Determinants of health care seeking behavior for childhood infectious diseases and malnutrition: A slum-based survey from Bangladesh

The Impact of Diabetes Mellitus Duration and Complications on Health-Related Quality of Life Among Type 2 Diabetic Patients in Khamis Mushit City, Saudi Arabia

BACKGROUND AND OBJECTIVES

 Diabetes mellitus is one of the most significant public health problems in Saudi Arabia. Therefore, this study aims to investigate the impact of disease duration and disease complications on health-related quality of life among type 2 diabetic patients.

MATERIALS AND METHODS

A cross-sectional study was conducted on 380 adult diabetic type 2 patients at a tertiary hospital in the city of Khamis Mushit in Saudi Arabia. The participants were asked to complete a pre-validated health status questionnaire (SF-36) consisting of 36 questions measuring eight domains of health, with each domain providing a score from 0 to 100. Demographic and clinical variables were collected using a diabetes type 2 specification form designed to be used in conjunction with the health status questionnaire. The clinical data included variables such as duration of diabetes, co-morbidities, and treatment modality. Statistical analysis was conducted using SPSS version 22 (IBM Corp., Armonk, NY, USA), with differences tested using various statistical tests. Spearman correlation was done between the score and continuous variables, such as age and BMI. A p-value less than 0.05 was considered statistically significant.

RESULTS

Most of the participants (40%) were recently diagnosed with diabetes mellitus (less than one year ago) and 29.5% of the participants were diagnosed with diabetes mellitus within one to five years. The percentage of those with complications was 39.2%, which was mainly diabetic foot (43.4%) followed by nephropathy (29.5%). 46.8% of the participants were admitted due to conditions related to diabetes mellitus. Dietary modifications were prescribed in 38.4% of the participants, 19.5% used non-insulin medications only, 22.6% were on insulin, and 19.5% were using oral medications and insulin. The relationship between diabetes mellitus complications and quality of life domains revealed no significant difference in most of the domains except physical function and general health, which were lower with complicated diabetes melitus. Similarly, the relation between diabetes mellitus duration and quality of life domains was also not significant in all domains except physical function, which was low with a duration of more than 10 years.

CONCLUSIONS

Understandably, the complications associated with diabetes melitus resulted in low quality of life - in terms of physical function and general health - due to the organ-dysfunction associated with poor glycaemic control. Similarly, disease duration greater than 10 years resulted in impaired physical functioning.

Factors associated with mothers' health care-seeking behaviours for childhood fever in Burkina Faso: findings from repeated cross-sectional household surveys

INTRODUCTION

Fever is one of the most frequent reasons for paediatric consultations in Burkina Faso, but health care-seeking behaviours and the factors associated with health care-seeking in the event of childhood fever are poorly documented. This study aims to analyse the health care-seeking behaviours and the factors associated with health care-seeking for childhood fever in Burkina Faso.

METHODS

This study used the data from the baseline and endline surveys conducted to evaluate the impact of the Performance-Based Financing program in Burkina Faso. Univariate and multivariate binary logistic regression analyses were used to identify the factors associated with appropriate healthcare-seeking for childhood fever. Odds ratios were estimated to assess the strength of associations and 95% confidence intervals (CIs) were used for significance tests. Data were cleaned, coded and analysed using Stata software version 16.1.

RESULTS

Among the children under five who had a fever, 75.19% and 79.76% sought appropriate health care in 2013 and 2017, respectively. Being 24-59 months old (AOR: 0.344, 95% CI 0.182-0.649 in 2013 and AOR: 0. 208, 95% CI 0.115-0.376 in 2017), living in a very wealthy household (AOR: 2.014, 95% CI 1.149-3.531 in 2013 and AOR: 2.165, 95% CI 1.223-3.834 in 2017), having a mother with a secondary or higher level of education or having made at least four antenatal care visits were significantly associated with seeking appropriate health care for childhood fever. Living in an area where the health facility is safe was also significantly associated with seeking appropriate care for childhood fevers.

CONCLUSIONS

The findings underscore the need to concentrate efforts aiming at sensitizing the population (especially women of childbearing age) to improve sanitation and the use of family planning (household composition), skilled antenatal care and postnatal care to help reduce the prevalence of fever in children under five and improve the use of medical healthcare for childhood fever.

Exploring the Factors Associated with Dietary Diversity of Children Aged 6-59 Months in Some Rural and Slum Areas of Bangladesh amid the COVID-19 Pandemic: A Mixed-Effect Regression Analysis

Background

Dietary diversity (DD) is a key component of diet quality, and malnutrition due to poor diet quality leads to child morbidity and mortality. However, in Bangladesh, there is a lack of information on childhood DD (for children aged 6-59 mo) amid the coronavirus disease 2019 (COVID-19) pandemic.

Objectives

The purpose of this study was to assess the minimum DD and its associated factors among children aged 6-59 mo during the COVID-19 pandemic in Bangladesh.

Methods

A cross-sectional study was carried out in 6 districts of Bangladesh. A total of 1190 respondents were included using cluster random sampling. The Individual Dietary Diversity Score (IDDS) for children was used to assess the children's DD. Factors associated with DD of children were identified using a multilevel binary logistics regression model.

Results

About 70% of the children aged 6-59 mo had minimum DD during the COVID-19 pandemic in Bangladesh. Children who belonged to slum areas [adjusted odds ratio (AOR): 0.45; 95% CI: 0.24, 0.83], family income 12,000-15,000 Bangladeshi taka (BDT) (AOR: 1.79; 95% CI: 1.06, 3.05) and >15,000 BDT (AOR: 2.59; 95% CI: 1.47, 4.57), mothers aged 26-30 y (AOR: 0.35; 95% CI: 0.20, 0.62) and >30 y (AOR: 0.43; 95% CI: 0.22, 0.85), respondents who had 2 children <5 y old (AOR: 0.43; 95% CI: 0.28, 0.66), and children aged 12-23 mo (AOR: 1.89; 95% CI: 1.14, 3.20) were significantly associated with DD among children aged 6-59 mo.

Conclusions

The findings of this study highlight the need for food and nutrition-related intervention, particularly targeting mothers of younger age and with >2 children <5 y old, mothers from slum regions, and fathers who were unemployed, to improve children's DD practices.