Non-specific effects of BCG and DTP vaccination on infant mortality: An analysis of birth cohorts in Ghana and Tanzania
Background: Vaccines may induce non-specific effects on survival and health outcomes, in addition to protection against targeted pathogens or disease. Observational evidence suggests that infant Baccillus Calmette-Guérin (BCG) vaccination may provide non-specific survival benefits, while diphtheria-tetanus-pertussis (DTP) vaccination may increase the risk of mortality. Non-specific vaccine effects have been hypothesized to modify the effect of […]
Effects of parenting classes and economic strengthening for caregivers on the cognition of HIV-exposed infants: A pragmatic cluster randomised controlled trial in rural Zimbabwe
Introduction HIV-exposed children show signs of developmental delay. We assessed the impact of a pragmatic multicomponent intervention for caregivers of HIV-exposed children aged 0-2 years in Zimbabwe. Methods We conducted a cluster-randomised trial from 2016 to 2018. Clusters were catchments surrounding clinics, allocated (1:1) to either National HIV guidelines standard of care or standard care […]
Burden of disease among the world’s poorest billion people: An expert-informed secondary analysis of Global Burden of Disease estimates
Background The health of populations living in extreme poverty has been a long-standing focus of global development efforts, and continues to be a priority during the Sustainable Development Goal era. However, there has not been a systematic attempt to quantify the magnitude and causes of the burden in this specific population for almost two decades. […]
Evaluation of a custom-developed computer game to improve executive functioning in 4- To 6-year-old children exposed to alcohol in utero: Protocol for a feasibility randomized controlled trial
Background: Fetal alcohol spectrum disorder (FASD) is one of the most common causes of preventable intellectual disability, and the key associated deficits are in executive function (EF). Aspects of EF can be improved using cognitive training interventions. The highest prevalence of FASD globally (at a rate of 135.1 per 1000) has been found in a […]
Periconceptional multiple-micronutrient supplementation and placental function in rural Gambian women: A double-blind, randomized, placebo-controlled trial
Background: Maternal micronutrient deficiencies are commonly associated with clinical indicators of placental dysfunction. Objective: We tested the hypothesis that periconceptional multiplemicronutrient supplementation (MMS) affects placental function. Design: We conducted a double-blind, randomized, placebo-controlled trial of MMS in 17- to 45-y-old Gambian women who were menstruating regularly and within the previous 3 mo. Eligible subjects were […]
Expanding care for perinatal women with depression (EXPONATE): Study protocol for a randomized controlled trial of an intervention package for perinatal depression in primary care
Background: Depression is common among women during perinatal period and is associated with long-term adverse consequences for the mother and infant. In Nigeria, as in many other low- and-middle-income countries (LMIC), perinatal depression usually goes unrecognized and untreated. The aim of EXPONATE is to test the effectiveness and cost-effectiveness of an intervention package for perinatal […]
Time to first birth and its predictors among reproductive-age women in Ethiopia: inverse Weibull gamma shared frailty model
Background: High maternal and child death with high fertility rate have been reported in Ethiopia. Extreme age at first birth is linked with both maternal and child morbidity and mortality. However, literatures showed there were limited studies on the timing of the first birth and its predictors in the area so far. Therefore, determining the […]
Mental health financing challenges, opportunities and strategies in low- And middle-income countries: Findings from the Emerald project
BackgroundCurrent coverage of mental healthcare in low- and middle-income countries is very limited, not only in terms of access to services but also in terms of financial protection of individuals in need of care and treatment.AimsTo identify the challenges, opportunities and strategies for more equitable and sustainable mental health financing in six sub-Saharan African and […]
What elements of the work environment are most responsible for health worker dissatisfaction in rural primary care clinics in Tanzania?
Background: In countries with high maternal and newborn morbidity and mortality, reliable access to quality healthcare in rural areas is essential to save lives. Health workers who are satisfied with their jobs are more likely to remain in rural posts. Understanding what factors influence health workers’ satisfaction can help determine where resources should be focused. […]
Adapting the HIV infant tracking system to support prevention of mother-to-child transmission of HIV in Kenya: Protocol for an intervention development pilot study in two hospitals
Background: Despite progress to expand access to HIV testing and treatment during pregnancy in Kenya, gaps still remain in prevention of mother-to-child transmission of HIV (PMTCT) services. This study addresses the need for effective and scalable interventions to support women throughout the continuum of care for PMTCT services in low-resource settings. Our research team has […]
