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Festo C, Vannevel V, Ali H, Tamrat T, Mollel GJ, Hlongwane T, Fahmida KA, Alland K, Barreix M, Mehrtash H, Silva R, Thwin SS, Mehl G, Labrique AB, Masanja H, Tunçalp Ӧ. Accuracy of a smartphone application for blood pressure estimation in Bangladesh, South Africa, and Tanzania. NPJ Digit Med 2023; 6:69. [PMID: 37069209 PMCID: PMC10107587 DOI: 10.1038/s41746-023-00804-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 03/13/2023] [Indexed: 04/19/2023] Open
Abstract
Undetected and unmonitored hypertension carries substantial mortality and morbidity, especially during pregnancy. We assessed the accuracy of OptiBPTM, a smartphone application for estimating blood pressure (BP), across diverse settings. The study was conducted in community settings: Gaibandha, Bangladesh and Ifakara, Tanzania for general populations, and Kalafong Provincial Tertiary Hospital, South Africa for pregnant populations. Based on guidance from the International Organization for Standardization (ISO) 81,060-2:2018 for non-invasive BP devices and global consensus statement, we compared BP measurements taken by two independent trained nurses on a standard auscultatory cuff to the BP measurements taken by a research version of OptiBPTM called CamBP. For ISO criterion 1, the mean error was 0.5 ± 5.8 mm Hg for the systolic blood pressure (SBP) and 0.1 ± 3.9 mmHg for the diastolic blood pressure (DBP) in South Africa; 0.8 ± 7.0 mmHg for the SBP and -0.4 ± 4.0 mmHg for the DBP in Tanzania; 3.3 ± 7.4 mmHg for the SBP and -0.4 ± 4.3 mmHg for the DBP in Bangladesh. For ISO criterion 2, the average standard deviation of the mean error per subject was 4.9 mmHg for the SBP and 3.4 mmHg for the DBP in South Africa; 6.3 mmHg for the SBP and 3.6 mmHg for the DBP in Tanzania; 6.4 mmHg for the SBP and 3.8 mmHg for the DBP in Bangladesh. OptiBPTM demonstrated accuracy against ISO standards in study populations, including pregnant populations, except in Bangladesh for SBP (criterion 2). Further research is needed to improve performance across different populations and integration within health systems.
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Affiliation(s)
- Charles Festo
- Ifakara Health Institute, Dar es Salaam, Dar es Salaam, United Republic of Tanzania
| | - Valerie Vannevel
- South African Medical Research Council Maternal and Infant Health Care Strategies Unit, Pretoria, South Africa
- Research Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, Pretoria, South Africa
- Department of Obstetrics and Gynaecology, Kalafong Provincial Tertiary Hospital, Pretoria, South Africa
| | - Hasmot Ali
- The JiVitA Maternal and Child Health and Nutrition Research Project, Nasirabad, Keranipara, Rangpur, 5400, Bangladesh
| | - Tigest Tamrat
- UNDP/UNFPA/UNICEF/World Bank Special Program of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
| | - Getrud J Mollel
- Ifakara Health Institute, Dar es Salaam, Dar es Salaam, United Republic of Tanzania
| | - Tsakane Hlongwane
- South African Medical Research Council Maternal and Infant Health Care Strategies Unit, Pretoria, South Africa
- Research Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, Pretoria, South Africa
- Department of Obstetrics and Gynaecology, Kalafong Provincial Tertiary Hospital, Pretoria, South Africa
| | - Kaniz A Fahmida
- The JiVitA Maternal and Child Health and Nutrition Research Project, Nasirabad, Keranipara, Rangpur, 5400, Bangladesh
| | - Kelsey Alland
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - María Barreix
- UNDP/UNFPA/UNICEF/World Bank Special Program of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Hedieh Mehrtash
- UNDP/UNFPA/UNICEF/World Bank Special Program of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Ronaldo Silva
- UNDP/UNFPA/UNICEF/World Bank Special Program of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Soe Soe Thwin
- UNDP/UNFPA/UNICEF/World Bank Special Program of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Garrett Mehl
- Department of Digital Health and Innovations, World Health Organization, Geneva, Switzerland
| | - Alain B Labrique
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Digital Health and Innovations, World Health Organization, Geneva, Switzerland
| | - Honorati Masanja
- Ifakara Health Institute, Dar es Salaam, Dar es Salaam, United Republic of Tanzania
| | - Ӧzge Tunçalp
- UNDP/UNFPA/UNICEF/World Bank Special Program of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Weisser M, Rohacek M, Ndege R, Luoga E, Katende A, Mollel GJ, Gingo W, Vanobberghen F, Paris DH, Hatz C, Battegay M. The Chronic Diseases Clinic of Ifakara (CDCI)—Establishing a Model Clinic for Chronic Care Delivery in Rural Sub-Saharan Africa. Diseases 2022; 10:diseases10040072. [PMID: 36278571 PMCID: PMC9590064 DOI: 10.3390/diseases10040072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/14/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022] Open
Abstract
The rollout of antiretroviral drugs in sub-Saharan Africa to address the huge health impact of the HIV pandemic has been one of the largest projects undertaken in medical history and is an unprecedented medical success story. However, the path has been and still is characterized by many far reaching implementational challenges. Here, we report on the building and maintaining of a role model clinic in Ifakara, rural Southwestern Tanzania, within a collaborative project to support HIV services within the national program, training for staff and integrated research to better understand local needs and improve patients’ outcomes.
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Affiliation(s)
- Maja Weisser
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, 4031 Basel, Switzerland
- University of Basel, 4001 Basel, Switzerland
- Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- Ifakara Health Institute, Ifakara P.O. Box 53, Tanzania
- Correspondence: (M.W.); (M.B.); Tel.: +41-328-67-42 (M.W.); +41-61-265-50-53 (M.B.)
| | - Martin Rohacek
- University of Basel, 4001 Basel, Switzerland
- Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- Ifakara Health Institute, Ifakara P.O. Box 53, Tanzania
| | - Robert Ndege
- Ifakara Health Institute, Ifakara P.O. Box 53, Tanzania
- St. Francis Referral Hospital, Ifakara P.O. Box 73, Tanzania
| | - Ezekiel Luoga
- Ifakara Health Institute, Ifakara P.O. Box 53, Tanzania
- St. Francis Referral Hospital, Ifakara P.O. Box 73, Tanzania
| | - Andrew Katende
- Ifakara Health Institute, Ifakara P.O. Box 53, Tanzania
- St. Francis Referral Hospital, Ifakara P.O. Box 73, Tanzania
| | - Getrud J. Mollel
- Ifakara Health Institute, Ifakara P.O. Box 53, Tanzania
- St. Francis Referral Hospital, Ifakara P.O. Box 73, Tanzania
| | - Winfrid Gingo
- St. Francis Referral Hospital, Ifakara P.O. Box 73, Tanzania
| | - Fiona Vanobberghen
- University of Basel, 4001 Basel, Switzerland
- Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
| | - Daniel H. Paris
- University of Basel, 4001 Basel, Switzerland
- Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
| | - Christoph Hatz
- University of Basel, 4001 Basel, Switzerland
- Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
| | - Manuel Battegay
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, 4031 Basel, Switzerland
- University of Basel, 4001 Basel, Switzerland
- Correspondence: (M.W.); (M.B.); Tel.: +41-328-67-42 (M.W.); +41-61-265-50-53 (M.B.)
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Gerber M, Ayekoé S, Bonfoh B, Coulibaly JT, Daouda D, Gba BC, Kouassi B, Traoré SG, du Randt R, Nqweniso S, Walter C, Finda MF, Minja EG, Mollel GJ, Masanja H, Okumu FO, Beckmann J, Gall S, Lang C, Z Long K, Müller I, Probst-Hensch N, Pühse U, Steinmann P, Utzinger J. Is grip strength linked to body composition and cardiovascular risk markers in primary schoolchildren? Cross-sectional data from three African countries. BMJ Open 2022; 12:e052326. [PMID: 35667732 PMCID: PMC9171173 DOI: 10.1136/bmjopen-2021-052326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 02/02/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES Muscular strength represents a specific component of health-related fitness. Hand grip strength (HGS) is used as an indicator for musculoskeletal fitness in children. HGS can also be used as a marker of cardiometabolic risk, but most available HGS data are derived from Western high-income countries. Therefore, this study examines whether HGS is associated with body composition and markers of cardiovascular risk in children from three sub-Saharan African countries. DESIGN Cross-sectional study. SETTING Public primary schools (grade 1-4) in Taabo (Côte d'Ivoire), Gqeberha (South Africa) and Ifakara (Tanzania). PARTICIPANTS Data from 467 children from Côte d'Ivoire (210 boys, 257 girls), 864 children from South Africa (429 boys, 435 girls) and 695 children from Tanzania (334 boys, 361 girls) were analysed. PRIMARY AND SECONDARY OUTCOME MEASURES Body composition (assessed via bioelectrical impedance analysis) was the primary outcome. Cardiovascular risk markers were considered as secondary outcome. Blood pressure was measured with an oscillometric monitor, and blood markers (cholesterol, triglycerides, glycated haemoglobin) via Afinion point-of-care testing. HGS (independent variable) was assessed with a hydraulic hand dynamometer. Inferential statistics are based on mixed linear regressions and analyses of covariance. RESULTS Across all study sites, higher HGS was associated with lower body fat, higher muscle mass and higher fat-free mass (p<0.001, 3.9%-10.0% explained variance), both in boys and girls. No consistent association was found between HGS and cardiovascular risk markers. CONCLUSIONS HGS assessment is popular due to its simplicity, feasibility, practical utility and high reliability of measurements. This is one of the first HGS studies with children from sub-Saharan Africa. There is a great need for further studies to examine whether our findings can be replicated, to develop reference values for African children, to establish links to other health outcomes, and to explore whether HGS is associated with later development of cardiovascular risk markers. TRIAL REGISTRATION NUMBER ISRCTN29534081.
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Affiliation(s)
- Markus Gerber
- University of Basel, Basel, Switzerland
- Departement of Sport Exericse and Health, University of Basel, Basel, Switzerland
| | - Serge Ayekoé
- Institut National de la Jeunesse et des Sports, Abidjan, Côte d'Ivoire
| | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Jean T Coulibaly
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Dao Daouda
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Bomey Clément Gba
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Benal Kouassi
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Université Nangui Abrogoua, Abidjan, Côte d'Ivoire
| | - Sylvain G Traoré
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Université Peleforo Gon Coulibaly, Korhogo, Côte d'Ivoire
| | | | | | | | - Marceline F Finda
- Ifakara Health Institute, Ifakara/Dar es Salam, United Republic of Tanzania
| | - Elihaika G Minja
- Ifakara Health Institute, Ifakara/Dar es Salam, United Republic of Tanzania
| | - Getrud J Mollel
- Ifakara Health Institute, Ifakara/Dar es Salam, United Republic of Tanzania
| | - Honorati Masanja
- Ifakara Health Institute, Ifakara/Dar es Salam, United Republic of Tanzania
| | - Fredros O Okumu
- Ifakara Health Institute, Ifakara/Dar es Salam, United Republic of Tanzania
| | - Johanna Beckmann
- University of Basel, Basel, Switzerland
- Departement of Sport Exericse and Health, University of Basel, Basel, Switzerland
| | - Stefanie Gall
- University of Basel, Basel, Switzerland
- Departement of Sport Exericse and Health, University of Basel, Basel, Switzerland
| | - Christin Lang
- University of Basel, Basel, Switzerland
- Departement of Sport Exericse and Health, University of Basel, Basel, Switzerland
| | - Kurt Z Long
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Ivan Müller
- University of Basel, Basel, Switzerland
- Departement of Sport Exericse and Health, University of Basel, Basel, Switzerland
| | - Nicole Probst-Hensch
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Uwe Pühse
- University of Basel, Basel, Switzerland
- Departement of Sport Exericse and Health, University of Basel, Basel, Switzerland
| | - Peter Steinmann
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Juerg Utzinger
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
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4
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Gerber M, Ayekoé SA, Beckmann J, Bonfoh B, Kouassi KB, Gba BC, Traoré SG, Coulibaly JT, Daouda D, du Randt R, Finda MF, Minja EG, Gall S, Mollel GJ, Lang C, Long KZ, Masanja H, Müller I, Nqweniso S, Okumu FO, Probst-Hensch N, Pühse U, Steinmann P, Walter C, Utzinger J. Moderate-to-Vigorous Physical Activity Is Associated With Cardiorespiratory Fitness Among Primary Schoolchildren Living in Côte d'Ivoire, South Africa, and Tanzania. Front Public Health 2021; 9:671782. [PMID: 34490179 PMCID: PMC8416979 DOI: 10.3389/fpubh.2021.671782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 07/19/2021] [Indexed: 01/21/2023] Open
Abstract
Background: Physical inactivity and low cardiorespiratory fitness (CRF) are independent cardiovascular risk factors among children, but have rarely been investigated concurrently in sub-Saharan Africa. The purpose of this study was to compare physical activity (PA) and CRF of primary schoolchildren living in Côte d'Ivoire (CI), South Africa (ZA), and Tanzania (TZ), to test sex- and age-related differences, and to examine whether PA and CRF are associated with each other. Methods: Baseline data from an ongoing cluster-randomized controlled trial were used, including 499 children from CI (Taabo, 49% girls, M = 8.0 ± 1.6 years), 1,074 children from ZA (Gqeberha, 49% girls, M = 8.3 ± 1.4 years), and 593 children from TZ (Ifakara, 51% girls, M = 9.4 ± 1.7 years). PA was assessed by accelerometry and CRF by a 20 m shuttle-run test. The data were analyzed using multi-/univariate analyses of variance and mixed linear models. Results: Most children met recommendations put forward by the World Health Organization for moderate-to-vigorous PA (MVPA) and achieved high CRF scores. In CI, 89.6% of the children met MVPA recommendations (boys: 91.7%, girls: 87.4%), whereas this rate was 76.9% in ZA (boys: 91.0%, girls: 62.4%), and 93.8% in TZ (boys: 95.5%, girls: 92.0%). Children from TZ had the highest CRF and MVPA levels, followed by children from CI and ZA. Boys had higher MVPA levels than girls, whereas girls engaged in more sedentary behavior. Sex differences were strongest in ZA. Sedentary behavior and MVPA were higher among older schoolchildren compared to their younger peers. Higher MVPA, but not sedentary behavior, was associated with better CRF. Conclusions: In all three settings, higher levels of MVPA were associated with higher CRF scores. Nevertheless, children living in the most urbanized setting (such as observed in ZA) were physically less active and had lower CRF than peers living in more rural areas (such as observed in CI and TZ). Particularly for girls, urbanization might increase the risk for insufficient MVPA, which may have negative effects on their CRF, thus negatively influencing health and well-being at later age.
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Affiliation(s)
| | - Serge A. Ayekoé
- Institut National de la Jeunesse et des Sports, Abidjan, Côte d'Ivoire
| | | | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Kouadio Benal Kouassi
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Unité de Formation et de Recherche des Sciences et Technologies des Aliments, Université Nangui Abrogoua, Abidjan, Côte d'Ivoire
| | - Bomey Clément Gba
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Sylvain G. Traoré
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Unité de Formation et de Recherche, Université Peleforo Gon Coulibaly, Korhogo, Côte d'Ivoire
| | - Jean T. Coulibaly
- University of Basel, Basel, Switzerland
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Dao Daouda
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | | | | | | | | | | | | | - Kurt Z. Long
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | | | | | | | | | - Nicole Probst-Hensch
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Uwe Pühse
- University of Basel, Basel, Switzerland
| | - Peter Steinmann
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | | | - Jürg Utzinger
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
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Gerber M, Ayekoé SA, Beckmann J, Bonfoh B, Coulibaly JT, Daouda D, du Randt R, Finda L, Gall S, Mollel GJ, Lang C, Long KZ, Ludyga S, Masanja H, Müller I, Nqweniso S, Okumu F, Probst-Hensch N, Pühse U, Steinmann P, Traoré SG, Walter C, Utzinger J. Effects of school-based physical activity and multi-micronutrient supplementation intervention on growth, health and well-being of schoolchildren in three African countries: the KaziAfya cluster randomised controlled trial protocol with a 2 × 2 factorial design. Trials 2020; 21:22. [PMID: 31907019 DOI: 10.1186/s13063-13019-13883-13065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 11/05/2019] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND In low- and middle-income countries, infectious diseases remain a key public health issue. Additionally, non-communicable diseases are a rapidly growing public health problem that impose a considerable burden on population health. One way to address this dual disease burden, is to incorporate (lifestyle) health promotion measures within the education sector. In the planned study, we will (i) assess and compare physical activity, physical fitness, micronutrient status, body composition, infections with soil-transmitted helminths, Schistosoma mansoni, malaria, inflammatory and cardiovascular health risk markers, cognitive function, health-related quality of life, and sleep in schoolchildren in Côte d'Ivoire, South Africa and Tanzania. We will (ii) determine the bi- and multivariate associations between these variables and (iii) examine the effects of a school-based health intervention that consists of physical activity, multi-micronutrient supplementation, or both. METHODS Assuming that no interaction occurs between the two interventions (physical activity and multi-micronutrient supplementation), the study is designed as a cluster-randomised, placebo-controlled trial with a 2 × 2 factorial design. Data will be obtained at three time points: at baseline and at 9 months and 21 months after the baseline assessment. In each country, 1320 primary schoolchildren from grades 1-4 will be recruited. In each school, classes will be randomly assigned to one of four interventions: (i) physical activity; (ii) multi-micronutrient supplementation; (iii) physical activity plus multi-micronutrient supplementation; and (iv) no intervention, which will serve as the control. A placebo product will be given to all children who do not receive multi-micronutrient supplementation. After obtaining written informed consent from the parents/guardians, the children will be subjected to anthropometric, clinical, parasitological and physiological assessments. Additionally, fitness tests will be performed, and children will be invited to wear an accelerometer device for 7 days to objectively assess their physical activity. Children infected with S. mansoni and soil-transmitted helminths will receive deworming drugs according to national policies. Health and nutrition education will be provided to the whole study population independently of the study arm allocation. DISCUSSION The study builds on the experience and lessons of a previous study conducted in South Africa. It involves three African countries with different social-ecological contexts to investigate whether results are generalisable across the continent. TRIAL REGISTRATION The study was registered on August 9, 2018, with ISRCTN. https://doi.org/10.1186/ISRCTN29534081.
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Affiliation(s)
- Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.
| | - Serge A Ayekoé
- Institut National de la Jeunesse et des Sports, Abidjan, Côte d'Ivoire
| | - Johanna Beckmann
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Bassirou Bonfoh
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Jean T Coulibaly
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Dao Daouda
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Rosa du Randt
- Nelson Mandela University, Port Elizabeth, South Africa
| | - Lina Finda
- Ifakara Health Institute, Dar es Salaam/Ifakara, Tanzania
| | - Stefanie Gall
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | | | - Christin Lang
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Kurt Z Long
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Sebastian Ludyga
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | | | - Ivan Müller
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | | | - Fredros Okumu
- Ifakara Health Institute, Dar es Salaam/Ifakara, Tanzania
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Sylvain G Traoré
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Unité de Formation et de Recherche des Sciences et Technologies des Aliments, Université Nangui Abrogoua, Abidjan, Côte d'Ivoire
| | - Cheryl Walter
- Nelson Mandela University, Port Elizabeth, South Africa
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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6
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Gerber M, Ayekoé SA, Beckmann J, Bonfoh B, Coulibaly JT, Daouda D, du Randt R, Finda L, Gall S, Mollel GJ, Lang C, Long KZ, Ludyga S, Masanja H, Müller I, Nqweniso S, Okumu F, Probst-Hensch N, Pühse U, Steinmann P, Traoré SG, Walter C, Utzinger J. Effects of school-based physical activity and multi-micronutrient supplementation intervention on growth, health and well-being of schoolchildren in three African countries: the KaziAfya cluster randomised controlled trial protocol with a 2 × 2 factorial design. Trials 2020; 21:22. [PMID: 31907019 PMCID: PMC6945709 DOI: 10.1186/s13063-019-3883-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 11/05/2019] [Indexed: 12/18/2022] Open
Abstract
Background In low- and middle-income countries, infectious diseases remain a key public health issue. Additionally, non-communicable diseases are a rapidly growing public health problem that impose a considerable burden on population health. One way to address this dual disease burden, is to incorporate (lifestyle) health promotion measures within the education sector. In the planned study, we will (i) assess and compare physical activity, physical fitness, micronutrient status, body composition, infections with soil-transmitted helminths, Schistosoma mansoni, malaria, inflammatory and cardiovascular health risk markers, cognitive function, health-related quality of life, and sleep in schoolchildren in Côte d’Ivoire, South Africa and Tanzania. We will (ii) determine the bi- and multivariate associations between these variables and (iii) examine the effects of a school-based health intervention that consists of physical activity, multi-micronutrient supplementation, or both. Methods Assuming that no interaction occurs between the two interventions (physical activity and multi-micronutrient supplementation), the study is designed as a cluster-randomised, placebo-controlled trial with a 2 × 2 factorial design. Data will be obtained at three time points: at baseline and at 9 months and 21 months after the baseline assessment. In each country, 1320 primary schoolchildren from grades 1–4 will be recruited. In each school, classes will be randomly assigned to one of four interventions: (i) physical activity; (ii) multi-micronutrient supplementation; (iii) physical activity plus multi-micronutrient supplementation; and (iv) no intervention, which will serve as the control. A placebo product will be given to all children who do not receive multi-micronutrient supplementation. After obtaining written informed consent from the parents/guardians, the children will be subjected to anthropometric, clinical, parasitological and physiological assessments. Additionally, fitness tests will be performed, and children will be invited to wear an accelerometer device for 7 days to objectively assess their physical activity. Children infected with S. mansoni and soil-transmitted helminths will receive deworming drugs according to national policies. Health and nutrition education will be provided to the whole study population independently of the study arm allocation. Discussion The study builds on the experience and lessons of a previous study conducted in South Africa. It involves three African countries with different social-ecological contexts to investigate whether results are generalisable across the continent. Trial registration The study was registered on August 9, 2018, with ISRCTN. 10.1186/ISRCTN29534081.
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Affiliation(s)
- Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.
| | - Serge A Ayekoé
- Institut National de la Jeunesse et des Sports, Abidjan, Côte d'Ivoire
| | - Johanna Beckmann
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Bassirou Bonfoh
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Jean T Coulibaly
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Dao Daouda
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Rosa du Randt
- Nelson Mandela University, Port Elizabeth, South Africa
| | - Lina Finda
- Ifakara Health Institute, Dar es Salaam/Ifakara, Tanzania
| | - Stefanie Gall
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | | | - Christin Lang
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Kurt Z Long
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Sebastian Ludyga
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | | | - Ivan Müller
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | | | - Fredros Okumu
- Ifakara Health Institute, Dar es Salaam/Ifakara, Tanzania
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Sylvain G Traoré
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Unité de Formation et de Recherche des Sciences et Technologies des Aliments, Université Nangui Abrogoua, Abidjan, Côte d'Ivoire
| | - Cheryl Walter
- Nelson Mandela University, Port Elizabeth, South Africa
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
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