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Child mortality from sickle cell disease in Nigeria: a model-estimated, population-level analysis of data from the 2018 Demographic and Health Survey
Authors: Obiageli E. Nnodu, Assaf P. Oron, Alayo Sopekan, Godwin O. Akaba, Frederic B. Piel, and Dennis L. Chao
Source: Lancet Haematology, Volume 8, Issue 10; DOI: https://doi.org/10.1016/S2352-3026(21)00216-7
Topic(s): Anemia
Childhood mortality
Country: Africa
  Nigeria
Published: SEP 2021
Abstract: Background: Child mortality from sickle cell disease in sub-Saharan Africa is presumed to be high but is not well quantified. This uncertainty contributes to the neglect of sickle cell disease and delays the prioritisation of interventions. In this study, we estimated the mortality of children in Nigeria with sickle cell disease, and the proportion of national under-5 mortality attributable to sickle cell disease. Methods: We did a model-estimated, population-level analysis of data from Nigeria's 2018 Demographic and Health Survey (DHS) to estimate the prevalence and geographical distribution of HbSS and HbSC genotypes assuming Hardy-Weinberg equilibrium near birth. Interviews for the survey were done between Aug 14 and Dec 29, 2018, and the embedded sickle cell disease survey was done in a randomly selected third of the overall survey's households. We developed an approach for estimating child mortality from sickle cell disease by combining information on tested children and their untested siblings. Tested children were aged 6–59 months at the time of the survey. Untested siblings born 0–14 years before the survey were also included in analyses. Testing as part of the DHS was done without regard to disease status. We analysed mortality differences using the inheritance-derived genotypic distribution of untested siblings older than the tested cohort, enabling us to estimate excess mortality from sickle cell disease for the older-sibling cohort (ie, those born between 2003 and 2013). Findings: We analysed test results for 11,186 children aged 6–59 months from 7411 households in Nigeria. The estimated average birth prevalence of HbSS was 1.21% (95% CI 1.09–1.37) and was 0.24% (0.19–0.31) for HbSC. We obtained data for estimating child mortality from 10,195 tested children (who could be matched to the individual mother survey) and 17,205 of their untested siblings. 15,227 of the siblings were in the older-sibling cohort. The group of children with sickle cell disease born between 2003 and 2013 with at least one younger sibling in the survey had about 370 excess under-5 deaths per 1000 livebirths (95% CI 150–580; p=0.0008) than children with HbAA. The estimated national average under-5 mortality for children with sickle cell disease born between 2003 and 2013 was 490 per 1000 livebirths (95% CI 270–700), 4.0 times higher (95% CI 2.1–6.0) than children with HbAA. About 4.2% (95% CI 1.7–6.9) of national under-5 mortality was attributable to excess mortality from sickle cell disease. Interpretation: The burden of child mortality from sickle cell disease in Nigeria continues to be disproportionately higher than the burden of mortality of children without sickle cell disease. Most of these deaths could be prevented if adequate resources were allocated and available focused interventions were implemented. The methods developed in this study could be used to estimate the burden of sickle cell disease elsewhere in Africa and south Asia. Funding: Sickle Pan African Research Consortium, and the Bill & Melinda Gates Foundation.
Web: https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(21)00216-7/fulltext


Debugging Information
ColdFusion Server Developer 2018,0,19,330149
Template /Publications/journal-details.cfm
Time Stamp 03-Jul-24 09:36 AM
Locale English (US)
User Agent Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)
Remote IP 10.0.0.149
Host Name 10.0.0.149


Execution Time

Total Time Avg Time Count Template
454 ms 19 ms 24 C:/inetpub/wwwroot/commonspot/utilities/ct-render-element.cfm
438 ms 18 ms 24 C:/inetpub/wwwroot/commonspot/utilities/ct-render-element-core.cfm
297 ms 297 ms 1 C:/inetpub/wwwroot/commonspot/master.cfm
297 ms 297 ms 1 C:/inetpub/wwwroot/dhs/Publications/journal-details.cfm
250 ms 250 ms 1 C:/inetpub/wwwroot/commonspot/master-render.cfm
250 ms 250 ms 1 C:/inetpub/wwwroot/commonspot/render-page-meat.cfm
250 ms 250 ms 1 C:/inetpub/wwwroot/commonspot/render-page.cfm
250 ms 250 ms 1 C:/inetpub/wwwroot/commonspot/uncached-master.cfm
250 ms 250 ms 1 C:/inetpub/wwwroot/commonspot/utilities/cached-page-render.cfm
235 ms 24 ms 10 C:/inetpub/wwwroot/commonspot/utilities/ct-render-named-element.cfm
235 ms 235 ms 1 C:/inetpub/wwwroot/dhs/templates/template-basepage.cfm
187 ms 187 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c1378-l70-t51-dAny.read
172 ms 172 ms 1 C:/inetpub/wwwroot/commonspot/utilities/run-element.cfm
32 ms 32 ms 1 C:/inetpub/wwwroot/commonspot/controls/customcf/cpe-customcf.cfm
32 ms 32 ms 1 C:/inetpub/wwwroot/commonspot/set-page-vars.cfm
16 ms 16 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19152-l70-t51-dAny.read
16 ms 16 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19169-l70-t51-dAny.read
16 ms 16 ms 1 C:/inetpub/wwwroot/dhs/customcf/legacy/journal/detail_article_summary.cfm
16 ms 8 ms 2 CFC[ C:/inetpub/wwwroot/commonspot/public_api/cache.cfc | getElementCacheSettings(9706, 4304) ] from C:/inetpub/wwwroot/commonspot/public_api/cache.cfc
15 ms 15 ms 1 C:/inetpub/wwwroot/commonspot/controls/control-setup.cfm
15 ms 15 ms 1 C:/inetpub/wwwroot/commonspot/render-head.cfm
15 ms 15 ms 1 C:/inetpub/wwwroot/commonspot/site-application.cfm
15 ms 15 ms 1 C:/inetpub/wwwroot/commonspot/startup/core-application-meat.cfm
15 ms 15 ms 1 C:/inetpub/wwwroot/commonspot/startup/site-application-meat.cfm
15 ms 15 ms 1 C:/inetpub/wwwroot/commonspot/utilities/flush-cache-db-queue.cfm
15 ms 15 ms 1 C:/inetpub/wwwroot/dhs/Publications/Application.cfm
15 ms 15 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/public_api/livebookmarks.cfc | getTags(9706) ] from C:/inetpub/wwwroot/commonspot/public_api/livebookmarks.cfc
0 ms 0 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c1432-l70-t51-dAny.read
0 ms 0 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19153-l70-t51-dAny.read
0 ms 0 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19154-l70-t51-dAny.read
0 ms 0 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19155-l70-t51-dAny.read
0 ms 0 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19172-l70-t51-dAny.read
0 ms 0 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19174-l70-t51-dAny.read
0 ms 0 ms 1 C:/commonspot-data/customers/commonspot-users/sites/commonspot-site-dhs/mapped/cache/2/p9706-c19177-l70-t51-dAny.read
0 ms 0 ms 1 C:/inetpub/wwwroot/ADF/core/load_site_adf.cfm
0 ms 0 ms 2 C:/inetpub/wwwroot/commonspot/controls/ct-include-once.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/controls/dhtmlmenu/menu-output-display.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/controls/handle-styles.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/controls/upfront-generic.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/lview-contribute-mode-redirect-check.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/non-dashboard-include.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/pagemode/pagemodeui.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/render-body-tag.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/render-foot.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/render-metatags.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/render-tracking-code.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/security/security-page.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/startup/build-request-params.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/startup/handle-head-request.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/startup/handle-request-timeout.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/startup/init-customer-scope.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/startup/init-server-scope.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/add-resource-request.cfm
0 ms 0 ms 6 C:/inetpub/wwwroot/commonspot/utilities/add-unregistered-resource-request.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/append-to-resource-group.cfm
0 ms 0 ms 3 C:/inetpub/wwwroot/commonspot/utilities/cp-cfheader.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/cp-cfmail-request-queue.cfm
0 ms 0 ms 2 C:/inetpub/wwwroot/commonspot/utilities/define-upfront-vars.cfm
0 ms 0 ms 4 C:/inetpub/wwwroot/commonspot/utilities/handle-in-list.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/load-template-properties.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/newwindow-js-meat.cfm
0 ms 0 ms 2 C:/inetpub/wwwroot/commonspot/utilities/newwindow-js.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/nocache-headers.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/update-page-cache-status.cfm
0 ms 0 ms 3 C:/inetpub/wwwroot/commonspot/utilities/validate-date-string.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/commonspot/utilities/verify-stub-data.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/dhs/custom-application.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/dhs/custom-search/inc-custom-application-search-vars.cfm
0 ms 0 ms 1 C:/inetpub/wwwroot/dhs/templates/template-basepage.head
0 ms 0 ms 2 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc | getPageSettings(1) ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc
0 ms 0 ms 2 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc | getPageSettings(1652) ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc
0 ms 0 ms 2 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc | getPageSettings(2) ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc
0 ms 0 ms 2 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc | getPageSettings(9706) ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-settings-cache.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc | DBQueue_Count() ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc | GetPageCacheStatus(1652, 2, 2, 0) ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc
0 ms 0 ms 2 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc | GetPageCacheStatus(9706, 2, 1652, 0) ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc | UpdateStatus(argumentCollection = [complex value]) ] from C:/inetpub/wwwroot/commonspot/components/cache/cache-status.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/custom-module-cache.cfc | getCustomAppPath(2) ] from C:/inetpub/wwwroot/commonspot/components/cache/custom-module-cache.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/custom-module-cache.cfc | getCustomModulePath(post-page-render, 2) ] from C:/inetpub/wwwroot/commonspot/components/cache/custom-module-cache.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/item-security-cache.cfc | GetEntry(9706) ] from C:/inetpub/wwwroot/commonspot/components/cache/item-security-cache.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/rewrite-rules-cache.cfc | getRewriteSettings(2) ] from C:/inetpub/wwwroot/commonspot/components/cache/rewrite-rules-cache.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/subsite-cache-manager.cfc | getLatest() ] from C:/inetpub/wwwroot/commonspot/components/cache/subsite-cache-manager.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/subsite-cache-manager.cfc | getSecurityPageIDMap([complex value]) ] from C:/inetpub/wwwroot/commonspot/components/cache/subsite-cache-manager.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/cache/template-cache.cfc | LoadTemplateProperties(publication-template.cfm, 1652, 2) ] from C:/inetpub/wwwroot/commonspot/components/cache/template-cache.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/custom-application-framework/handle-applications.cfc | executeFunction(handleRequestStart) ] from C:/inetpub/wwwroot/commonspot/components/custom-application-framework/handle-applications.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/engine/ACF/utilities.cfc | checkFileExists(C:/inetpub/wwwroot/dhs/templates/template-basepage.cfm, 0, false) ] from C:/inetpub/wwwroot/commonspot/components/engine/ACF/utilities.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/engine/ACF/utilities.cfc | queryRowToStruct(ArgumentCollection = [complex value]) ] from C:/inetpub/wwwroot/commonspot/components/engine/ACF/utilities.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/commonspot-context.cfc | getDSN(site) ] from C:/inetpub/wwwroot/commonspot/components/util/commonspot-context.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent('head' request check) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(CGI variable processing) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(Request object updates) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(Request.Params initialized) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(RequestTimeout check) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(Server-level remote requests checked) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(Subsite context updated (ID=2)) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(authoring suspended check) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(basic setup) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(check for server property changes) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(core cleanup) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(core initialization) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(core variables) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(custom-application.cfm) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(customerScope object initialized) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(handleRequestStart) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(init-server-scope loaded) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(lock checks/updates) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(site environment initialization) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(site session check) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(subsite context refreshed) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(wait for lock: CommonSpot_Server_Scope (read)) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | addEvent(wait for lock: CommonSpot_Site1_Core (exclusive)) ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc | init() ] from C:/inetpub/wwwroot/commonspot/components/util/debug-timing.cfc
0 ms 0 ms 2 CFC[ C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc | getObject(Cache) ] from C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc | getObject(Element) ] from C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc | getObject(Keywords) ] from C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc | getObject(LiveBookmarks) ] from C:/inetpub/wwwroot/commonspot/components/util/object-factory.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/components/util/visitor-context-rule-actions.cfc | onPageVisit(9706, 2) ] from C:/inetpub/wwwroot/commonspot/components/util/visitor-context-rule-actions.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/public_api/element.cfc | getInfo(elementTypeID = 26) ] from C:/inetpub/wwwroot/commonspot/public_api/element.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/public_api/keywords.cfc | appendEnforced(subsiteIDOrURL = , keywordList = Journal Details) ] from C:/inetpub/wwwroot/commonspot/public_api/keywords.cfc
0 ms 0 ms 1 CFC[ C:/inetpub/wwwroot/commonspot/udf/database.cfc | getUDF(commonspot-site-dhs) ] from C:/inetpub/wwwroot/commonspot/udf/database.cfc
0 ms  STARTUP, PARSING, COMPILING, LOADING, & SHUTDOWN
312 ms  TOTAL EXECUTION TIME
red = over 250 ms average execution time


SQL Queries

SelectedCustomRenderElements (Datasource=commonspot-site-dhs, Time=32ms, Records=2117) in C:\inetpub\wwwroot\commonspot\set-page-vars.cfm @ 09:36:39.039
		SELECT dcr.*
		  FROM Data_Custom_Render dcr, CustomElementModules cem
		 WHERE (dcr.PageID IN (?,?,?,?)) 
			AND dcr.VersionState=?
			AND (dcr.ModuleID = cem.ID OR dcr.ModuleID <= 0)
	 ORDER BY dcr.ControlID, dcr.PageID DESC, dcr.VersionID DESC
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 1
Parameter #2(CF_SQL_INTEGER) = 2
Parameter #3(CF_SQL_INTEGER) = 1652
Parameter #4(CF_SQL_INTEGER) = 9706
Parameter #5(CF_SQL_INTEGER) = 2

Request.PageData.PageParams (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\render-page-meat.cfm @ 09:36:39.039
			SELECT *
			  FROM Param_Page
			 WHERE (PageID=9706 OR (PageID IN (1652,2,1) AND (VersionState = 2)))
			   AND VersionState=2
			 ORDER BY PageID DESC
		
qry (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\core.cfm @ 09:36:39.039
					SELECT SubsiteID
					  FROM SitePages
					 WHERE ID = ? 
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 9706

testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 09:36:39.039
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 9706

qry (Datasource=commonspot-site-dhs, Time=0ms, Records=0) in C:\inetpub\wwwroot\commonspot\commands\livebookmarks.cfc @ 09:36:39.039
		SELECT Data_SeeAlso.ID, SubSites.SubSiteURL, SitePages.filename as pagename,
				 XMLPublications.name as feedname, XMLPublicationFormat.name as feedformat,
				 XMLPublications.description,
				 CASE
					 	WHEN XMLPublicationFormat.IsSyndication = 0 THEN 0
						ELSE 1
				 END AS IsSyndicationFeed
		  FROM Data_SeeAlso, XMLPublications, XMLPublicationFormat, SitePages, SubSites
		 WHERE Data_SeeAlso.PageID = ?
		 	AND Data_SeeAlso.Action = ?
		 	AND Data_SeeAlso.ItemID = XMLPublicationFormat.XMLPublicationFormatID
		 	AND Data_SeeAlso.TargetPageID = XMLPublications.XMLPublicationID
		 	AND XMLPublications.XMLPublicationFormatID = XMLPublicationFormat.XMLPublicationFormatID
		 	AND XMLPublications.PageID = SitePages.ID
		 	AND SitePages.SubSiteID = SubSites.ID
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 9706
Parameter #2(CF_SQL_INTEGER) = 11

ControlInstanceData (Datasource=commonspot-site-dhs, Time=0ms, Records=76) in C:\inetpub\wwwroot\commonspot\controls\control-setup.cfm @ 09:36:39.039
		SELECT ControlID, ControlName, ControlType, ParentControlID, ParentControlType, pageID
		  FROM ControlInstance
		 WHERE (PageID IN (?,?,?,?)) 
	 ORDER BY ControlID, PageID DESC
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 1
Parameter #2(CF_SQL_INTEGER) = 2
Parameter #3(CF_SQL_INTEGER) = 1652
Parameter #4(CF_SQL_INTEGER) = 9706

qInfo (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\commands\element.cfc @ 09:36:39.039
		SELECT ac.ShortDesc AS Name, CustomRenderSupport AS SupportsCustomLayouts,
				 CASE
					WHEN ac.ID <?
					 THEN 'Standard'
					WHEN (ac.Name is NULL or ac.Name = '')
					 THEN 'Saved'
					WHEN fcm.ClassID = 1
					 THEN 'Global'
					ELSE 'Local'
				 END AS ElementType,
				 CASE WHEN ac.Name = 'custom' THEN 'custom/ce' ELSE ac.ControlPrefix END AS ElementURLPrefix,
				 CASE WHEN (ac.ID IN (?,?,?,?,?,?,?,?,?,?,?,?))  THEN 0 ELSE 1 END AS HasFontColorProperties,
				 CASE WHEN (ac.ID IN (?,?,?,?,?,?,?))  THEN 0 ELSE 1 END AS HasLayoutProperties,
				 1 AS HasStyleProperties
		  FROM AvailableControls ac
		  LEFT OUTER JOIN FormControlMap fcm ON fcm.FormID = ac.ID
		 WHERE ac.ID = ? 
Query Parameter Value(s) -
Parameter #1(cf_sql_integer) = 400
Parameter #2(CF_SQL_INTEGER) = 22
Parameter #3(CF_SQL_INTEGER) = 44
Parameter #4(CF_SQL_INTEGER) = 55
Parameter #5(CF_SQL_INTEGER) = 1
Parameter #6(CF_SQL_INTEGER) = 56
Parameter #7(CF_SQL_INTEGER) = 47
Parameter #8(CF_SQL_INTEGER) = 26
Parameter #9(CF_SQL_INTEGER) = 48
Parameter #10(CF_SQL_INTEGER) = 27
Parameter #11(CF_SQL_INTEGER) = 28
Parameter #12(CF_SQL_INTEGER) = 51
Parameter #13(CF_SQL_INTEGER) = 31
Parameter #14(CF_SQL_INTEGER) = 33
Parameter #15(CF_SQL_INTEGER) = 26
Parameter #16(CF_SQL_INTEGER) = 48
Parameter #17(CF_SQL_INTEGER) = 37
Parameter #18(CF_SQL_INTEGER) = 27
Parameter #19(CF_SQL_INTEGER) = 38
Parameter #20(CF_SQL_INTEGER) = 28
Parameter #21(cf_sql_integer) = 26

Request.customCFUpfront (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\controls\upfront-generic.cfm @ 09:36:39.039
	SELECT *
	  FROM Data_CustomCF
	 WHERE (PageID=9706 OR (PageID IN (1652,2,1) AND (VersionState = 2)))
		AND (VersionState = 2) 
 ORDER BY ControlID, PageID DESC, VersionID DESC 
testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 09:36:39.039
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 9706

qry (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\commands\cache.cfc @ 09:36:39.039
		SELECT SubsiteID, InheritedTemplateList
		  FROM SitePages
		 WHERE ID=? 
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 9706

testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 09:36:39.039
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 1652

testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 09:36:39.039
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 2

testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 09:36:39.039
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 1

getArticlesDetails (Datasource=dhs_legacy_live, Time=16ms, Records=1) in C:\inetpub\wwwroot\dhs\customcf\legacy\journal\detail_article_summary.cfm @ 09:36:39.039
SELECT distinct(a.article_id),p.pub_id,tp.article_type_id,title,authors,article_date,article_year,
vol,link,active,source,pub_name,article_type_name,
abstract as abstractText
FROM dhs_articles a
INNER JOIN  Dhs_article_pub p ON a.pub_id = p.pub_id
INNER JOIN   Dhs_article_type Tp ON a.article_type_id = Tp.Article_type_Id

INNER JOIN  dhs_article_topics_lnk l ON  l.article_id=a.article_id
INNER JOIN  dhs_article_topics t on  l.topic_id=t.topic_id

WHERE active=1	and tp.article_type_id=1

AND a.article_id =? 
Order By title
Query Parameter Value(s) -
Parameter #1(cf_sql_integer) = 4985

getart_topic (Datasource=dhs_legacy_live, Time=0ms, Records=2) in C:\inetpub\wwwroot\dhs\customcf\legacy\journal\detail_article_summary.cfm @ 09:36:39.039
				select * from dhs_article_topics_lnk l, dhs_article_topics t 
				where article_id=?
				and l.topic_id=t.topic_id
				order by topic_name
			 
Query Parameter Value(s) -
Parameter #1(cf_sql_integer) = 4985

getart_Ctry (Datasource=dhs_legacy_live, Time=0ms, Records=1) in C:\inetpub\wwwroot\dhs\customcf\legacy\journal\detail_article_summary.cfm @ 09:36:39.039
				select * from dhs_article_ctry_lnk l, dhs_article_ctry c ,dhs_article_rgn r
				where article_id=? and l.country_id=c.country_id
				and R.Rgn_id = c.country_rgn_id	
			 
Query Parameter Value(s) -
Parameter #1(cf_sql_integer) = 4985

testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 09:36:39.039
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 9706

qry (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\commands\cache.cfc @ 09:36:39.039
		SELECT SubsiteID, InheritedTemplateList
		  FROM SitePages
		 WHERE ID=? 
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 9706

testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 09:36:39.039
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 1652

testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 09:36:40.040
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 2

testQuery (Datasource=commonspot-site-dhs, Time=0ms, Records=1) in C:\inetpub\wwwroot\commonspot\udf\validation\generated-validators.cfm @ 09:36:40.040
		SELECT ID
		  FROM SitePages
		 WHERE ID = ?
			AND (PageType IN (0,1,2) AND Uploaded=0)
	
Query Parameter Value(s) -
Parameter #1(CF_SQL_INTEGER) = 1


Scope Variables

Application Variables:
activesubsites=1,2,5,6,8,17,18,19,20,21,22,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58
adf=Struct (89)
adfscheduler=Struct (0)
applicationname=site1
assocpubdocs=Struct (4)
blogcache=Struct (4)
cachedimages=Struct (32)
cacheinfocache=Struct (53)
confidentiality=Array (5)
controlinstance_toplevel_cache=Struct (126)
covid_articlecount=10
covid_newsarticlecount=49
covid_pressreleasecount=4
covid_pubcount=3
cs_elementcache=Struct (10)
cs_resourcesmissing=Struct (0)
cs_rewriterulescache=Struct (21)
cs_subsitecachemanager=Struct (28)
customerinfo=Complex type
customerscope=Struct (21)
custommodulecache=Struct (21)
defaultconfidentiality=2
dhspagesyncdata=Struct (1)
itemsecuritycache=Struct (31)
languagenames=Struct (51)
languages=Struct (51)
lastknownchange=Struct (18)
lastupdate=Struct (14)
metadatacache=Struct (4)
pendingstubrequests=Struct (0)
rsscache=Struct (2)
search_archive_next_clean=2024-07-03 12:12:03
serverstatus=Struct (1)
site=Struct (74)
sitescope=Struct (9)
styleids=Struct (248)
stylenames=Struct (248)
subsitecache=Struct (46)
subsitecachebysecuritypageid=Struct (46)
templatecache=Struct (28)
templatedefaultsecuritycache=Struct (60)
templateenforcedsecuritycache=Struct (60)
treecache=Struct (25)
twittercache=Struct (2)
typefactory=Complex type
youtubecache=Struct (3)
CGI Variables:
AUTH_PASSWORD=
AUTH_TYPE=
AUTH_USER=
CERT_COOKIE=
CERT_FLAGS=
CERT_ISSUER=
CERT_KEYSIZE=
CERT_SECRETKEYSIZE=
CERT_SERIALNUMBER=
CERT_SERVER_ISSUER=
CERT_SERVER_SUBJECT=
CERT_SUBJECT=
CF_TEMPLATE_PATH=C:\inetpub\wwwroot\dhs\Publications\journal-details.cfm
CONTENT_LENGTH=0
CONTENT_TYPE=
CONTEXT_PATH=
GATEWAY_INTERFACE=CGI/1.1
HTTPS=off
HTTPS_KEYSIZE=
HTTPS_SECRETKEYSIZE=
HTTPS_SERVER_ISSUER=
HTTPS_SERVER_SUBJECT=
HTTP_ACCEPT=*/*
HTTP_ACCEPT_ENCODING=gzip, br, zstd, deflate
HTTP_ACCEPT_LANGUAGE=
HTTP_CONNECTION=
HTTP_COOKIE=CSRFTOKEN=255386DCB2968AA315AEBCA43FA40A94ED43606C; JSESSIONID=D79D24902FED84299C673E71CEBE6F69.cfusion
HTTP_HOST=preview.dhsprogram.com
HTTP_REFERER=
HTTP_URL=/Publications/journal-details.cfm?C_id=0&P_ID=0&T_ID=11&article_id=4985&r_id=0
HTTP_USER_AGENT=Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)
LOCAL_ADDR=10.0.0.111
PATH_INFO=
PATH_TRANSLATED=C:\inetpub\wwwroot\dhs\Publications\journal-details.cfm
QUERY_STRING=C_id=0&P_ID=0&T_ID=11&article_id=4985&r_id=0
REMOTE_ADDR=10.0.0.149
REMOTE_HOST=10.0.0.149
REMOTE_USER=
REQUEST_METHOD=GET
SCRIPT_NAME=/Publications/journal-details.cfm
SERVER_NAME=preview.dhsprogram.com
SERVER_PORT=80
SERVER_PORT_SECURE=0
SERVER_PROTOCOL=HTTP/1.1
SERVER_SOFTWARE=Microsoft-IIS/10.0
WEB_SERVER_API=
Cookie Variables:
CSRFTOKEN=255386DCB2968AA315AEBCA43FA40A94ED43606C
JSESSIONID=D79D24902FED84299C673E71CEBE6F69.cfusion
Request Parameters:
anonnoreadelements=
applockname=CS_App_Site1_1
archiveemail=archive@dhsprogram.com
assetsdir=/assets/
author_approve_whereclause=(VersionState = 2)
authormode=0
authorok=1
blupfront=
browser=Struct (13)
browserallincluded=1
cachefilesused=22
cachestatus=Complex type
cfflushcount=0
cgivars=Struct (49)
cloudfrontkeypairid=K3LSHNFSZFMIUC
cloudfronturl=d1vyaiefsqy4pf
constants=Complex type
cors.isCorsRequest=NO
cp=Struct (123)
cs_includedobjects=nwjs
cs_init_timings=Struct (23)
cs_isdashboardcmd=0
cs_request_start_memory=2464427016
cs_runningdashboardcmdcode=0
csrftoken=255386DCB2968AA315AEBCA43FA40A94ED43606C
ctrl_data=Struct (64)
customcf_data=Struct (2)
customcfupfront=Query (1)
customerinfo=Complex type
customhead=1
customrenderhandlerpairs=
customsearch=Struct (11)
dbdsn=measure_db
debugstate=Struct (1)
dhspagesyncdata=Struct (1)
dhtmlmenuitemsprefetch=
disablehideformenus=0
dsource=dhs_legacy_live
editmode=0
element=Struct (42)
elementrundetail=Struct (1)
elementsrun=1
environment=Struct (5)
finalreportids=5,26,21,10,18,30,39
finalreportna=139,315,445,488,107,138,459,518
formattedtimestamp=2024-07-03 09:36:39
getghost=
hivbold=1,3,8,9
imageupfront=
imgdir=/images/
includerootdir=/
initialsiteid=1
initticks=1719999399882
jswarnmessage=
linkdataupfront_itempos=
linkdataupfront_itemtitle=
lockid=0
mainpage=Struct (84)
master_cfm_used=1
maxperms=Complex type
modeorderbyclause=VersionID Desc
modewhereclause=(VersionState = 2)
modewhereclause_page=(VersionState = 2)
multisectionupfront=
noauthorreason=
nocacheelementtypes=
nocacheheaderincluded=1
nondashboardincludedone=1
obcountires=EG,ZM
package=Struct (0)
page=Struct (84)
pagedata=Struct (1)
pagedhtmlitems=
pagedhtmlmenus=
pageperms=Complex type
pagesync=Struct (4)
params=Struct (9)
params_formfields=
params_urlfields=T_ID,r_id,P_ID,C_id,article_id
readmodewhereclause=(VersionState = 2)
renderedelements=Struct (0)
renderelementdata=Struct (0)
renderfordiff=0
renderforprint=0
renderstate=Struct (73)
req_cam_callcount=1
req_inittimestamp=2024-07-03 09:36:39.882
req_sequenceid=74811
req_startticks=1719999399882
rootdir=/
rootpath=
rooturldatasetadmin=https://preview.dhsprogram.com/data/dataset_admin
samesite_value=
scheduleupfront=
serverdatasource=commonspot-sites
sessionlockname=Session_1_D79D24902FED84299C673E71CEBE6F69.cfusion
sessionstring=1_D79D24902FED84299C673E71CEBE6F69.cfusion
sicupfront=
sicupfrontparam=
site=Struct (74)
siteid=1
standardrenderhandlers=
styleids=Struct (248)
stylenames=Struct (248)
subsite=Struct (0)
subsitecache=Struct (46)
subsitecachebysecuritypageid=Struct (46)
subsiteid=2
taiupfrontparam=
tbupfront=
tbupfrontparam=
templatecachestatus=Struct (0)
templaterootdir=/
timestamp={ts '2024-07-03 09:36:39'}
trustcachestatus=1
typefactory=Complex type
udslockname=CS_Customer_commonspot-users
updatingschemas=0
user=Struct (30)
usersdatasource=commonspot-users
wanterrorsrethrown=0
warnmessage=
xmlbrowser=Struct (13)
Server Variables:
ADF=Struct (15)
COMMONSPOT=Struct (44)
EMAILALERTKEY=BSu0cRa8xSWdSrClnnGvpA==
coldfusion=Struct (10)
os=Struct (5)
system=Struct (2)
Session Variables:
_csrf_token=255386DCB2968AA315AEBCA43FA40A94ED43606C
adf=Struct (0)
authormode=0
contributemode=read
currentpageid=9706
debugmode=0
debugstate=Struct (1)
editmode=0
environment=Struct (5)
hasusertempfiles=0
language=Struct (216)
lastupdate=Struct (2)
lastuserupdate=1719999399397
lockid=0
lockobjectid=0
lockobjecttype=
locktype=
logintime=
ownedobjecttypes=
pendingapprovalpages=
pendingapprovals=
previewmode=0
requestedversioncounter=
requestedversiontimestamp=
sessionid=D79D24902FED84299C673E71CEBE6F69.cfusion
sessionstring=1_D79D24902FED84299C673E71CEBE6F69.cfusion
urltoken=CFID=2328752&CFTOKEN=a20d4c689dbecd4c-AF87E396-BF04-FC27-E0194442BA381B59&jsessionid=D79D24902FED84299C673E71CEBE6F69.cfusion
usagelist=
user=Struct (30)
xmlbrowser=Struct (13)
xmlenvironment=Struct (5)
URL Parameters:
C_id=0
P_ID=0
T_ID=11
article_id=4985
r_id=0
Debug Rendering Time: 16 ms