@article{Roberts2021-gg,

title = {Seasonal patterns of malaria, genital infection, nutritional and  iron status in non-pregnant and pregnant adolescents in Burkina  Faso: a secondary analysis of trial data},

author = {Stephen A Roberts and Loretta Brabin and Halidou Tinto and Sabine Gies and Salou Diallo and Bernard Brabin},

doi = {10.1186/s12889-021-11819-0},

issn = {1471-2458},

year  = {2021},

date = {2021-09-01},

urldate = {2021-09-01},

journal = {BMC Public Health},

volume = {21},

number = {1},

pages = {1764},

publisher = {Springer Science and Business Media LLC},

abstract = {BACKGROUND: Adolescents are considered at high risk of developing iron deficiency. Studies in children indicate that the prevalence of iron deficiency increased with  malaria transmission, suggesting malaria seasonally may drive iron deficiency. This  paper examines monthly seasonal infection patterns of malaria, abnormal vaginal  flora, chorioamnionitis, antibiotic and antimalarial prescriptions, in relation to  changes in iron biomarkers and nutritional indices in adolescents living in a rural  area of Burkina Faso, in order to assess the requirement for seasonal infection  control and nutrition interventions. METHODS: Data collected between April 2011 and  January 2014 were available for an observational seasonal analysis, comprising  scheduled visits for 1949 non-pregnant adolescents (≤19 years), (315 of whom  subsequently became pregnant), enrolled in a randomised trial of periconceptional  iron supplementation. Data from trial arms were combined. Body Iron Stores (BIS)  were calculated using an internal regression for ferritin to allow for inflammation.  At recruitment 11% had low BIS (\< 0 mg/kg). Continuous outcomes were fitted to a  mixed-effects linear model with month, age and pregnancy status as fixed effect  covariates and woman as a random effect. Dichotomous infection outcomes were fitted  with analogous logistic regression models. RESULTS: Seasonal variation in malaria  parasitaemia prevalence ranged between 18 and 70% in non-pregnant adolescents  (P \< 0.001), peaking at 81% in those who became pregnant. Seasonal variation  occurred in antibiotic prescription rates (0.7-1.8 prescriptions/100 weekly visits,  P \< 0.001) and chorioamnionitis prevalence (range 15-68%, P = 0.026). Mucosal  vaginal lactoferrin concentration was lower at the end of the wet season (range  2-22 μg/ml, P \< 0.016), when chorioamnionitis was least frequent. BIS fluctuated  annually by up to 53.2% per year around the mean BIS (5.1 mg/kg(2), range  4.1-6.8 mg/kg), with low BIS (\< 0 mg/kg) of 8.7% in the dry and 9.8% in the wet  seasons (P = 0.36). Median serum transferrin receptor increased during the wet  season (P \< 0.001). Higher hepcidin concentration in the wet season corresponded  with rising malaria prevalence and use of prescriptions, but with no change in BIS.  Mean Body Mass Index and Mid-Upper-Arm-Circumference values peaked mid-dry season  (both P \< 0.001). CONCLUSIONS: Our analysis supports preventive treatment of malaria  among adolescents 15-19 years to decrease their disease burden, especially  asymptomatic malaria. As BIS were adequate in most adolescents despite seasonal  malaria, a requirement for programmatic iron supplementation was not substantiated.},

note = {© 2021. The Author(s).

PMID: 34579679 

PMCID: PMC8477466},

keywords = {Abnormal vaginal flora, Adolescents, Bacterial vaginosis, Body Mass Index, Burkina Faso/epidemiology, Child, Female, Humans, Iron, iron biomarkers, Malaria, Malaria/drug therapy/epidemiology, MUAC, Pregnancy, Seasons, Vagina},

pubstate = {published},

tppubtype = {article}

}

@article{Nonterah2021-pc,

title = {Adiposity phenotypes and subclinical atherosclerosis in adults  from sub-Saharan Africa: An H3Africa AWI-gen study},

author = {Engelbert A Nonterah and Michiel L Bots and Abraham Oduro and Godfred Agongo and Cassandra C Soo and Lisa K Micklesfield and Felistas Mashinya and Palwend\'{e} R Boua and Shukri F Mohamed and Alisha N Wade and Catherine Kyobutungi and Halidou Tinto and Shane A Norris and Stephen M Tollman and Mich`ele Ramsay and Diederick E Grobbee and Kerstin Klipstein-Grobusch and Nigel J Crowther and AWI-Gen and H3Africa Consortium},

doi = {10.5334/gh.863},

issn = {2211-8179 2211-8160},

year  = {2021},

date = {2021-03-19},

urldate = {2021-03-19},

journal = {Glob. Heart},

volume = {16},

number = {1},

pages = {19},

publisher = {Ubiquity Press, Ltd.},

abstract = {Background: Obesity and adipose tissue distribution contribute 

 to an increased risk of cardiovascular disease (CVD) by 

 promoting atherosclerosis. This association has been poorly 

 studied in sub-Saharan Africa (SSA) despite the rising 

 prevalence of cardiovascular disease. Objectives: We determined 

 the association between various adiposity phenotypes and carotid 

 intima-media thickness (CIMT), a proxy of subclinical 

 atherosclerosis, in a large SSA population. Methods: A 

 population-based cross-sectional study was performed from 

 2013-2016 in Burkina Faso, Ghana, Kenya and South Africa. Body 

 mass index (BMI), waist (WC), hip circumferences (HC), visceral 

 (VAT) and subcutaneous adipose tissue (SCAT) using B-mode 

 ultrasound were measured. Ultrasonography of left and right far 

 wall CIMT of the common carotid artery was used as an indicator 

 of subclinical atherosclerosis. Individual participant data 

 meta-analyses were used to determine the associations between 

 adiposity phenotypes and CIMT in the pooled sample while 

 adjusted multivariable linear regression analyses were used for 

 site specific analyses. Results: Data were obtained from 9,010 

 adults (50.3% women and a mean age of 50$pm$ 6years). Men had 

 higher levels of visceral fat than women while women had higher 

 BMI, waist and hip circumference and subcutaneous fat than men 

 at all sites except Burkina Faso. In the pooled analyses, BMI 

 ($beta$-value [95% CIs]: 19.5 [16.8, 22.3] $mu$m) showed the 

 strongest relationship with CIMT followed by VAT (5.86 [4.65, 

 7.07] $mu$m), SCAT (5.00 [2.85, 7.15] $mu$m), WC (1.27 [1.09, 

 1.44] $mu$m) and HC (1.23 [1.04, 1.42] $mu$m). Stronger 

 associations were observed in men than in women. Conclusion: 

 Obesity within SSA will likely result in higher levels of 

 atherosclerosis and promote the occurrence of cardio- and 

 cerebrovascular events, especially in males, unless addressed 

 through primary prevention of obesity in both rural and urban 

 communities across Africa. The inverse association of VAT with 

 CIMT in Burkina Faso and Ghana requires further investigation. 

 Highlights: All adiposity phenotypes were positively associated 

 with common carotid intima-media thickness (CIMT) in the entire 

 cohort (pooled analyses).BMI had the strongest association with 

 CIMT compared to other phenotypes.The magnitude of association 

 between adiposity phenotypes and CIMT was higher in men than in 

 women.Subcutaneous adipose tissue was inversely associated with 

 CIMT only in women.An unexpected finding was the inverse 

 association of visceral adipose tissue with CIMT in Burkina Faso 

 and Ghana.},

note = {Copyright: © 2021 The Author(s).

PMID: 33833943 

PMCID: PMC7977036},

keywords = {adiposity, Adult, Body Mass Index, cardiovascular   disease, Carotid intima-media thickness, Cross-Sectional Studies, Female, Ghana, Humans, Male, Middle Aged, obesity, Obesity/complications/epidemiology, Phenotype, Risk Factors, sub-Saharan Africa, subclinical   atherosclerosis},

pubstate = {published},

tppubtype = {article}

}