Publications by authors named "Felix A Ogbo"

17 Publications

  • Page 1 of 1

Global Burden of Childhood Epilepsy, Intellectual Disability, and Sensory Impairments.

Pediatrics 2020 07 17;146(1). Epub 2020 Jun 17.

Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington.

Background: Estimates of children and adolescents with disabilities worldwide are needed to inform global intervention under the disability-inclusive provisions of the Sustainable Development Goals. We sought to update the most widely reported estimate of 93 million children <15 years with disabilities from the Global Burden of Disease Study 2004.

Methods: We analyzed Global Burden of Disease Study 2017 data on the prevalence of childhood epilepsy, intellectual disability, and vision or hearing loss and on years lived with disability (YLD) derived from systematic reviews, health surveys, hospital and claims databases, cohort studies, and disease-specific registries. Point estimates of the prevalence and YLD and the 95% uncertainty intervals (UIs) around the estimates were assessed.

Results: Globally, 291.2 million (11.2%) of the 2.6 billion children and adolescents (95% UI: 249.9-335.4 million) were estimated to have 1 of the 4 specified disabilities in 2017. The prevalence of these disabilities increased with age from 6.1% among children aged <1 year to 13.9% among adolescents aged 15 to 19 years. A total of 275.2 million (94.5%) lived in low- and middle-income countries, predominantly in South Asia and sub-Saharan Africa. The top 10 countries accounted for 62.3% of all children and adolescents with disabilities. These disabilities accounted for 28.9 million YLD or 19.9% of the overall 145.3 million (95% UI: 106.9-189.7) YLD from all causes among children and adolescents.

Conclusions: The number of children and adolescents with these 4 disabilities is far higher than the 2004 estimate, increases from infancy to adolescence, and accounts for a substantial proportion of all-cause YLD.
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http://dx.doi.org/10.1542/peds.2019-2623DOI Listing
July 2020

Intimate partner violence identified through routine antenatal screening and maternal and perinatal health outcomes.

BMC Pregnancy Childbirth 2019 Oct 16;19(1):357. Epub 2019 Oct 16.

Translational Health Research Institute, School of Medicine, Campbelltown Campus, Western Sydney University, Penrith, NSW, Australia.

Background: This study investigated the association between intimate partner violence (IPV) identified on routine prenatal screening and perinatal outcomes for mother and infant.

Methods: Routinely collected perinatal data for a cohort of all women and their infants born in public health facilities in Sydney (Australia) over the period 2014-2016 (N = 52,509) were analysed to investigate the risk of adverse maternal and perinatal outcomes associated with a history of IPV. The association between an affirmative response on prenatal IPV screening and low birth weight (LBW) < 2.5 kg, preterm birth < 37 weeks, breastfeeding indicators and postnatal depressive symptoms (PND) was investigated in a series of logistic regression models.

Results: IPV was associated with an increased risk of PND (OR = 2.53, 95% CI 1.76-3.63), not breastfeeding at birth (OR = 1.65, 95% CI 1.30-2.09), non-exclusive breastfeeding at discharge (OR = 1.66, 95% CI 1.33-2.07) and first post-natal visit (OR = 1.54, 95% CI 1.24-1.91). Self-reported fear of a partner was strongly associated with an increased risk of PND (OR = 3.53, 95% CI 2.50-5.00), and also LBW (OR = 1.58, 95% CI 1.12-2.22), preterm birth (OR = 1.38, 95% CI 1.08-1.76), lack of early initiation of breastfeeding (OR = 1.67, 95% CI 1.28-2.17), non-exclusive breastfeeding at discharge from hospital (OR = 1.60, 95% CI 1.24-2.06) and at the first post-natal visit (OR = 1.27, 95% CI 0.99-3.04).

Conclusions: IPV reported at the time of pregnancy was associated with adverse infant and maternal health outcomes. Although women may be disinclined to report IPV during pregnancy, universal, routine antenatal assessment for IPV is essential for early identification and appropriate management to improve maternal and newborn health.
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http://dx.doi.org/10.1186/s12884-019-2527-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6796368PMC
October 2019

Factors associated with inadequate receipt of components and use of antenatal care services in Nigeria: a population-based study.

Int Health 2018 05;10(3):172-181

Sydney School of Public Health, Edward Ford Building (A27), University of Sydney, Sydney NSW 2006, Australia.

Background: Antenatal care (ANC) is an essential intervention to improve maternal and child health. In Nigeria, no population-based studies have investigated predictors of poor receipt of components and uptake of ANC at the national level to inform targeted maternal health initiatives. This study aimed to examine factors associated with inadequate receipt of components and use of ANC in Nigeria.

Methods: The study used information on 20 405 singleton live-born infants of the mothers from the 2013 Nigeria Demographic and Health Survey. Multivariable logistic regression analyses that adjusted for cluster and survey weights were used to determine potential factors associated with inadequate receipt of components and use of ANC.

Results: The prevalence of underutilization and inadequate components of ANC were 47.5% (95% CI: 45.2 to 49.9) and 92.6% (95% CI: 91.8 to 93.2), respectively. Common risk factors for underutilization and inadequate components of ANC in Nigeria included residence in rural areas, no maternal education, maternal unemployment, long distance to health facilities and less maternal exposure to the media. Other risk factors for underutilization of ANC were home births and low household wealth.

Conclusion: The study suggests that underutilization and inadequate receipt of the components of ANC were associated with amenable factors in Nigeria. Subsidized maternal services and well-guided health educational messages or financial support from the government will help to improve uptake of ANC services.
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http://dx.doi.org/10.1093/inthealth/ihy011DOI Listing
May 2018

Predictors of stillbirths in Bangladesh: evidence from the 2004-2014 nation-wide household surveys.

Glob Health Action 2017 ;10(1):1410048

d Sydney School of Public Health, Edward Ford Building (A27) , University of Sydney , Sydney , Australia.

Background: Globally, stillbirth remains a significant public health issue, particularly in developing countries such as Bangladesh.

Objective: This study aimed to investigate the potential predictors of stillbirths in Bangladesh over a ten-year period.

Methods: The Bangladesh Demographic and Health Surveys data for the years 2004, 2007, 2011 and 2014 (n = 29,094) were used for the study to investigate the predictors of stillbirths. Stillbirth was examined against a set of community, socio-economic and child characteristics, using a multivariable logistic regression model that adjusted for cluster and sampling variability.

Results: The pooled rate of stillbirth in Bangladesh was 28 in 1000 births (95% CI: 22, 34). Stillbirth rates were higher in rural compared to urban areas in Bangladesh. Mothers who had a secondary or higher level of education (OR = 0.59, 95%CI: 0.43-0.82, P = 0.002) and those with primary education (OR = 0.66, 95%CI: 0.55-0.80, P < 0.001) were less likely to experience stillbirths compared to mothers with no education. Mothers with more than two children were significantly less likely to have stillbirths compared to mothers with one child. Those from poor households reported increased odds of stillbirth compared to those from rich households.

Conclusion: Our analysis indicated that no maternal education, primiparity and poor household were predictors of stillbirths in Bangladesh. A collaborative effort is needed to reduce stillbirth rates among these high-risk groups in Bangladesh, with the socio-economic and health-related Sustainable Development Goals providing a critical vehicle for the co-ordination of this work.
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http://dx.doi.org/10.1080/16549716.2017.1410048DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5757223PMC
September 2018

Incidence, prevalence, mortality, disability-adjusted life years and risk factors of cancer in Australia and comparison with OECD countries, 1990-2015: findings from the Global Burden of Disease Study 2015.

Cancer Epidemiol 2018 02 5;52:43-54. Epub 2017 Dec 5.

Division of Hematology, Department of Medicine, University of Washington, Seattle, USA; Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA.

Background: Comparative evidence on the burden, trend, and risk factors of cancer is limited. Using data from the Global Burden of Disease (GBD) study, we aimed to assess cancer burden - incidence, prevalence, mortality, disability-adjusted life years (DALYs) - and attributable risk factors for Australia between 1990 and 2015, and to compare them with those of 34 members of the Organisation for Economic Co-operation and Development (OECD).

Methods: The general GBD cancer estimation methods were used with data input from vital registration systems and cancer registries. A comparative risk assessment approach was used to estimate the population-attributable fractions due to risk factors.

Results: In 2015 there were 198,880 (95% uncertainty interval [UI]: 183,908-217,365) estimated incident cancer cases and 47,562 (95% UI: 46,061-49,004) cancer deaths in Australia. Twenty-nine percent (95% UI: 28.2-29.8) of total deaths and 17.0% (95% UI: 15.0-19.1) of DALYs were caused by cancer in Australia in 2015. Cancers of the trachea, bronchus and lung, colon and rectum, and prostate were the most common causes of cancer deaths. Thirty-six percent (95% UI: 33.1-37.9) of all cancer deaths were attributable to behavioral risks. The age-standardized cancer incidence rate (ASIR) increased between 1990 and 2015, while the age-standardized cancer death rate (ASDR) decreased over the same period. In 2015, compared to 34 other OECD countries Australia ranked first (highest) and 24 based on ASIR and ASDR, respectively.

Conclusion: The incidence of cancer has increased over 25 years, and behavioral risks are responsible for a large proportion of cancer deaths. Scaling up of prevention (using strategies targeting cancer risk factors), early detection, and treatment of cancer is required to effectively address this growing health challenge.
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http://dx.doi.org/10.1016/j.canep.2017.11.007DOI Listing
February 2018

The impact of sociodemographic and health-service factors on breast-feeding in sub-Saharan African countries with high diarrhoea mortality.

Public Health Nutr 2017 Dec 5;20(17):3109-3119. Epub 2017 Oct 5.

11School of Science and Health,Western Sydney University,Campbelltown Campus,New South Wales,Australia.

Objective: The current study aimed to examine the impact of sociodemographic and health-service factors on breast-feeding in sub-Saharan African (SSA) countries with high diarrhoea mortality.

Design: The study used the most recent and pooled Demographic and Health Survey data sets collected in nine SSA countries with high diarrhoea mortality. Multivariate logistic regression models that adjusted for cluster and sampling weights were used to investigate the association between sociodemographic and health-service factors and breast-feeding in SSA countries.

Setting: Sub-Saharan Africa with high diarrhoea mortality.

Subjects: Children (n 50 975) under 24 months old (Burkina Faso (2010, N 5710); Demographic Republic of Congo (2013, N 6797); Ethiopia (2013, N 4193); Kenya (2014, N 7024); Mali (2013, N 3802); Niger (2013, N 4930); Nigeria (2013, N 11 712); Tanzania (2015, N 3894); and Uganda (2010, N 2913)).

Results: Overall prevalence of exclusive breast-feeding (EBF) and early initiation of breast-feeding (EIBF) was 35 and 44 %, respectively. Uganda, Ethiopia and Tanzania had higher EBF prevalence compared with Nigeria and Niger. Prevalence of EIBF was highest in Mali and lowest in Kenya. Higher educational attainment and frequent health-service visits of mothers (i.e. antenatal care, postnatal care and delivery at a health facility) were associated with EBF and EIBF.

Conclusions: Breast-feeding practices in SSA countries with high diarrhoea mortality varied across geographical regions. To improve breast-feeding behaviours among mothers in SSA countries with high diarrhoea mortality, breast-feeding initiatives and policies should be context-specific, measurable and culturally appropriate, and should focus on all women, particularly mothers from low socio-economic groups with limited health-service access.
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http://dx.doi.org/10.1017/S1368980017002567DOI Listing
December 2017

Health Effects of Overweight and Obesity in 195 Countries over 25 Years.

Authors:
Ashkan Afshin Mohammad H Forouzanfar Marissa B Reitsma Patrick Sur Kara Estep Alex Lee Laurie Marczak Ali H Mokdad Maziar Moradi-Lakeh Mohsen Naghavi Joseph S Salama Theo Vos Kalkidan H Abate Cristiana Abbafati Muktar B Ahmed Ziyad Al-Aly Ala’a Alkerwi Rajaa Al-Raddadi Azmeraw T Amare Alemayehu Amberbir Adeladza K Amegah Erfan Amini Stephen M Amrock Ranjit M Anjana Johan Ärnlöv Hamid Asayesh Amitava Banerjee Aleksandra Barac Estifanos Baye Derrick A Bennett Addisu S Beyene Sibhatu Biadgilign Stan Biryukov Espen Bjertness Dube J Boneya Ismael Campos-Nonato Juan J Carrero Pedro Cecilio Kelly Cercy Liliana G Ciobanu Leslie Cornaby Solomon A Damtew Lalit Dandona Rakhi Dandona Samath D Dharmaratne Bruce B Duncan Babak Eshrati Alireza Esteghamati Valery L Feigin João C Fernandes Thomas Fürst Tsegaye T Gebrehiwot Audra Gold Philimon N Gona Atsushi Goto Tesfa D Habtewold Kokeb T Hadush Nima Hafezi-Nejad Simon I Hay Masako Horino Farhad Islami Ritul Kamal Amir Kasaeian Srinivasa V Katikireddi Andre P Kengne Chandrasekharan N Kesavachandran Yousef S Khader Young-Ho Khang Jagdish Khubchandani Daniel Kim Yun J Kim Yohannes Kinfu Soewarta Kosen Tiffany Ku Barthelemy Kuate Defo G Anil Kumar Heidi J Larson Mall Leinsalu Xiaofeng Liang Stephen S Lim Patrick Liu Alan D Lopez Rafael Lozano Azeem Majeed Reza Malekzadeh Deborah C Malta Mohsen Mazidi Colm McAlinden Stephen T McGarvey Desalegn T Mengistu George A Mensah Gert B M Mensink Haftay B Mezgebe Erkin M Mirrakhimov Ulrich O Mueller Jean J Noubiap Carla M Obermeyer Felix A Ogbo Mayowa O Owolabi George C Patton Farshad Pourmalek Mostafa Qorbani Anwar Rafay Rajesh K Rai Chhabi L Ranabhat Nikolas Reinig Saeid Safiri Joshua A Salomon Juan R Sanabria Itamar S Santos Benn Sartorius Monika Sawhney Josef Schmidhuber Aletta E Schutte Maria I Schmidt Sadaf G Sepanlou Moretza Shamsizadeh Sara Sheikhbahaei Min-Jeong Shin Rahman Shiri Ivy Shiue Hirbo S Roba Diego A S Silva Jonathan I Silverberg Jasvinder A Singh Saverio Stranges Soumya Swaminathan Rafael Tabarés-Seisdedos Fentaw Tadese Bemnet A Tedla Balewgizie S Tegegne Abdullah S Terkawi J S Thakur Marcello Tonelli Roman Topor-Madry Stefanos Tyrovolas Kingsley N Ukwaja Olalekan A Uthman Masoud Vaezghasemi Tommi Vasankari Vasiliy V Vlassov Stein E Vollset Elisabete Weiderpass Andrea Werdecker Joshua Wesana Ronny Westerman Yuichiro Yano Naohiro Yonemoto Gerald Yonga Zoubida Zaidi Zerihun M Zenebe Ben Zipkin Christopher J L Murray

N Engl J Med 2017 07 12;377(1):13-27. Epub 2017 Jun 12.

Background: Although the rising pandemic of obesity has received major attention in many countries, the effects of this attention on trends and the disease burden of obesity remain uncertain.

Methods: We analyzed data from 68.5 million persons to assess the trends in the prevalence of overweight and obesity among children and adults between 1980 and 2015. Using the Global Burden of Disease study data and methods, we also quantified the burden of disease related to high body-mass index (BMI), according to age, sex, cause, and BMI in 195 countries between 1990 and 2015.

Results: In 2015, a total of 107.7 million children and 603.7 million adults were obese. Since 1980, the prevalence of obesity has doubled in more than 70 countries and has continuously increased in most other countries. Although the prevalence of obesity among children has been lower than that among adults, the rate of increase in childhood obesity in many countries has been greater than the rate of increase in adult obesity. High BMI accounted for 4.0 million deaths globally, nearly 40% of which occurred in persons who were not obese. More than two thirds of deaths related to high BMI were due to cardiovascular disease. The disease burden related to high BMI has increased since 1990; however, the rate of this increase has been attenuated owing to decreases in underlying rates of death from cardiovascular disease.

Conclusions: The rapid increase in the prevalence and disease burden of elevated BMI highlights the need for continued focus on surveillance of BMI and identification, implementation, and evaluation of evidence-based interventions to address this problem. (Funded by the Bill and Melinda Gates Foundation.).
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http://dx.doi.org/10.1056/NEJMoa1614362DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5477817PMC
July 2017

Prevalence and determinants of cessation of exclusive breastfeeding in the early postnatal period in Sydney, Australia.

Int Breastfeed J 2016 8;12:16. Epub 2017 Apr 8.

Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.

Background: Optimal breastfeeding has benefits for the mother-infant dyads. This study investigated the prevalence and determinants of cessation of exclusive breastfeeding (EBF) in the early postnatal period in a culturally and linguistically diverse population in Sydney, New South Wales, Australia.

Methods: The study used routinely collected perinatal data on all live births in 2014 ( = 17,564) in public health facilities in two Local Health Districts in Sydney, Australia. The prevalence of mother's breastfeeding intention, skin-to-skin contact, EBF at birth, discharge and early postnatal period (1-4 weeks postnatal) were estimated. Multivariate logistic regression models that adjusted for confounders were conducted to determine association between cessation of EBF in the early postnatal period and socio-demographic, psychosocial and health service factors.

Results: Most mothers intended to breastfeed (92%), practiced skin-to-skin contact (81%), exclusively breastfed  at delivery (90%) and discharge (89%). However, the prevalence of EBF declined (by 27%) at the early postnatal period (62%). Younger mothers (<20 years) and mothers who smoked cigarettes in pregnancy were more likely to cease EBF in the early postnatal period compared to older mothers (20-39 years) and those who reported not smoking cigarettes, respectively [Adjusted Odds Ratio (AOR) =2.7, 95%CI 1.9-3.8, <0.001 and AOR = 2.5, 95%CI 2.1-3.0, <0.001, respectively]. Intimate partner violence, assisted delivery, low socio-economic status, pre-existing maternal health problems and a lack of partner support were also associated with early cessation of EBF in the postnatal period.

Conclusions: Our findings suggest that while most mothers intend to breastfeed, and commence EBF at delivery and at discharge, the maintenance of EBF in the early postnatal period is sub-optimal. This highlights the need for efforts to promote breastfeeding in the wider community along with targeted actions for disadvantaged groups and those identified to be at risk of early cessation of EBF to maximise impact.
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http://dx.doi.org/10.1186/s13006-017-0110-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385049PMC
April 2017

Assessment of provider-initiated HIV screening in Nigeria with sub-Saharan African comparison.

BMC Health Serv Res 2017 03 9;17(1):188. Epub 2017 Mar 9.

Centre for Health Research, School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2571, Australia.

Background: Despite Nigeria's high HIV prevalence, voluntary testing and counselling rates remain low. UNAIDS/WHO/CDC recommends provider-initiated testing and counselling (PITC) for HIV in settings with high HIV prevalence. We aimed to assess the acceptability and logistical feasibility of the PITC strategy among adolescents and adults in a secondary health care centre in Idekpa Benue state, Nigeria.

Method: All patients (aged ≥ 13 years) who visited the out-patient department and antenatal care unit of General Hospital Idekpa, Benue state, Nigeria were offered PITC for HIV. The intervention was implemented by trained health professionals for the period spanning (June to December 2010).

Results: Among the 212 patients who were offered PITC for HIV, 199 (94%) accepted HIV testing, 10 patients (4.7%) opted out and 3 patients (1.4%) were undecided. Of the 199 participants who were tested for HIV, 9% were HIV seropositive. The PITC strategy was highly acceptable and feasible, and increased the number of patients who tested for HIV by 5% compared to voluntary counselling and testing. Findings from this assessment were consistent with those from other sub-Saharan African countries (such as Uganda and South Africa).

Conclusion: PITC for HIV was highly acceptable and logistically feasible, and resulted in an increased rate of HIV testing among patients. Public health initiatives (such as the PITC strategy) that facilitate early detection of HIV and referral for early treatment should be encouraged for broader HIV control and prevention in Nigerian communities.
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http://dx.doi.org/10.1186/s12913-017-2132-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5345139PMC
March 2017

Have policy responses in Nigeria resulted in improvements in infant and young child feeding practices in Nigeria?

Int Breastfeed J 2016 8;12. Epub 2017 Feb 8.

School of Science and Health, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571 Australia.

Background: Nigeria initiated a range of programs and policies (from 1992 to 2005) to improve infant and young child feeding (IYCF) practices. However, the prevalence of children fed in accordance with IYCF recommendations in Nigeria remains low. This paper presents time trends in IYCF practices in Nigeria for the period (1999-2013), and considers trends in the context of key national policy responses and initiatives.

Methods: Prevalence and percentage change (including 95% confidence intervals) of IYCF indicators were investigated over the period 1999-2013 based on a total of 88,152 maternal responses from the Nigeria Demographic and Health Surveys, ( = 8,199 in 1999;  = 7,620 in 2003;  = 33,385 in 2008 and  = 38,948 in 2013).

Results: Early or timely initiation of breastfeeding decreased significantly by 4.3% (95% Confidence Interval [CI]: -8.1, -0.5;  = 0.0280 for the period (1999-2013); while exclusive breastfeeding remained unchanged 1.6% (95% CI: -2.7, 5.9;  = 0.478). From 2003 to 2013, minimum meal frequency increased significantly by 13.8% (95% CI: 9.9, 17.8;  < 0.001), but minimum dietary diversity and minimum acceptable decreased significantly by 9.7% (95% CI: -9.2, -6.3;  < 0.001) and 3.5% (95% CI: -5.7, -1.3;  = 0.002), respectively. Predominant breastfeeding increased significantly by 13.1% ( < 0.001), and children ever breastfed declined by 16.4% ( < 0.001) over time.

Conclusion: Despite considerable improvements in national legislation, health system responses and community level development, IYCF practices in Nigeria are still below expected levels. Strengthening community and facility based participation, and broader stand-alone/integrated IYCF policy implementations are needed to improve the current feeding practices of Nigerian mothers.
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http://dx.doi.org/10.1186/s13006-017-0101-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5299643PMC
February 2017

Infant feeding practices and diarrhoea in sub-Saharan African countries with high diarrhoea mortality.

PLoS One 2017 13;12(2):e0171792. Epub 2017 Feb 13.

Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia.

Background: The impacts of optimal infant feeding practices on diarrhoea have been documented in some developing countries, but not in countries with high diarrhoea mortality as reported by the World Health Organisation/United Nations Children's Fund. We aimed to investigate the association between infant feeding practices and diarrhoea in sub-Saharan African countries with high diarrhoea mortality.

Method: The study used the most recent Demographic and Health Survey datasets collected in nine sub-Saharan African countries with high diarrhoea mortality, namely: Burkina Faso (2010, N = 9,733); Demographic Republic of Congo (2013; N = 10,458); Ethiopia (2013, N = 7,251); Kenya (2014, N = 14,034); Mali (2013, N = 6,365); Niger (2013, N = 7,235); Nigeria (2013, N = 18,539); Tanzania (2010, N = 5,013); and Uganda (2010, N = 4,472). Multilevel logistic regression models that adjusted for cluster and sampling weights were used to investigate the association between infant feeding practices and diarrhoea in these nine African countries.

Results: Diarrhoea prevalence was lower among children whose mothers practiced early initiation of breastfeeding, exclusive and predominant breastfeeding. Early initiation of breastfeeding and exclusive breastfeeding were significantly associated with lower risk of diarrhoea (OR = 0.81; 95% confidence interval (CI): 0.77-0.85, P<0.001 and OR = 0.50; 95%CI: 0.43-0.57, respectively). In contrast, introduction of complementary foods (OR = 1.31; 95%CI: 1.14-1.50) and continued breastfeeding at one year (OR = 1.27; 95%CI: 1.05-1.55) were significantly associated with a higher risk of diarrhoea.

Conclusion: Early initiation of breastfeeding and exclusive breastfeeding are protective of diarrhoea in sub-Saharan African countries with high diarrhoea mortality. To reduce diarrhoea mortality and also achieve the health-related sustainable development goals in sub-Saharan African, an integrated, multi-agency strategic partnership within each country is needed to improve optimal infant feeding practices.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0171792PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5305225PMC
August 2017

The Impact of Antenatal Depression on Perinatal Outcomes in Australian Women.

PLoS One 2017 17;12(1):e0169907. Epub 2017 Jan 17.

Ingham Institute for Applied Medical Research, Liverpool NSW Australia.

Background: In Australia, there is limited evidence on the impact of antenatal depression on perinatal outcomes. This study investigates the association between maternal depressive symptoms during pregnancy and key perinatal outcomes, including birth weight, gestational age at birth, breastfeeding indicators and postnatal depressive symptoms.

Method: A retrospective cohort of mothers (N = 17,564) of all infants born in public health facilities within South Western Sydney Local Health District and Sydney Local Health District in 2014, in the state of New South Wales (NSW), Australia, was enumerated from routinely collected antenatal data to investigate the risk of adverse perinatal outcomes associated with maternal depressive symptoms during pregnancy. Antenatal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS). Logistic regression models that adjusted for confounders were conducted to determine associations between antenatal depressive symptoms and low birth weight, early gestational age at birth (<37 weeks), breast feeding indicators and postnatal depressive symptoms.

Results: The prevalence of maternal depressive symptoms during pregnancy was 7.0% in the cohort, and was significantly associated with postnatal depressive symptoms [Adjusted Odd Ratios (AOR) = 6.4, 95% CI: 4.8-8.7, P<0.001]. Antenatal depressive symptoms was associated with a higher odds of low birth weight [AOR = 1.7, 95% CI: 1.2-2.3, P = 0.003] and a gestational age at birth of <37 weeks [AOR = 1.3, 95% CI: 1.1-1.7, P = 0.018] compared to women who reported lower EPDS scores in antenatal period. Antenatal depressive symptoms were not strongly associated with non-exclusive breast feeding in the early postnatal period.

Conclusion: Maternal depressive symptoms in the antenatal period are strongly associated with postnatal depressive symptoms and adverse perinatal outcomes in Australian infants. Early identification of antenatal and postnatal depressive symptoms, and referral for appropriate management could benefit not only the mother's mental health, but also the infant's health and development.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0169907PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241141PMC
August 2017

Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study.

Authors:
Christina Fitzmaurice Christine Allen Ryan M Barber Lars Barregard Zulfiqar A Bhutta Hermann Brenner Daniel J Dicker Odgerel Chimed-Orchir Rakhi Dandona Lalit Dandona Tom Fleming Mohammad H Forouzanfar Jamie Hancock Roderick J Hay Rachel Hunter-Merrill Chantal Huynh H Dean Hosgood Catherine O Johnson Jost B Jonas Jagdish Khubchandani G Anil Kumar Michael Kutz Qing Lan Heidi J Larson Xiaofeng Liang Stephen S Lim Alan D Lopez Michael F MacIntyre Laurie Marczak Neal Marquez Ali H Mokdad Christine Pinho Farshad Pourmalek Joshua A Salomon Juan Ramon Sanabria Logan Sandar Benn Sartorius Stephen M Schwartz Katya A Shackelford Kenji Shibuya Jeff Stanaway Caitlyn Steiner Jiandong Sun Ken Takahashi Stein Emil Vollset Theo Vos Joseph A Wagner Haidong Wang Ronny Westerman Hajo Zeeb Leo Zoeckler Foad Abd-Allah Muktar Beshir Ahmed Samer Alabed Noore K Alam Saleh Fahed Aldhahri Girma Alem Mulubirhan Assefa Alemayohu Raghib Ali Rajaa Al-Raddadi Azmeraw Amare Yaw Amoako Al Artaman Hamid Asayesh Niguse Atnafu Ashish Awasthi Huda Ba Saleem Aleksandra Barac Neeraj Bedi Isabela Bensenor Adugnaw Berhane Eduardo Bernabé Balem Betsu Agnes Binagwaho Dube Boneya Ismael Campos-Nonato Carlos Castañeda-Orjuela Ferrán Catalá-López Peggy Chiang Chioma Chibueze Abdulaal Chitheer Jee-Young Choi Benjamin Cowie Solomon Damtew José das Neves Suhojit Dey Samath Dharmaratne Preet Dhillon Eric Ding Tim Driscoll Donatus Ekwueme Aman Yesuf Endries Maryam Farvid Farshad Farzadfar Joao Fernandes Florian Fischer Tsegaye Tewelde G/Hiwot Alemseged Gebru Sameer Gopalani Alemayehu Hailu Masako Horino Nobuyuki Horita Abdullatif Husseini Inge Huybrechts Manami Inoue Farhad Islami Mihajlo Jakovljevic Spencer James Mehdi Javanbakht Sun Ha Jee Amir Kasaeian Muktar Sano Kedir Yousef S Khader Young-Ho Khang Daniel Kim James Leigh Shai Linn Raimundas Lunevicius Hassan Magdy Abd El Razek Reza Malekzadeh Deborah Carvalho Malta Wagner Marcenes Desalegn Markos Yohannes A Melaku Kidanu G Meles Walter Mendoza Desalegn Tadese Mengiste Tuomo J Meretoja Ted R Miller Karzan Abdulmuhsin Mohammad Alireza Mohammadi Shafiu Mohammed Maziar Moradi-Lakeh Gabriele Nagel Devina Nand Quyen Le Nguyen Sandra Nolte Felix A Ogbo Kelechi E Oladimeji Eyal Oren Mahesh Pa Eun-Kee Park David M Pereira Dietrich Plass Mostafa Qorbani Amir Radfar Anwar Rafay Mahfuzar Rahman Saleem M Rana Kjetil Søreide Maheswar Satpathy Monika Sawhney Sadaf G Sepanlou Masood Ali Shaikh Jun She Ivy Shiue Hirbo Roba Shore Mark G Shrime Samuel So Samir Soneji Vasiliki Stathopoulou Konstantinos Stroumpoulis Muawiyyah Babale Sufiyan Bryan L Sykes Rafael Tabarés-Seisdedos Fentaw Tadese Bemnet Amare Tedla Gizachew Assefa Tessema J S Thakur Bach Xuan Tran Kingsley Nnanna Ukwaja Benjamin S Chudi Uzochukwu Vasiliy Victorovich Vlassov Elisabete Weiderpass Mamo Wubshet Terefe Henock Gebremedhin Yebyo Hassen Hamid Yimam Naohiro Yonemoto Mustafa Z Younis Chuanhua Yu Zoubida Zaidi Maysaa El Sayed Zaki Zerihun Menlkalew Zenebe Christopher J L Murray Mohsen Naghavi

JAMA Oncol 2017 Apr;3(4):524-548

Institute for Health Metrics and Evaluation, University of Washington, Seattle.

Importance: Cancer is the second leading cause of death worldwide. Current estimates on the burden of cancer are needed for cancer control planning.

Objective: To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 32 cancers in 195 countries and territories from 1990 to 2015.

Evidence Review: Cancer mortality was estimated using vital registration system data, cancer registry incidence data (transformed to mortality estimates using separately estimated mortality to incidence [MI] ratios), and verbal autopsy data. Cancer incidence was calculated by dividing mortality estimates through the modeled MI ratios. To calculate cancer prevalence, MI ratios were used to model survival. To calculate YLDs, prevalence estimates were multiplied by disability weights. The YLLs were estimated by multiplying age-specific cancer deaths by the reference life expectancy. DALYs were estimated as the sum of YLDs and YLLs. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility. Countries were categorized by SDI quintiles to summarize results.

Findings: In 2015, there were 17.5 million cancer cases worldwide and 8.7 million deaths. Between 2005 and 2015, cancer cases increased by 33%, with population aging contributing 16%, population growth 13%, and changes in age-specific rates contributing 4%. For men, the most common cancer globally was prostate cancer (1.6 million cases). Tracheal, bronchus, and lung cancer was the leading cause of cancer deaths and DALYs in men (1.2 million deaths and 25.9 million DALYs). For women, the most common cancer was breast cancer (2.4 million cases). Breast cancer was also the leading cause of cancer deaths and DALYs for women (523 000 deaths and 15.1 million DALYs). Overall, cancer caused 208.3 million DALYs worldwide in 2015 for both sexes combined. Between 2005 and 2015, age-standardized incidence rates for all cancers combined increased in 174 of 195 countries or territories. Age-standardized death rates (ASDRs) for all cancers combined decreased within that timeframe in 140 of 195 countries or territories. Countries with an increase in the ASDR due to all cancers were largely located on the African continent. Of all cancers, deaths between 2005 and 2015 decreased significantly for Hodgkin lymphoma (-6.1% [95% uncertainty interval (UI), -10.6% to -1.3%]). The number of deaths also decreased for esophageal cancer, stomach cancer, and chronic myeloid leukemia, although these results were not statistically significant.

Conclusion And Relevance: As part of the epidemiological transition, cancer incidence is expected to increase in the future, further straining limited health care resources. Appropriate allocation of resources for cancer prevention, early diagnosis, and curative and palliative care requires detailed knowledge of the local burden of cancer. The GBD 2015 study results demonstrate that progress is possible in the war against cancer. However, the major findings also highlight an unmet need for cancer prevention efforts, including tobacco control, vaccination, and the promotion of physical activity and a healthy diet.
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http://dx.doi.org/10.1001/jamaoncol.2016.5688DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6103527PMC
April 2017

Trends and Predictors of Prelacteal Feeding Practices in Nigeria (2003-2013).

Nutrients 2016 Jul 29;8(8). Epub 2016 Jul 29.

Centre for Health Research, School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith 2571, NSW, Australia.

Prelacteal feeding practices are associated with an increased risk of diarrhoea and many early-life diseases. This paper examined trends and predictors of prelacteal feeding practices in Nigeria. A sample of 6416 infants aged 0-6 months from the Nigeria Demographic and Health Survey data for the period (2003-2013) was used. Trends and multilevel logistic regression analyses were used to determine the predictors. The trends of prelacteal feeding rates fluctuated between 55% and 66% over the study period and were significantly lower among mothers with secondary or higher levels of education (13.1%, 95% confidence interval (CI): 0.54-25.9, p-value = 0.041), delivered at the health facility (13.7%, CI: 1.39-25.9, p-value = 0.029), from more affluent households (18.7%, CI: 1.53-35.9, p-value = 0.033), and lived in urban areas (26.9%, CI: 18.3-35.5, p-value < 0.001). Multivariable analyses revealed that mothers with no schooling, younger mothers (aged 15-24 years), mothers who delivered at home, and delivered by caesarean section were more likely to introduce prelacteal feeds. Many mothers still engage in prelacteal feeding practices in Nigeria, with prelacteal feeding more prevalent in young mothers, mothers with no schooling, and mothers who delivered at home. Interventions involving community health volunteers are needed to improve feeding practices in Nigeria.
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http://dx.doi.org/10.3390/nu8080462DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4997375PMC
July 2016

Diarrhoea and Suboptimal Feeding Practices in Nigeria: Evidence from the National Household Surveys.

Paediatr Perinat Epidemiol 2016 Jul 24;30(4):346-55. Epub 2016 Mar 24.

School of Science and Health, Western Sydney University, Penrith, NSW, Australia.

Background: Globally, Nigeria has the largest burden of infectious diseases (including diarrhoea). Optimal feeding practices have been well-documented to protect against diarrhoea in other contexts; but this benefit has not been broadly studied in Nigeria. The study aimed to examine the association between diarrhoea and childhood feeding practices to provide country-specific evidence.

Method: Data from the Nigeria Demographic and Health Survey for the period spanning 1999-2013 were used. Prevalence of diarrhoea by infant and young child feeding indicators was estimated, and the association between diarrhoea and childhood feeding indicators was examined using multilevel regression analyses.

Results: Prevalence of diarrhoea was higher among children whose mothers did not initiate breast feeding within the first hour of birth, infants who were not exclusively breastfed, and infants who were prematurely introduced to complementary foods. Early initiation of breast feeding was significantly associated with lower risk of diarrhoea (RR 0.68, 95% confidence interval (CI) 0.63, 0.74). Exclusively breastfed infants were less likely to develop diarrhoea compared to non-exclusively breastfed infants (RR 0.61, 95% CI 0.44, 0.86). Predominant breast feeding was significantly associated with a lower risk of diarrhoea (RR 0.66, 95% CI 0.54, 0.80). Bottle feeding and introduction of complementary foods were associated with a higher risk of diarrhoea.

Conclusion: Early initiation of breast feeding as well as exclusive and predominant breast feeding protect against diarrhoea in Nigeria, while bottle feeding and introduction of complementary foods were risk factors for diarrhoea. Community- and facility-based initiatives are needed to improve feeding practices, and to reduce diarrhoea prevalence in Nigeria.
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http://dx.doi.org/10.1111/ppe.12293DOI Listing
July 2016

Trends in complementary feeding indicators in Nigeria, 2003-2013.

BMJ Open 2015 Oct 6;5(10):e008467. Epub 2015 Oct 6.

School of Science and Health, Western Sydney University, Penrith, New South Wales, Australia.

Objective: The study aimed to examine secular trends and determinants of changes in complementary feeding indicators in Nigeria.

Design, Setting And Participants: Data on 79 953 children aged 6-23 months were obtained from the Nigeria Demographic and Health Surveys (NDHS) for the period spanning 2003-2013. The surveys used a stratified two-stage cluster sample of eligible mothers aged 15-49 years from the six geopolitical zones of Nigeria. Trends in complementary feeding indicators and socioeconomic, health service and individual characteristics including factors associated with complementary feeding indicators were examined using multilevel logistic regression analyses.

Results: Minimum dietary diversity for children aged 6-23 months worsened from 26% in 2003 to 16% in 2013. Minimum meal frequency improved from 43% in 2003 to 56% in 2013 and minimum acceptable diet worsened from 11% to 9%. Among educated mothers, there was a decreasing prevalence of the introduction of solid, semisolid and soft foods in infants aged 6-8 months (67% in 2003 to 57% in 2013); minimum dietary diversity (33% in 2003 to 24% in 2013) and minimum acceptable diet (13% in 2003 to 8% in 2013). Mothers with a higher education level and mothers who reported more health service contacts were more likely to meet the minimum dietary diversity. Similarly, the odds for minimum acceptable diet were higher among mothers from higher socioeconomic status groups and mothers who reported frequent health services use.

Conclusions: Complementary feeding practices in Nigeria declined over the study period and are below the expected levels required to ensure adequate growth and development of Nigerian children. National policies and programmes that ensure sustainability of projects post-MDGs and higher health service coverage for mothers, including community-based education initiatives, are proposed to improve complementary feeding practices among Nigerian mothers.
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http://dx.doi.org/10.1136/bmjopen-2015-008467DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606380PMC
October 2015

Determinants of suboptimal breastfeeding practices in Nigeria: evidence from the 2008 demographic and health survey.

BMC Public Health 2015 Mar 18;15:259. Epub 2015 Mar 18.

Background: In Nigeria, suboptimal breastfeeding practices are contributing to the burden of childhood diseases and mortality. This study identified the determinants of key suboptimal breastfeeding practices among children 0-23 months in Nigeria.

Method: Data on 10,225 children under-24 months were obtained from the 2008 Nigeria Demographic and Health Survey (NDHS). Socio-economic, health service and individual factors associated with key breastfeeding indicators (early initiation of breastfeeding, exclusive breastfeeding, predominant breastfeeding and bottle feeding) were investigated using multiple logistic regression analyses.

Results: Among infants 0-5 months of age, 14% [95% confidence Interval (CI): 13%, 15%] were exclusively breastfed and 48% [95% CI: 46, 50%] were predominantly breastfed. Among children aged 0-23 months, 38% [95% CI 36, 39%] were breastfed within the first hour of birth, and 15% [95% CI: 14, 17%] were bottle-fed. Early initiation of breastfeeding was associated with higher maternal education, frequent antenatal care (ANC) visits and birth interval but deliveries at a health facility with caesarean section was associated with delayed initiation of breastfeeding. Educated mothers, older mothers and mothers from wealthier households exclusively breastfeed their babies. The risk for bottle feeding was higher among educated mothers and fathers, and women from wealthier households including mothers who made frequent ANC visits.

Conclusion: Socio-economic and health service factors were associated with suboptimal breastfeeding practices in Nigeria. To improve the current breastfeeding practices, breastfeeding initiatives should target all mothers - particularly low SES mothers - including, national and sub-national health policies that ensure improved access to maternal health services, and improvements to baby friendly hospital and community initiatives for mothers.
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http://dx.doi.org/10.1186/s12889-015-1595-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4367831PMC
March 2015