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Mazumder T, Mohanty I, Ahmad D, Niyonsenga T. An analysis of cause-specific under-5 mortality in Bangladesh using the demographic and health survey 2011 and 2017-2018. BMC Pediatr 2024; 24:572. [PMID: 39251961 PMCID: PMC11386380 DOI: 10.1186/s12887-024-04979-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 07/29/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND As the Sustainable Development Goal 3.2.1 deadline (2030) approaches, rapidly reducing under-5 mortality (U5M) gains more prominence. However, initiatives or interventions that aided Bangladesh in achieving Millennium Development Goal 4 showed varied effectiveness in reducing certain cause-specific U5M. Therefore, this study aimed to examine the predictors of the key cause-specific mortalities. METHODS This cross-sectional study was conducted using the Bangladesh Demographic and Health Survey 2011 and 2017-18 data. Cause-specific U5M was examined using multilevel multinomial mixed-effects analyses, and overall/all-cause U5M was examined using multilevel mixed-effects analyses. The respective estimates were compared. RESULTS The cause-specific analysis revealed that pneumonia and prematurity-related U5M were significantly associated with antenatal care and postnatal care, respectively. However, analysis of overall/all-cause U5M did not reveal any significant association with health services. Twins or multiples had a greater risk of mortality from preterm-related conditions (adjusted Relative Risk Ratio (aRRR): 38.01, 95% CI: 19.08-75.7, p < .001), birth asphyxia (aRRR: 6.52, 95% CI: 2.51-16.91, p < .001), and possible serious infections (aRRR: 11.12, 95% CI: 4.52-27.36, p < .001) than singletons. Children born to mothers 18 years or younger also exhibited a greater risk of mortality from these three causes than children born to older mothers. This study also revealed an increase in the predicted risk of prematurity-related mortality in the 2017-18 survey among children born to mothers 18 years or younger, children born to mothers without any formal education, twins or multiples and children who did not receive postnatal care. CONCLUSIONS This research provides valuable insights into accelerating U5M reduction; a higher risk of preterm-related death among twins underscores the importance of careful monitoring of mothers pregnant with twins or multiples through the continuum of care; elevated risk of death among children who did not receive postnatal care, or whose mothers did not receive antenatal care stresses the need to strengthen the coverage and quality of maternal and neonatal health care; furthermore, higher risks of preterm-related deaths among the children of mothers with low formal education or children born to mothers 18 years or younger highlight the importance of more comprehensive initiatives to promote maternal education and prevent adolescent pregnancy.
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Affiliation(s)
- Tapas Mazumder
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, ACT, 2617, Australia.
| | - Itismita Mohanty
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, ACT, 2617, Australia
| | - Danish Ahmad
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, ACT, 2617, Australia
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT, 2601, Australia
| | - Theo Niyonsenga
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, ACT, 2617, Australia
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Azanaw J, Weldegebriel F, Malede A. Investigating neighbourhood environmental risk factors associated with childhood acute respiratory infection symptoms in Ethiopia mixed effect and multilevel logistic regression analysis based on EDHS 2016. Front Public Health 2024; 12:1391682. [PMID: 39157531 PMCID: PMC11328150 DOI: 10.3389/fpubh.2024.1391682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 07/17/2024] [Indexed: 08/20/2024] Open
Abstract
Background Acute respiratory infection is an infectious illness caused by acute viral or bacterial infection. According to a 2018 WHO report, exposures to indoor and ambient air environmental pollution were contributing factors to a higher risk of respiratory problems following 7 million deaths of children under five globally. Housing conditions such as wall material, roof type, kitchen location, sanitation condition, and cooking fuel type are household-level predictors of acute respiratory disease among children under five years of age. Method This research used EDHS-2016 secondary data, which are nationally representative. The data collection period was from January 18, 2016, to June 27, 2016. Among the 16,650 total surveys, 10,006 households that had children below 5 years of age. The outcome variable for this study was acute respiratory infection symptoms. Analyses were performed using STATA Version 17.1. The data were weighted before performing analysis to reinstate the representativeness of the sample. In the bivariable analysis, a p value <0.2 was used to screen for multivariable. Multicollinearity was checked using the variance inflation factor. Then, a multilevel multivariable regression model was used in this study for the analysis of acute respiratory infection symptoms and possible predictor variables. Variables with a p value <0.05 in multivariable regression analysis were considered statistically significant predictors. Results Most (95.00%) households commonly used solid fuel for cooking, and household main construction materials: 81.44 and 91.03% of floors and walls of households were constructed with unprocessed natural materials, respectively. The prevalence of acute respiratory infection symptoms among children under five years of age was 7.955% (7.397, 8.551%). The findings indicated that acute respiratory infection symptoms among children under five years of age were significantly linked with the age of the children, diarrhea status, residence, region, fuel type, stool disposal, wall material, and floor material. Conclusion Interventions should target modifiable factors such as proper stool disposal of the youngest child, informing the health effects of poor housing conditions such as improving wall and floor construction material to reduce acute respiratory infection symptoms among children under five years of age.
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Affiliation(s)
- Jember Azanaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Bakchi J, Rasel RA, Shammi KF, Ferdous S, Sultana S, Rabeya MR. Effect of housing construction material on childhood acute respiratory infection: a hospital based case control study in Bangladesh. Sci Rep 2024; 14:8163. [PMID: 38589435 PMCID: PMC11001851 DOI: 10.1038/s41598-024-57820-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 03/21/2024] [Indexed: 04/10/2024] Open
Abstract
Despite several studies conducted to investigate housing factors, the effects of housing construction materials on childhood ARI symptoms in Bangladesh remain unclear. Hence, the study aimed to measure such a correlation among children under the age of five. A hospital-based case-control study was conducted, involving 221 cases and 221 controls from January to April 2023. Bivariate and multivariate binary logistic regression was performed to measure the degree of correlation between housing construction materials and childhood ARI symptoms. Households composed of natural floor materials had 2.7 times (95% confidence interval 1.27-5.57) and households composed of natural roof materials had 1.8 times (95% confidence interval 1.01-3.11) higher adjusted odds of having under-five children with ARI symptoms than household composed of the finished floor and finished roof materials respectively. Households with natural wall type were found protective against ARI symptoms with adjusted indoor air pollution determinants. The study indicates that poor housing construction materials are associated with an increased risk of developing ARI symptoms among under-five children in Bangladesh. National policy regarding replacing poor housing materials with concrete, increasing livelihood opportunities, and behavioral strategies programs encouraging to choice of quality housing construction materials could eliminate a fraction of the ARI burden.
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Affiliation(s)
- Jhantu Bakchi
- Department of Public Health Nutrition, School of Science, Primeasia University, Dhaka-1213, Bangladesh.
| | - Rosul Ahmed Rasel
- Department of Public Health Nutrition, School of Science, Primeasia University, Dhaka-1213, Bangladesh
| | - Khandokar Farmina Shammi
- Department of Public Health Nutrition, School of Science, Primeasia University, Dhaka-1213, Bangladesh
| | - Sumaiya Ferdous
- Department of Public Health Nutrition, School of Science, Primeasia University, Dhaka-1213, Bangladesh
| | - Shamima Sultana
- Department of Public Health Nutrition, School of Science, Primeasia University, Dhaka-1213, Bangladesh
| | - Mst Rokshana Rabeya
- Department of Public Health Nutrition, School of Science, Primeasia University, Dhaka-1213, Bangladesh
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Islam M, Islam K, Dalal K, Hossain Hawlader MD. In-house environmental factors and childhood acute respiratory infections in under-five children: a hospital-based matched case-control study in Bangladesh. BMC Pediatr 2024; 24:38. [PMID: 38216932 PMCID: PMC10787469 DOI: 10.1186/s12887-024-04525-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 01/01/2024] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Acute respiratory infection (ARI) is one of the leading causes of morbidity and mortality among children under five globally, particularly in regions like South Asia and sub-Saharan Africa. Bangladesh has made substantial progress in reducing child mortality, yet pneumonia remains a significant contributor to under-five deaths. This study aimed to investigate the association between in-house environmental factors and childhood ARI, considering factors such as household crowding, smoking, and sanitation facilities. METHODS This case-control study was conducted at a tertiary-level children's hospital in Dhaka, Bangladesh, from March to September 2019. The study included children aged 6-59 months. Cases were children with ARI symptoms, while controls were children without such symptoms. Rigorous matching by age and gender was employed to ensure comparability. Data were collected through structured questionnaires, and bivariate and conditional logistic regression analyses were performed. RESULTS Several household environmental factors were significantly associated with childhood ARIs. Children from overcrowded households (AOR = 2.66, 95% CI = 1.52-4.71; p < 0.001), those using unclean cooking fuels (OR = 2.41, 95% CI: 1.56, 3.73; p = < 0.001), those exposed to in-house smoking (AOR = 1.74, 95% CI = 1.01, 3.05; p = 0.04) and those with unimproved sanitation facilities faced higher odds (AOR = 4.35, 95% CI = 2.14-9.26) of ARIs. Additionally, preterm birth and higher birth order were associated with an increased risk of ARI. In contrast, exclusive breastfeeding was a protective factor. CONCLUSION In-house environmental factors, including sanitation, crowding and in-house smoking, significantly influence childhood ARIs. Additionally, birth order and preterm birth play a crucial role. Promoting exclusive breastfeeding is associated with a lower ARI risk among under-five children in Bangladesh. These findings can guide interventions to reduce ARIs in low-income regions, particularly in South Asia.
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Affiliation(s)
- Moktarul Islam
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
| | - Kariul Islam
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
| | - Koustuv Dalal
- School of Health Sciences, Division of Public Health Science, Mid Sweden University, Sundsvall, 851 70, Sweden.
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Varghese JS, Muhammad T. Prevalence, potential determinants, and treatment-seeking behavior of acute respiratory infection among children under age five in India: Findings from the National Family Health Survey, 2019-21. BMC Pulm Med 2023; 23:195. [PMID: 37280601 DOI: 10.1186/s12890-023-02487-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/18/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Acute respiratory infections (ARI) are a major cause of mortality and morbidity among under-five children worldwide, particularly in developing countries. Current evidence using nationally representative data on determinants and care-seeking behavior for ARI is limited in the Indian context. Hence, the present study complements the existing literature by examining the prevalence, determinants, and health-care-seeking behavior regarding ARI among Indian children under age five. STUDY DESIGN Cross-sectional study. METHODS The data for the present study were drawn from the fifth round of the National Family Health Survey (NFHS-5) conducted in 28 states and 8 union territories of India in 2019-21. A total of 222,233 children age less than five years were selected to estimate the prevalence and determinants of ARI, and 6198 children having ARI were selected to explore the treatment-seeking behavior. Bivariate analysis and multivariable binary logistic regression analysis were employed. RESULTS Among children under five years, 2.8% suffered from ARI in the two weeks preceding the survey, and 56.1% sought treatment for ARI. Younger age, a recent episode of diarrhea, maternal asthmatic history, and tobacco smoke exposure in the household increase the risk of having ARI. Further, having a separate room as a kitchen in the household reduces the likelihood of having ARI by 14% (AOR: 0.86; CI: 0.79-0.93). Female children (AOR: 0.88; CI: 0.77-1.00) and children belonging to households having difficulty in accessing transport to health facility (AOR: 0.83; CI: 0.69-0.99) are less likely to seek treatment. CONCLUSION The study identified several socio-demographic, maternal, and household characteristics associated with ARI and treatment seeking for ARI. The study also recommends making health centers more accessible to the people in terms of proximity and cost.
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Affiliation(s)
- Jesty Saira Varghese
- Indian Institute of Technology (IIT) Delhi, New Delhi, 110016, India.
- Department of Family & Generations, International Institute for Population Sciences (IIPS), Mumbai, 400088, Maharashtra, India.
| | - T Muhammad
- Indian Institute of Technology (IIT) Delhi, New Delhi, 110016, India
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Jabin N, Rahman MM, Salam MT, Sharna TI, Franklin M, Bailey MJ, Alderete TL, Ahmed A, Quaiyum MA, Islam T. Cohort profile: Bangladesh Cook Stove Pregnancy Cohort Study (CSPCS). BMJ Open 2023; 13:e068539. [PMID: 37164456 PMCID: PMC10174037 DOI: 10.1136/bmjopen-2022-068539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
PURPOSE The Cook Stove Pregnancy Cohort Study (CSPCS) was designed to assess the effects of biomass fuel use on household air pollution (HAP) as well as the effects of HAP (fine particulate matter, PM2.5) on birth outcomes and acute lower respiratory infection (ALRI) among infants in Bangladesh. PARTICIPANTS We recruited 903 women within 18 weeks of pregnancy from rural and semiurban areas of Bangladesh between November 2016 and March 2017. All women and their infants (N=831 pairs) were followed until 12 months after delivery and a subset have undergone respiratory and gut microbiota analysis. METHODS Questionnaires were administered to collect detailed sociodemographic, medical, nutritional and behavioural information on the mother-child dyads. Anthropometric measurements and biological samples were also collected, as well as household PM2.5 concentrations. FINDINGS TO DATE Published work in this cohort showed detrimental effects of biomass fuel and health inequity on birth outcomes. Current analysis indicates high levels of household PM2.5 being associated with cooking fuel type and infant ALRI. Lastly, we identified distinct gut and respiratory microbial communities at 6 months of age. FUTURE PLANS This study provides an economical yet effective framework to conduct pregnancy cohort studies determining the health effects of adverse environmental exposures in low-resource countries. Future analyses in this cohort include assessing the effect of indoor PM2.5 levels on (1) physical growth, (2) neurodevelopment, (3) age of first incidence and frequency of ALRI in infants and (4) the development of the respiratory and gut microbiome. Additional support has allowed us to investigate the effect of in utero exposure to metals on infant neurodevelopment in the first year of life.
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Affiliation(s)
- Nusrat Jabin
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Md Mostafijur Rahman
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Muhammad T Salam
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
- Department of Psychiatry, Kern Medical Center, Bakersfield, California, USA
| | | | - Meredith Franklin
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
- Department of Statistical Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Maximilian J Bailey
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Tanya L Alderete
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Anisuddin Ahmed
- International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
| | - M A Quaiyum
- Projohnmo Research Foundation (PRF), Dhaka, Bangladesh
| | - Talat Islam
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
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El-Koofy NM, El-Shabrawi MH, Abd El-Alim BA, Zein MM, Badawi NE. Patterns of respiratory tract infections in children under 5 years of age in a low-middle-income country. J Egypt Public Health Assoc 2022; 97:22. [PMID: 36336730 PMCID: PMC9637678 DOI: 10.1186/s42506-022-00118-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 09/22/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Respiratory tract infections (RTIs) are among the most commonly encountered major public health problems, with a higher prevalence of lower RTIs among children and more generally the poor. The present study aimed to describe the pattern of respiratory tract infections in Egyptian children aged under 5 years and explore possible associations between socio-demographics and nutritional status and types of RTIs. METHODS Over 6 months beginning in September 2018 (including one winter season), a cross-sectional, observational, epidemiological study was conducted on a sample of patients with upper and lower RTIs diagnosed clinically and/or radiologically in the outpatient clinics at Cairo University Children's Hospital in Egypt. An interview questionnaire was employed to collect socio-demographic and nutritional data. Heights/lengths and weights were measured and analyzed using the World Health Organization's (WHO) Anthro Plus [Computer Program]. Patients with pneumonia (n = 28) were compared to 97 healthy children of the same age and sex. RESULTS The total number of children diagnosed with upper and lower respiratory infections was 611. Malnutrition was present in 12.4% of all children with upper and lower RTIs. Lower RTI and malnutrition were substantially more prevalent among children aged under 2 years (p = 0.048 and p < 0.001, respectively). The strongest predictor of lower RTI was a younger age (OR 0.797, CI 0.713-0.89, p < 0.001). CONCLUSION At our center, approximately one-third of infections in under-fives were lower RTI. Malnutrition was one of the significant risk factors for lower RTI in children below 2 years. The nutritional status of infants and young children should be improved by encouraging exclusive breastfeeding during the first 6 months of life and strengthening the healthcare and nutritional counseling available for vulnerable children, particularly in rural regions.
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Affiliation(s)
- Nehal M El-Koofy
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | | | - Marwa M Zein
- Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Nora E Badawi
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
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Kamal MM, Tewabe T, Tsheten T, Hossain SZ. Individual and community-level factors associated with under-five diarrhea in Bangladesh: Evidence from Demographic and Health Survey 2014. Curr Ther Res Clin Exp 2022; 97:100686. [PMID: 36267421 PMCID: PMC9576538 DOI: 10.1016/j.curtheres.2022.100686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 09/08/2022] [Indexed: 11/23/2022] Open
Abstract
Background Diarrheal disease is among the leading causes of morbidity and mortality among children younger than age 5 years in Bangladesh. Objective The objective of this study is to assess the prevalence of diarrhea among children younger than age 5 years and its associated risk factors. Methods Data were sourced from the Bangladesh Demographic and Health Survey, a nationally representative study conducted in 2014. We used multilevel logistic regression models to identify factors associated with diarrheal disease. Results Children aged 6 to11 months (odds ratio = 2.26; 95% CI, 1.50–3.42), and 12 to 23 months (odds ratio = 2.31; 95% CI, 1.62–3.31) were more likely to have diarrhea than older children. Other significant risk factors for diarrheal infection included households without access to drinking water (odds ratio = 1.39; 95% CI, 1.03–1.88) and mothers lacking mass media access (odds ratio = 1.32; 55% CI, 1.01–1.73). Conclusions Childhood diarrhea in Bangladesh was associated with individual- and community-level factors. The finding of this study suggests that diarrhea prevention programs in the country can effectively be delivered by targeting young children through expanding community-based education and increasing access to health information through mass media.
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Hossain MS, Tasnim S, Chowdhury MA, Chowdhury FIF, Hossain D, Rahman MM. Under five children's acute respiratory infection dropped significantly in Bangladesh: an evidence from Bangladesh demographic and health survey (BDHS), 1996-2018. Acta Paediatr 2022; 111:1981-1994. [PMID: 35678484 DOI: 10.1111/apa.16447] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 05/29/2022] [Accepted: 06/07/2022] [Indexed: 11/29/2022]
Abstract
AIM This study aims to systematically identify and review the most significant risk factors and the trends that follow Acute Respiratory Infection (ARI) among children under five in Bangladesh. METHODS A total of 6863 under-five children were eligible for our analysis, retrieved from Bangladesh Demographic and Health Survey, 2014. ARI cases were defined if a child experienced of coughing with short and rapid breathing at the chest that occurred during two weeks prior to the study. Logistic regression and systematic review methods were appraised to explore the various risk factors involving ARI in Bangladesh. Furthermore, a trend analysis was performed to overlook the historical trend of ARI prevalence and affiliated determinants from 1996/97 to 2017/18 in Bangladesh. RESULTS Over the past two decades, Bangladesh experienced a significant drop in ARI prevalence from 12.8% in 1996 to only 3.0% in 2018. The cross-sectional findings revealed that boys (OR=1.35, 95% CI: 1.03-1.78), stunted children (OR=1.35, 95% CI: 1.03-1.78) and mothers with primary or no education (OR=2.53, 95% CI: 1.43-4.90) and secondary education (OR=1.77, 95% CI: 1.00-3.44) has the higher odds of ARI than their counterparts. CONCLUSION ARI prevalence significantly declined in Bangladesh while boys, stunted children and uneducated or primary educated mothers were identified as potential risk factors.
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Affiliation(s)
- Md Sabbir Hossain
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Sumaiya Tasnim
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
| | - Md Alamgir Chowdhury
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
| | | | - Daluwar Hossain
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
| | - Mohammad Meshbahur Rahman
- Department of Biostatistics, National Institute of Preventive and Social Medicine, Mohakhali, Dhaka, -1212, Bangladesh
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Kundu S, Kundu S, Banna MHA, Ahinkorah BO, Seidu AA, Okyere J. Prevalence of and factors associated with childhood diarrhoeal disease and acute respiratory infection in Bangladesh: an analysis of a nationwide cross-sectional survey. BMJ Open 2022; 12:e051744. [PMID: 35387807 PMCID: PMC8987759 DOI: 10.1136/bmjopen-2021-051744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 03/17/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES This study aimed to estimate the prevalence of childhood diarrhoeal diseases (CDDs) and acute respiratory infections (ARIs) and also to determine the factors associated with these conditions at the population level in Bangladesh. SETTING The study entailed an analysis of nationally representative cross-sectional secondary data from the most recent Bangladesh Demographic and Health Survey conducted in 2017-2018. PARTICIPANTS A total of 7222 children aged below 5 years for CDDs and 7215 children aged below 5 years for ARIs during the survey from mothers aged between 15 and 49 years were the participants of this study. In the bivariate and multivariable analyses, we used Pearson χ2 test and binary logistic regression, respectively, for both outcomes. RESULTS The overall prevalence of CDD and ARI among children aged below 5 years was found to be 4.91% and 3.03%, respectively. Younger children were more likely to develop both CDDs and ARIs compared with their older counterparts. Children belonging to households classified as poorest and with unimproved floor materials had a higher prevalence of diarrhoea than those from households identified as richest and with improved floor material, respectively. Stunted children had 40.8% higher odds of diarrhoea than normal children. Being male and having mothers aged below 20 years were 48.9% and two times more likely to develop ARI than female counterparts and children of mothers aged 20-34 years, respectively. Children whose mothers had no formal education or had primary and secondary education had higher odds of ARI compared with children of mothers having higher education. CONCLUSION This study found that children aged below 24 months were at higher risk of having CDDs and ARIs. Thus, programmes targeting these groups should be designed and emphasis should be given to those from poorest wealth quintile to reduce CDDs and ARIs.
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Affiliation(s)
- Satyajit Kundu
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
- School of Public Health, Southeast University, Nanjing, China
| | - Subarna Kundu
- Statistics Discipline, Khulna University, Khulna, Bangladesh
| | - Md Hasan Al Banna
- Department of Food Microbiology, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Abdul-Aziz Seidu
- Faculty of Built and Natural Environment, Department of Estate Management, Takoradi Technical University, Takoradi, Ghana
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
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Kouser S, Munir S, Abedullah. Does communal women empowerment mitigate the risk of acute respiratory infection among under-five children in Pakistan? Public Health 2022; 205:133-138. [DOI: 10.1016/j.puhe.2022.01.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 11/05/2021] [Accepted: 01/28/2022] [Indexed: 11/30/2022]
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Mir F, Ariff S, Bhura M, Chanar S, Nathwani AA, Jawwad M, Hussain A, Rizvi A, Umer M, Memon Z, Habib A, Soofi SB, Bhutta ZA. Risk Factors for Acute Respiratory Infections in Children Between 0 and 23 Months of Age in a Peri-Urban District in Pakistan: A Matched Case-Control Study. Front Pediatr 2022; 9:704545. [PMID: 35083182 PMCID: PMC8784846 DOI: 10.3389/fped.2021.704545] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 11/18/2021] [Indexed: 01/10/2023] Open
Abstract
Background: Acute respiratory infection (ARI) accounts for nearly 15% of all childhood mortality in South Asia, with children from rural areas at higher risk due to inaccessibility to healthcare facilities. We therefore aimed to identify risk factors associated with ARI in children under 2 years of age in rural Pakistan. Methods: A retrospective 1:2 matched case-control study was conducted between October and December 2018 in Taluka Kotri, Jamshoro District of Pakistan. Cases were identified as children between 0 and 23 months of age with a history of fever, cough, sore throat, fast breathing, difficulty breathing, or chest indrawing in the 2 weeks prior to the survey. Controls were participants without symptoms of ARI, matched based on age in months. Data analysis was conducted using STATA version 15. Univariate and multivariable conditional logistic regression analyses were used to identify factors associated with ARI, and p < 0.05 was considered statistically significant. Results: We identified 1,071 cases of ARI who were matched with 2,142 controls. Multivariable analysis revealed that female gender [odds ratio (OR) 0.78, 95% confidence interval (CI): 0.67-0.91], exclusive breastfeeding (OR 0.81, 95% CI: 0.69-0.97), and comorbidity with diarrhea (OR: 1.64, 95% CI: 1.40-1.91) were significantly associated with ARI. Conclusion: Pakistan continues to progress toward reducing childhood mortality, particularly ARI-related deaths, for which it bears a great burden. This study identifies risk factors such as the male gender, breastfeeding, and comorbidities with diarrhea, which could open grounds for further programmatic implications in targeting a multifaceted approach to reducing incidences of ARI in rural areas of the country.
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Affiliation(s)
| | - Shabina Ariff
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
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Singh PK, Sinha P, Singh N, Singh L, Singh S. Does secondhand smoke exposure increase the risk of acute respiratory infections among children aged 0-59 months in households that use clean cooking fuel? A cross-sectional study based on 601 509 households in India. INDOOR AIR 2022; 32:e12980. [PMID: 35014716 DOI: 10.1111/ina.12980] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 12/21/2021] [Accepted: 12/27/2021] [Indexed: 06/14/2023]
Abstract
This study examines whether exposure to secondhand smoke (SHS) increases the risk of acute respiratory infections (ARI) among children aged 0-59 months. Study utilized nationally representative data from National Family Health Survey (2015-2016), which adopted two-stage stratified random sampling. Four mutually exclusive groups based on the type of cooking fuel usage and SHS exposure were created. Descriptive statistics and multivariate logistics regression analysis were applied. At the national level, 10.5% prevalence of ARI was reported during 2015-2016. About 47.9% (95%CI 47.7-48.2) of households was exposed to SHS and used solid biomass fuel for cooking. Nearly, 20.7% of households with clean fuel usage was exposed to SHS. Regression analysis suggests that the likelihood of ARI among children who were living in households with solid biomass fuel usage and exposed to SHS was 11% (95%CI 1.06-1.17) greater than children living in households with clean fuel usage with no SHS exposure. Moreover, our results further revealed that the odds of ARI among children living in households with clean fuel but exposed to SHS were 19% (95%CI 1.13-1.25) higher than the children living in the household with no SHS exposure and clean fuel use. Children living in households exposed to SHS are at higher risk of ARI.
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Affiliation(s)
- Prashant Kumar Singh
- Division of Preventive Oncology and Population Health, ICMR - National Institute of Cancer Prevention and Research, Noida, India
- WHO FCTC Knowledge Hub on Smokeless Tobacco, ICMR-National Institute of Cancer Prevention and Research, Noida, India
| | - Pallavi Sinha
- Division of Preventive Oncology and Population Health, ICMR - National Institute of Cancer Prevention and Research, Noida, India
| | - Nishikant Singh
- Division of Preventive Oncology and Population Health, ICMR - National Institute of Cancer Prevention and Research, Noida, India
| | - Lucky Singh
- ICMR - National Institute of Medical Statistics, New Delhi, India
| | - Shalini Singh
- WHO FCTC Knowledge Hub on Smokeless Tobacco, ICMR-National Institute of Cancer Prevention and Research, Noida, India
- ICMR - National Institute of Cancer Prevention and Research, Noida, India
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14
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Starkweather KE, Keith MH, Prall SP, Alam N, Zohora F, Emery Thompson M. Are fathers a good substitute for mothers? Paternal care and growth rates in Shodagor children. Dev Psychobiol 2021; 63:e22148. [PMID: 34087947 DOI: 10.1002/dev.22148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 12/21/2022]
Abstract
Biparental care is a hallmark of human social organization, though paternal investment varies between and within societies. The facultative nature of paternal care in humans suggests males should invest when their care improves child survival and/or quality, though testing this prediction can be challenging because of the difficulties of empirically isolating paternal effects from those of other caregivers. Additionally, the broader context in which care is provided, vis-à-vis care from mothers and others, may lead to different child outcomes. Here, we examine the effects of paternal care on child growth among Shodagor fisher-traders, where fathers provide high levels of both additive and substitutive care, relative to mothers. We modeled seasonal z-scores and velocities for height, weight, and body mass index (BMI) outcomes using linear mixed models. Our evidence indicates that, as predicted, the context of paternal care is an important predictor of child outcomes. Results show that environmental seasonality and alloparental help contribute to a nuanced understanding of the impact of Shodagor paternal care on child physiology.
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Affiliation(s)
- K E Starkweather
- Department of Anthropology, University of Illinois Chicago, Chicago, Illinois.,Department of Anthropology, University of New Mexico, Albuquerque, New Mexico.,Department of Human Behavior, Ecology, and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - M H Keith
- Department of Anthropology, University of Washington, Seattle, Washington
| | - S P Prall
- Department of Anthropology, University of Missouri, Columbia, Missouri
| | - N Alam
- Health Systems and Population Studies Division, ICDDR,B, Dhaka, Bangladesh
| | - F Zohora
- Health Systems and Population Studies Division, ICDDR,B, Dhaka, Bangladesh
| | - M Emery Thompson
- Department of Anthropology, University of New Mexico, Albuquerque, New Mexico
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Musa TH, Akintunde TY, Musa HH, Ghimire U, Gatasi G. Malnutrition Research Output: A Bibliometric Analysis for articles Index in Web of Science between 1900 and 2020. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2021. [DOI: 10.29333/ejgm/10840] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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16
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Islam M, Sultana ZZ, Iqbal A, Ali M, Hossain A. Effect of in-house crowding on childhood hospital admissions for acute respiratory infection: A matched case-control study in Bangladesh. Int J Infect Dis 2021; 105:639-645. [PMID: 33684561 DOI: 10.1016/j.ijid.2021.03.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Despite previous studies conducted to identify potential household factors, no conclusive evidence exists regarding the effect of in-house crowding on hospitalization for acute respiratory infection (ARI) in Bangladesh. Hence, the aim of this study was to detect such an association in children aged 6-59 months. METHODS An age and sex-matched case-control study was conducted involving 348 children in Bangladesh. In-house crowding was measured by people-per-bedroom. Conditional logistic regression was performed to identify the association between in-house crowding and hospitalization for ARI. RESULTS In-house overcrowding was associated with a 2.9-fold (95% confidence interval 1.80-4.73) greater adjusted odds of hospitalization for ARI compared to children from less crowded houses. In-house overcrowding was common in rural areas and in households with a poor economic status. Suboptimal breastfeeding and household tobacco smoke exposure were found to prevail in overcrowded households. CONCLUSION In-house overcrowding is associated with an increased risk of hospitalization for ARI in young children. Eliminating the fraction of the ARI burden due to in-house overcrowding will rely on increasing awareness regarding indoor air pollution and ventilation in the house and making efforts to avoid smoking in dwellings. Along with the management of crowding, child nutrition and exclusive breast-feeding requirements should be continued for a wide range of child health benefits.
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Affiliation(s)
- Moktarul Islam
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
| | - Zeeba Zahra Sultana
- Cambridge Programme to Assist Bangladesh in Lifestyle and Environmental Risk Reduction, University of Cambridge, Cambridge, UK
| | - Adiba Iqbal
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
| | - Mohammad Ali
- Uttara Adhunik Medical College and Hospital, Dhaka, 1230, Bangladesh
| | - Ahmed Hossain
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh; Global Health Institute, North South University, Bashundhara, Dhaka, 1229, Bangladesh.
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Vidal K, Sultana S, Patron AP, Salvi I, Shevlyakova M, Foata F, Rahman M, Deeba IM, Brüssow H, Ahmed T, Sakwinska O, Sarker SA. Changing Epidemiology of Acute Respiratory Infections in Under-Two Children in Dhaka, Bangladesh. Front Pediatr 2021; 9:728382. [PMID: 35083183 PMCID: PMC8785242 DOI: 10.3389/fped.2021.728382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 12/01/2021] [Indexed: 01/09/2023] Open
Abstract
Objectives: Risk factors for acute respiratory infections (ARIs) in community settings are not fully understood, especially in low-income countries. We examined the incidence and risk factors associated with ARIs in under-two children from the Microbiota and Health study. Methods: Children from a peri-urban area of Dhaka (Bangladesh) were followed from birth to 2 years of age by both active surveillance of ARIs and regular scheduled visits. Nasopharyngeal samples were collected during scheduled visits for detection of bacterial facultative respiratory pathogens. Information on socioeconomic, environmental, and household conditions, and mother and child characteristics were collected. A hierarchical modeling approach was used to identify proximate determinants of ARIs. Results: Of 267 infants, 87.3% experienced at least one ARI episode during the first 2 years of life. The peak incidence of ARIs was 330 infections per 100 infant-years and occurred between 2 and 4 months of age. Season was the main risk factor (rainy monsoon season, incidence rate ratio [IRR] 2.43 [1.92-3.07]; cool dry winter, IRR 2.10 [1.65-2.67] compared with hot dry summer) in the first 2 years of life. In addition, during the first 6 months of life, young maternal age (<22 years; IRR 1.34 [1.01-1.77]) and low birth weight (<2,500 g; IRR 1.39 [1.03-1.89]) were associated with higher ARI incidence. Conclusions: Reminiscent of industrialized settings, cool rainy season rather than socioeconomic and hygiene conditions was a major risk factor for ARIs in peri-urban Bangladesh. Understanding the causal links between seasonally variable factors such as temperature, humidity, crowding, diet, and ARIs will inform prevention measures.
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Affiliation(s)
- Karine Vidal
- Nestlé Institute of Health Sciences, Nestlé Research, Lausanne, Switzerland
| | - Shamima Sultana
- International Center for Diarrheal Disease Research (icddr, b), Dhaka, Bangladesh
| | | | - Irene Salvi
- Nestlé Institute of Health Sciences, Nestlé Research, Lausanne, Switzerland
| | - Maya Shevlyakova
- Nestlé Institute of Health Sciences, Nestlé Research, Lausanne, Switzerland
| | - Francis Foata
- Nestlé Institute of Health Sciences, Nestlé Research, Lausanne, Switzerland
| | - Mahbubur Rahman
- International Center for Diarrheal Disease Research (icddr, b), Dhaka, Bangladesh
| | - Iztiba Mallik Deeba
- International Center for Diarrheal Disease Research (icddr, b), Dhaka, Bangladesh
| | - Harald Brüssow
- Nestlé Institute of Health Sciences, Nestlé Research, Lausanne, Switzerland.,Department of Biosystems, Division of Animal and Health Engineering, University of Leuven, Leuven, Belgium
| | - Tahmeed Ahmed
- International Center for Diarrheal Disease Research (icddr, b), Dhaka, Bangladesh
| | - Olga Sakwinska
- Nestlé Institute of Health Sciences, Nestlé Research, Lausanne, Switzerland
| | - Shafiqul Alam Sarker
- International Center for Diarrheal Disease Research (icddr, b), Dhaka, Bangladesh
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Liu MC, Chou FH. Play Effects on Hospitalized Children With Acute Respiratory Infection: An Experimental Design Study. Biol Res Nurs 2020; 23:430-441. [PMID: 33334144 DOI: 10.1177/1099800420977699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Acute respiratory infection is a major health issue and a primary cause of morbidity and mortality among preschool-aged children worldwide. Disease and hospitalization are chief stressors for children during their development. Therapeutic play has been used in pediatric care processes and has been demonstrated to be effective by most studies that have targeted children undergoing surgeries or invasive medical treatments. Currently, few published studies have focused on children receiving acute inpatient care. Additionally, not all types of therapeutic play produce significant results, and few studies have elaborated on the purposes, principles, and concrete measures of therapeutic play. Therefore, this study aimed to design therapeutic play that would reduce the stress responses of preschool-aged children hospitalized with acute respiratory infection. An experimental design with a pretest/posttest was conducted with 105 preschool children recruited from a regional teaching hospital in southern Taiwan. The children in the experimental group received the therapeutic play, while those in the control group received routine nursing care. Children in the experimental group showed significantly greater reductions in their physiological, psychological, and behavioral stress responses than those in the control group. Future studies could apply therapeutic play to children from different age groups with diverse health issues before recommending it be used in pediatric health settings.
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Affiliation(s)
- Mei-Chun Liu
- 63408Chung-Jen College of Nursing, Health Sciences and Management, Chia-Yi.,210832College of Nursing, Kaohsiung Medical University, Kaohsiung
| | - Fan-Hao Chou
- 210832College of Nursing, Kaohsiung Medical University, Kaohsiung
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Hasan MN, Chowdhury MAB, Jahan J, Jahan S, Ahmed NU, Uddin MJ. Cesarean delivery and early childhood diseases in Bangladesh: An analysis of Demographic and Health Survey (BDHS) and Multiple Indicator Cluster Survey (MICS). PLoS One 2020; 15:e0242864. [PMID: 33270671 PMCID: PMC7714212 DOI: 10.1371/journal.pone.0242864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 11/10/2020] [Indexed: 12/02/2022] Open
Abstract
Introduction The rate of cesarean delivery (C-section) has been increasing worldwide, including Bangladesh, and it has a negative impact on the mother and child's health. Our aim was to examine the association between C-section and childhood diseases and to identify the key factors associated with childhood diseases. Methods We used four nationally representative data sets from multiple indicator cluster survey (MICS, 2012 and 2019) and Bangladesh Demographic and Health Survey (BDHS, 2011and 2014) and analyzed 25,270 mother-child pairs. We used the frequency of common childhood diseases (fever, short or rapid breaths, cough, blood in stools, and diarrhea) as our outcome variable and C-section as exposure variable. We included mother’s age, place of residence, division, mother’s education, wealth index, child age, child sex, and child size at birth as confounding variables. Negative binomial regression model was used to analyze the data. Results In the BDHS data, the prevalence of C-section increased from 17.95% in 2011 to 23.33% in 2014. Also, in MICS, the prevalence almost doubled over an eight-year period (17.74% in 2012 to 35.41% in 2019). We did not observe any significant effect of C-section on childhood diseases in both surveys. Only in 2014 BDHS, we found that C-section increases the risk of childhood disease by 5% [Risk Ratio (RR): 1.05, 95% CI: 0.95, 1.17, p = 0.33]. However, the risk of childhood disease differed significantly in all survey years by division, child's age, and child’s size at birth after adjusting for important confounding variables. For example, children living in Chittagong division had a higher risk [(2011 BDHS RR: 1.22, 95% CI: 1.08, 1.38) and (2019 MICS RR: 1.21, 95% CI: 1.08, 1.35)] of having disease compared to Dhaka division. Maternal age, education, and wealth status showed significant differences with the outcome in some survey years. Conclusion Our study shows that C-section in Bangladesh continued to increase over time, and we did not find significant association between C-section and early childhood diseases. High C-section rate has a greater impact on maternal and child health as well as the burden on the health care system. We recommend raising public awareness of the negative impact of unnecessary C-section in Bangladesh.
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Affiliation(s)
- Mohammad Nayeem Hasan
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
| | | | - Jenifar Jahan
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
| | - Sumyea Jahan
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
| | - Nasar U. Ahmed
- Department of Epidemiology, Florida International University, Miami, FL, United States of America
| | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
- * E-mail:
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20
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JANSEN SUSIANA, WASITYASTUTI WIDYA, ASTARINI FAJARDWI, HARTINI SRI. Mothers' knowledge of breastfeeding and infant feeding types affect acute respiratory infections. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2020; 61:E401-E408. [PMID: 33150229 PMCID: PMC7595061 DOI: 10.15167/2421-4248/jpmh2020.61.3.1499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 06/15/2020] [Indexed: 01/12/2023]
Abstract
Introduction World Health Organization (WHO) recommends exclusive breastfeeding for new-borns until 6 months of age. However, exclusive breastfeeding in Indonesia only reached 52.3% in 2014 and 65.16% in 2018. It is known that administration of infant formula and non-formula supplements to infants aged less than 6 months increases the risk of Acute Respiratory Infections (ARIs). In addition, the high prevalence of ARIs in infants in Sleman Regency, Indonesia indicates the need of optimal early prevention. Therefore, we conducted this study to confirm that mothers’ knowledge of breastfeeding and infant feeding types affect the prevalence of Acute Respiratory Infections (ARIs). Methods Data were collected through questionnaires from 50 mothers with infants aged 7-12 months who had experienced ARIs in the last 3 months (case group) and 50 mothers with healthy infants (control group). Collected data were then analysed using Chi-Square, Logistic Regression, Lambda, and Somers’ D tests. Results The results showed that types of infant feeding are associated with the prevalence of ARIs. Non-breastfed infants were 14 times riskier to contract ARIs. Mothers’ knowledge of exclusive breastfeeding influenced their preferences of feeding practice. However, their attitude towards breastfeeding did not appear to significantly affect their choices of feeding practice. Conclusions Exclusive breastfeeding during the first 6 months of an infant’s life can lower the prevalence of ARIs for when they are older. Mothers’ good knowledge of breastfeeding is associated with its practice.
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Affiliation(s)
- SUSIANA JANSEN
- PELNI Nursing Academy of Jakarta, Indonesia
- Master in Nursing Program, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
| | - WIDYA WASITYASTUTI
- Department of Physiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
- Correspondence: Widya Wasityastuti, Department of Physiology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Jl. Farmako, Senolowo, Sekip Utara, Mlati, Kabupaten Sleman, Daerah Istimewa Yogyakarta 55281, Indonesia - Tel. +62-274-6492492 - Fax. +62-274-631185 - E-mail:
| | - FAJAR DWI ASTARINI
- Master in Biomedical Sciences, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
| | - SRI HARTINI
- Department of Pediatric Nursing and Maternity, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
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