Abstract only
Under nutrition, malaria and anemia are significant public health concerns in Ghana, especially among children under five years. There is growing interest in the effects of nutritional ...status on clinical malaria outcomes in pre‐school age children.
Objectives
To characterize the effects of indicators of dietary risk on clinical malaria during both the wet and dry seasons.
Methods
Cases of clinical malaria in the previous wet season (n=49) and dry season (n=60), and matched controls (wet season n=72, dry season n=55) were identified from records of the longitudinal Birth Cohort Study. Clinical indicators (Hgb, malaria parasitemia, weight) were extracted from study records, and household questionnaires captured indicators of household hunger, dietary diversity, household food security, and malaria risk behavior.
Results
Significantly more cases of malaria in both the wet and dry seasons came from families who reported household hunger (McNemar p‐values <0.001 for both seasons). In the wet season, 22.5% of cases reported hunger, compared to 16.9% of the controls; in the dry season, cases reported 30% compared to 18.2% of the controls.
Conclusion
Independent of season, hunger is associated with higher rates of clinical malaria among preschool aged children in the KND. Study funded by Wilbur G. Downs International Health Fellowship & Office of Student Research, Yale School of Medicine.
Objectives To compare (i) side effects associated with the simultaneous adminstration of praziquantel, albendazole and ivermectin with side affects associated with albendazole and ivermectin only and ...(ii) coverage by volunteers distributing three or two drugs. Methods Two-arm comparative study in northern Ghana integrated praziquantel distribution into an existing lymphatic filariasis and onchocerciasis control programme using Community Directed Distributors. The control arm continued to distribute only ivermectin and albendazole. Dosages of ivermectin and praziquantel were based on height. Treatment was directly observed, and all two/three drugs were co-administered. Adverse effects were recorded based on passive surveillance. Parasitological, anthropometric and haematological data were collected at baseline. Results Prevalence of Schistosoma haematobium infection among 1001 (boys: 47.9% girls: 52.1%) school-age children (6-15years) intervention: 30.0% (CI: 23.1-34.2); control: 23.0% (CI: 18.9-27.0), mean haemoglobin, weight and age were similar among the intervention and control groups. While 1676 (99.1%) compounds in the control area were visited and 15020 (96.58%) people were treated, only 1375 (88.5%) compounds in the intervention area were visited and 8454 (80.97%) people treated (P<0.001). The numbers of adverse effects were similar (intervention: 50/6896; control: 130/15020). The most reported adverse effects was headache (intervention: 14/50; control: 13/130), followed by body weakness, which was reported more from the intervention group (intervention: 13/50, 95% CI: 14.6-40.3; control: 6/130, 95% CI: 1.7-9.8. Sixty-six per cent (6896/10441) of the eligible population received praziquantel. Conclusions Reported adverse events were mild and managed at the subdistrict level with no cases of hospitalization; intensive health education will, however, be required to improve coverage.Original Abstract: Objetivos: Comparar (1) los efectos secundarios asociados con la administracion simultanea de pazicuantel, albendazol e ivermectina con los efectos secundarios asociados al albendazol e ivermectina solas; y (2) cobertura por voluntarios distribuyendo tres o dos medicamentos. Metodos: Estudio comparativo de dos brazos en el norte de Ghana integrando la distribucion de prazicuantel en un programa existente de control de la filariasis linfatica y oncocercosis utilizando distribuidores dirigidos por la comunidad. En el brazo control se continuo distribuyendo solo la ivermectina y el albendazol. Las dosis de ivermectina y prazicuantel se basaban en la altura. El tratamiento era de observacion directa y todos los medicamentos (dos o tres) fueron co-administrados. Los efectos adversos se registraron basandose en una vigilancia pasiva. Los datos parasitologicos, antropometricos y hematologicos se recolectaron al inicio del estudio. Resultados: La prevalencia de la infeccion por S. haematobium entre 1,001 (ninos: 47.9% ninas: 52.1%) ninos en edad escolar (6-15 anos) intervencion: 30.0% (IC: 23.1-34.2); control: 23.0% (IC: 18.9-27.0), la hemoglobina media, el peso y la edad eran similares entre los grupos de la intervencion y de control. Mientras que se visitaron 1,676 (99.1%) viviendas en el area de control y se trato a 15,020 (96.58%) personas, solo se visitaron 1,375 (88.5%) viviendas en el area de la intervencion y se trataron 8,454 (80.97%) personas P<0.001. El numero de efectos adversos era similar (intervencion: 50/6896; control: 130/15,020). Los efectos adversos mas reportados eran el dolor de cabeza (intervencion: 14/50; control: 13/130), seguido por la debilidad corporal que se reporto mas en el grupo de intervencion (intervencion: 13/50, 95% CI: 14.6-40.3; control: 6/130, 95% CI: 1.7-9.8. Un sesenta y seis por ciento (6,896/10,441) de la poblacion elegible recibio praziquantel. Conclusiones: Los eventos adversos reportados eran leves y manejables a nivel del sub-distrito, sin casos de hospitalizacion; sin embargo, es necesario el que haya un fuerte compromiso en pos de la educacion sanitaria si se quiere mejorar la cobertura.
Background Globally, diarrhoea and acute respiratory infections (ARIs) have been identified as major threats to child survival. In Ghana, the two conditions are among the top three causes of ...morbidity and mortality among children under 5 years. An in-depth analysis of the factors associated with these two diseases is warranted, because of their high degree of fatality and also it provides a basis for intervention planning. Objectives To investigate socio-demographic and environmental factors associated with infectious disease morbidity in children under 5 years old in Ghana. Design Population-based cross-sectional survey. The study sample comprised 2,790 children aged 0-59 months, drawn from the Ghana Demographic and Health Surveys. The mothers reported whether their children under age 5 had been ill with a cough accompanied by short, rapid breathing (ARI), or diarrhoea with the presence of blood or mucus in the stool, in the 2 weeks preceding the survey. Results Children in the 6-11, 12-23, and 24-59 months age groups had, respectively, 3.48 (95% CI=2.23, 5.44), 4.57 (95% CI=3.03, 6.90), and 1.93 (95% CI=1.30, 2.87) increased odds of getting diarrhoea infection compared to those in the youngest age category (0-5). Similarly, children in the 6-11, 12-23, and 24-59 months age brackets were, respectively, 2.64 (95% CI=1.76, 3.97), 2.63 (95% CI=1.81, 3.83), and 1.83 (95% CI=1.29, 2.59) times more likely to have cough compared to children in 0-5 months age brackets. Children who were not breastfeeding had higher odds of childhood diarrhoea (OR=1.33, 95% CI=1.03, 1.73) compared to those who were breastfeeding. Compared to children who were living in households without co-wives, children who were living in households with co-wives had 1.74 increased odds of diarrhoea (95% CI=1.33, 2.27). A unit increase in maternal opinion regarding wife beating was associated with 14% reduced odds of diarrhoea (OR=0.86, 95% CI=0.80, 0.91), while a unit change in the women's attitude towards sex index was associated with 14% reduced odds of childhood cough (OR=0.86, 95% CI=0.77, 0.97). Conclusions Our results show that breastfeeding, polygamous marriage, and maternal decision-making autonomy are significant predictors of child morbidity. Therefore, implementing effective educational programmes that aim at promoting breastfeeding, empowering women, and discouraging polygamous marriages could help save many children from infectious disease morbidity in Ghana.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
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