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Fulltext Healthy Eating Determinants: A Study among Malaysian Young Adults

Mamun AA, Hayat N, Zainol NRB

Foods, 2020 Jul 23;9(8).
PMID: 32717851 DOI: 10.3390/foods9080974

This study aimed to examine the effect of health consciousness, knowledge about healthy food, attitudes toward healthy food, subjective norms, and perceived behavioural control on the intention to consume healthy food, which subsequently affects the consumption of healthy food among Malaysian young adults. The current study also examined the moderating effect of perceived barriers on the association between intention to consume healthy food and the consumption of healthy food. This study adopted a cross-sectional design and collected quantitative data from 1651 Malaysian young adults (between the age of 18 and 40 years) by sharing a Google form link through social media. The findings reveal that health consciousness, knowledge about healthy food, attitude toward healthy food, subjective norms, and perceived behavioural control had a significant positive effect on the intention to consume healthy food. Findings also show that the intention to consume healthy food has a significant positive effect on the consumption of healthy food among Malaysian young adults. Furthermore, the findings reveal the positive and significant mediating effect of the intention to consume healthy food and the significant moderating effect of perceived barriers on the association between the intention to consume healthy food and the consumption of healthy food. The multi-group analysis revealed that the effect of perceived barriers on the consumption of healthy food and the moderating effect of perceived barriers were significantly higher among urban respondents. Health and agriculture policymakers should focus on the attributes of healthy eating practices and their health benefits to promote the mass adoption of healthy food among Malaysian young adults.
Fulltext Editorial: Effective occupational health and safety management in advancing global agri-food sustainability

Bhowmik S, Mamun AA, Nordin N

Front Public Health, 2024;12:1438907.
PMID: 39071146 DOI: 10.3389/fpubh.2024.1438907
Fulltext A comparative drug utilisation study of the treatment of diabetes in Malaysia and Australia

Hasan SS, Clavarino AM, Mamun AA, Kairuz T

Australas Med J, 2015;8(6):179-88.
PMID: 26213581 DOI: 10.4066/AMJ.2015.2330

Once a disease of developed countries, type 2 diabetes mellitus (T2DM) has become widespread worldwide. For people with T2DM, achievement of therapeutic outcomes demands the rational and quality use of medicine.
Fulltext Examining the effect of logistics service quality on customer satisfaction and re-use intention

Lin X, Mamun AA, Yang Q, Masukujjaman M

PLoS One, 2023;18(5):e0286382.
PMID: 37256860 DOI: 10.1371/journal.pone.0286382

For logistics service providers (LSPs), improving customer satisfaction and obtaining customer re-use intention are key to gaining sustainable competitive advantages and success. Logistics service quality (LSQ) is a concern for logistics service providers, retailers, and customers. The proposed model, which is based on the stimuli-organism-response theory and the logistics service quality framework, integrates operational quality, resource quality, information quality, personal contact quality, customization quality, and customer satisfaction to study logistics service re-use intentions. The data were obtained from an online survey using a structured questionnaire given to those with experience in logistics service. Using partial least squares structural equation modeling on 810 respondents who were adult Chinese customers, this study discovered that operational, resource, information, personal contact, and customization qualities positively affect the satisfaction of logistics service customers, while customer satisfaction positively affects re-use intention. Moreover, the results of the mediation analysis revealed that customer satisfaction mediated the connection between the five components of LSQ and the re-use intention of logistics services. The originality of the study lies in its comprehensive examination of the direct and indirect effects of service quality dimensions on customer satisfaction and logistics service re-use intention in the context of logistics services. This study provides valuable insights into the importance of customer satisfaction in the logistics industry and highlights the need for logistics companies to prioritize customer satisfaction and improve their overall performance and competitiveness.
Pregnancy complications, mental health-related problems and type 2 diabetes mellitus in Malaysian women

Hasan SS, Thiruchelvam K, Ahmed SI, Clavarino AM, Mamun AA, Kairuz T

Diabetes Metab Syndr, 2013;7(4):191-7.
PMID: 24290082 DOI: 10.1016/j.dsx.2013.10.023

AIMS: The aim of this study was to investigate the association between pregnancy complications, mental health-related problems, and type 2 diabetes mellitus (T2DM) in Malaysian women.
MATERIALS AND METHODS: A case-control study of women with T2DM (n=160) matched by age range to controls without T2DM (n=160). Data were collected in the Negeri Sembilan and PutraJaya regions in Malaysia, from two hospital outpatient clinics, PutraJaya Hospital and Tuanku Jaa'far Hospital Seremban, and one health clinic at Seremban. Validated, interviewer-administered questionnaires were used to obtain the data. The unadjusted and adjusted estimates were calculated using the Mantel-Haenszel method.
RESULTS: Neither depression (RR 0.74, 95% CI: 0.39-1.41) nor anxiety (RR 1.00, 95% CI: 0.53-1.88) symptoms increased the risk of T2DM significantly. However, gestational diabetes (RR 1.35, 95% CI: 1.02-1.79), and ≥3 pregnancies (RR 1.39, 95% CI: 1.08-1.79) were significant risk factors for the development of T2DM. T2DM was not a significant risk factor for either depression (RR 1.26, 95% CI: 0.91-1.74) or anxiety symptoms (RR 1.13, 95% CI: 0.59-2.19).
CONCLUSION: In this study, T2DM is not a significant risk factor for depression and anxiety; similarly, neither are depression and anxiety significant risk factors for T2DM. Although prevalence of depression and anxiety is not alarming, the findings reported here should alert clinicians to screen and treat anxiety and depression in people with diabetes and also note the importance of monitoring women with complications in pregnancy for risk of later T2DM.

Study site: two hospital outpatient clinics, PutraJaya Hospital and Tuanku Jaa'far Hospital Seremban, and one health clinic at Seremban, Negeri Sembilan, Malaysia
Psychological health and menopause-specific quality of life of Malaysian women with type 2 diabetes

Hasan SS, Thiruchelvam K, Ahmed SI, Clavarino AM, Mamun AA, Kairuz T

Asian J Psychiatr, 2016 Oct;23:56-63.
PMID: 27969080 DOI: 10.1016/j.ajp.2016.07.005

Anxiety and depression are more common among females and those experiencing diabetes and menopause. Menopausal symptoms experienced by women can vary tremendously from population to population; therefore, there is a need to investigate these symptoms and associated risk factors in different communities. This study investigated the differences in psychological health and menopause-specific quality of life (MENQOL) between women with and without diabetes type 2 (T2DM) in Malaysia. Women with T2DM (n=320) were matched by age range to controls without T2DM (n=320). Data were collected from March 2012 to January 2013. Delusions Symptoms States Inventory (DSSI) instrument was used to identify symptoms of depression and anxiety. Women with diabetes had higher depressive (11.8% versus 8.4%) and anxiety (8.4% versus 6.6%) symptoms compared to women without diabetes. In both groups, the most common menopausal symptom was aches (muscles and joints). Women without diabetes had significantly higher scores for the sexual domain compared to women with diabetes (4.20 versus 3.21, p=0.001). The odds that a postmenopausal woman with diabetes was depressed or anxious on the DSSI scale increased significantly when the MENQOL score on the physical, vasomotor, and psychosocial domains increased by one unit. Both diabetes and psychological problems have negative impact on MENQOL. Our findings support the view of screening postmenopausal women with diabetes for depressive and anxiety, to improve overall quality of life.
Fulltext Modeling the adoption of medical wearable devices among the senior adults: Using hybrid SEM-neural network approach

Xinyan Z, Mamun AA, Ali MH, Siyu L, Yang Q, Hayat N

Front Public Health, 2022;10:1016065.
PMID: 36388276 DOI: 10.3389/fpubh.2022.1016065

The world is witnessing an increasing number of senior adult residents who experience health issues. Healthcare innovation facilitates monitoring the health conditions of senior adults and reducing the burden on healthcare institutions. The study explored the effect of health improvement expectancy, effort expectancy, price value, perceived vulnerability, health consciousness, and perceived reliability on the intention and adoption of medical wearable devices (MWD) among senior adults in China. Furthermore, a cross-sectional design was adopted, while quantitative data was collected from 304 senior adults through an online survey. A hybrid approach of partial least square structural equational modeling and artificial neural network-based analysis technique was adopted. The findings demonstrated that health improvement expectancy, perceived vulnerability, price value, and perceived reliability significantly affected the intention to adopt MWDs. Moreover, the intention to adopt MWDs significantly positively affected the actual adoption of MWDs among senior adults. Although the moderating effect of the pre-existing conditions and income between the intention to use MWDs and actual adoption of MWDs was positive, it was not statistically significant. The artificial neural network analysis has proven that perceived reliability, price value, and vulnerability are the most critical factors contributing to the intention to use MWDs. The current study offered valuable insights into the factors affecting the intention and adoption of MWDs among senior adults. Following that, theoretical and practical contributions were documented to improve the ease of use and price value for the prospective users of MWDs. The correct healthcare policies could curtail the influx of senior adults into the hospital and empower these adults to track and manage their health issues at home.
Fulltext Deep Learning-Based Segmentation of 3D Volumetric Image and Microstructural Analysis

Mahmud BU, Hong GY, Mamun AA, Ping EP, Wu Q

Sensors (Basel), 2023 Feb 27;23(5).
PMID: 36904845 DOI: 10.3390/s23052640

As a fundamental but difficult topic in computer vision, 3D object segmentation has various applications in medical image analysis, autonomous vehicles, robotics, virtual reality, lithium battery image analysis, etc. In the past, 3D segmentation was performed using hand-made features and design techniques, but these techniques could not generalize to vast amounts of data or reach acceptable accuracy. Deep learning techniques have lately emerged as the preferred method for 3D segmentation jobs as a result of their extraordinary performance in 2D computer vision. Our proposed method used a CNN-based architecture called 3D UNET, which is inspired by the famous 2D UNET that has been used to segment volumetric image data. To see the internal changes of composite materials, for instance, in a lithium battery image, it is necessary to see the flow of different materials and follow the directions analyzing the inside properties. In this paper, a combination of 3D UNET and VGG19 has been used to conduct a multiclass segmentation of publicly available sandstone datasets to analyze their microstructures using image data based on four different objects in the samples of volumetric data. In our image sample, there are a total of 448 2D images, which are then aggregated as one 3D volume to examine the 3D volumetric data. The solution involves the segmentation of each object in the volume data and further analysis of each object to find its average size, area percentage, total area, etc. The open-source image processing package IMAGEJ is used for further analysis of individual particles. In this study, it was demonstrated that convolutional neural networks can be trained to recognize sandstone microstructure traits with an accuracy of 96.78% and an IOU of 91.12%. According to our knowledge, many prior works have applied 3D UNET for segmentation, but very few papers extend it further to show the details of particles in the sample. The proposed solution offers a computational insight for real-time implementation and is discovered to be superior to the current state-of-the-art methods. The result has importance for the creation of an approximately similar model for the microstructural analysis of volumetric data.
Fulltext Exploring the mass adoption potential of wearable fitness devices in Malaysia

Hayat N, Salameh AA, Mamun AA, Alam SS, Zainol NR

Digit Health, 2023;9:20552076231180728.
PMID: 37325073 DOI: 10.1177/20552076231180728

OBJECTIVE: The current study explores the formation of an intention to use wearable fitness devices (WFDs) with wearable fitness attributes and health consciousness (HCS). Moreover, the research examines the use of WFDs with the health motivation (HMT) and intention to use WFDs. The study also exposes the moderating effect of HMT between the intention to use WFDs and the use of WFDs.
METHODS: Five hundred and twenty-five adults participated in the current study, and data were collected from January 2021 to March 2021 through the online survey of Malaysian respondents. The cross-sectional data was analyzed using the second-generation statistical method of partial least square structural equation modeling.
RESULTS: HCS is insignificantly associated with the intention to use WFDs. Perceived compatibility, perceived product value, perceived usefulness, and perceived technology accuracy significantly influence the intention to use WFDs. HMT significantly impacts the adoption of WFDs; however, the intention to use WFDs negatively but significantly influences the use of WFDs. Lastly, the association between the intention to use WFDs and the adoption of WFDs is significantly moderated by HMT.
CONCLUSIONS: Our study findings illuminate the significant impact of technology-level attributes of WFDs on the intention to use WFDs. However, an insignificant impact of HCS on the intention to use WFDs was reported. Our result confirms that HMT plays a significant role in the use of WFDs. Such as the moderating role of HMT is vital to transform the intention to use WFDs into the adoption of WFDs.
Fulltext Assessment of index-based traffic noise annoyance level at major road intersections in a tourist city: A case study towards environmental sustainability

Nath H, Adhikary SK, Alsulamy S, Kafy AA, Rahaman ZA, Roy S, et al.

Heliyon, 2024 Nov 15;10(21):e40005.
PMID: 39559207 DOI: 10.1016/j.heliyon.2024.e40005

Urban noise pollution poses significant challenges to public health and environmental sustainability, particularly in rapidly developing tourist destinations. Noise pollution and associated annoyance level in five major intersections of Cox's Bazar City, Bangladesh, was assessed in this study during the peak tourist season. Noise measurements were conducted using various indices (L10, Leq, and TNI) across morning, midday, and afternoon time slots. TNI scores were compared with Mean Dissatisfaction Score (MDS) standards to assess traffic-induced noise annoyance levels. Additionally, a survey of 675 respondents was conducted to assess their perceptions of noise pollution. Statistical analyses included linear regression for noise indices, multinomial logistic regression for TNI-related dissatisfaction, and ordinal logistic regression for respondents' perceived annoyances. Results revealed significant noise pollution issues, with Leq scores consistently exceeding national guidelines across all intersections and time periods, particularly on weekends during afternoon timeslots. TNI values frequently surpassed standard dissatisfaction regulations, with 19 out of 105 time slots exhibiting extreme dissatisfaction levels. Link Road and Kolatoli Circle intersections consistently showed higher noise levels and dissatisfaction. Over 95% of survey respondents perceived increased noise pollution during peak tourist seasons, with 87.11% describing it as "extremely" or "very" noisy. Longer exposure duration and awareness of health risks were significantly associated with reported perceived annoyance levels. Respondents reported various health impacts, including annoyance (84.44%), headaches (62.37%), and cognitive impairment (44.44%). This comprehensive study provides valuable insights for policymakers, city planners, and environmentalists to develop sustainable urban strategies that balance the acoustic environment with the well-being of residents and tourists alike.
Fulltext Internet Use Impact on Physical Health during COVID-19 Lockdown in Bangladesh: A Web-Based Cross-Sectional Study

Abir T, Osuagwu UL, Nur-A Yazdani DM, Mamun AA, Kakon K, Salamah AA, et al.

Int J Environ Res Public Health, 2021 10 13;18(20).
PMID: 34682502 DOI: 10.3390/ijerph182010728

Previous studies on internet use frequency were focused on mental health impact, with little known about the impact on physical health during the COVID-19 lockdown. This study examined the impact of internet use frequency on self-reported physical health during the COVID-19 lockdown in Bangladesh. A web-based cross-sectional study on 3242 individuals was conducted from 2 August-1 October 2020. The survey covered demographics, internet use frequency and self-reported physical health questions. Linear regression analyses were used to examine the impact of internet use frequency on physical health. 72.5%, 69.9%, 65.1% and 55.3% respondents reported headache, back pain, numbness of the fingers and neck pain, respectively. The analyses showed increased physical health impact among regular (coefficient β = 0.52, 95% confidence interval [CI]: 0.18-0.85, p = 0.003), frequent (β = 1.21, 95% CI: 0.88-1.54, p < 0.001) and intense (β = 2.24, 95% CI: 1.91-2.57, p < 0.001) internet users. Other important predictors were gender, income, occupation, regions, and working status. Frequent and extensive uses of the internet were strong predictors of physical health problems, and our findings suggest the need for increased awareness about the physical health problems that can be triggered by excessive internet usage.
Fulltext Factors Associated with the Perception of Risk and Knowledge of Contracting the SARS-Cov-2 among Adults in Bangladesh: Analysis of Online Surveys

Abir T, Kalimullah NA, Osuagwu UL, Yazdani DMN, Mamun AA, Husain T, et al.

Int J Environ Res Public Health, 2020 Jul 21;17(14).
PMID: 32708161 DOI: 10.3390/ijerph17145252

This study investigated the perception and awareness of risk among adult participants in Bangladesh about Coronavirus Disease 2019 (COVID-19). During the lockdown era in Bangladesh at two different time points, from 26-31 March 2020 (early lockdown) and 11-16 May 2020 (late lockdown), two self-administered online surveys were conducted on 1005 respondents (322 and 683 participants, respectively) via social media. To examine risk perception and knowledge-related factors towards COVID-19, univariate and multiple linear regression models were employed. Scores of mean knowledge (8.4 vs. 8.1, p = 0.022) and perception of risk (11.2 vs. 10.6, p < 0.001) differed significantly between early and late lockdown. There was a significant decrease in perceived risk scores for contracting SARS-Cov-2 [β = -0.85, 95%CI: -1.31, -0.39], while knowledge about SARS-Cov-2 decreased insignificantly [β = -0.22, 95%CI: -0.46, 0.03] in late lockdown compared with early lockdown period. Self-quarantine was a common factor linked to increased perceived risks and knowledge of SARS-Cov-2 during the lockdown period. Any effort to increase public awareness and comprehension of SARS-Cov-2 in Bangladesh will then offer preference to males, who did not practice self-quarantine and are less worried about the propagation of this kind of virus.
Psychological Impact of COVID-19 Pandemic in Bangladesh: Analysis of a Cross-Sectional Survey

Abir T, Osuagwu UL, Kalimullah NA, Yazdani DMN, Husain T, Basak P, et al.

Health Secur, 2021 08 03;19(5):468-478.
PMID: 34348050 DOI: 10.1089/hs.2020.0205

The COVID-19 pandemic has generated fear, panic, distress, anxiety, and depression among many people in Bangladesh. In this cross-sectional study, we examined factors associated with different levels of psychological impact as a result of COVID-19 in Bangladesh. From April 1 to 30, 2020, we used a self-administered online questionnaire to collect data from 10,609 respondents. Using the Impact of Event Scale-Revised to assess the psychological impact of the COVID-19 pandemic on respondents, we categorized the levels of impact as normal, mild, moderate, or severe. Ordinal logistic regression was used to examine the associated factors. The prevalence of mild, moderate, and severe psychological impact was 10.2%, 4.8%, and 45.5%, respectively. Multivariate analysis revealed that the odds of reporting normal vs mild, moderate, or severe psychological impact were 5.9 times higher for people living in the Chittagong Division, 1.7 times higher for women with lower education levels, 3.0 times higher among those who were divorced or separated, 1.8 times higher for those working full time, and 2.4 times higher for those living in shared apartments. The odds of reporting a psychological impact were also higher among people who did not enforce protective measures inside the home, those in self-quarantine, those who did not wear face masks, and those who did not comply with World Health Organization precautionary measures. Increased psychological health risks due to COVID-19 were significantly higher among people who experienced chills, headache, cough, breathing difficulties, dizziness, and sore throat before data collection. Our results showed that 1 in 2 respondents experienced a significant psychological impact as a result of the COVID-19 pandemic. Public health researchers should consider these factors when targeting interventions that would have a protective effect on the individual's psychological health during a pandemic or future disease outbreak.
Fulltext Antidiabetic Potential of Commonly Available Fruit Plants in Bangladesh: Updates on Prospective Phytochemicals and Their Reported MoAs

Alam S, Dhar A, Hasan M, Richi FT, Emon NU, Aziz MA, et al.

Molecules, 2022 Dec 08;27(24).
PMID: 36557843 DOI: 10.3390/molecules27248709

Diabetes mellitus is a life-threatening disorder affecting people of all ages and adversely disrupts their daily functions. Despite the availability of numerous synthetic-antidiabetic medications and insulin, the demand for the development of novel antidiabetic medications is increasing due to the adverse effects and growth of resistance to commercial drugs in the long-term usage. Hence, antidiabetic phytochemicals isolated from fruit plants can be a very nifty option to develop life-saving novel antidiabetic therapeutics, employing several pathways and MoAs (mechanism of actions). This review focuses on the antidiabetic potential of commonly available Bangladeshi fruits and other plant parts, such as seeds, fruit peals, leaves, and roots, along with isolated phytochemicals from these phytosources based on lab findings and mechanism of actions. Several fruits, such as orange, lemon, amla, tamarind, and others, can produce remarkable antidiabetic actions and can be dietary alternatives to antidiabetic therapies. Besides, isolated phytochemicals from these plants, such as swertisin, quercetin, rutin, naringenin, and other prospective phytochemicals, also demonstrated their candidacy for further exploration to be established as antidiabetic leads. Thus, it can be considered that fruits are one of the most valuable gifts of plants packed with a wide spectrum of bioactive phytochemicals and are widely consumed as dietary items and medicinal therapies in different civilizations and cultures. This review will provide a better understanding of diabetes management by consuming fruits and other plant parts as well as deliver innovative hints for the researchers to develop novel drugs from these plant parts and/or their phytochemicals.
Fulltext COVID-19 impacts and adaptations in Asia and Africa's aquatic food value chains

Belton B, Rosen L, Middleton L, Ghazali S, Mamun AA, Shieh J, et al.

Mar Policy, 2021 Jul;129:104523.
PMID: 34744258 DOI: 10.1016/j.marpol.2021.104523

The COVID-19 pandemic is a shock affecting all areas of the global food system. We tracked the impacts of COVID-19 and associated policy responses on the availability and price of aquatic foods and production inputs during 2020, using a high frequency longitudinal survey of 768 respondents in Bangladesh, Egypt, India, Myanmar, Nigeria. We found the following: (1) Aquatic food value chains were severely disrupted but most effects on the availability and accessibility of aquatic foods and production inputs were short-lived. (2) Impacts on demand for aquatic foods, production inputs, and labor have been longer lasting than impacts on their supply. (3) Retail prices of aquatic foods spiked briefly during March-May 2020 but trended down thereafter, whereas prices of production inputs rose. These trends suggest a deepening 'squeeze' on the financial viability of producers and other value chain actors. (4) Survey respondents adapted to the challenges of COVID-19 by reducing production costs, sourcing alternative inputs, diversifying business activities, leveraging social capital, borrowing, seeking alternative employment, and reducing food consumption. Many of these coping strategies are likely to undermine well-being and longer-term resilience, but we also find some evidence of proactive strategies with potential to strengthen business performance. Global production of aquatic food likely contracted significantly in 2020. The importance of aquatic food value chains in supporting livelihoods and food and nutrition security in Asia and Africa makes their revitalization essential in the context of COVID-19 recovery efforts. We outline immediate and longer-term policies and interventions to support this goal.
Fulltext Diseases, Injuries, and Risk Factors in Child and Adolescent Health, 1990 to 2017: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2017 Study

GBD 2017 Child and Adolescent Health Collaborators, Reiner RC, Olsen HE, Ikeda CT, Echko MM, Ballestreros KE, et al.

JAMA Pediatr, 2019 06 01;173(6):e190337.
PMID: 31034019 DOI: 10.1001/jamapediatrics.2019.0337

Importance: Understanding causes and correlates of health loss among children and adolescents can identify areas of success, stagnation, and emerging threats and thereby facilitate effective improvement strategies.
Objective: To estimate mortality and morbidity in children and adolescents from 1990 to 2017 by age and sex in 195 countries and territories.
Design, Setting, and Participants: This study examined levels, trends, and spatiotemporal patterns of cause-specific mortality and nonfatal health outcomes using standardized approaches to data processing and statistical analysis. It also describes epidemiologic transitions by evaluating historical associations between disease indicators and the Socio-Demographic Index (SDI), a composite indicator of income, educational attainment, and fertility. Data collected from 1990 to 2017 on children and adolescents from birth through 19 years of age in 195 countries and territories were assessed. Data analysis occurred from January 2018 to August 2018.
Exposures: Being under the age of 20 years between 1990 and 2017.
Main Outcomes and Measures: Death and disability. All-cause and cause-specific deaths, disability-adjusted life years, years of life lost, and years of life lived with disability.
Results: Child and adolescent deaths decreased 51.7% from 13.77 million (95% uncertainty interval [UI], 13.60-13.93 million) in 1990 to 6.64 million (95% UI, 6.44-6.87 million) in 2017, but in 2017, aggregate disability increased 4.7% to a total of 145 million (95% UI, 107-190 million) years lived with disability globally. Progress was uneven, and inequity increased, with low-SDI and low-middle-SDI locations experiencing 82.2% (95% UI, 81.6%-82.9%) of deaths, up from 70.9% (95% UI, 70.4%-71.4%) in 1990. The leading disaggregated causes of disability-adjusted life years in 2017 in the low-SDI quintile were neonatal disorders, lower respiratory infections, diarrhea, malaria, and congenital birth defects, whereas neonatal disorders, congenital birth defects, headache, dermatitis, and anxiety were highest-ranked in the high-SDI quintile.
Conclusions and Relevance: Mortality reductions over this 27-year period mean that children are more likely than ever to reach their 20th birthdays. The concomitant expansion of nonfatal health loss and epidemiological transition in children and adolescents, especially in low-SDI and middle-SDI countries, has the potential to increase already overburdened health systems, will affect the human capital potential of societies, and may influence the trajectory of socioeconomic development. Continued monitoring of child and adolescent health loss is crucial to sustain the progress of the past 27 years.
Fulltext Predicting the environmental suitability for onchocerciasis in Africa as an aid to elimination planning

Cromwell EA, Osborne JCP, Unnasch TR, Basáñez MG, Gass KM, Barbre KA, et al.

PLoS Negl Trop Dis, 2021 07;15(7):e0008824.
PMID: 34319976 DOI: 10.1371/journal.pntd.0008824

Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 0·71 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 50·2% exceed this threshold for suitability in at least one 5 × 5-km location. The formidable scale of data collection required to map onchocerciasis endemicity across the African continent presents an opportunity to use spatial data to identify areas likely to be suitable for onchocerciasis transmission. National onchocerciasis elimination programmes may wish to consider prioritising these IUs for mapping surveys as human resources, laboratory capacity, and programmatic schedules may constrain survey implementation, and possibly delaying MDA initiation in areas that would ultimately qualify.
Fulltext Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Burstein R, Henry NJ, Collison ML, Marczak LB, Sligar A, Watson S, et al.

Nature, 2019 Oct;574(7778):353-358.
PMID: 31619795 DOI: 10.1038/s41586-019-1545-0

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2-to end preventable child deaths by 2030-we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000-2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations.

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