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  • No causal effects of serum urate levels on the risk of chronic kidney disease: A Mendelian randomization study

    Posted 2019-01-15 22:00:00 by: The HealthFolk Team

    by Daniel M. Jordan, Hyon K. Choi, Marie Verbanck, Ruth Topless, Hong-Hee Won, Girish Nadkarni, Tony R. Merriman, Ron Do Background Studies have shown strong positive associations between serum urate (SU) levels and chronic kidney disease (CKD) risk; however, whether the relation is causal remains uncertain. We evaluate whether genetic data are consistent with a causal impact of SU level on the risk of CKD and estimated glomerular filtration rate (eGFR). Methods and findings We used Mendelian randomization (MR) methods to evaluate the presence of a causal effect. We used aggregated genome-wide association data (N = 110,347 for SU, N = 69,374 for gout, N = 133,413 for eGFR, N = 117,165 for CKD), electronic-medical-record-linked UK Biobank data (N = 335,212), and population-based cohorts (N = 13,425), all in individuals of European ancestry, for SU levels and CKD. Our MR analysis showed that SU has a causal effect on neither eGFR level nor CKD risk across all MR analyses (all P > 0.05). These null associations contrasted with our epidemiological association findings from the 4 population-based cohorts (change in eGFR level per 1-mg/dl [59.48 μmol/l] increase in SU: −1.99 ml/min/1.73 m2; 95% CI −2.86 to −1.11; P = 8.08 × 10−6; odds ratio [OR] for CKD: 1.48; 95% CI 1.32 to 1.65; P = 1.52 × 10−11). In contrast, the same MR approaches showed that SU has a causal effect on the risk of gout (OR estimates ranging from 3.41 to 6.04 per 1-mg/dl increase in SU, all P < 10−3), which served as a positive control of our approach. Overall, our MR analysis had >99% power to detect a causal effect of SU level on the risk of CKD of the same magnitude as the observed epidemiological association between SU and CKD. Limitations of this study include the lifelong effect of a genetic perturbation not being the same as an acute perturbation, the inability to study non-European populations, and some sample overlap between the datasets used in the study. Conclusions ...

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  • Rapid antiretroviral therapy initiation in low- and middle-income countries: A resource-based approach

    Posted 2019-01-15 22:00:00 by: The HealthFolk Team

    by Mark W. Tenforde, A. Sarah Walker, Diana M. Gibb, Yukari C. Manabe In an Essay, Mark Tenforde and colleagues advocate continued provision of baseline CD4 cell count testing in HIV care in low- and middle-income ...

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  • Association between severe drought and HIV prevention and care behaviors in Lesotho: A population-based survey 2016–2017

    Posted 2019-01-14 22:00:00 by: The HealthFolk Team

    by Andrea J. Low, Koen Frederix, Stephen McCracken, Salome Manyau, Elizabeth Gummerson, Elizabeth Radin, Stefania Davia, Herbert Longwe, Nahima Ahmed, Bharat Parekh, Sally Findley, Amee Schwitters Background A previous analysis of the impact of drought in Africa on HIV demonstrated an 11% greater prevalence in HIV-endemic rural areas attributable to local rainfall shocks. The Lesotho Population-Based HIV Impact Assessment (LePHIA) was conducted after the severe drought of 2014–2016, allowing for reevaluation of this relationship in a setting of expanded antiretroviral coverage. Methods and findings LePHIA selected a nationally representative sample between November 2016 and May 2017. All adults aged 15–59 years in randomly selected households were invited to complete an interview and HIV testing, with one woman per household eligible to answer questions on their experience of sexual violence. Deviations in rainfall for May 2014–June 2016 were estimated using precipitation data from Climate Hazards Group InfraRed Precipitation with Station Data (CHIRPS), with drought defined ...

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  • Effects of a lifestyle intervention during pregnancy to prevent excessive gestational weight gain in routine care – the cluster-randomised GeliS trial

    Posted 2019-01-14 00:00:00 by: The HealthFolk Team

    Excessive gestational weight gain (GWG) leads to obstetric complications, maternal postpartum weight retention and an increased risk of offspring obesity. The GeliS study examines the effect of a lifestyle ...

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  • Monkeypox virus phylogenetic similarities between a human case detected in Cameroon in 2018 and the 2017-2018 outbreak in Nigeria.

    Posted 2019-01-12 13:39:34 by: The HealthFolk Team

    Monkeypox virus phylogenetic similarities between a human case detected in Cameroon in 2018 and the 2017-2018 outbreak in Nigeria. Infect Genet Evol. 2019 Jan 08;: Authors: Sadeuh-Mba SA, Yonga MG, Els M, Batejat C, Eyangoh S, Caro V, Alain E, Carniel E, Njouom R Abstract A monkeypox virus was detected from a human clinical case in 2018 in Cameroon; a country where no human cases were reported since 1989. The virus exhibited close genetic relatedness with another monkeypox virus isolated in Nigeria during the 2017-2018 outbreak. Although our molecular findings argue in favor of an extension of the monkeypox outbreak from Nigeria into Cameroon, the possibility that the monkeypox virus detected could be indigenous to Cameroon cannot be ruled out. PMID: 30634001 [PubMed - as supplied by ...

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  • Evaluating the Reasons for Partial and Non-immunization of Children in Wushishi Local Government Area, Niger State, Nigeria: Methodological Comparison.

    Posted 2019-01-12 13:39:34 by: The HealthFolk Team

    Evaluating the Reasons for Partial and Non-immunization of Children in Wushishi Local Government Area, Niger State, Nigeria: Methodological Comparison. Afr J Reprod Health. 2018 Dec;22(4):113-122 Authors: Obasohan PE, Mustapha MA, Makada A, Obasohan DN Abstract Immunization of children against childhood preventable diseases has remained one of the most important cost effective and public health strategies to reduce childhood preventable morbidity and mortalities arising from infectious diseases. A recent report released by World Health Organization (WHO) stated that 1 in 10 infants did not receive vaccination in 2016. Also, a survey conducted in Bida Emirate Area of Niger State Nigeria in 2015 found that full routine immunization coverage in this area was less than 30%. The aim of this study was to establish the full routine immunization status and the reasons for its partial and non-immunization of children in Wushishi Local Government Area using WHO recommended cluster survey method and contrast with Factor Analysis (FA) method to see if the same results were achieved. The findings showed that the full immunization status for this area was very low (36%) and the results of analysis of reasons for failure from both methods seem contradictory. However, it reflected that lack of proper information was strongest for both methods. The disparity obtained in the two methods might be a result of methodological issues. The health implication is that much is expected to be done in the area of enlightenment campaign of the need for immunization and the need to complete the required basic dose especially in the rural areas. PMID: 30632728 [PubMed - in ...

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  • Postpartum Sexual Abstinence and its Implications for Under-Five Health Outcome among Childbearing Women in South-east Nigeria.

    Posted 2019-01-12 13:39:34 by: The HealthFolk Team

    Postpartum Sexual Abstinence and its Implications for Under-Five Health Outcome among Childbearing Women in South-east Nigeria. Afr J Reprod Health. 2018 Dec;22(4):102-112 Authors: Imo CK, Okoronkwo E, Ukoji V, Mbah C Abstract Abstinence from sexual intercourse after childbirth is a common practice deeply rooted in the cultures of different communities, including Nigeria with varying duration. Despite the high level of postpartum abstinence in the South-east compared to other neighbouring regions of Nigeria, under-five mortality is relatively higher in the South-east. This paper examined postpartum sexual abstinence as a predictive factor for under-five health outcome in Abia State with data from a sample of 609 childbearing women within 15-49 years. The mean duration of postpartum abstinence was 3.1±1.5 months; shorter in rural than urban areas with 2.7±1.4 and 3.5±1.3 months, respectively. The months of abstinence from sexual activity after childbirth is significantly related to experiences of under-five mortality and childhood diseases (p<0.05). The qualitative data showed that period of abstinence from sexual activity after childbirth is rooted in culture and was alluded to have great influence on under-five health outcomes. It is concluded that most women resumed sexual activity early after childbirth mostly to secure their marriages which affect their under-five children's health. Proper guidelines on resumption of sexual activity after childbirth to avoid its negative effects on under-five health outcome should be instituted to facilitate the achievement of sustainable development. PMID: 30632727 [PubMed - in ...

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  • Genotype Diversity of Newcastle Disease Virus in Nigeria: Disease Control Challenges and Future Outlook.

    Posted 2019-01-12 13:39:34 by: The HealthFolk Team

    Related Articles Genotype Diversity of Newcastle Disease Virus in Nigeria: Disease Control Challenges and Future Outlook. Adv Virol. 2018;2018:6097291 Authors: Bello MB, Yusoff KM, Ideris A, Hair-Bejo M, Peeters BPH, Jibril AH, Tambuwal FM, Omar AR Abstract Newcastle disease (ND) is one of the most important avian diseases with considerable threat to the productivity of poultry all over the world. The disease is associated with severe respiratory, gastrointestinal, and neurological lesions in chicken leading to high mortality and several other production related losses. The aetiology of the disease is an avian paramyxovirus type-1 or Newcastle disease virus (NDV), whose isolates are serologically grouped into a single serotype but genetically classified into a total of 19 genotypes, owing to the continuous emergence and evolution of the virus. In Nigeria, molecular characterization of NDV is generally very scanty and majorly focuses on the amplification of the partial F gene for genotype assignment. However, with the introduction of the most objective NDV genotyping criteria which utilize complete fusion protein coding sequences in phylogenetic taxonomy, the enormous genetic diversity of the virus in Nigeria became very conspicuous. In this review, we examine the current ecological distribution of various NDV genotypes in Nigeria based on the available complete fusion protein nucleotide sequences (1662 bp) in the NCBI database. We then discuss the challenges of ND control as a result of the wide genetic distance between the currently circulating NDV isolates and the commonest vaccines used to combat the disease in the country. Finally, we suggest future directions in the war against the economically devastating ND in Nigeria. PMID: 30631359 ...

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  • Cost of three models of care for drug-resistant tuberculosis patients in Nigeria.

    Posted 2019-01-12 13:39:34 by: The HealthFolk Team

    Related Articles Cost of three models of care for drug-resistant tuberculosis patients in Nigeria. BMC Infect Dis. 2019 Jan 10;19(1):41 Authors: Bada FO, Okpokoro E, Blok N, Meribole E, Dutt S, Dakum P, Abimiku A, Zwerling A, Kik SV Abstract BACKGROUND: Nigeria accounts for a significant proportion of the global drug-resistant tuberculosis (DR-TB) burden, a large proportion of which goes untreated. Different models for managing DR-TB treatment with varying levels of hospitalization are in use across Nigeria, however costing evidence is required to guide the scale up of DR-TB care. We aimed to estimate and compare the costs of different DR-TB treatment and care models in Nigeria. METHODS: We estimated the costs associated with three models of DR-TB treatment and care: Model (A) patients are hospitalized throughout the 8-month intensive phase, Model (B) patients are partially hospitalized during the intensive phase and Model (C) is entirely ambulatory. Costs of treatment, in-patient and outpatient care and diagnostic and monitoring tests were collected using a standardized data collection sheet from six sites through an ingredient's approach and cost models were based on the Nigerian National Tuberculosis, Leprosy and Buruli Ulcer Guideline - Sixth Edition (2014) and Guideline for programmatic and clinical management of drug-resistant tuberculosis in Nigeria (2015). RESULTS: Assuming adherence to the Nigerian DR-TB guidelines, the per patient cost of Model A was $18,528 USD, Model B $15,159 USD and Model C $9425 USD. Major drivers of cost included hospitalization (Models A and B) and costs of out-patient consultations and supervision (Model C). CONCLUSION: Utilizing a decentralized ambulatory model, is a more economically viable approach for the expansion of DR-TB care in Nigeria, given that patient beds for DR-TB treatment and care are limited and costs of hospitalized treatment are ...

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  • Mobile Instant Messaging (MIM) to support teaching practice: Insights from a nurse tutor program in Nigeria.

    Posted 2019-01-12 13:39:34 by: The HealthFolk Team

    Related Articles Mobile Instant Messaging (MIM) to support teaching practice: Insights from a nurse tutor program in Nigeria. Malawi Med J. 2018 Jun;30(2):120-126 Authors: Ajuwon A, Pimmer C, Odetola T, Gröhbiel U, Oluwasola O, Olaleye O Abstract Aim: To determine the feasibility of using the Mobile Instant Messaging (MIM) platform, WhatsApp, to provide supervision and support for student nurse tutors during a teaching practice placement in Nigeria. Methods: A descriptive qualitative method was used to design and evaluate a six-week WhatsApp group discussion intervention among 19 student nurse tutors. Two pre-intervention focus group sessions (n=9 and n=10) and a workshop were conducted to assess the students' content needs and media usage, and to develop a short online supervisory curriculum. To evaluate the intervention, two focus group sessions (n=9 and n=9) were carried out, transcribed verbatim, and analysed together with the actual WhatsApp conversations using thematic content analysis. Findings: The participants found the WhatsApp-enabled learning space valuable, in particular for the transfer and application of knowledge in their day-to-day teaching practice and, more generally, for their professional development. There were rich and multifaceted indicators of learning and professional development in evidence which were mostly triggered by specific facilitation techniques. The four themes from the WhatsApp conversations are: (1) sharing and discussing "tricks of the trade"; (2) providing direction and triggering reflective (teaching) practice; (3) sparking professional discussions and announcing professional development opportunities; and (4) maintaining a continuous moderating and teaching "presence". Conclusion: Despite some technical challenges centred mainly on the accessibility of the MIM space, the study identified indicators of good supervision practice and the results ...

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