Panel data indicate that nonpregnant women’s dietary diversity fluctuates across climatic seasons in low- and middle-income countries. The natural day-to-day variability in food group consumption ...during gestation is unknown.
A longitudinal study was conducted among pregnant women enrolled in the Micronutriments pour la Santé de la Mère et de l’Enfant study 3 randomized controlled efficacy trial i.e., daily fortified balanced energy-protein supplement and an iron-folic acid (IFA) tablet compared with an IFA tablet only to investigate the number of 24-hour recalls required to estimate usual prenatal food group (FG) diversity and the seasonality of pregnant women’s dietary diversity in Houndé, Burkina Faso.
FG consumption was assessed twice weekly by qualitative, list-based, 24-hour recalls among 1757 pregnant women (892 control, 865 intervention). The number of days needed to estimate a woman’s usual prenatal 10-point FG diversity score was calculated using the within-subject coefficient of variation. Regression models, including truncated Fourier series, were fitted to assess seasonal variations in the FG diversity score and the probability of reaching Minimum Dietary Diversity for Women (MDD-W; i.e., ≥5 FGs).
The monthly mean FG scores (<5 FGs) and MDD-W prevalence (<45%) were low. Five list-based recalls allowed observed FG diversity to lie within 15% of the true mean in 90% of the estimations (mean ± SD, 40.4 ± 20.7 recalls per woman). Both the FG diversity score and prevalence achieving MDD-W showed responsiveness to seasonal variations, with peaks at the end of the dry season (i.e., April or May) and troughs in the rainy season (i.e., August).
Five list-based recalls are sufficient to estimate usual FG diversity during gestation, although intra-annual seasonal patterns did modestly affect the FG diversity score and MDD-W prevalence. Thus, timing of repeated dietary surveys is critical to ensure nonbiased inferences of change and trends in Burkina Faso. This trial was registered at clinicaltrials.gov as NCT 03533712.
The amount of data in soil science increased at exponential rates over the last decades, promoted by rapid technological innovation. This development led to a better understanding of processes but ...also required the introduction of data mining into soil science. With diffuse reflectance Fourier transform (DRIFT) spectroscopy, one of those new methods, soil scientist could build up large spectral libraries. These libraries can expand over large, heterogeneous areas requiring classification algorithms to find subsets or patterns in the data prior to further analysis. The k-means algorithm has become one of the most frequently used algorithms for this task. However, fuzzy k-means (FKM) clustering, a fuzzy variation of k-means, is potentially better suited for spectral data. Fuzzy logic allows for class overlaps and is supposed to reflect the complex nature of soil spectra and continuous environmental variables. In this study, we collected over 1000 mid-infrared DRIFT spectra of agricultural soils from the West African savannah zone and clustered the data using k-means and FKM. Our aim was to explore the feasibility of centroid-based cluster algorithms in finding substructures in spectral data and to discuss the benefits of fuzzy clustering. We found a two-group pattern separating the data set in a northern and southern part. The clustering could primarily be explained by geology and climatic gradients. While both algorithms performed similarly well in picking up the structure, FKM could reveal a transition zone between the two clusters that was not detectable with k-means. This transition zone was explained by a gradual change in aeolian dust deposition, topography, and a change in geology. With this study, we showed the benefits of fuzzy clustering over traditional hard clustering for finding substructure in unexplored spectral data. We recommend the use of continuous classes, as they incorporate more information that could potentially improve subsequent analysis.
•K-means and fuzzy k-means picked up pattern in the data set very well.•Fuzzy k-means clustering could show a transition zone between clusters.•Fuzzy k-means clustering reflected gradual changes of environmental parameters.•Fuzzy classes contain more information than discrete classes to improve analysis.
Background: From birth to 6 months, children must be exclusively breastfed, and from 6 months, food diversification starts to supplement breast milk. This cross-sectional study aims to evaluate some ...of the feeding practices regarding children aged 6 to 23 months in the city of Ouagadougou. Methods: First, data were food consumption data as well as recalling meals over the past 24 hours were collected. Then, technological and labeling data regarding infant flours produced locally and sold in Ouagadougou were obtained. For analysis, data were entered into Sphinx V5 and IBM SPSS Statistics 20 software, and means were compared using XLSTAT 2016 software. Results: In total, 33 local infant flours were evaluated, and all the formulations contained cereals. Fruits and legumes (30.30%), milk (30.30%), and eggs (0,00%) were the least used materials. Instant type flours were rarely encountered (9.09%), and packaging in plastic bags was consumed the most (57.57%). Regarding labeling information, batch number (28%) and the method of preservation (32%) were the least identified. With respect to food consumption, 94.84% of the children were breastfed and 98.33% aged 6 to 8 months consumed solid foods. At least 85.28% of women considered the age of 6 months for introduction of solid foods. Concerning consumption of infant porridges, imported infant porridges were preferred the most (37.44%). Conclusion: Concerning local infant flour, some of them did not meet WHO guidelines. With regard to food practice indicators in Ouagadougou, some of them are relatively satisfactory; however, there is still a need to raise awareness regarding feeding practices.
The temporal relationship between length (linear) and weight (ponderal) growth in early life is important to support optimal nutrition program design. Studies based on measures of attained size have ...established that wasting often precedes stunting, but such studies do not capture responsiveness of growth to previous compared with current conditions. As a result, the temporality of linear and ponderal growth relationships remain unclear.
We used growth velocity indicators to assess the temporal bidirectional relationships between linear and ponderal growth in children.
Using monthly anthropometric measurements from 5039 Burkinabè children enrolled at 6 months of age and followed until 28 months from August 2014 to December 2016, we employed multilevel mixed-effects models to investigate concurrent and lagged associations between linear and ponderal growth velocity, controlling for time trends, seasonality, and morbidity.
Faster ponderal growth is associated with faster concurrent and subsequent linear growth (0.21–0.72 increase in length velocity z-score per unit increase in weight velocity z-score), while faster linear growth is associated with slower future weight gain (0.009–0.02 decrease in weight velocity z-score per unit increase in length velocity z-score), especially among children 9–14 months. Ponderal growth slows around the same time as peaks in morbidity, followed roughly a month later by slower linear growth.
Use of velocity measures to assess temporal dependencies between linear and ponderal growth demonstrate that the same growth-limiting conditions likely affect both length and weight velocity, that slow ponderal growth likely limits subsequent linear growth, and that linear growth spurts may not be accompanied by sufficient increases in dietary intake to avoid slowdowns in weight gain.
Stalled progress in controlling Plasmodium falciparum malaria highlights the need for an effective and deployable vaccine. RTS,S/AS01, the most effective malaria vaccine candidate to date, ...demonstrated 56% efficacy over 12 months in African children. We therefore assessed a new candidate vaccine for safety and efficacy.
In this double-blind, randomised, controlled, phase 2b trial, the low-dose circumsporozoite protein-based vaccine R21, with two different doses of adjuvant Matrix-M (MM), was given to children aged 5–17 months in Nanoro, Burkina Faso—a highly seasonal malaria transmission setting. Three vaccinations were administered at 4-week intervals before the malaria season, with a fourth dose 1 year later. All vaccines were administered intramuscularly into the thigh. Group 1 received 5 μg R21 plus 25 μg MM, group 2 received 5 μg R21 plus 50 μg MM, and group 3, the control group, received rabies vaccinations. Children were randomly assigned (1:1:1) to groups 1–3. An independent statistician generated a random allocation list, using block randomisation with variable block sizes, which was used to assign participants. Participants, their families, and the local study team were all masked to group allocation. Only the pharmacists preparing the vaccine were unmasked to group allocation. Vaccine safety, immunogenicity, and efficacy were evaluated over 1 year. The primary objective assessed protective efficacy of R21 plus MM (R21/MM) from 14 days after the third vaccination to 6 months. Primary analyses of vaccine efficacy were based on a modified intention-to-treat population, which included all participants who received three vaccinations, allowing for inclusion of participants who received the wrong vaccine at any timepoint. This trial is registered with ClinicalTrials.gov, NCT03896724.
From May 7 to June 13, 2019, 498 children aged 5–17 months were screened, and 48 were excluded. 450 children were enrolled and received at least one vaccination. 150 children were allocated to group 1, 150 children were allocated to group 2, and 150 children were allocated to group 3. The final vaccination of the primary series was administered on Aug 7, 2019. R21/MM had a favourable safety profile and was well tolerated. The majority of adverse events were mild, with the most common event being fever. None of the seven serious adverse events were attributed to the vaccine. At the 6-month primary efficacy analysis, 43 (29%) of 146 participants in group 1, 38 (26%) of 146 participants in group 2, and 105 (71%) of 147 participants in group 3 developed clinical malaria. Vaccine efficacy was 74% (95% CI 63–82) in group 1 and 77% (67–84) in group 2 at 6 months. At 1 year, vaccine efficacy remained high, at 77% (67–84) in group 1. Participants vaccinated with R21/MM showed high titres of malaria-specific anti-Asn-Ala-Asn-Pro (NANP) antibodies 28 days after the third vaccination, which were almost doubled with the higher adjuvant dose. Titres waned but were boosted to levels similar to peak titres after the primary series of vaccinations after a fourth dose administered 1 year later.
R21/MM appears safe and very immunogenic in African children, and shows promising high-level efficacy.
The European & Developing Countries Clinical Trials Partnership, Wellcome Trust, and National Institute for Health Research Oxford Biomedical Research Centre.
The ACE2 gene polymorphisms (rs143936283, rs146676783, and rs4646116) in infected and noninfected persons by SARS-CoV-2 in Burkina Faso. Our cross-sectional study population comprised 137 SARS-CoV-2 ...infected persons and 181 non-infected persons. Three ACE2 gene polymorphisms rs143936283, rs146676783, and rs4646116, were genotyped using the real-time PCR standard TaqMan allelic discrimination technique. The association between SARS-CoV-2 infection and the polymorphisms were evaluated by a binary logistic regression. There was no association between the polymorphisms rs143936283, rs4646116 haplotypes, and SARS-CoV-2 infection in our study population. However, in the female population, the heterozygous genotype CT of rs146676783 increased by two and half the risk (OR=2.58 95%CI (1.2-5.48), p= 0.014) of being infected by SARS-CoV-2. Additionally, carrying the homozygous minor allele (genotype TT) of rs146676783 increased by more than five and half the risk (OR=5.57 95%CI (1.64-18.78), p=0.006) of being infected by SARS-CoV-2 among females. This study showed that the ACE2 gene variant rs146676783 was associated with an increased risk of being infected by SARS-CoV-2 in females, suggesting a need for further investigation to contribute to a better understanding of the African COVID-19 enigma.
In the current context of tailoring interventions to maximize impact, it is important that current data of clinical epidemiology guide public health programmes and health workers in the management of ...severe disease. This study aimed at describing the burden of severe malaria at hospital level in two areas with distinct malaria transmission intensity.
A hospital-based surveillance was established in two regional hospitals located in two areas exposed to different malaria transmission. Data on paediatric severe malaria admissions were recorded using standardized methods from August 2017 to August 2018 with an interruption during the dry season from April to June 2018.
In total, 921 children with severe malaria cases were enrolled in the study. The mean age was 33.9 (± 1.3) and 36.8 (± 1.6) months in lower malaria transmission (LMT) and higher malaria transmission (HMT) areas (p = 0.15), respectively. The geometric mean of asexual P. falciparum density was significantly higher in the LMT area compared to the HMT area: 22,861 trophozoites/µL (95% CI 17,009.2-30,726.8) vs 11,291.9 trophozoites/µL (95% CI 8577.9-14,864.5). Among enrolled cases, coma was present in 70 (9.2%) participants. 196 patients (21.8%) presented with two or more convulsions episodes prior to admission. Severe anaemia was present in 448 children (49.2%). Other clinical features recorded included 184 (19.9%) cases of lethargy, 99 (10.7%) children with incoercible vomiting, 80 (8.9%) patients with haemoglobinuria, 43 (4.8%) children with severe hypoglycaemia, 37 (4.0%) cases where child was unable to drink/suck, 11 (1.2%) cases of patients with circulatory collapse/shock, and 8 cases (0.9%) of abnormal bleeding (epistaxis). The adjusted odds of presenting with coma, respiratory distress, haemoglobinuria, circulatory collapse/shock and hypoglycaemia were significantly higher (respectively 6.5 (95%CI 3.4-12.1); 1.8 (95%CI 1.0-3.2); 2.7 (95%CI 1.6-4.3); 5.9 (95%CI 1.3-27.9); 1.9 (95%CI 1.0-3.6)) in children living in the HMT area compared to those residing in the LMT area. Overall, forty-four children died during hospitalization (case fatality rate 5.0%) with the highest fatalities in children admitted with respiratory distress (26.0%) and those with hypoglycaemia (25.0%).
The study showed that children in the HMT area have a higher risk of presenting with coma, shock/dehydration, haemoglobinuria, hypoglycaemia, and respiratory distress. Case-fatality rate is higher among patients with respiratory distress or hypoglycaemia. Hospital surveillance provides a reliable and sustainable means to monitor the clinical presentation of severe malaria and tailor the training needs and resources allocation for case management.
Although historians today turn increasingly to oral tradition as a source of data on the history of non-literate peoples, Paul Irwin cautions them against uncritical use of such evidence. In an ...attempt to determine how much historians can learn about the past from oral traditions, he studies those of Liptako, now a part of Upper Volta hut in the nineteenth century an emirate in one of West Africa's great imperial systems.
Originally published in 1981.
ThePrinceton Legacy Libraryuses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These paperback editions preserve the original texts of these important books while presenting them in durable paperback editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905.
PDF
