The Lancet
Jun 11, 2016 Volume 387 Number 10036 p2351-2478 e29
http://www.thelancet.com/journals/lancet/issue/current
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Articles
Global burden of diseases, injuries, and risk factors for young people’s health during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013
Ali H Mokdad, Mohammad Hossein Forouzanfar, Farah Daoud, Arwa A Mokdad, Charbel El Bcheraoui, Maziar Moradi-Lakeh, Hmwe Hmwe Kyu, Ryan M Barber, Joseph Wagner, Kelly Cercy, Hannah Kravitz, Megan Coggeshall, Adrienne Chew, Kevin F O’Rourke, Caitlyn Steiner, Marwa Tuffaha, Raghid Charara, Essam Abdullah Al-Ghamdi, Yaser Adi, Rima A Afifi, Hanan Alahmadi, Fadia AlBuhairan, Nicholas Allen, Mohammad AlMazroa, Abdulwahab A Al-Nehmi, Zulfa AlRayess, Monika Arora, Peter Azzopardi, Carmen Barroso, Mohammed Basulaiman, Zulfiqar A Bhutta, Chris Bonell, Cecilia Breinbauer, Louisa Degenhardt, Donna Denno, Jing Fang, Adesegun Fatusi, Andrea B Feigl, Ritsuko Kakuma, Nadim Karam, Elissa Kennedy, Tawfik A M Khoja, Fadi Maalouf, Carla Makhlouf Obermeyer, Amitabh Mattoo, Terry McGovern, Ziad A Memish, George A Mensah, Vikram Patel, Suzanne Petroni, Nicola Reavley, Diego Rios Zertuche, Mohammad Saeedi, John Santelli, Susan M Sawyer, Fred Ssewamala, Kikelomo Taiwo, Muhammad Tantawy, Russell M Viner, Jane Waldfogel, Maria Paola Zuñiga, Mohsen Naghavi, Haidong Wang, Theo Vos, Alan D Lopez, Abdullah A Al Rabeeah, George C Patton, Christopher J L Murray
Summary
Background
Young people’s health has emerged as a neglected yet pressing issue in global development. Changing patterns of young people’s health have the potential to undermine future population health as well as global economic development unless timely and effective strategies are put into place. We report the past, present, and anticipated burden of disease in young people aged 10–24 years from 1990 to 2013 using data on mortality, disability, injuries, and health risk factors.
Methods
The Global Burden of Disease Study 2013 (GBD 2013) includes annual assessments for 188 countries from 1990 to 2013, covering 306 diseases and injuries, 1233 sequelae, and 79 risk factors. We used the comparative risk assessment approach to assess how much of the burden of disease reported in a given year can be attributed to past exposure to a risk. We estimated attributable burden by comparing observed health outcomes with those that would have been observed if an alternative or counterfactual level of exposure had occurred in the past. We applied the same method to previous years to allow comparisons from 1990 to 2013. We cross-tabulated the quantiles of disability-adjusted life-years (DALYs) by quintiles of DALYs annual increase from 1990 to 2013 to show rates of DALYs increase by burden. We used the GBD 2013 hierarchy of causes that organises 306 diseases and injuries into four levels of classification. Level one distinguishes three broad categories: first, communicable, maternal, neonatal, and nutritional disorders; second, non-communicable diseases; and third, injuries. Level two has 21 mutually exclusive and collectively exhaustive categories, level three has 163 categories, and level four has 254 categories.
Findings
The leading causes of death in 2013 for young people aged 10–14 years were HIV/AIDS, road injuries, and drowning (25·2%), whereas transport injuries were the leading cause of death for ages 15–19 years (14·2%) and 20–24 years (15·6%). Maternal disorders were the highest cause of death for young women aged 20–24 years (17·1%) and the fourth highest for girls aged 15–19 years (11·5%) in 2013. Unsafe sex as a risk factor for DALYs increased from the 13th rank to the second for both sexes aged 15–19 years from 1990 to 2013. Alcohol misuse was the highest risk factor for DALYs (7·0% overall, 10·5% for males, and 2·7% for females) for young people aged 20–24 years, whereas drug use accounted for 2·7% (3·3% for males and 2·0% for females). The contribution of risk factors varied between and within countries. For example, for ages 20–24 years, drug use was highest in Qatar and accounted for 4·9% of DALYs, followed by 4·8% in the United Arab Emirates, whereas alcohol use was highest in Russia and accounted for 21·4%, followed by 21·0% in Belarus. Alcohol accounted for 9·0% (ranging from 4·2% in Hong Kong to 11·3% in Shandong) in China and 11·6% (ranging from 10·1% in Aguascalientes to 14·9% in Chihuahua) of DALYs in Mexico for young people aged 20–24 years. Alcohol and drug use in those aged 10–24 years had an annual rate of change of >1·0% from 1990 to 2013 and accounted for more than 3·1% of DALYs.
Interpretation
Our findings call for increased efforts to improve health and reduce the burden of disease and risks for diseases in later life in young people. Moreover, because of the large variations between countries in risks and burden, a global approach to improve health during this important period of life will fail unless the particularities of each country are taken into account. Finally, our results call for a strategy to overcome the financial and technical barriers to adequately capture young people’s health risk factors and their determinants in health information systems.
Funding
Bill & Melinda Gates Foundation.

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The Lancet Commissions
Our future: a Lancet commission on adolescent health and wellbeing
George C Patton, Susan M Sawyer, John S Santelli, David A Ross, Rima Afifi, Nicholas B Allen, Monika Arora, Peter Azzopardi, Wendy Baldwin, Christopher Bonell, Ritsuko Kakuma, Elissa Kennedy, Jaqueline Mahon, Terry McGovern, Ali H Mokdad, Vikram Patel, Suzanne Petroni, Nicola Reavley, Kikelomo Taiwo, Jane Waldfogel, Dakshitha Wickremarathne, Carmen Barroso, Zulfiqar Bhutta, Adesegun O Fatusi, Amitabh Mattoo, Judith Diers, Jing Fang, Jane Ferguson, Frederick Ssewamala, Russell M Viner
Summary
Unprecedented global forces are shaping the health and wellbeing of the largest generation of 10 to 24 year olds in human history. Population mobility, global communications, economic development, and the sustainability of ecosystems are setting the future course for this generation and, in turn, humankind.1,2 At the same time, we have come to new understandings of adolescence as a critical phase in life for achieving human potential. Adolescence is characterised by dynamic brain development in which the interaction with the social environment shapes the capabilities an individual takes forward into adult life.

Nature
Volume 534 Number 7606 pp152-290 9 June 2016
http://www.nature.com/nature/current_issue.html

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Letters
The Brazilian Zika virus strain causes birth defects in experimental models
Fernanda R. Cugola, Isabella R. Fernandes, Fabiele B. Russo, Beatriz C. Freitas, João L. M. Dias
+ et al.
The Zika virus can cross the placenta and cause intrauterine growth restriction, including microcephaly, in the SJL strain of mice; the virus can also infect human brain organoids, inducing cell death by apoptosis and disrupting cortical layers.

Nature Medicine
June 2016, Volume 22 No 6 pp569-692
http://www.nature.com/nm/journal/v22/n5/index.html

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Opinion
Use the Bayh-Dole Act to lower drug prices for government healthcare programs – p576
Alfred B Engelberg & Aaron S Kesselheim
doi:10.1038/nm0616-576
As drug prices have increased, there is also greater pressure to find ways to ensure access to medicines. An existing provision of the Bayh-Dole Act could help to lower costs for qualifying drugs in federal programs such as Medicare and Medicaid.

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Article
Protection against malaria at 1 year and immune correlates following PfSPZ vaccination – pp614 – 623
Andrew S Ishizuka, Kirsten E Lyke, Adam DeZure, Andrea A Berry, Thomas L Richie, Floreliz H Mendoza, Mary E Enama, Ingelise J Gordon, Lee-Jah Chang, Uzma N Sarwar, Kathryn L Zephir, LaSonji A Holman, Eric R James, Peter F Billingsley, Anusha Gunasekera, Sumana Chakravarty, Anita Manoj, MingLin Li, Adam J Ruben, Tao Li, Abraham G Eappen, Richard E Stafford, Natasha K C, Tooba Murshedkar, Hope DeCederfelt, Sarah H Plummer, Cynthia S Hendel, Laura Novik, Pamela J M Costner, Jamie G Saunders, Matthew B Laurens, Christopher V Plowe, Barbara Flynn, William R Whalen, J P Todd, Jay Noor, Srinivas Rao, Kailan Sierra-Davidson, Geoffrey M Lynn, Judith E Epstein, Margaret A Kemp, Gary A Fahle, Sebastian A Mikolajczak, Matthew Fishbaugher, Brandon K Sack, Stefan H I Kappe, Silas A Davidson, Lindsey S Garver, Niklas K Björkström, Martha C Nason, Barney S Graham, Mario Roederer, B Kim Lee Sim, Stephen L Hoffman, Julie E Ledgerwood & Robert A Seder
doi:10.1038/nm.4110
Fifty-five percent of individuals vaccinated with an attenuated Plasmodium falciparum sporozoite vaccine remained without parasitemia after controlled human malaria infection one year later; immune correlate analysis in humans and non-human primates suggest a role for liver-resident T cells.

New England Journal of Medicine
June 9, 2016 Vol. 374 No. 23
http://www.nejm.org/toc/nejm/medical-journal

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Perspective
Saving Tiny Tim — Pediatrics and Childhood Poverty in the United States
Perri Klass, M.D.
N Engl J Med 2016; 374:2201-2205 June 9, 2016 DOI: 10.1056/NEJMp1603516
Free Full Text

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Perspective
The Hell of Syria’s Field Hospitals
Samer Attar, M.D.
N Engl J Med 2016; 374:2205-2207 June 9, 2016 DOI: 10.1056/NEJMp1603673
Free Full Text

PLOS Currents: Disasters
http://currents.plos.org/disasters/
[Accessed 11 June 2016]

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Brief Report
Needs of Internally Displaced Women and Children in Baghdad, Karbala, and Kirkuk, Iraq
June 10, 2016 ·
Background: The continuing conflict in Iraq has now created an estimated four million internally displaced persons (IDPs). The bulk of recently displaced persons are in Central Iraq, often in insecure and difficult situations.
Objective: To determine the health status and health needs of women and children, age 15 and under, among a sample of this IDP population in Kirkuk, Baghdad, and Karbala governorates.
Methods: Data were collected from the senior female in 1216 families which contained 3665 children living in 45 makeshift settlements.
Findings: The majority of IDPs were living in tents or religious centers. Repeated displacements were common. Kidnappings were reported by 5.2% of families, and 7.9% of families reported a death of a family member during or after displacement. Intentional violence accounted for 72.3% of deaths. Only a third of children in school at the time of displacement continued in school. On average, households had received assistance on 3.2 occasions since displacement, food being the most common form. Access to health services was difficult. Some form of transport was often required. Few women knew where to secure antenatal services and many did not know where childhood immunization services were available. During or after displacement 307 women had delivered or were currently pregnant. Complications of pregnancies were common, with a quarter reporting anemia, and 22.1% experiencing hemorrhage. Both communicable and non-communicable diseases (NCDs) were common in the women and children in the survey. Scabies, diarrhea and lice were common among children. Among women, hypertension accounted for 36.6% of NCDs and type 2 diabetes for 15.9%. Domestic violence directed against women was reported in 17.4% of families and against children in 26.6%
Interpretation: Women and children in IDP settlements of Central Iraq experience many vulnerabilities involving their health, education and their environment, in addition to living in physical danger. While some external assistance was received, much more is needed to meet the needs of a displaced population which is unlikely to return home soon.

PLoS Currents: Outbreaks
http://currents.plos.org/outbreaks/
(Accessed 11 June 2016)

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Research Article
FLIRT-ing with Zika: A Web Application to Predict the Movement of Infected Travelers Validated Against the Current Zika Virus Epidemic
June 10, 2016 ·
Introduction: Beginning in 2015, Zika virus rapidly spread throughout the Americas and has been linked to neurological and autoimmune diseases in adults and babies. Developing accurate tools to anticipate Zika spread is one of the first steps to mitigate further spread of the disease. When combined, air traffic data and network simulations can be used to create tools to predict where infectious disease may spread to and aid in the prevention of infectious diseases. Specific goals were to: 1) predict where travelers infected with the Zika Virus would arrive in the U.S.; and, 2) analyze and validate the open access web application’s (i.e., FLIRT) predictions using data collected after the prediction was made.
Method: FLIRT was built to predict the flow and likely destinations of infected travelers through the air travel network. FLIRT uses a database of flight schedules from over 800 airlines, and can display direct flight traffic and perform passenger simulations between selected airports. FLIRT was used to analyze flights departing from five selected airports in locations where sustained Zika Virus transmission was occurring. FLIRT’s predictions were validated against Zika cases arriving in the U.S. from selected airports during the selected time periods. Kendall’s τ and Generalized Linear Models were computed for all permutations of FLIRT and case data to test the accuracy of FLIRT’s predictions.
Results: FLIRT was found to be predictive of the final destinations of infected travelers in the U.S. from areas with ongoing transmission of Zika in the Americas from 01 February 2016 – 01 to April 2016, and 11 January 2016 to 11 March 2016 time periods. MIA-FLL, JFK-EWR-LGA, and IAH were top ranked at-risk metro areas, and Florida, Texas and New York were top ranked states at-risk for the future time period analyzed (11 March 2016 – 11 June 2016). For the 11 January 2016 to 11 March 2016 time period, the region-aggregated model indicated 7.24 (95% CI 6.85 – 7.62) imported Zika cases per 100,000 passengers, and the state-aggregated model suggested 11.33 (95% CI 10.80 – 11.90) imported Zika cases per 100,000 passengers.
Discussion: The results from 01 February 2016 to 01 April 2016 and 11 January 2016 to 11 March 2016 time periods support that modeling air travel and passenger movement can be a powerful tool in predicting where infectious diseases will spread next. As FLIRT was shown to significantly predict distribution of Zika Virus cases in the past, there should be heightened biosurveillance and educational campaigns to medical service providers and the general public in these states, especially in the large metropolitan areas.

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Radiological Characterization of Cerebral Phenotype in Newborn Microcephaly Cases from 2015 Outbreak in Brazil
June 8, 2016 · Research Article
Introduction: Brazil is facing, since October of 2015, an outbreak of microcephalic fetuses. This outbreak is correlated with the beginning of circulation of Zika virus (ZIKV) in the country. Although it is clear that the size of the head is diminished in these fetuses, the brain phenotype associated with these malformations is unknown.
Methods: We collected computed tomography images of the microcephaly cases from the region of Natal, Rio Grande do Norte, from September 2015 to February 2016.
Findings: The microcephalies derived from the current outbreak are associated with intracerebral calcifications, malformation of the ventricular system, migratory disorders in the telencephalon and, in a lower frequency, malformation of the cerebellum and brainstem.
Discussion: The characteristics described herein are not usually found in other types of microcephaly. We suggest that this work can be used as a guideline to identify microcephaly cases associated to the current outbreak.

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 11 June 2016)

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Research Article
Early Childhood Developmental Status in Low- and Middle-Income Countries: National, Regional, and Global Prevalence Estimates Using Predictive Modeling
Dana Charles McCoy, Evan D. Peet, Majid Ezzati, Goodarz Danaei, Maureen M. Black, Christopher R. Sudfeld, Wafaie Fawzi, Günther Fink
Research Article | published 07 Jun 2016 | PLOS Medicine
http://dx.doi.org/10.1371/journal.pmed.1002034
Abstract
Background
The development of cognitive and socioemotional skills early in life influences later health and well-being. Existing estimates of unmet developmental potential in low- and middle-income countries (LMICs) are based on either measures of physical growth or proxy measures such as poverty. In this paper we aim to directly estimate the number of children in LMICs who would be reported by their caregivers to show low cognitive and/or socioemotional development.
Methods and Findings
The present paper uses Early Childhood Development Index (ECDI) data collected between 2005 and 2015 from 99,222 3- and 4-y-old children living in 35 LMICs as part of the Multiple Indicator Cluster Survey (MICS) and Demographic and Health Surveys (DHS) programs. First, we estimate the prevalence of low cognitive and/or socioemotional ECDI scores within our MICS/DHS sample. Next, we test a series of ordinary least squares regression models predicting low ECDI scores across our MICS/DHS sample countries based on country-level data from the Human Development Index (HDI) and the Nutrition Impact Model Study. We use cross-validation to select the model with the best predictive validity. We then apply this model to all LMICs to generate country-level estimates of the prevalence of low ECDI scores globally, as well as confidence intervals around these estimates.
In the pooled MICS and DHS sample, 14.6% of children had low ECDI scores in the cognitive domain, 26.2% had low socioemotional scores, and 36.8% performed poorly in either or both domains. Country-level prevalence of low cognitive and/or socioemotional scores on the ECDI was best represented by a model using the HDI as a predictor. Applying this model to all LMICs, we estimate that 80.8 million children ages 3 and 4 y (95% CI 48.1 million, 113.6 million) in LMICs experienced low cognitive and/or socioemotional development in 2010, with the largest number of affected children in sub-Saharan Africa (29.4.1 million; 43.8% of children ages 3 and 4 y), followed by South Asia (27.7 million; 37.7%) and the East Asia and Pacific region (15.1 million; 25.9%). Positive associations were found between low development scores and stunting, poverty, male sex, rural residence, and lack of cognitive stimulation. Additional research using more detailed developmental assessments across a larger number of LMICs is needed to address the limitations of the present study.
Conclusions
The number of children globally failing to reach their developmental potential remains large. Additional research is needed to identify the specific causes of poor developmental outcomes in diverse settings, as well as potential context-specific interventions that might promote children’s early cognitive and socioemotional well-being.

PLoS Neglected Tropical Diseases
http://www.plosntds.org/

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Viewpoints
Dengue Vaccine: Considerations before Rollout in Colombia
Christian Julian Villabona-Arenas, Raquel Elvira Ocazionez Jimenez, Cinthy Lorena Jimenez Silva
Viewpoints | published 09 Jun 2016 | PLOS Neglected Tropical Diseases
http://dx.doi.org/10.1371/journal.pntd.0004653

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Research Article
Health Services for Gender-Based Violence: Médecins Sans Frontières Experience Caring for Survivors in Urban Papua New Guinea
Kamalini Lokuge, Meggy Verputten, Maryanne Ajakali, Bianca Tolboom, Grace Joshy, Katherine A. Thurber, Daisy Plana, Steven Howes, Anastasia Wakon, Emily Banks
| published 10 Jun 2016 | PLOS ONE
http://dx.doi.org/10.1371/journal.pone.0156813

Preventive Medicine
Volume 87, Pages 1-238 (June 2016)
http://www.sciencedirect.com/science/journal/00917435/86

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Review Article
Mapping interventions that promote mental health in the general population: A scoping review of reviews
Pages 70-80
Jennifer Enns, Maxine Holmqvist, Pamela Wener, Gayle Halas, Janet Rothney, Annette Schultz, Leah Goertzen, Alan Katz
Abstract
Health policies and programs promoting mental health or preventing mental illness in the general public are under-recognized facets of primary prevention. Increasing awareness and adoption of such strategies could reduce the burden of mental illness in individuals, families, communities, and society as whole. We conducted a scoping review of reviews of interventions to promote mental health or prevent mental illness. We searched PubMed, PsycINFO, Scopus, Cochrane CENTRAL, CINAHL and ERIC from 2004 to 2014. Reviews were included if the authors indicated a systematic approach in their literature searches, and if they comprised interventions in Westernized countries targeting the general population. We identified 39 reviews that met the inclusion criteria. Mental health intervention approaches and outcomes varied across age groups and settings, and included functional, social, and cognitive measures. Most interventions aimed to prevent a specific mental illness or symptoms (depression, anxiety, burnout, or stress). Cognitive-behavioral therapy and educational components were common. School-based programs focused on outcomes involving social and academic development. Interventions for families, especially for young or disadvantaged parents, taught parenting skills to help improve the well-being of children and their care-givers. In the workplace, the focus was on managing stress, while programs for the elderly emphasized quality of life determinants. This review summarizes a wide variety of interventions to promote mental health or prevent mental illness, but the literature is primarily focused on the individual or family unit. More information is required about interventions at the community and societal levels.

Reproductive Health
http://www.reproductive-health-journal.com/content
[Accessed 11 June 2016]

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Research
Barriers and facilitators to health care seeking behaviours in pregnancy in rural communities of southern Mozambique
In countries, such as Mozambique, where maternal mortality remains high, the greatest contribution of mortality comes from the poor and vulnerable communities, who frequently reside in remote and rural areas w…
Khátia Munguambe, Helena Boene, Marianne Vidler, Cassimo Bique, Diane Sawchuck, Tabassum Firoz, Prestige Tatenda Makanga, Rahat Qureshi, Eusébio Macete, Clara Menéndez, Peter von Dadelszen and Esperança Sevene
Reproductive Health 2016 13(Suppl 1):31
Published on: 8 June 2016

Science
10 June 2016 Vol 352, Issue 6291
http://www.sciencemag.org/current.dtl

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Perspectives
Environmental governance for all
By Eduardo S. Brondizio, Francois-Michel Le Tourneau
Science10 Jun 2016 : 1272-1273
Summary
In a world increasingly thought of as overpopulated, sparsely populated spaces remain a dominant feature: ~57% of Asia, ~81% of North America, and ~94% of Australia have population densities below 1 person per square kilometer, equivalent to the population density of most of the Sahara desert (1). These vast, sparsely populated landscapes include rural settlements, towns, agricultural spaces, extractive economies, indigenous lands, and conservation areas. They are crucial for climate change adaptation and mitigation, from carbon sequestration to provisioning of water, food, and energy to cities. Yet governmental and nongovernmental initiatives tend to mostly pay lip service to the diverse views and needs of their populations. Without more inclusive governance, attempts to mitigate and adapt to climate change and conserve ecosystems will be compromised.

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Perspective
Environment
Bridging indigenous and scientific knowledge
Jayalaxshmi Mistry1, Andrea Berardi2
Science 10 Jun 2016:
Vol. 352, Issue 6291, pp. 1274-1275
DOI: 10.1126/science.aaf1160
Summary
Indigenous land use practices have a fundamental role to play in controlling deforestation and reducing carbon dioxide emissions. Satellite imagery suggests that indigenous lands contribute substantially to maintaining carbon stocks and enhancing biodiversity relative to adjoining territory (1). Many of these sustainable land use practices are born, developed, and successfully implemented by the community without major influence from external stakeholders (2). A prerequisite for such community-owned solutions is indigenous knowledge, which is local and context-specific, transmitted orally or through imitation and demonstration, adaptive to changing environments, collectivized through a shared social memory, and situated within numerous interlinked facets of people’s lives (3). Such local ecological knowledge is increasingly important given the growing global challenges of ecosystem degradation and climate change (4).

Social Science & Medicine
Volume 157, Pages 1-192 (May 2016)
http://www.sciencedirect.com/science/journal/02779536/156

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Commentary
What does India need to do to address childhood malnutrition at scale?
Pages 186-188
Zulfiqar A. Bhutta

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Improving household-level nutrition-specific and nutrition–sensitive conditions key to reducing child undernutrition in India
Pages 189-192
Daniel J. Corsi, Iván Mejía-Guevara, S.V. Subramanian

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Regular Articles
Risk factors for chronic undernutrition among children in India: Estimating relative importance, population attributable risk and fractions
Original Research Article
Pages 165-185
Daniel J. Corsi, Iván Mejía-Guevara, S.V. Subramanian
Highlights
:: Research on risk factors for child undernutrition has been single-factorial and downstream.
:: We assessed the relative and joint contribution of multiple factors for growth and development.
:: Maternal stature, education, household wealth, dietary diversity, and maternal BMI were the top 5 risk factors.
:: Together these five 5 factors accounted for more than 65% of the PAR for child undernutrition.
:: Strategies focused on social circumstances and direct investments in nutrition specific-programs are required.

Tropical Medicine & International Health
June 2016 Volume 21, Issue 6 Pages 691–817
http://onlinelibrary.wiley.com/doi/10.1111/tmi.2016.21.issue-6/issuetoc

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Gender and age disparities in adult undernutrition in northern Uganda: high-risk groups not targeted by food aid programmes (pages 807–817)
Stine Schramm, Felix Ocaka Kaducu, Siri Aas Smedemark, Emilio Ovuga and Morten Sodemann
Version of Record online: 16 MAY 2016 | DOI: 10.1111/tmi.12708
Abstract
Objective
To determine the prevalence of adult malnutrition and associated risk factors in a post-conflict area of northern Uganda.
Methods
A cross-sectional community survey was performed from September 2011 to June 2013. All registered residents in Gulu Health and Demographic Surveillance System aged 15 years and older were considered eligible. Trained field assistants collected anthropometric measurements (weight and height) and administered questionnaires with information on sociodemographic characteristics, food security, smoking and alcohol. Nutritional status was classified by body mass index.
Results
In total, 2062 men and 2924 women participated and were included in the analyses. The prevalence of underweight was 22.3% for men and 16.0% for women, whereas the prevalence of overweight was 1.5% for men and 7.6% for women. In men, underweight was associated with younger (15–19 years) and older age (>55 years) (P < 0.001), being divorced/separated [odds ratio (OR) = 1.91 (95% confidence interval (CI): 1.21–2.99] and smoking (OR = 2.13, 95% CI: 1.67–2.73). For women, underweight was associated with older age (P < 0.001) and hungry-gap rainy season (May–July) (OR = 1.33, 95% CI: 1.04–1.69). Widowed or divorced/separated women were not more likely to be underweight. No association was found between education, alcohol consumption or food security score and underweight.
Conclusions
Our findings are not in line with the conventional target groups in nutritional programmes and highlight the importance of continuous health and nutritional assessments of all population groups that reflect local social determinants and family structures.

Tropical Medicine & International Health
June 2016 Volume 21, Issue 6 Pages 691–817
http://onlinelibrary.wiley.com/doi/10.1111/tmi.2016.21.issue-6/issuetoc

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Ethical challenges in designing and conducting medicine quality surveys (pages 799–806)
Patricia Tabernero, Michael Parker, Raffaella Ravinetto, Souly Phanouvong, Shunmay Yeung, Freddy E. Kitutu, Phaik Yeong Cheah, Mayfong Mayxay, Philippe J. Guerin and Paul N. Newton
Version of Record online: 20 MAY 2016 | DOI: 10.1111/tmi.12707
Abstract
Objectives
In this paper we discuss the main ethical challenges related to the conduct of medicine quality surveys and make suggestions on how to address them.
Method
Most evidence-based information regarding medicine quality derives from surveys. However, existing research ethical guidelines do not provide specific guidance for medicine quality surveys. Hence, those conducting surveys are often left wondering how to judge what counts as best practice. A list of the main ethical challenges in the design and conduct of surveys is presented.
Results and conclusions
It is vital that the design and conduct of medicine quality surveys uphold moral and ethical obligations and analyse the ethical implications and consequences of such work. These aspects include the impact on the local availability of and access to medicines; the confidentiality and privacy of the surveyors and the surveyed; questions as to whether outlet staff personnel should be told they are part of a survey; the need of ethical and regulatory approvals; and how the findings should be disseminated. Medicine quality surveys should ideally be conducted in partnership with the relevant national Medicine Regulatory Authorities. An international, but contextually sensitive, model of good ethical practice for such surveys is needed.

Tropical Medicine & International Health
June 2016 Volume 21, Issue 6 Pages 691–817
http://onlinelibrary.wiley.com/doi/10.1111/tmi.2016.21.issue-6/issuetoc

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Reviews
Tuberculosis and diabetes: current state and future perspectives (pages 694–702)
Damiano Pizzol, Francesco Di Gennaro, Kajal D. Chhaganlal, Claudia Fabrizio, Laura Monno, Giovanni Putoto and Annalisa Saracino
Version of Record online: 18 MAY 2016 | DOI: 10.1111/tmi.12704
Abstract
This review outlines the association between tuberculosis and diabetes, focusing on epidemiology, physiopathology, clinical aspects, diagnosis and treatment, and evaluates future perspectives, with particular attention to developing countries.

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Mortality risk and associated factors in HIV-exposed, uninfected children (pages 720–734)
Shino Arikawa, Nigel Rollins, Marie-Louise Newell and Renaud Becquet
Version of Record online: 19 APR 2016 | DOI: 10.1111/tmi.12695
Abstract
Objective
With increasing maternal antiretroviral treatment (ART), the number of children newly infected with HIV has declined. However, the possible increased mortality in the large number of HIV-exposed, uninfected (HEU) children may be of concern. We quantified mortality risks among HEU children and reviewed associated factors.
Methods
Systematic search of electronic databases (PubMed, Scopus). We included all studies reporting mortality of HEU children to age 60 months and associated factors. Relative risk of mortality between HEU and HIV-unexposed, uninfected (HUU) children was extracted where relevant. Inverse variance methods were used to adjust for study size. Random-effects models were fitted to obtain pooled estimates.
Results
A total of 14 studies were included in the meta-analysis and 13 in the review of associated factors. The pooled cumulative mortality in HEU children was 5.5% (95% CI: 4.0–7.2; I2 = 94%) at 12 months (11 studies) and 11.0% (95% CI: 7.6–15.0; I2 = 93%) at 24 months (four studies). The pooled risk ratios for the mortality in HEU children compared to HUU children in the same setting were 1.9 (95% CI: 0.9–3.8; I2 = 93%) at 12 months (four studies) and 2.4 (95% CI: 1.1–5.1; I2 = 93%) at 24 months (three studies).
Conclusion
Compared to HUU children, mortality risk in HEU children was about double at both age points, although the association was not statistically significant at 12 months. Interpretation of the pooled estimates is confounded by considerable heterogeneity between studies. Further research is needed to characterise the impact of maternal death and breastfeeding on the survival of HEU infants in the context of maternal ART, where current evidence is limited.

UN Chronicle
LIII No. 1 2016 May 2016
http://unchronicle.un.org/

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Humanitarian Action: A Shared Responsibility
This issue provides a variety of perspectives on improving the international humanitarian system, along with personal reflections on recovering from natural and human-induced disasters. It was planned as a way to support the objectives of the first-ever World Humanitarian Summit (Istanbul, Turkey, 23–24 May 2016).

World Heritage Review
n°79 – April 2016
http://whc.unesco.org/en/review/79/

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Planet at the Crossroads
From 1 to 10 September 2016, thousands of leaders and decision-makers from government, civil society, indigenous peoples, business and academia will gather together in Honolulu (Hawaii) to share ideas on how to improve the ways we manage the natural environment for human, social and economic development. Held every four years, the IUCN World Conservation Congress (WCC) focuses on joint progress in ways to protect biodiversity, a crucial factor in addressing some of our greatest challenges today, such as tackling climate change and achieving food security.

The Sentinel

Human Rights Action :: Humanitarian Response :: Health ::
Holistic Development :: Sustainable Resilience
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Week ending 4 June 2016

This weekly digest is intended to aggregate and distill key content from a broad spectrum of practice domains and organization types including key agencies/IGOs, NGOs, governments, academic and research institutions, consortia and collaborations, foundations, and commercial organizations. We also monitor a spectrum of peer-reviewed journals and general media channels. The Sentinel’s geographic scope is global/regional but selected country-level content is included. We recognize that this spectrum/scope yields an indicative and not an exhaustive product. Comments and suggestions should be directed to:

David R. Curry
Editor &
Founding Managing Director
GE2P2 – Center for Governance, Evidence, Ethics, Policy, Practice
david.r.curry@ge2p2center.net

pdf version: The Sentinel_ week ending 4 June 201

:: Journal Watch

The Sentinel will track key peer-reviewed journals which address a broad range of interests in human rights, humanitarian response, health and development. It is not intended to be exhaustive. We will add to those monitored below as we encounter relevant content and upon recommendation from readers. We selectively provide full text of abstracts and other content but note that successful access to some of the articles and other content may require subscription or other access arrangement unique to the publisher. Please suggest additional journals you feel warrant coverage.

BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content
(Accessed 4 June 2016)

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Research article
Perspectives of frontline health workers on Ghana’s National Health Insurance Scheme before and after community engagement interventions
Barely a decade after introduction of Ghana’s National Health Insurance Scheme (NHIS), significant successes have been recorded in universal access to basic healthcare services. However, sustainability of the …
Robert Kaba Alhassan, Edward Nketiah-Amponsah, Nicole Spieker, Daniel Kojo Arhinful and Tobias F. Rinke de Wit
BMC Health Services Research 2016 16:192
Published on: 28 May 2016