Browsing by Author "Ahmed, I."
Now showing 1 - 3 of 3
Results Per Page
Sort Options
Item Direct maternal morbidity and the risk of pregnancy-related deaths, stillbirths, and neonatal deaths in South Asia and sub Saharan Africa: A population-based prospective cohort study in 8 countries(PLOS, 2021) Aftab, F.; Ahmed, I.; Ahmed, S.; Ali, S.M.; Amenga-Etego, S.; Ariff, S.; Bahl, R.; Baqui, A.H.; Begum, N.; Bhutta, Z.A.; Biemba, G.; Cousens, S.; Das, V.; Deb, S.; Dhingra, U.; Dutta, A.; Edmond, K.; Esamai, F.; Ghosh, A.K.; Gisore, P.; Grogan, C.; Hamer, D.H.; Herlihy, J.; Hurt, L.; Ilyas, M.; Jehan, F.; Juma, M.H.; Kalonji, M.; Khanam, R.; Kirkwood, B.R.; Kumar, A.; Kumar, A.; Kumar, V.; Manu, A.; Marete, I.; Mehmood, U.; Minckas, N.; Mishra, S.; Mitra, D.K.; Moin, M.I.; Muhammad, K.; Newton, S.; Ngaima, S.; Nguwo, A.; Nisar, M.I.; Otomba, J.; Quaiyum, M.A.; Sarrassat, S.; SazawalI, S.; Semrau, K.E.; Shannon, C.; Singh, V.P.; Soofi, S.; Soremekun, S.; Suleiman, A.M.; Sunday, V.; Dilip, T.R.; Tshefu, A.; Wasan, Y.; Yeboah-Antwi, K.; Yoshida, S.; Zaidi, A.K.Maternal morbidity occurs several times more frequently than mortality, yet data on morbidity burden and its effect on maternal, foetal, and newborn outcomes are limited in low- and middle-income countries. We aimed to generate prospective, reliable population-based data on the burden of major direct maternal morbidities in the antenatal, intrapartum, and postnatal periods and its association with maternal, foetal, and neonatal death in South Asia and sub-Saharan Africa. This is a prospective cohort study, conducted in 9 research sites in 8 countries of South Asia and sub-Saharan Africa. We conducted population-based surveillance of women of reproductive age (15 to 49 years) to identify pregnancies. Pregnant women who gave consent were include in the study and followed up to birth and 42 days postpartum from 2012 to 2015. We used standard operating procedures, data collection tools, and training to harmonise study implementation across sites. Three home visits during pregnancy and 2 home visits after birth were conducted to collect maternal morbidity information and maternal, foetal, and newborn out comes. We measured blood pressure and proteinuria to define hypertensive disorders of pregnancy and woman’s self-report to identify obstetric haemorrhage, pregnancy-related infection, and prolonged or obstructed labour. Enrolled women whose pregnancy lasted at least 28 weeks or those who died during pregnancy were included in the analysis. We used meta-analysis to combine site-specific estimates of burden, and regression analysis combining all data from all sites to examine associations between the maternal morbidities and adverse outcomes. Among approximately 735,000 women of reproductive age in the study population, and 133,238 pregnancies during the study period, only 1.6% refused consent. Of these, 114,927 pregnancies had morbidity data collected at least once in both antenatal and in postnatal period, and 114,050 of them were included in the analysis. Overall, 32.7% of included pregnancies had at least one major direct maternal morbidity; South Asia had almost double the burden compared to sub-Saharan Africa (43.9%, 95% CI 27.8% to 60.0% in South Asia; 23.7%, 95% CI 19.8% to 27.6% in sub-Saharan Africa). Antepartum haemorrhage was reported in 2.2% (95% CI 1.5% to 2.9%) pregnancies and severe postpartum in 1.7% (95% CI 1.2% to 2.2%) pregnancies. Preeclampsia or eclampsia was reported in 1.4% (95% CI 0.9% to 2.0%) pregnancies, and gestational hypertension alone was reported in 7.4% (95% CI 4.6% to 10.1%) pregnancies. Prolonged or obstructed labour was reported in about 11.1% (95% CI 5.4% to 16.8%) pregnancies. Clinical features of late third trimester antepartum infection were present in 9.1% (95% CI 5.6% to 12.6%) pregnancies and those of postpartum infection in 8.6% (95% CI 4.4% to 12.8%) pregnancies. There were 187 pregnancy related deaths per 100,000 births, 27 stillbirths per 1,000 births, and 28 neonatal deaths per 1,000 live births with variation by country and region. Direct maternal morbidities were associated with each of these outcomes. Our findings imply that health programmes in sub-Saharan Africa and South Asia must intensify their efforts to identify and treat maternal morbidities, which affected about one-third of all pregnancies and to prevent associated maternal and neonatal deaths and stillbirths.Item Non-tuberculous mycobacterial infections—A neglected and emerging problem(International Journal of Infectious Diseases, 2020-02-27) Yeboah-Manu, D.; Ahmed, I.; Tiberi, S.; Farooqi, J.; Jabeen, K.; Migliori, G.B.; Hasan, R.Non-tuberculous mycobacteria (NTM) are ubiquitous dwellers of environmental niches and are an established cause of natural and nosocomial infections. The incidence of NTM infections is rising owing to a growing population of immunocompromised and vulnerable individuals, complex medical and surgical procedures, as well as increased awareness and diagnostic capabilities. The prevalence of different NTM varies between continents, regions, and countries. The true global burden of pulmonary and extrapulmonary disease is unknown and estimates are subject to under and/or over-estimation. Diagnosis requires confirmation by isolation of NTM along with clinical and radiological criteria, which may be suboptimal at all levels. Susceptibility testing is complex and clinical breakpoints are not available for many of the drugs. Frequently, NTM infections are not considered until late in the course of disease. Improved and rapid detection of tuberculosis cases in high-burden countries has, however, also brought NTM infections into the limelight, and has identified a need for research efforts towards rapid diagnostic tests and the identification of biomarkers to monitor the treatment response in patients with NTM infections.Item Post-Cold War Foreign Policy of the U.S. in West Africa: A Case Study Of Ghana and Nigeria.(University of Ghana, 2020-10) Ahmed, I.U.S. foreign policy formulation and implementation is one of the complex political processes in America. Post-Cold War foreign policy of the U.S. towards the West African sub-region can be understood in the broad context of U.S. policy towards Africa. West African states were used as pawns during the Cold War between the U.S. and the Soviet Union. The sub-region is still of strategic importance to America in the Post-Cold War era. Extant literature on U.S. foreign policy towards Africa focused on continuity. And this study seeks to find out in what ways the foreign policy of the U.S. in West Africa has undergone change after the end of the Cold War. Thus, it investigates the parameters or trends of change in Post-Cold War U.S. foreign policy in the sub-region. Also, it discovers the exact interests of U.S. and the strategies adopted by America to halt the creeping rise of China in West Africa. Data collected from semi-structured interview and literatures were interpreted and analysed within the theoretical framework adopted by this study. That is Offensive Realism. The study found out that the parameters or trends of change in Post-Cold War U.S. policy border around ideological, economic and security interests but the two major changes are economic and security interests. The study also revealed that the U.S. are using propaganda tools, soft diplomacy and hard power to halt the creeping rise of China’s influence in West Africa. The study claims that U.S. foreign policy toward the sub-region changes on the basis current happenings in the international system in order to suit its interests