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  1. Article: Puberty health intervention to improve menstrual health and school attendance among adolescent girls in The Gambia: study methodology of a cluster-randomised controlled trial in rural Gambia (MEGAMBO TRIAL).

    Shah, Vishna / Phillips-Howard, Penelope / Hennegan, Julie / Cavill, Sue / Sonko, Bakary / Sinjanka, Edrisa / Camara Trawally, Nyima / Kanteh, Abdou / Mendy, Francois / Bah, Amadou B / Saar, Momodou / Ross, Ian / Schmidt, Wolf / Torondel, Belen

    Emerging themes in epidemiology

    2022  Volume 19, Issue 1, Page(s) 6

    Abstract: Background: Menstrual health (MH) is a recognised global public health challenge. Poor MH may lead to absence from school and work, and adverse health outcomes. However, reviews suggest a lack of rigorous evidence for the effectiveness of MH ... ...

    Abstract Background: Menstrual health (MH) is a recognised global public health challenge. Poor MH may lead to absence from school and work, and adverse health outcomes. However, reviews suggest a lack of rigorous evidence for the effectiveness of MH interventions on health and education outcomes. The objective of this paper is to describe the methods used in a cluster-randomised controlled trial to estimate the effect of a multi-component intervention to improve MH and school attendance in The Gambia.
    Methods: The design ensured half the schools (25) were randomised to receive the intervention which comprised of the following components: (i) Peer education camps and menstrual hygiene laboratories in schools, (ii) Mother's outreach sessions, (iii) Community meetings, and (iv) minor improvements of school Water Sanitation and Hygiene (WASH) facilities and maintenance. The intervention was run over a three-month period, and the evaluation was conducted at least three months after the last intervention activity was completed in the school or community. The other 25 schools acted as controls. Of these 25 control schools one Arabic school dropped out due to COVID-19. The primary outcome was the prevalence of girls missing at least one day of school during their last period. Secondary outcomes included: Urinary Tract Infection (UTI) symptoms, biochemical markers of UTI in urine, Reproductive Tract Infection symptoms, self-reported menstruation related wellbeing, social support and knowledge, perceptions and practices towards menstruation and MH in target school girls. In addition, a process evaluation using observations, routine monitoring data, survey data and interviews was undertaken to assess dose and reach (quantitative data) and assess acceptability, fidelity, context and possible mechanisms of impact (qualitative data). Cost and cost-effectiveness of the intervention package will also be assessed.
    Conclusion: Results will add to scarce resources available on effectiveness of MH interventions on school attendance. A positive result may encourage policy makers to increase their commitment to improve operation and maintenance of school WASH facilities and include more information on menstruation into the curriculum and help in the reporting and management of infections related to adolescent menstruation. Trial Registration PACTR, PACTR201809769868245, Registered 14th August 2018, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=3539.
    Language English
    Publishing date 2022-07-16
    Publishing country England
    Document type Journal Article
    ZDB-ID 2164388-X
    ISSN 1742-7622
    ISSN 1742-7622
    DOI 10.1186/s12982-022-00114-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Circulation of respiratory viruses during the COVID-19 pandemic in The Gambia.

    Jarju, Sheikh / Senghore, Elina / Brotherton, Helen / Affleck, Lucy / Saidykhan, Alasana / Jallow, Samba / Krubally, Ebrima / Sinjanka, Edrisa / Ndene, Morris Ngor / Bajo, Fabakary / Sanyang, Musa M / Saidy, Binta / Bah, Alasana / Mohammed, Nuredin I / Forrest, Karen / Clarke, Ed / Dalessandro, Umberto / Sesay, Abdul K / Usuf, Effua /
    Cerami, Carla / Roca, Anna / Kampmann, Beate / de Silva, Thushan I

    Gates open research

    2023  Volume 6, Page(s) 148

    Abstract: Background: ...

    Abstract Background:
    Language English
    Publishing date 2023-03-27
    Publishing country United States
    Document type Journal Article
    ISSN 2572-4754
    ISSN (online) 2572-4754
    DOI 10.12688/gatesopenres.14155.3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Circulation of respiratory viruses during the COVID-19 pandemic in The Gambia

    Jarju, Sheikh / Senghore, Elina / Brotherton, Helen / Saidykhan, Alasana / Jallow, Samba / Krubally, Ebrima / Sinjanka, Edrisa / Ndene, Morris Ngor / Bajo, Fabakary / Sanyang, Musa M / Saidy, Binta / Bah, Alasana / Forrest, Karen / Clarke, Ed / Dalessandro, Umberto / Usuf, Effua / Cerami, Carla / Roca, Anna / Kampmann, Beate /
    Silva, Thushan de

    medRxiv

    Abstract: In many countries, non-pharmaceutical interventions to limit SARS-CoV-2 transmission resulted in significant reductions in other respiratory viruses. However, similar data from Africa are limited. We explored the extent to which viruses such as influenza ...

    Abstract In many countries, non-pharmaceutical interventions to limit SARS-CoV-2 transmission resulted in significant reductions in other respiratory viruses. However, similar data from Africa are limited. We explored the extent to which viruses such as influenza and rhinovirus co-circulated with SARS-CoV-2 in The Gambia during the COVID-19 pandemic. Between April 2020 and March 2022, respiratory viruses were detected using RT-PCR in nasopharyngeal swabs from 1397 participants with influenza-like illness. Overall virus positivity was 44.2%, with prevalence higher in children <5 years (80%) compared to children aged 5-17 years (53.1%), adults aged 18-50 (39.5%) and >50 years (39.9%), p<0.0001. After SARS-CoV-2 (18.3%), rhinoviruses (10.5%) and influenza viruses (5.5%) were the most prevalent. SARS-CoV-2 positivity was lower in children <5 (4.3%) and 5-17 years (12.7%) than in adults aged 18-50 (19.3%) and >50 years (24.3%), p<0.0001. In contrast, rhinoviruses were most prevalent in children <5 years (28.7%), followed by children aged 5-17 (15.8%), adults aged 18-50 (8.3%) and >50 years (6.3%), p<0.0001. Four SARS-CoV-2 waves occurred, with 36.1%-52.4% SARS-CoV-2 positivity during peak months. Influenza infections were observed in both 2020 and 2021 during the rainy season as expected (peak positivity 16.4%-23.5%). Peaks of rhinovirus were asynchronous to the months when SARS-CoV-2 and influenza peaked.
    Keywords covid19
    Language English
    Publishing date 2022-08-14
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2022.08.08.22278521
    Database COVID19

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  4. Article ; Online: Impact of fortified versus unfortified lipid-based supplements on morbidity and nutritional status: A randomised double-blind placebo-controlled trial in ill Gambian children.

    Unger, Stefan A / Drammeh, Saikou / Hasan, Jahid / Ceesay, Kabiru / Sinjanka, Edrisa / Beyai, Sainey / Sonko, Bakary / Dondeh, Bai Lamin / Fulford, Anthony J / Moore, Sophie E / Prentice, Andrew M

    PLoS medicine

    2017  Volume 14, Issue 8, Page(s) e1002377

    Abstract: Background: Multiple micronutrients (MMN) are commonly prescribed in pediatric primary healthcare in sub-Saharan Africa to improve nutritional status and appetite without evidence for their effectiveness or international clinical guidelines. Community- ... ...

    Abstract Background: Multiple micronutrients (MMN) are commonly prescribed in pediatric primary healthcare in sub-Saharan Africa to improve nutritional status and appetite without evidence for their effectiveness or international clinical guidelines. Community-wide MMN supplementation has shown limited and heterogeneous impact on growth and morbidity. Short-term ready-to-use therapeutic foods in acutely sick children in a hospital setting also had limited efficacy regarding subsequent growth. The effectiveness of MMN in improving morbidity or growth in sick children presenting for primary care has not been assessed.
    Methods and findings: We undertook a double-blind randomised controlled trial of small-quantity lipid-based nutrient supplements (SQ-LNS) fortified with 23 micronutrients in children aged 6 months (mo) to 5 years (y) presenting with an illness at a rural primary healthcare centre in The Gambia. Primary outcomes were repeat clinic presentations and growth over 24 wk. Participants were randomly assigned to receive 1 of 3 interventions: (1) supplementation with micronutrient-fortified SQ-LNS for 12 wk (MMN-12), (2) supplementation with micronutrient-fortified SQ-LNS for 6 wk followed by unfortified SQ-LNS for 6 wk (MMN-6), or (3) supplementation with unfortified SQ-LNS for 12 wk (MMN-0) to be consumed in daily portions. Treatment masking used 16 letters per 6-wk block in the randomisation process. Blinded intention-to-treat analysis based on a prespecified statistical analysis plan included all participants eligible and correctly enrolled. Between December 2009 and June 2011, 1,101 children (age 6-60 mo, mean 25.5 mo) were enrolled, and 1,085 were assessed (MMN-0 = 361, MMN-6 = 362, MMN-12 = 362). MMN supplementation was associated with a small increase in height-for-age z-scores 24 wk after recruitment (effect size for MMN groups combined: 0.084 SD/24 wk, 95% CI: 0.005, 0.168; p = 0.037; equivalent to 2-5 mm depending on age). No significant difference in frequency of morbidity measured by the number of visits to the clinic within 24 wk follow-up was detected with 0.09 presentations per wk for all groups (MMN-0 versus MMN-6: adjusted incidence rate ratio [IRR] 1.03, 95% CI: 0.92, 1.16; MMN-0 versus MMN-12: 1.05, 95% CI: 0.93, 1.18). In post hoc analysis, clinic visits significantly increased by 43% over the first 3 wk of fortified versus unfortified SQ-LNS (adjusted IRR 1.43; 95% CI: 1.07, 1.92; p = 0.016), with respiratory presentations increasing by 52% with fortified SQ-LNS (adjusted IRR 1.52; 95% CI: 1.01, 2.30; p = 0.046). The number of severe adverse events during supplementation were similar between groups (MMN-0 = 20 [1 death]; MMN-6 = 21 [1 death]; MMN-12 = 20 [0 death]). No participant withdrew due to adverse effects. Study limitations included the lack of supervision of daily supplementation.
    Conclusion: Prescribing micronutrient-fortified SQ-LNS to ill children presenting for primary care in rural Gambia had a very small effect on linear growth and did not reduce morbidity compared to unfortified SQ-LNS. An early increase in repeat visits indicates a need for the establishment of evidence-based guidelines and caution with systematic prescribing of MMN. Future research should be directed at understanding the mechanisms behind the lack of effect of MMN supplementation on morbidity measures and limited effect on growth.
    Trial registration: ISRCTN 73571031.
    MeSH term(s) Child, Preschool ; Dietary Supplements/analysis ; Double-Blind Method ; Female ; Gambia ; Humans ; Infant ; Lipids/pharmacology ; Male ; Micronutrients/pharmacology ; Morbidity ; Nutritional Status/drug effects
    Chemical Substances Lipids ; Micronutrients
    Language English
    Publishing date 2017-08-15
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 2185925-5
    ISSN 1549-1676 ; 1549-1277
    ISSN (online) 1549-1676
    ISSN 1549-1277
    DOI 10.1371/journal.pmed.1002377
    Database MEDical Literature Analysis and Retrieval System OnLINE

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