Prevalence and concentration of Aflatoxin M1 in human breast milk in sub-Saharan Africa: a systematic review and meta-analysis, and cancer risk assessment.

This study aimed to assess the prevalence, concentration of AFM1 in human breast milk, and to determine the risk of cancer for infants in sub-Saharan Africa. A systematic literature search was performed using PubMed, CINAHL, Web of science, global health, Cochrane, and Google Scholar electronic databases. A random-effects model was used to estimate the pooled prevalence and concentration of AFM1 in breast milk. The meta-analysis of 8 articles containing 9 studies showed the pooled prevalence of AFM1 in breast milk to be 56.18% (95% CI: 29.65-82.71) and the pooled concentration to be 31.12 ng/L (95% CI: 25.97-36.25). The cancer risk assessment indicated for both male and female 1-month infants in Sierra Leone (HI > 1) is high, and all the rest of the infants are free of risk (HI < 1). The pooled prevalence and mean concentration of AFM1 in breast milk is high. Monitoring of AFB1 concentration of commonly used foods will be of high value in reducing the burden of AFM1.

Vitamin D deficiency among apparently healthy children and children with common medical illnesses in Sub-Saharan Africa: A systematic review and meta-analysis.

Background: Studies show that 25 (OH) D status appears to have beneficial influence on the incidence and severity of some types of infections. However, studies with vitamin D supplementation on young children produced conflicting results. This study was conducted to assess and compare the pooled prevalence of vitamin D deficiency among healthy and sick children in sub-Saharan Africa. Method: A systematic review of PubMed, CINAHL, Web of science, global health and Google scholar electronic databases was conducted. Both published and unpublished observational studies conducted among under-five children in the year 2010-2020 were included. STATA Version 14 was used for analysis. Heterogeneity of studies was assessed using I2 test. A random-effects model was used to estimate the pooled prevalence among both healthy and sick children. Result: A total of 1212 articles were retrieved from data bases, of which 10 papers were included. The pooled prevalence of vitamin D deficiency among healthy children was 50.06% with mean serum vitamin D level of 41.06 nm/L. The pooled prevalence among the sick children was 39.36% with 66.96 nm/L of mean concentration. The pooled prevalence among healthy children was significantly higher compared to those who have common medical illnesses and the pooled mean concentration among the sick was also much higher than the mean concentration among healthy children. Conclusion: The pooled prevalence among both groups of population was significantly high and a concerning public health problem. The prevalence among healthy children was much higher as compared to sick children.

Time to Cure and Predictors of Recovery Among Children Aged 6-59 Months with Severe Acute Malnutrition Admitted in Jimma University Medical Center, Southwest Ethiopia: A Retrospective Cohort Study.

PURPOSE: Treatment at a stabilization center is an important intervention to avert the huge burden of mortality for children with complicated severe acute malnutrition (SAM). Despite the improvement in hospital coverage and the development of standardized WHO treatment guidelines, recent reviews indicated a wide range in recovery rate (34-88%) due to several context-specific factors. This study aimed to estimate time to recovery and to determine predictors of time to recovery among children aged 6-59 months with severe acute malnutrition. PATIENTS AND METHODS: An institution-based retrospective cohort study design was used among 375 children aged 6-59 months admitted to Jimma University Medical Center, Jimma, Ethiopia from September 2015 to September 2017. All eligible children were enrolled and assessed using a pretested questionnaire. Kaplan-Meir estimates and survival curves were used to compare the time to recovery using log rank test among different characteristics. Cox proportional hazard model was used to identify significant predictors of time to recovery. A p-value less than 0.05 was declared statistically significant. RESULTS: The rate of recovery was 4.06 per 100 person days. Median time of recovery for our cohort of SAM children's was 19 days (95% CI: 17.95-20.05). Independent predictors of time to recovery were play stimulation (AHR=1.93, 95% CI: 1.23-3.03), vaccination status (AHR=2.26, 95% CI: 1.12-4.57), tuberculosis (AHR= 0.48, 95% CI: 0.27-0.87), malaria (AHR=0.34,95% CI:0.13-0.88), use of amoxicillin (AHR=1.54, 95% CI: 0.008-2.34), deworming (AHR=1.8, 95% CI: 1.18-2.73), and shock (AHR=0.18, 95% CI: 0.05-0.59). CONCLUSION: The findings of this study showed that the average length of stay on treatment and median time for recovery are within the sphere standard. Psychosocial stimulation, appropriate provision of routine medication and management of medical co-morbidity are needed to promote fast recovery.

Magnitude of Anemia and Its Associated Factors Among Pregnant Women Attending Antenatal Care in Southern Ethiopia: A Cross-Sectional Study.

PURPOSE: The aim of this study was to assess the magnitude of anemia and its associated factors among pregnant women attending antenatal care (ANC) at Dilla University referral Hospital, South Ethiopia. PATIENTS AND METHODS: An institution-based cross-sectional study was conducted from January to February 2019, among 373 pregnant women who attended antenatal care at Dilla University referral hospital. Socio-demographic factors, nutritional, medical and obstetric information of the study participants were collected using a structured questionnaire. Hemoglobin was measured using a hemacue machine, and fecal specimens were examined to detect intestinal parasites. Bivariate and multiple variable binary logistic regressions were used to identify predictors of anemia. A p-value less than 0.05 was used to declare statistical significance. RESULTS: Overall prevalence of anemia was 28.7%, of which 19.6% had mild anemia. Decreased odds of anemia were found in women with good nutritional status (MUAC ≥24 cm) (AOR= 0.07 95% CI: 0.03-0.1), iron supplementation (AOR=0.06 95% CI: 0.02-0.15) and birth spacing ≥2 yrs (AOR=0.03 95% CI: 0.009-0.45). However, increased odds of anemia were seen in pregnant women with intestinal parasites (AOR=6.11 95% CI 7.70-37.0). CONCLUSION: The magnitude of anemia among pregnant women was found to be a moderate public health problem. Iron supplementation, good nutritional status (MUAC> 24 cm), and birth spacing reduce the odds of anemia. But having intestinal parasites was found to increase the likelihood of anemia during pregnancy. Counseling on birth spacing, strengthening iron supplementation, and intestinal parasite management during pregnancy should be given due emphasis.