Prevalence and determinants of skilled birth attendance among young women aged 15-24 years in Northern Nigeria: evidence from multiple indicator cluster survey 2011 to 2021.

BACKGROUND: Childbirth among adolescents and young mothers has been linked to various complications, including perinatal mortality, preterm births, low birth weight, and infections, which collectively contribute to the high burden of neonatal and maternal mortality. Despite some progress, the prevalence of skilled birth attendance, proven to improve maternal and newborn health outcomes, remains consistently low in Northern Nigeria. This study assessed the prevalence and determinants of Skilled Birth Attendance (SBA) among young women ages 15-24 years in Northern Nigeria. METHODS: This pooled cross-sectional study included 6,461 young women aged 15-24 years from 2011, 2016 and 2021 multiple indicator cluster surveys in Nigeria. We used a binary logistic regression model to assess the factors associated with skilled birth attendance at 95% confidence intervals (CIs) with computed adjusted odds ratios (aORs). RESULTS: The prevalence of skilled birth attendance among young women in Northern Nigeria increased from 25.6% in 2011 to 33.1% in 2021. Women who were atleast 18 years of age at first marriage had 2.48 higher odds of SBA (aOR 2.48, 95% CI = 1.54-4.00) compared those less than 18 years of age at first marriage after controlling for confounders. Young women from rich household wealth quintile were more likely to utilize SBA (aOR 1.84, 95% CI = 1.11-3.14) compared to young women from poor household wealth quintile. In terms of education, those women who had secondary (aOR = 2.52, 95% CI = 1.77-3.56) and higher education (aOR = 10.01, 95% CI = 2.21-49.31) had higher odds of SBA compared to those with no education. Individual women with media exposure had 59% higher likelihood (aOR = 1.59, 95% CI = 1.16-2.19), women who attended 4 or more antenatal care visits during their last pregnancy demonstrated 2.28 times higher odds (aOR = 2.28, 95% CI = 1.67-3.09), while those who reported no intention for their last pregnancy were 37% less likely (aOR = 0.63, 95% CI = 0.42-0.96) to utilize SBA. CONCLUSION: A slight increase in the prevalence of skilled birth attendance was observed over the 10-year period. For a significant boost in skilled birth attendance among young women in Northern Nigeria, particular attention needs to be paid to girls' child education, delay in marriage, economic empowerment of young women, and strategic ways of leveraging trained community health workers (CHIPs) to bring reproductive healthcare close to young women living in rural areas.

Can global health security frameworks measure One Health implementation in West Africa?A mixed-methods study.

BACKGROUND: The 2014 outbreak of the Ebola virus disease highlighted the importance of overhauling and transforming healthcare systems in West Africa to improve the ability of individual countries to deal with infectious diseases. As part of this effort, in November 2016 the West African Health Organization (WAHO) began the process of institutionalizing the One Health (OH) approach to health security across the Economic Community of West African States (ECOWAS). The lack of clear metrics and evaluation frameworks to measure the progress of OH implementation in West Africa has been reported as a challenge. Therefore, this study sought to assess and explore whether the existing metrics of global health security frameworks can measure the successful implementation of OH activities, evaluate the progress made since 2016, and identify key areas for improvement in the region. METHOD: The study employed predetermined keywords to select indicators from the International Health Regulations (IHR) Monitoring Frameworks, specifically the State Party Self-Assessment Annual Report (SPAR) and Joint External Evaluation (JEE), deemed relevant to the OH approach. In addition, the COVID-19 performance index scores (severity and recovery) for June 2022 were extracted from the Global COVID-19 Index (GCI). The GCI Recovery Index evaluated the major recovery parameters reported daily to indicate how a country performed on the path to recovery from the COVID-19 pandemic compared to other countries. National documents were also analyzed using categorical variables to assess the performance status of OH platforms across implementing countries. A quantitative analysis of these indicators was conducted and supplemented with qualitative data gathered through interviews with key stakeholders. Between March and April 2022, we conducted 18 key informant interviews with purposively selected representatives from regional governmental agencies and international multilateral agencies, including ECOWAS member states. Interviews were conducted online, transcribed, and analysed following the tenets of thematic analysis. RESULTS: Our quantitative analysis revealed no significant association between the implementation status of OH activities and any of the selected indicators from SPAR and JEE. The descriptive analysis of the JEE scores at the country level revealed that countries with existing OH platforms scored relatively higher on the selected JEE indicators than other countries in the pre-implementation stage. OH implementation status did not significantly affect COVID-19 recovery and severity indices. The qualitative findings with relevant stakeholders revealed noteworthy challenges related to insufficient human capacity, inadequate coordination, and a lack of government funding for the sustainability of OH initiatives. Nonetheless, countries in the ECOWAS region are making progress toward the integration of OH into their health security systems. CONCLUSION: Standardized metrics were used to assess the implementation and efficacy of OH systems in the ECOWAS region. Current indicators for monitoring global health security frameworks lack specificity and fail to comprehensively capture essential OH components, particularly at the sub-national level. To ensure consistency and effectiveness across countries, OH implementation metrics that align with global frameworks such as IHR should be developed.

Climate change and health in the Sahel: a systematic review.

The Sahel region is projected to be highly impacted by the more frequent hazards associated with climate change, including increased temperature, drought and flooding. This systematic review examined the evidence for climate change-related health consequences in the Sahel. The databases used were Medline (PubMed), Embase (Ovid), Web of Science (Clarivate) and CABI Global Health. Hand searches were also conducted, which included directly engaging Sahelian researchers and hand-searching in the African Journals Online database. Of the 4153 studies found, 893 were identified as duplicates and the remaining 3260 studies were screened (title and abstract only) and then assessed for eligibility. A total of 81 studies were included in the systematic review. Most studies focused on vector-borne diseases, food security, nutrition and heat-related stress. Findings suggest that mosquito distribution will shift under different climate scenarios, but this relationship will not be linear with temperature, as there are other variables to consider. Food insecurity, stunting (chronic malnutrition) and heat-related mortality are likely to increase if no action is taken owing to the projected impact of climate change on environmental factors and agriculture. Seventy-one per cent of manuscripts (n = 58) had first authors from institutions in North America or Europe, of which 39.7% (n = 23) included co-authors from African institutions.

Decomposing Education-Based Inequalities in Pre-Exposure Prophylaxis Knowledge for HIV Prevention Among Women in Cote d'Ivoire.

Background: Antiretroviral chemoprophylaxis is a promising strategy for preventing the spread of human immunodeficiency virus (HIV). The knowledge of pre-exposure prophylaxis (PrEP) is required for intervention uptake and adherence to prevent the spread of HIV. This study aimed to decompose education-based inequalities in PrEP knowledge for HIV prevention among reproductive-aged women in Cote d'Ivoire. Methods: A cross-sectional study design with a nationally representative sample of 12,934 women aged 15-49 years was analyzed from the 2021 Cote d'Ivoire Demographic and Health Survey. The survey was conducted between September to December, 2021. The outcome variable was the knowledge of PrEP for HIV prevention. Statistical analysis was conducted using percentage, concentration index, and Lorenz curve. The level of significance was set at p<0.05. Results: A weighted prevalence of 14.5% (95% CI: 12.5-16.3%) was estimated for PrEP knowledge for HIV prevention. Overall, educated women had a higher knowledge of PrEP for HIV prevention (Conc. Index= 0.225; SE= 0.012; p<0.001). Across the levels of women's characteristics, the results showed higher PrEP knowledge for HIV prevention among educated women. Education (Contri: 40.7327%, Ec: 0.5390), exposure to internet (Contri: 20.1039%, Ec: 0.3484), place of residence (Contri: 12.9801%, Ec: -0.0537), household wealth (Contri: 10.0062%, Ec: 0.0642) and religion (Contri: 5.7509%, Ec: 0.0354) were positive contributors to PrEP knowledge for HIV prevention. On the other hand, age (Contri: -8.8298%, Ec: -0.0950) and region (Contri: -3.5942, Ec: -0.0768) were negative contributors to PrEP knowledge regarding HIV prevention among women of reproductive age in Cote d'Ivoire. Conclusion: There is limited knowledge of PrEP for HIV prevention among women in Cote d'Ivoire. Educated women had greater knowledge of PrEP for HIV prevention. The results of this study could guide interventions targeted to enhance the knowledge of PrEP as an HIV prevention option.

Prevalence and factors associated with pre-exposure prophylaxis awareness among cisgender women of reproductive age in Burkina Faso.

BACKGROUND: HIV remains a global public health concern, and women continue to be disproportionately affected. Understanding the factors associated with pre-exposure prophylaxis awareness among women is crucial as an effective HIV prevention strategy. OBJECTIVES: We investigated the prevalence and associated factors of pre-exposure prophylaxis awareness among women in Burkina Faso. DESIGN: This was a cross-section study that used population-based data. METHODS: A total of 17,659 women of reproductive age (15-49 years) from the 2021 Burkina Faso Demographic and Health Survey were analyzed. Percentage and multivariable logistic regression model were used to examine the prevalence and factors associated with pre-exposure prophylaxis awareness. RESULTS: The prevalence of pre-exposure prophylaxis awareness was 8.2% (95% confidence interval = 7.8%-8.6%). Women's age was positively associated pre-exposure prophylaxis awareness. Women with primary and secondary education had 39% and 48% higher odds of pre-exposure prophylaxis awareness, when compared with women with no formal education. The odds of pre-exposure prophylaxis awareness were 1.40 (95% confidence interval = 1.19-1.66) times higher among Christians when compared with the Muslims. Women who were exposed to mass media including newspaper or magazine, radio, TV, and Internet had higher odds of pre-exposure prophylaxis awareness, when compared with those without exposure to mass media channels. Women who have previously tested for HIV had 37% higher odds of pre-exposure prophylaxis awareness, when compared with those who have not been tested (adjusted odds ratio = 1.37; 95% confidence interval = 1.09-1.72). CONCLUSION: This study found women's age, geographical region, education, religion, exposure to mass media channels, employment, and HIV testing to be associated with pre-exposure prophylaxis awareness. These findings can inform the development of targeted interventions and public health campaigns to increase awareness and practice to pre-exposure prophylaxis, particularly among key population.

Contextual factors associated with diarrhea among under-five children in the Gambia: a multi-level analysis of population-based data.

BACKGROUND: Diarrhea poses a significant threat to the lives of children in The Gambia, accounting for approximately 9% of all deaths among children under the age of five. Addressing and reducing child mortality from diarrhea diseases is crucial for achieving the Sustainable Development Goal (SDG) 3, specifically target 3.2, which aims to eliminate preventable deaths in newborns and children under the age of five by 2030. Thus, this research aims to assess the prevalence and contextual factors associated with diarrhea among under-five children in The Gambia. METHODS: This research employed secondary data from the 2019/20 Gambia Demographic Health Survey (GDHS). The study initially involved 8,362 women aged between 15 and 49 years. Of these, 6,929 women with children under five were included in this analysis. Data were analyzed using STATA with cross-tabulation and model fitting. Multilevel logistic regression was applied to accommodate the hierarchical structure of the demographic health survey data. The model comparison parameters were BIC, AIC, deviance, and LLR. Variables with a p-value less than 0.05 were selected for multivariable analysis. The statistical significance of the factors was determined using an adjusted odds ratio with a 95% confidence interval (CI) and a p-value of less than 0.05. RESULTS: The prevalence of diarrhea in under-five children was 53.2% in males and 46.8% in females. In the final model, Kerewan (aOR = 0.58; 95% CI = 0.33-0.98) and Basse (aOR = 0.59; 95% CI = 0.35-0.98) have significantly lower odds of childhood diarrhea compared to Banjul, female children show slightly lower, yet significant, odds of diarrhea compared to males (aOR = 0.96; 95% CI = 0.86-0.98), deliveries at government health centers are associated with higher odds of childhood diarrhea compared to home births (aOR = 1.24; 95% CI = 1.01-1.52). Mothers with post-secondary education had significantly lower odds of having children with diarrhea than those without any education (aOR = 0.50; 95% CI = 0.26-0.99) after controlling for confounders. CONCLUSION: The study findings indicate that several factors significantly impact the risk of childhood diarrhea in The Gambia. These factors include region of residence, sex of the child, place of delivery, and education level of the mother. The study suggests that existing interventions aimed at improving child health outcomes in the country should take into consideration these influential factors. Addressing these modifiable factors can enhance the effectiveness of interventions and promote better health outcomes for children in Gambia.

Comprehensive HIV knowledge and associated factors among reproductive-age women: analysis of the Gambia Demographic and Health Survey 2019/2020.

INTRODUCTION: Globally, there are 37.7 million people living with human immunodeficiency virus (HIV). So far, there is no study done in Gambia which assessed comprehensive HIV knowledge and its associated factors. Therefore, this study aims to assess comprehensive HIV knowledge and its associated factors among reproductive-age women in Gambia. OBJECTIVE: To assess the prevalence of comprehensive HIV knowledge and its associated factors among reproductive-age women in Gambia. METHODS: The study used the Gambian Demographic and Health Survey, which was conducted from 21 November 2019 to 30 March 2020 in Gambia. The survey employed a stratified two-stage cluster sampling technique to recruit study participants. Logistic regression analysis was used to identify factors associated with HIV comprehensive knowledge. Statistical significance was declared at a P value of less than 0.05 with a 95% confidence interval (CI). RESULTS: The overall prevalence of comprehensive HIV knowledge was 27.1% (25.1-36.2%). Older age [adjusted odds ratio (AOR) of 1.20 (95% CI 1.16-1.26)], using contraceptive [AOR of 1.15 (95% CI 1.01-1.31)], higher education [AOR of 4.73 (95% CI 3.86-5.81)], rich wealth quintile [AOR of 1.61 (95% CI 1.37-1.87)], media exposure [AOR of 1.76 (95% CI 1.39-2.23)], ever tested for HIV [AOR of 1.55 (95% CI 1.42-1.74)], visited health facility within the last 12 months [AOR of 1.26 (95% CI 1.12-1.41)] and decision-making autonomy [AOR of 1.42 (95% CI 1.27-1.60)] were positively associated with comprehensive HIV knowledge. However, being married [AOR of 0.72 (95% CI 0.62-0.82)] was negatively associated with comprehensive HIV knowledge. CONCLUSIONS: The prevalence of comprehensive HIV knowledge was low in Gambia. Educational interventions that focused mainly on awareness creation about HIV/AIDS should be designed especially for married women and lower socio-economic status. An effort has to be made to address those disparities at the national level.

Breast Cancer Screening: Knowledge, Attitudes, and Practices among Female University Students in The Gambia.

Background: Breast cancer is the second most prevalent form of cancer in The Gambia, with an incidence rate of approximately 15% and a mortality rate exceeding 50% in 2020. The all-age prevalence stands at 11.25 per 100,000 population. In light of this, we conducted a study to assess the knowledge, attitude, and practice of breast cancer screening among female university students. Method: We conducted an institutional cross-sectional study involving 361 randomly sampled female university students. Data collection was done using a pretested, self-administered questionnaire. We utilized descriptive statistics to describe the prevalence and burden of breast cancer screening among the participants. Results: Our study revealed good knowledge regarding breast cancer screening among female university students, yet 82.8% had a negative attitude about the disease. More than three-quarters (76.6%) of the respondents had never practiced any form of breast cancer screening. Notably, there was a significant association between knowledge of breast cancer screening and attitude (p = 0.027), and factors such as level of study (p = 0.041), ethnicity (p = 0.026), parity (p = 0.018), and faculty of study (p = <0.001) influenced the participants' knowledge. Conclusion: It is crucial to implement comprehensive awareness campaigns to address the negative attitude and poor screening practices among female university students regarding breast cancer. Additionally, providing free and widespread breast cancer screening services to students should be considered as a means to combat this disease.

Uptake and determinants of childhood vaccination status among children aged 0-12 months in three West African countries.

BACKGROUND: Vaccination has long been recognized as one of the most effective ways to reduce child mortality. It has played a significant role, particularly for children, and is considered a major achievement and relevant in preventing childhood diseases worldwide. This study looks at the uptake and determinants of childhood vaccination status among children under the age of one year, for Gambia, Sierra Leon, and Liberia. METHOD: Data from 2019 to 20 Demographic and Health Survey (DHS) data from Gambia, Sierra Leone, and Liberia were pooled for the analysis used in this study. Data were obtained from a total weighted sample of 5,368 children aged 0-12 months through a stratified two-stage cluster sampling approach. A multivariable logistic regression model was used to assess the predictors of childhood vaccination uptake at 95% confidence interval (CIs) with computed adjusted odds ratios (aORs). RESULTS: The weighted sample pooled prevalence of full vaccination among children under 12 months of age was 15.1% for males and 15.0% for females. After controlling for confounders in the regression model, factors that were found to be associated with vaccination status include children whose mothers attended postnatal care (PNC) visits had higher odds of being fully vaccinated (aOR = 1.23, 95% CI = 1.03-1.46), while children whose fathers had primary education (aOR = 0.67, 95% CI = 0.48-0.96), children whose households never watched TV (aOR = 0.68, 95% CI = 0.56-0.82) and children whose mothers attended 1-3 antenatal care (ANC) visits (aOR = 0.59, 95% CI = 0.45-0.79) had lower odds of being fully vaccinated. CONCLUSION: Childhood vaccination uptake was low among children under 12 months of age in these countries. Hence, there is a need to promote the uptake of vaccination across these three West African countries especially among rural dwellers.

Achieving the UNAIDS first '95' in prenuptial HIV/AIDS testing among reproductive-aged Rwandese women: A multilevel analysis of 2019-20 population-based data.

A significant public health concern that disproportionately affects women is human immunodeficiency virus (HIV). Prenuptial HIV testing is no doubt a major step for people to learn their HIV status. In this study, the coverage of prenuptial HIV testing and its associated factors were examined among reproductive-aged Rwandese women. This study included a total of 14,634 reproductive-aged Rwandese women using 2019-20 Rwanda Demographic and Health Survey (RDHS). The coverage of prenuptial HIV/AIDS testing and the variables influencing it were evaluated using percentage and multilevel logit model. The level of significance was set at p<0.05. The weighted prevalence of prenuptial HIV/AIDS testing was 45.9% (95%CI: 44.8%-47.1%). The respondents who attained primary and secondary+ education had 31% (OR = 1.31; 95%CI: 1.09-1.59) and 56% (OR = 1.56; 95%CI: 1.25-1.95) higher odds of prenuptial HIV/AIDS testing, when compared with uneducated women. Those who got married or had their first sex at an adult age (18+ years), had higher odds of prenuptial HIV/AIDS testing, when compared with women who got married before age 18 years or never had sex respectively. Women's age, nativity and region were associated with prenuptial HIV testing. Women with knowledge of HIV test kits, had higher odds of prenuptial HIV/AIDS testing (OR = 1.45; 95%CI: 1.30-1.63), when compared with those with no knowledge of HIV test kits. The respondents from female-headed households had 12% reduction in prenuptial HIV/AIDS testing (OR = 0.88; 95%CI: 0.80-0.97), when compared with their male-headed counterparts. The moderately (OR = 1.16; 95%CI: 1.03-1.31) and highly (OR = 1.55; 95%CI: 1.37-1.75) enlightened women had higher odds of prenuptial HIV/AIDS testing, when compared with those with low enlightenment. The uptake of prenuptial HIV/AIDS testing was relatively low among Rwandese women. We recommend improving women's education, enlightenment, delay in sexual debut, marriage at adult age (18years) and increasing knowledge about HIV testing among women.

Differentials in the Prevalence of Acute Respiratory Infections Among Under-Five Children: An Analysis of 37 Sub-Saharan Countries.

Objective: We investigated the prevalence and risk factors of ARI in children under 5 years old in 37 SSA countries. Methods: Data from Demographic and Health Survey (DHS) of 37 African countries was examined in this analysis. Data from children under the age of 5 years old were examined. Forest plot was used to identify disparities in the occurrence of ARIs across SSA countries. Results: We observed a higher prevalence of ARI among children under 5 in Uganda, Kenya, Sao Tome and Principe (9% each), Gabon, Chad, Eswatini (8% each), Burundi, Ethiopia, Congo Democratic Republic (7.0% each). The prevalence of ARI among under-five children who sought medical advice/treatment from health facility was higher in South Africa (88%), Sierra Leone (86%), Tanzanian (85%), Guinea (83%) and Uganda (80%). The prevalence rate of ARI among under-five children who received antibiotics was higher in Tanzania (61%), Sao Tome and Principe (60%), Rwanda and Congo (58% each), Angola (56.0%), Mozambique (54.0%), Kenya (53.0%), Namibia (52.0%) and Gabon (50.0%). This study found that the household wealth index, maternal education, and urban residence were significantly associated with ARI (p <0.001). A higher prevalence of ARI was observed among urban residents, low income families, and those with mothers with lower education. Conclusion: ARI prevalence could be reduced by improving household socioeconomic status, child nutrition and community awareness of indoor and outdoor pollution. Interventions and programs focused on early diagnosis, treatment and prevention of ARIs are crucial in reducing ARIs particularly in developing countries.

Cultural beliefs, attitudes and perceptions of lactating mothers on exclusive breastfeeding in The Gambia: an ethnographic study.

BACKGROUND: WHO/UNICEF recommends that women in resource-poor developing countries- like the Gambia, should exclusively breastfeed their infants for the first six months of their lives because of its health benefits to both mother and infant. The study aimed to explore the cultural beliefs, attitudes, and perceptions of lactating mothers towards exclusive breastfeeding in The Gambia. METHODS: This was a qualitative ethnographic study of culture-sharing groups of mothers with infants 4 to 6 months old. The study was conducted from July to October 2014 and data collection was done through a face-to-face, in-depth interview and moderate participant observation. The study recruited 22 breastfeeding mothers attending government health facilities in the Kanifing Municipality. The collected data were transcribed verbatim and analyzed through a constant comparison method generating six cultural themes, each with sub-themes. RESULTS: Baby's welfare is traditionally based on the types of food mother's eat. To this end, mothers reportedly shunned eating green leafy vegetables, liquid and hot foods for their infants' wellbeing. Encounters such as weight loss, nipple inflammation, and backache, which mothers associated with hyper latching and sitting for prolonged breastfeeding, respectively, were among major undesirable physical effects revealed by the participants. Furthermore, the necessity of giving water to infants for their survival was illustrated as a barricade to exclusive breastfeeding practices. Likewise, the entrenched practice of giving charm water to instill the Islamic faith and shielding infants against evil spirits was another factor influencing exclusive breastfeeding practices. Finally, the belief that breast milk adequacy is based on breast size and nurturing men's physical strength by starting prelacteal feeds early in infancy also contributes to the meek exclusive breastfeeding rate among mothers. CONCLUSION: This study could be a gazette piece for effective policy making and enhance nurses' cultural sensitivity while caring for lactating mothers. Cultural meanings of health care behaviors in lactating mothers challenge universally applying guidelines of exclusive breastfeeding to all societies. The study findings could benefit healthcare providers in informing policies and designing culturally adaptive and acceptable community-based breastfeeding intervention programs in resource-limited settings.

Measuring the Uptake of Growth Monitoring and Nutrition Promotion among under-5 Children: Findings from the Rwanda Population-Based Study.

Regular growth monitoring can be used to evaluate the nutritional and physical health of children. Ample evaluation of the reach and quality of nutrition interventions is necessary to increase their effectiveness, but there is little research on improving coverage measurement. The aim of this study was to explore the coverage of growth monitoring, nutrition promotion, and associated factors by Rwandan caregivers of children under the age of five. Data from 2019−2020 Rwanda Demographic and Health Survey with a total of 8092 children under the age of five were used for this study. Prevalence of growth monitoring and nutrition promotion were reported and the factors influencing this were evaluated using multivariable logistic regression model. The prevalence of growth monitoring and nutrition promotion among under-5 children was 33.0% (95%CI: 30.6−35.6%). Older children, caregivers who were native residents, those with a health insurance, in a marital relationship, employed, and residing in rural areas had higher odds to participate in growth monitoring and nutrition promotion compared to their counterparts. Rwanda has a low rate of coverage for growth monitoring and nutrition promotion among children <5 and public health nutrition interventions should prioritize nutritional counseling as well as the availability of growth monitoring and promotion services.

The Influence of Parental Environmental Exposure and Nutrient Restriction on the Early Life of Offspring Growth in Gambia-A Pilot Study.

BACKGROUND: The role of the germline in epigenetic transgenerational inheritance starts with environmental factors, acting on the first generation of a gestating mother. These factors influence the developing second-generation fetus by altering gonadal development, thereby reprogramming the primordial germ cell DNA methylation and leading to consequences that might be seen along generations. OBJECTIVE: Despite these epigenetic factors now surfacing, the few available studies are on animal-based experiments, and conducting a follow-up on human intergenerational trials might take decades. To this response, this study aimed to determine the influence of parental energy, toxicant exposure, age, and nutrient restriction on the early life of offspring growth in Gambia. METHOD: This pilot study was based on population observation and combined both maternal and paternal factors across the country between August and October 2021. It captures the lifestyle and health detailed account of 339 reproductive parents and their last born (child under 5 years) using a structured interview questionnaire performed by nurses and public health officers. RESULTS: This study showed that parents who worked in industrial areas were more likely to have offspring with poor psychosocial skills. In addition, mothers who are exposed to oxidative stress and high temperatures are more likely to have offspring with poor psychosocial skills. Mothers who consume a high-protein diet were almost three times more likely to have infants with good psychosocial skills in their offspring. Furthermore, there was a negative correlation between maternal stress during pregnancy and the psychosocial skills of offspring. CONCLUSION: This study was able to ascertain if the maternal diet during gestation, toxicant exposure, maternal stress, and parental smoking habits have an influence on the early life of offspring. While the study recommends a large sample size study to eliminate selection bias, there should be an increased level of awareness of mothers of their offspring's health and their husbands' lifestyles that might influence the adulthood health of their offspring.

Parental Knowledge, Willingness, and Attitude towards Contraceptive Usage among Their Unmarried Adolescents in Ekpoma, Edo State, Nigeria.

Background: Adolescence is a time of opportunity, vulnerability, and risk, particularly in relation to health, unsafe sexual activity, and reproductive health. Neglecting their reproductive health issues leads to a great risk of agonizing transition to parenthood, lifetime effects, and early pregnancy, which can compromise educational achievements and economic potentials. Meeting the reproductive health needs of adolescents mostly rests on the parents' shoulders. Thus, this study explored parental knowledge, willingness, and attitude towards contraceptive use among their unmarried adolescents. Methods: This was an analytical cross-sectional study design. The multistage sampling technique was used to recruit 360 parents from Ekpoma community, Edo State, Nigeria. A structured questionnaire was used to generate data for this study. Data processing and analysis were done using SPSS version 24. In order to determine association with outcome variables, chi-square (χ 2) and Fisher's exact test statistics were used while statistical significance was set at p < 0.05. Results: The proportion of parental knowledge on contraceptive methods was at 96.9%, parental willingness for their adolescents' contraceptive uptake at 31.7%, and positive attitude at 24.2%. Associated factors for parental knowledge of contraceptives include gender (χ 2=8.655, p = 0.003), age († = 13.377, p = 0.001), marital status († = 133.730, p < 0.001), educational level († = 103.689, p < 0.001), religion († = 164.592, p < 0.001), ethnicity († = 25.273, p < 0.001), and duration of marriage († = 11.365, p = 0.008). Factors such as educational level († = 21.220, p < 0.001), marital status († = 9.001, p = 0.022), and religion († = 6.058, p = 0.046) were associated with parental attitude towards contraceptives for their unmarried adolescents. Education level († = 19.905, p < 0.001) was associated with parental willingness for their unmarried adolescents' use of contraceptives. Conclusion: Although parents have good knowledge of contraception, this knowledge has not been passed on to their adolescents. However, few parents would encourage their adolescents to use contraceptives and advise the use of condoms if they are sexually active. Parents should be advised about contraceptive matters further to influence their adolescents' attitudes towards its usage. Establishing youth-friendly health centers will also encourage health information use and exposure.

Inequalities in the prevalence of stunting, anemia and exclusive breastfeeding among African children.

BACKGROUND: Childhood stunting and anemia are on the increase in many resource-constrained settings, without a counter increase in proper feeding practices such as exclusive breastfeeding. The objective of this study was to explore the prevalence of stunting, anemia and exclusive breastfeeding across African countries. METHODS: Demographic and Health Survey (DHS) data from 39 African countries was analyzed. Data from under 5 children were analyzed. Forest plot was used to determine inequalities in the prevalence of the outcome variables. RESULTS: The prevalence of stunting was highest in Burundi (56%), Madagascar (50%) and Niger (44%). In addition, Burkina Faso (88%), Mali (82%), Cote d'Ivoire and Guinea (75% each) and Niger (73%) had the highest prevalence of anemia. Furthermore, Burundi (83%), Rwanda (81%) and Zambia (70%) had the highest exclusive breastfeeding. We found statistical significant difference in the prevalence of stunting, anemia and exclusive breastfeeding (p < 0.001). Higher prevalence of stunting and anemia were estimated among the male, rural residents, those having mothers with low education and from poor household wealth. CONCLUSION: Concerted efforts are required to improve childhood health, survival and proper feeding practice. Reduced stunting and anemia could be achieved through sustained socioeconomic improvement that is shared in equity and equality among the population. Interventions aimed at increasing food availability can also aid in the reduction of hunger, particularly in impoverished communities.

Antenatal care positive responses to pregnant women in preventing and controlling malaria in pregnancy: the sub-Saharan African perspective.

BACKGROUND: The response to antenatal care (ANC) for maternal and offspring outcomes, especially in pregnant women has been thoroughly studied. However, despite the number of interventional studies on the treatment of sulfadoxine-pyrimethamine combination (IPTp-SP) uptake, the point in point cases of the positive responses of ANC in improving health conditions of pregnant women are not found in the literature. DATA SOURCES: This review collected ANC responses to the positive health outcomes for pregnant women with malaria, the challenges faced regarding IPTp-SP uptake during ANC visits and the role of ANC in preventing and controlling malaria in sub-Saharan Africa. It elucidated ANC and uptake of optimal intermittent preventive IPTp-SP and further described ANC as a tool for heterogeneity for malaria prevention. RESULTS: ANC is seen as a microscope to malaria in pregnacy, maternal iron deficiency and anemia checkpoints, ANC and malaria treatment strategies, and ANC and the use of insecticide treated nets (ITN). The review further discussed ANC attendance influencing factors, limitations to ANC implications and the prospects in ANC visits on preventing malaria in pregnancy. CONCLUSIONS: A declining trend of malaria transmission in Africa has been observed in recent years. However, the burden of malaria in pregnancy remains a health concern. The rate of SP resistance, low uptake of IPTp-SP, low LLINs distribution, late gestational ANC visits and low turnaround for optimal ANC visits for first time mothers' aggrevated the malaria-endemic settings among pregnant women in sub-Saharan Africa.

Epidemiology of occupational hazards and injuries among fishermen at Tanji fishing site in The Gambia: an analytical cross-sectional study design.

Fishing is a well-known industry, and there are certain risks of work-related diseases and accidents, occupational hazards and safety issues. This study aimed at examining the determinants of occupational hazards and injuries among fishermen at Tanji fishing site, a major fish-landing site in the Gambia, West Africa. An analytical cross-sectional design was conducted in August to October 2019. Structured questionnaires were administered to fishermen at Tanji fishing site. A simple random sampling method was used to select fishermen in this study. Data entry and processing for preliminary data analysis was done using Stata version 15. Descriptive and bivariate analysis using chi-square/fisher exact test as well as binary logistics regression analysis were used. The adjusted risk ratios (aRRs) and confidence intervals of 95% were calculated. A P-value < .05 was considered for statistical significance. The proportion of occupational hazards were 95%, while reported injuries were 85%. Ergonomics, physical, and environmental/climatic hazards formed the majority at 25%, 23%, and, 21%, while muscle strains and falling formed the majority for types of injuries at 19% and 17%, respectively. Fishermen who used PPE (aRR: 0.12and 95% CI: 0.01-0.99) were less likely to have occupational hazards relative to those who did not use PPE. In terms of injuries, fishermen who were smokers (aRR: 3.18, 95% CI: 1.32-7.66), had chemical hazards (aRR: 3.14, 95% CI: 1.26-7.86) and had no fishing safety rules (aRR: 2.81, 95% CI: 1.15-6.85) were more likely to sustained injuries relative to other categories after controlling for confounders. This research found a high prevalence of OSH hazards and injuries among fishermen, highlighting the critical nature of strengthening safety regulatory services for this workforce.

Differentials in prevalence and correlates on uptake of tetanus toxoid and intermittent preventive treatment with sulfadoxine-pyrimethamine during pregnancy: A community-based cross-sectional study in The Gambia.

OBJECTIVES: The study examined the differentials in prevalence and correlates on the uptake of tetanus toxoid and intermittent preventive treatment of malaria among pregnant women in The Gambia. METHODS: The 2018 data from The Gambia Multiple Indicators Cluster Survey were analyzed. Data from 6143 women of reproductive age who have given birth were extracted for the analysis. Percentages and Chi-square tests were used. In addition, a multivariable logistic regression model was used to calculate the adjusted odds ratios (with a corresponding 95% confidence interval). The level of significance was set at p < 0.05. RESULTS: The prevalence of tetanus toxoid uptake among women in The Gambia was 88.2%, while that of the adequate tetanus toxoid doses was 34.8%. The prevalence of intermittent preventive treatment with sulfadoxine-pyrimethamine uptake among maternal women in The Gambia was 98.6%, while that of the adequate intermittent preventive treatment with sulfadoxine-pyrimethamine doses taken was 34.3%. The identified statistically significant covariates of tetanus toxoid immunization and intermittent preventive treatment with sulfadoxine-pyrimethamine uptake includes women's age, local government areas, parity, use of radio, use of newspaper, and antenatal care visits. CONCLUSION: The current utilization rate for adequate intermittent preventive treatment with sulfadoxine-pyrimethamine and tetanus toxoid immunization during pregnancy in The Gambia is very low and even below universal levels. The country needs to strengthen more and effective mass media advocacy programs that would target both rural and urban populace, and motivate maternal women to ensure adequate vaccination against malaria and tetanus.