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Satty A, Salih M, Abdalla FA, A Mahmoud AF, Gumma EAE, Saad Mohamed Khamis G, Adam AMA, Hassaballa AA, Hamed OMA, M S Mohammed Z. Statistical Analysis of Factors Associated with Diarrhea in Yemeni Children under Five: Insights from the 2022-2023 Multiple Indicator Cluster Survey. J Epidemiol Glob Health 2024:10.1007/s44197-024-00253-1. [PMID: 38856818 DOI: 10.1007/s44197-024-00253-1] [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: 03/28/2024] [Accepted: 05/29/2024] [Indexed: 06/11/2024] Open
Abstract
Diarrheal disease remains a significant cause of preventable morbidity and mortality in the pediatric population, particularly among children below five years of age. Although the occurrence of diarrheal episodes is on the decline, its impact continues to escalate at a concerning rate among children under the age of five, especially in developing countries. The objective of this paper is to investigate the factors associated with diarrhea in Yemeni children younger than five years, drawing on data from the latest edition of the Multiple Indicator Cluster Survey (MICS) Yemen conducted in 2022-2023. To identify factors associated with the prevalence of childhood diarrhea, bivariate analysis and multivariable logistic regression were utilized. The findings of this study suggest that age group 6-23, unimproved sanitation, and low-income households are associated with high risk of diarrhea in children under five years of age in Yemen. The study contributes additional evidence regarding factors that should be prioritized in public health strategies geared towards reducing diarrheal prevalence among Yemeni children.
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Affiliation(s)
- Ali Satty
- Department of Mathematics, College of Science, Northern Border University, Arar, Saudi Arabia.
| | - Mohyaldein Salih
- Department of Mathematics, College of Science, Northern Border University, Arar, Saudi Arabia
| | - Faroug A Abdalla
- Department of Computer Science, College of Science, Northern Border University, Arar, Saudi Arabia
| | - Ashraf F A Mahmoud
- Department of Computer Science, College of Science, Northern Border University, Arar, Saudi Arabia
| | - Elzain A E Gumma
- Department of Mathematics, College of Science, Northern Border University, Arar, Saudi Arabia
| | | | - Ahmed M A Adam
- Department of Mathematics, College of Science, Northern Border University, Arar, Saudi Arabia
| | - Abaker A Hassaballa
- Department of Mathematics, College of Science, Northern Border University, Arar, Saudi Arabia
| | - Omer M A Hamed
- Department of Finance, College of Business Administration, Northern Border University, Arar, Saudi Arabia
| | - Zakariya M S Mohammed
- Department of Mathematics, College of Science, Northern Border University, Arar, Saudi Arabia
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Barrow A, Jatta SPS, Oladele OS, Okungbowa OG, Ekholuenetale M. Contextual factors associated with diarrhea among under-five children in the Gambia: a multi-level analysis of population-based data. BMC Infect Dis 2024; 24:453. [PMID: 38724924 PMCID: PMC11080268 DOI: 10.1186/s12879-024-09350-9] [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: 07/12/2023] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Diarrhea poses a significant threat to the lives of children in The Gambia, accounting for approximately 9% of all deaths among children under the age of five. Addressing and reducing child mortality from diarrhea diseases is crucial for achieving the Sustainable Development Goal (SDG) 3, specifically target 3.2, which aims to eliminate preventable deaths in newborns and children under the age of five by 2030. Thus, this research aims to assess the prevalence and contextual factors associated with diarrhea among under-five children in The Gambia. METHODS This research employed secondary data from the 2019/20 Gambia Demographic Health Survey (GDHS). The study initially involved 8,362 women aged between 15 and 49 years. Of these, 6,929 women with children under five were included in this analysis. Data were analyzed using STATA with cross-tabulation and model fitting. Multilevel logistic regression was applied to accommodate the hierarchical structure of the demographic health survey data. The model comparison parameters were BIC, AIC, deviance, and LLR. Variables with a p-value less than 0.05 were selected for multivariable analysis. The statistical significance of the factors was determined using an adjusted odds ratio with a 95% confidence interval (CI) and a p-value of less than 0.05. RESULTS The prevalence of diarrhea in under-five children was 53.2% in males and 46.8% in females. In the final model, Kerewan (aOR = 0.58; 95% CI = 0.33-0.98) and Basse (aOR = 0.59; 95% CI = 0.35-0.98) have significantly lower odds of childhood diarrhea compared to Banjul, female children show slightly lower, yet significant, odds of diarrhea compared to males (aOR = 0.96; 95% CI = 0.86-0.98), deliveries at government health centers are associated with higher odds of childhood diarrhea compared to home births (aOR = 1.24; 95% CI = 1.01-1.52). Mothers with post-secondary education had significantly lower odds of having children with diarrhea than those without any education (aOR = 0.50; 95% CI = 0.26-0.99) after controlling for confounders. CONCLUSION The study findings indicate that several factors significantly impact the risk of childhood diarrhea in The Gambia. These factors include region of residence, sex of the child, place of delivery, and education level of the mother. The study suggests that existing interventions aimed at improving child health outcomes in the country should take into consideration these influential factors. Addressing these modifiable factors can enhance the effectiveness of interventions and promote better health outcomes for children in Gambia.
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Affiliation(s)
- Amadou Barrow
- Department of Public & Environmental Health, School of Medicine & Allied Health Sciences, University of The Gambia, Kanifing, The Gambia.
- Department of Epidemiology, College of Public Health & Health Professions, University of Florida, Gainesville, FL, USA.
| | - Solomon P S Jatta
- Amrita School of Sustainable Development, Amrita Vishwa Vidyapeetha University, Kollam, Kerela, India
- School of Public Health, Gambia College, Brikama, The Gambia
| | - Oluwarotimi Samuel Oladele
- Department of Demography and Social Statistics, Faculty of Social Sciences, Federal University Oye-Ekiti, Oye-Ekiti, Ekiti State, Nigeria
| | - Osaretin Godspower Okungbowa
- Department of Economic and Social Research, National Institute for Legislative and Democratic Studies, National Assembly, Abuja, Nigeria
- Department of Economics, Faculty of Social Sciences, University of Benin, Benin City, Nigeria
| | - Michael Ekholuenetale
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Tareke AA, Jemal SS, Yemane GD, Zakaria HF, Shiferaw EW, Ngabonzima A. Spatial disparity and associated factors of diarrhea among under-five children in Rwanda: a multilevel logistic regression analysis. BMC Pediatr 2024; 24:266. [PMID: 38658869 PMCID: PMC11040746 DOI: 10.1186/s12887-024-04748-5] [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: 12/20/2023] [Accepted: 04/09/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Diarrhea, defined as three or more loose stool per day, is a major cause of child mortality. Exploring its spatial distribution, prevalence, and influencing factors is crucial for public health decision and targeted interventions. This study aimed to investigate these aspects using 2019 Rwanda demographic health survey data. METHOD A total 7,978 (weighted) under-five children were included in this study. Spatial clustering (hotspots areas) were mapped using ArcGIS and SaTscan software. A multilevel logistic regression model was fitted to assessed factors associated with diarrhea, reporting significance at p < 0.05 and a 95% confidence interval. RESULTS diarrheal diseases in Rwanda showed a clustered spatial pattern (Moran's I = 0.126, p = 0.001), with the primary cluster in west and north provinces. Under-five diarrhea prevalence was 14.3% (95% CI: 13.55, 15.08). Factors increasing likelihood included maternal age 15-34 years, child age 7-24 months, while full immunization was protective (aOR = 0.74, 95% CI: 0.56, 0.98). CONCLUSION Spatial clustering of diarrheal diseases is found in west and north provinces of Rwanda. Being born to a young mother, being a child aged 7-24 months, being fully immunized, being born to a low-educated mother and belonging to a community having low level education are factors associated with diarrheal diseases in Rwanda. Developing interventional plans based on identified clusters and approaching children based on their immunization status, maternal education and age could be cost-effective in reducing diarrheal diseases in Rwanda. Location based intervention could allow for the efficient allocation of resources by focusing on areas with higher prevalence and need.
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Affiliation(s)
- Abiyu Abadi Tareke
- West Gondar Zonal Health Department, Amref Health Africa, Gondar, Ethiopia.
| | - Sebwedin Surur Jemal
- Department of Statistics, College of Natural and Computational Science, Mizan-Tepi University, Tepi, Ethiopia
| | - Getahun Dejene Yemane
- Department of Statistics, College of Natural and Computational Science, Mizan-Tepi University, Tepi, Ethiopia
| | - Hamdi Fekredin Zakaria
- Department of Epidemiology and Biostatistics, School of Public Health, Haramaya University, Harar, Ethiopia
| | - Enyew Woretaw Shiferaw
- Department of Maternal and Child Health (MCH), West Gondar Zonal Health Department, Gondar, Ethiopia
| | - Anaclet Ngabonzima
- John Snow, Inc.(JSI) Research & Training Institute, Inc, Washington, DC, USA
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Gaffan N, Degbey C, Kpozehouen A, Ahanhanzo YG, Paraïso MN. Exploring the association between household access to water, sanitation and hygiene (WASH) services and common childhood diseases using data from the 2017-2018 Demographic and Health Survey in Benin: focus on diarrhoea and acute respiratory infection. BMJ Open 2023; 13:e074332. [PMID: 37730407 PMCID: PMC10510876 DOI: 10.1136/bmjopen-2023-074332] [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: 04/03/2023] [Accepted: 09/01/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVE The paper aimed to study the association between household access to water, sanitation and hygiene (WASH) services and the occurrence of diarrhoea and acute respiratory infection among children under 5 years in Benin. DESIGN We performed secondary analyses using Benin's Fifth Demographic and Health Survey datasets. The dependent variables were diarrhoea and acute respiratory infection (yes=1, no=0). Among the independent variables were the household access to individual WASH services, grouped as follows: 'basic', 'limited', 'unimproved' and 'no service'. Multivariate logistic regression was used to determine the association between household access to WASH services and the occurrence of diarrhoea and acute respiratory infection. Results from the multivariate logistic regression were presented using adjusted Odds Ratios (aORs) with 95% Confidence Intervals (95% CIs). SETTING Benin. PARTICIPANTS Children under 5 years successfully surveyed during Benin's Fifth Demographic and Health Survey. OUTCOME MEASURES Diarrhoea and acute respiratory infection. RESULTS In the current study, 12 034 children under 5 years met the selection criteria and were included in the analyses. The prevalence of diarrhoea and acute respiratory infection was 10.5% (95% CI=9.8% to 11.3%) and 2.9% (95% CI=2.5% to 3.4%), respectively. Children living in households without sanitation service, that is, practising open defecation (aOR=1.9, 95% CI=1.4 to 2.6), and with unimproved (aOR=1.9, 95% CI=1.3 to 2.7) and limited (aOR=1.5, 95% CI=1.1 to 2.2) services were more likely to have diarrhoea compared with children with basic sanitation services. Household access to WASH services was not associated with acute respiratory infection. CONCLUSION We suggest reinforcing household access to basic sanitation services to combat diarrhoea in children under 5 years. Further research is needed on the effects of WASH interventions on diarrhoea and acute respiratory infection in children under 5 years.
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Affiliation(s)
- Nicolas Gaffan
- Department of Epidemiology and Biostatistics, Regional Institute of Public Health, University of Abomey-Calavi, Cotonou, Benin
| | - Cyriaque Degbey
- Department of Environmental Health, Regional Institute of Public Health, University of Abomey-Calavi, Cotonou, Benin
| | - Alphonse Kpozehouen
- Department of Epidemiology and Biostatistics, Regional Institute of Public Health, University of Abomey-Calavi, Cotonou, Benin
| | - Yolaine Glele Ahanhanzo
- Department of Epidemiology and Biostatistics, Regional Institute of Public Health, University of Abomey-Calavi, Cotonou, Benin
| | - Moussiliou Noël Paraïso
- Department of Health Promotion, Regional Institute of Public Health, University of Abomey-Calavi, Cotonou, Benin
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Gayawan E, Egbon OA, Adegboye O. Copula based trivariate spatial modeling of childhood illnesses in Western African countries. Spat Spatiotemporal Epidemiol 2023; 46:100591. [PMID: 37500230 DOI: 10.1016/j.sste.2023.100591] [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] [Received: 05/19/2022] [Revised: 12/21/2022] [Accepted: 05/31/2023] [Indexed: 07/29/2023]
Abstract
Acute respiratory infections (ARI), diarrhea, and fever are three common childhood illnesses, especially in sub-Saharan Africa. This study investigates the marginal and pairwise correlated effects of these diseases across Western African countries in a single analytical framework. Using data from nationally representative cross-sectional Demographic and Health Surveys, the study analyzed specific and correlated effects of each pair of childhood morbidity from ARI, diarrhea, and fever using copula regression models in fourteen contiguous Western African countries. Data concerning childhood demographic and socio-economic conditions were used as covariates. In this cross-sectional analysis of 152,125 children aged 0-59 months, the prevalence of ARI was 6.9%, diarrhea, 13.8%, and fever 19.6%. The results showed a positive correlation and geographical variation in the prevalence of the three illnesses across the study region. The estimated correlation and 95% confidence interval between diarrhea and fever is 0.431(0.300,0.539); diarrhea and ARI is 0.270(0.096,0.422); and fever and ARI is 0.502(0.350,0.614). The marginal and correlated spatial random effects reveal within-country spatial dependence. Source of water and access to electricity was significantly associated with any of the three illnesses, while television, birth order, and gender were associated with diarrhea or fever. The place of residence and access to newspapers were associated with fever or ARI. There was an increased likelihood of childhood ARI, diarrhea, and fever, which peaked at about ten months but decreased substantially thereafter. Mother's age was associated with a reduced likelihood of the three illnesses. The maps generated could be resourceful for area-specific policy-making to speed up mitigation processes.
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Affiliation(s)
- Ezra Gayawan
- Department of Statistics, Federal University of Technology, Akure, Nigeria
| | - Osafu Augustine Egbon
- Institute of Mathematical and Computer Sciences, University of São Paulo, São Carlos, Brazil; Department of Statistics, Universidade Federal de São Carlos, Brazil.
| | - Oyelola Adegboye
- Menzies School of Health Research, Charles Darwin University, Casuarina 0810, NT, Australia
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Ekholuenetale M, Nzoputam CI, Okonji OC, Barrow A, Wegbom AI, Edet CK. Differentials in the Prevalence of Acute Respiratory Infections Among Under-Five Children: An Analysis of 37 Sub-Saharan Countries. Glob Pediatr Health 2023; 10:2333794X231156715. [PMID: 36814530 PMCID: PMC9940173 DOI: 10.1177/2333794x231156715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 01/26/2023] [Indexed: 02/19/2023] Open
Abstract
Objective We investigated the prevalence and risk factors of ARI in children under 5 years old in 37 SSA countries. Methods Data from Demographic and Health Survey (DHS) of 37 African countries was examined in this analysis. Data from children under the age of 5 years old were examined. Forest plot was used to identify disparities in the occurrence of ARIs across SSA countries. Results We observed a higher prevalence of ARI among children under 5 in Uganda, Kenya, Sao Tome and Principe (9% each), Gabon, Chad, Eswatini (8% each), Burundi, Ethiopia, Congo Democratic Republic (7.0% each). The prevalence of ARI among under-five children who sought medical advice/treatment from health facility was higher in South Africa (88%), Sierra Leone (86%), Tanzanian (85%), Guinea (83%) and Uganda (80%). The prevalence rate of ARI among under-five children who received antibiotics was higher in Tanzania (61%), Sao Tome and Principe (60%), Rwanda and Congo (58% each), Angola (56.0%), Mozambique (54.0%), Kenya (53.0%), Namibia (52.0%) and Gabon (50.0%). This study found that the household wealth index, maternal education, and urban residence were significantly associated with ARI (p <0.001). A higher prevalence of ARI was observed among urban residents, low income families, and those with mothers with lower education. Conclusion ARI prevalence could be reduced by improving household socioeconomic status, child nutrition and community awareness of indoor and outdoor pollution. Interventions and programs focused on early diagnosis, treatment and prevention of ARIs are crucial in reducing ARIs particularly in developing countries.
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Affiliation(s)
| | | | | | - Amadou Barrow
- University of The Gambia, Kanifing, The Gambia,Amadou Barrow, University of the Gambia, Kanifing, P.O Box 3530, Serrekunda, The Gambia.
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Egbewale BE, Karlsson O, Sudfeld CR. Childhood Diarrhea Prevalence and Uptake of Oral Rehydration Solution and Zinc Treatment in Nigeria. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9111722. [PMID: 36360449 PMCID: PMC9688883 DOI: 10.3390/children9111722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/06/2022] [Accepted: 11/07/2022] [Indexed: 11/12/2022]
Abstract
Given the disproportionate burden of childhood diarrhea deaths in Nigeria, this study assessed the prevalence and predictors of the disease and the uptake of ORS and zinc supplementation as treatments in a population-based national survey. Cross-sectional data from the 2018 Nigeria Demographic Health Survey were used. A log-Poisson regression was used to estimate the relative risks (RR) for the individual-level predictors of childhood diarrhea and the uptake of ORS and zinc treatments. A total of 30,713 children under 5 years of age were included in the survey. The period prevalence of reported diarrhea in the last two weeks was 12.9% (95% CI: 12.5%, 13.3%). Among the children with diarrhea, the proportion who received ORS was 39.7% (95% CI: 38.2%, 41.3%), while 29.1% of them received zinc supplements (95% CI: 27.7%, 30.5%), and 21.8% of them received both the ORS and zinc treatments as recommended. Children under 6 months of age with diarrhea had a significantly lower likelihood of being given ORS or zinc when they were compared to the older children. The institutional delivery of them, maternal employment, and improved water sources were also independent predictors of the uptake of ORS and zinc treatments for diarrhea (p-values < 0.05). Interventions to prevent childhood diarrhea and improve the coverage of ORS and zinc treatments may reduce the large burden of childhood diarrhea deaths in Nigeria.
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Affiliation(s)
- Bolaji Emmanuel Egbewale
- Takemi Program in International Health, Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
- Department of Community Medicine, College of Health Sciences Ladoke Akintola University of Technology, Ogbomoso 210214, Nigeria
- Correspondence:
| | - Omar Karlsson
- Takemi Program in International Health, Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
| | - Christopher Robert Sudfeld
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
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Angnunavuri PN, Attiogbe F, Mensah B. Microbial contamination and quantitative microbial risk assessment of high-density polyethylene (HDPE) film sachet drinking water in Ghana. JOURNAL OF WATER AND HEALTH 2022; 20:1587-1603. [PMID: 36308501 DOI: 10.2166/wh.2022.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The present research estimated the impact of storage on the microbial quality of high-density polyethylene drinking water. Samples were taken from two popular companies in Greater Accra using a two-sided exact test in SAS JMP to estimate the sample size. The samples were stored across three temperature profiles at 8 °C, 30 °C (average room temperature), and 40 °C (average outdoor temperature) for 28 days. The samples were examined using standard microbiological methods for heterotrophic plate counts (HPCs), faecal coliforms, and Escherichia coli. The data were described and regressed with Microsoft Excel, Argo 4.3.1, and SAS JMP software. The results demonstrated increasing deterioration of the water samples for all microbial indices at all temperatures with increasing storage duration. The highest HPC, faecal coliforms, and E. coli were 1,312; 622; and 252 cfu/100 mL, respectively, all at 40 °C. The daily risk of infection due to E. coli O157:H7 was 5.22 × 10-5 infections per child per day for children under 5 years, and 1.6 × 10-4 attacks per adult per day, compared to the upper limit of 1.0 × 10-6. These results are higher than recommended exposures, and interventions along the sachet drinking water value chain are needed to protect public health.
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Affiliation(s)
- Prosper Naah Angnunavuri
- School of Engineering, Department of Civil and Environmental Engineering, University of Energy and Natural Resources, Sunyani, Ghana E-mail:
| | - Francis Attiogbe
- School of Engineering, Department of Civil and Environmental Engineering, University of Energy and Natural Resources, Sunyani, Ghana E-mail:
| | - Bismark Mensah
- School of Engineering, University of Ghana, Legon, Ghana
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Afrifa-Anane GF, Kyei-Arthur F, Agyekum MW, Afrifa-Anane EK. Factors associated with comorbidity of diarrhoea and acute respiratory infections among children under five years in Ghana. PLoS One 2022; 17:e0271685. [PMID: 35862358 PMCID: PMC9302777 DOI: 10.1371/journal.pone.0271685] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 07/05/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Globally, childhood mortality is an important public health concern. In Ghana, both diarrhoea and acute respiratory infections (ARIs) are among the top five causes of morbidity and mortality among children under five years old (CU5). Yet, there is a paucity of studies on the comorbidity of diarrhoea and ARIs in CU5 in Ghana. Aim This study sought to examine factors associated with comorbidity of diarrhoea and ARIs among CU5 in Ghana. Methods The Ghana Demographic and Health Survey (GDHS) 2014 was used for this study. A total of 932 CU5 who had at least one morbidity were included in the study. Binary logistic regression was used to predict the factors associated with comorbidity among CU5. Results The prevalence of comorbidity of diarrhoea and ARI among CU5 was 11%. Factors including unimproved source of water, unimproved main floor material, age of child, and initiation of breastmilk were significantly associated with comorbidity of diarrhea and ARI. Improved source of water (AOR = 0.42; 95% CI = 0.22–0.78; p = 0.01) reduces the likelihood of having comorbidity than unimproved source of water. Children aged 36–47 months were less likely (AOR = 0.36; 95% CI = 0.14–0.93; p = 0.04) to have comorbidity than those aged 48–59 months. Also, improved floor materials (AOR = 0.45; 95% CI = 0.22–0.95; p = 0.03) reduces the likelihood of having comorbidity than unimproved floor materials. Children breastfed within the first day of birth were more likely (AOR = 1.66; 95% CI = 1.01–0.2.72; p = 0.04) to have comorbidity than those breastfed immediately after birth. Conclusion Policymakers and health practitioners should consider risk factors such as age of child, initiation of breastfeeding, unimproved floor material, and unimproved water supply in the design of interventions to reduce morbidity and mortality associated with comorbidity of diarrhoea and ARI among CU5.
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Affiliation(s)
- Grace Frempong Afrifa-Anane
- Department of Environment and Public Health, University of Environment and Sustainable Development, Somanya, Eastern Region, Ghana
- * E-mail:
| | - Frank Kyei-Arthur
- Department of Environment and Public Health, University of Environment and Sustainable Development, Somanya, Eastern Region, Ghana
| | - Martin Wiredu Agyekum
- Institute for Educational Research and Innovation Studies, University of Education, Winneba, Ghana
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Tareke AA, Enyew EB, Takele BA. Pooled prevalence and associated factors of diarrhea among under-five years children in East Africa: A multilevel logistic regression analysis. PLoS One 2022; 17:e0264559. [PMID: 35421129 PMCID: PMC9009646 DOI: 10.1371/journal.pone.0264559] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 02/13/2022] [Indexed: 11/19/2022] Open
Abstract
Background Worldwide, diarrhea is the second most common cause of death and morbidity among under -five years’ children. In sub-saran Africa, access to water, sanitation, and hygiene are very scanty and the burden of diarrhea diseases is countless relative to the rest of the world. Prior studies conducted in East Africa vary in design, sample size, and other data collection tools. Through those studies, it is hard to make regional comparisons. Combining datasets that are studied on similar people and having common variable identified enhances statistical power due to the large sample size, advance the ability to compare outcomes, and create the opportunity to develop new indicators. Hence, this study aimed to assess the prevalence and associated factors of diarrhea among under five years’ children using the most recent national representative Demographic and Health Surveys from 12 East African countries. The information generated from this pooled datasets will give good insight into the sub-regional prevalence of diarrhea. Methods This study utilized secondary data from 12 East African countries’ most recent demographic health survey. Variables were extracted and appended together to assess the pooled prevalence of diarrhea and associated factors. A total of 90,263 under-five years of age children were encompassed in this study. STATA version was used to cross-tabulate and fit the models. To account for the hierarchical nature of the demographic health survey, multilevel logistic regression was calibrated. BIC, AIC, deviance, and LLR were used as Model comparison parameters. Variables with a p-value of <0.2 were considered for multivariable analysis. Adjusted odds ratio with 95% CI and p-value <0.05 were used to declare statistical significances of factors. Results The pooled prevalence of diarrhea in under five years children was 14.28% [95%CI; 14.06%, 14.51%]. Being child whose mother age is 15–24 years [AOR = 1.41, 95% CI; 1.33, 1.49], 25–34 years[AOR = 1.17, 95%CI; 1.10, 1.23], being 7–12 months child [AOR = 3.10, 95%CI; 2.86, 3.35], being 12–24 months child [AOR = 2.56, 95%CI; 2.38, 3.75], being 25–59 months child [AOR = 0.88, 95%CI; 0.82, 0.95], being child from poor household [AOR = 1.16, 95%CI; 1.09, 1.23], delayed breast feeding initiation (initiated after an hour of birth) [AOR = 1.15, 95%CI; 1.10, 1.20], and being a child from community with low educational status [AOR = 1.10, 95%CI; 1.03, 1.18] were factors associated with diarrheal diseases. Conclusion The pooled prevalence of diarrhea among under five years of children in East African countries is high. Maternal age, child’s age, wealth status of the household, the timing of breast feeding initiation, sex of the child, community level of educational status, working status of the mother, and the number of under five children were factors that were associated with diarrheal diseases. Scaling up of maternal and child health services by government and other concerned bodies should consider those economically marginalized communities. Additionally, awareness should be created for those uneducated mothers concerning the nature of childhood diarrhea.
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Affiliation(s)
- Abiyu Abadi Tareke
- Department of Monitoring and Evaluation, West Armachiho District Health Office, Gondar, Ethiopia
- * E-mail:
| | | | - Bayley Adane Takele
- Department of Medical Auditing, Ethiopian Health Insurance Agency Gondar Branch, Gondar, Ethiopia
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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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