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Child Feeding for Human Health and Development: Bridging the Know-Do Gap
(University of Ghana, 2024-07-11) Aryeetey, R.O.N.
‘You are what you eat’ is a commonly quoted phrase when people think of diet. A healthy diet promotes optimal health and development. On the other hand, suboptimal diet can hurt you in more ways than you can imagine. Diet simply refers to what you eat and drink regularly as a lifestyle. It also relates to the habits and practices surrounding how you eat. Transitions in lifestyles, fuelled by rapid industrialisation, urbanisation, global trade, information access and other indicators of civilisation is creating a situation where unhealthy diets have become the norm. Indeed, there is a global pandemic of unhealthy diets. The bad news is that, unhealthy diet is one of the leading risk factors driving the main causes of death, diseases and disabilities, including diseases like cardiovascular diseases, diabetes and some cancers. Infants and young children are most vulnerable to unhealthy diets. In our part of the world, they suffer twice from unhealthy diets. During childhood, they experience undernutrition that is occasioned by suboptimal feeding. Across West Africa, about one-third or all children under 5 years are chronically malnourished. The suboptimal feeding in childhood and its resulting malnutrition, then physiologically programmes young children into adults, with a high risk for diet-related chronic diseases. These young children have an even bigger challenge. They depend on their caregivers (mothers, fathers, grandmothers, others), to make the decisions that ensure that their diets are adequate for not only surviving childhood, but also to grow, thrive and to contribute meaningfully to society. This is because when infant feeding goes wrong, it has implications not only for individual children and their families but also for the entire society. A large part of my research and extension over the past two decades has focused on understanding the barriers to optimal infant and young child feeding. My expectation is that this evidence will serve as a basis for advocacy to improve the quality of the public health interventions that target young children. There is robust and consistent evidence that when children are exposed to appropriate ways of breastfeeding and subsequently complementing breast milk with appropriate nutrient-rich foods from the 6th month, in line with national and global recommendations, they, their mothers, their households and society benefit in many ways including reduced risk of disease, death, savings of revenue that will otherwise be spent for health care, improved learning abilities and enhanced productivity. However, despite the weight of the evidence related to these outcomes, as a nation, we have failed to ensure adequate feeding of our children. Our failure is not due to the lack of effort to address this challenge. Indeed, several programmes and projects have been, and continue to be implemented, with much resources expended to address the multi-dimensional and hierarchical drivers of sub-optimal child diets. In this lecture, I utilise global evidence, as well as my own research to demonstrate why we have not been successful in addressing the challenge of child feeding. In outlining the barriers, I point to the irony of having access to all the evidence of what works (efficacy) and yet not being able to translate them into action. I will argue that this is partly a challenge of our institutional arrangements regarding the delivery of services for ensuring optimal infant and young child feeding as well as our individual choices as caregivers of the children we love so much. I also underscore the complexity of delivering interventions in an increasingly urbanising population with diverse needs, and how important it is to enhance coordination across sectors in our governance system to meet the needs. Between 2014 and 2018, I led multiple research projects in Ghana focusing on young child nutrition that provided evidence on how we can improve the diets of infants and young children. I will provide a brief synthesis of findings of these studies as a basis for bridging the know-do gap, to limit the current sub-optimal diets of Ghanaian children. Further, there are emerging challenges that must be recognised as well as novel solutions to infant and young child feeding that Ghana is yet to take advantage of. I will make reference to some of these as a basis for the recommendations that I will advance for improving infant and young child feeding in Ghana.
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Ending HIV/AIDS in Africa: Reflections from the Clinic, Field and Classroom
(University of Ghana, 2023-08-10) Torpey, K.
The first case of AIDS was first identified in early 1980 in Los Angeles, USA with patients showing evidence of severe immunosuppression. In 1981, the syndrome was described and the virus was subsequently isolated in 1983. There are two types of HIV. HIV-1 is the predominant type found all over the world. In addition, HIV 2 is found in the West Africa region. HIV 2 is less virulent compared to HIV 1. In Ghana HIV 1 accounts for almost 98% whilst HIV 2 alone or in combination with HIV1 account for approximately 2%. The origins of HIV range from several conspiracy theories to divine retribution. Viruses related to HIV-1 have been isolated from the common chimpanzee and several monkey species. There are different clades of HIV -1. Ranging from main group M made up several clades to the outlier O group. Simian immunodeficiency virus of sooty mangabeys (SIVsmm) is recognized as the progenitor of human immunodeficiency virus type 2 (HIV-2). SIV infection in humans has been documented. A paper by Marcia Kallish on Emerging Infectious Disease in 2005 among Central African hunters, showed a prevalence of 17.1% in the most exposed, that is those who hunted and butchered or kept non-human primates. There are about 39million people living with HIV. 20.8 million of them are in East and Southern Africa, 4.8million in West and Central Africa. UNAIDS update in 2023 estimates that a life is lost every minute due to HIV. This is equivalent to 650,000 HIV related deaths. In addition, there are 4,000 new infections daily. Every week, 4,000 adolescent girls and young women get infected, while 84,000 children died of HIV last year. Subsaharan Africa accounts for 51% of all new infections. 76% of people living with HIV are on treatment. Unfortunately for children, only 57% are on treatment. Key populations account for less than 5% of the world population but 70% of new infections occur among them and their sexual partners, underlying their vulnerability and a call to action. In 2002, the HIV treatment project called START was birthed through a collaboration of Family Health International and the Ministry of Health. The funding was to start the first 100 patients in St. Martin’s Hospital in Agomanya and Atua Government Hospital in Atua in the Manya Krobo District, on antiretroviral therapy. Following the overwhelming success in the pilot project, the then UK Department for International Development moved to support the programme. Subsequently the national treatment programme secured funding from USAID, Global Fund and the World Bank. The success was attributable to the commitment of health care workers, facilities, and use of evidence based approach. The experiences in treating persons living with HIV from the pilot project allowed the development of practice guidelines on the management of side effects like anaemia, peripheral neuropathy, hepatoxicity among others. Antiretroviral therapy made a huge difference in the life of individuals. There was a reduction in morbidity and mortality. It was clear that patient level strategies at the clinic was effective, however many persons living with HIV did not have access to treatment. This required radical change in mindset to transfer the benefits observed at the clinic to the population level, particularly in countries with high HIV prevalence or population. This influenced our intervention strategies particularly in Eastern, Southern Africa and Nigeria and marked an important transition in my career by moving the advantages observed in the clinic to the population level. In Zambia, we implemented the adherence support worker strategy to address the human resource challenges. Adherence Support (Models of Hope in Ghana) are persons living with HIV who are trained to offer adherence counseling and follow up. We showed that the adherence counselling provided by these lay providers was comparable to that provided by nurses. We were also able to demonstrate that HIV testing using lay providers was comparable to testing service by nurses. This important evidence provided a strong basis for task shifting efforts to expand access to HIV services across sub-Saharan African countries. HIV in children is a blot on the conscience of humanity. This is because we have the knowledge and the strategies to eliminate pediatric HIV Elimination of Mother to Child Transmission in Africa. Mother to child transmission of HIV can take place during pregnancy, labour and delivery and during the breastfeeding period. In an observation study of over 28,320 HIV positive mother baby pairs from 317 facilities and 40 districts in Zambia, we observed that HIV transmission was lowest among those where baby and mother received prophylaxis and highest among those who did not attend antenatal clinic. In addition, mothers who received the drugs were less likely to transmit HIV to their babies. Women who practiced mixed feeding were likely to transmit HIV to the babies. Other early infant diagnosis studies that we conducted in Kenya and Malawi affirmed this fact. Majority of pregnant women screened at the antenatal clinic would test negative. Unfortunately, several of them would seroconvert during the pregnancy because of repeated sexual exposure. In our published work in JIAPAC, we were able to show that pregnant women who seroconverted during pregnancy were four times more likely to transmit the infection to the baby. HIV re-testing among seronegative mothers is essential in eliminating HIV. Key populations are defined groups who, due to specific higher risk behaviors, are at increased risk of HIV, irrespective of the epidemic type or local context. Also, they often have legal and social issues related to their behaviors that increase their vulnerability to HIV. The key populations are important to the dynamics of HIV transmission. UNAIDS describes five main groups as key population. They include the following; sex workers, men who have sex with men, transgender people, persons who inject drugs and prisoners as well as other incarcerated people. Key populations account for less than 5% of the world’s population but about 70% of new infections in 2021. In sub-Saharan Africa, 49% of new infections are among the general population, 41% are among sex workers, clients of sex workers and sexual partners of other key populations and 6% among men who have sex with men. In terms of relative risk, for persons who inject drugs the risk is 7X higher, 4X higher among sex workers, 11X among men who have sex with men and 14X among transgender people. A strong HIV programme can only do well in a strong health system.Globally, official development assistance for HIV from bilateral partners apart from the US Government has declined. The World Bank projects that 52 countries, home to 43% of people living with HIV, will experience a significant drop in their public spending capacity through 2026. The role of domestic financing of HIV programmes will become very crucial. Ghana must make urgent steps to increase its domestic contribution to HIV not only to provide services to its people but also demonstrate its commitment to the national response. The approval and operationalization of the National HIV/AIDS fund will be a step in the right direction. As a teacher, building capacity of the next generation of implementers and scientists in HIV programming, is an area of great importance. Currently our training grants and scholarships, programme related research and evaluations seek to give hands on experience in programme implementation to our beneficiaries. The use of long-acting agents in HIV treatment is another interesting area. Evidence from LATTE 1&2, FLAIR and ATLAS studies has shown that long acting Carbotegravir and Rilpivirine administered monthly or bimonthly are effective compared to the standard of care for treatment. Carbotegravir and Rilpivirine also known as Carbenuva, was approved by the US FDA in January 2021 for two monthly dosing. Lenacapavir is an exciting new drug that was approved in the European Union and UK, recently, in August 2022 for drug resistant HIV. It belongs to capsid inhibitors group. It can be given 6 monthly. Can we end AIDS in Africa? To get into the right trajectory to end AIDS in Africa, we need to attain the state of epidemic control. Epidemic control of HIV is when the number of new HIV infections in less than the number of HIV deaths. This will lead to a gradual decline of persons infected with HIV. In 2022, West and Central Africa had 160,000 new HIV infections with 120,000 HIV deaths. In Eastern and Southern Africa there were 500,000 new infections and 260,000 deaths. Back home in Ghana, there were 17,000 new infections and 9,900 deaths in 2021. Eswatini, Botswana, Rwanda, Tanzania and Zimbabwe have achieved the 95-95-95 whilst eight others are on track to reach the target. Achieving epidemic control requires systematic reduction of new infections in the Africa region.
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Defining ‘Smart Rural’ in the Framework of Regional Digitalisation
(IST-Africa 2021 Conference Proceedings, 2021) Lindblom, P.; Kolog , E.A.; Nygren, E.; Sutinen, E.
In this paper, we explored how a smart development framework could be harnessed for enhancing small and medium enterprise (SME) activities in rural communities. With this aim, this study considered and compared the landscape of the SME ecosystems in Ghana and Finland. Alongside the deprived countryside or remote work context, it has become clear that contemporary digital platforms and collaborative media represent an integral part of smart development. In addition, remote working possibilities help tackle challenging times or even a state of emergency, such as the ongoing COVID-19 crisis. We created our Smart rural development model (SRDm) to facilitate the digital transformation of SMEs and strategies in peripheral settings. Our SRDm was developed from the exploration of smart development literature in regional settings, and filtering numerous initiatives utilutilizedhin digitalization SME development context. The key target groups who can benefit from our research endeavor are the various strategic development organizations, financing authorities, and of course regional stakeholders, policymakers, business clusters, SMEs, and individuals.
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Institutions and African Economic Development
(Working Paper, 2022) Fosu, A.K.
In light of the increasing importance of institutions in economic development and Africa’s desire to catch up, the present paper provides an account of this crucial subject, ‘Institutions and African Economic Development. First, adopting the usual definition of ‘institutions’ as ‘rules of the game’, the paper shows that improvements in economic institutions, such as economic freedom, had begun by the early 1990s, and accelerated about the mid-1990s, consistent with observed improvements in economic and development outcomes. Also improved are measures of political institutions: an index of electoral competitiveness, constraint on the executive branch of government, and polity 2 as an indicator of the level of democracy, beginning in the late 1980s or early 1990s. Second, based primarily on a review of the extant literature, the paper observes that these improvements in the measures of economic and political institutions are positively associated with the increasing economic development in Africa. Third, indicators of institutional instability, measured by the frequency of civil wars and the incidence of coups d’etat, have been diminishing since the early 1990s, with implications for improved growth and human development. Fourth, some evidence is provided in support of the notion that African countries with better performance on institutional quality during the period of growth resurgence have also exhibited greater progress in poverty reduction. Finally, the paper concludes by flagging the potential risk of African countries backtracking on their respective trajectories toward achieving the democratic consolidation required to sustain the gains in growth and development.
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Ensemble learning prediction of transmittance at different wavenumbers in natural hydroxyapatite
(Scientific African, 2020) Okafor, E.; Dodoo-Arhin, D.; Obada, D.O.
Material engineering-based research has often relied so much on tedious human exper iments for generating specific engineering properties with a major draw-back of high time demand that can span between an hour and days. Hence to deviate from the usual paradigm, we provide an alternative approach which employs artificial intelligence (AI) based ensemble learning methods for predicting the degree of transmittance for a range of wavenumbers of infrared radiation through hydroxyapatite (HAp) samples. The effective samples (transmittance and wavenumber) were passed as input to the predictive systems. For this, we trained two ensemble learning methods: Extreme Gradient Boosting (XGBoost) and Random Forest on variants of HAp (density and time variations), while considering a fixed amount of 10,000 base estimators. The results show that Random Forest marginally outperforms the XGBoost in the testing phase but requires a much longer computing time. However, XGBoost is much faster than the Random Forest. Furthermore, the examined en semble learning models yielded a coefficient of determination (R2 > 0.997): which are in close agreement with experimental data, depicting an excellent generalization capacity. Additionally, the examined ensemble learning models showed a significant ≥ 99.83% de crease in computational complexity relative to the time spent when generating the exper imental data. Overall, the use of ensemble learning models is very important for validating material engineering properties
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Photocatalytic degradation of Rhodamine dyes using zinc oxide nanoparticles
(Materials Today: Proceedings, 2020) Dodoo-Arhin, D.; Asiedu, T.; Agyei-Tuffour, B.; et al.
This paper presents the synthesis of nanocrystalline zinc oxide (ZnO) particles via the sol-gel method using zinc acetate as a precursor. The calcination temperature of the ZnO was varied to determine its effect on particle size. The resultant samples were characterized using X-ray diffraction (XRD), Fourier Transform Infrared (FTIR), UltraViolet–visible Spectroscopy (UV–Vis) and Scanning Electron Microscopy (SEM). Nanocrystalline wurtzite ZnO particles with crystallite sizes ranging from 16 nm to 30 nm were produced. The Energy Band gap of the synthesized zinc oxide nanoparticles decreased with increasing calcination temperature and crystallite size. SEM Micrographs showed rice-like microstructure morphology of ZnO nanoparticles. The usage of the ZnO nanoparticles as a photocatalyst was also explored in the degradation of Rhodamine B dye using UV light, with particular attention paid to the effect of particle size and catalyst load on the degradation efficiency of the dyes. The nanoparticles calcined at 400 C with a crystallite size of 16 nm resulted in the highest degradation efficiency of 95.41% when 0.2 g catalyst loading was applied. 2019 Elsevier Ltd. All rights reserved. Selection and peer review under the responsibility of the scientific committee of the International Symposium on Nanostructured, Nanoengineered, and Advanced Materials
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The physico-mechanical influence of dehydroxylized activated local kaolin: A supplementary cementitious material for construction applications
(Case Studies in Construction Materials, 2019) Marfo, K.K.; Dodoo-Arhin, D.; Agyei-Tuffou, B.; et al.
This work presents the effect of partially replacing metakaolin with Portland limestone cement to produce mortars for construction. Teleku Bokazo kaolin was explored as an SCM for the production of mortars. The hydration product between Portland limestone and metakaolin was studied. The kaolin was heat treated to form metakaolin and partially used to replace Portland limestone cement (PLC) in mortars to explore the optimum replacement and its mechanical and durability effect. The samples were characterized using X-ray diffraction (XRD) for phases and crystallinity of the kaolin. Fourier transform infrared spectroscopy (FTIR) and Scanning electron microscopy (SEM) gave information on the functional groups formed during the hydration and structure and surface morphology respectively. The pastes and mortars produced were subjected to setting time, water absorption, flexure, and compression strength tests. The mechanical properties were observed to increase with increasing metakaolin replacements. Therefore, from the results obtained, it is suggested that a 20 % replacement of Portland limestone cement with Teleku Bokazzo metakaolin can be very suitable for construction applications.
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Hydroxyapatite ceramics prepared from two natural sources by direct thermal conversion: From material processing to mechanical measurements
(Materials Today: Proceedings, 2020) Akpan, E.S.; Dodoo-Arhin, D.; Dauda, M.; et al.
In this study, hydroxyapatite (HAp) was extracted from catfish bones (CB) and non-separated animal bones (NB). The bioceramic samples were prepared by a facile synthesis route and the representative scaffolds were prepared by cold compaction and sintered at 900 C, 1000 C, and 1100 C. To evaluate the properties of the produced HAp, X-ray diffraction (XRD) and Fourier Transform Spectroscopy (FT IR) analyses were carried out. The evaluation of the hardness of the representative bio-derived scaffolds was experimentally conducted while the fracture toughness and brittleness index were obtained by calculation using the hardness test parameters. The experimental data showed that as temperature increased up to 1000 C for CB, there was a consequential increase in hardness, while for NB, hardness values reduced throughout the sintering regimes. These gradients in mechanical measurements are ascribed to phase changes during heat treatment. 2020 The Authors. Published by Elsevier Ltd. This is an open-access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by nc-nd/4.0). Selection and Review under the responsibility of the scientific committee of the International Conference & Exposition on Mechanical, Material and Manufacturing Technology
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Modified nanostructured titania photocatalysts for aquatic disinfection applications
(Materials Today: Proceedings, 2020) Dodoo-Arhin, D.; Bowen-Dodoo, E.; Agyei-Tuffour, B.; et al.
According to SDG 6, everyone on earth should have access to safe and affordable drinking water. In sharing water-treatment technologies that lead to accomplishing this goal, it is imperative to devise ways of removing microbial contaminants such as E. coli from drinking water, especially in resource-limited settings that lack centralized water supply systems. One of the approaches is bacterial disinfection of water at the point of use. In this study, the bactericidal effects of the photocatalysis of titanium dioxide-based nanoparticles under UV and visible light are explored. Pristine and silver doped nanostructured mesoporous titanium dioxide (Ag-TiO2, TiO2) particles with high specific surface area and average crystallite domain size of 7.0–7.5 nm were prepared using the simple and cost-effective sol-gel technique followed by thermal treatment. The addition of Ag+ ions during the hydrolysis/condensation of the Ti(IV) molecular precursor led to the homogeneous dispersion of the Ag+ cations on the titania matrix. The As-prepared nanoparticles were characterized using X-ray diffraction (XRD), Brunauer–Emmett–Teller (BET) surface area analysis, Transmission Electron Microscopy (TEM), Scanning Electron Microscopy (SEM), thermogravimetry, Fourier Transform Infra-Red (FTIR), and Raman Spectroscopy. X-ray diffraction, FTIR, and Raman spectroscopy confirmed that the crystalline structure of the TiO2 matrix corresponds to the anatase polymorph; however, the presence of the dopant led to an increase in the system disorder due to the rise in the concentration of oxygen vacancies. The As-prepared nanoparticles were used for Escherichia coli (E. coli) inactivation under dark and UV–visible light conditions. Under dark conditions, Ag-doped titania and pristine titania resulted in 95% and 64% E. coli population inactivity while under light conditions, 99% and 97% degradation respectively were observed. Taken together, these results demonstrate that, the synthesized TiO2 nanoparticles have promising applications in the light-mediated point-of-use inactivation of bacterial contaminants in water. 2019 Elsevier Ltd. All rights reserved. Selection and peer review under the responsibility of the scientific committee of the International Symposium on Nanostructured, Nanoengineered, and Advanced Materials.