Evaluation of the Integrated Management Program for Acute Malnutrition in the Douentza Health District, Mopti Region, Mali

Introduction: Malnutrition is a major public health problem in Mali, despite the efforts of the government, its technical and financial partners. The aim of this study was to evaluate the integrated management program for acute malnutrition (IMPAM). Methodology: This was a descriptive cross-sectional study that took place from January to December 2020 in the Douentza health district. The study included anyone with at least one malnourished child aged 6 to 59 months in their care who agreed to take part in the study, community health center staff who had given their consent, and the URENI manager at the Douentza reference health center. Data collected via questionnaires were entered into Excel and then analyzed using Epi-Info version 7 software. Results: A total of 138 acutely malnourished children aged 6 - 59 months, including 71 girls (51.45%), 138 accompanying mothers and 11 health workers, were included in our case study. Among the malnourished, 54.34% were in the 12 - 23 months age group and 69.57% had the severe form. 93% of the mothers interviewed were satisfied with the care provided, and all the health staff interviewed stated that community conflicts had an impact on IMPAM’s activities. Cure rates were 81% in Moderate Outpatient Nutritional Recovery and Education Unit (URENAM), 84% in Severe Ambulatory Nutritional Recovery and Education Unit (URENAS) and 92% in Recovery and Intensive Nutritional Education Unit (URENI). Drop-out rates were 19% in URENAM, 16% in URENAS and 0% in URENI. The death rate was 8% in URENI and 0% in URENAM and URENAS. Conclusion: This study confirms the high prevalence of malnutrition in the district (10.54%). It also reveals that factors such as inter-community conflict and insecurity have seriously affected the IMPAM program.

益肾通络解毒汤对气阴两虚兼毒瘀互结型糖尿病肾病疗效及氧化应激的影响

目的探讨益肾通络解毒汤对气阴两虚兼毒瘀互结型糖尿病肾病的临床疗效及对氧化应激的影响。方法选取2018年1月—2019年6月医院收治的120例气阴两虚兼毒瘀互结型糖尿病肾病患者,随后依据患者就诊顺序将其分为观察组及对照组各60例,两组均予以口服降糖药、皮注胰岛素、运动疗法、饮食控制等基础治疗,在基础治疗上对照组加以尿毒清颗粒治疗,观察组予以益肾通络解毒汤治疗,比较治疗前后两组肾脏功能指标[肾小球滤过率(eGFR)、血肌酐(SCr)、24 h尿蛋白排泄率(24 h UAER)]、炎症指标[白细胞介素-6(IL-6)、超敏C反应蛋白(hsCRP)]、氧化应激指标[8-羟基脱氧鸟嘌呤(8-OHdG)、晚期糖基化终产物(AGEs)、丙二醛(MDA)、活性氧(ROS)、超氧化物歧化酶(SOD)、晚期氧化蛋白产物(AOPP)]变化情况,并比较两组病人的临床疗效。结果两组治疗疗程结束后,观察组肾功能、炎症反应及氧化应激水平各项指标均明显优于对照组(P<0.05)。观察组总有效率为90.00%,对照组总有效率为70.00%,观察组优于对照组(P<0.05)。结论益肾通络解毒汤治疗气阴两虚兼毒瘀互结型糖尿病肾病患者疗效确切,能有效改善患者的肾功能,其机制可能与其抑制炎症反应及抗氧化应激相关。

Vitamin A supplement: a key strategy to prevent vitamin A deficiency among young children in Afghanistan

Background:Vitamin A deficiency is the main problem of public health worldwide demonstrated that 190 million population of preschool children and 122 countries(in Africa and South-East Asia)have vitamin A deficiency,according to recent estimated research.In Afghanistan,vitamin A supplementation is a key strategy to prevent vitamin A deficiency among young children.Children receive vitamin A supplements as part of National Immunization Days(NID)campaigns.Methods:In this case study,the data was collected from June 15/2015 to February 23/2016,and the final report of the Afghanistan Demographic Health Survey(AfDHS)2015 was released on February 15/2017.All 27,209 children aged 6-59 months who are living with their mothers were included in this study.Who consumed foods rich in vitamin A was not included in this study.Results:The percentages who were given vitamin A supplements in the last 6 months among all children 6-59 months aged.A total of 1,572 children aged among 6-8 months were given vitamin A supplements 670(42.6%)children and comparison with the total community of the study(27,209)children(2.46%).A total of 1,148 children aged among 9-11 months were given vitamin A supplements to 465(40.5%)children and comparison with the total community of the study(27,209)children(1.70%).Conclusion:After following up on more studies,we found that vitamin A deficiency is a public problem,thus it is better to use wheat flour fortification,vitamin A capsule(VAC)supplementation,nutrition education,source of vitamin A,and training of primary healthcare workers on the clinical to prevent and treat the vitamin A deficiency among children.Therefore,we aimed to determine the given vitamin A supplementation among children aged 6-59 months in 33 provinces in Afghanistan,in 2015.