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Too many babies are born too small

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More than 20 million babies were born with a low birthweight (less than 2500g; 5.5 pounds) in 2015—around one in seven of all births worldwide according to the first-ever estimates documenting this major health challenge.

These findings and more are documented in a new research paper developed by experts from the World Health Organization, UNICEF and the London School of Hygiene & Tropical Medicine, published in The Lancet Global Health.

More than 80% of the world’s 2.5 million newborns who die every year are of low birthweight. Those low birthweight babies who survive have a greater risk of stunting, and developmental and physical ill health later in life, including diabetes and cardiovascular disease.

“Low birthweight is a complex clinical entity composed of intrauterine growth restriction and preterm birth,” says co-author Dr Mercedes de Onis from the Department of Nutrition at WHO.

“This is why reducing low birthweight requires an understanding of the underlying causes in a given country. For example, in Southern Asia a large proportion of low birthweight babies are born at term but with intrauterine growth restriction, which is associated with maternal undernutrition, including maternal stunting.

“Conversely, preterm birth is the major contributor to low birthweight in settings with many adolescent pregnancies, high prevalence of infection, or where pregnancy is associated with high levels of fertility treatment and caesarean sections (like in USA and Brazil). Understanding and tackling these underlying causes in high-burden countries should be a priority.”

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Although close to three-quarters were born in Southern Asia and sub-Saharan Africa, the problem remains substantial in high-income countries in Europe, North America, Australia and New Zealand. High-income countries have seen virtually no progress.

What is being done to tackle this major public health problem

Reducing the incidence of low birth weight requires a comprehensive global strategy, which must include improving maternal nutritional status; treating pregnancy-associated conditions such as pre-eclampsia (hypertensive disease of pregnancy); and providing adequate maternal care, perinatal clinical services and social support.

Affordable, accessible and appropriate health-care is critical for preventing and treating low birthweight. Reductions in death, illness and disability in newborn babies will only be achieved if pregnancy care is fully integrated with appropriate care for low birthweight babies.

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Bello insists Kogi is COVID-19 free, lifts lockdown in Kabba-Bunu

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The Yahaya Bello led Kogi State government has lifted the lockdown imposed on Kabba-Bunu Local Government Area of the state over suspected cases of  COVID-19.

Governor Bello, on Friday announced this at the Government House in Lokoja, the state capital.

The governor informed that the decision became necessary after the result of all the samples taken and subjected to tests by the health workers in the local government came out negative.

As a result of this, Bello insisted that Kogi has remained a COVID-19-free state.

The governor also urged the people of the state to adhere strictly to the protocols of the World Health Organisation (WHO) and the Nigeria Centre for Disease Control (NCDC) to curb the spread of the disease.

Governor Bello had earlier ordered a 14-day total lockdown in Kabba-Bubu in a state broadcast on Monday.

 

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Oyo discharges 11 COVID-19 cases at Olodo Infectious Disease Centre

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Professor Alonge addressing newsmen (Filed photo)

The Oyo State Task Force on COVID-19, on Friday, recorded a major victory in its ongoing fight against the novel Coronavirus when it discharged 11 persons after they tested negative to COVID-19 twice.

 

The Chief Press Secretary to Governor Seyi Makinde, Mr. Taiwo Adisa, in a statement quoted a member of the Task Force and former Chief Medical Director of the University College Hospital (UCH), Ibadan, Professor Temitope Alonge, as saying that after the discharge of the 11 cases, the Centre now had 32 patients and that all but one, were in stable condition.

 

The statement added that of the 11 persons discharged at the Infectious Disease Centre, Olodo, Ibadan, three were females and eight were males.

 

According to Alonge, eight of the discharged persons were the Northerners who came from Sokoto axis.

 

He said: “We all must have behind our minds that this novel coronavirus, even though it belongs to a particular family, is not in any way similar to the HIV virus, meaning that it does not reside in you forever as it were. It has a span of time that it stays and your body’s immune system is built up enough to be able to get rid of it and you come back to normal.

 

“But, of course, if at the time you have a high load of the virus, you happen to have some other co-morbidities or you are under some treatment that reduces your immunity, then you can have a full flare. So, it is not like the HIV virus that you have to use medications to suppress or reduce their effects.

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“When patients come down and they are tested as positive, it means the load of the virus is enough to make them feel sickly. When they are in isolation, what we do is to boost their immunity. There are so many regimens in the world that are being tried and used but here, our patients have stuck to a very simple regimen. They all have 500mg of azithromycin daily for three days. They also have zinc on a daily basis. 2gram of Vitamin C, Chloroquine 500mg and 250mg for another three days.

 

“We are privileged to have linked up with our colleagues in UCH, who have been exceptionally wonderful. So, we are not only looking at their symptoms but also the viral load and their CT. But the value of the CT is also in correlation with the value of the viral load. The higher the viral load, the lower the CT value.”

 

The ex-CMD maintained that there were now 32 active patients at the Infectious Disease Centre, noting that all of them except one were in stable condition.

 

“We have 32 (patients). All of them are very stable. We only have one of them who has a comorbid issue and, as I speak, one of our senior consultants from the University College Hospital is attending to him. Also, another consultant in the Psychiatry Department will come and counsel this particular client on the use of medications, because we found out that he was using too many medications that can be injurious to his health.

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“Apart from that, everybody is fine. We even have a family here; father, mother, and children and they are doing exceptionally well.

“Eight of those cases discharged are the Northerners who came from the Sokoto axis. Since they are now negative, they want to go back to Sokoto.”

 

Speaking earlier, one of the discharged persons (names withheld), who spoke on behalf of the other patients, appreciated the state government, the governor and the medical personnel at the Centre.

 

She said: “On behalf of all of us here who are COVID-19 patients, we want to appreciate Governor Seyi Makinde. We pray that God will reward him.

 

“We experienced good care. They took us as their sisters and brothers. They did not stigmatise us. So, we really appreciate all the doctors and nurses. We really appreciate the Oyo State government.”

 

When asked what her experience was while in isolation, she maintained she and most of those in the Centre were asymptomatic, saying: “I did not show any symptoms. I just went for the test voluntarily. So, after nine days, they called me that the test came out positive and I was asked to come to the isolation centre to quarantine myself.

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“The test was conducted on me on the 22nd of April at Etiosa Local Government, but I was already in Ibadan when they told me the result and I was asked to go into isolation in Ibadan because there was no isolation centre in Lagos again.”

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Africa: As COVID-19 devastates health systems, over 6,000 additional children could die a day – UNICEF

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An additional 6,000 children under five  could die every day from preventable causes over the next six months as the COVID-19 pandemic continues to weaken health systems and disrupt routine services, UNICEF said today.

The estimate is based on an analysis by researchers from the Johns Hopkins Bloomberg School of Public Health, newly published in The Lancet Global Health journal. Based on the worst of three scenarios in 118 low- and middle-income countries, the analysis estimates that an additional 1.2 million under-five deaths could occur in just six months, due to reductions in routine health service coverage levels and an increase in child wasting.

These potential child deaths will be in addition to the 2.5 million children who already die before their 5th birthday every six months in the 118 countries included in the study, threatening to reverse nearly a decade of progress on ending preventable under-five mortality.

Some 56,700 more maternal deaths could also occur in just six months, in addition to the 144,000 deaths that already take place in the same countries over a six-month period.

“Under a worst-case scenario, the global number of children dying before their fifth birthdays could increase for the first time in decades,” said UNICEF Executive Director Henrietta Fore. “We must not let mothers and children become collateral damage in the fight against the virus. And we must not let decades of progress on reducing preventable child and maternal deaths be lost.”

In countries with already weak health systems, COVID-19 is causing disruptions in medical supply chains and straining financial and human resources. Visits to health care centres are declining due to lockdowns, curfews and transport disruptions, and as communities remain fearful of infection. In a commentary to the Lancet report, UNICEF warns these disruptions could result in potentially devastating increases in maternal and child deaths.

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The paper analyzes three scenarios for the impact of reductions in lifesaving interventions due to the crisis on child and maternal deaths. It warns that in the least severe scenario, where coverage is reduced around 15 per cent, there would be a 9.8 per cent increase in under-five child deaths, or an estimated 1,400 a day, and an 8.3 per cent increase in maternal deaths. In the worst-case scenario, where health interventions are reduced by around 45 per cent, there could be as much as a 44.7 per cent increase in under-five child deaths and 38.6 per cent increase in maternal deaths per month.

These interventions range from family planning, antenatal and postnatal care, child delivery, vaccinations and preventive and curative services. The estimates show that if, for whatever reason, routine health care is disrupted and access to food is decreased, the increase in child and maternal deaths will be devastating. The greatest number of additional child deaths will be due to an increase in wasting prevalence among children, which includes the potential impact beyond the health system, and reduction in treatment of neonatal sepsis and pneumonia.

According to the modeling, and assuming reductions in coverage in the worst-case scenario, the 10 countries that could potentially have the largest number of additional child deaths are: Bangladesh, Brazil, Democratic Republic of the Congo, Ethiopia, India, Indonesia, Nigeria, Pakistan, Uganda and United Republic of Tanzania.

The 10 countries that are most likely to witness the highest excess child mortality rates under the worst-case scenario are: Djibouti, Eswatini, Lesotho, Liberia, Mali, Malawi, Nigeria, Pakistan, Sierra Leone and Somalia. Continued provision of life-saving services is critical in these countries.

In addition to the estimated potential rise in under-five and maternal deaths described in the Lancet Global Health Journal analysis, UNICEF is deeply alarmed by the other knock-on effects of the pandemic on children:

  • An estimated 77 per cent of children under the age of 18 worldwide – 1.80 billion out of 2.35 billion – were living in one of the 132 countries with stay-at-home policies, as of early May.
  • Nearly 1.3 billion students – over 72 per cent – are out of school as a result of nationwide school closures in 177 countries.
  • 40 per cent of the world’s population are not able to wash their hands with soap and water at home.
  • Nearly 370 million children across 143 countries who normally rely on school meals for a reliable source of daily nutrition must now look to other sources as schools are shuttered.
  • As of 14 April, over 117 million children in 37 countries may miss out on their measles vaccination as the pandemic causes immunization campaigns to stop to reduce the risk of spreading the virus.
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This week, UNICEF is launching #Reimagine, a global campaign to prevent the COVID-19 pandemic from becoming a lasting crisis for children, especially the most vulnerable children – such as those affected by poverty, exclusion or family violence. Through the campaign, UNICEF is issuing an urgent appeal to governments, the public, donors and the private sector to join UNICEF as we seek to respond, recover and reimagine a world currently besieged by the coronavirus:

  • Respond. We must act now to stop the disease from spreading, help the sick, and protect first responders on the frontlines risking their own lives to save others.
  • Recover. Even when the pandemic slows, each country will have to continue to work to mitigate the knock-on effects on children and address the damage inflicted. Communities will also have to work together, and across borders to rebuild and prevent a return of the disease.
  • Reimagine. If we have learned anything from COVID-19, it’s that our systems and policies must protect people, all the time, not just in the event of a crisis. As the world recovers from the pandemic, now is the time to lay the groundwork for building back better.

To kickstart the campaign, two of UNICEF’s valued partners – Pandora and ING – have both agreed to pledge a generous donation to show their part in answering the call to this appeal and to spur more donations from the public in the coming weeks.

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“The COVID-19 crisis is a child rights crisis. We need an immediate-, medium- and long-term response that not only addresses the challenges created by the pandemic and its secondary impacts on children, but also outlines a clear version for building back a better world when the crisis finally recedes. For that, we need everyone’s ideas, resources, creativity and heart.” said Fore. “It is our shared responsibility today, to reimagine what the world will look like tomorrow.”

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