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Yehuala TZ, Derseh NM, Tewelgne MF, Wubante SM. Exploring Machine Learning Algorithms to Predict Diarrhea Disease and Identify its Determinants among Under-Five Years Children in East Africa. J Epidemiol Glob Health 2024:10.1007/s44197-024-00259-9. [PMID: 39073532 DOI: 10.1007/s44197-024-00259-9] [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: 02/14/2024] [Accepted: 06/01/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND The second most common cause of death for children under five is diarrhea. Early Predicting diarrhea disease and identify its determinants (factors) using an advanced machine learning model is the most effective way to save the lives of children. Hence, this study aimed to predict diarrheal diseases, identify their determinants, and generate some rules using machine learning models. METHODS The study used secondary data from the 12 east African countries for DHS dataset analysis using Python. Machine learning techniques such as Random Forest, Decision Tree (DT), K-Nearest Neighbor, Logistic Regression (LR), wrapper feature selection and SHAP values are used for identify determinants. RESULT The final experimentation results indicated the random forest model performed the best to predict diarrhea disease with an accuracy of 86.5%, precision of 89%, F-measure of 86%, AUC curve of 92%, and recall of 82%. Important predictors' identified age, countries, wealth status, mother's educational status, mother's age, source of drinking water, number of under-five children immunization status, media exposure, timing of breast feeding, mother's working status, types of toilet, and twin status were associated with a higher predicted probability of diarrhea disease. CONCLUSION According to this study, child caregivers are fully aware of sanitation and feeding their children, and moms are educated, which can reduce child mortality by diarrhea in children in east Africa. This leads to a recommendation for policy direction to reduce infant mortality in East Africa.
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Affiliation(s)
- Tirualem Zeleke Yehuala
- Department Health informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Nebiyu Mekonnen Derseh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Makda Fekadie Tewelgne
- Department Health informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sisay Maru Wubante
- Department Health informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Yitageasu G, Feleke H, Andualem Z, Demoze L, Asrat K, Gizaw Z. Detection of spatial, temporal and spatiotemporal distribution of diarrhea incidence among under-five children in Central Gondar zone, Northwest Ethiopia: a time-series study (2019-2022). BMC Pediatr 2024; 24:433. [PMID: 38969969 PMCID: PMC11225151 DOI: 10.1186/s12887-024-04900-1] [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: 03/16/2024] [Accepted: 06/20/2024] [Indexed: 07/07/2024] Open
Abstract
Under-five children's diarrhea is a significant public health threat and the World Health Organization (WHO) reported it as the second leading cause of children's death worldwide. In this study area, little is known about the spatiotemporal distribution of under-5 diarrhea incidence. This study was therefore, conducted among all districts in the Central Gondar zone to assess the spatial, temporal, and spatiotemporal variation in diarrhea incidence among under-five children in the Central Gondar zone. The data for children under 5 years of age with diarrhea was obtained from Central Gondar Zone Health Department diarrhea reports from January 2019 to December 2022. All districts were included and geo-coded. The spatial data were created in ArcGIS 10.8.1. Global and local spatial autocorrelation were used to detect hot spots and cold spots. The Poisson model was generated by applying the Kulldorff method in SaTScan™9.6 to analyse the the purely temporal, spatial, and space-time clusters. The study revealed spatial variation of under-5 diarrhea where Gondar City, Gondar Zuria, East Dembia, and Lay Armacho districts were the high-rate spatial clusters during the study period. A year search window for temporal scan statistic identified 01 January 2020-30 December 2021 as risk periods across all districts. Spatiotemporal scan statistics detected high-rate clusters at Gondar City, Gondar Zuria, East Dembia, Lay Armacho, and Alefa between 2019 and 2022. In conclusion, there has been a spatial, temporal, and spatiotemporal variability of under-5 children's diarrhea in the Central Gondar Zone. Interventional and preventive strategies should be developed and given priority to the areas that has been detected as a hotspot in this study to reduce the mortality and morbidity of under 5 children.
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Affiliation(s)
- Gelila Yitageasu
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Hailemariam Feleke
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zewudu Andualem
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Lidetu Demoze
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kidist Asrat
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zemichael Gizaw
- 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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Lora-Ariza B, Piña A, Donado LD. Assessment of groundwater quality for human consumption and its health risks in the Middle Magdalena Valley, Colombia. Sci Rep 2024; 14:11346. [PMID: 38762566 PMCID: PMC11102493 DOI: 10.1038/s41598-024-61259-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 05/03/2024] [Indexed: 05/20/2024] Open
Abstract
Groundwater is the primary source of water for people living in rural areas, especially during seasons when surface water is contaminated or unavailable. In Colombia, people use groundwater as drinking water without additional treatment. In addition, there is no infrastructure for wastewater collection and sewage treatment in the region of the Middle Magdalena Valley. The current study aims to evaluate the quality of groundwater in this region to determine any potential health hazards associated with its consumption. To reach the objective, three (3) physicochemical and microbiological sampling campaigns were carried out during different hydrological periods. A total of 428 groundwater samples were analyzed for over 28 parameters. The results were compared with the water quality standards proposed by the US EPA and Colombian regulations for human consumption. The analysis revealed the presence of total and fecal coliforms in 89% and 58% of the analyzed samples, respectively, identifying them as the main contaminants in groundwater. Furthermore, the pH levels did not meet the standards set by the US EPA in 33.8% of the cases and by Colombian regulations in 31.02%. Additionally, 32.8%, 17.6%, 14.3%, and 10.9% of the samples failed to meet the established thresholds for apparent color, magnesium, iron, and nitrates, respectively, under both standards. Moreover, only the analyses of selenium, mercury, and zinc complied with the quality standards under both regulatory frameworks. Based on the Colombian Drinking-Water Quality Risk Index (CDWQRI-IRCA), the risk associated with water quality meant for human consumption was assessed. The results showed that over 84% of the samples analyzed posed a high risk to human health, 4.6% posed a medium risk, 5.5% posed a low risk, and only 5.7% posed no risk at all. Additionally, official mortality statistics for children under four years old were reviewed, which revealed two deaths in 2019 due to Acute Diarrheal Disease (ADD) caused by consumption of contaminated water. Therefore, it is crucial to implement water treatment systems, establish aqueducts in rural areas, and conduct rigorous and systematic monitoring of drinking water to ensure it is safe for human consumption. It is also important to track morbidity and mortality rates associated with water consumption.
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Affiliation(s)
- Boris Lora-Ariza
- HYDS-Hydrodynamics of the Natural Media Research Group, Universidad Nacional de Colombia, Sede Bogotá, 111321, Bogotá, Colombia.
| | - Adriana Piña
- HYDS-Hydrodynamics of the Natural Media Research Group, Universidad Nacional de Colombia, Sede Bogotá, 111321, Bogotá, Colombia
| | - Leonardo David Donado
- HYDS-Hydrodynamics of the Natural Media Research Group, Universidad Nacional de Colombia, Sede Bogotá, 111321, Bogotá, Colombia
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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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Hossain MI, Rouf ASMR, Rukon MR, Sarkar S, Haq I, Habib MJ, Zinia FA, Tithy TA, Islam A, Hasan MA, Moshiur M, Hisbullah MSA. Application of a count regression model to identify the risk factors of under-five child morbidity in Bangladesh. Int Health 2023:ihad107. [PMID: 37970990 DOI: 10.1093/inthealth/ihad107] [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: 05/10/2023] [Revised: 10/09/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Bangladesh has seen a significant decline in child mortality in recent decades, but morbidity among children <5 y of age remains high. The aim of this analysis was to examine trends and identify risk factors related to child morbidity in Bangladesh. METHODS This analysis is based on data from four successive cross-sectional Bangladesh Demographic and Health Surveys for the years 2007, 2011, 2014 and 2017-18. Several count regression models were fitted and the best model was used to identify risk factors associated with morbidity in children <5 y of age. RESULTS According to the results of the trend analysis, the prevalence of non-symptomatic children increased and the prevalence of fever, diarrhoea and acute respiratory infections (ARIs) decreased over the years. The Vuong's non-nested test indicated that Poisson regression could be used as the best model. From the results of the Poisson regression model, child age, sex, underweight, wasted, stunting, maternal education, wealth status, religion and region were the important determinants associated with the risk of child morbidity. The risk was considerably higher among women with a primary education compared with women with a secondary or greater education in Bangladesh. CONCLUSIONS This analysis concluded that child morbidity is still a major public health problem for Bangladesh. Thus it is important to take the necessary measures to reduce child morbidity (particularly fever, diarrhoea and ARI) by improving significant influencing factors.
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Affiliation(s)
- Md Ismail Hossain
- Department of Statistics, Jagannath University, Dhaka-1100, Bangladesh
- Department of Mathematics and Natural Sciences, BRAC University, Dhaka 1212, Bangladesh
| | | | | | - Shuvongkar Sarkar
- Department of Statistics, Jagannath University, Dhaka-1100, Bangladesh
| | - Iqramul Haq
- Department of Agricultural Statistics, Sher-e-Bangla Agricultural University, Dhaka-1207, Bangladesh
| | - Md Jakaria Habib
- Department of Statistics, Jagannath University, Dhaka-1100, Bangladesh
| | - Faozia Afia Zinia
- Department of Statistics, Jagannath University, Dhaka-1100, Bangladesh
| | | | - Asiqul Islam
- Department of Statistics, Jagannath University, Dhaka-1100, Bangladesh
| | - Md Amit Hasan
- Department of Statistics, Jagannath University, Dhaka-1100, Bangladesh
| | - Mir Moshiur
- Department of Statistics, Jagannath University, Dhaka-1100, Bangladesh
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Pramestutie HR, Kristina SA, Lazuardi L, Widayanti AW. Using the Simulated Patient Method to Evaluate the Community Pharmacy Management of Childhood Diarrhoea: A Systematic Review. Malays J Med Sci 2023; 30:52-69. [PMID: 37928786 PMCID: PMC10624447 DOI: 10.21315/mjms2023.30.5.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/21/2022] [Indexed: 11/07/2023] Open
Abstract
The simulated patient method has been widely used to assess community pharmacy practice in the management of childhood diarrhoea. In such a process, a community pharmacist is required to explore a patient's history, choose the right medication and provide drug-related information. The aim of this review was to evaluate the aforementioned practice. A comprehensive literature search was carried out over Sage Journal, PubMed, ScienceDirect and Google Scholar, and the analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Eligible articles were those published from 2011 to 2021 and original studies that used the simulated patient method to examine the pharmaceutical services provided by pharmacists in relation to childhood diarrhoea. The eight studies that satisfied the eligibility criteria were reviewed. These investigations were undertaken in Brazil, Nigeria, Turkey, Ethiopia and Pakistan. Five of the studies focused on history taking with regard to the characteristics of diarrhoea and revealed that the evaluated pharmacists asked about patient histories. In terms of therapy, three studies indicated that the evaluated pharmacists recommended the administration of oral rehydration salts. Pharmacies should improve their history-taking process, provide drug-related information and recommend therapies to increase the knowledge of simulated patients about diarrhoea treatment in children.
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Affiliation(s)
- Hananditia Rachma Pramestutie
- Doctoral Program in Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Department of Community Pharmacy, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Susi Ari Kristina
- Department of Pharmaceutics, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Lutfan Lazuardi
- Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Anna Wahyuni Widayanti
- Department of Pharmaceutics, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Girmay AM, Weldetinsae A, Mengesha SD, Adugna EA, Alemu ZA, Wagari B, Serte MG, Awoke KS, Bedada TL, Weldegebriel MG, Dinssa DA, Alemayehu TA, Kenea MA, Tekulu KT, Gobena W, Fikresilassie G, Wube W, Melese AW, Redwan E, Hoffmann V, Tessema M, Tollera G. Associations of WHO/UNICEF Joint Monitoring Program (JMP) Water, Sanitation and Hygiene (WASH) Service Ladder service levels and sociodemographic factors with diarrhoeal disease among children under 5 years in Bishoftu town, Ethiopia: a cross-sectional study. BMJ Open 2023; 13:e071296. [PMID: 37500269 PMCID: PMC10387618 DOI: 10.1136/bmjopen-2022-071296] [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: 07/29/2023] Open
Abstract
OBJECTIVE To determine the associations of WHO/UNICEF Joint Monitoring Program Water, Sanitation and Hygiene (WASH) Service Ladder service levels and sociodemographic factors with diarrhoeal disease among children under 5 years in Bishoftu town, Ethiopia. DESIGN A community-based cross-sectional study. SETTING Bishoftu town, Ethiopia, January-February 2022. PARTICIPANTS A total of 1807 mothers with at least one child under 5 years were included. Sociodemographic and WASH variables were collected using a structured questionnaire. 378 drinking water samples were collected. OUTCOME The response variable was diarrhoeal disease among children under 5 years. RESULTS The 2-week prevalence of diarrhoeal disease among children under 5 years was 14.8%. Illiteracy (adjusted OR 3.15; 95% CI 1.54 to 6.47), occupation (0.35; 0.20 to 0.62), mother's age (1.63; 1.15 to 2.31), family size (2.38; 1.68 to 3.39), wealth index (5.91; 3.01 to 11.59), residence type (1.98; 1.35 to 2.90), sex of the child (1.62; 1.17 to 2.24), child's age (3.52; 2.51 to 4.93), breastfeeding status (2.83; 1.74 to 4.59), food storage practice (3.49; 1.74 to 8.26), unimproved drinking water source (8.16; 1.69 to 39.46), limited drinking water service (4.68; 1.47 to 14.95), open defecation practice (5.17; 1.95 to 13.70), unimproved sanitation service (2.74; 1.60 to 4.67), limited sanitation service (1.71; 1.10 to 2.65), no hygiene service (3.43; 1.91 to 6.16) and limited hygiene service (2.13; 1.17 to 3.86) were significantly associated with diarrhoeal disease. CONCLUSION In this study, diarrhoea among children is a significant health issue. Child's age, drinking water service, residence type and hygiene service were the largest contributors with respect to the prevalence of diarrhoeal disease. This investigation provides information that could help to inform interventions to reduce childhood diarrhoea. The findings suggest that state authorities should initiate robust WASH strategies to achieve the Sustainable Development Goal 3 agenda.
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Affiliation(s)
- Aderajew Mekonnen Girmay
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Abel Weldetinsae
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Sisay Derso Mengesha
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Ermias Alemayehu Adugna
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Zinabu Assefa Alemu
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Bedasa Wagari
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Melaku Gizaw Serte
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Kaleab Sebsibe Awoke
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Tesfaye Legesse Bedada
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mesaye Getachew Weldegebriel
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Danial Abera Dinssa
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Tsigereda Assefa Alemayehu
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Moa Abate Kenea
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Kirubel Tesfaye Tekulu
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Waktole Gobena
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Getinet Fikresilassie
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Wendayehu Wube
- Department of Hygiene and Environmental Health, Ministry of Health, Addis Ababa, Ethiopia
| | - Abayew Wassie Melese
- Department of Hygiene and Environmental Health, Ministry of Health, Addis Ababa, Ethiopia
| | - Ekram Redwan
- Department of Hygiene and Environmental Health, Ministry of Health, Addis Ababa, Ethiopia
| | - Vivian Hoffmann
- International Food Policy Research Institute (IFPRI), Washington, DC, USA
- Department of Economics and School of Public Policy and Administration, Carleton University, Ottawa, Ontario, Canada
| | - Masresha Tessema
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Getachew Tollera
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Hernández-Vásquez A, Vargas-Fernández R, Turpo Cayo EY. Determinants, inequalities, and spatial patterns of diarrhea in the Peruvian under-five population: findings from nationally representative survey data. Front Public Health 2023; 11:1170670. [PMID: 37441648 PMCID: PMC10333518 DOI: 10.3389/fpubh.2023.1170670] [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: 02/22/2023] [Accepted: 06/08/2023] [Indexed: 07/15/2023] Open
Abstract
Objective To determine the associated factors, decompose the socioeconomic inequalities, and analyze the spatial distribution of childhood diarrhea in Peru. Methods A cross-sectional analytical study was conducted using data from the National Demographic and Family Health Survey 2021. The dependent variable was the presence of diarrhea in the last two weeks. Three types of analysis were performed: (i) to evaluate the associated factors, generalized linear models of the Poisson family with logarithmic link were applied and prevalence ratios with their 95% confidence intervals were reported; (ii) for the analysis of inequalities, a decomposition of the Erreygers concentration index was performed using a generalized linear model; and (ii) a spatial autocorrelation analysis, hot spot analysis and cluster and outlier analysis were performed. Results A total of 18,871 children under 5 years of age were included. The prevalence of diarrhea in this population was 10.0%. Determinants such as being aged 0-23 months, being male, belonging to the poorest, poorer and rich wealth index, and residing in the Highlands and Jungle increased the probability of presenting diarrhea. In the decomposition analysis, diarrhea had a pro-poor orientation, with the greatest contributors were age 0-23 months, belonging to the poorest and poorer wealth indexes, and residing in the Highlands and Jungle. Spatial analysis showed that the highest concentrations and occurrence of this event were observed in departments of the Highlands and Jungle. Conclusion Government institutions seeking to reduce the numbers and burden of childhood diarrhea should focus their strategies on promoting hygiene measures and improving access to water and sanitation services, especially in poor populations living in the Peruvian Highlands and Jungle.
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Affiliation(s)
- Akram Hernández-Vásquez
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
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Birhan TA, Bitew BD, Dagne H, Amare DE, Azanaw J, Genet M, Engdaw GT, Tesfaye AH, Yirdaw G, Maru T. Prevalence of diarrheal disease and associated factors among under-five children in flood-prone settlements of Northwest Ethiopia: A cross-sectional community-based study. Front Pediatr 2023; 11:1056129. [PMID: 36756237 PMCID: PMC9899848 DOI: 10.3389/fped.2023.1056129] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/06/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Diarrheal illnesses are a long-standing public health problem in developing countries due to numerous sanitation issues and a lack of safe drinking water. Floods exacerbate public health issues by spreading water-borne infectious diseases such as diarrhea through the destruction of sanitation facilities and contamination of drinking water. There has been a shortage of studies regarding the magnitude of diarrheal disease in flood-prone areas. Therefore, this research aimed to evaluate the prevalence of diarrheal disease and its predictors among under-five children living in flood-prone localities in the south Gondar zone of Northwest Ethiopia. METHOD A community-based cross-sectional research was carried out in flood-prone villages of the Fogera and Libokemkem districts from March 17 to March 30, 2021. Purposive and systematic sampling techniques were used to select six kebeles and 717 study units, respectively. Structured and pretested questionnaires were used to collect the data. A multivariable analysis was performed to determine the predictors of diarrheal disease, with P-value <0.05 used as the cut-off point to declare the association. RESULT The prevalence of a diarrheal disease among under-five children was 29.0%. The regular cleaning of the compound [AOR: 2.13; 95% CI (1.25, 3.62)], source of drinking water [AOR: 2.36; 95% CI: (1.26, 4.41)], animal access to water storage site [AOR: 3.04; 95% CI: (1.76, 5.24)], vector around food storage sites [AOR: 9.13; 95% CI: (4.06, 20.52)], use of leftover food [AOR: 4.31; 95% CI: (2.64, 7.04)], and fecal contamination of water [AOR: 12.56; 95% CI: (6.83, 23.20)] remained to have a significant association with diarrheal diseases. CONCLUSION The present study found that the prevalence of the diarrheal disease among under-five children was high. Routine compound cleaning, the source of drinking water, animal access to a water storage site, vectors near food storage sites, consumption of leftover food, and fecal contamination of water were significant predictors of diarrheal disease. Therefore, it is advised to provide improved water sources, encourage routine cleaning of the living area, and offer health education about water, hygiene, and sanitation.
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Affiliation(s)
- Tsegaye Adane Birhan
- Department of Environmental & Occupational Health & Safety, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bikes Destaw Bitew
- Department of Environmental & Occupational Health & Safety, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Henok Dagne
- Department of Environmental & Occupational Health & Safety, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dagnachew Eyachew Amare
- Department of Environmental & Occupational Health & Safety, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Jember Azanaw
- Department of Environmental & Occupational Health & Safety, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mengesha Genet
- Department of Environmental & Occupational Health & Safety, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Garedew Tadege Engdaw
- Department of Environmental & Occupational Health & Safety, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Amensisa Hailu Tesfaye
- Department of Environmental & Occupational Health & Safety, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getasew Yirdaw
- Department of Environmental Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Tadele Maru
- Department of Environmental Health, Teda College of Health Sciences, Gondar, Ethiopia
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Melese M, Birhan TA, Simegn W, Adugna DG, Diress M, Getawa S, Azanaw J. Prevalence of Diarrhea, Intestinal Parasites, and Associated Factors Among Under-Five Children in Dabat District, Northwest Ethiopia: Multicenter Cross-sectional Study. ENVIRONMENTAL HEALTH INSIGHTS 2023; 17:11786302231174744. [PMID: 37187706 PMCID: PMC10176582 DOI: 10.1177/11786302231174744] [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: 01/30/2023] [Accepted: 04/21/2023] [Indexed: 05/17/2023]
Abstract
Background Despite global interventions to prevent and control diarrhea, it remains a public health problem leading to childhood morbidity and mortality majorly in developing countries. According to the World Health Organization, data from 2021 indicated that diarrheal disease is responsible for 8% of deaths in children under the age of 5. In the world, more than 1 billion under-five children live in poverty, social exclusion, and discrimination affected by intestinal parasitic infections and diarrhea disease. In sub-Saharan African countries like Ethiopia, diarrheal diseases and parasite infections continue to cause significant and persistent morbidity and mortality in under-five children. Therefore, the purpose of this study was to assess the prevalence and associated factors of intestinal parasites and diarrheal diseases in children under the age of 5 years in Dabat District, Northwest Ethiopia in 2022. Method A community-based, cross-sectional study was carried out from September 16 to August 18th 2022. Four hundred households with at least one child under the age of 5 years were recruited by simple random sampling technique. Sociodemographic, clinical, and behavioral factors were also collected using pretested interviewer-administered questionnaires. Data was entered into Epi-data version 3.1 and exported to Statistical Package for Social Science (SPSS) version 25 for analysis. Binary logistic regression was performed to identify factors associated with diarrhea and intestinal parasitic infections. The level of significance was computed at a P-value ⩽ .05. Descriptive statistics such as frequency and other summary statistics were used for describing sociodemographic variables and determining the prevalence of diarrhea and intestinal parasites. Tables, figures, and texts were used to present the findings. The variables having a P-value of less than .2 in the bivariable analysis were entered into the multivariable analysis at a P-value of ⩽.5. Results According to this study, the prevalence of diarrhea and intestinal parasites among under-five children was 20.8% (95% CI: [16.8-37.8] and 32.5% (95% CI: [28.6, 37.8], respectively. In multivariable logistic analysis at a P-value of ⩽.5, the educational level of mothers (Adjusted odds ratio [AOR]: 3.7, 95% CI: [1.52, 8.95], residence (AOR: 4.7, 95% CI: [1.52, 8.09]), undernutrition (AOR: 3.6, 95% CI: [1.09, 11.3]), latrine availability (AOR:3.9, 95% CI: [1.23, 9.56]), types of the latrine (AOR: 5.9, 95% CI: [3.42, 11.66]), water treatment (AOR = 7.6; 95% CI: [6.4, 12.7]), eating uncooked vegetable or fruits (AOR = 4.6; 95% CI: [1.025, 15.2]), and source of water (AOR = 4.5; 95% CI: [2.32,8.92]) were significantly associated with diarrheal disease. Intestinal parasitic infection was also significantly associated with undernutrition (AOR = 3.9; 95% CI: [1.09, 9.67]), latrine availability (AOR = 2.1; 95% CI:[1.32, 9.32]), types of the latrine (AOR = 2.8; 95% CI: [1.92, 8.12]) residence (AOR = 4.7; 95% CI: [1.52, 8.09]), water treatment, source of water for drinking (AOR = 4.5; 95% CI: [2.32, 8.92]), eating uncooked vegetables or fruits (AOR = 6.7:95% CI: [3.9, 9.8]), and deworming children with anti-parasitic medication (AOR = 2.4; 95% CI: [1.34, 5.62]), washing hands after latrine used (AOR = 2.2: 95% CI: [1.06, 3.86]). Conclusion The prevalence of diarrhea and intestinal parasite among under-five children was 20.8% and 32.5%, respectively. Undernutrition, latrine availability, types of latrines, residence, eating uncooked vegetables or fruits, and source of water for drinking and water treatment were associated with intestinal parasitic infection and diarrheal disease. Deworming children with antiparasitic medications and washing hands after latrine use was also significantly associated with parasitic infection. Hence, awareness creation activities on latrine utilization and building, keeping personal hygiene, safe water supply, feeding cooked vegetables or fruits, taking anti-parasitic medications, practice hand washing habit after toilet use are strongly recommended.
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Affiliation(s)
- Mihret Melese
- Department of Human Physiology, School
of Medicine, College of Medicine and Health Science, University of Gondar, Gondar,
Ethiopia
- Mihret Melese, Department of Human
Physiology, School of Medicine, College of Medicine and Health Science,
University of Gondar, Gondar 196, Ethiopia.
| | - Tsegaye Adane Birhan
- Department of Environmental and
Occupational Health and Safety, Institute of Public Health, College of Medicine and
Health Science, University of Gondar, Gondar, Ethiopia
| | - Wudneh Simegn
- Social and administrative pharmacy,
School of Pharmacy, College of Medicine and Health Science, University of Gondar,
Gondar, Ethiopia
| | - Dagnew Getnet Adugna
- Department of Human Anatomy, School of
Medicine, College of Medicine and Health Science, University of Gondar, Gondar,
Ethiopia
| | - Mengistie Diress
- Department of Human Physiology, School
of Medicine, College of Medicine and Health Science, University of Gondar, Gondar,
Ethiopia
| | - Solomon Getawa
- Department of Hematology and
Immunohematology, School of Biomedical and Laboratory Science, College of Medicine
and Health Science, University of Gondar, Gondar, Ethiopia
| | - Jember Azanaw
- Department of Environmental and
Occupational Health and Safety, Institute of Public Health, College of Medicine and
Health Science, University of Gondar, Gondar, Ethiopia
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Wolde D, Tilahun GA, Kotiso KS, Medhin G, Eguale T. The Burden of Diarrheal Diseases and Its Associated Factors among Under-Five Children in Welkite Town: A Community Based Cross-Sectional Study. Int J Public Health 2022; 67:1604960. [PMID: 36312315 PMCID: PMC9596767 DOI: 10.3389/ijph.2022.1604960] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 09/30/2022] [Indexed: 11/18/2022] Open
Abstract
Objective: This study assessed the magnitude of diarrhea and associated risk factors among under-five children in Welkite town. Methods: We used a community-based cross-sectional study design. Data collection period was February to March 2021 and 426 parents/guardians of under-five children were the study participants. A structured questionnaire and observation checklist were used to collect the data. Results: The 2 weeks prevalence of diarrhea among under-five years old children was 20.7% (88/426); 95% CI (17.1, 24.6). The child’s mother/caregiver being merchant (AOR: 5.34; 95% CI: 2.1, 13.8) compared to housewife, partial immunization status (AOR: 2.67; 95% CI: 1.2, 5.8), disposing child’s stool into the garbage (AOR: 5.05; 95% CI: 1.1, 23.3) compared to putting in a toilet, not covering water storage materials (AOR: 2.4; 95% CI: 1.2, 4.7) and presence of flies in food preparation area (AOR: 2.24; 95% CI: 1.05, 4.8) were associated with increased odds of having diarrhea. Conclusion: The prevalence of diarrhea among under-five old children is high and it is associated with the occupation of the mothers/caregivers, the immunization status of children, unhygienic water storage condition and non-hygienic household practice.
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Affiliation(s)
- Deneke Wolde
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wachemo University, Hosssana, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- *Correspondence: Deneke Wolde,
| | - Genet Asfaw Tilahun
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Kehabtimer Shiferaw Kotiso
- Department of Public Health, College of Medicine and Health Sciences, Worabe University, Worabe, Ethiopia
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tadesse Eguale
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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Adamu I, Andrade FCD, Singleton CR. Availability of Drinking Water Source and the Prevalence of Diarrhea among Nigerian Households. Am J Trop Med Hyg 2022; 107:893-897. [PMID: 36067986 PMCID: PMC9651543 DOI: 10.4269/ajtmh.21-0901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 06/17/2022] [Indexed: 11/07/2022] Open
Abstract
Diarrhea is highly prevalent in Nigeria and accounts for 16% of deaths among Nigerian children. The WHO classifies water source into two categories: improved and unimproved. This study aimed to examine the association between type of water source and the prevalence of diarrhea among members of a nationally representative sample of Nigerian households while controlling for key sociodemographic and household factors. This study used cross-sectional data from 22,571 households participating in the 2018 Water, Sanitation and Hygiene-National Outcome Routine Mapping survey. Data collectors visited and interviewed household members across all 36 states in the country. Logistic regression was used to assess associations between water source type and the odds of a family member reporting diarrhea, after controlling for financial status, availability of soap/detergent for handwashing, availability of a refrigerator in the home, toilet type, and urban/rural status. After controlling for explanatory variables in the adjusted model, having an unimproved water source was associated with greater odds of diarrhea among a family member (odds ratio, 1.59; 95% CI, 1.44-1.77). Not having a refrigerator and not having soap/detergent for handwashing were also associated with greater odds of diarrhea. In summary, this study found an association between water-source type and diarrhea prevalence among Nigerian households. This study is in line with prior studies in Nigeria and elsewhere, and the results call for greater commitment and action by stakeholders to improve water sources and, ultimately, reduce the prevalence of diarrhea in Nigeria.
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Affiliation(s)
- Isa Adamu
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois
| | | | - Chelsea R. Singleton
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
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13
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Aluri KZ, Halder AK, Islam M, Benjamin‐Chung J, Alam M, Shoab AK, Rahman M, Unicomb L, Luby SP. The effect of a large-scale water, sanitation and hygiene intervention in Bangladesh on knowledge, behaviour and health: Findings from an endline programme evaluation. Trop Med Int Health 2022; 27:913-924. [PMID: 36096154 PMCID: PMC9826406 DOI: 10.1111/tmi.13813] [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] [Indexed: 01/11/2023]
Abstract
OBJECTIVES The Sanitation, Hygiene Education and Water Supply in Bangladesh Programme (SHEWA-B) was a 5-year intervention aiming to improve water, sanitation and hygiene (WASH) practices among 20 million rural residents through community hygiene promoters. This analysis evaluates the impact of SHEWA-B on knowledge, behaviour and childhood diarrhoea outcomes. METHODS The evaluation included repeated cross-sectional surveys and health surveillance in matched cohorts in intervention and control clusters. Cross-sectional surveys and structured observations at baseline, midline, and endline assessed the availability of WASH technology, caregiver knowledge and behaviour. Fieldworkers collected monthly health data in a subset of control and intervention households to determine the prevalence of diarrhoea. RESULTS Of 5091 households surveyed, participants residing in intervention clusters showed minimal improvements in knowledge, reported behaviour, or use of WASH technology compared to the control clusters. During structured observations, intervention households increased more than control households at handwashing before preparing food and after cleaning a baby's anus when comparing endline to baseline, but these changes were not seen when comparing endline to the midline. The prevalence of childhood diarrhoea remained similar in both groups before (10.2% in intervention, 10.0% in control) and after (8.8% in intervention, 11.7% in control) midline changes were made to improve the intervention. Intervention clusters showed no improvement in diarrhoea over time compared to control clusters. CONCLUSIONS SHEWA-B's community-based WASH promotion did not yield the intended impact on knowledge, behaviour or health. Greater priority should be given to approaches that have demonstrated effectiveness. Including rigorous evaluations would broaden the evidence base to support and improve large-scale programmes.
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Affiliation(s)
- Kelly Zhang Aluri
- Department of Epidemiology and Population HealthStanford University School of MedicineStanfordCaliforniaUSA
| | - Amal K. Halder
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | - Mahfuza Islam
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | - Jade Benjamin‐Chung
- Department of Epidemiology and Population HealthStanford University School of MedicineStanfordCaliforniaUSA
| | - Monirul Alam
- United Nations Children's Fund BangladeshDhakaBangladesh
| | - Abul Kasham Shoab
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | - Mahbubur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | - Leanne Unicomb
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | - Stephen P. Luby
- Department of Epidemiology and Population HealthStanford University School of MedicineStanfordCaliforniaUSA,Department of Medicine, Infectious DiseaseStanford University School of MedicineStanfordCaliforniaUSA
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Irenso AA, Zheng M, Campbell KJ, Chamberlain D, Laws R. The influence of household structure and composition on the introduction of solid, semisolid and soft foods among children aged 6-8 months: An analysis based on Ethiopia Demographic and Health Surveys. MATERNAL & CHILD NUTRITION 2022; 19:e13429. [PMID: 36148628 PMCID: PMC9749599 DOI: 10.1111/mcn.13429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/13/2022] [Accepted: 08/20/2022] [Indexed: 12/15/2022]
Abstract
The early and late introduction of complementary food, both prevalent in Ethiopia, are associated with morbidities, growth faltering and developmental risks in children. The interhousehold network around the primary caregiver's intrahousehold network is critical in influencing the age of introducing complementary foods. This study examined the influence of household composition and structures on complementary food introduction. This is a secondary data analysis of four Ethiopian Demographic and Health Surveys conducted between 2000 and 2016. The household structure and composition variables were calculated from household members' kinship status and attribute, respectively. The introduction of solid, semisolid or soft foods was dichotomised as whether the children within 6 to 8 months have been given complementary foods. Multivariable logistic regression with adjustment for the primary caregiver and household characteristics was run to examine the associations between household structure and composition variables and the introduction of complementary foods. The marginal effects (ME) were calculated to facilitate the practical interpretation of the study findings. Large households (>3 nonredundant contacts) with extended family or unrelated people (high effective size, ME = 6.01%, 95% confidence interval [CI]: -8.53, -3.49) lowered the proportion of children starting food within the recommended 6-8 months. Households with close kins (high constraint) (ME = 7.22%, 95% CI: -13.65, 28.09) and greater age diversity (ME = 0.65%, 95% CI: 0.15, 1.15) increased the proportion of children receiving complementary food at an appropriate age. This study revealed that interhousehold structure and composition influence the age of introduction of complementary foods. These factors, therefore, need to be considered in designing interventions to improve age at the introduction of complementary foods.
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Affiliation(s)
- Asnake Ararsa Irenso
- School of Public HealthAmbo UniversityAmboEthiopia,School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition (IPAN)Deakin UniversityBurwoodVictoriaAustralia
| | - Miaobing Zheng
- School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition (IPAN)Deakin UniversityBurwoodVictoriaAustralia
| | - Karen J. Campbell
- School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition (IPAN)Deakin UniversityBurwoodVictoriaAustralia
| | - Dan Chamberlain
- Centre for Social Impact UNSWUniversity of New South WalesSydneyNew South WalesAustralia
| | - Rachel Laws
- School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition (IPAN)Deakin UniversityBurwoodVictoriaAustralia
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Prevalence of Diarrhea, Feeding Practice, and Associated Factors among Children under Five Years in Bereh District, Oromia, Ethiopia. Infect Dis Obstet Gynecol 2022; 2022:4139648. [PMID: 35754527 PMCID: PMC9232332 DOI: 10.1155/2022/4139648] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background Diarrheal disease is a major public health problem among under-five children globally. In Ethiopia, it is the second cause of hospital admission and death among children under five years. Objectives To assess the prevalence of diarrhea, feeding practice, and associated factors among children under five years in Bereh District, Oromia Special Zone Surrounding Finfine, Ethiopia. Methods A community-based cross-sectional study was conducted among children less than 5 years old in Bereh District from May 15 to 29, 2021. A systematic random sampling technique was used to select a total of 455 study participants. Descriptive statistics were used to measure the prevalence of diarrhea as well as to summarize other study variables. A binary logistic regression model with an adjusted odds ratio and a 95% confidence interval (CI) was used to declare the associated factors with childhood diarrhea. Results The prevalence of diarrhea was 17.3% in the past 15 days preceding the study period. About 53.4% of the mothers/caregivers were engaged in poor child feeding practices. Age of children [AOR = 9.146, 95% CI (2.055, 40.707)], birth order [AOR = 0.137, 95% CI (0.057, 0.329)], total family size [AOR: 5.042, 95% CI (2.326, 10.931)], not EBF [AOR: 4.723, 95% CI (1.166, 19.134)], prepare child foods separately [AOR: 0.252, 95% CI (0.091, 0.701)], feeding child immediately after cooking, handwashing method, and source of drinking water were significantly associated with under-five diarrhea. Conclusions The prevalence of diarrhea among children under five is high. More than half of the participants were engaged in poor IYCF practice. Action targeting the factors associated with diarrhea should be taken to improve under-five child's health.
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Saha J, Mondal S, Chouhan P, Hussain M, Yang J, Bibi A. Occurrence of Diarrheal Disease among Under-Five Children and Associated Sociodemographic and Household Environmental Factors: An Investigation Based on National Family Health Survey-4 in Rural India. CHILDREN (BASEL, SWITZERLAND) 2022; 9:658. [PMID: 35626835 PMCID: PMC9139802 DOI: 10.3390/children9050658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/24/2022] [Accepted: 04/27/2022] [Indexed: 12/07/2022]
Abstract
Diarrheal disease is a significant public health problem leading to mortality and morbidity among children aged 0-59 months in rural India. Therefore, the rationale of this study was to identify the sociodemographic and environmental predictors associated with diarrhea among under-five children in rural India. A total of 188,521 living children (0-59 months) were studied from the National Family Health Survey-4, (NFHS-4) 2015-2016. Bivariate and binary logistic regression models were carried out from the available NFHS-4 data for selected sociodemographic and environmental predictors to identify the relationship of occurrence of diarrhea using STATA 13.1. In rural India, children aged 12-23 months, 24-35 months, 36-47 months, and 48-59 months were significantly improbable to suffer diarrheal disease. Children of the female sex, as well as children of scheduled tribes (ST) and other backward classes (OBC), were less likely to experience diarrhea. The disease was more likely to occur among children of scheduled castes (SC); Muslim or other religions; children belonging to central, eastern, and western regions; children with low birth weight; as well as children with improper stool disposal and rudimentary roof materials. In the rural parts of India, sociodemographic and household environmental factors were most influential. Effective community education; improved handwashing practices; pure water supply; and proper waste disposal, including building and utilizing latrines, would help reduce the burden of diarrheal disease in children.
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Affiliation(s)
- Jay Saha
- Department of Geography, University of Gour Banga (UGB), Malda 732103, WB, India; (S.M.); (P.C.)
| | - Sabbir Mondal
- Department of Geography, University of Gour Banga (UGB), Malda 732103, WB, India; (S.M.); (P.C.)
| | - Pradip Chouhan
- Department of Geography, University of Gour Banga (UGB), Malda 732103, WB, India; (S.M.); (P.C.)
| | - Mulazim Hussain
- The Children Hospital, Pakistan Institute of Medical Sciences (PIMS), Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU), Islamabad 44000, Pakistan;
| | - Juan Yang
- Chinese Academy of Science and Technology for Development, Beijing 100038, China
| | - Asma Bibi
- Independent Researcher, Lahore 54000, Pakistan;
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Time to under-five mortality and its predictors in rural Ethiopia: Cox-gamma shared frailty model. PLoS One 2022; 17:e0266595. [PMID: 35385556 PMCID: PMC8985961 DOI: 10.1371/journal.pone.0266595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/24/2022] [Indexed: 11/21/2022] Open
Abstract
Background Under-five mortality (U5M) is one of the most important and sensitive indicators of the health status of the community. Despite there having been a substantial reduction in U5M since 1990, its rate is still high in Sub-Saharan African countries. Thus, this study aimed to assess time to under-five mortality and its predictors in rural Ethiopia. Methods This study utilized a secondary analysis of the 2016 Ethiopia Demographic and Health Survey (EDHS). A total of 9,807 weighted under-five children selected at different stages were included in the analysis. The Kaplan-Meier and Cox’s-gamma shared frailty models were used to estimate survival time and to identify predictors of under-five mortality, respectively. An adjusted Hazard Ratio (AHR) along with a 95% Confidence Interval (CI) was used to measure the effect size and direction of the association. Results The study indicated that 6.69% (95% CI: 6.13, 7.30) of children died before celebrating their fifth birthday in rural Ethiopia. Of all the deaths, the median time to death was 27 months. After controlling the effect of cluster and other confounding factors, female sex (AHR = 0.62, 95% CI: 0.52, 0.75), ever born greater than five children (AHR = 1.40, 95% CI: 1.07, 1.83), very large size at birth (AHR = 1.33, 95% CI: 1.03 1.71), very small size at birth (AHR = 1.41, 95% CI: 1.10, 1.82), twin pregnancy (AHR = 3.5, 95% CI: 2.47, 4.88), not ever breastfeeding (AHR = 11.29, 95% CI: 9.03, 14.12), unimproved latrine (AHR = 3.44, 95% CI: 1.91, 6.17), covered by health insurance (AHR = 0.29, 95% CI: 0.12, 0.70) were predictors of under-five mortality. Conclusions Still under-five mortality was high in rural Ethiopia as compared to the global under-five mortality rate. In the final model, sex of a child, the total number of children ever born, children’s size at birth, type of pregnancy, breastfeeding, type of toilet, and being covered by health insurance were significant predictors of under-five mortality. Further emphasis should be given to twin and not breastfeeding children, as well as households’ better encouraging membership of community health insurance and utilization of improved latrines.
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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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Hao Q, Gao Q, Zhao R, Wang H, Li H, Jiang B. The effect and attributable risk of daily temperature on category C infectious diarrhea in Guangdong Province, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:23963-23974. [PMID: 34817816 DOI: 10.1007/s11356-021-17132-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/17/2021] [Indexed: 05/16/2023]
Abstract
Previous studies have explored the effect between ambient temperature and infectious diarrhea (ID) mostly using relative risk, which provides limited information in practical applications. Few studies have focused on the disease burden of ID caused by temperature, especially for different subgroups and cities in a multi-city setting. This study aims to estimate the effects and attributable risks of temperature on category C ID and explore potential modifiers among various cities in Guangdong. First, distributed lag non-linear models (DLNMs) were used to explore city-specific associations between daily mean temperature and category C ID from 2014 to 2016 in Guangdong and pooled by applying multivariate meta-analysis. Then, multivariate meta-regression was implemented to analyze the potential heterogeneity among various cities. Finally, we assessed the attributable burden of category C ID due to temperature, low (below the 5th percentile of temperature) and high temperature (above the 95th percentile of temperature) for each city and subgroup population. Compared with the 50th percentile of daily mean temperature, adverse effects on category C ID were found when the temperature was lower than 12.27 ℃ in Guangdong Province. Some city-specific factors (longitude, urbanization rate, population density, disposable income per capita, and the number of medical technicians and beds per thousand persons) could modify the relationship of temperature-category C ID. During the study period, there were 60,505 category C ID cases (17.14% of total cases) attributable to the exposure of temperature, with the attributable fraction (AF) of low temperature (4.23%, 95% empirical confidence interval (eCI): 1.79-5.71%) higher than high temperature (1.34%, 95% eCI: 0.86-1.64%). Males, people under 5 years, and workers appeared to be more vulnerable to temperature, with AFs of 29.40%, 19.25%, and 21.49%, respectively. The AF varied substantially at the city level, with the largest AF of low temperature occurring in Shaoguan (9.58%, 95% eCI: 8.36-10.09%), and that of high temperature occurring in Shenzhen (3.16%, 95% eCI: 2.70-3.51%). Low temperature was an important risk factor for category C ID in Guangdong Province, China. The exposure-response relationship could be modified by city-specific characteristics. Considering the whole population, the attributable risk of low temperature was much higher than that of high temperature, and males, people under 5 years, and workers were vulnerable populations.
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Affiliation(s)
- Qiang Hao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, No.44 Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong Province, People's Republic of China
- Shandong University Climate Change and Health Center, Jinan, 250012, Shandong Province, People's Republic of China
| | - Qi Gao
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong Province, People's Republic of China
| | - Ran Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, No.44 Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong Province, People's Republic of China
- Shandong University Climate Change and Health Center, Jinan, 250012, Shandong Province, People's Republic of China
| | - Haitao Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, No.44 Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong Province, People's Republic of China
| | - Hao Li
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, No.44 Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong Province, People's Republic of China
- Shandong University Climate Change and Health Center, Jinan, 250012, Shandong Province, People's Republic of China
| | - Baofa Jiang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, No.44 Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong Province, People's Republic of China.
- Shandong University Climate Change and Health Center, Jinan, 250012, Shandong Province, People's Republic of China.
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Rahman A, Hossain MM. Prevalence and determinants of fever, ARI and diarrhea among children aged 6–59 months in Bangladesh. BMC Pediatr 2022; 22:117. [PMID: 35248016 PMCID: PMC8897933 DOI: 10.1186/s12887-022-03166-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 02/15/2022] [Indexed: 11/10/2022] Open
Abstract
Background Although efforts have been made by the international community to improve childhood health, risk factors linked with the healthiness of preschool-age children in low and middle-income countries (LMICs) are very diverse. Therefore, this paper examines the prevalence and determinants of fever, acute respiratory infection and diarrhea of preschool children in Bangladesh. Methods A sample of 8,421 children from the latest country representative BDHS-2017–18 survey was analyzed by utilizing both the bivariate and multivariate techniques. Results The results revealed that about 4.7, 33.1, and 35.8% of the children aged under 5 years had suffered from diarrhea, fever and ARI respectively during the 2 weeks preceding the date of the survey. Demographic, socio-economic, and community and health characteristics likely to play an important role in suffering under-five children from diarrhea, fever, and ARI in Bangladesh. The child’s age of 13–24 months, delivery by cesarean section, unsafe drinking water, unhygienic toilet facility, low level of family wealth index and parental education, a higher number of living children in the household, rural residency and regional difference were all found to be most crucial determinants of the occurrences of fever, ARI and diarrhea. Conclusion Interventions should focus on improving these significant demographic, socioeconomic, and community and health risk factors. A special attention is necessary to the people who live in rural areas and geospatially disadvantaged regions.
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Kurniawan AW, Nursalam N, Devy SR, Ahsan A, Astutik E, Nurbadriyah W, Hastuti AP. Risk Factors of Infant Diarrhea and Under-five Children Diarrhea. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Infant and under-five children diarrhea in Indonesia is a health problem that seriously impacts death.
AIM: The main objective of this study was to determine the most significant factors that influence infant and under-five children diarrhea between the years 2012 and 2017.
METHODS: This study used data from the Indonesia Demographic and Health Survey of 2012 and 2017 with a cross-sectional design. We modeled the infant and under-five of age children diarrhea as categorical dependent variable (diarrhea vs. no diarrhea of the infant and under-five of age children). At the same time, 14 covariates are used as an independent variable using χ2 statistic and multiple logistic regression (MLR).
FINDINGS: For infant diarrhea, television as an information resources showed the highest positive coefficient (OR = 1.966; β = 3.35; and p = 0.001) significant covariate for 2012. Higher mother education was negative correlation (β = –2.31 and p = 0.021) for infant diarrhea in 2017. For under-five children diarrhea, reading newspaper and magazine < 1 a week showed positive coefficients (OR = 1.059; β = 2.62; and p = 0.009) for 2012. Sex of household head female showed the highest positive coefficient (OR = 1.387; β = 2.82; and p = 0.005) for under-five children diarrhea in 2017.
CONCLUSIONS: The finding has important policy implications for infant and under-five of age diarrhea intervention programs. Thus, activities focus on the proper hygienic toilet, improving health information from newspapers, magazines, and TV.
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Mengistie B, Gobena T, Admassu D, Assefa N, Mekbib Ayele D, Mengistu DA, Worku A, Kumie A, Terfa W, Bikila Z, Azage M. Seasonal Variability Influence on the Prevalence of Diarrhoea among Under-Five-Year-old Children in Kersa District, Eastern Ethiopia: A Community-Based Longitudinal Study. ENVIRONMENTAL HEALTH INSIGHTS 2022; 16:11786302221093480. [PMID: 35465144 PMCID: PMC9019326 DOI: 10.1177/11786302221093480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/23/2022] [Indexed: 05/16/2023]
Abstract
BACKGROUND The health effects of climate change have been found to be a global concern for the last 2 centuries. However, the effect of climate variability on diarrhoea among under-five-year-old children is perhaps undocumented or otherwise unknown. The aim of the present study was to determine the effect of climate variability on diarrhoea among children under 5 years of age. METHODS A community-based longitudinal study was conducted over 8 repeated visits from June 2016 to May 2018 at the Kersa Demographic Surveillance and Health Research Center. A total of 500 randomly selected households and their 48 improved water sources were included in the survey from 3 agro-ecological zones, the rural and urban areas of the study area. Data was collected on household characteristics, diarrhoea, WASH practices, water quality and quantity in households, and improved water sources. A structured pre-tested questionnaire, an observational check list and laboratory tests were used for data collection. The data was entered into Epi Data Version 3.01 and transferred to Stata Version 12 for analysis. Multilevel mixed-effect Poisson regression was used to determine the relationship between predictors and outcome variables. A P-value of less than .05 was the cut-off point for statistically significant. RESULTS The prevalence of diarrhoea in 2 weeks among children under 5 years of age was 17.2% (95% CI: 15.8-19.71). Rainfall, E. coli contamination of drinking water at the source and in the home, 20 L of water consumption per capita per day, sharing water sources with animals and home water treatment by residents of the mid- and lowlands were all predictors of diarrhoea. The space-time scan statistic confirmed that child diarrhoea had random variation in both space and time. CONCLUSION Climate variability has influenced the prevalence of diarrhoea among under-five-year-old children. Climate-resilient measures should be taken to reduce the burden of diarrhoea in the community.
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Affiliation(s)
- Bezatu Mengistie
- Haramaya University, College of Health and Medical Sciences, Ethiopia
| | - Tesfaye Gobena
- Haramaya University, College of Health and Medical Sciences, Ethiopia
| | - Desalegn Admassu
- Haramaya University, College of Health and Medical Sciences, Ethiopia
| | - Nega Assefa
- Haramaya University, College of Health and Medical Sciences, Ethiopia
| | - Dinku Mekbib Ayele
- Haramaya University, College of Health and Medical Sciences, Ethiopia
- Dinku Mekbib Ayele, Haramaya University, College of Health and Medical Sciences, Ethiopia. Emails: ;
| | | | | | - Abera Kumie
- Addis Ababa University, School of Public Health, Ethiopia
| | | | | | - Muluken Azage
- Bahidar University, College of Medicine and Health Sciences, Ethiopia
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Gessesse DN, Tarekegn AA. Prevalence and associated factors of diarrhea among under-five children in the Jawi district, Awi Zone Ethiopia, 2019. Community based comparative cross-sectional study. Front Pediatr 2022; 10:890304. [PMID: 36090569 PMCID: PMC9458862 DOI: 10.3389/fped.2022.890304] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 06/23/2022] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Although most deaths are preventable with simple and inexpensive measures, death from diarrhea accounts for one out of nine deaths in children worldwide which makes it the disease with the highest mortality rate in children under the age of five. Therefore, this study is aims to investigate diarrhea prevalence and risk factors among children under the age of five in Jawi district, Awi Zone, Ethiopia. MATERIALS AND METHODS A comparative cross-sectional study was done among 440 study participants from March to June 2019. Data were collected with a face-to-face interviewer-administered questionnaire. Data was entered into EPI Info version 7 software and cleaned and analyzed using SPSS version 20 software. Binary logistic regression was done to assess independent factors associated with the dependent variable. A significant association was determined using an adjusted odds ratio at a confidence level of 95% and a p-value of less than or equal to 0.05. RESULTS In the current study, the overall under-five children diarrheal disease was found to be 15.5%. Diarrheal disease prevalence in model and non-model households was 10.9 and 20%, respectively. Shallow water [AOR: 6.12, 95%CI; (1.52, 24.58)], and maternal diarrhea [AOR: 4.11, 95%CI; (1.75, 9.61)] were determinants of childhood diarrhea. Place of birth [OR: 2.52, 95%CI (1.16, 5.49)] and maternal diarrhea [AOR: 3.50; 95%CI (1.28, 9.56)] in non-model households were also determinants of childhood diarrhea. CONCLUSION Under-five children diarrheal disease was found to be high in the Jawi District. Thus, to decrease the disease prevalence in the study area, the health extension workers aim to better educate the mothers on how to handle diarrheal diseases. It is also better for concerned stakeholders to promote institutional delivery and to give access to safe water for the community.
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Affiliation(s)
- Dereje Nibret Gessesse
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Abebe Aynalem Tarekegn
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
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Derseh BT, Tafese NM, Panari H, Bilchut AH, Dadi AF. Behavioral and environmental determinants of acute diarrhea among under-five children from public health facilities of Siyadebirena Wayu district, north Shoa zone, Amhara regional state, Ethiopia: Unmatched case-control study. PLoS One 2021; 16:e0259828. [PMID: 34807922 PMCID: PMC8608321 DOI: 10.1371/journal.pone.0259828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 10/27/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Acute diarrhea is a major public health problem in the world. Next to pneumonia, it is the leading cause of death in children under five years old. Globally, even though childhood diarrhea disease kills millions, the interaction of socio-demographic, behavioral, and environmental factors of acute diarrhea in children aged 6-59 months is not investigated yet in the current study area. OBJECTIVE To determine behavioral and environmental predictors of acute diarrhea among under-five children from public health facilities of Siyadebirena Wayu district, North Shoa, Amhara Regional State, Ethiopia, 2019. METHODS A facility-based unmatched case-control study was conducted from March 12, 2019, to May 12, 2019. A total of 315 under-five children were included in the study (105 cases and 210 controls). A systematic random sampling technique was used to select study participants. Data were collected by a structured questionnaire and analyzed by using SPSS. To analyze the data, bivariable and multivariable logistic regression analysis was used. RESULTS The study showed that average family monthly income of 12-23 USD (AOR = 6. 22; 95% CI: 1.30, 29.64), hand washing practice of mothers/ care givers with water only (AOR = 3.75; 95% CI: 1.16, 12.13), improper disposal of infant feces (AOR = 11.01; 95% CI: 3.37, 35.96), not treating drinking water at home (AOR = 9.36; 95% CI: 2.73, 32.08), children consuming left-over food stored at room temperature (AOR = 5.52; 95% CI: 1.60, 19.03) and poor knowledge of the respondents about the risk factors for diarrhea were the determinants that significantly associated with acute childhood diarrhea. CONCLUSION The potential predictors of childhood diarrhea morbidity were improper hand-washing practice, not treating drinking water at home, unsafe disposal of children's feces, children consuming left-over food stored at room temperature, and having poor knowledge about the major risk factors for diarrhea. Thus, awareness of the community on hygiene and sanitation focusing on proper handling of human excreta, safe water handling, proper hand washing practice, and proper management of leftover food should be enhanced to prevent children from acute diarrhea diseases.
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Affiliation(s)
- Behailu Tariku Derseh
- Department of Public Health, Asrat Woldeyes Health Sciences Campus, Debre Berhan University, Debre Berhan, Amhara, Ethiopia
- * E-mail:
| | - Natnael Mulushewa Tafese
- Waghimira Health Department, Amhara Region Health Bureau, Health System Strengthening Special Support Directorate, Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Hazaratali Panari
- Department of Nursing, Asrat Woldeyes Health Sciences Campus, Debre Berhan University, Debre Berhan, Amhara, Ethiopia
| | - Awraris Hailu Bilchut
- Department of Public Health, Asrat Woldeyes Health Sciences Campus, Debre Berhan University, Debre Berhan, Amhara, Ethiopia
| | - Abel Fekadu Dadi
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
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Dolstad HA, Franke MF, Vissieres K, Jerome JG, Ternier R, Ivers LC. Factors associated with diarrheal disease among children aged 1-5 years in a cholera epidemic in rural Haiti. PLoS Negl Trop Dis 2021; 15:e0009726. [PMID: 34679083 PMCID: PMC8535179 DOI: 10.1371/journal.pntd.0009726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 08/12/2021] [Indexed: 11/18/2022] Open
Abstract
Diarrheal illness is a major cause of morbidity and mortality among children in Haiti, and the impact of diarrheal illness was compounded by a cholera outbreak between 2010 and 2019. Our understanding of risk factors for diarrhea among children during this outbreak is limited. We conducted a secondary analysis of data collected as part of a cholera vaccine effectiveness study to identify factors associated with medically attended diarrhea among children in central Haiti from October of 2012 through November of 2016. We identified 47 children aged one to five years old who presented to medical clinics with acute, watery diarrhea, and 166 matched controls who did not have diarrhea, and we performed conditional logistic regression to identify factors associated with diarrhea. Discontinuing exclusive breastfeeding within one month of birth was associated with increased risk of diarrhea (RR 6.9, 95% CI 1.46–32.64), and diarrhea was inversely associated with reported history of supplementation with vitamin A (RR 0.05, 95% CI 0.004–0.56) and zinc (reported among 0% of cases vs. 17% of controls). Because of the concordance in supplementation patterns, it was not possible to attribute the association to vitamin A or zinc independently. While having a respondent who correctly identified ≥3 means of avoiding cholera was associated with reduced risk of diarrhea (RR 0.43, 95% CI 0.19–1.01), reported household sanitation practices and knowledge of cholera were not consistently associated with risk of diarrhea. These findings support ongoing efforts to reduce barriers to breastfeeding and promote pediatric supplementation with vitamin A and zinc in Haiti. Given the reduced efficacy of current oral cholera vaccines (OCV) among children, the results reinforce the importance of breastfeeding and micronutrient supplementation in preventing all-cause pediatric diarrheal illness generally and during cholera outbreaks. Diarrheal diseases are leading causes of illness and death among children throughout the world, and children in Haiti were particularly impacted by diarrhea during the cholera outbreak that started in 2010. Between 2012 and 2016, data were collected as part of a case-control study of oral cholera vaccine (OCV) effectiveness in Haiti. We analyzed data from that study to identify factors associated with diarrheal illness, including cholera and non-cholera diarrhea, among children ages one through five years old. We found a direct association between longer duration of exclusive breastfeeding and supplementation with vitamin A and zinc and a reduced risk of diarrhea. These findings shed light on potentially important components of efforts to reduce pediatric diarrheal illness in Haiti generally, and to reduce pediatric diarrhea in the context of cholera outbreaks in Haiti and elsewhere.
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Affiliation(s)
- Hilary A. Dolstad
- Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
| | - Molly F. Franke
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | | | | | | | - Louise C. Ivers
- Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, United States of America
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Barry MA, Qu K, Gainey M, Schmid CH, Garbern SC, Nasrin S, Alam NH, Lee JA, Nelson EJ, Rosen R, Levine AC. Derivation and Internal Validation of a Score to Predict Dehydration Severity in Patients over 5 Years with Acute Diarrhea. Am J Trop Med Hyg 2021; 105:1368-1375. [PMID: 34398821 PMCID: PMC8592223 DOI: 10.4269/ajtmh.21-0143] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/06/2021] [Indexed: 11/07/2022] Open
Abstract
Diarrheal disease accounts for more than one million deaths annually in patients over 5 years of age. Although most patients can be managed with oral rehydration solution, patients with severe dehydration require resuscitation with intravenous fluids. Scoring systems to assess dehydration have been empirically derived and validated in children under 5 years, but none have been validated for patients over 5 years. In this study, a prospective cohort of 2,172 patients over 5 years presenting with acute diarrhea to International Centre for Diarrhoeal Disease Research, Dhaka Hospital, Bangladesh, were assessed for clinical signs of dehydration. The percent difference between presentation and posthydration stable weight determined severe (≥ 9%), some (3-9%), or no (< 3%) dehydration. An ordinal regression model was derived using clinical signs and demographics and was then converted to a 13-point score to predict none (score of 0-3), some (4-6), or severe (7-13) dehydration. The Novel, Innovative Research for Understanding Dehydration in Adults and Kids (NIRUDAK) Score developed by our team included age, sex, sunken eyes, radial pulse, respiration depth, skin turgor, and vomiting episodes in 24 hours. Accuracy of the NIRUDAK Score for predicting severe dehydration, as measured by the area under the receiver operating characteristic curve, was 0.76 (95% confidence interval = 0.73-0.78), with a sensitivity of 0.78 and a specificity of 0.61. Reliability was also robust, with an Inter-Class Correlation Coefficient of 0.88 (95% confidence interval = 0.84-0.91). This study represents the first empirically derived and internally validated scoring system for assessing dehydration in children ≥ 5 years and adults with acute diarrhea in a resource-limited setting.
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Affiliation(s)
- Meagan A. Barry
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Kexin Qu
- Department of Biostatistics, Brown University School of Public Health, Providence, Rhode Island
| | | | - Christopher H. Schmid
- Department of Biostatistics, Brown University School of Public Health, Providence, Rhode Island
| | - Stephanie C. Garbern
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Sabiha Nasrin
- International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Nur H. Alam
- International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - J. Austin Lee
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Eric J. Nelson
- Departments of Pediatrics and Environmental and Global Health, Emerging Pathogens Institute, University of Florida, Gainesville, Florida
| | - Rochelle Rosen
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island
| | - Adam C. Levine
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
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Natnael T, Lingerew M, Adane M. Prevalence of acute diarrhea and associated factors among children under five in semi-urban areas of northeastern Ethiopia. BMC Pediatr 2021; 21:290. [PMID: 34174851 PMCID: PMC8235618 DOI: 10.1186/s12887-021-02762-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 06/07/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Diarrheal disease is still one of the most common causes of mortality and morbidity in children under five in developing countries, including Ethiopia. Lack of specific data on the prevalence of acute diarrhea and associated factors among under-five children in the semi-urban areas of Gelsha, found in northeastern Ethiopia's South Wollo zone, remains a major gap. Therefore, this study was designed to provide data that is important for proper planning of intervention measures to reduce the problem in this area. METHODS A community-based cross-sectional study was conducted among 340 systematically selected children under five in semi-urban areas of Gelsha from January to March 2019. The data was collected using a structured questionnaire and an observational checklist. Bivariable (crude odds ratio [COR]) and multivariable analysis (adjusted odds ratio [AOR]) were employed using binary logistic regression model with 95% CI (confidence interval). Variables with a p-value < 0.05 from the multivariable analysis were declared as factors significantly associated with acute diarrhea. RESULT The prevalence of acute diarrhea among children under five in the study area was 11% (95%CI: 7.8-14.3%). About two-thirds (63.60%) of study participants used water from improved sources. About half (54.90%) of study participants practiced poor handwashing and 45.10% practiced good handwashing. We found that factors significantly associated with acute diarrhea were a child's age of 12-23 months (AOR = 4.68, 95% CI: 1.45-1.50), the presence of two or more under-five children in the house (AOR = 2.84, 95% CI: 1.19-6.81), unimproved water sources (AOR = 2.97, 95% CI: 1.28-6.87) and presence of feces around the pit hole/slab/floor of the latrine (AOR = 3.34, 95% CI: 1.34-8.31). CONCLUSION The prevalence of acute diarrhea among children under five was relatively high. To reduce the problem, various prevention strategies are essential, such as the provision of health education to mothers/caregivers that focuses on keeping sanitation facilities clean and child care, and construction of improved water sources. Furthermore, implementing a strong health extension program, advocating an open defecation-free environment, and practicing a community-led total sanitation and hygiene approach might be helpful to sustainably reduce childhood diarrhea.
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Affiliation(s)
- Tarikuwa Natnael
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mistir Lingerew
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Metadel Adane
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
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Bennion N, Mulokozi G, Allen E, Fullmer M, Kleinhenz G, Dearden K, Linehan M, Torres S, West J, Crookston B, Hall C. Association between WASH-Related Behaviors and Knowledge with Childhood Diarrhea in Tanzania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094681. [PMID: 33924817 PMCID: PMC8124880 DOI: 10.3390/ijerph18094681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Diarrhea remains a major cause of morbidity and mortality among children in Tanzania. The purpose of this study was to explore associations between diarrheal disease and water, sanitation, and hygiene (WASH) related behaviors and determine care-seeking predictors for diarrheal disease. METHODS Data from 9996 female primary caregivers were collected as part of a larger integrated nutrition program. Logistic regression was used to measure associations between predictor and dependent variables and diarrheal and care-seeking outcomes. RESULTS Knowledge of the importance of handwashing after assisting a child who has defecated (OR 0.79, CI 0.72-0.87), before preparing food (OR 0.88, CI 0.80-0.97), and before feeding a child (OR 0.89, CI 0.81-0.99) were each associated with not having a child with diarrhea in the past two weeks. Fathers or male caregivers (OR 0.65, CI 0.48-0.89) were less likely to seek medical care for a child with diarrhea. No associations were found between WASH-related knowledge or behavior and seeking medical care for a child with diarrhea. CONCLUSIONS Findings indicate that knowledge of handwashing importance was significant in washing hands after assisting a child who has defecated, before preparing food, and prior to feeding a child. These findings demonstrate the value of parental involvement to lower morbidity and mortality among children.
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Affiliation(s)
- Natalie Bennion
- Department of Public Health, Brigham Young University, LSB, Provo, UT 84602, USA; (E.A.); (M.F.); (G.K.); (J.W.); (B.C.); (C.H.)
- Correspondence:
| | - Generose Mulokozi
- IMA World Health, Nyalali Curve, PO Box 9260, Plot 1657, Dar es Salaam, Tanzania;
| | - Emily Allen
- Department of Public Health, Brigham Young University, LSB, Provo, UT 84602, USA; (E.A.); (M.F.); (G.K.); (J.W.); (B.C.); (C.H.)
| | - Margaret Fullmer
- Department of Public Health, Brigham Young University, LSB, Provo, UT 84602, USA; (E.A.); (M.F.); (G.K.); (J.W.); (B.C.); (C.H.)
| | - Gwen Kleinhenz
- Department of Public Health, Brigham Young University, LSB, Provo, UT 84602, USA; (E.A.); (M.F.); (G.K.); (J.W.); (B.C.); (C.H.)
| | - Kirk Dearden
- IMA World Health, 1730 M St NW #1100, Washington, DC 20036, USA; (K.D.); (M.L.)
| | - Mary Linehan
- IMA World Health, 1730 M St NW #1100, Washington, DC 20036, USA; (K.D.); (M.L.)
| | - Scott Torres
- RTI International, 701 13th St NW #750, Washington, DC 20005, USA;
| | - Joshua West
- Department of Public Health, Brigham Young University, LSB, Provo, UT 84602, USA; (E.A.); (M.F.); (G.K.); (J.W.); (B.C.); (C.H.)
| | - Benjamin Crookston
- Department of Public Health, Brigham Young University, LSB, Provo, UT 84602, USA; (E.A.); (M.F.); (G.K.); (J.W.); (B.C.); (C.H.)
| | - Cougar Hall
- Department of Public Health, Brigham Young University, LSB, Provo, UT 84602, USA; (E.A.); (M.F.); (G.K.); (J.W.); (B.C.); (C.H.)
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Turyare MD, Mativo JN, Kerich M, Ndiritu AK. Prevalence and socio-demographic determinants of diarrhea among children below 5 years in Bondhere district Somalia. Pan Afr Med J 2021; 38:391. [PMID: 34381535 PMCID: PMC8325449 DOI: 10.11604/pamj.2021.38.391.21636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 05/08/2020] [Indexed: 11/25/2022] Open
Abstract
Introduction globally diarrhea is rated as the second leading cause of mortality among children below the age of five years. The highest rates of morbidity and mortality as a result of diarrhea are reported in sub-Saharan Africa and South East Asia. Studies have documented Somalia as among the countries with significant high rates of diarrhea among children below the age of 5 years. The aim of the study was to assess the prevalence and socio-demographic determinants of diarrhea. Methods the study employed a descriptive cross-sectional study design where data was collected using semi structured questionnaires. Simple random sampling was employed to identify caregivers that were included in the study. The data collected was analyzed using SPSS version 20 at 95% confidence interval. Both descriptive and regression analysis were carried out. The data was presented using tables and graphs. Ethical clearance was sought from University of Eastern Africa Baraton ethical review committee. Permission and consent were sought from the administrative leadership of Bondhere district and caregivers respectively. Results the prevalence of diarrhea among children under 5 years was 22.4%. Socio-demographic factors reported to significantly influence the prevalence of diarrhea among children under years were caregiver education level and number of children under 5 years. Conclusion the prevalence of diarrhea among children under 5 years was considerably high. Several socio-demographic factors were associated with diarrhea. The study recommends improvement of education and sensitization of communities on family planning.
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Affiliation(s)
- Mahad Dahir Turyare
- Department of Nutrition, UNICEF, Mogadishu, Somalia.,Department of Public Health, Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
| | - Japheth Nzioki Mativo
- Department of Public Health, Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
| | - Mary Kerich
- Department of Public Health, Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
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Assefa GM, Sherif S, Sluijs J, Kuijpers M, Chaka T, Solomon A, Hailu Y, Muluneh MD. Gender Equality and Social Inclusion in Relation to Water, Sanitation and Hygiene in the Oromia Region of Ethiopia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084281. [PMID: 33920729 PMCID: PMC8073105 DOI: 10.3390/ijerph18084281] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 11/16/2022]
Abstract
The main purpose of the study was to deepen the understanding of gender and social inclusion in the context of water, sanitation, and hygiene (WASH) in the Oromia region of Ethiopia. An explorative qualitative study was conducted in three districts of the Oromia region using gender analysis frameworks. Twenty-one key informant interviews and nine focus group discussions were conducted. Findings showed 52% of households in the study area have basic service level water, 29% have basic service level sanitation, and 14% have basic service level hygiene. Women, girls, and people living with disability disproportionately experience poor access to quality WASH services. Women and girls participate in unequal domestic labor related to water management which often exposes them to discrimination and violence such as rape, abduction, and assault. Overall, women, girls, and other socially excluded groups are rarely consulted and engaged by local actors. This results in incongruent policy and political commitment which limits action at the grassroots level. Integrating gender equality and inclusion efforts into local governance agendas can help to increase access to and the quality of WASH services. These efforts must advocate for moving beyond gender parity to promote gender transformative approaches and inclusion to realize better WASH services for the communities they serve.
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Affiliation(s)
- Geteneh Moges Assefa
- Monitoring, Evaluation and Research Department, Amref Health Africa in Ethiopia, P.O. Box 20855, Addis Ababa 1000, Ethiopia;
- Correspondence: ; Tel.: +251-913141467
| | | | - Jose Sluijs
- Amref Flying Doctors, Leiden, Schuttersveld 9, 2316 XG Leiden, The Netherlands; (J.S.); (M.K.)
| | - Maarten Kuijpers
- Amref Flying Doctors, Leiden, Schuttersveld 9, 2316 XG Leiden, The Netherlands; (J.S.); (M.K.)
| | - Tamene Chaka
- Amref Health Africa in Ethiopia, P.O. Box 20855, Addis Ababa 1000, Ethiopia; (T.C.); (A.S.); (Y.H.)
| | - Arsema Solomon
- Amref Health Africa in Ethiopia, P.O. Box 20855, Addis Ababa 1000, Ethiopia; (T.C.); (A.S.); (Y.H.)
| | - Yeshitila Hailu
- Amref Health Africa in Ethiopia, P.O. Box 20855, Addis Ababa 1000, Ethiopia; (T.C.); (A.S.); (Y.H.)
| | - Muluken Dessalegn Muluneh
- Monitoring, Evaluation and Research Department, Amref Health Africa in Ethiopia, P.O. Box 20855, Addis Ababa 1000, Ethiopia;
- School of Nursing and Midwifery, Western Sydney University, Sydney 2751, Australia
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Sahiledengle B, Teferu Z, Tekalegn Y, Zenbaba D, Seyoum K, Atlaw D, Chattu VK. A Multilevel Analysis of Factors Associated with Childhood Diarrhea in Ethiopia. ENVIRONMENTAL HEALTH INSIGHTS 2021; 15:11786302211009894. [PMID: 33953568 PMCID: PMC8056729 DOI: 10.1177/11786302211009894] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 03/18/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Childhood diarrhea is the major contributor to the deaths of children under the age of 5 years in Ethiopia, but evidence at the national level to identify the contributing factors associated with diarrhea by considering the clustering effects is limited. Hence, this study aimed to identify factors associated with childhood diarrhea at the individual and community levels. METHODS A secondary data analysis was conducted using the 2011 and 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total of 23 321 children with their mothers were included in this study, and multilevel logistic regression models were applied for the data analysis. RESULTS The odds of diarrhea among female children were 13% lower (AOR = 0.87; 95% CI: 0.79-0.94) compared with male children. The odds of diarrhea among children aged between 13 and 24 months were 31% higher than (AOR = 1.31; 95% CI: 1.17-1.47) their younger counter parts. Children aged ⩾25 months (AOR = 0.50; 95% CI: 0.45-0.56), those whose mothers were unemployed (AOR = 0.79; 95% CI: 0.73-0.87), and children live in households between 2 and 3 under-5 children (AOR = 0.87; 95% CI: 0.79-0.96) were associated with lower odds of experiencing diarrhea. The odds of diarrhea among children whose mother had no formal education were 49% higher than (AOR = 1.49; 95% CI: 1.08-2.07) their counterparts. Besides, children residing in city administrations (AOR = 0.69; 95% CI: 0.58-0.82) had lower odds of experiencing diarrhea than children living in agrarian regions. CONCLUSIONS At the individual level (sex and age of the child, mother's employment status, and educational level, and the number of under-5 children) and the community-level (contextual region) were found to be significant factors associated with childhood diarrhea in Ethiopia.
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Affiliation(s)
- Biniyam Sahiledengle
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Zinash Teferu
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Yohannes Tekalegn
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Demisu Zenbaba
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Kenbon Seyoum
- Department of Midwifery, Goba Referral Hospital, School of Health Science, Madda Walabu University, Bale-Goba, Ethiopia
| | - Daniel Atlaw
- Department of Human Anatomy, Goba Referral Hospital, School of Health Science, Madda Walabu University, Bale-Goba, Ethiopia
| | - Vijay Kumar Chattu
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Getaneh DK, Hordofa LO, Ayana DA, Tessema TS, Regassa LD. Prevalence of Escherichia coli O157:H7 and associated factors in under-five children in Eastern Ethiopia. PLoS One 2021; 16:e0246024. [PMID: 33508023 PMCID: PMC7842931 DOI: 10.1371/journal.pone.0246024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 01/12/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Escherichia coli O157:H7 (E. coli O157:H7) is one of the most potent zoonotic pathogens that causes mild diarrhea and leads to hemolytic uremic syndrome or death. This study was aimed to assess the prevalence and determinants of E. coli O157:H7 related to diarrhea among under-five children with acute diarrhea. METHODS A cross-sectional study design was carried out in 2018 on 378 under-five-year children recruited randomly from hospitals in Eastern Ethiopia. Stool specimens were collected and processed using enrichment, differential and selective medium. Among isolates, E. coli O157:H7 was confirmed using latex test (Oxoid, Basingstoke, Hants, England). Factors associated with E. coli O157:H7 infection were identified using binary and multivariable logistic regression. Associations were reported by odds ratio with 95% confidence interval. RESULTS The prevalence of E. coli O157:H7 related diarrhea was 15.3% (95%CI: 11.8-19.5). The E. coli O157:H7 infection was positively associated with rural residence (AOR;3.75, 95%CI:1.26-11.20), consumption of undercooked meat (AOR;3.95, 95%CI: 1.23-12.67), raw vegetables and/or fruit juice (AOR;3.37, 95%CI:1.32-8.62), presence of bloody diarrhea (AOR;4.42, 95% CI:1.78-10.94), number of under-five children in a household (AOR;7.16, 95%CI: 2.90-17.70), presence of person with diarrhea in a household (AOR;4.22, 95% CI: 1.84-12.69), owning domestic animal (AOR;3.87, 95% CI: 1.48-10.12) and uneducated mother (AOR;3.14, 95%CI: 1.05-9.42). CONCLUSION The Prevalence of E. coli O157:H7 related diarrhea among under-five children is relatively high in Eastern Ethiopia. The E. coli infection was associated with sanitation and hygiene in a household. Thus, education focused on food cooking and handling, child care, and household sanitation associated with animal manure in rural resident children are helpful in.
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Seidu AA. Are children's stools in Ghana disposed of safely? Evidence from the 2014 Ghana demographic and health survey. BMC Public Health 2021; 21:113. [PMID: 33422043 PMCID: PMC7797132 DOI: 10.1186/s12889-021-10155-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 01/01/2021] [Indexed: 12/03/2022] Open
Abstract
Background Safe disposal of children’s faeces has always been one of the main challenges to good hygiene in Ghana. Although it has been proven that children’s faeces are more likely to spread diseases than adults’ faeces, people usually mistake them for harmlessness. This study, therefore, sought to determine the prevalence and factors associated with safe disposal of children’s faeces in Ghana. Methods Data from the 2014 Ghana Demographic and Health Survey was used for the analysis. A sample size of 2228 mother-child pairs were used for the study. The outcome variable was disposal of children stools. Both bivariate and multivariable logistic regression analyses were performed to identify the factors with safe child stool disposal. Results The prevalence of safe child stool disposal in Ghana was 24.5%. Women in the middle [Adjusted odds ratio (AOR) = 4.62; Confidence Interval (CI) = 3.00–7.10], Coastal Zone [AOR = 4.52; CI = 2.82–7.22], mothers whose children were aged 12–17 [AOR = 1.56; CI = 1.15–2.13] and 18–23 months [AOR = 1.75; CI = 1.29–2.39], and mothers whose household had improved type of toilet facility [AOR = 2.04; CI = 1.53–2.73] had higher odds of practicing safe children’s faeces disposal. However, women from households with access to improved source of drinking water [AOR = 0.62; CI = 0.45–2.7] had lower odds of practicing safe children’s faeces disposal. Conclusion Approximately only about 25 out of 100 women practice safe disposal of their children’s faeces in Ghana. The age of the child, ecological zone, the type of toilet facilities, and the type of drinking water source are associated with the disposal of child faeces. These findings have proven that only improved sanitation (i.e. drinking water and toilet facilities) are not enough for women to safely dispose of their children’s faeces. Therefore, in addition to provision of toilet facilities especially in the northern zone of Ghana, there is also the need to motivate and educate mothers on safe disposal of children’s stools especially those with children below 12 months. More so, mothers without access to improved toilet facility should also be educated on the appropriate ways to bury their children’s stools safely. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10155-7.
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Affiliation(s)
- Abdul-Aziz Seidu
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana. .,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.
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Damtew YT, Geremew A. Households with unimproved water sources in Ethiopia: spatial variation and point-of-use treatment based on 2016 Demographic and Health Survey. Environ Health Prev Med 2020; 25:81. [PMID: 33287699 PMCID: PMC7722338 DOI: 10.1186/s12199-020-00921-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 11/25/2020] [Indexed: 11/10/2022] Open
Abstract
Background Improved water sources are not equally available in all geographical regions. Populations dependent on unsafe water sources are recommended to treat their water at point-of-use using adequate methods to reduce associated health problems. In Ethiopia, the spatial distribution of households using unimproved water sources have been incomplete or ignored in most of the studies. Moreover, evidence on the point-of-use water treatment practice of households dependent on such water sources is scarce. Therefore, the current study is intended to analyze the spatial distribution of unimproved water sources by wealth quintiles at country level and point-of-use treatment (POU) practices using nationally representative data. Method The data of 2016 Ethiopian Demographic and Health Survey (EDHS) conducted on 16650 households from 643 clusters were used for the analysis. For spatial analysis, the raw and spatially smoothed coverage data was joined to the geographic coordinates based on EDHS cluster identification code. Global spatial autocorrelation was performed to analyze whether the pattern of unimproved water coverage is clustered, dispersed, or random across the study areas. Once a positive global autocorrelation was confirmed, a local spatial autocorrelation analysis was applied to detect local clusters. The POU water treatment is analyzed based on reported use of either boiling, chlorine (bleach), filtration, or solar disinfection (SODIS). Results There were 5005 households using unimproved water sources for drinking purposes. Spatial variation of unimproved water coverage was observed with high coverage observed at Amhara, Afar, Southern Nations Nationalities and People and Somalia regions. Disparity in unimproved water coverage between wealth quintiles was also observed. The reported point-of-use water treatment practice among these households is only 6.24%. The odds of POU water treatment among household heads with higher education status is 2.5 times higher (95% CI = 1.43-4.36) compared to those who did not attend education. Conclusion An apparent clustering trend with high unimproved water coverage was observed between regions and among wealth quintiles hence indicates priority areas for future resource allocation and the need for regional and national policies to address the issue. Promoting households to treat water prior to drinking is essential to reduce health problems.
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Affiliation(s)
- Yohannes Tefera Damtew
- Department of Environmental Health, College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Abraham Geremew
- Department of Environmental Health, College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia.
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Prevalence of vancomycin-resistant enterococcus in Africa in one health approach: a systematic review and meta-analysis. Sci Rep 2020; 10:20542. [PMID: 33239734 PMCID: PMC7688635 DOI: 10.1038/s41598-020-77696-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 11/02/2020] [Indexed: 11/08/2022] Open
Abstract
Vancomycin-resistant enterococci are a global challenge currently as reported by the World Health Organization. It is also important to recognize that combating antimicrobial resistance needs to recognize the interconnections between people, animals, plants and their shared environment in creating public health, the so-called One Health approach. Although the presence of VRE has been described in many regions of the world, there is a lack of comprehensive data indicating their prevalence of in Africa. Therefore, this study aimed to aggregate the result of studies describing VRE reported across multiple regions in Africa. A literature search was conducted on PubMed, Google scholar, and Hinari with the term “Vancomycin resistance enterococcus in Africa” on August 1–3, 2019. All available articles were downloaded to “Endnote version 7.1” then to Microsoft Word 2013. Articles determined to meet our criteria for the review was extracted to Microsoft Excel 2013. Those articles that reported the prevalence of vancomycin resistance Enterococcus obtained from all sample types and published from 2010 to 2019 in the English language were included for the review. A meta-analysis was conducted with OpenMetaAnalyst version R.3.1.0 software. The effect size was determined using a binary random effect model and statically significant considered when p < 0.05. Heterogeneity determined with the inconsistency index. A leave one out analysis used to perform the sensitivity analysis. There were 151 articles identified from the database searches; of this, 36 articles included after extensive review with two independent authors. Out of 4073 samples collected, 1488 isolates identified with an overall pooled prevalence of VRE 26.8% (95% CI; 10.7–43.0%) in Africa with a one-health perspective. The analysis showed that considerable heterogeneity among the studies (I2 = 99.97%; p < 0.001). Subgroup analysis in-country, African region, laboratory method, year of publication, and sample source showed that a high prevalence was identified from South Africa (74.8%), South African regions (74.8%), PCR (959.2%), 2010–2015 years (30.3%) and environmental (52.2%), respectively. This meta-analysis indicates that there was a high-pooled prevalence of vancomycin-resistant enterococci in African. A lot should be done to prevent and control the transmission of vancomycin resistance enterococci to a human being from the environment in the continent.
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Rissman L, Deavenport-Saman A, Corden MH, Zipkin R, Espinoza J. A pilot project: handwashing educational intervention decreases incidence of respiratory and diarrheal illnesses in a rural Malawi orphanage. Glob Health Promot 2020; 28:14-22. [PMID: 33103585 DOI: 10.1177/1757975920963889] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Children who live in orphanages represent a population particularly vulnerable to transmissible diseases. Handwashing interventions have proven efficacy for reducing the rate of transmission of common infectious diseases. Few studies have analyzed the delivery of health interventions for children in orphanages in sub-Saharan Africa. To address this gap, we conducted an ecological assessment and piloted a handwashing intervention in an orphanage in rural Malawi, focusing on caregiver knowledge and behaviors, child handwashing behaviors, and disease incidence. A secondary study aim was to demonstrate program feasibility for a future randomized controlled trial. Orphanage caregivers participated in a three-module educational intervention on handwashing based on WHO recommendations and workshops on how to teach the curriculum to children. Seventeen orphanage caregivers and 65 children were monitored for handwashing behavior and child disease incidence. Friedman's tests were conducted to compare changes in caregiver knowledge and behaviors. Child handwashing behaviors and surveillance of child disease incidence were measured pre- and post-intervention. There were significant increases in caregiver hand hygiene knowledge. At six months post-intervention, handwashing with soap increased significantly among caregivers (p < 0.001) and was observed in children. The incidence of acute respiratory infections decreased from 30% to 6% post-intervention, resulting in an 80% decrease. The incidence of diarrhea decreased from 9.2% to 6.2% post-intervention, resulting in a 33% decrease. A brief educational intervention may improve handwashing knowledge and behaviors and help to decrease the incidence of common infectious diseases in an orphanage in rural Malawi. In addition, the caregiver uptake of the intervention demonstrated feasibility for future studies.
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Affiliation(s)
- Lauren Rissman
- Division of Pediatric Critical Care, Ann and Robert H. Lurie Children's Hospital of Chicago, USA
| | - Alexis Deavenport-Saman
- Division of General Pediatrics, Department of Pediatrics, Children's Hospital Los Angeles, USA.,Department of Pediatrics, Keck School of Medicine, University of Southern California, USA
| | - Mark H Corden
- Department of Pediatrics, Keck School of Medicine, University of Southern California, USA.,Division of Hospital Medicine, Department of Pediatrics, Children's Hospital Los Angeles, USA
| | - Ronen Zipkin
- Department of Pediatrics, Keck School of Medicine, University of Southern California, USA.,Division of Hospital Medicine, Department of Pediatrics, Children's Hospital Los Angeles, USA
| | - Juan Espinoza
- Division of General Pediatrics, Department of Pediatrics, Children's Hospital Los Angeles, USA.,Department of Pediatrics, Keck School of Medicine, University of Southern California, USA
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Zenebe T, Mitiku M, Alem Y. Prevalence of Escherichia coli in Under-Five Children with Diarrhea in Ethiopia: A Systematic Review and Meta-Analysis. Int J Microbiol 2020; 2020:8844294. [PMID: 32963539 PMCID: PMC7492924 DOI: 10.1155/2020/8844294] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/26/2020] [Indexed: 11/26/2022] Open
Abstract
Diarrhea remains as a high health burden, especially to children in low-income countries including Ethiopia. Diarrheagenic Escherichia coli have been commonly associated as bacterial pathogens causing diarrheal disease among children. This systemic review and meta-analysis was intended to determine the pooled prevalence of Escherichia coli in under-five children with diarrhea in Ethiopia. A comprehensive search in PubMed, Google Scholar, ScienceDirect, ResearchGate, and Google search engine and manual searching were done for this systematic review and meta-analysis. The eligibility criteria for selecting studies were studies involving under-five children with diarrhea in Ethiopia, published articles, cross-sectional studies, and articles reported in English. The study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. The data analysis was done using STATA 16.0 software. Cochran's Q-test and I 2 statistics were used for the assessment of heterogeneity. The random-effect model was used to estimate the pooled prevalence of Escherichia coli. A total of 797 articles were initially retrieved, and finally, 11 studies met the eligibility criteria and were included in the final meta-analysis. The pooled prevalence of Escherichia coli was 25% (95% CI: 9, 41). The pooled prevalence was varied by region, detection method, and sample size. The high prevalence emphasizes that Escherichia coli is a potential pathogen in under-five children with diarrhea in Ethiopia.
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Affiliation(s)
- Tizazu Zenebe
- Department of Medicine, Medical Microbiology Unit, DebreBerhan University, DebreBerhan, Ethiopia
| | - Meseret Mitiku
- Department of Medical Laboratory Sciences, MaddaWalabu University, Bale Robe, Ethiopia
| | - Yonas Alem
- Department of Medical Laboratory Sciences, Ambo University, Ambo, Ethiopia
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Delelegn MW, Endalamaw A, Belay GM. <p>Determinants of Acute Diarrhea Among Children Under-Five in Northeast Ethiopia: Unmatched Case–Control Study</p>. Pediatric Health Med Ther 2020; 11:323-333. [PMID: 32982540 PMCID: PMC7490045 DOI: 10.2147/phmt.s256309] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 08/17/2020] [Indexed: 11/23/2022] Open
Abstract
Background Diarrheal disease is the second leading causes of death among under-five children. Most of the death due to diarrhea is reporting in developing countries. To prevent this highly prevalent problem, identifying the contributing factors across different settings is necessary. Therefore, this study aimed to identify the determinants of acute diarrhea among under-five children in the Northeast part of Ethiopia. Methods An institution-based unmatched case–control study was conducted among 306 under-five children from March to April 2019. A systematic random sampling technique was employed to select study participants. Data were collected by face to face interviews using a pretested structured questionnaire. Data were entered using Epi-info 7 and analyzed with SPSS version 20.0. We applied logistic regression analysis. Those variables with p-value <0.05 were significant determinants of acute diarrhea. Results Improper child’s stool disposal [AOR=4.12; 95% CI (1.25,13.5)], absence of home-based water treatment [AOR=2.85; 95% CI (1.27,6.42)], did not wash hand at critical times [AOR=5.47; 95% CI (1.68,17.8)], did not practice exclusive breastfeed [AOR=3.32; 95% CI (1.21,9.14], unable to get counseling from health professionals [AOR= 3.23; 95%,CI (1.15,13.5)], provide left over food to the child [AOR=2.96; 95% CI (1.19,7.32)], and maternal diarrhea [AOR=6.06; 95% CI (2.42,15.22)] were determinants of acute diarrhea among under five children. Conclusion Most of the determinants of acute diarrhea could be preventable. Thus, collaborative intervention by emphasizing health education about the importance of personal and environmental hygiene, safe food handling, exclusive breastfeeding practice, and home-based water treatment are essential.
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Affiliation(s)
- Mekdess Wesenyeleh Delelegn
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Aklilu Endalamaw
- Department of Pediatrics and Child Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Correspondence: Aklilu Endalamaw Department of Pediatrics and Child Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, P.O. Box 79, Bahir Dar, EthiopiaTel +251 945842524 Email
| | - Getaneh Mulualem Belay
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Fetensa G, Fekadu G, Tekle F, Markos J, Etafa W, Hasen T. Diarrhea and associated factors among under-5 children in Ethiopia: A secondary data analysis. SAGE Open Med 2020; 8:2050312120944201. [PMID: 32821387 PMCID: PMC7406926 DOI: 10.1177/2050312120944201] [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] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 06/25/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives Diarrhea is a major contributing factor for preventable childhood morbidity and death. Despite the occurrence of diarrhea is decreasing, its effect is increasing at an alarming rate among under-5 children particularly in developing countries. The survey was aimed to assess diarrhea and associated factors among children less than 5 years (0-59 months) in Ethiopia with nationally representative data. Methods The data were extracted from the Ethiopian National Survey of 2016. A logistic regression model was undertaken to identify the contributing factors for childhood diarrhea. Variables with p < 0.05 were considered as independent predictors of childhood diarrhea. Results From a total of 10,641 under-5 children, 5483(51.5%) were males and most of the children (62.3%) were above 24 months. About 10.2% had diarrhea 14 days before data collection, and the majority (93.1%) were born to married mothers. Receiving no treatment or advice for fever/cough (adjusted odd ratio (AOR) = 0.170, 95% confidence interval (CI): 0.139-0.208, p = 0.001), being permanent residence (AOR = 0.583, 95% CI: 0.347-0.982, p = 0.043), initiating breastfeeding after 24 h of birth (AOR = 1.553, 95% CI: 1.197-2.015, p = 0.001), and lack of prenatal care (AOR = 2.142, 95% CI: 0.624-0.875, p = 0.001) were independent predictors of diarrhea among under-5 children's in Ethiopia. Conclusion The result of this survey indicated that diarrhea is a significant health challenge among under-5 children. To tackle this illness, sufficient education on child and maternal health has to be provided for mothers focusing on predictive factors.
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Affiliation(s)
- Getahun Fetensa
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Ginenus Fekadu
- Clinical Pharmacy Unit, Department of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Firew Tekle
- Department of Public health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Jote Markos
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Werku Etafa
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Tahir Hasen
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
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Solomon ET, Gari SR, Kloos H, Mengistie B. Diarrheal morbidity and predisposing factors among children under 5 years of age in rural East Ethiopia. Trop Med Health 2020; 48:66. [PMID: 32774129 PMCID: PMC7409453 DOI: 10.1186/s41182-020-00253-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diarrheal diseases remain a leading cause of preventable death among children under-five in low- and middle-income countries (LMICs). In Ethiopia, diarrhea is the major contributor to deaths for children under the age of 5 years. In order to develop prevention strategies for the alleviation of childhood diarrhea, it is necessary to identify the important predisposing factors. These predisposing factors have been observed to vary by location across Eastern Ethiopia. Moreover, the evidence on prevalence and determinants of diarrhea among children under 5 years of age in Dire Dawa and its suburbs is very limited and those available have been erratic. The objective of this study was to determine the prevalence and predisposing factors of diarrhea among children under the age of 5 years in rural Dire Dawa, East Ethiopia. METHODS A community-based cross-sectional study was conducted in rural Dire Dawa City Administration in May 2018. Multistage sampling technique was employed to recruit 1180 under-five children from the rural population of Dire Dawa City Administration. Data on socio-demographic, environmental, and child hygiene-related factors were collected by trained data collectors using a structured questionnaire. Logistic regression was used to identify independent risk factors for childhood diarrhea. RESULTS The 2-week prevalence of diarrhea among the under-five children was 23% (95% CI 20.8-25.7%). Maternal diarrhea (AOR = 2.22, 95% CI 1.10-4.47), handwashing after contact with child feces (AOR = 6.27, 95% CI 2.01-19.55), use of a dipper to draw water from containers (AOR = 2.88, 95% CI 1.41-5.89), and presence of a refuse disposal facility (AOR = 2.47, 95% CI 1.09-5.60) were the significant predisposing factors of diarrhea. CONCLUSION Our study identified a high burden of childhood diarrheal disease in rural Dire Dawa City Administration in Eastern Ethiopia. The identified risk factors were maternal diarrhea, handwashing after contact with child feces, use of a dipper to draw water from containers, and presence of refuse disposal facility. To minimize the risk of diarrhea, health education programs focusing on good hygiene practice and sanitation as well as early treatment are recommended.
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Affiliation(s)
- Ephrem Tefera Solomon
- Ethiopian Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Sirak Robele Gari
- Ethiopian Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia
| | - Helmut Kloos
- San Francisco Medical Center, University of California, San Francisco, CA USA
| | - Bezatu Mengistie
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Prevalence and Determinants of Diarrhea among Under-Five Children in Benna Tsemay District, South Omo Zone, Southern Ethiopia: A Community-Based Cross-Sectional Study in Pastoralist and Agropastoralist Context. ADVANCES IN PUBLIC HEALTH 2020. [DOI: 10.1155/2020/4237368] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background. Diarrhea is the second leading cause of death among children under-five years globally and accounts for about 1.5 million deaths each year. In low-income countries, children under three years of age experience three episodes of diarrhea on average every year. In Ethiopia, diarrheal disease is one of the common causes of mortality in under-five children. In Benna Tsemay district, pastoralist community lives with lack of clean water, sanitation, and hygiene problems, which increase the risk of childhood diarrhea. Objective. To assess the prevalence and determinant of diarrheal disease among under five children in Benna Tsemay District, South Omo Zone, Southern Ethiopia. Methods. A community-based cross-sectional study was conducted on a sample of 722 under five children selected randomly from eight pastoralists and two agropastoralist kebels. Data were collected using an interviewer-administered questionnaire. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20. Logic regression was performed to identify the association between diarrheal disease and independent variables. Adjusted odds ratio with 95% confidence intervals (CIs) was used to judge the presence of association. Results. The two-week period prevalence of childhood diarrheal disease in the study was 23.5% (95% CI: 20.4%–26.6%). Diarrheal illness was associated with nonavailability of latrine (AOR: 2.77, 95% CI: 1.66–4.63), faeces seen around the pit hole or floor of latrine (AOR: 2.92, 95% CI: 1.38–6.19), improper kitchen waste disposal (AOR: 2.31, 95% CI: 1.26–4. 24), unprotected drinking water source (AOR: 1.81, 95% CI: 1.14–2.88), mother’s or caretaker’s diarrhea history in the last two weeks (AOR: 6.74, 95% CI: 2.51–18.07), materials used for feeding the child (cup and spoon) (AOR: 0.60, 95% CI: 0.36–0.97), and being unvaccinated for “rotavirus” (AOR: 2.87, 95% CI: 1.86–4.44). Conclusion. Nearly one-fourth of children had diarrheal illness in the preceding two weeks. Water, sanitation and hygiene-related factors, child feeding practice, and children’s vaccination status for rotavirus were the determinants of the occurrence of diarrhea among under-five children. The health office should conduct sustainable health education programs that emphasize on risk of open defecation, waste disposal mechanisms, and child feeding practices and also should strengthen rotavirus vaccination activities. The district administration and partners’ needed to improve water sources.
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Overbey KN, Schwab KJ, Exum NG. Comparison of 1-week and 2-week recall periods for caregiver-reported diarrhoeal illness in children, using nationally representative household surveys. Int J Epidemiol 2020; 48:1228-1239. [PMID: 30907423 PMCID: PMC6693818 DOI: 10.1093/ije/dyz043] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Diarrhoeal outcomes in children are often ascertained using caregiver-reported symptoms, which are subject to a variety of biases and methodological challenges. One source of bias is the time window used for reporting diarrhoeal illness and the ability of caregivers to accurately recall episodes in children. METHODS Diarrhoea period prevalence in children under five was determined using two similarly administered, nationally representative household surveys: Performance Monitoring and Accountability 2020 (PMA2020) (1-week recall, N = 14 603) and Demographic and Health Surveys (DHS) (2-week recall, N = 66 717). Countries included in the analysis were the Democratic Republic of the Congo, Ethiopia, Ghana, Kenya and Uganda. Diarrhoea period prevalence estimates were compared and water, sanitation and hygiene risk factors were analysed. RESULTS Childhood diarrhoea prevalence using 1-week recall (PMA2020) pooled across countries was 21.4% [95% confidence interval (CI): 19.9%, 22.9%] versus 16.0% using 2-week recall (DHS) (95% CI: 15.4%, 16.5%). In stratified analyses for all five countries, the number of diarrhoea cases detected was consistently higher using 1-week recall versus 2-week recall. The key risk factors identified in the PMA2020 data that were not associated with diarrhoeal episodes or were attenuated in the DHS data included: the main sanitation classifications for households, disposal method used for child faeces, number of household members and wealth quintiles. CONCLUSIONS For nationally representative household surveys assessing childhood diarrhoea period prevalence, a 2-week recall period may underestimate diarrhoea prevalence compared with a 1-week period. The household sanitation facility and practices remain key risk factors for diarrhoeal disease in children under five.
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Affiliation(s)
- Katie N Overbey
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Kellogg J Schwab
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Natalie G Exum
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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Shine S, Muhamud S, Adanew S, Demelash A, Abate M. Prevalence and associated factors of diarrhea among under-five children in Debre Berhan town, Ethiopia 2018: a cross sectional study. BMC Infect Dis 2020; 20:174. [PMID: 32093615 PMCID: PMC7041267 DOI: 10.1186/s12879-020-4905-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 02/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diarrhea is responsible for 525,000 children under-five deaths and 1.7 billion cases globally and is the second leading cause of death among children under-five every year. It is a major public health problem in low income countries like Ethiopia. The main aim of this study was to assess the prevalence of diarrhea and associated risk factors among children under-five in Debre Berhan Town, Ethiopia. METHODS A community-based cross-sectional study was conducted in 420 parent or caretaker/children pairs in Debre Berhan town between 13 and 18 April 2018. A multi-stage sampling strategy was used to select the study participants. Data were collected using pre-tested and structured questionnaires. Data were entered in Epi-info computer software version 3.5.1 and exported to SPSS Window Version-16 for analysis. Adjusted odds ratio with 95% confidence intervals were used to assess the level of significance. RESULTS The two week prevalence of diarrhea among children under-five was 16.4% (69/351). Children aged 7-11 months (adjusted odds ratio (AOR): 4.2, 95% confidence interval (CI): 1.2-15.3), being the second-born child (AOR: 3.9, 95%CI: 1.8-8.5), not vaccinated against rotavirus (AOR: 10.3, 95%CI: 3.2-91.3) and feeding children by hand (AOR: 2.5, 95%CI: 1.1-6.1) were significant predictors of diarrhea. CONCLUSIONS This study revealed that the two weeks period prevalence of diarrhea among children under-five years was 16.4%. Education programs on the importance of vaccination against rotavirus, increasing breast feeding frequency with complementary food after six months and the critical points of hand washing are recommended.
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Affiliation(s)
- Sisay Shine
- Public Health Department, College of Health Science, Debre Berhan University, P.O.Box: 445, Debre Berhan, Ethiopia.
| | - Sindew Muhamud
- Nursing Department, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Solomon Adanew
- Midwifery Department, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Alebachew Demelash
- Nursing Department, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Makda Abate
- Midwifery Department, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
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Nisa I, Qasim M, Driessen A, Nijland J, Bari F, Haroon M, Rahman H, Yasin N, Khan TA, Hussain M, Ullah W. Molecular epidemiology of Shigella flexneri isolated from pediatrics in a diarrhea-endemic area of Khyber Pakhtunkhwa, Pakistan. Eur J Clin Microbiol Infect Dis 2020; 39:971-985. [PMID: 31938959 DOI: 10.1007/s10096-020-03811-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 01/02/2020] [Indexed: 10/25/2022]
Abstract
Shigella flexneri is considered as an important causative agent of Shigellosis causing diarrhea in the countries with a low socioeconomic status. No study has been carried out on the molecular prevalence of S. flexneri in Khyber Pakhtunkhwa, Pakistan. So this study was designed to evaluate the molecular prevalence of S. flexneri and their associated risk factors. A total of 2014 diarrheal stool samples were collected from January 2016 to May 2017 from pediatrics patients of Khyber Pakhtunkhwa followed by identification of S. flexneri through biochemical, serological, and molecular methods. The overall prevalence of Shigella species was found to be 7.9% (n = 160). The predominant Shigella specie was S. flexneri (n = 155, 96.8%) followed by S. boydii (n = 5, 3.1%). Interestingly, no sample was found positive for S. sonnei and S. dysenteriae. The majority of Shigellosis cases occurred from June to September. Potential risk factors related with Shigellosis were unhygienic latrine usage, bad hand washing, and consumption of unhygienic food and water, and pipe leakage in the sewage system. In this study, we have observed a high number of Shigellosis cases especially those caused by S. flexneri. It is suggested that effective health awareness programs should be organized by the regional health authorities to minimize the magnitude of pediatrics Shigellosis.
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Affiliation(s)
- Iqbal Nisa
- Department of Microbiology, Kohat University of Science and Technology, Kohat, 26000, Pakistan
| | - Muhammad Qasim
- Department of Microbiology, Kohat University of Science and Technology, Kohat, 26000, Pakistan.
| | - Arnold Driessen
- Department of Molecular Microbiology, Groningen Biomolecular Sciences, and Biotechnology Institute, Faculty of Science and Engineering, Rijksuniversiteit Groningen, Groningen, The Netherlands
| | - Jeroen Nijland
- Department of Molecular Microbiology, Groningen Biomolecular Sciences, and Biotechnology Institute, Faculty of Science and Engineering, Rijksuniversiteit Groningen, Groningen, The Netherlands
| | - Fazli Bari
- Department of Pathology, Lady Reading Hospital, Peshawar, Pakistan.,Department of Microbiology, Nowshera Medical College, Nowshera, Pakistan
| | - Mohammad Haroon
- Department of Medicine, Khyber Teaching Hospital, Peshawar, Pakistan
| | - Hazir Rahman
- Department of Microbiology, Abdul Wali Khan University, Mardan, Pakistan
| | - Nusrat Yasin
- Department of Microbiology, Kohat University of Science and Technology, Kohat, 26000, Pakistan
| | - Taj Ali Khan
- Department of Microbiology, Kohat University of Science and Technology, Kohat, 26000, Pakistan
| | - Mubbashir Hussain
- Department of Microbiology, Kohat University of Science and Technology, Kohat, 26000, Pakistan
| | - Waheed Ullah
- Department of Microbiology, Kohat University of Science and Technology, Kohat, 26000, Pakistan
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Ullah MB, Mridha MK, Arnold CD, Matias SL, Khan MSA, Siddiqui Z, Hossain M, Paul RR, Dewey KG. Factors associated with diarrhea and acute respiratory infection in children under two years of age in rural Bangladesh. BMC Pediatr 2019; 19:386. [PMID: 31656181 PMCID: PMC6815354 DOI: 10.1186/s12887-019-1738-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 09/20/2019] [Indexed: 12/02/2022] Open
Abstract
Background Diarrhea and acute respiratory infection (ARI) are major causes of child mortality. We aimed to identify risk factors associated with diarrhea and ARI among children under 2 years of age in rural northern Bangladesh. Method We collected information on diarrhea and ARI in the previous 14 days and the previous 6 months at 6, 12, 18 and 24 months of age as part of a longitudinal, cluster randomized effectiveness trial, the Rang-Din Nutrition Study which enrolled 4011 pregnant women at ≤20 gestational weeks. Women and their children were followed up until 2 years postpartum. Information on household socioeconomic status, type of toilet, garbage disposal system, food insecurity, number of under-five children in the household, type of family, maternal characteristics and child characteristics was collected at baseline and/or at 6, 12, 18 and 24 months postpartum. Data on newborn health and feeding behaviors were collected within 72 h of delivery. Associations between potential risk factors and morbidity prevalence outcomes were assessed using logistic regression controlling for potential confounders. Results Out of 3664 live born children, we collected information from ~ 3350 children at 6, 12, 18 and 24 months of age. Diarrhea in the previous 14 days, and in the previous 6 months, was associated with maternal depression score and food insecurity; diarrhea in the previous 6 months was also associated with family type (nuclear vs. joint). ARI in the previous 14 days was associated with maternal depression score, type of toilet and garbage disposal, household food insecurity and sex. Cough or nasal discharge in the past 6 months was associated with maternal depression score, type of toilet and garbage disposal, household food insecurity, sex and perceived overall physical condition of the infant after birth. Conclusion Maternal depression and food insecurity appear to be important risk factors for diarrhea and respiratory infection among children under 2 years of age in this setting. These findings suggest that policies and programs that include strategies to address maternal mental health and household food insecurity may contribute to improved child health. Trial registration The trial was registered with the US National Institutes of Health at ClinicalTrials.gov, # NCT01715038, with registration completed October 26, 2012.
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Affiliation(s)
- Md Barkat Ullah
- Department of Nutrition, University of California, One Shields Ave., Davis, CA, 95616, USA.
| | - Malay K Mridha
- Center for Non-communicable Disease and Nutrition, James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Charles D Arnold
- Department of Nutrition, University of California, One Shields Ave., Davis, CA, 95616, USA
| | - Susana L Matias
- Department of Nutritional Sciences and Toxicology, University of California, 225 Morgan Hall, Berkeley, CA, 94720, USA
| | - Md Showkat A Khan
- Center for Non-communicable Disease and Nutrition, James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Zakia Siddiqui
- Health System and Population Studies Division, ICDDR,B, Dhaka, Bangladesh
| | - Mokbul Hossain
- Center for Non-communicable Disease and Nutrition, James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | | | - Kathryn G Dewey
- Department of Nutrition, University of California, One Shields Ave., Davis, CA, 95616, USA
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Jarman AF, Long SE, Robertson SE, Nasrin S, Alam NH, McGregor AJ, Levine AC. Sex and Gender Differences in Acute Pediatric Diarrhea: A Secondary Analysis of the DHAKA Study. J Epidemiol Glob Health 2019; 8:42-47. [PMID: 30859786 PMCID: PMC7325822 DOI: 10.2991/j.jegh.2018.08.102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 04/28/2018] [Indexed: 01/06/2023] Open
Abstract
Pediatric diarrheal disease is a significant source of morbidity and mortality in the developing world. While several studies have demonstrated an increased incidence of diarrheal illness in boys compared with girls in low- and middle-income countries (LMIC), the reasons for this difference are unclear. This secondary analysis of the dehydration: assessing kids accurately (DHAKA) derivation and validation studies included children aged <5 years old with acute diarrhea in Dhaka, Bangladesh. The dehydration status was established by percentage weight change with rehydration. Multivariable regression was used to compare percent dehydration, while controlling for differences in age and nutritional status. In this cohort, a total of 1396 children were analyzed; 785 were male (56.2%) and 611 were female (43.8%). Girls presenting with diarrhea were older than boys (median age 17 months vs. 15 months, p = 0.02) and had significantly more malnutrition than boys, even when controlled for age (mean 134.2 mm vs. 136.4 mm, p < 0.01). The mean percent dehydration did not differ between boys and girls after controlling for age and nutrition status (p = 0.25). Although girls did have higher rates of malnutrition than boys, measures of diarrhea severity were similar between the two groups, arguing against a cultural bias in care-seeking behavior that favors boys.
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Affiliation(s)
- Angela F Jarman
- Department of Emergency Medicine, Warren Alpert School of Medicine, Brown University, Providence, RI, USA.,Center for Evidence Synthesis in Health, School of Public Health, Brown University, Providence, RI, USA
| | - Sara E Long
- Center for Evidence Synthesis in Health, School of Public Health, Brown University, Providence, RI, USA
| | - Sarah E Robertson
- Center for Evidence Synthesis in Health, School of Public Health, Brown University, Providence, RI, USA
| | - Sabiha Nasrin
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Nur Haque Alam
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Alyson J McGregor
- Department of Emergency Medicine, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Adam C Levine
- Department of Emergency Medicine, Warren Alpert School of Medicine, Brown University, Providence, RI, USA.,Center for Evidence Synthesis in Health, School of Public Health, Brown University, Providence, RI, USA
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Bhandari P, Bak J, Lee KS, Chon Y, Bhattachan A, Rimal P, Shrestha BR, Bhandari B, Moon JO, Wu N, Chu WS, Song CK, Lee CS, Mogasale V, Ahn SH. Assessment of Socio-Demographic Factors, Mother and Child Health Status, Water, Sanitation, and Hygienic Conditions Existing in a Hilly Rural Village of Nepal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203965. [PMID: 31627456 PMCID: PMC6843700 DOI: 10.3390/ijerph16203965] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 11/16/2022]
Abstract
In many low income developing countries, socioeconomic, environmental and demographic factors have been linked to around half of the disease related deaths that occur each year. The aim of this study is to investigate the sociodemographic factors, mother and child health status, water, sanitation, and hygienic conditions of a Nepalese community residing in a hilly rural village, and to identify factors associated with mother and child health status and the occurrence of diarrheal and febrile disease. A community-based cross-sectional survey was carried out and 315 households from the village of Narjamandap were included in this study. Factors associated with diarrhea, febrile disease, and full maternal and under-five immunizations were assessed using logistic regression. Results showed that higher education level (middle school versus primary education; Odds Ratio (OR): 0.55, p = 0.04; high school versus primary education; OR 0.21, p = 0.001) and having a toilet facility at home were significantly associated with a lower risk of developing diarrhea and febrile disease (OR 0.49, p = 0.01), while, interestingly, the use of improved water supply was associated with higher risk (OR 3.07, p = 0.005). In terms of maternal immunization, the odds of receiving a tetanus toxoid vaccination were higher in women who had regular antenatal checkups (OR 12.9, p < 0.001), and in those who developed complications during pregnancy (OR 4.54, p = 0.04); for under-five immunization, the odds of receiving full vaccination were higher among children from households that reported diarrhea (OR 2.76, p < 0.001). The findings of this study indicated that gaps still exist in the mother and child healthcare being provided, in terms of receiving antenatal checkups and basic immunizations, as evidenced by irregular antenatal checkups, incomplete and zero vaccination cases, and higher under-five deaths. Specific public health interventions to promote maternal health and the health of under-five children are suggested.
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Affiliation(s)
- Pratibha Bhandari
- Department of Nursing, College of Health & Welfare, Woosong University, Daejeon 300718, Korea;
| | - JeongEun Bak
- International Vaccine Institute, Seoul 08826, Korea; (J.B.); (K.-S.L.); (Y.C.); (A.B.)
| | - Kang-Sung Lee
- International Vaccine Institute, Seoul 08826, Korea; (J.B.); (K.-S.L.); (Y.C.); (A.B.)
| | - Yun Chon
- International Vaccine Institute, Seoul 08826, Korea; (J.B.); (K.-S.L.); (Y.C.); (A.B.)
| | - Anuj Bhattachan
- International Vaccine Institute, Seoul 08826, Korea; (J.B.); (K.-S.L.); (Y.C.); (A.B.)
| | - Pradip Rimal
- Epidemiology and Disease Control Division, Department of Health Services, Teku, Kathmandu 44600, Nepal;
| | | | - Binayak Bhandari
- Department of Railroad Integrated System Engineering, Woosong University, Daejeon 300718, Korea;
- Innovative Design and Integrated Manufacturing Nepal, Grishma Marg, Babarmahal-11, Kathmandu 44600, Nepal
| | - Jeong-Ook Moon
- Department of Mechanical and Aerospace Engineering, Seoul National University, Seoul 08826, Korea; (J.-O.M.); (N.W.)
| | - Namkyu Wu
- Department of Mechanical and Aerospace Engineering, Seoul National University, Seoul 08826, Korea; (J.-O.M.); (N.W.)
| | - Won-Shik Chu
- Department of Mechanical Convergence Engineering, Gyeongsang National University, Changwon 51390, Korea;
| | - Chul-Ki Song
- Department of Mechanical Engineering, Gyeongsang National University, Jinju 52828, Korea;
| | - Caroline S. Lee
- Department of Materials and Chemical Engineering, Hanyang University, Ansan 15588, Korea;
| | - Vittal Mogasale
- International Vaccine Institute, Seoul 08826, Korea; (J.B.); (K.-S.L.); (Y.C.); (A.B.)
- Correspondence: (V.M.); (S.-H.A.)
| | - Sung-Hoon Ahn
- Department of Mechanical and Aerospace Engineering, Seoul National University, Seoul 08826, Korea; (J.-O.M.); (N.W.)
- Correspondence: (V.M.); (S.-H.A.)
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Workie GY, Akalu TY, Baraki AG. Environmental factors affecting childhood diarrheal disease among under-five children in Jamma district, South Wello zone, Northeast Ethiopia. BMC Infect Dis 2019; 19:804. [PMID: 31519160 PMCID: PMC6743097 DOI: 10.1186/s12879-019-4445-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 09/06/2019] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Globally, diarrhea is the leading cause of morbidity and mortality among less than 5 years old children and it contributes to the deaths of approximately one million children every year. In Ethiopia, diarrhea is the second cause of under-five mortality and morbidity. However, in the study area, studies were limited. Therefore, this study has assessed the prevalence of diarrhea and associated factors among < 5 years of age in Jamma district, Northeast Ethiopia. METHODS A community-based cross-sectional study was conducted from August 15 to September 15, 2017, in Jamma district, South Wello zone, northeast Ethiopia. A Systematic random sampling technique was used to select 614 households and a pretested structured questionnaire was used to collect the data. A multivariable logistic regression analysis was used to investigate factors associated with diarrheal disease. Adjusted Odds Ratio (AOR) with the corresponding 95% Confidence Interval (CI) for variables with P-value < 0.05 was used to show statistically significant association. RESULTS In this study, the prevalence of diarrhea among under-five children was 23.1% (95% CI: (19.4, 26.5). Child's age 6 to 23 months [AOR: 2.46, 95% CI: (1.49, 4.05)], Living in rural area [AOR: 2.75, 95% CI: (1.33,5.66)], absence of latrine [AOR: 4.80, 95% CI: (2.39,9.60)], absence of handwashing facility [AOR: 2.45, 95% CI: (1.53,3.93], unprotected drinking water source [AOR:2.68, 95% CI: (1.54,4.68)], and Improper waste disposal practices [AOR:3.86, 95% CI: (2.38,6.26)] were associated with diarrhea disease. CONCLUSION There was a high prevalence of diarrheal disease among children in the study area. Child age, rural residence, availability of latrine and handwashing facility, source of drinking water, and improper waste disposal were notably associated with childhood diarrheal disease. Therefore, improving handwashing practices and pure water supply, proper waste disposal including the availability of latrines would minimize the burden of diarrheal disease.
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Affiliation(s)
- Getachew Yismaw Workie
- South Wello Zonal Health Department Public Health Emergency Early Warning and Preparedness Officer, South Wello, Ethiopia
| | - Temesgen Yihunie Akalu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Dey NC, Parvez M, Islam MR, Mistry SK, Levine DI. Effectiveness of a community-based water, sanitation, and hygiene (WASH) intervention in reduction of diarrhoea among under-five children: Evidence from a repeated cross-sectional study (2007-2015) in rural Bangladesh. Int J Hyg Environ Health 2019; 222:1098-1108. [PMID: 31439422 DOI: 10.1016/j.ijheh.2019.08.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/25/2019] [Accepted: 08/15/2019] [Indexed: 11/29/2022]
Abstract
Diarrhoea, the most common disease directly related to water, sanitation, and hygiene (WASH), still remains one of the most significant health problems among children under-five worldwide. In this reality, BRAC, the largest NGO in the world initiated a comprehensive WASH intervention in 50 upazilas (sub-districts) of Bangladesh in 2007 which was later scaled up to cover 150 upazilas in two subsequent phases. The intervention period of the programme was 2007-2011. The present study encompassed 30 upazilas of the first phase of intervention. The aim of the study was to investigate the effectiveness of this intervention on reduction of diarrhoea among under-five children, and to identify the factors associated with childhood diarrhoea. A repeated cross-sectional study design was followed, and a population-based survey was carried out on four occasions: baseline (2007), midline (2009), endline (2011), and post-endline (2015) among 4,775 households. This analysis considers only households having at least one under-five children. Absence of handwashing practice with soap after defecation and before eating food, unclean latrine condition, and unsafe disposal of child faeces were identified as significant risk factors associated with under-five diarrhoea from Log-binomial regression. The prevalence of under-five diarrhoea within the past 2 weeks of the survey declined from 13.7% at baseline to 3.6% at end-line (p < 0.001) in the WASH intervention area. However, the progress seemingly stalled after 2011, which may have occurred due to the lack of improvement in unsafe disposal of child faeces and unclean latrine condition after the intervention period. Study findings suggest that, to reduce the prevalence of childhood diarrhoea it is important to promote safe disposal of child faeces, maintaining cleanliness of latrines, and washing hand with soap at critical times, beyond merely increasing the sanitation coverage. Findings also underline the necessity of maintaining a small-scale monitoring component involving local community, such as a WatSan committee (a local committee comprising the user communities for supervising WASH related activities) for periodic monitoring at household level for a certain period after the program intervention works to make the behavioural change more sustainable and to keep the reduction rate of under-five diarrhoeal prevalence steady.
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Affiliation(s)
- Nepal C Dey
- Environmental Health Sciences, BRAC James P. Grant School of Public Health, BRAC University, Dhaka, 1212, Bangladesh; SID Foundation, Dhaka, 1216, Bangladesh.
| | - Mahmood Parvez
- Environmental Health Sciences, BRAC James P. Grant School of Public Health, BRAC University, Dhaka, 1212, Bangladesh.
| | - Mir Raihanul Islam
- Environmental Health Sciences, BRAC James P. Grant School of Public Health, BRAC University, Dhaka, 1212, Bangladesh.
| | - Sabuj K Mistry
- Environmental Health Sciences, BRAC James P. Grant School of Public Health, BRAC University, Dhaka, 1212, Bangladesh; Center for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.
| | - David I Levine
- Haas School of Business, University of California, Berkeley, CA, 94720-1900, USA.
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Exploring the spatio-temporal variation in diarrhoea prevalence in under-five children: the case of Nigeria, 1990–2013. Int J Public Health 2019; 64:1183-1192. [DOI: 10.1007/s00038-019-01285-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 07/05/2019] [Accepted: 07/17/2019] [Indexed: 12/24/2022] Open
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