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3 results on '"Emmanuel Okoh"'

1. Haem iron versus ferrous iron salts to treat iron deficiency anaemia in Gambian children: protocol for randomised controlled trial {1}

Author

Mamadou Bah, Hans Verhoef, Emmanuel Okoh, Abdoulie Bah, Andrew M. Prentice, and Carla Cerami

Subjects
Iron deficiency, Anaemia, Iron supplements, Haem iron, Gambia, Infants, Medicine (General), R5-920
Abstract

Abstract Background The World Health Organization recommends universal iron supplementation for children aged 6–23 months in countries where anaemia is seen in over 40% of the population. Conventional ferrous salts have low efficacy due to low oral absorption in children with inflammation. Haem iron is more bioavailable, and its absorption may not be decreased by inflammation. This study aims to compare daily supplementation with haem iron versus ferrous sulphate on haemoglobin concentration and serum ferritin concentration after 12 weeks of supplementation. Methods This will be a two-arm, randomised controlled trial. Gambian children aged 6–12 months with anaemia will be recruited within a predefined geographical area and recruited by trained field workers. Eligible participants will be individually randomised using a 1:1 ratio within permuted blocks to daily supplementation for 12 weeks with either 10.0 mg of elemental iron as haem or ferrous sulphate. Safety outcomes such as diarrhoea and infection-related adverse events will be assessed daily by the clinical team (see Bah et al. Additional file 4_Adverse event eCRF). Linear regression will be used to analyse continuous outcomes, with log transformation to normalise residuals as needed. Binary outcomes will be analysed by binomial regression or logistic regression, Primary analysis will be by modified intention-to-treat (i.e., those randomised and who ingested at least one supplement dose of iron), with multiple imputations to replace missing data. Effect estimates will be adjusted for baseline covariates (C-reactive protein, alpha-1-acid glycoprotein, haemoglobin, ferritin, soluble transferrin receptor). Discussion This study will determine if therapeutic supplementation with haem iron is more efficacious than with conventional ferrous sulphate in enhancing haemoglobin and ferritin concentrations in anaemic children aged 6–12 months. Trial registration Pan African Clinical Trial Registry PACTR202210523178727

Published
2024
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2. Intense and Mild First Epidemic Wave of Coronavirus Disease, The Gambia

Author

Ousman Secka, Charles Roberts, Nuredin Mohammed, Carla Cerami, Modou Jobe, Mamadou Ousmane Ndiath, Babatunde Awokola, Yekini Olatunji, Babanding Sabally, Abdoulie Bojang, Mariama Drammeh, Beate Kampmann, Sheikh Jarju, Bubacarr Susso, Assan Jaye, Abdul Karim Sesay, Anna Roca, Aminata Vilane, Orighomisan Agboghoroma, Sherifo Jagne, Ahmadou Lamin Samateh, Buba Manjang, Sana Sambou, Kalifa Bojang, Karen Forrest, Andrew M. Prentice, Effua Usuf, Eniyou Oriero, Fatai Akemoke, Yankuba Singhateh, Baderinwa Abatan, Helen Brotherton, Francis Oko, Natalie Hofmann, Uduak Okomo, Hawanatu Jah, Martin Antonio, Davis Nwakanma, Melisa Martinez-Alvarez, Ed Clarke, Oghenebrume Wariri, Emmanuel Okoh, Esin Nkereuwem, Behzad Nadjm, Thushan I de Silva, Umberto D'Alessandro, and Mustapha Bittaye

Subjects
Microbiology (medical), transmission rate, Epidemiology, Population, severity respiratory infections, coronavirus, Infectious and parasitic diseases, RC109-216, Asymptomatic, disease burden, Seroepidemiologic Studies, Environmental health, Pandemic, medicine, Humans, Cumulative incidence, viruses, education, Pandemics, Disease burden, SARS, education.field_of_study, Intense and Mild First Epidemic Wave of Coronavirus Disease, The Gambia, Transmission (medicine), business.industry, SARS-CoV-2, Research, COVID-19, The Gambia, zoonoses, Infectious Diseases, coronavirus disease, Africa, Medicine, Gambia, medicine.symptom, business, Contact tracing, severe acute respiratory syndrome coronavirus 2
Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is evolving differently in Africa than in other regions. Africa has lower SARS-CoV-2 transmission rates and milder clinical manifestations. Detailed SARS-CoV-2 epidemiologic data are needed in Africa. We used publicly available data to calculate SARS-CoV-2 infections per 1,000 persons in The Gambia. We evaluated transmission rates among 1,366 employees of the Medical Research Council Unit The Gambia (MRCG), where systematic surveillance of symptomatic cases and contact tracing were implemented. By September 30, 2020, The Gambia had identified 3,579 SARS-CoV-2 cases, including 115 deaths; 67% of cases were identified in August. Among infections, MRCG staff accounted for 191 cases; all were asymptomatic or mild. The cumulative incidence rate among nonclinical MRCG staff was 124 infections/1,000 persons, which is >80-fold higher than estimates of diagnosed cases among the population. Systematic surveillance and seroepidemiologic surveys are needed to clarify the extent of SARS-CoV-2 transmission in Africa.

Published
2021

3. Establishing and operating a 'virtual ward' system to provide care for patients with COVID-19 at home: experience from The Gambia

Author

Esin Nkereuwem, Naffie Jobe, Kalifa Bojang, Francis Oko, Bubacarr Susso, Ghata Sowe, Orighomisan Agboghoroma, Effua Usuf, Fatai M. Akemokwe, Thomas Gilleh, Modou Jobe, Ed Clarke, Bunja Kebbeh, Helen Brotherton, Yekini Olatunji, Carla Cerami, Karen Forrest, Uduak Okomo, Hawanatu Jah, Oghenebrume Wariri, and Emmanuel Okoh

Subjects
Medicine (General), Coronavirus disease 2019 (COVID-19), 030231 tropical medicine, Infectious and parasitic diseases, RC109-216, control strategies, Multidisciplinary team, Unit (housing), 03 medical and health sciences, 0302 clinical medicine, R5-920, Pandemic, medicine, Humans, 030212 general & internal medicine, Human resources, Pandemics, Africa South of the Sahara, Practice, business.industry, SARS-CoV-2, Health Policy, Public Health, Environmental and Occupational Health, COVID-19, medicine.disease, Medical research, Hospitals, 3. Good health, West african, Gambia, Medical emergency, Business, health systems, Healthcare system
Abstract

Health systems in sub-Saharan Africa have remained overstretched from dealing with endemic diseases, which limit their capacity to absorb additional stress from new and emerging infectious diseases. Against this backdrop, the rapidly evolving COVID-19 pandemic presented an additional challenge of insufficient hospital beds and human resource for health needed to deliver hospital-based COVID-19 care. Emerging evidence from high-income countries suggests that a ‘virtual ward’ (VW) system can provide adequate home-based care for selected patients with COVID-19, thereby reducing the need for admissions and mitigate additional stress on hospital beds. We established a VW at the Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine, a biomedical research institution located in The Gambia, a low-income west African country, to care for members of staff and their families infected with COVID-19. In this practice paper, we share our experience focusing on the key components of the system, how it was set up and successfully operated to support patients with COVID-19 in non-hospital settings. We describe the composition of the multidisciplinary team operating the VW, how we developed clinical standard operating procedures, how clinical oversight is provided and the use of teleconsultation and data capture systems to successfully drive the process. We demonstrate that using a VW to provide an additional level of support for patients with COVID-19 at home is feasible in a low-income country in sub-Saharan Africa. We believe that other low-income or resource-constrained settings can adopt and contextualise the processes described in this practice paper to provide additional support for patients with COVID-19 in non-hospital settings.

Published
2021

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