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This document provides a summary of various research articles on the impact of the COVID-19 pandemic on vaccine implementation strategies and routine immunization services in different countries. The articles highlight the importance of effective communication systems, multidisciplinary leadership structures, and patient-centered engagement strategies in vaccine implementation. They also discuss the Whole Family Approach in Nigeria, which aims to increase COVID-19 vaccine uptake by leveraging the demand for other primary health services. The articles address challenges such as vaccine scarcity, vaccine hesitancy, and disruptions to routine immunization services. They propose interventions such as tailored decision aids, social mobilization campaigns, and the involvement of politicians to improve vaccine acceptance and uptake. The research findings contribute to the evidence needed to inform immunization recovery strategies during and after the pandemic. [Extracted from the article]

Background Obesity is a classified risk factor for several of the world’s leading causes of death. In this study, we combined information contained in body mass index (BMI), total percentage body fat (TPBF) and relative fat mass (RFM) to estimate obesity prevalence and examine the risk factors associated with obesity. Methods The study recruited 1027 undergraduate students aged between 16 and 25 years using a cross-sectional study design and two-stage stratified random sampling between January and April 2019 from the Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Demographic, lifestyle, and family history of chronic disease data, were collected using a structured questionnaire. Bioelectrical impedance, along with height, weight, age, and gender, were used to estimate BMI and TPBF. The RFM was calculated using a published equation. The TPBF and RFM ranges were evaluated based on standard BMI thresholds and an informative combined obesity prevalence estimated in a Bayesian framework. Multiple logistic regression analysis was used to evaluate potential risk factors of overweight/ obesity. Results Concordance between BMI, TPBF and RFM for obesity classification was 84% among female and 82.9% among male students. The Bayesian analysis revealed a combined prevalence means of obesity of 9.4% (95%CI: 6.9- 12.2%) among female students and 6.7% (95%CI:4.3-9.5%) among male students. The odds of obesity were increased between 1.8 and 2.5 for females depending on the classification index. A significant increasing trend of obesity was observed with university-level. A family history of obesity was associated with a high estimate of general, central, and high TPBF. Conclusion Using multiple adiposity indicators conjointly in a Bayesian framework offers a greater power to examine obesity prevalence. We have applied this and reported high obesity prevalence, especially among female students. University level and family history of obesity were key determinants for obesity among the student population. [ABSTRACT FROM AUTHOR]

Background: Systemic inflammatory response syndrome (SIRS) and model for end-stage liver disease (MELD) predict short-term mortality in patients with cirrhosis. Prediction of mortality at initial hospitalization is unknown in black African patients with decompensated cirrhosis. Aim: This study aimed to look at the role of MELD score and SIRS as the predictors of morbidity and mortality at initial hospitalization. Patients and methods: In this retrospective cohort study, we enrolled 159 patients with cirrhosis (median age: 49 years, 70.4% males). The role of Child-Pugh-Turcotte (CPT) score, MELD score, and SIRS on mortality was determined by the Kaplan-Meier method, and the prognosis factors were assessed with Cox regression model. Results: At initial hospitalization, 74.2%, 20.1%, and 37.7% of the patients with cirrhosis showed the presence of ascites, hepatorenal syndrome, and esophageal varices, respectively. During the in-hospital follow-up, 40 (25.2%) patients died. The overall incidence of mortality was found to be 3.1 [95% confidence interval (CI): 2.2-4.1] per 100 person-days. Survival probabilities were found to be high in case of patients who were SIRS negative (log-rank test= 4.51, p=0.03) and in case of patients with MELD score =16 (log-rank test=7.26, p=0.01) compared to the patients who were SIRS positive and those with MELD score >16. Only SIRS (hazard ratio (HR)=3.02, [95% CI: 1.4-7.4], p=0.01) and MELD score >16 (HR=2.2, [95% CI: 1.1-4.3], p=0.02) were independent predictors of mortality in multivariate analysis except CPT, which was not relevant in our study. Patients with MELD score >16 experienced hepatorenal syndrome (p=0.002) and encephalopathy (p=0.001) more frequently than that of patients with MELD score =16. SIRS was not useful in predicting complications. Conclusion: MELD score and SIRS can be used as tools for the prediction of mortality in black African patients with decompensated cirrhosis. [ABSTRACT FROM AUTHOR]