Interventions to reduce and prevent childhood obesity in low-income and middle-income countries: a systematic review and meta-analysis.

BACKGROUND: 70% of children with obesity and overweight live in low-income and middle-income countries. Several interventions have been done to reduce the prevalence of childhood obesity and prevent incident cases. Hence, we did a systematic review and meta-analysis to determine the effectiveness of these interventions in reducing and preventing childhood obesity. METHODS: We conducted a search for randomised controlled trials and quantitative non-randomised studies published on MEDLINE, Embase, Web of Science, and PsycINFO databases between Jan 1, 2010, and Nov 1, 2022. We included interventional studies on the prevention and control of obesity in children up to age 12 years in low-income and middle-income countries. Quality appraisal was performed using Cochrane's risk-of-bias tools. We did three-level random-effects meta-analyses and explored the heterogeneity of studies included. We excluded critical risk-of-bias studies from primary analyses. We assessed the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation. FINDINGS: The search generated 12 104 studies, of which eight studies were included involving 5734 children. Six studies were based on obesity prevention, most of which targeted behavioural changes with a focus on counselling and diet, and a significant reduction in BMI was observed (standardised mean difference 2·04 [95% CI 1·01-3·08]; p<0·001). In contrast, only two studies focused on the control of childhood obesity; the overall effect of the interventions in these studies was not significant (p=0·38). The combined studies of prevention and control had a significant overall effect, with study-specific estimates ranging between 0·23 and 3·10, albeit with a high statistical heterogeneity (I2>75%). INTERPRETATION: Preventive interventions, such as behavioural change and diet modification, are more effective than control interventions in reducing and preventing childhood obesity. FUNDING: None.

The reemergence of the human monkeypox: strengthening Africa's epidemic preparedness and response system.

The reemergence of the monkeypox (MPX) virus poses a serious threat to global health security. While the first human case was reported in Democratic Republic of Congo in 1970, a recent outbreak of this disease in May 2022 has gone 'viral,' spreading to most continents and occurring in nonendemic countries. Outside Africa, there have been reports of cases of MPX in countries such as Singapore in May 2019, Israel in September 2018, UK in September 2018, among others which have been traced back to importation of infected wild rodents from Africa. The Centers for Disease Control and Prevention (CDC) recommends that the standard laboratory facility to carry out MPX tests is Biosafety Containment Level (BSL)-2 working standards if the laboratory staff has taken smallpox vaccine within the last 3 years and BSL-3 working standards if the laboratory staff has not taken the smallpox vaccine. However, African countries have a shortage of BSL laboratories. Hence, there is a need to improve the integrated surveillance of the MPX virus, strengthen diagnostic capacity, capacity building of health workforce, public education programs, fund research, and development, among others. Leveraging a 'One Health' approach will offer fresh insight into the human-animal-environment interface and boost the understanding on the possibility and mechanisms of spillback and reverse zoonosis as well as disease severity and risk factors for severe disease as well as its epidemiology in various subpopulations. Not leaving Africa behind in the prevention, diagnosis, and management of MPX is important to stopping the spread and reemergence of this virus.

"Watching my family being killed by terrorists made me really depressed": Mental health experiences, challenges and needed support of young internally displaced persons in northern Nigeria.

Background: Over 3.9 million people have been displaced in Nigeria as a result of the over one-decade-long Boko Haram insurgency and about 2.1 million of this population are internally displaced within the country. Young internally displaced persons (IDPs) are at higher risk of mental illness such as depression, anxiety, post-traumatic stress disorder (PTSD) among others, however, there are sparse studies on this population. Therefore, this study explored the mental health experiences, challenges, and needed support for young internally displaced persons in Durumi and New Kuchingoro Internally Displaced Persons Camps in Nigeria. Methods: This qualitative study was conducted among young IDPs in Durumi and New Kuchingoro IDP camps in Northern Nigeria. Fourteen (14) focus group discussions comprising 89 participants and 30 in-depth interviews with 30 participants were conducted with young IDPs. The interviews were in Hausa and Pidgin English, audio-recorded, transcribed, translated into English, and applied thematic analysis was done using MAXQDA Analytics Pro 2020. Results: A total of 89 participants consisting of 47 males and 42 females participated in the FGDs and IDIs. Five key themes emerged from the FGDs and IDI: (1) knowledge about mental health, (2) mental Health Experiences, (3) coping strategies, (4) availability of mental health and other health Support, and (5) needed support. Young IDPs had fair knowledge about mental healthcare. Participants reported their experience before displacement as being peaceful with members of the family together in a good environment while they experienced stress, trauma, shock, sadness, and symptoms of anxiety, depression, and PTSD during and post displacement. Personal coping strategies such as listening to music, engaging in sports, reading books, farming, and other economic activities were reported by participants. Participants reported the absence of structured and specialized mental health support in the IDP camps and solicited mental health, physical health, economic and educational support. Conclusion: Young IDPs had negative experiences that led to symptoms of mental health disorders such as depression, anxiety disorders, PTSD among others with little or no access to quality mental healthcare. Hence, they require specialized and structured mental health support to lead healthy and productive lives. Policy and programs aimed at increasing access to mental health information and services for forced migrants are recommended.

Global fund: Analyzing 10 Years of bridging health inequalities.

The Global Fund is a non-profit organization founded by Bill Gates, Melinda Gates, Kofi Annan, Amir Attaran, and Jeffrey Sachs on the 28th January, 2002. Each year, about US$ 4 billion is invested to support programs and organizations led by local experts in various communities towards developing strategies and ways in which these three (HIV/AIDS, Malaria and Tuberculosis) diseases could be fought. The Global Fund has supported various innovative strategies used in tackling these infectious diseases. It is also worthy of note that 38 million lives have been saved through the Global Funds Partnership resulting in a 50% decline in mortality rate caused by tuberculosis, AIDS and Malaria in these reached countries. However, the Global Fund is not without its challenges as there has been lack of fund commitment from the G8 countries who instituted the idea in the first place. Another limitation being experienced is the poor risk management that has resulted in discrepancies of over US$4 million discovered in the Global Fund grants received by Nigeria as of 2016. This study discusses the current state of the Global Fund and suggests recommendations to policymakers that could be instrumental in strengthening health systems and achieving increased impact.