their health and well-being. Given the considerable impact that work-related health hazards can have on the health and socioeconomic well-being of construction workers, we suggest that the implementation of a comprehensive occupational health programme is essential. Such a programme would extend beyond the mere provision of personal protective equipment and would incorporate a range of proactive measures aimed at controlling the hazards and mitigating the risk of exposure to the occupational health hazards.

Duration of immunity following full vaccination against SARS-CoV-2: a systematic review.

BACKGROUND: As vaccine roll-out continues across the globe as part of the efforts to protect humanity against SARS-CoV-2, concerns are increasingly shifting to the duration of vaccine-induced immunity. Responses to these concerns are critical in determining if, when, and who will need booster doses following full vaccination against SARS-CoV-2. However, synthesised studies about the durability of vaccine-induced immunity against SARS-CoV-2 are scarce. This systematic review synthesised available global evidence on the duration of immunity following full vaccination against SARS-CoV-2. METHODS: We searched through Psych Info, Web of Science, Scopus, Google Scholar, PubMed, and WHO COVID-19 databases for relevant studies published before December 2021. Five eligibility criteria were used in scrutinising studies for inclusion. The quality of the included studies was assessed based on Joana Briggs Institute's (JBI) Critical Appraisal tool and Cochrane's Risk of Bias tool-version 2 (RoB 2), while the reporting of the results was guided by the Synthesis Without Meta-analysis (SWiM) guidelines. RESULTS: Twenty-seven out of the 666 identified studies met the inclusion criteria. The findings showed that vaccine-induced protection against SARS-CoV-2 infections builds rapidly after the first dose of vaccines and peaks within 4 to 42 days after the second dose, before waning begins in subsequent months, typically from 3 to 24 weeks. Vaccine-induced antibody response levels varied across different demographic and population characteristics and were higher in people who reported no underlying health conditions compared to those with immunosuppressed conditions. CONCLUSIONS: Waning of immunity against SARS-CoV-2 begins as early as the first month after full vaccination and this decline continues till the sixth month when the level of immunity may not be able to provide adequate protection against SARS-CoV-2. While the evidence synthesised in this review could effectively inform and shape vaccine policies regarding the administration of booster doses, more evidence, especially clinical trials, are still needed to ascertain, with greater precision, the exact duration of immunity offered by different vaccine types, across diverse population characteristics, and in different vulnerability parameters. REGISTRATION: The protocol for this review was pre-registered with the International Prospective Register of Systematic Reviews [PROSPERO] (Registration ID: CRD420212818).

Modelling of fire count data: fire disaster risk in Ghana.

Stochastic dynamics involved in ecological count data require distribution fitting procedures to model and make informed judgments. The study provides empirical research, focused on the provision of an early warning system and a spatial graph that can detect societal fire risks. It offers an opportunity for communities, organizations, risk managers, actuaries and governments to be aware of, and understand fire risks, so that they will increase the direct tackling of the threats posed by fire. Statistical distribution fitting method that best helps identify the stochastic dynamics of fire count data is used. The aim is to provide a fire-prediction model and fire spatial graph for observed fire count data. An empirical probability distribution model is fitted to the fire count data and compared to the theoretical probability distribution of the stochastic process of fire count data. The distribution fitted to the fire frequency count data helps identify the class of models that are exhibited by the fire and provides time leading decisions. The research suggests that fire frequency and loss (fire fatalities) count data in Ghana are best modelled with a Negative Binomial Distribution. The spatial map of observed fire frequency and fatality measured over 5 years (2007-2011) offers in this study a first regional assessment of fire frequency and fire fatality in Ghana.