Hair cortisol concentrations are associated with greater adiposity in late adolescence amongst non-Hispanic White individuals.

INTRODUCTION: Hair cortisol concentration (HCC) is a biomarker of long-term stress. Higher HCC is associated with higher adiposity in adults; however, associations are not well characterized in adolescents. OBJECTIVE: To examine cross-sectional associations of HCC with adiposity in late adolescence. METHODS: Amongst 336 non-Hispanic White participants (48.5% female, mean 17.7 years) in Project Viva, we used multivariable linear regression models, overall and sex-stratified, to estimate associations of HCC with body mass index (BMI), bioelectric impedance (BIA) percent body fat, waist circumference (WC) and dual X-ray absorptiometry-measured percent and total fat or trunk fat mass. We adjusted models for age and known predictors of adiposity. RESULTS: Median (interquartile range) HCC was 2.1 pm/mg (1.0-4.5) and mean (SD) BMI was 23.1 kg/m2 (3.9), BIA %body fat 20.2% (9.9) and WC 80.6 cm (10.9). In adjusted models, higher HCC (per doubling) was associated with higher BMI (ß = 0.19 kg/m2; 95%CI 0.00, 0.37) and BIA percent body fat (ß = 0.41%; 95%CI 0.04, 0.77). We observed no evidence of effect modification by sex. CONCLUSIONS: Higher HCC was associated with greater adiposity in late adolescence. Further research is needed to disentangle the relationship between HCC and adolescent adiposity, including the temporal direction of the relationship and sex-specific associations.

Measurement invariance of a household water insecurity metric in Greater Accra, Ghana: Implications for test-retest reliability.

The mitigation of household water insecurity is recognized as an important component of global poverty alleviation, but until recently was difficult to measure. Several new metrics of household water insecurity have been proposed and validated, but few have been field-tested for reliability in diverse contexts. We used confirmatory factor analysis to test the psychometric equivalence of one such metric-the Household Water Insecurity Experiences (HWISE) scale-across two survey waves administered 18 months apart in similar climatic conditions among households in a peri-urban community outside of Accra, Ghana. The HWISE metric was not equivalent across survey waves, which may be attributable to the metric itself, sample size, subtle instrumentation changes, or other unobserved factors. Test-retest reliability may also be difficult to achieve given the dynamic nature of household water use, and we discuss the implications of using household water insecurity metrics as longitudinal measures of well-being in global anti-poverty programs.

Animal contact and paediatric acute febrile illness in Greater Accra Region, Ghana.

Objective: To examine the association between animal contact (primarily dogs and cats) and non-malarial fever, as well as with secondary symptoms of headache, nausea, vomiting, and cough, in 687 children in Greater Accra Region, Ghana. Design: Cross-sectional study of acute febrile illness among children aged 1-15 years old between October 2016 and August 2017. Setting: Ledzokuku-Krowor Municipal Assembly (LEKMA) Hospital, Teshie, Greater Accra Region. Participants: The study included children with acute fever, defined as a measured temperature of greater than 37.5°C, occurring less than seven days before the hospital visit, and afebrile children as controls. Main outcome measures: Measured fever, self-reported fever, and secondary symptoms, each adjusting for patient household characteristics. Results: Animal contact was neither associated with measured fever (OR = 1.04, 95% CI 0.73-1.49) nor with self-reported fever (OR = 0.97, 95% CI 0.68-1.39). Animal contact was associated with headache (OR = 3.26, 95% CI 2.23-4.77, P < .01) and nausea (OR = 3.05, 95% CI 1.99-4.68, P < .01), but not with vomiting or cough. Additional models that used alternate inclusion criteria to define non-malarial fever yielded similar results. Several bacterial zoonoses that could plausibly have been transmitted by dogs and cats were diagnosed in the study population. Conclusion: These findings suggest the need for future studies to evaluate animal contact as a risk factor for bacterial zoonoses that may serve as an etiological driver of acute febrile illness. Funding: no external funding.