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Yeboah E, Lohmann J, Koulidiati JL, Kuunibe N, Kyei NNA, Hamadou S, Ridde V, Danquah I, Brenner S, De Allegri M. Quality of nutritional status assessment and its relationship with the effect of rainfall on childhood stunting: a cross-sectional study in rural Burkina Faso. Public Health 2024; 234:91-97. [PMID: 38970856 DOI: 10.1016/j.puhe.2024.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 05/08/2024] [Accepted: 05/11/2024] [Indexed: 07/08/2024]
Abstract
OBJECTIVES In Burkina Faso, one in every four children under 5 years is stunted. Climate change will exacerbate childhood stunting. Strengthening the health system, particularly the quality of nutrition care at primary health facilities, can minimise the adverse climate effect on stunting. Thus, we examined the quality of nutritional status assessment (QoNA) during curative childcare services in primary health facilities in rural Burkina Faso and its relationship with rainfall-induced childhood stunting. STUDY DESIGN We conducted a cross-sectional analysis using anthropometric, rainfall, and clinical observation data. METHODS Our dependent variable was the height-for-age z-score (HAZ) of children under 2 years. Our focal climatic measure was mean rainfall deviation (MRD), calculated as the mean of the difference between 30-year monthly household-level rainfall means and the corresponding months for each child from conception to data collection. QoNA was based on the weight, height, general paleness and oedema assessment. We used a mixed-effect multilevel model and analysed heterogeneity by sex and socio-economic status. RESULTS Among 5027 young (3-23 months) children (mean age 12 ± 6 months), 21% were stunted (HAZ ≤ -2). The mean MRD was 11 ± 4 mm, and the mean QoNA was 2.86 ± 0.99. The proportion of children in low, medium, and high QoNA areas was 10%, 54%, and 36%, respectively. HAZ showed a negative correlation with MRD. Higher QoNA lowered the negative effect of MRD on HAZ (β = 0.017, P = 0.003, confidence interval = [0.006, 0.029]). Males and children from poor households benefited less from the moderating effect of QoNA. CONCLUSION Improving the quality of nutrition assessments can supplement existing efforts to reduce the adverse effects of climate change on children's nutritional well-being.
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Affiliation(s)
- Edmund Yeboah
- Heidelberg Institute of Global Health, University Hospital and Medical Faculty, Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
| | - Julia Lohmann
- Heidelberg Institute of Global Health, University Hospital and Medical Faculty, Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany; Department of Global Health and Development, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - J-L Koulidiati
- Institut Supérieur des Sciences de la Santé, Université Nazi Boni, 01 BP 1091, Bobo Dioulasso, Burkina Faso
| | - Naasegnibe Kuunibe
- Department of Economics, Faculty of Social Science and Arts, Simon Diedong Dombo University of Business and Integrated Development Studies, P O Box WA64, Wa, Ghana
| | - N N A Kyei
- Heidelberg Institute of Global Health, University Hospital and Medical Faculty, Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany; Institute of Public Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Unversität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany; Research Department 2, Potsdam Institute for Climate Impact Research (PIK), Member of the Leibniz Association, P. O. Box 60 12 03, 14412, Potsdam, Germany
| | - S Hamadou
- The World Bank, 1818 H Street, NW Washington, DC, 20433, USA
| | - V Ridde
- Université Paris Cité, IRD, Inserm, Ceped Paris, France
| | - I Danquah
- Heidelberg Institute of Global Health, University Hospital and Medical Faculty, Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - S Brenner
- Heidelberg Institute of Global Health, University Hospital and Medical Faculty, Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - M De Allegri
- Heidelberg Institute of Global Health, University Hospital and Medical Faculty, Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
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Acosta D, Barrow A, Mahamadou IS, Assuncao VS, Edwards ME, McKune SL. Climate change and health in the Sahel: a systematic review. ROYAL SOCIETY OPEN SCIENCE 2024; 11:231602. [PMID: 39021778 PMCID: PMC11251769 DOI: 10.1098/rsos.231602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 05/07/2024] [Accepted: 06/11/2024] [Indexed: 07/20/2024]
Abstract
The Sahel region is projected to be highly impacted by the more frequent hazards associated with climate change, including increased temperature, drought and flooding. This systematic review examined the evidence for climate change-related health consequences in the Sahel. The databases used were Medline (PubMed), Embase (Ovid), Web of Science (Clarivate) and CABI Global Health. Hand searches were also conducted, which included directly engaging Sahelian researchers and hand-searching in the African Journals Online database. Of the 4153 studies found, 893 were identified as duplicates and the remaining 3260 studies were screened (title and abstract only) and then assessed for eligibility. A total of 81 studies were included in the systematic review. Most studies focused on vector-borne diseases, food security, nutrition and heat-related stress. Findings suggest that mosquito distribution will shift under different climate scenarios, but this relationship will not be linear with temperature, as there are other variables to consider. Food insecurity, stunting (chronic malnutrition) and heat-related mortality are likely to increase if no action is taken owing to the projected impact of climate change on environmental factors and agriculture. Seventy-one per cent of manuscripts (n = 58) had first authors from institutions in North America or Europe, of which 39.7% (n = 23) included co-authors from African institutions.
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Affiliation(s)
- Daniel Acosta
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
- Sahel Research Group, University of Florida, Gainesville, FL, USA
- Center for African Studies, College of Liberal Arts and Sciences, University of Florida, Gainesville, FL, USA
| | - Amadou Barrow
- Department of Epidemiology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Idrissa Saidou Mahamadou
- Department of Sociology and Rural Economy, Faculty of Agronomy, Abdou Moumouni University of Niamey, Niamey, Niger
| | - Victoria Simoni Assuncao
- Department of Geography, College of Liberal Arts and Sciences, University of Florida, Gainesville, FL, USA
| | - Mary E. Edwards
- Health Science Center Libraries, University of Florida, Gainesville, FL, USA
| | - Sarah L. McKune
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
- Sahel Research Group, University of Florida, Gainesville, FL, USA
- Center for African Studies, College of Liberal Arts and Sciences, University of Florida, Gainesville, FL, USA
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Bountogo M, Sié A, Zakane A, Compaoré G, Ouédraogo T, Lebas E, O’Brien KS, Lietman TM, Oldenburg CE. Neonatal anthropometric indicators of infant growth and mortality in Burkina Faso. Public Health Nutr 2024; 27:e123. [PMID: 38639113 PMCID: PMC11091928 DOI: 10.1017/s1368980024000880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/01/2024] [Accepted: 03/26/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVE Most evidence supporting screening for undernutrition is for children aged 6-59 months. However, the highest risk of mortality and highest incidence of wasting occurs in the first 6 months of life. We evaluated relationships between neonatal anthropometric indicators, including birth weight, weight-for-age Z-score (WAZ), weight-for-length Z-score (WLZ), length-for-age Z-score (LAZ) and mid-upper arm circumference (MUAC) and mortality and growth at 6 months of age among infants in Burkina Faso. DESIGN Data arose from a randomised controlled trial evaluating neonatal azithromycin administration for the prevention of child mortality. We evaluated relationships between baseline anthropometric measures and mortality, wasting (WLZ < -2), stunting (LAZ < -2) and underweight (WAZ < -2) at 6 months of age were estimated using logistic regression models adjusted for the child's age and sex. SETTING Five regions of Burkina Faso. PARTICIPANTS Infants aged 8-27 d followed until 6 months of age. RESULTS Of 21 832 infants enrolled in the trial, 7·9 % were low birth weight (<2500 g), 13·3 % were wasted, 7·7 % were stunted and 7·4 % were underweight at enrolment. All anthropometric deficits were associated with mortality by 6 months of age, with WAZ the strongest predictor (WAZ < -2 to ≥ -3 at enrolment v. WAZ ≥ -2: adjusted OR, 3·91, 95 % CI, 2·21, 6·56). Low WAZ was also associated with wasting, stunting, and underweight at 6 months. CONCLUSIONS Interventions for identifying infants at highest risk of mortality and growth failure should consider WAZ as part of their screening protocol.
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Affiliation(s)
| | - Ali Sié
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | | | | | | | - Elodie Lebas
- Francis I Proctor Foundation, San Francisco, CA, USA
| | - Kieran Sunanda O’Brien
- Francis I Proctor Foundation, San Francisco, CA, USA
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA
- Department of Ophthalmology, University of California, San Francisco, CA, USA
| | - Thomas M Lietman
- Francis I Proctor Foundation, San Francisco, CA, USA
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA
- Department of Ophthalmology, University of California, San Francisco, CA, USA
| | - Catherine E Oldenburg
- Francis I Proctor Foundation, San Francisco, CA, USA
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA
- Department of Ophthalmology, University of California, San Francisco, CA, USA
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Müller C, Ouédraogo WA, Schwarz M, Barteit S, Sauerborn R. The effects of climate change-induced flooding on harvest failure in Burkina Faso: case study. Front Public Health 2023; 11:1166913. [PMID: 37614457 PMCID: PMC10442567 DOI: 10.3389/fpubh.2023.1166913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/24/2023] [Indexed: 08/25/2023] Open
Abstract
Background Climate change leads to more frequent and severe extreme weather events including floods, heatwaves, heavy rainfalls, and droughts. In contrast to the majority of research on weather extremes in sub-Saharan Africa, which focus primarily on how a lack of rainfall causes droughts, this paper aims to elucidate the effect of flooding on harvest failure in rural Burkina Faso. Methods We conducted a case study in north-western Nouna, Burkina Faso, between August and December 2021 covering a study population of n = 180 participants. The study comprised four components: (i) interviews with farmers (n = 180) on whether any of their fields had been inundated and if so, on harvest loss on these fields; (ii) determining the feasibility of using Sentinel-2 satellite images to validate study participants reports of floods; (iii) characterizing short-term weather including frequency and duration, of extreme rainfall events within the study area, as well as comparing cumulative rainfall (long-term) over the past 50 years; and (v), estimating both the food energy and economic loss of harvest failure due to flooding. Results 49% of interviewed farmers (n = 88) reported that floods had damaged at least one of their fields. Some fields (n = 13, 7%) had no harvest due to flooding, while some farmers (n = 14, 8%) had lost part of their harvest. Images from the Sentinel-2-Satellite indicated that reported and remotely observed flooding were consistent. According to time series of data from the local weather station, there has been an increase irregular rainfall distribution and at the same time of cumulative annual rainfall in Nouna. Furthermore, a first illustrative calculation allowed us to estimate the amount of energy lost when one hectare of a common crop is flooded. Conclusion This case study demonstrated that flood-related harvest failures leading to crop losses in sub-Saharan Africa, exemplified by Burkina Faso, are likely to be substantial. This study serves as a proof-of-principle for flooding effects on food security. This could provide more detail for agricultural adaptation and mitigation strategies. Inundation-vulnerable fields need alternative and novel management practices, which may only be effectively implemented if agricultural institutions and national policy-making bodies receive evidence of flooding e.g., from remote sensing.
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Affiliation(s)
- Charlotte Müller
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Faculty of Health Science and Medicine, University of Lucerne, Lucerne, Switzerland
| | | | | | - Sandra Barteit
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
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Belesova K, Gasparrini A, Wilkinson P, Sié A, Sauerborn R. Child Survival and Annual Crop Yield Reductions in Rural Burkina Faso: Critical Windows of Vulnerability Around Early-Life Development. Am J Epidemiol 2023; 192:1116-1127. [PMID: 37116074 PMCID: PMC10326605 DOI: 10.1093/aje/kwad068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 10/02/2022] [Accepted: 03/21/2023] [Indexed: 04/30/2023] Open
Abstract
Populations that are reliant on subsistence farming are particularly vulnerable to climatic effects on crop yields. However, empirical evidence on the role of the timing of exposure to crop yield deficits in early-life development is limited. We examined the relationship between child survival and annual crop yield reductions at different stages of early-life development in a subsistence farming population in Burkina Faso. Using shared frailty Cox proportional hazards models adjusting for confounders, we analyzed 57,288 children under 5 years of age followed by the Nouna Health and Demographic Surveillance System (1994-2016) in relation to provincial food-crop yield levels experienced in 5 nonoverlapping time windows (12 months before conception, gestation, birth-age 5.9 months, ages 6.0 months-1.9 years, and ages 2.0-4.9 years) and their aggregates (birth-1.9 years, first 1,000 days from conception, and birth-4.9 years). Of the nonoverlapping windows, point estimates were largest for child survival related to food-crop yields for the time window of 6.0 months-1.9 years: The adjusted mortality hazard ratio was 1.10 (95% confidence interval: 1.03, 1.19) for a 90th-to-10th percentile yield reduction. These findings suggest that child survival in this setting is particularly vulnerable to cereal-crop yield reductions during the period of nonexclusive breastfeeding.
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Affiliation(s)
- Kristine Belesova
- Correspondence to Dr. Kristine Belesova, Department of Department of Primary Care and Public Health, Faculty of Medicine, Imperial College London, Reynolds Building, St. Dunstan's Road, London W6 8RP, United Kingdom (e-mail: )
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Chacha S, Hui J, Yuxin T, Wang Z, Ali S, Mbonile N, Msumari M, Msuya N, Malimu E, Revocatus B, Maokola W, Mtali G, Simon V, Dang S. Epidemiological profile of malnutrition status and spatial distribution of children and adolescents living with HIV/AIDS in Tanzania. Trop Med Int Health 2023; 28:203-214. [PMID: 36617637 DOI: 10.1111/tmi.13852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES To determine the prevalence of malnutrition status, analyse the association between malnutrition status and individual-level factors, and explore the spatial variation among children and adolescents living with HIV/AIDS in Tanzania. METHODS The study is based on large-scale baseline routine data from the National AIDS Control Programme on people living with HIV from January 2016 to December 2021 in mainland Tanzania. 70,102 children and adolescents aged 5-19 years receiving active antiretroviral therapy were included in the analysis. Nutritional status of participants was assessed by anthropometric measurement. Pearson's Chi-square test was used to describe the association between individual-level factors with all malnutrition outcomes and spatial analysis was used to investigate spatial distribution of malnutrition. The excess risk of malnutrition for each region was calculated while Anselin Local Moran's I and Getis-Ord statistical tools were used to identify significant hot spots regions of malnutrition. RESULTS The mean age of participants was 11.1 (SD 4.7) years, with 71.7% in the 5-14-year age group and 58.4% being girls. 39.2% were attending care and treatment clinics services at hospital level with public ownership. 53.4% started using ARV at age 5-14 years and 55.5% had already switched to second- or third-line ARV with 61.1% using ARV for less than 3 years. 51.2% were in WHO HIV clinical stage III or IV. The prevalence of malnutrition was 36.0% for stunting, 28.9% for underweight, 13.0% for wasting, and 48.0% for anthropometric failure. Individual-level factors which accounted for a higher proportion of malnutrition based on anthropometric failure were male sex (56.3%), age 5-14 years (50.0%), being unmarried (52.9%), being on second- or third-line ARV treatment (51.4%), ART initiation at age 5-14 years (55.7%), ARV for more than 3 years (49.4%), and stage IV of WHO HIV clinical status (57.8%). There were regional hot spots (p < 0.05): the prevalence rate and excess risk of malnutrition for stunting and anthropometric failure were highest in the southern highlands regions, for underweight in the central regions, and for wasting in the northern regions. CONCLUSIONS Children and adolescents living with HIV/AIDS in Tanzania suffer from poor nutritional status. Malnutrition does not occur arbitrarily, and the regions identified as hot spots should be given priority for nutritional intervention. Effective nutritional interventions for children living with HIV/AIDS should incorporate multiple approaches by considering unique geographical factors.
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Affiliation(s)
- Samuel Chacha
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China.,Department of Molecular Diagnostics, Sumbwanga Regional Referral Hospital, Rukwa, Tanzania
| | - Jing Hui
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Teng Yuxin
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Ziping Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Saumu Ali
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Nicolaus Mbonile
- Department of Molecular Diagnostics, Sumbwanga Regional Referral Hospital, Rukwa, Tanzania
| | - Mary Msumari
- Department of Molecular Diagnostics, Sumbwanga Regional Referral Hospital, Rukwa, Tanzania
| | - Ndovera Msuya
- Department of Biochemistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Emmanuel Malimu
- Global Fund, Ministry of Health, Dodoma, Tanzania.,Department of Parasitology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Baraka Revocatus
- Department of Data and Statistics, Bugando Medical Centre, Mwanza, Tanzania.,National AIDS Control Program, Ministry of Health, Dodoma, Tanzania
| | - Werner Maokola
- National AIDS Control Program, Ministry of Health, Dodoma, Tanzania
| | - Godwin Mtali
- Department of Oncology, Bugando Medical Centre, Mwanza, Tanzania
| | - Victor Simon
- Global Health Program, HJFMRI, U.S. Military HIV Research Program, Rukwa, Tanzania
| | - Shaonong Dang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
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Oldenburg CE, Hinterwirth A, Ourohiré M, Dah C, Ouédraogo M, Sié A, Boudo V, Chen C, Ruder K, Zhong L, Lebas E, Nyatigo F, Arnold BF, O’Brien KS, Doan T. Gut Resistome after Antibiotics among Children with Uncomplicated Severe Acute Malnutrition: A Randomized Controlled Trial. Am J Trop Med Hyg 2022; 107:59-64. [PMID: 35895362 PMCID: PMC9294673 DOI: 10.4269/ajtmh.22-0007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/27/2022] [Indexed: 08/19/2023] Open
Abstract
A broad-spectrum antibiotic, typically amoxicillin, is included in many country guidelines as part of the management of uncomplicated severe acute malnutrition (SAM) in children without overt clinical symptoms of infection. Alternative antibiotics may be beneficial for children with SAM without increasing selection for beta-lactam resistance. We conducted a 1:1 randomized controlled trial of single dose azithromycin versus a 7-day course of amoxicillin for SAM. Children 6-59 months of age with uncomplicated SAM (mid-upper arm circumference < 11.5 cm and/or weight-for-height Z-score < -3) were enrolled in Boromo District, Burkina Faso, from June through October 2020. Rectal swabs were collected at baseline and 8 weeks after treatment and processed using DNA-Seq. We compared the resistome at the class level in children randomized to azithromycin compared with amoxicillin. We found no evidence of a difference in the distribution of genetic antibiotic resistance determinants to any antibiotic class 8 weeks after treatment. There was no difference in genetic macrolide resistance determinants (65% azithromycin, 65% placebo, odds ratio, OR, 1.00, 95% confidence interval, CI, 0.43-2.34) or beta-lactam resistance determinants (82% azithromycin, 83% amoxicillin, OR 0.94, 95% CI, 0.33-2.68) at 8 weeks. Although presence of genetic antibiotic resistance determinants to macrolides and beta-lactams was common, we found no evidence of a difference in the gut resistome 8 weeks after treatment. If there are earlier effects of antibiotics on selection for genetic antibiotic resistance determinants, the resistome may normalize by 8 weeks.
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Affiliation(s)
- Catherine E. Oldenburg
- Francis I Proctor Foundation, University of California, San Francisco, California
- Department of Ophthalmology, University of California, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California
| | - Armin Hinterwirth
- Francis I Proctor Foundation, University of California, San Francisco, California
| | | | - Clarisse Dah
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | | | - Ali Sié
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Valentin Boudo
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Cindi Chen
- Francis I Proctor Foundation, University of California, San Francisco, California
| | - Kevin Ruder
- Francis I Proctor Foundation, University of California, San Francisco, California
| | - Lina Zhong
- Francis I Proctor Foundation, University of California, San Francisco, California
| | - Elodie Lebas
- Francis I Proctor Foundation, University of California, San Francisco, California
| | - Fanice Nyatigo
- Francis I Proctor Foundation, University of California, San Francisco, California
| | - Benjamin F. Arnold
- Francis I Proctor Foundation, University of California, San Francisco, California
- Department of Ophthalmology, University of California, San Francisco, California
| | - Kieran S. O’Brien
- Francis I Proctor Foundation, University of California, San Francisco, California
- Department of Ophthalmology, University of California, San Francisco, California
| | - Thuy Doan
- Francis I Proctor Foundation, University of California, San Francisco, California
- Department of Ophthalmology, University of California, San Francisco, California
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Mank I, Belesova K, Bliefernicht J, Traoré I, Wilkinson P, Danquah I, Sauerborn R. The Impact of Rainfall Variability on Diets and Undernutrition of Young Children in Rural Burkina Faso. Front Public Health 2021; 9:693281. [PMID: 34616704 PMCID: PMC8489680 DOI: 10.3389/fpubh.2021.693281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Climate change and consequent increases in rainfall variability may have negative consequences for the food production of subsistence farmers in West Africa with adverse impacts on nutrition and health. We explored the pathway from rainfall through diet up to child undernutrition for rural Burkina Faso. Methods: The study used data of a dynamic cohort with 1,439 children aged 7-60 months from the Nouna Health and Demographic Surveillance Site (HDSS) for 2017 to 2019. We assessed data on diets, height, weight, household characteristics, and daily precipitation (from 1981 to 2019). Principal component analysis was used to identify distinct child dietary patterns (Dietary Pattern Scores, DPS). These were related to 15 rainfall indicators by area to obtain a precipitation variability score (PVS) through reduced rank regression (RRR). Associations between the PVS and anthropometric measures, height-for-age (HAZ), and weight-for-height (WHZ), were examined using multi-level regression analysis. Results: Stunting (HAZ < -2) and wasting (WHZ < -2) were seen in 24 and 6% of the children. Three main dietary patterns were identified (market-based, vegetable-based, and legume-based diets) and showed mixed evidence for associations with child undernutrition. The RRR-derived PVS explained 14% of the total variance in these DPS. The PVS was characterized by more consecutive dry days during the rainy season, higher cumulative rainfall in July and more extremely wet days. A 1-point increase in the PVS was associated with a reduction of 0.029 (95% CI: -0.06, 0.00, p < 0.05) in HAZ in the unadjusted, and an increase by 0.032 (95% CI: 0.01, 0.06, p < 0.05) in WHZ in the fully adjusted model. Conclusion: Rainfall variability was associated with dietary patterns in young children of a rural population of Burkina Faso. Increased rainfall variability was associated with an increase in chronic undernutrition, but not in acute undernutrition among young children.
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Affiliation(s)
- Isabel Mank
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Kristine Belesova
- Department of Public Health, Environments and Society and Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
| | - Jan Bliefernicht
- Institute of Geography, Faculty of Applied Computer Science, University of Augsburg, Augsburg, Germany
| | - Issouf Traoré
- Centre de Recherche en Santé de Nouna (CRSN), Institut National de Santé Publique, Nouna, Burkina Faso.,Institut Universitaire de Formations Initiale et Continue (IUFIC), Université Thomas Sankara (UTS), Ouagadougou, Burkina Faso
| | - Paul Wilkinson
- Department of Public Health, Environments and Society and Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
| | - Ina Danquah
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
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10
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Climate Change, Health Risks, and Vulnerabilities in Burkina Faso: A Qualitative Study on the Perceptions of National Policymakers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094972. [PMID: 34067050 PMCID: PMC8125418 DOI: 10.3390/ijerph18094972] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/23/2021] [Accepted: 04/30/2021] [Indexed: 11/17/2022]
Abstract
Climate change (CC) constitutes one of the greatest threats to human health, and requires political awareness for effective and efficient adaptation planning. This study identified the perceptions of climate change and health adaptation (CC&H) among relevant stakeholders, decision-makers, and policymakers (SDPs) in Burkina Faso (BF) by determining their perceptions of CC, of related health risks and vulnerabilities, and of CC impacts on agriculture and food security. We carried out 35 semi-structured, qualitative in-depth interviews with SDPs, representing national governmental institutions, international organizations, and civil society organizations. The interviews were analyzed using content analysis. SDPs shared similar perceptions of CC and concurred with three ideas (1) CC is a real and lived experience in BF; (2) the population is aware of climatic changes in their environment; (3) CC is intertwined with the agricultural and economic development of the country. SDPs identified biodiversity loss, floods, droughts, and extreme heat as posing the highest risk to health. They elaborated five exposure pathways that are and will be affected by CC: water quality and quantity, heat stress, food supply and safety, vector borne diseases, and air quality. In conclusion, SDPs in Burkina Faso are highly aware of CC hazards, relevant health exposure pathways, and their corresponding health outcomes. Mental health and the interplay between social factors and complex health risks constitute perception gaps. SDPs perceived CC&H risks and vulnerabilities align with current evidence.
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Estimating Yields of Household Fields in Rural Subsistence Farming Systems to Study Food Security in Burkina Faso. REMOTE SENSING 2020. [DOI: 10.3390/rs12111717] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Climate change has an increasing impact on food security and child nutrition, particularly among rural smallholder farmers in sub-Saharan Africa. Their limited resources and rainfall dependent farming practices make them sensitive to climate change-related effects. Data and research linking yield, human health, and nutrition are scarce but can provide a basis for adaptation and risk management strategies. In support of studies on child undernutrition in Burkina Faso, this study analyzed the potential of remote sensing-based yield estimates at household level. Multi-temporal Sentinel-2 data from the growing season 2018 were used to model yield of household fields (median 1.4 hectares (ha), min 0.01 ha, max 12.6 ha) for the five most prominent crops in the Nouna Health and Demographic Surveillance (HDSS) area in Burkina Faso. Based on monthly metrics of vegetation indices (VIs) and in-situ harvest measurements from an extensive field survey, yield prediction models for different crops of high dietary importance (millet, sorghum, maize, and beans) were successfully generated producing R² between 0.4 and 0.54 (adj. R² between 0.32 and 0.5). The models were spatially applied and resulted in a yield estimation map at household level, enabling predictions of up to 2 months prior to harvest. The map links yield on a 10-m spatial resolution to households and consequently can display potential food insecurity. The results highlight the potential for satellite imagery to provide yield predictions of smallholder fields and are discussed in the context of health-related studies such as child undernutrition and food security in rural Africa under climate change.
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Chuang YC, Chuang TW, Chao HJ, Tseng KC, Nkoka O, Sunaringsih S, Chuang KY. Contextual Factors and Spatial Patterns of Childhood Malnutrition in Provinces of Burkina Faso. J Trop Pediatr 2020; 66:66-74. [PMID: 31086979 DOI: 10.1093/tropej/fmz031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Approximately 45% of all children's deaths are associated with malnutrition, and sub-Saharan Africa is hardest hit by this phenomenon. However, information on geographical variations of malnutrition in developing countries is limited. This study examined the geographical distribution and community characteristics associated with child malnutrition in Burkina Faso. DESIGN Data from the 2011 Burkina Faso Demographic Health Survey were analyzed. A general Kriging interpolation method was used to generate spatial malnutrition patterns. The global Moran's I test was used to identify significant malnutrition spatial patterns. Generalized estimating equations (GEEs) were fitted to examine the association between community level factors and malnutrition. RESULTS Average rates of stunting and wasting in the communities were 32.48% and 15.05%, respectively. Stunting hotspots were observed in the eastern and northeastern parts of Burkina Faso (i.e. Oudolan, Séno and Yagha, among others), while high rates of wasting were observed in the north-central part. The GEE results revealed lower stunting rates in communities with a higher percentage of households with improved sanitation. Communities with higher rates of professionally assisted births were associated with low wasting rates, while communities with higher rates of households with a low wealth index reported higher rates of wasting. CONCLUSIONS Spatial statistical models of malnutrition prevalence are useful for indicating hotspots over wide areas and hence, for guiding intervention strategies. This study revealed significant geographical patterns and community factors associated with childhood malnutrition. These factors should be considered in future programs aimed at reducing malnutrition in Burkina Faso.
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Affiliation(s)
- Ying-Chih Chuang
- School of Public Health, Taipei Medical University, 250 Wu-Hsing St, Taipei 11031, Taiwan
| | - Ting-Wu Chuang
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, Taipei Medical University, 250 Wu-Hsing St, Taipei 11031, Taiwan
| | - Hsing Jasmine Chao
- School of Public Health, Taipei Medical University, 250 Wu-Hsing St, Taipei 11031, Taiwan
| | - Kuo-Chien Tseng
- School of Public Health, Taipei Medical University, 250 Wu-Hsing St, Taipei 11031, Taiwan
| | - Owen Nkoka
- School of Public Health, Taipei Medical University, 250 Wu-Hsing St, Taipei 11031, Taiwan
| | - Sri Sunaringsih
- School of Public Health, Taipei Medical University, 250 Wu-Hsing St, Taipei 11031, Taiwan
| | - Kun-Yang Chuang
- School of Public Health, Taipei Medical University, 250 Wu-Hsing St, Taipei 11031, Taiwan
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Sié A, Tapsoba C, Dah C, Ouermi L, Zabre P, Bärnighausen T, Arzika AM, Lebas E, Snyder BM, Moe C, Keenan JD, Oldenburg CE. Dietary diversity and nutritional status among children in rural Burkina Faso. Int Health 2019; 10:157-162. [PMID: 29579204 DOI: 10.1093/inthealth/ihy016] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 02/15/2018] [Indexed: 01/21/2023] Open
Abstract
Background Burkina Faso has a seasonal malnutrition pattern, with higher malnutrition prevalence during the rainy season when crop yields are low. We investigated the association between dietary diversity and nutritional status among children aged 6-59 mo during the low crop yield season in rural Burkina Faso to assess the role of dietary diversity during the lean season on childhood nutritional status. Methods Caregivers reported the dietary diversity of the past 7 d, consisting of 11 food groups, summed into a scale. Anthropometric measurements were taken from all children. Height-for-age (HAZ), weight-for-height (WHZ) and weight-for-age (WAZ) z-scores were calculated based on 2006 WHO standards. Stunting, wasting and underweight were defined as HAZ, WHZ and WAZ <-2 SD, respectively. Multivariable regression models adjusting for potential confounders including household food insecurity and animal ownership were used to assess the relationship between anthropometric indices and dietary diversity. Results Of 251 children enrolled in the study, 20.6% were stunted, 10.0% wasted and 13.9% underweight. Greater dietary diversity was associated with greater HAZ (SD 0.14, 95% CI 0.04 to 0.25) among all children. There was no association between dietary diversity and wasting or mid-upper arm circumference in this study. Conclusions Increasing dietary diversity may be an approach to reduce the burden of stunting and chronic malnutrition among young children in regions with seasonal food insecurity.
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Affiliation(s)
- Ali Sié
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | | | - Clarisse Dah
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | | | - Pascal Zabre
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Till Bärnighausen
- Heidelberg Institute of Public Health, University of Heidelberg, Heidelberg, Germany.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Africa Health Research Institute, KwaZulu-Natal, South Africa
| | | | - Elodie Lebas
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, CA, USA
| | - Blake M Snyder
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, CA, USA
| | - Caitlin Moe
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Jeremy D Keenan
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, CA, USA.,Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, USA.,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Catherine E Oldenburg
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, CA, USA.,Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, USA.,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
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Sié A, Dah C, Ouermi L, Tapsoba C, Zabre P, Bärnighausen T, Lebas E, Arzika AM, Snyder BM, Porco TC, Lietman TM, Keenan JD, Oldenburg CE. Effect of Antibiotics on Short-Term Growth among Children in Burkina Faso: A Randomized Trial. Am J Trop Med Hyg 2018; 99:789-796. [PMID: 30014828 DOI: 10.4269/ajtmh.18-0342] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Antibiotics improve both weight and height gain in randomized trials of preschool children with preexisting morbidity. Here, we assess the effect of a short course of three different antibiotics (amoxicillin, azithromycin, and cotrimoxazole) on short-term linear and ponderal growth in a population-based sample of preschool children in rural Burkina Faso. We randomized households with at least two children in the Nouna district, Burkina Faso, to a 5-day course of amoxicillin, azithromycin, cotrimoxazole, or placebo. Within each antibiotic-randomized household, one child was randomly assigned to receive the antibiotic and the other to receive the placebo. Weight and height measurements were taken at baseline and 30 days following the last study medication dose. Weight-for-height Z (WHZ), height-for-age Z (HAZ), and weight-for-age Z (WAZ) scoreswere calculated based on the 2006 World Health Organization standards. Of the 124 households and 248 children enrolled, 229 had anthropometry measurements at 1 month and were analyzed. Children randomized to amoxicillin gained significantly more weight compared with both the placebo household (mean difference 317 g, 95% confidence interval [CI]: 115-519 g) and placebo sibling (mean difference 315 g, 95% CI: 147-482 g) controls. Growth velocity in g/kg/day, and WHZ and WAZ scores were higher in amoxicillin-treated children compared with placebo households and siblings. There were no differences in weight gain in children randomized to azithromycin or cotrimoxazole compared with placebo households or placebo siblings. There were no differences in height gain or HAZ across any of the study arms. Amoxicillin may have short-term growth-promoting effects in healthy children.
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Affiliation(s)
- Ali Sié
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Clarisse Dah
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | | | | | - Pascal Zabre
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Till Bärnighausen
- Africa Health Research Institute, KwaZulu-Natal, South Africa.,Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Heidelberg Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | - Elodie Lebas
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | | | - Blake M Snyder
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Travis C Porco
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California.,Department of Ophthalmology, University of California, San Francisco, San Francisco, California.,Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Thomas M Lietman
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California.,Department of Ophthalmology, University of California, San Francisco, San Francisco, California.,Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Jeremy D Keenan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California.,Department of Ophthalmology, University of California, San Francisco, San Francisco, California.,Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Catherine E Oldenburg
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California.,Department of Ophthalmology, University of California, San Francisco, San Francisco, California.,Francis I. Proctor Foundation, University of California, San Francisco, California
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