Andrew Seal
Biographic Data
| ID | 3700913 |
|---|---|
| NAME | Andrew Seal |
| GIVEN NAMES | Andrew |
| FAMILY NAME | Seal |
| SIGNATURE | SEAL A |
| AFFILIATIONS | University College London |
| ORCID | 0000-0003-3656-4054 |
| VERIFIED | Yes |
| TOTAL WORKS | 24 |
| TOTAL CITATIONS | 5 |
| AUTHOR COUNT | 24 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2001 |
| LATEST PUBLICATION YEAR | 2023 |
| H-INDEX | 1 |
How age and sex affect treatment outcomes for children with severe malnutrition
Age and sex influence the risk of childhood wasting. We aimed to determine if wasting treatment outcomes differ by age and sex in children under 5 years, enroled in therapeutic and supplementary feeding programmes. Utilising data from stage 1 of the ComPAS trial, we used logistic regression to assess the association between age, sex and wasting treatment outcomes (recovery, death, default, non-response, and transfer), modelling the likelihood of …
Understanding multilevel barriers to childhood vaccination uptake among Internally Displaced Populations (IDPs) in Mogadishu, Somalia
ISRCTN-83,172,390. Date of registration: 03/08/2021
Changing sex differences in undernutrition of African children
The study investigates sex differences in the prevalence of undernutrition in sub-Saharan Africa. Undernutrition was defined by Z -scores using the CDC-2000 growth charts. Some 128 Demographic and Health Surveys (DHS) were analysed, totalling 700,114 children under-five. The results revealed a higher susceptibility of boys to undernutrition. Male-to-female ratios of prevalence averaged 1.18 for stunting (height-for-age Z -score Z -score Z -score …
Forced evictions and their social and health impacts in Southern Somalia
BACKGROUND: Forced evictions are common in conflict-affected settings. More than 500 internally displaced persons (IDPs) are evicted daily in Mogadishu. Context specific research is necessary to inform responsive humanitarian interventions and to monitor the effectiveness of these interventions on IDPs health. OBJECTIVE: This study explored the causes of forced evictions and their health impacts among IDPs in southern Somalia. METHODS: We used a …
Data innovation in response to Covid-19 in Somalia
BACKGROUND: During the COVID-19 pandemic, the importance of reliable public health data has been highlighted, as well as the multiple challenges in collecting it, especially in low income and conflict-affected countries. Somalia reported its first confirmed case of COVID-19 on 16 March 2020 and has experienced fluctuating infection levels since then. OBJECTIVES: To monitor the impact of COVID-19 on beneficiaries of a long-term cash transfer progr…
Long-term outcomes for children with disability and severe acute malnutrition in Malawi
INTRODUCTION: Severe acute malnutrition (SAM) and disability are major global health issues. Although they can cause and influence each other, data on their co-existence are sparse. We aimed to describe the prevalence and patterns of disability among a cohort of children with SAM. METHODS: A longitudinal cohort study in Malawi followed SAM survivors up to 7 years postdischarge. Clinical and anthropometric profiles were compared with sibling and c…
Boys are more likely to be undernourished than girls
Brain MRI and cognitive function seven years after surviving an episode of severe acute malnutrition in a cohort of Malawian children
Objective To assess differences in cognition functions and gross brain structure in children seven years after an episode of severe acute malnutrition (SAM), compared with other Malawian children. Design Prospective longitudinal cohort assessing school grade achieved and results of five computer-based (CANTAB) tests, covering three cognitive domains. A subset underwent brain MRI scans which were reviewed using a standardized checklist of gross ab…
Findings from a cluster randomised trial of unconditional cash transfers in Niger
Unconditional cash transfers (UCTs) are used as a humanitarian intervention to prevent acute malnutrition, despite a lack of evidence about their effectiveness. In Niger, UCT and supplementary feeding are given during the June-September "lean season," although admissions of malnourished children to feeding programmes may rise from March/April. We hypothesised that earlier initiation of the UCT would reduce the prevalence of global acute malnutrit…
A weak health response is increasing the risk of excess mortality as food crisis worsens in Somalia
Admission profile and discharge outcomes for infants aged less than 6 months admitted to inpatient therapeutic care in 10 countries. A secondary data analysis
Evidence on the management of acute malnutrition in infants aged less than 6 months (infants <6mo) is scarce. To understand outcomes using current protocols, we analysed a sample of 24 045 children aged 0-60 months from 21 datasets of inpatient therapeutic care programmes in 10 countries. We compared the proportion of admissions, the anthropometric profile at admission and the discharge outcomes between infants <6mo and children aged 6-60 months …
Rapid acceptability and adherence testing of a lipid-based nutrient supplement and a micronutrient powder among refugee children and pregnant and lactating women in Algeria
Objective To assess the acceptability and adherence to daily doses of lipid-based nutrient supplement (LNS) among children and micronutrient powder (MNP) among children and pregnant and lactating women. Design Household interviews and sachet counting were conducted to measure acceptability and adherence, 15 and 30 d after product distribution. Qualitative information on product acceptability was collected using focus group discussions. Setting Sa…
Thinking Small
Development of a competency framework for the nutrition in emergencies sector
Objective There is a recognised need to strengthen capacity in the nutrition in emergencies sector and for greater clarity on the role of emergency nutritionists and the skills they require. Competency frameworks are an important tool for human resource development and have been developed for several other humanitarian sectors. We therefore developed a technical competency framework for practitioners in nutrition in emergencies. Design Existing c…
The 2011 Famine in Somalia
The 2011 famine in Somalia was predicted and could have been mitigated or prevented if the humanitarian response had been timely and more effective. To improve responsiveness to early warnings, action is required to better insulate the humanitarian system from political agendas. While overcoming constraints, such as lack of access, may sometimes be beyond the scope of humanitarian actors, more could be done to enhance the perceived neutrality of …
A qualitative investigation of adherence to nutritional therapy in malnourished adult Aids patients in Kenya
Objective To understand factors affecting the compliance of malnourished, HIV-positive adults with a nutritional protocol using ready-to-use therapeutic food (RUTF; Plumpy'nut ® ). Design Qualitative study using key informant interviews, focus group discussions and direct observations. Setting Ministry of Health HIV/programme supported by Médecins Sans Frontièrs (MSF) in Nyanza Province, Kenya. Subjects Adult patients ( n 46) currently or previou…
Excessive iodine intake during pregnancy in Somali refugees
Iodine deficiency and excess are both associated with adverse health consequences, with fetuses, children and pregnant women being most vulnerable to the devastating effects of severe deficiency. It is often assumed that the iodine status of a population if displaced or in a remote or emergency situation is low. However, there is little evidence available to support this assumption, especially among long-term food-aid-dependent pregnant women. An…
Evaluation of the effectiveness of stainless steel cooking pots in reducing iron-deficiency anaemia in food aid-dependent populations
Objective To evaluate the effectiveness of stainless steel (Fe alloy) cooking pots in reducing Fe-deficiency anaemia in food aid-dependent populations. Design Repeated cross-sectional surveys. Between December 2001 and January 2003, three surveys among children aged 6–59 months and their mothers were conducted in 110 households randomly selected from each camp. The primary outcomes were changes in Hb concentration and Fe status. Setting Two long-…
Acceptability and use of iron and iron-alloy cooking pots
Objective To evaluate the acceptability of iron and iron-alloy cooking pots prior to an intervention trial and to investigate factors affecting retention and use. Design Pre-trial research was conducted on five types of iron and iron-alloy pots using focus group discussions and a laboratory evaluation of Fe transfer during cooking was undertaken. Usage and retention during the subsequent intervention trial were investigated using focus group disc…
Maize meal fortification is associated with improved vitamin A and iron status in adolescents and reduced childhood anaemia in a food aid-dependent refugee population
Objective To assess changes in the Fe and vitamin A status of the population of Nangweshi refugee camp associated with the introduction of maize meal fortification. Design Pre- and post-intervention study using a longitudinal cohort. Setting Nangweshi refugee camp, Zambia. Subjects Two hundred and twelve adolescents (10–19 years), 157 children (6–59 months) and 118 women (20–49 years) were selected at random by household survey in July 2003 and f…
The effect of body shape on weight-for-height and mid-upper arm circumference based case definitions of acute malnutrition in Ethiopian children
WHZ and WHZ case status in children are associated with body shape and may overestimate the prevalence of acute malnutrition in some populations. Consideration should be given as to whether WHZ should be replaced by MUAC for the purposes of estimating the prevalence of acute malnutrition
Excess dietary iodine intake in long-term African refugees
Objective To assess the iodine status of long-term refugees dependent on international food aid and humanitarian assistance. Design A series of cross-sectional two-stage cluster or systematic random sample surveys which assessed urinary iodine excretion and the prevalence of visible goitre. Salt samples were also collected and tested for iodine content by titration. Setting Six refugee camps in East, North and Southern Africa. Subjects Male and f…
Infant feeding indicators for use in emergencies
Objective: To assess the applicability and use of infant nutrition and health indicators during emergencies. Design: Indicators recommended by international health and nutrition organisations for assessing infant feeding practice were compiled and analysed to evaluate their consistency and applicability for use in surveys of emergency-affected populations. These indicators included measures of breast-feeding status, use of artificial feeding, ant…
From Policy to Practice
The preparation and dissemination of policy statements are necessary but insufficient to prevent the inappropriate use of infant-feeding products in emergencies. The widespread failure of humanitarian agencies operating in the Balkan crisis to act in accordance with international policies and recommendations provides a recent example of the failure to translate infant-feeding policies into practice. This article explores the underlying reasons be…
From Policy to Practice
The preparation and dissemination of policy statements are necessary but insufficient to prevent the inappropriate use of infant-feeding products in emergencies. The widespread failure of humanitarian agencies operating in the Balkan crisis to act in accordance with international policies and recommendations provides a recent example of the failure to translate infant-feeding policies into practice. This article explores the underlying reasons be…
From Policy to Practice
The preparation and dissemination of policy statements are necessary but insufficient to prevent the inappropriate use of infant-feeding products in emergencies. The widespread failure of humanitarian agencies operating in the Balkan crisis to act in accordance with international policies and recommendations provides a recent example of the failure to translate infant-feeding policies into practice. This article explores the underlying reasons be…
Infant feeding indicators for use in emergencies
Objective: To assess the applicability and use of infant nutrition and health indicators during emergencies. Design: Indicators recommended by international health and nutrition organisations for assessing infant feeding practice were compiled and analysed to evaluate their consistency and applicability for use in surveys of emergency-affected populations. These indicators included measures of breast-feeding status, use of artificial feeding, ant…
Excess dietary iodine intake in long-term African refugees
Objective To assess the iodine status of long-term refugees dependent on international food aid and humanitarian assistance. Design A series of cross-sectional two-stage cluster or systematic random sample surveys which assessed urinary iodine excretion and the prevalence of visible goitre. Salt samples were also collected and tested for iodine content by titration. Setting Six refugee camps in East, North and Southern Africa. Subjects Male and f…
Maize meal fortification is associated with improved vitamin A and iron status in adolescents and reduced childhood anaemia in a food aid-dependent refugee population
Objective To assess changes in the Fe and vitamin A status of the population of Nangweshi refugee camp associated with the introduction of maize meal fortification. Design Pre- and post-intervention study using a longitudinal cohort. Setting Nangweshi refugee camp, Zambia. Subjects Two hundred and twelve adolescents (10–19 years), 157 children (6–59 months) and 118 women (20–49 years) were selected at random by household survey in July 2003 and f…
The effect of body shape on weight-for-height and mid-upper arm circumference based case definitions of acute malnutrition in Ethiopian children
WHZ and WHZ case status in children are associated with body shape and may overestimate the prevalence of acute malnutrition in some populations. Consideration should be given as to whether WHZ should be replaced by MUAC for the purposes of estimating the prevalence of acute malnutrition
Excessive iodine intake during pregnancy in Somali refugees
Iodine deficiency and excess are both associated with adverse health consequences, with fetuses, children and pregnant women being most vulnerable to the devastating effects of severe deficiency. It is often assumed that the iodine status of a population if displaced or in a remote or emergency situation is low. However, there is little evidence available to support this assumption, especially among long-term food-aid-dependent pregnant women. An…
Evaluation of the effectiveness of stainless steel cooking pots in reducing iron-deficiency anaemia in food aid-dependent populations
Objective To evaluate the effectiveness of stainless steel (Fe alloy) cooking pots in reducing Fe-deficiency anaemia in food aid-dependent populations. Design Repeated cross-sectional surveys. Between December 2001 and January 2003, three surveys among children aged 6–59 months and their mothers were conducted in 110 households randomly selected from each camp. The primary outcomes were changes in Hb concentration and Fe status. Setting Two long-…
Acceptability and use of iron and iron-alloy cooking pots
Objective To evaluate the acceptability of iron and iron-alloy cooking pots prior to an intervention trial and to investigate factors affecting retention and use. Design Pre-trial research was conducted on five types of iron and iron-alloy pots using focus group discussions and a laboratory evaluation of Fe transfer during cooking was undertaken. Usage and retention during the subsequent intervention trial were investigated using focus group disc…
A qualitative investigation of adherence to nutritional therapy in malnourished adult Aids patients in Kenya
Objective To understand factors affecting the compliance of malnourished, HIV-positive adults with a nutritional protocol using ready-to-use therapeutic food (RUTF; Plumpy'nut ® ). Design Qualitative study using key informant interviews, focus group discussions and direct observations. Setting Ministry of Health HIV/programme supported by Médecins Sans Frontièrs (MSF) in Nyanza Province, Kenya. Subjects Adult patients ( n 46) currently or previou…
The 2011 Famine in Somalia
The 2011 famine in Somalia was predicted and could have been mitigated or prevented if the humanitarian response had been timely and more effective. To improve responsiveness to early warnings, action is required to better insulate the humanitarian system from political agendas. While overcoming constraints, such as lack of access, may sometimes be beyond the scope of humanitarian actors, more could be done to enhance the perceived neutrality of …
Development of a competency framework for the nutrition in emergencies sector
Objective There is a recognised need to strengthen capacity in the nutrition in emergencies sector and for greater clarity on the role of emergency nutritionists and the skills they require. Competency frameworks are an important tool for human resource development and have been developed for several other humanitarian sectors. We therefore developed a technical competency framework for practitioners in nutrition in emergencies. Design Existing c…
Admission profile and discharge outcomes for infants aged less than 6 months admitted to inpatient therapeutic care in 10 countries. A secondary data analysis
Evidence on the management of acute malnutrition in infants aged less than 6 months (infants <6mo) is scarce. To understand outcomes using current protocols, we analysed a sample of 24 045 children aged 0-60 months from 21 datasets of inpatient therapeutic care programmes in 10 countries. We compared the proportion of admissions, the anthropometric profile at admission and the discharge outcomes between infants <6mo and children aged 6-60 months …
Rapid acceptability and adherence testing of a lipid-based nutrient supplement and a micronutrient powder among refugee children and pregnant and lactating women in Algeria
Objective To assess the acceptability and adherence to daily doses of lipid-based nutrient supplement (LNS) among children and micronutrient powder (MNP) among children and pregnant and lactating women. Design Household interviews and sachet counting were conducted to measure acceptability and adherence, 15 and 30 d after product distribution. Qualitative information on product acceptability was collected using focus group discussions. Setting Sa…
Thinking Small
A weak health response is increasing the risk of excess mortality as food crisis worsens in Somalia
Findings from a cluster randomised trial of unconditional cash transfers in Niger
Unconditional cash transfers (UCTs) are used as a humanitarian intervention to prevent acute malnutrition, despite a lack of evidence about their effectiveness. In Niger, UCT and supplementary feeding are given during the June-September "lean season," although admissions of malnourished children to feeding programmes may rise from March/April. We hypothesised that earlier initiation of the UCT would reduce the prevalence of global acute malnutrit…
Brain MRI and cognitive function seven years after surviving an episode of severe acute malnutrition in a cohort of Malawian children
Objective To assess differences in cognition functions and gross brain structure in children seven years after an episode of severe acute malnutrition (SAM), compared with other Malawian children. Design Prospective longitudinal cohort assessing school grade achieved and results of five computer-based (CANTAB) tests, covering three cognitive domains. A subset underwent brain MRI scans which were reviewed using a standardized checklist of gross ab…
Long-term outcomes for children with disability and severe acute malnutrition in Malawi
INTRODUCTION: Severe acute malnutrition (SAM) and disability are major global health issues. Although they can cause and influence each other, data on their co-existence are sparse. We aimed to describe the prevalence and patterns of disability among a cohort of children with SAM. METHODS: A longitudinal cohort study in Malawi followed SAM survivors up to 7 years postdischarge. Clinical and anthropometric profiles were compared with sibling and c…
Boys are more likely to be undernourished than girls
Forced evictions and their social and health impacts in Southern Somalia
BACKGROUND: Forced evictions are common in conflict-affected settings. More than 500 internally displaced persons (IDPs) are evicted daily in Mogadishu. Context specific research is necessary to inform responsive humanitarian interventions and to monitor the effectiveness of these interventions on IDPs health. OBJECTIVE: This study explored the causes of forced evictions and their health impacts among IDPs in southern Somalia. METHODS: We used a …
Data innovation in response to Covid-19 in Somalia
BACKGROUND: During the COVID-19 pandemic, the importance of reliable public health data has been highlighted, as well as the multiple challenges in collecting it, especially in low income and conflict-affected countries. Somalia reported its first confirmed case of COVID-19 on 16 March 2020 and has experienced fluctuating infection levels since then. OBJECTIVES: To monitor the impact of COVID-19 on beneficiaries of a long-term cash transfer progr…
Changing sex differences in undernutrition of African children
The study investigates sex differences in the prevalence of undernutrition in sub-Saharan Africa. Undernutrition was defined by Z -scores using the CDC-2000 growth charts. Some 128 Demographic and Health Surveys (DHS) were analysed, totalling 700,114 children under-five. The results revealed a higher susceptibility of boys to undernutrition. Male-to-female ratios of prevalence averaged 1.18 for stunting (height-for-age Z -score Z -score Z -score …
How age and sex affect treatment outcomes for children with severe malnutrition
Age and sex influence the risk of childhood wasting. We aimed to determine if wasting treatment outcomes differ by age and sex in children under 5 years, enroled in therapeutic and supplementary feeding programmes. Utilising data from stage 1 of the ComPAS trial, we used logistic regression to assess the association between age, sex and wasting treatment outcomes (recovery, death, default, non-response, and transfer), modelling the likelihood of …
Understanding multilevel barriers to childhood vaccination uptake among Internally Displaced Populations (IDPs) in Mogadishu, Somalia
ISRCTN-83,172,390. Date of registration: 03/08/2021
Medicine (22 works) · Environmental health (15 works) · Child Nutrition and Water Access (14 works) · Internal Medicine (12 works) · Population (10 works) · Food Security and Health in Diverse Populations (8 works) · Malnutrition (8 works) · Pediatrics (8 works) · Refugee (7 works) · Geography (6 works)