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Banjul, Gambia

Bashorun A.,MRC Unit the Gambia | Worwui A.,Data Management | Parker D.,Data Management
AICT 2013 - 7th International Conference on Application of Information and Communication Technologies, Conference Proceedings | Year: 2013

Information security awareness has become the focal point of businesses around the world. IT (information Technology) services are less effective due to the fact that IT users the key factor are the weakest security link which renders technology and its solutions less sufficient in providing a well secured environment. Thus, it is important for an organization to determine the level of information security awareness among users so as to gain valuable knowledge on how to encourage strong commitment and support. Also to put in place policies and procedures, provide security awareness and education, and stimulate future IT security plans. © 2013 IEEE. Source

Mendy M.,Medical Research Council Laboratories | Mendy M.,International Agency for Research on Cancer | Peterson I.,Medical Research Council Laboratories | Peterson I.,Boston University | And 10 more authors.
PLoS ONE | Year: 2013

Objectives: To determine the duration of protection from hepatitis B vaccine given in infancy and early childhood and asses risk factors for HBV infection and chronic infection. Methods: In 1984 infant HBV vaccination was started in two Gambian villages. Cross sectional serological surveys have been undertaken every 4 years to determine vaccine efficacy. In the current survey 84.6% of 1508 eligible participants aged 1-28 years were tested. A spouse study was conducted in females (aged 14 years and above) and their male partners. Results: Vaccine efficacy against chronic infection with hepatitis B virus was 95.1% (95% confidence interval 91.5% to 97.1%), which did not vary significantly between age groups or village. Efficacy against infection was 85.4% (82.7% to 87.7%), falling significantly with age. Concentrations of hepatitis B antibody fell exponentially with age varying according to peak response: 20 years after vaccination only 17.8% (95% CI 10.1-25.6) of persons with a low peak response (10-99 mIU/ml) had detectable HBs antibody compared to 27% (21.9% to 32.2%) of those with a high peak response (>999 mIU/ml). Time since vaccination and a low peak response were the strongest risk factors for HBV infections; males were more susceptible, marriage was not a significant risk for females. Hepatitis B DNA was not detected after infection, which tested soley core antibody positive. An undetectable peak antibody response of <10 mIU/ml and a mother who was hepatitis B e antigen positive were powerful risk factors for chronic infection. Conclusions: Adolescents and young adults vaccinated in infancy are at increased risk of hepatitis B infection, but not chronic infection. Married women were not at increased risk. There is no compelling evidence for the use of a booster dose of HBV vaccine in The Gambia. © 2013 Mendy et al. Source

Bah A.,MRC Unit The Gambia and MRC International Nutrition Group | Wegmuller R.,MRC Unit The Gambia and MRC International Nutrition Group | Cerami C.,MRC Unit The Gambia and MRC International Nutrition Group | Kendall L.,MRC Unit the Gambia | And 3 more authors.
BMC Pregnancy and Childbirth | Year: 2016

Background: Until recently, WHO recommended daily iron supplementation for all pregnant women (60 mg/d iron combined with 400ug/d folic acid) where anaemia rates exceeded 40 %. Recent studies indicate that this may pose a risk to pregnant women. Therefore, there is a need to explore screen-and-treat options to minimise iron exposure during pregnancy using an overall lower dosage of iron that would achieve equivalent results as being currently recommended by the WHO. However, there is a lack of agreement on how to best assess iron deficiency when infections are prevalent. Here, we test the use of hepcidin a peptide hormone and key regulator of iron metabolism, as a potential index for 'safe and ready to receive' iron. Design/Methods: This is a 3-arm randomised-controlled proof-of-concept trial. We will test the hypothesis that a screen-and-treat approach to iron supplementation using a pre-determined hepcidin cut-off value of <2.5 ng/ml will achieve similar efficacy in preventing iron deficiency and anaemia at a lower iron dose and hence will improve safety. A sample of 462 pregnant women in rural Gambia will be randomly assigned to receive: a) UNU/UNICEF/WHO international multiple micronutrient preparation (UNIMMAP) containing 60 mg/d iron (reference arm); b) UNIMMAP containing 60 mg/d iron but based on a weekly hepcidin screening indicating if iron can be given for the next 7 days or not; c) or UNIMMAP containing 30 mg/d iron as in (b) for 12 weeks in rural Gambia. The study will test if the screen-and-treat approach is non-inferior to the reference arm using the primary endpoint of haemoglobin levels at a non-inferiority margin of 0.5 g/dl. Secondary outcomes of adverse effects, compliance and the impact of iron supplementation on susceptibility to infections will also be assessed. Discussion: This trial is expected to contribute towards minimising the exposure of pregnant women to iron that may not be needed and therefore potentially harmful. If the evidence in this study shows that the overall lower dosage of iron is non-inferior to 60 mg/day iron, this may help decrease side-effects, improve compliance and increase safety. The potential for the use of hepcidin for a simple point-of-care (PoC) diagnostic for when it is most safe and effective to give iron may improve maternal health outcomes. Trial registration:ISRCTN21955180 © 2016 The Author(s). Source

Prentice A.M.,London School of Hygiene and Tropical Medicine | Nabwera H.,London School of Hygiene and Tropical Medicine | Kwambana B.,MRC Unit the Gambia | Antonio M.,MRC Unit the Gambia | Moore S.E.,London School of Hygiene and Tropical Medicine
Science Translational Medicine | Year: 2013

New research implicates a dysfunctional gut microbiome in the etiology of severe childhood malnutrition and conf rms a role for antibiotics in its treatment. Source

Andreas N.J.,Imperial College London | Kampmann B.,Imperial College London | Kampmann B.,MRC Unit the Gambia | Mehring Le-Doare K.,Imperial College London | And 2 more authors.
Early Human Development | Year: 2015

Breast milk is the perfect nutrition for infants, a result of millions of years of evolution, finely attuning it to the requirements of the infant. Breast milk contains many complex proteins, lipids and carbohydrates, the concentrations of which alter dramatically over a single feed, as well as over lactation, to reflect the infant's needs.In addition to providing a source of nutrition for infants, breast milk contains a myriad of biologically active components. These molecules possess diverse roles, both guiding the development of the infants immune system and intestinal microbiota.Orchestrating the development of the microbiota are the human milk oligosaccharides, the synthesis of which are determined by the maternal genotype. In this review, we discuss the composition of breast milk and the factors that affect it during the course of breast feeding.Understanding the components of breast milk and their functions will allow for the improvement of clinical practices, infant feeding and our understanding of immune responses to infection and vaccination in infants. © 2015 Elsevier Ireland Ltd. Source

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