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This study aims at examining whether wellbeing and health should be considered as a fifth dimension of sustainable eco-districts. This study assesses the four dimensions of sustainable eco-districts (energy, socio-economic, mobility, urban design) and nine categories of health & wellbeing (physical, emotional, financial, intellectual, career, social, creative, environmental, spiritual) to understand the benefit of incorporating wellbeing and health. A thorough systematic review literature analysis was conducted using secondary data sources, including academic literature, industry reports, and government publications to compile available data. To categorize and find patterns in the data, thematic analysis was used. According to the research, there has to be a relationship between the growing number of hospital-led certified eco-districts and a fifth dimension of sustainable eco-districts (wellbeing and health) in order for residents of these communities to lead healthy lifestyles that support all facets of their wellness. This study adds to the existing body of knowledge and further investigates the impact of including wellbeing and health into sustainable eco-district design and construction. It sheds light on the importance of incorporating quantitative and qualitative techniques and the use empirical data gathering techniques for research studies.

Background: The ongoing revolution in health care, driven by wearable technology, virtual reality, and the Internet of Things, is reshaping both health care operations and our daily lives. This digital transformation ensures broader access to health care options, fosters patient-centered care and affects both health care institutions and individuals. In Sweden, health care is undergoing a digital shift, with initiatives like personal health management, remote monitoring, and virtual care enhancing patient involvement. This article reviews Sweden's health care digital transformation and compares it with the United Arab Emirates (UAE's) initiatives to assess viability. Methods: Using systematic literature review methods, databases from 2011 to 2023 were searched, supplemented by reference lists. Results: Database searches identified 761 records. A total of 480 articles were screened on basis of title and abstract, yielding 184 that were assessed for eligibility, leading to 40 academic studies to be included and 12 grey literature. Conclusions: The findings highlight Sweden's success in empowering patients through enhanced connectivity with clinical teams, knowledge sharing, and care management. However, due to contextual differences, the UAE should not blindly replicate Sweden's strategy. In conclusion, Sweden's efforts have positively engaged patients in health care, but challenges such as emerging technologies, demographic shifts, and budget constraints persist. Proactive planning and adaptation are crucial, with lessons applicable to the UAE market. Establishing a clear regulatory framework for digital care is imperative for future resilience. [ABSTRACT FROM AUTHOR]

In 2016, invasive bacterial diseases accounted for one quarter of the 5.6 million childhood deaths worldwide (1). Most invasive bacterial diseases occur in sub-Saharan Africa and other low- and middle-income [...]

It has become standard practice for governments and transportation engineers around the world to infuse sustainability principles into their plans as higher-level goals and priorities, with indicators to reflect the same. The transformation towards sustainable mobility should involve the three interconnected pillars of sustainable development: environment, social equity, and economy. These pillars, known in the business field as the 'triple-bottom-line', require specific indicators that can be used to measure the attainment of each pillar. There is evidence that the social equity impacts of construction projects, such as transport projects, and their distributional effects across various segments of society have traditionally been viewed as secondary or subsidiary concerns relative to their economic and environmental impacts. Recognizing the relative relegation in both academic and policy circles of social impacts and the 'weak' tools to identify such impacts, this research aims to employ a hybrid decision method based on the analytic network process and Delphi method to identify the major adverse impacts of highway automobiles on health and social equity in the UAE. In doing so, governments will be better positioned to mitigate adverse impacts through engineering, urban planning, technological, and other appropriate initiatives. Throughout the Delphi process, 15 health and social equity indicators have been validated by experts in the field of sustainability and transportation through an iterative process. Then, experts in the same field were chosen to develop and validate the ANP model based on the validated indicators through pairwise comparison questionnaires. The results and findings revealed that the experts' judgment preferences are consistent (inconsistency value less than 0.1), wherein the highest priority is the 'Safety' indicator, and the lowest priority is the 'Public participation in transport decision' indicator. [ABSTRACT FROM AUTHOR]

After gaining independence, at the Addis Ababa meeting (1961) most African countries, including Senegal, decided to develop their education systems. In 1980, a number of objectives were set out, including the democratization of primary education and universal sustainable schooling. According to its economic possibilities, its human resources and the support of its partners, each country began to invest a substantial proportion of its national wealth in education and training. In Senegal's case, more than a third of its budget goes on education, although this is still below the objectives advocated in Addis Ababa. Since independence, the chance for all to access education in Senegal has been called for at numerous international and regional conferences held in Addis Ababa, Nairobi, Lagos, Jomtien, Dakar and finally Johannesburg in 2002. Yet the difficulties are considerable, both in quantitative terms (access to education, financing) and in qualitative terms (quality of education and adaptation to requirements) and they affect the non-formal as much as the formal system. Thus, in both quantitative and qualitative terms Senegal's educational needs are enormous. It has therefore become imperative to improve the system by developing the capacities of civil society and by establishing technical and financial partnerships. This study is a modest attempt to review the issues involved with partnerships for the development of education in the light of Senegal's experience. (Contains 1 note.)

In 2012, an outbreak of Neisseria meningitidis serogroup W135 occurred in The Gambia. The attack rate was highest among young children. The associated risk factors were male sex, contact with meningitis patients, and difficult breathing. Enhanced surveillance facilitates early epidemic detection, and multiserogroup conjugate vaccine could reduce meningococcal epidemics in The Gambia.

Background Representative data describing serious infections in children aged ≥5 years and adults in Africa are limited. Methods We conducted population-based surveillance for pneumonia, meningitis, and septicemia in a demographic surveillance area in The Gambia between 12 May 2008 and 31 December 2015. We used standardized criteria to identify, diagnose, and investigate patients aged ≥5 years using conventional microbiology and radiology. Results We enrolled 1638 of 1657 eligible patients and investigated 1618. Suspected pneumonia, septicemia, or meningitis was diagnosed in 1392, 135, and 111 patients, respectively. Bacterial pathogens from sterile sites were isolated from 105 (7.5%) patients with suspected pneumonia, 11 (8.1%) with suspected septicemia, and 28 (25.2%) with suspected meningitis. Streptococcus pneumoniae (n = 84), Neisseria meningitidis (n = 16), and Staphylococcus aureus (n = 15) were the most common pathogens. Twenty-eight (1.7%) patients died in hospital and 40 (4.1%) died during the 4 months after discharge. Thirty postdischarge deaths occurred in patients aged ≥10 years with suspected pneumonia. The minimum annual incidence was 133 cases per 100 000 person-years for suspected pneumonia, 13 for meningitis, 11 for septicemia, 14 for culture-positive disease, and 46 for radiological pneumonia. At least 2.7% of all deaths in the surveillance area were due to suspected pneumonia, meningitis, or septicemia. Conclusions Pneumonia, meningitis, and septicemia in children aged ≥5 years and adults in The Gambia are responsible for significant morbidity and mortality. Many deaths occur after hospital discharge and most cases are culture negative. Improvements in prevention, diagnosis, inpatient, and follow-up management are urgently needed. [ABSTRACT FROM AUTHOR]

The excessive application of mineral fertilizers in maize cultivation leads to progressive soil contamination in the long term and increases the cost of production. An alternative to reduce over-fertilization is to perform a partial replacement with microbes that promote nutrition and growth, such as Arbuscular Mycorrhizal Fungi (AMF). A pot experiment which was followed by two field experiments was performed with and without the application of indigenous AMF in combination with five nitrogen–phosphorus–potassium (NPK) fertilization rates (100% NPK = N120P60K60; 75% NPK = N90P45K45; 50% NPK = N60P30K30; 25% NPK = N30P15K15; control = N0P0K0). The objective was to investigate whether the soil application of indigenous mycorrhizal fungi inoculum combined with NPK fertilization can provide higher maize yields and soil-available N, P, and K than chemical fertilization can alone. The greenhouse results showed that the application of AMF with a 50% NPK treatment significantly increased the plant's growth, root colonization, leaf chlorophyll content, and N, P, and K tissue content. The results from the field conditions showed that there was a highly significant yield after the treatment with AMF + 50% NPK. The study also revealed that mycorrhizal fungi inoculation increased the available soil N and P concentrations when it was combined with a 50% NPK dose. This suggests that the inoculation of fields with AM fungi can reduce the chemical fertilizer application by half, while improving soil chemistry. The results suggested that AMF inoculation can be used in integrated soil fertility management strategies. [ABSTRACT FROM AUTHOR]

Background Invasive bacterial diseases (IBD) cause significant mortality in young infants. There are limited population-based data on IBD in young infants in Sub-Saharan Africa. Methods We conducted population-based surveillance for IBD among infants aged 0-90 days in a demographic surveillance area in rural Gambia between 1 March 2011 and 31 December 2017. Infants admitted to health facilities within the study area had standardised clinical evaluation plus conventional microbiological investigation. We defined IBD as isolation of pathogenic bacteria from blood, cerebrospinal fluid, lung, or pleural aspirate. We determined incidence, aetiology and case-fatality of IBD. Results A total of 3794 infants were admitted and 3605 (95%) had at least one sample collected for culture. We detected 254 (8.0%) episodes of IBD (bacteraemia 241; meningitis 14; pneumonia seven). The incidence of IBD in infants aged 0-90 days was 25 episodes/1000 person-years (95% confidence interval (CI) = 22-28), the incidence in neonates was 50 episodes/1000 person-years (95% CI = 43-58) and the incidence in infants aged 29-90 days was 12 episodes/1000 person-years (95% CI = 9-15). The most common pathogens causing IBD were Staphylococcus aureus (n = 102, 40%), Escherichia coli (n = 37, 15%), Streptococcus pneumoniae (n = 24, 9%) and Klebsiella pneumoniae (n = 12, 5%). Case-fatality was 29% (95% CI = 23-37) in neonates and 19% (95% CI = 11-29) in infants aged 29-90 days. A minimum of 7.3% of all young infant deaths in the population were caused by IBD. Conclusions IBD are common in young infants in rural Gambia and have a high case-fatality. Strategies are needed to prevent IBD in young infants. Overcoming barriers to widespread implementation of existing vaccines and developing new vaccines against the most common pathogens causing IBD should be among top priorities for reducing the high mortality rate in young infants. [ABSTRACT FROM AUTHOR]

Many plant species adapted to semi-arid environments are grown in the Sahelian region in northern Africa. One such species is Acacia seyal (Delile), a multipurpose leguminous tree grown in various agroecological zones, including saline soils. These challenging arid and semi-arid environments harbor a diversity of arbuscular mycorrhizal fungi (AMF) communities that can develop symbiotic associations with plants to improve their hydromineral nutrition. This study compared the effects of native AMF communities isolated from semi-arid sites (high, moderate, and low salinity zones Ndiafate, Ngane, and Bambey, respectively) and the AMF Rhizoglomus aggregatum on the development and phosphate nutrition of A. seyal seedlings subject to three salinity treatments (0, 340, and 680 mM). Plant height, dry matter weight of the shoots and roots, and phosphorus uptake from the soil were measured. Plants inoculated with AMF native species from each site that were provided with up to 340 mM of NaCl had greater shoot height than plants grown under 680 mM salinity. At NaCl concentrations above 340 mM, shoot and root development of A. seyal seedlings diminished. However, dry matter production of shoots (7%) and roots (15%) improved following AMF inoculation compared with the control (respectively 0.020 and 0.07 g for shoots and roots). When inoculated with AMF isolates from the high salinity zone (Ndiafate), phosphate content/nutrition was increased by 10% around 30 days after inoculation compared with non-inoculated seedlings (2.84 mg/kg of substrate). These results demonstrate that native AMF inoculants are capable of helping plants withstand environmental constraints, especially those exposing plants to harsh climatic conditions. We discuss insights on how AMF influences the interplay between soil phosphorus and perceived salinity that may have implications for broader relationships between plants and symbiotic fungi. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Il s'agit de déterminer les profils épidémiologiques et histologiques des tumeurs submandibulaires. METHODES: Il s'agissait d'une étude rétrospective et descriptive de 10 ans (1er janvier 2000 au 31 décembre 2009), réalisée dans le service universitaire d'ORL de l'hôpital de Fann. Etaient inclus dans cette étude tous patients porteurs d'une tumeur submandibulaire (opéré ou non), confirmée par un document histologique. RESULTATS: Vingt-une tumeurs submandibulaires ont été colligées. L'âge moyen des patients était de 34,42 ans ( 14,10), avec des extrêmes de 2 et 55 ans. Quinze patients (71,4%) étaient de sexe féminin, soit un sex-ratio de 0,4. Les résultats histologiques étaient obtenus à partir de 4 biopsies et de 17 pièces opératoires. Dans 13 cas (61,9%) la tumeur était bénigne et dans 8 cas (38,1%) la tumeur était maligne. L'adénome pléomorphe dans 12 cas (57,1%), le carcinome épidermoïde dans 4 cas (19%) et l'adénocarcinome dans 2 cas (9,5%) étaient les types histologiques fréquents. Treize (13) patients étaient porteurs d'une tumeur bénigne, dont huit (8) patients étaient de sexe féminin. Huit (8) patients étaient porteurs d'une tumeur maligne. Sept patients étaient de sexe féminin. CONCLUSION: Cette étude sur les tumeurs submandibulaires est marquée par une prédominance féminine et une fréquence élevée des adénomes pléomorphes et des carcinomes épidermoïdes.

Background: The introduction in many countries of conjugate vaccines against Haemophilus influenzae type b, Streptococcus pneumoniae, and Neisseria meningitidis has led to significant reductions in acute bacterial meningitis (ABM) in children. However, recent population-based data on ABM in sub-Saharan Africa are limited. Methods: Population-based surveillance for meningitis was carried out in a rural area of The Gambia under demographic surveillance from 2008 to 2017, using standardised criteria for referral, diagnosis and investigation. We calculated incidence using population denominators. Results: We diagnosed 1,666 patients with suspected meningitis and collected cerebrospinal fluid (n = 1,121) and/or blood (n = 1,070) from 1,427 (88%) of cases. We identified 169 cases of ABM, 209 cases of suspected non-bacterial meningitis (SNBM) and 1,049 cases of clinically suspected meningitis (CSM). The estimated average annual incidence of ABM was high at 145 per 100,000 population in the <2-month age group, 56 per 100,000 in the 2–23-month age group, but lower at 5 per 100,000 in the 5–14-year age group. The most common causes of ABM were Streptococcus pneumoniae (n = 44), Neisseria meningitidis (n = 42), and Gram-negative coliform bacteria (n = 26). Eighteen of 22 cases caused by pneumococcal serotypes included in PCV13 occurred prior to vaccine introduction and four afterwards. The overall case fatality ratio for ABM was 29% (49/169) and was highest in the <2-month age group 37% (10/27). The case fatality ratio was 8.6% (18/209) for suspected non-bacterial meningitis and 12.8% (134/1049) for clinically suspected meningitis cases. Conclusions: Gambian children continue to experience substantial morbidity and mortality associated with suspected meningitis, especially acute bacterial meningitis. Such severely ill children in sub-Saharan Africa require improved diagnostics and clinical care. [ABSTRACT FROM AUTHOR]

The well-known Riccati differential equations play a key role in many fields, including problems in protein folding, control and stabilization, stochastic control, and cybersecurity (risk analysis and malware propagation). Quantum computer algorithms have the potential to implement faster approximate solutions to the Riccati equations compared with strictly classical algorithms. While systems with many qubits are still under development, there is significant interest in developing algorithms for near-term quantum computers to determine their accuracy and limitations. In this paper, we propose a hybrid quantum-classical algorithm, the Matrix Riccati Solver (MRS). This approach uses a transformation of variables to turn a set of nonlinear differential equation into a set of approximate linear differential equations (i.e., second order non-constant coefficients) which can in turn be solved using a version of the Harrow-Hassidim-Lloyd (HHL) quantum algorithm for the case of Hermitian matrices. We implement this approach using the Qiskit language and compute near-term results using a 4 qubit IBM Q System quantum computer. Comparisons with classical results and areas for future research are discussed. [ABSTRACT FROM AUTHOR]

Improving maize yield is an objective of utmost importance for food security in Uganda. In the evaluation of soil microorganisms in crop production, it is important to assess the composition and diversity of the arbuscular mycorrhizal fungi (AMF) species in different agroecosystems. AMF play an important role in improving crop growth and yield. We present a study of the morphological diversity of native AMF species associated with the rhizosphere of maize in two locations in eastern Uganda (the Amuria and Serere districts). The effects of soil chemical properties on this diversity are also assessed. AMF diversity is assessed by the morphological identification of the spores extracted from soils samples by the wet sieving method. Spores abundance, species richness, and diversity are determined. A total of 19 AMF morphotypes distributed in 7 genera (Gigaspora, Scutellospora, Glomus, Acaulospora, Archaeospora, Entrophospora, and Paraglomus) are observed. Glomus species are abundant in all sites. Spore densities are higher in Amuria than in Serere. Soil pH, CEC, and phosphorus content influence AMF distribution. Finding the species in various agroecological environments indicates that they are adapted to the environments. Maize grown in eastern Uganda is associated with a diversity of AMF that could be selected as bio-fertilizers to improve crop production. [ABSTRACT FROM AUTHOR]

Background: We investigated the pathogenesis of pneumococcal pneumonia using clinical specimens collected for pneumonia surveillance in The Gambia.Methods: Lung aspirates and nasopharyngeal swabs from 31 patients were examined by culture, quantitative polymerase chain reaction (qPCR), whole genome sequencing, serotyping, and reverse-transcription qPCR.Results: Five lung aspirates cultured pneumococci, with a matching strain identified in the nasopharynx. Three virulence genes including ply (pneumolysin) were upregulated >20-fold in the lung compared with the nasopharynx. Nasopharyngeal pneumococcal density was higher in pediatric pneumonia patients compared with controls (P < .0001).Conclusions: Findings suggest that changes in pneumococcal gene expression occurring in the lung environment may be important in pathogenesis. [ABSTRACT FROM AUTHOR]

Identification of highly performing varieties under Senegalese environment is crucial to sustain rice production. Genotype-environment interaction and stability performance on the grain yield of ten upland rice genotypes were investigated across 11 environments in Senegal during the rainy seasons of 2016 and 2017 to identify adapted varieties. The experiment was conducted using a randomized complete block design with three replications at each environment. Data on grain yield were recorded and analyzed using the additive main effects and multiplicative interaction (AMMI) model. The combined analysis of variance revealed that the grain yield was significantly affected by environment (67.9%), followed by genotype × environment (G × E) interaction (23.6%) and genotype (8.5%). The first two principal component axes were highly significant with 37.5 and 26% of the total observed G × E interaction variation, respectively. GGE biplot grouped the environments into four potential megaenvironments. Based on the yield stability index parameter and ranking GGE biplot, NERICA 8 and ART3-7-L9P8-1-B-B-1 were stable and high-yielding varieties compared to the local check NERICA 6. These varieties should be proposed for cultivation in order to sustain the rice production in the southern part of the groundnut basin of Senegal and used as parental lines in rice breeding program for grain yield improvement. [ABSTRACT FROM AUTHOR]

Obtaining informed consent from individuals may be possible in cultures in which community leaders usually make decisions to participate in studies. Researchers obtained consent from Senegal, African mothers for participation in a study comparing two types of whooping cough vaccine. Consensus meetings were held in villages explaining the study. Subsequently, individual mothers were asked for consent when their child was immunized. There were informed refusals at both meetings and clinic visits, which shows that individuals made informed choices.

Background: In 1997, The Gambia introduced three primary doses of Haemophilus influenzae type b (Hib) conjugate vaccine without a booster in its infant immunisation programme along with establishment of a population-based surveillance on Hib meningitis in the West Coast Region (WCR). This surveillance was stopped in 2002 with reported elimination of Hib disease. This was re-established in 2008 but stopped again in 2010. We aimed to re-establish the surveillance in WCR and to continue surveillance in Basse Health and Demographic Surveillance System (BHDSS) in the east of the country to assess any shifts in the epidemiology of Hib disease in The Gambia.Methods: In WCR, population-based surveillance for Hib meningitis was re-established in children aged under-10 years from 24 December 2014 to 31 March 2017, using conventional microbiology and Real Time Polymerase Chain Reaction (RT-PCR). In BHDSS, population-based surveillance for Hib disease was conducted in children aged 2-59 months from 12 May 2008 to 31 December 2017 using conventional microbiology only. Hib carriage survey was carried out in pre-school and school children from July 2015 to November 2016.Results: In WCR, five Hib meningitis cases were detected using conventional microbiology while another 14 were detected by RT-PCR. Of the 19 cases, two (11%) were too young to be protected by vaccination while seven (37%) were unvaccinated. Using conventional microbiology, the incidence of Hib meningitis per 100 000-child-year (CY) in children aged 1-59 months was 0.7 in 2015 (95% confidence interval (CI) = 0.0-3.7) and 2.7 (95% CI = 0.7-7.0) in 2016. In BHDSS, 25 Hib cases were reported. Nine (36%) were too young to be protected by vaccination and five (20%) were under-vaccinated for age. Disease incidence peaked in 2012-2013 at 15 per 100 000 CY and fell to 5-8 per 100 000 CY over the subsequent four years. The prevalence of Hib carriage was 0.12% in WCR and 0.38% in BHDSS.Conclusions: After 20 years of using three primary doses of Hib vaccine without a booster Hib transmission continues in The Gambia, albeit at low rates. Improved coverage and timeliness of vaccination are of high priority for Hib disease in settings like Gambia, and there are currently no clear indications of a need for a booster dose. [ABSTRACT FROM AUTHOR]

We report a case of metastasis to the gingiva of breast carcinoma. The breast tumor was treated with neoadjuvant chemotherapy followed by a radical mastectomy associated with axillary dissection. The gingival lesion occurred 7 months after surgery; the metastasis was confirmed by a biopsy. [ABSTRACT FROM AUTHOR]

Objectives. To describe reoperative thyroid surgeries in our department. Study Design. Retrospective cross-sectional and descriptive study at the Ouakam Military Hospital in Dakar (Senegal), over a period of eight and a half years. Methods. The study involved all records of patients who had a reoperative thyroidectomy regardless of the indication and time of the second surgery. Parameters evaluated for first and reoperative surgery were time interval between the two surgeries, operative indications, surgical procedures, intraoperative findings, pathological examination, and morbidity. Results. 30 records of patients were selected out of a total of 698 thyroidectomies (4.3%). Thyroid cancers diagnosed on first surgical specimens were the first indications of reoperations (46.67%) followed by neck hematoma (20%). Completion thyroidectomy with a prophylactic central lymph nodes dissection was the most performed surgical procedure (43.33%) followed by haemostasis (20%). During reoperation, we found active bleeding (20%), textiloma (6.67%), and fourth branchial cleft fistula (3.33%). The morbidity accounted for 10%: lymphorrhea, permanent hypocalcemia, and permanent recurrent nerve palsy, in one case, respectively. There were no statistically significant differences between the morbidity in patients reoperated on and the one for patients operated on once. Conclusion. We did not find an increased risk of postoperative morbidity after reintervention. [ABSTRACT FROM AUTHOR]

Objective: To measure mortality and its risk factors among children discharged from a health centre in rural Gambia. Methods: We conducted a cohort study between 12 May 2008 and 11 May 2012. Children aged 2–59 months, admitted with suspected pneumonia, sepsis, or meningitis after presenting to primary and secondary care facilities, were followed for 180 days after discharge. We developed models associating post-discharge mortality with clinical syndrome on admission and clinical risk factors. Findings: One hundred and five of 3755 (2.8%) children died, 80% within 3 months of discharge. Among children aged 2–11 and 12–59 months, there were 30 and 29 deaths per 1000 children per 180 days respectively, compared to 11 and 5 respectively in the resident population. Children with suspected pneumonia unaccompanied by clinically severe malnutrition (CSM) had the lowest risk of post-discharge mortality. Mortality increased in children with suspected meningitis or septicaemia without CSM (hazard ratio [HR] 2.6 and 2.2 respectively). The risk of mortality greatly increased with CSM on admission: CSM with suspected pneumonia (HR 8.1; 95% confidence interval (CI) 4.4 to 15), suspected sepsis (HR 18.4; 95% CI 11.3 to 30), or suspected meningitis (HR 13.7; 95% CI 4.2 to 45). Independent associations with mortality were: mid-upper arm circumference (MUAC) of 11.5–13.0 cm compared to >13.0 cm (HR 7.2; 95% CI 3.0 to 17.0), MUAC 10.5–11.4 cm (HR 24; 95% CI 9.4 to 62), and MUAC <10.5 cm (HR 44; 95% CI 18 to 108), neck stiffness (HR 10.4; 95% CI 3.1 to 34.8), non-medical discharge (HR 4.7; 95% CI 2.0 to 10.9), dry season discharge (HR 2.0; 95% CI 1.2 to 3.3), while greater haemoglobin (HR 0.82; 0.73 to 0.91), axillary temperature (HR 0.71; 95% CI 0.58 to 0.87), and oxygen saturation (HR 0.96; 95% CI 0.93 to 0.99) were associated with reduced mortality. Conclusion: Gambian children experience increased mortality after discharge from primary and secondary care. Interventions should target both moderately and severely malnourished children. [ABSTRACT FROM AUTHOR]