Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m 2 . In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, the...

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions.

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.

BackgroundMaternal mortality in developing countries is higher than that in developed countries. There are few published articles on the factors associated with maternal deaths in northern Nigeria.ObjectivesThe objective of this study was to identify the medical causes and factors associated with maternal mortality in Sokoto, northern Nigeria.MethodA verbal autopsy questionnaire was used to interview close relatives of women within the reproductive age group who had died of pregnancy-related complications in the Sokoto metropolis during the preceding two years. A multistage sampling method using simple random sampling at each step was used to select areas of study within the Sokoto metropolis. Data analysis was carried out using a statistical package for social sciences (SPSS), version 19, and the Spearman correlation was used to test association. Significance level was set at 0.05.ResultsThe major causes of death were haemorrhage (48.3%), eclampsia (19%) and prolonged labour (13.8%). The association between maternal mortality and the absence of antenatal booking was significant (p < 0.001); the association between maternal mortality and the ‘three delays’ was also significant (p = 0.013). The association between maternal mortality and educational status and occupation was, however, not significant (p = 0.687 and p = 0.427 respectively).ConclusionThe medical causes of maternal mortality identified in this study were similar to those of the hospital-based studies in the area. In addition, an association between maternal deaths and the ‘three delays’ and the absence of antenatal booking was found. There is a need for public education efforts to address these factors in order to reduce maternal mortality in the study area.

Background: Mother to child transmission of HIV (MTCT) is globally known to be the major route of spread of HIV to the unborn fetus and neonate. Many factors related to the mother, infant or the type of HIV virus interplay to increase the risk of MTCT of the virus. Antepartum antiretroviral drugs administration reduces the maternal viral load therefore lowering   the risk of transmission. The objective is to determine infection rate and assess determinants of MTCT of HIV exposed infants delivered in UDUTH Sokoto.Methods: It was a 5-year retrospective study. Records of all HIV positive pregnant women and their babies managed in UDUTH were reviewed from the E health system of the hospital. Patient’s details were recorded from booking to delivery for the period under study. The infant’s records were retrieved and information from delivery to 18 months post-delivery obtained. Structured data collection tool was developed to compile the required information. Data was analyzed using SPSS IBMS 22. Descriptive statistics and comparisons between variables were made statistically using Chi square. P value of   ≤ 0.005 was considered as significant.Results: Records of all the patients recruited were all available for evaluation because authors use the E-health system of records keeping in our hospital. MTCT rate was 0.92%. Majority 60 (47.2%) were within age group 26-30yrs. The subjects were predominantly house wives 97(71.4%) and multipara 77 (60.6%). Viral load ranged between 112 to 28228 copies/ml. Twenty-two (17.3%) had CD4 count less than 250 cells/µl while 61 (48%) had counts above 500cells/µl. All were in WHO clinical stage 1-3. All were on triple regimen anti-retroviral drugs. Spontaneous rupture of membranes for over 4 hours occurred in 51(32%). Vaginal delivery was recorded in 89.7%. Breast feeding was practiced by 48%.Conclusions: Breast-feeding still remains a risk factor for MTCT OF HIV Early administration of   maternal antiretroviral drugs significantly reduces the rate of mother to child transmission of HIV.

Background: Intrauterine devices are one of the popular long term reversible contraceptive methods. Earlier forms were associated with genital infections, however more recent types such copper IUDs and hormonal types have been shown to have better safety profile. However, there is no conclusive evidence to demonstrate that hormonal IUD is less associated with genital infection when compared with copper IUDs. The objectives include determination of prevalence of genital tract infections among IUD users, to determine the type of IUD that is less associated with genital infection, and also determine clinical features seen among IUD users.Methods: We conducted a descriptive, cross sectional study of clients who were at 6 months following IUD insertion. Endocervical and high vaginal samples were taken to isolate microbes.Results: The prevalence of genital tract infection was 20% in Copper IUD users and 8.6% among LNG-IUS users. Genital infection was significantly higher among copper IUD users compared to hormonal IUD users (p=0.038, OR= 2.88). Abnormal vaginal discharge was the commonest symptoms among IUD users and formal education was associated with less risk of genital infections (p=0.048).Conclusions: Hormonal IUDs are less associated with genital tract infection compared to copper IUDs and women with formal education are less likely to have genital infection among IUD users.

Background: Semen analysis has remained an objective, inexpensive and readily available means of assessing male factor infertility. Aim and Objective: This study aims to determine the prevalence of male infertility, the types and semen quality among infertile couples attending infertility clinic at UDUTH, Sokoto. Materials and Method: This is a retrospective study carried out between January, 2012 to December, 2016. All case notes of infertile patients managed were retrieved The data obtained was analysed using SPSS version 20 and the results were presented in text, tables and charts. Results: Eight hundred and seventy-six out of 11,938 total gynaecological consultations over the study period were due to infertility, giving a prevalence of 7.3%. Among them, 34.4% (320) accounted for male factor infertility. The age ranged between 22 to 75 years with a mean of 37.44 years ± 7.44. Majority, 50.2% were within the ages of 35 -44 years and up to 73.8% of them had at least secondary education and were mostly, 39.7% civil servants. Up to 75.4% had sperm abnormalities, among which 65% (196/301) had primary infertility while, 35% (105/301) had secondary infertility. About half of them (47.5% (153/301)) had Azoospermia, 22.3% (67/301) Oligospermia and only 30.3% (91/301) had a normal sperm count. More than half of them, 121/227 (53.3% had multiple abnormalities). Conclusion: Male factor infertility contributes significantly to the burden of infertility in our environment. Therefore, there is the need to create awareness so that males fully participate in the evaluation, as the blames are mainly on the females.

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