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Keita S, Thiero O, Toure M, Kane F, Keita M, Sanogo I, Konate D, Sanogo D, Diawara SI, Coulibaly H, Thiam SM'B, Sogoba N, Diakite M, Doumbia S. Prognostics of multiple malaria episodes and nutritional status in children aged 6 to 59 months from 2013 to 2017 in Dangassa, Koulikoro region, Mali. Malar J 2024; 23:186. [PMID: 38872178 PMCID: PMC11177378 DOI: 10.1186/s12936-024-04999-8] [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: 11/13/2023] [Accepted: 05/26/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND In Africa, the relationship between childhood nutritional status and malaria remains complex and difficult to interpret. Understanding it is important in the improvement of malaria control strategies. This study aimed to assess the influence of nutritional status on the occurrence of multiple malaria episodes in children aged 6 to 59 months between 2013 and 2017 living in the village of Dangassa, Mali. METHODS A community-based longitudinal study was conducted using cross-sectional surveys (CSSs) at the beginning (June) and end (November) of the malaria transmission season associated with passive case detection (PCD) at the Dangassa Community Health Centre. Children with asymptomatic malaria infection during cross-sectional surveys were selected and their malaria episodes followed by PCD. Malaria indicators in person-months were estimated using an ordinal-logistic model repeated on subjects during follow-up periods. RESULTS The incidence rate (IR) during the period of high transmission (June to October), for 1 episode and for 2 + episodes peaked in 2013 with 65 children (IR = 95.73 per 1000 person-months) and 24 cases (IR = 35.35 per 1000 person-months), respectively. As expected, the risk of multiple episodes occurring during the period of high transmission was 3.23 compared to the period of low transmission after adjusting for other model parameters (95% CI [2.45-4.26], p = 0.000). Children with anaemia were at high risk of having multiple episodes (OR = 1.6, 95% CI [1.12-2.30], p = 0.011). However, the risk of having 2 + episodes for anemic children was higher during the period of low transmission (RR = 1.67, 95% CI [1.15-2.42], p = 0.007) compared to the period of high transmission (RR = 1.58, 95% CI [1.09-2.29], p = 0.016). The trend indicated that anemic and underweight children were significantly associated with multiple malaria episodes during the period of low transmission (p < 0.001). CONCLUSION Results show that multiple episodes of malaria are significantly related to the nutritional status (anaemia and underweight) of the child during the two transmission seasons and more pronounced during the dry season (period of low transmission). Further research including other malnutrition parameters will be needed to confirm these findings.
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Affiliation(s)
- Soumba Keita
- West African International Center for Excellence in Malaria Research, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali.
- University Clinical Research Center (UCRC), University of Sciences, Techniques and Technologies of Bamako, UCRC-USTTB / Point-G, 1805, Bamako, Mali.
- Malaria Research and Training Center (MRTC), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali.
| | - Oumar Thiero
- West African International Center for Excellence in Malaria Research, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
- Department of Health Research and Education, Faculty of Medicine and Odonto Stomatology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Mahamoudou Toure
- West African International Center for Excellence in Malaria Research, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
- University Clinical Research Center (UCRC), University of Sciences, Techniques and Technologies of Bamako, UCRC-USTTB / Point-G, 1805, Bamako, Mali
- Malaria Research and Training Center (MRTC), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Fousseyni Kane
- West African International Center for Excellence in Malaria Research, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
- University Clinical Research Center (UCRC), University of Sciences, Techniques and Technologies of Bamako, UCRC-USTTB / Point-G, 1805, Bamako, Mali
- Malaria Research and Training Center (MRTC), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Moussa Keita
- West African International Center for Excellence in Malaria Research, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
- Malaria Research and Training Center (MRTC), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Ibrahim Sanogo
- West African International Center for Excellence in Malaria Research, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
- University Clinical Research Center (UCRC), University of Sciences, Techniques and Technologies of Bamako, UCRC-USTTB / Point-G, 1805, Bamako, Mali
- Malaria Research and Training Center (MRTC), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Drissa Konate
- West African International Center for Excellence in Malaria Research, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
- University Clinical Research Center (UCRC), University of Sciences, Techniques and Technologies of Bamako, UCRC-USTTB / Point-G, 1805, Bamako, Mali
- Malaria Research and Training Center (MRTC), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Daouda Sanogo
- West African International Center for Excellence in Malaria Research, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
- University Clinical Research Center (UCRC), University of Sciences, Techniques and Technologies of Bamako, UCRC-USTTB / Point-G, 1805, Bamako, Mali
- Malaria Research and Training Center (MRTC), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Sory Ibrahim Diawara
- West African International Center for Excellence in Malaria Research, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
- University Clinical Research Center (UCRC), University of Sciences, Techniques and Technologies of Bamako, UCRC-USTTB / Point-G, 1805, Bamako, Mali
- Malaria Research and Training Center (MRTC), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Hamady Coulibaly
- West African International Center for Excellence in Malaria Research, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
- University Clinical Research Center (UCRC), University of Sciences, Techniques and Technologies of Bamako, UCRC-USTTB / Point-G, 1805, Bamako, Mali
| | - Sidibé M 'Baye Thiam
- West African International Center for Excellence in Malaria Research, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
- University Clinical Research Center (UCRC), University of Sciences, Techniques and Technologies of Bamako, UCRC-USTTB / Point-G, 1805, Bamako, Mali
| | - Nafomon Sogoba
- West African International Center for Excellence in Malaria Research, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
- Malaria Research and Training Center (MRTC), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Mahamadou Diakite
- West African International Center for Excellence in Malaria Research, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
- University Clinical Research Center (UCRC), University of Sciences, Techniques and Technologies of Bamako, UCRC-USTTB / Point-G, 1805, Bamako, Mali
- Malaria Research and Training Center (MRTC), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Seydou Doumbia
- West African International Center for Excellence in Malaria Research, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali.
- University Clinical Research Center (UCRC), University of Sciences, Techniques and Technologies of Bamako, UCRC-USTTB / Point-G, 1805, Bamako, Mali.
- Malaria Research and Training Center (MRTC), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali.
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Toma TM, Andargie KT, Alula RA, Kebede BM, Temesgen K, Guyo TG. Underweight and Predictors Among Children Aged 6-59 Months in South Ethiopia. Int J Public Health 2024; 69:1606837. [PMID: 38835805 PMCID: PMC11148288 DOI: 10.3389/ijph.2024.1606837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 05/06/2024] [Indexed: 06/06/2024] Open
Abstract
Objectives Underweight remains the primary public health concern among under-five-year-old children in Ethiopia, despite numerous government-implemented nutrition-specific and sensitive interventions. Therefore, this study aimed to assess underweight and associated factors among children in South Ethiopia. Methods Between March and April 2021, 717 children in the South Ari district who were between the ages of 6 and 59 months participated in a cross-sectional study. To choose a sample of households containing a minimum of one child between the ages of 6 and 59 months, a multi-stage sampling procedure was used. Data were collected by interviewer-administered structured questionnaires from the mothers of the children. To determine the factors associated with being underweight, a binary logistic regression analysis was built. All variables with a p-value <0.25 in the bivariable analysis were entered into a multivariable logistic regression analysis. To assess the strength of the association, an adjusted odds ratio (AOR) with a 95% confidence interval was used. With a p-value below 0.05, statistical significance was declared. Results The prevalence of underweight was determined to be 29.7% (95% CI: 26.5%, 33.2%). Child age 6-23 months [adjusted odds ratio (AOR) = 0.28; 95% confidence interval (CI): 0.18, 0.44], food insecurity (AOR = 1.48; 95% CI: 1.04, 2.10), sub-optimal child dietary diversity (AOR = 1.44; 95% CI: 1.01, 2.03), birth interval <24 months (AOR = 2.49; 95% CI: 1.75, 3.54), and common childhood illness (AOR = 2.21; 95% CI: 1.52, 3.21) were associated with being underweight. Conclusion Underweight among children is predicted by household food insecurity, suboptimal dietary diversity, and common childhood illnesses, necessitating further efforts to improve food security and manage common illnesses.
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Affiliation(s)
- Temesgen Mohammed Toma
- Department of Public Health, Arba Minch College of Health Sciences, Arba Minch, Ethiopia
- Department of Public Health Emergency Management, South Ethiopia Region Public Health Institute, Jinka, Ethiopia
| | | | - Rahel Abera Alula
- Department of Public Health, Arba Minch College of Health Sciences, Arba Minch, Ethiopia
| | - Bahiru Mulatu Kebede
- Department of Nursing, Arba Minch College of Health Sciences, Arba Minch, Ethiopia
| | - Kidus Temesgen
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Tamirat Gezahegn Guyo
- Department of Public Health, Arba Minch College of Health Sciences, Arba Minch, Ethiopia
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Keita S, Thiero O, Toure M, Kane F, Keita M, Konate D, Sanogo D, Diawara SI, Coulibaly H, Thiam SM, Sogoba N, Diakite M, Bamako M. Prognostics of multiple malaria episodes and nutritional status in children aged 6 to 59 months from 2013 to 2017 in Dangassa, Mali. RESEARCH SQUARE 2023:rs.3.rs-3604955. [PMID: 38014243 PMCID: PMC10680945 DOI: 10.21203/rs.3.rs-3604955/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Background In Africa, the relationship between nutritional status and malaria remains complex and difficult to interpret in children. Understanding it is important in the development of malaria control strategies. This study evaluated the effect of nutritional status on the occurrence of multiple malaria episodes in children aged 6 to 59 months between 2013 and 2017 living in the village of Dangassa, Mali. Methods A community-based longitudinal study was conducted using cross-sectional surveys (SSCs) at the beginning (June) and end (November) of the malaria transmission season associated with passive case detection (PCD) at the Dangassa Community Health Center. Children with asymptomatic malaria infection during cross-sectional surveys were selected and their malaria episodes followed by PCD. Palustrine indicators in person-months were estimated using an ordinal-logistic model repeated on subjects during follow-up periods. Results The incidence rate (IR) during the period of high transmission (June to October), for 1 episode and for 2 + episodes peaked in 2013 with 65 children (IR = 95.73 per 1000 person-months) and 24 cases (IR = 35.35 per 1000 person-months), respectively. As expected, the risk of multiple episodes occurring during the period of high transmission was 3.23 compared to the period of low transmission after adjusting for other model parameters (95% CI = [2.45-4.26], p = 0.000). Children with anemia were at high risk of having multiple episodes (OR = 1.6, 95% CI [1.12-2.30], p = 0.011). However, the risk of having 2 + episodes for anemic children was higher during the period of low transmission (RR = 1.67, 95% CI [1.15-2.42], p = 0.007) compared to the period of high transmission (RR = 1.58, 95% CI [1.09-2.29], p = 0.016). The trend indicated that anemic and underweight children were significantly associated with multiple malaria episodes during the period of low transmission (p < = 0.001). Conclusion Our results indicate that multiple episodes of malaria are significantly related to the nutritional status (anemia and underweight) of the child during the two transmission seasons and more pronounced during the dry season (period of low transmission). Further research including other malnutrition parameters will be needed to confirm our findings.
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Affiliation(s)
- Soumba Keita
- University Clinical Research Center (UCRC), University of Sciences, Techniques and Technologies of Bamako
| | - Oumar Thiero
- Department of Health Research and Education, Faculty of Medicine and Odonto Stomatology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako
| | - Mahamoudou Toure
- University Clinical Research Center (UCRC), University of Sciences, Techniques and Technologies of Bamako
| | - Fousseyni Kane
- University Clinical Research Center (UCRC), University of Sciences, Techniques and Technologies of Bamako
| | - Moussa Keita
- University Clinical Research Center (UCRC), University of Sciences, Techniques and Technologies of Bamako
| | - Drissa Konate
- University Clinical Research Center (UCRC), University of Sciences, Techniques and Technologies of Bamako
| | - Daouda Sanogo
- University Clinical Research Center (UCRC), University of Sciences, Techniques and Technologies of Bamako
| | - Sory Ibrahim Diawara
- Malaria Research and Training Center, International Center for Excellence in Research, Faculty of Medicine and Odonto Stomatology, University of Sciences, Techniques and Technologies of Bamako (USTTB)
| | - Hamady Coulibaly
- University Clinical Research Center (UCRC), University of Sciences, Techniques and Technologies of Bamako
| | - Sidibé M'Baye Thiam
- University Clinical Research Center (UCRC), University of Sciences, Techniques and Technologies of Bamako
| | - Nafomon Sogoba
- Malaria Research and Training Center, International Center for Excellence in Research, Faculty of Medicine and Odonto Stomatology, University of Sciences, Techniques and Technologies of Bamako (USTTB)
| | - Mahamadou Diakite
- University Clinical Research Center (UCRC), University of Sciences, Techniques and Technologies of Bamako
| | - Mali Bamako
- University Clinical Research Center (UCRC), University of Sciences, Techniques and Technologies of Bamako
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Sahiledengle B, Mwanri L, Blumenberg C, Agho KE. Gender-specific disaggregated analysis of childhood undernutrition in Ethiopia: evidence from 2000-2016 nationwide survey. BMC Public Health 2023; 23:2040. [PMID: 37853384 PMCID: PMC10585928 DOI: 10.1186/s12889-023-16907-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 10/05/2023] [Indexed: 10/20/2023] Open
Abstract
INTRODUCTION Childhood undernutrition has been investigated extensively in previous literature but gender inequality detailing the burden of undernutrition has not been adequately addressed in scientific papers, especially in Ethiopia, where undernutrition is known to be a public health problem of high significance, necessitating increased efforts to address it and reduce this inequality. This study was carried out to: (1) explore gender differences in the prevalence of stunting, wasting, and underweight, and (2) compare the factors associated with childhood undernutrition between boys and girls in Ethiopia. METHODS The study used a dataset of more than 33,564 children aged under 5 years (boys: 17,078 and girls: 16,486) who were included in the nationally representative Ethiopia Demographic and Health Survey (EDHS) from 2000 to 2016. The outcome variables were anthropometric indices: stunting (height-for-age < -2 standard deviations), wasting (weight-for-height < -2 standard deviations), and underweight (weight-for-age < -2 standard deviations). Gender-specific multilevel analyses were used to examine and compare the factors associated with child undernutrition. RESULTS The overall prevalence of stunting (49.1% for boys vs 45.3% for girls, p < 0.001), wasting (11.9% for boys vs 9.9% for girls, p < 0.001), and underweight (33.1% for boys vs 29.8% for girls, p < 0.001) higher among boys compared to girls. Boys significantly had higher odds of stunting (aOR: 1.31, 95%CI: 1.21-1.42), wasting (aOR: 1.35, 1.23-1.48), and underweight (aOR: 1.38, 95%CI: 1.26-1.50) than girls. The common factors associated with childhood undernutrition for male and female children were the child's age, perceived size of the child at birth, breastfeeding status, maternal stature, maternal education, toilet facility, wealth index, and place of residence. Boys who were perceived by their mothers to be average sized at birth and were born to uneducated mothers had a higher likelihood of experiencing wasting, in contrast to girls. Among boys, birth order (firstborn), household size (1-4), and place of residence (urban) were associated with lower odds of being underweight. Boys living in cities had lower odds of being stunted. While girls born to mothers with no education and worked in agriculture were at a higher odd of being stunted. CONCLUSION Our study revealed that boys were more likely to be malnourished than girls, regardless of their age category, and there were variations in the factors determining undernutrition among boys and girls. The differences in the burden of undernutrition were significant and alarming, positioning Ethiopia to be questioned whether it will meet the set Sustainable Development Goals (SDGs), including SDG 2 of zero hunger by 2030. These findings call for more effort to address malnutrition as a significant public health issue in Ethiopia, and to urgently recognise the need for enhanced interventions that address the gender gap in childhood undernutrition.
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Affiliation(s)
- Biniyam Sahiledengle
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia.
| | - Lillian Mwanri
- Research Centre for Public Health, Equity and Human Flourishing (PHEHF), Torrens University Australia, Adelaide Campus, SA, 5000, Australia
| | - Cauane Blumenberg
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Causale Consultoria, Pelotas, Brazil
| | - Kingsley Emwinyore Agho
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
- School of Medicine, Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Penrith, NSW, 2571, Australia
- Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
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Seidu AA, Hagan Jnr JE, Budu E, Aboagye RG, Okyere J, Sakyi B, Adu C, Ahinkorah BO. High-risk fertility behaviour and undernutrition among children under-five in sub-Saharan Africa: a cross-sectional study. BMJ Open 2023; 13:e066543. [PMID: 37369407 PMCID: PMC10410834 DOI: 10.1136/bmjopen-2022-066543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 03/09/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE The study examined high-risk fertility behaviour and its association with under-five undernutrition in sub-Saharan Africa (SSA). DESIGN We conducted a cross-sectional analysis of data from 32 sub-Saharan African countries' Demographic and Health Surveys. A weighted sample of 110 522 mother-child pairs was included in final analysis. Multilevel binary logistic regression was used to examine the association between high-risk fertility behaviour and undernutrition. The results were presented using adjusted odds ratio (aOR) with their respective 95% confidence intervals (CIs). SETTING Thirty-two countries in SSA. OUTCOME MEASURE Stunting, wasting, and underweight. RESULTS The pooled prevalence of stunting was 31.3%, ranging from 15.0% in Gabon to 51.7% in Burundi. Wasting was highest among children from Burkina Faso (19.1%) and lowest among those from South Africa (1.6%). The overall prevalence of wasting was 8.1%. The prevalence of underweight was 17.0%, with the highest among children in Niger (37.1%) and lowest in South Africa (4.8%). Mothers who gave birth at the age less than 18 years and those with short birth interval were more likely to have their children being stunted, wasted, and underweight. The odds of stunting and wasting were high among children born to women with high parity. However, maternal age at birth more than 34 was associated with lower odds of childhood underweight as against those with age at birth less than 34. CONCLUSION Countries in SSA are encouraged to address the issue of maternal age at birth less than 18, high parity, and shorter birth intervals in order to meet the Global Nutrition targets, which aim to achieve a 40% reduction in the number of stunted children under the age of 5 and to reduce and maintain childhood wasting to less than 5% by 2025.
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Affiliation(s)
- Abdul-Aziz Seidu
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - John Elvis Hagan Jnr
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany
| | | | - Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Barbara Sakyi
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Collins Adu
- Department of Health Promotion, Education and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Center for Social Research in Health, University of New South Wales, Sydney, Sydney, New South Wales, Australia
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Broadway, New South Wales, Australia
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Olcina Simón MA, Soriano JM, Morales-Suarez-Varela M. Assessment of Malnutrition among Children Presenting in a Nutrition Center in Gimbichu, Ethiopia. CHILDREN 2023; 10:children10040627. [PMID: 37189876 DOI: 10.3390/children10040627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 03/19/2023] [Accepted: 03/25/2023] [Indexed: 03/30/2023]
Abstract
Nowadays, Ethiopia has several problems affecting children below 5 years of age, resulting in low life expectancies. Our group carried out a study to calculate the presence of malnutrition as wasting, stunting underweight, and BMI-for-age in children presenting in a nutrition center in a rural Ethiopian village in the Oromia region according to WHO guidelines. Our results demonstrated that they had moderate chronic malnutrition or stunting from 1 to 2 years of age, affecting their life, their parents, their community/household, and their country. In our viewpoint, the solution for this situation will require a global focus on several levels, including individual, family, community, and country, the last being with the help of new health policies focused on short-, medium-, and long-term strategies with multi- and interdisciplinary approaches.
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Kamau-Mbuthia E, Lesorogol C, Wamukota A, Humphries A, Sarange C, Mbeyu R, Cheupe C, Cheupe J, Nunez-Garcia A, Blackmore I, Iannotti L. Sustainable aquatic food systems: Multisectoral analysis of determinants of child nutrition in coastal Kenya. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2023. [DOI: 10.3389/fsufs.2023.1091339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
Marine foods produced by small-scale fishers can make vital contributions to sustainable, healthy food systems with multisectoral considerations of public health nutrition, gender equity, economics, and marine ecology. This pilot study aimed to map the multidimensional determinants of fish food security and young child nutrition in four coastal communities of Kenya with a view toward designing a large intervention trial. We compared anthropometric and dietary diversity indicators of children under 5 years in fishing vs. non-fishing households. Mixed methods included household surveys, 24-h recalls for dietary intake, and anthropometric measures of children. Child dietary diversity score (CDDS) and height-for-age Z (HAZ) were primary outcomes tested in ordinary least square regression modeling. Stunting was widely prevalent (20.2%), as were morbidities for acute diarrhea (29.0%) and fever (46.5%), with no statistically significant differences in fishing compared to non-fishing households. High proportions of children showed nutrient intake inadequacies for vitamins A, C, and E, iron and zinc; <50% met requirements for all nutrients except protein, which was derived primarily from plant-based foods. Regression modeling showed children living in fishing households were associated with lower CDDS. Maternal education, maternal body mass index (BMI), and household livelihood diversity were positively associated with both CDDS and HAZ, while child morbidities and north coast (of Mombasa) residence showed negative associations. Our findings highlight nutritional vulnerabilities within a coastal food system of Kenya and the need to involve multiple sectors—education, environment, health, finance, communications, and governance and policy—in deriving solutions.
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Engidaye G, Aynalem M, Adane T, Gelaw Y, Yalew A, Enawgaw B. Undernutrition and its associated factors among children aged 6 to 59 months in Menz Gera Midir district, Northeast Ethiopia: A community-based cross-sectional study. PLoS One 2022; 17:e0278756. [PMID: 36473009 PMCID: PMC9725165 DOI: 10.1371/journal.pone.0278756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 11/08/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Undernutrition can lead to impaired physical growth, restricted intellectual skills, low school performance, reduced working capacity, and rooted disability in adult life. Thus, this study was designed to assess the prevalence and associated factors of undernutrition among children aged 6 to 59 months. METHODS A community-based cross-sectional study was conducted among 432 children aged 6 to 59 months in the Menz Gera Midir District. A multi-stage sampling technique was applied to recruit the study participants. Socio-demographic and socio-economic variables were collected by using structured questionnaires. Anthropometric measurements of the children were measured according to the World Health Organization's recommendation. A data collection sheet was used to collect information on the types of foods and number of meals consumed by the child. A bivariable and multivariable logistic regression was performed to identify factors associated with undernutrition. RESULT In this study, about 11.3% (95% CI: 8.3-14.3%), 50.2% (95% CI: 45.5-55.0%), and 28% (95% CI: 23.8-32.3%) were wasted, stunted, and underweight, respectively. Children aged 12-23 months (AOR: 1.97; 95% CI: 1.01-3.87), 36-47 months (AOR: 2.05; 95% CI: 1.00-4.19), and being anemic (AOR: 2.92; 95% CI: 1.73-4.92) were found to be an independent predictor of stunting. Moreover, being anemic was found to be significantly associated with wasting (AOR: 6.84; 95% CI: 3.16-14.82). CONCLUSION According to the findings of this study, undernutrition was a serious public health issue among 6-59 month old children in the Menz Gera Midir District. Children's age and anemia status were significantly associated with stunting and wasting. Therefore, community-based nutrition programs are vital to reduce childhood undernutrition.
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Affiliation(s)
- Getabalew Engidaye
- School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Melak Aynalem
- School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Tiruneh Adane
- School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Yemataw Gelaw
- School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Aregawi Yalew
- School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Bamlaku Enawgaw
- School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Tekle E, Gelaw Y, Dagnew M, Gelaw A, Negash M, Kassa E, Bizuneh S, Wudineh D, Asrie F. Risk stratification and prognostic value of prothrombin time and activated partial thromboplastin time among COVID-19 patients. PLoS One 2022; 17:e0272216. [PMID: 35951632 PMCID: PMC9371343 DOI: 10.1371/journal.pone.0272216] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 07/15/2022] [Indexed: 01/08/2023] Open
Abstract
Background COVID-19 is a viral disease caused by a new strain of corona virus. Currently, prognosis and risk stratification of COVID-19 patients is done by the disease’s clinical presentation. Therefore, identifying laboratory biomarkers for disease prognosis and risk stratification of COVID-19 patients is critical for prompt treatment. Therefore, the main objective of this study was to assess the risk stratification and prognostic value of basic coagulation parameters and factors associated with disease severity among COVID-19 patients at the Tibebe Ghion Specialized Hospital, COVID-19 treatment center, Northwest Ethiopia. Methods A follow-up study was conducted among conveniently recruited COVID-19 patients attended from March to June 2021. Socio-demographic and clinical data were collected using a structured questionnaire and checklist, respectively. Prothrombin time (PT) and activated partial thromboplastin time (APTT) were analyzed by the HUMACLOT DUE PLUS® machine. Descriptive statistics were used to summarize the socio-demographic and clinical characteristics of study participants. Kruskal Wallis tests were used to compare the difference between parametric and non-parametric continuous variables, respectively. The area under the receiver operating characteristic curve (AUC) was used to evaluate the value of PT and APTT in the risk stratification and disease prognosis of COVID-19 patients. Ordinal logistic regression was used to identify the factors associated with disease severity and prognosis. A P-value < 0.05 was defined as statistically significant for all results. Result Baseline PT at a cut-off value ≥ 16.25 seconds differentiated severe COVID-19 patients from mild and moderate patients (AUC: 0.89, 95% CI: 0.83–0.95). PT also differentiated mild COVID-19 patients from moderate and severe patients at a cut-off value ≤ 15.35 seconds (AUC: 0.90, 95% CI: 0.84–0.96). Moreover, alcohol drinkers were a 3.52 times more likely chance of having severe disease than non-drinkers (95% CI: 1.41–8.81). A one-year increment in age also increased the odds of disease severity by 6% (95% CI: 3–9%). An increment of ≥ 0.65 seconds from the baseline PT predicted poor prognosis (AUC: 0.93, 0.87–0.99). Conclusions and recommendations Prolonged baseline PT was observed in severe COVID-19 patients. Prolonged baseline PT was also predicted to worsen prognosis. An increase from the baseline PT was associated with worsen prognosis. Therefore, PT can be used as a risk stratification and prognostic marker in COVID-19 patients.
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Affiliation(s)
- Esayas Tekle
- Department of Medical Laboratory Sciences, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Yemataw Gelaw
- Department of Hematology and Immunohematology, College of Medicine and Health Sciences, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Mulat Dagnew
- Department of Medical Microbiology, College of Medicine and Health Sciences, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Aschalew Gelaw
- Department of Medical Microbiology, College of Medicine and Health Sciences, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Markos Negash
- Department of Immunology and Molecular Biology, College of Medicine and Health Sciences, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Eyuel Kassa
- College of Medicine and Health Sciences, University of Gondar Comprehensive Specialized Hospital Laboratory, University of Gondar, Gondar, Ethiopia
| | - Segenet Bizuneh
- College of Medicine and Health Sciences, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Dessalew Wudineh
- Department of Medical Laboratory Sciences, Institute of Health Sciences, Mizan Tepi University, Mizan Tepi, Ethiopia
| | - Fikir Asrie
- Department of Hematology and Immunohematology, College of Medicine and Health Sciences, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
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Spatial variation and determinants of underweight among under-five children in Ethiopia, Data from EDHS 2019: A multilevel and spatial analysis. Nutrition 2022; 102:111743. [DOI: 10.1016/j.nut.2022.111743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 04/22/2022] [Accepted: 05/14/2022] [Indexed: 11/20/2022]
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Waghmare H, Chauhan S, Sharma SK. Prevalence and determinants of nutritional status among women and children in Pakistan. BMC Public Health 2022; 22:766. [PMID: 35428254 PMCID: PMC9013048 DOI: 10.1186/s12889-022-13059-2] [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: 06/22/2021] [Accepted: 03/23/2022] [Indexed: 12/25/2022] Open
Abstract
Abstract
Background
Nutrition has been a low-priority area in Pakistan, with low visibility from the political leadership. Despite various efforts, Pakistan has been reported to have one of the highest prevalences of child and women malnutrition compared to other developing counties. Therefore, this study intends to examine the prevalence and determinants of nutritional status of women and children in Pakistan.
Methods
The present study uses the Demographic Health Survey (DHS) data from Pakistan 2012–13 (PDHS-3). The nutritional status of women was examined through Body-Mass Index (Underweight, normal, overweight, & obese), and that of children was examined through stunting (severe and moderate), wasting (severe, moderate, overweight), and underweight (severe, moderate, overweight). Descriptive statistics and bivariate analysis have been used along with multinomial logistic regression.
Results
A higher proportion of children in rural areas were severely stunted (19.6% vs. 12.5%), severe wasted (2.4% vs. 2.2%), and severe underweight (9.4% vs. 6%) than their urban counterparts. A higher proportion of rural women (9.5% vs. 5.5%) were underweight than urban women, whereas a higher proportion of urban women were obese (24.3% vs. 19.0%) than rural women. The odds of severe stunting (OR = 0.24; C.I. = 0.15–0.37), severe underweight (OR = 0.11; C.I. = 0.05–0.22) were lower among children from the richest wealth quintile than their poorest counterparts. The Relative Risk Ratio (RRR) of being overweight (RRR = 3.7; C.I. = 2.47–5.54) and Obese (RRR = 4.35; C.I. = 2.67–7.07) than normal BMI were higher among women from richest wealth quintile than women belonged to poorest wealth quintile.
Conclusion
This study has highlighted determinants associated with maternal and child nutritional status, whereby the child’s nutritional status was measured by stunting, wasting, and underweight, and BMI measured the mother’s nutritional status. The main risk factors for a child’s poor nutritional status include low household wealth, urban residence, and mother’s educational status. Similarly, the main risk factors for women’s poor nutritional status include increasing the women’s age, educational status, rural residence, and household wealth. Poor households should be provided special attention to improve the nutritional status among women and children in poor households.
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Ahmad S, Mishra S. Impact of feeding practices on nutritional status of preschool children of Lucknow district: A community based cross-sectional study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Shifti DM, Chojenta C, Holliday EG, Loxton D. Maternal anemia and baby birth size mediate the association between short birth interval and under-five undernutrition in Ethiopia: a generalized structural equation modeling approach. BMC Pediatr 2022; 22:108. [PMID: 35227241 PMCID: PMC8883659 DOI: 10.1186/s12887-022-03169-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 02/22/2022] [Indexed: 11/10/2022] Open
Abstract
Background Studies assessing the association between short birth interval, a birth-to-birth interval of less than 33 months, and under-five undernutrition have produced inconclusive results. This study aimed to assess the relationship between short birth interval and outcomes of stunting, underweight, and wasting among children aged under-five in Ethiopia, and potential mediation of any associations by maternal anemia and baby birth size. Method Data from the 2016 Ethiopia Demographic and Health Survey (EDHS) was used. Stunting, wasting, and underweight among children aged under-five were outcome variables. Generalized Structural Equation Modeling (GSEM) was used to examine associations between short birth interval and outcomes, and to assess hypothesized mediation by maternal anemia and baby birth size. Results Significant associations between short birth interval and stunting (AOR = 1.49; 95% CI = 1.35, 1.66) and underweight (AOR = 1.43; 95% CI = 1.28, 1.61) were found. There was no observed association between short birth interval and wasting (AOR = 1.05; 95% CI = 0.90, 1.23). Maternal anemia and baby birth size had a significant partial mediation effect on the association between short birth interval and stunting (the coefficient reduced from β = 0.337, p < 0.001 to β = 0.286, p < 0.001) and underweight (the coefficient reduced from β = 0.449, p < 0.001 to β = 0.338, p < 0.001). Maternal anemia and baby birth size mediated 4.2% and 4.6% of the total effect of short birth interval on stunting and underweight, respectively. Conclusion Maternal anemia and baby birth size were identified as mediators of the association between short birth interval and under-five undernutrition status. Policies and programs targeting the reduction of under-five undernutrition should integrate strategies to reduce maternal anemia and small baby birth size in addition to short birth interval.
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Affiliation(s)
- Desalegn Markos Shifti
- Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. .,Centre for Women's Health Research, School of Medicine and Public Health, University of Newcastle, New South Wales, Australia.
| | - Catherine Chojenta
- Centre for Women's Health Research, School of Medicine and Public Health, University of Newcastle, New South Wales, Australia
| | - Elizabeth G Holliday
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, New South Wales, Australia
| | - Deborah Loxton
- Centre for Women's Health Research, School of Medicine and Public Health, University of Newcastle, New South Wales, Australia
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Enbeyle W, Bitew D, Marzo RR, Pandey D, Abebaw S, Belay A. Multilevel Analysis of Factors Associated with Underweight Among Under-Five Children in Ethiopia. JOURNAL OF PEDIATRIC NEUROPSYCHOLOGY 2022. [DOI: 10.1007/s40817-021-00118-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Trends and Determinants of Underweight among Children under Five Years in Ethiopia: Further Analysis with Ethiopian Demographic and Health Survey 2005-2016-Multivariate Decomposition Analysis. J Nutr Metab 2022; 2022:6663756. [PMID: 35036006 PMCID: PMC8754623 DOI: 10.1155/2022/6663756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 01/28/2021] [Accepted: 12/20/2021] [Indexed: 11/28/2022] Open
Abstract
Background Underweight is one of the paramount major worldwide health problems, and it traces a big number of populations from infancy to old age. This study aimed to analyze the trends and predictors of change in underweight among children under five years in Ethiopia. Method The data for this study were accessed from three Ethiopian Demographic and Health Survey data sets 2005, 2011, and 2016. The trend was examined separately for the periods 2005–2011, 2005–2016, and 2011–2016. Multivariate decomposition analysis of change in underweight was employed to answer the major research question of this study. The technique employed the output from the logistic regression model to parcel out the observed difference in underweight into components, and STATA 14 was utilized for data management and analysis. Result Perceiving the overall trend, the rate of underweight was decreased from 38% in 2005 to 24% in 2016. The decomposition analysis results revealed that, about 12.60% of declines in underweight have been explained by the difference in population characteristics or endowments (E) over the study period. The size of the child at birth, husband's education, women's education, and household wealth index contributed significantly to the compositional decline in underweight. Conclusion The magnitude of underweight among children under five years indicates a remarkable decline over the last ten years in Ethiopia. In this study, two-twelfth of the overall decrease in underweight among children under five years over the decade was due to the difference in characteristics between 2005 and 2016. Continuing to educate the population and boost the population's economy is needed on the government side in Ethiopia.
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Abdo Z, Girma F, Demessie T. Magnitude of underweight and its associated factors among children aged 6–59 months visiting health center in Nefas Silk Lafto Sub City, Addis Ababa, Ethiopia. BLDE UNIVERSITY JOURNAL OF HEALTH SCIENCES 2022. [DOI: 10.4103/bjhs.bjhs_3_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kebede D, Aynalem A. Prevalence of undernutrition and potential risk factors among children below five years of age in Somali region, Ethiopia: evidence from 2016 Ethiopian demographic and health survey. BMC Nutr 2021; 7:56. [PMID: 34615555 PMCID: PMC8496010 DOI: 10.1186/s40795-021-00460-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 08/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Childhood under-nutrition is far-reaching in low and middle-income nations. Undernutrition is one of the major open wellbeing concerns among newborn children and youthful children in Ethiopia. The present study aimed to explore the potential risk factors of undernutrition among children under 5 years of age in Somali Region, Ethiopia. METHODS The data for this study was extricated from the Ethiopian Demographic and Health Survey (EDHS) 2016. The data collected from 1339 children born 5 years before was considered within the analysis. A multivariable binary logistic regression analysis was utilized at a 5% level of significance to decide the individual and community-level variables related to childhood malnutrition. RESULTS The prevalence of stunting, underweight and wasting were 27.4, 28.7 and 22.7%, respectively. About 16.1% of children were both stunted and underweight; the extent of both being underweight and wasted was 11.7%, the prevalence of both stunted and wasted children was 5.5%, and all three malnutrition conditions were 4.7% children. Among the variables considered in this study, age of the child in months, type of birth, anemia level, size of child at birth, sex of the child, mothers' BMI and sources of drinking water were significantly related to stunting, underweight and wasting in Somali Region. CONCLUSIONS The prevalence of stunting, underweight and wasting was relatively high. Undernutrition is one of the major open wellbeing concerns among children in Somali region. The impact of these variables ought to be considered to develop strategies for decreasing the lack of healthy sustenance due to undernutrition in the study areas. Hence, intercession should be centered on making strides for the under-nutrition determinant variables of the children to be solid, to improve the child's wholesome status, and decrease child mortality quickly.
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Affiliation(s)
- Damitie Kebede
- College of Agriculture and Environmental Sciences, Bahir Dar University, P O Box, 5501, Bahir Dar, Ethiopia.
| | - Alebel Aynalem
- Institute of Disaster Risk Management and Food Security Studies, Bahir Dar University, P O Box 5501, Bahir Dar, Ethiopia
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Khan AY, Fatima K, Ali M. Sanitation ladder and undernutrition among under-five children in Pakistan. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:38749-38763. [PMID: 33740192 DOI: 10.1007/s11356-021-13492-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/11/2021] [Indexed: 05/28/2023]
Abstract
While the state of sanitation in Pakistan has improved in the last decade, a significant proportion of its population is still using inadequate sanitation or no toilet facility at all. Open defecation has decreased over the years; however, it has been replaced by poor quality sanitation in rural areas that might still cause diarrhoea and undernutrition. The research regarding inadequate sanitation in Pakistan, especially in terms of the sanitation ladder, remains limited. The present research thus fills this research gap by assessing the impact of different types of sanitation on the prevalence of stunting and underweight (moderate as well as severe) among under-five children in Pakistan using the nationally representative micro survey, Pakistan Demographic and Health Survey (2017-18). The sanitation ladder comprises of piped to sewer (highest level, base) followed by flush to septic tank, flush to pit latrine, other improved, unimproved sanitation, and open defecation. In order to estimate the adjusted and unadjusted odds ratios of the determinants, this research uses logistic regressions are used to estimate adjusted and unadjusted odds ratios of the determinants. We show that toilets connected to piped sewerage network are rare in the rural areas of Pakistan and a large segment of the rural population is still practicing open defecation. The logistic regressions show that piped sewerage network and flush to septic tanks are associated with lowest odds (both adjusted and unadjusted) of stunting and underweight among under-five children. In multivariate regressions, pit latrines are associated with even higher adjusted odds of severe and moderate and severe stunting as well as underweight among under-five children, showing that poor quality pit latrines may bring the source of faecal contamination to the doorstep of the households. Therefore, interventions targeting reduction in open defecation should promote good quality toilets for sustainable long-term improvements in child health.
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Affiliation(s)
- Asfand Yar Khan
- Department of Economics, School of Social Sciences and Humanities (S3H), National University of Sciences and Technology, Islamabad, H-12, Pakistan
| | - Kaneez Fatima
- Department of Economics, School of Social Sciences and Humanities (S3H), National University of Sciences and Technology, Islamabad, H-12, Pakistan
| | - Muhammad Ali
- Department of Economics, School of Social Sciences and Humanities (S3H), National University of Sciences and Technology, Islamabad, H-12, Pakistan.
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Kebede D, Merkeb Y, Worku E, Aragaw H. Prevalence of undernutrition and potential risk factors among children under 5 years of age in Amhara Region, Ethiopia: evidence from 2016 Ethiopian Demographic and Health Survey. J Nutr Sci 2021; 10:e22. [PMID: 33996035 PMCID: PMC8080180 DOI: 10.1017/jns.2021.17] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 03/02/2021] [Accepted: 03/17/2021] [Indexed: 11/05/2022] Open
Abstract
More than one-third of deaths during the first 5 years of life are attributed to undernutrition, which are mostly preventable through economic development and public health measures. The present study aimed to explore the potential risk factors of undernutrition among children under 5 years of age in Amhara Region, Ethiopia. Data from the 2016 Ethiopian Demographic and Health Survey (EDHS) were used. A total of 974 children under 5 years of age were involved. A multivariable binary logistic regression analysis was used at a 5 % level of significance to determine the individual- and community-level factors associated with childhood undernutrition. The prevalence of stunting, wasting and underweight was 46⋅3, 9⋅8 and 28⋅4 %, respectively. About 23⋅1 % of children were both stunting and underweight, 7⋅3 % were both underweight and wasting and 4⋅5 % of children had all three conditions. Among the factors considered in the present study, the age of a child in months, birth weight, mother educational level, sex of household head, sources of drinking water and the type of toilet facility were significantly associated with undernutrition in the Amhara Region. Undernutrition among under-five children was one of the public health problems in the Amhara Region. The potential risk factors should be considered to develop strategies for reducing undernutrition in the Amhara Region. Finally, improving the living standards of the children is important to get better health care, to enhance the child's nutritional status and to reduce child mortality.
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Key Words
- AOR, adjusted odds ratio
- BMI, body mass index
- COR, crude odds ratio
- CSA, Central Statistical Agency
- DHS, Demographic and Health Surveys
- EDHS, Ethiopian Demographic and Health Survey
- Ethiopia
- SNNPR, South Nations, Nationalities, and Peoples’ Region
- SPSS, Statistical Package for Social Science
- Stunting
- Underweight
- Wasting
- Young children
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Affiliation(s)
- Damitie Kebede
- College of Agriculture and Environmental Sciences, Bahir Dar University, P.O. Box 5501, Bahir Dar, Ethiopia
- Department of Applied Human Nutrition, Faculty of Chemical and Food Engineering, Bahir Dar Institute of Technology, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia
| | - Yidnekachew Merkeb
- Institute of Disaster Risk Management and Food Security Studies, Bahir Dar University, P.O. Box 5501, Bahir Dar, Ethiopia
| | - Eyerusalem Worku
- Department of Applied Human Nutrition, Faculty of Chemical and Food Engineering, Bahir Dar Institute of Technology, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia
| | - Hayat Aragaw
- Department of Applied Human Nutrition, Faculty of Chemical and Food Engineering, Bahir Dar Institute of Technology, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia
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Tibebu NS, Emiru TD, Tiruneh CM, Getu BD, Azanaw KA. Underweight and Its Associated Factors Among Children 6-59 Months of Age in Debre Tabor Town, Amhara Region of Ethiopia, 2019: A Community-Based Cross-Sectional Study. PEDIATRIC HEALTH MEDICINE AND THERAPEUTICS 2020; 11:469-476. [PMID: 33273880 PMCID: PMC7708304 DOI: 10.2147/phmt.s288071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 11/24/2020] [Indexed: 11/23/2022]
Abstract
Introduction Even-thought malnutrition is a double burden now time being; under-nutrition among under-five year’s children is a common public health problem, and it is one of the main reasons for the death of children in developing countries. Therefore, this study aimed to assess the prevalence and associated factors of underweight among children age 6–59 months at Debre Tabor town Ethiopia, 2019. Methods A community-based cross-sectional study was conducted on an underweight using cluster and systematic random sampling. A sample of 608 participants completed a questionnaire designed for the study. The questionnaire was coded and entered into Epi info version 7.2.0.1 and exported to SPSS 20.0 for data analysis. Principal component analysis (PCA) was used to compute family wealth status. Bivariable and multivariable logistic regression analyses were done to see which independent variables have an association with the dependent variable, and a P value of less than 0.05 was considered as significant at 95% CI. Results The result revealed that underweight for children age 6–59 months was 17.4% (95% CI: 14.5–20.6%). Fathers who have primary education levels were 2.13 times more likely to have under-weighted children than those who have secondary and above education levels [adjusted odds ratio (AOR): 2.13; 95% CI: 1.19–3.80]. Similarly, parents who have poor wealth status in their family 2.2 times more likely to have underweight children than those who have rich wealth status in their family [AOR: 2.2 (1.21–4.09)]. However, on the sex of children being males were 1.8 times more likely to become underweight than females [AOR: 1.8 (1.14–2.85)]. Conclusion Among under-nutrition problems of children age 6–59 months, underweight is still an important public health problem. Therefore, family education and family wealth status should be modified, and responsible bodies design further nutritional intervention programs.
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Affiliation(s)
- Nigusie Selomon Tibebu
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tigabu Dessie Emiru
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Chalie Marew Tiruneh
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Bisrat Dessie Getu
- Department of Nursing, Debre Tabor Health Sciences College, Debre Tabor, Ethiopia
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Fagbohungbe TH, Gayawan E, Orunmoluyi OS. Spatial prediction of childhood malnutrition across space in Nigeria based on point-referenced data: an SPDE approach. J Public Health Policy 2020; 41:464-480. [PMID: 32807912 DOI: 10.1057/s41271-020-00246-x] [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: 12/28/2022]
Abstract
Malnutrition remains a leading cause of child mortality in Nigeria. The spatial analysis based on areal level approaches could, in reality, conceal variations at smaller units. Using point-referenced data from Nigeria Demographic and Health Survey, we quantify the prevalence of malnutrition among under-five children in Nigeria at 1.63 by 1.63 km spatial resolution, and compute the exceedance probability maps for stunting, wasting and underweight at 20% threshold level using the stochastic partial differential equation approach with Bayesian inference based on integrated nested Laplace approximation. Results show divergence prevalence of the malnutrition indicators among children living in neighbouring locations and that the prevalence of stunting and underweight increase with age. The prevalence of stunting was uneven among children living in Kebbi, Zamfara, Sokoto, Kaduna, Kano, Katsina, Bauchi, Gombe and Taraba states with more concentrations in the northern fringes of some of the states. Except for few locations in about three states, the probability is more than 90% that the prevalence of stunting in all parts of the country exceeds 20% but this was not the case for wasting. The findings can assist in location-specific policy formulation and implementations.
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Affiliation(s)
| | - Ezra Gayawan
- Informetrics Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam. .,Faculty of Mathematics & Statistics, Ton Duc Thang University, Ho Chi Minh City, Vietnam.
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Fenta HM, Tesfaw LM, Derebe MA. Trends and Determinants of Underweight among Under-Five Children in Ethiopia: Data from EDHS. Int J Pediatr 2020; 2020:3291654. [PMID: 32684940 PMCID: PMC7341408 DOI: 10.1155/2020/3291654] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/28/2020] [Accepted: 06/03/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND AND AIMS Malnutrition among under-five children is one of the major causes of death in low-income countries. Accordingly, health sectors in developing countries are providing renewed attention to the status of children's nutrition. This study sought to explore the trends and identify the determinants of underweight Ethiopian under-five children across time. METHODS The data in the study was obtained from the 2000, 2005, 2011, and 2016 Ethiopian Demographic and Health Surveys (EDHS). The study involved 27564 under-five children across Ethiopian regions. The status of underweight is determined using weight for age. This anthropometric index has been categorized as "underweight" (Z-score less than -2) and "not underweight" (Z-score greater or equal to -2). Logistic regression was used for each survey to detect significant determinants of underweight, while multivariate decomposition was used to determine the trends and identified the child, maternal, and household characteristics that are associated with underweight. RESULT The survey in 2000, 2005, 2011, and 2016 showed that 41, 33, 29, and 24% of sampled under-five children were underweight, respectively, and after adjusting for confounders, children were more likely to be underweight if they were male (OR = 1.16, 95%CI = 1.02, 1.33) in 2016 EDHS. Children whose mother's age is below 20 (OR = 5.75, 95%CI = 1.44, 23.1)) were more likely to be underweight compared with children whose mother's age is above 45. Children whose mothers had no education and primary education only (OR = 1.65, 95% CI 1.05, 2.59 and OR = 1.43, 95% CI 1.15, 1.78, respectively) were more likely underweight compared to children whose mothers had higher education. CONCLUSION Children's age, birth weight, mother's education status, and children's gender were the most common significant factors of underweight. The prevalence of underweight among under-five children declined over time which leads to an achievement in terms of meeting millennium development goals and nutritional targets. Government and concerned stakeholders should work to maintain this achievement for further reduction of underweight among under-five children.
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Nankinga O, Kwagala B, Walakira EJ. Maternal employment and child nutritional status in Uganda. PLoS One 2019; 14:e0226720. [PMID: 31856209 PMCID: PMC6922416 DOI: 10.1371/journal.pone.0226720] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 12/03/2019] [Indexed: 12/31/2022] Open
Abstract
Nearly half of all deaths among children under five (U5) years in low- and middle-income countries are a result of under nutrition. This study examined the relationship between maternal employment and nutrition status of U5 children in Uganda using the 2016 Uganda Demographic and Health Survey (UDHS) data. We used a weighted sample of 3531 children U5 years born to working women age 15-49. Chi-squared tests and multivariate logistic regressions were used to examine the relationship between maternal employment and nutritional outcomes while adjusting for other explanatory factors. Results show that children whose mothers had secondary education had lower odds of stunting and underweight compared with children whose mothers had no formal education. Children who had normal birth weight had lower odds of stunting, wasting and being underweight compared with children with low birth weight. Children whose mothers engaged in agriculture and manual work had higher odds of stunting compared with those whose mothers engaged in professional work. Additionally, children whose mothers were employed by nonfamily members had higher odds of wasting and being underweight compared with children whose mothers were employed by family members. Other determinants of child nutritional status included region, age of the mother, and age and sex of the child. Interventions aimed at improving the nutritional status of children of employed women should promote breastfeeding and flexible conditions in workplaces, target those of low socio-economic status and promote feeding programs and mosquito net use for both mothers and children.
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Affiliation(s)
- Olivia Nankinga
- Department of Population Studies, School of Statistics and Planning, Makerere University, Kampala, Uganda
- * E-mail:
| | - Betty Kwagala
- Department of Population Studies, School of Statistics and Planning, Makerere University, Kampala, Uganda
| | - Eddy J. Walakira
- Department of Social Work and Social Administration, Makerere University, Kampala, Uganda
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24
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Jumbri IA, Ikeda S, Jimichi M, Saka C, Managi S. Inequality of health stock and the relation to national wealth. Int J Equity Health 2019; 18:188. [PMID: 31791346 PMCID: PMC6889547 DOI: 10.1186/s12939-019-1096-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 11/18/2019] [Indexed: 11/26/2022] Open
Abstract
Background The decline in global and between-country health inequality is a major challenge to overcome. However, few studies have systematically investigated the relationship between inequality of health stock and national wealth. From an economic perspective, health can be viewed as a durable capital stock that produces an output of healthy time. Therefore, in this paper, we focused on health capital to investigate the relationship between inequalities of national health and national wealth. Methods Based on health stock data from 1990 to 2015 for 140 countries, we estimated Gini coefficients of health stock to investigate associations with a well-known economic flow indicator, Gross Domestic Product (GDP), stock-based national wealth indicator, Inclusive Wealth Index (IWI), and firm-level net income. Results The estimated Gini coefficient of global health stock shows that health stock has experienced a global decline. The Gini coefficient for low-income countries (LICs) showed the fastest decline in health stock, dropping from 0.69 to 0.66 in 25 years. Next, rapid population growth and the rise in the youth share of the working-age population in LICs were most likely contributing factors to the decline in inequality. Most countries that experienced positive health stock growth also indicated a strong positive relationship with GDP and IWI. However, some countries showed a negative relationship with natural capital, which is a part of IWI. In addition, firm-level net income showed no obvious associations with health stock, GDP and IWI. Conclusions We argue that a negative relationship between health stock and natural capital is a sign of unstable development because sustainable development involves maintaining not only GDP but also IWI, as it is a collective set of assets or wealth comprising human, produced and natural capital. Moreover, in our analysis of firm-level income data, we also discuss that income will be influenced by other factors, such as innovations, human resources, organization culture and strategy. Therefore, the paper concludes that health stock is a vital component in measuring health inequality and health-related Sustainable Development Goals (SDGs). Thus, IWI is more comprehensive in measuring national wealth and can complement GDP in measuring progress toward sustainable development.
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Affiliation(s)
- Isma Addi Jumbri
- Graduate School of Environmental Studies, Tohoku University, Sendai, Japan.,Faculty of Technology Management and Technopreneurship, University Teknikal, Melaka, Malaysia
| | - Shinya Ikeda
- College of Agriculture, Regional and Environmental Science, Ibaraki University, Tsuchiura, Japan.
| | - Masayuki Jimichi
- School of Business Administration, Kwansei Gakuin University, Nishinomiya, Japan
| | - Chika Saka
- School of Business Administration, Kwansei Gakuin University, Nishinomiya, Japan
| | - Shunsuke Managi
- Department of Urban and Environmental Engineering, Kyushu University, Fukuoka, Japan. .,Urban Institute, Kyushu University, Fukuoka, Japan.
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25
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Modjadji P, Madiba S. Childhood Undernutrition and Its Predictors in a Rural Health and Demographic Surveillance System Site in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3021. [PMID: 31438531 PMCID: PMC6747220 DOI: 10.3390/ijerph16173021] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 08/06/2019] [Accepted: 08/07/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND Overweight and obesity are increasing at an alarming rate in South Africa, while childhood undernutrition remains persistently high. This study determined the magnitude and predictors of stunting and underweight among schoolchildren in the Dikgale and Health Demographic Surveillance System Site, a rural site in South Africa. METHODS A cross sectional study using multistage sampling was conducted among 508 schoolchildren and their mothers. Anthropometric measurements were taken from children and their mothers, while sociodemographic information was obtained from mothers using a questionnaire. The World Health Organization Anthro Plus was used to generate height-for-age and weight-for-age z-scores to indicate stunting and underweight, respectively, among the children. Maternal overweight and obesity were assessed using body mass index. Bivariate and multivariate logistic regression analyses were used to evaluate the predictors of stunting and underweight among schoolchildren. RESULTS Twenty-two percent (22%) of children were stunted and 27% were underweight, while 27.4% of the mothers were overweight and 42.3% were obese. The odds of being stunted were lower in younger children, whereas having a mother who was overweight/obese and had a short stature increased the odds of stunting. Access to water, having a refrigerator, and having a young mother were protective against being underweight. Having a mother who was overweight/obese increased the odds of being underweight. CONCLUSIONS The study showed a high prevalence of stunting and underweight among children, and overweight and obesity among mothers, indicating a household double burden of malnutrition. The age of the child and maternal overweight/obesity and short stature were predictors of stunting and underweight, while having a younger mother and access to water and a refrigerator were protective against being underweight. The need for an evidence-based and feasible nutrition program for schoolchildren, especially those in rural schools, cannot be over-emphasized.
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Affiliation(s)
- Perpetua Modjadji
- School of Health Care Sciences, Department of Public Health, Sefako Makgatho Health Sciences University, Molotlegi St, Ga-Rankuwa Zone 1, Ga-Rankuwa 0208, South Africa.
| | - Sphiwe Madiba
- School of Health Care Sciences, Department of Public Health, Sefako Makgatho Health Sciences University, Molotlegi St, Ga-Rankuwa Zone 1, Ga-Rankuwa 0208, South Africa
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Kumar R, Abbas F, Mahmood T, Somrongthong R. Prevalence and factors associated with underweight children: a population-based subnational analysis from Pakistan. BMJ Open 2019; 9:e028972. [PMID: 31366654 PMCID: PMC6678069 DOI: 10.1136/bmjopen-2019-028972] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES This study aims to determine the prevalence of and factors associated with underweight children under the age of 5 in Punjab, Pakistan. DESIGN We analysed cross-sectional household-level subnationally representative Multiple Indicator Cluster Survey. SETTINGS Punjab province, Pakistan. PARTICIPANTS 24 042 children under 5 years of age. DATA ANALYSIS Multilevel multivariate logistic regression analysis. RESULTS Prevalence of moderately and severely underweight children was found to be (33.3% and 11.3%, respectively). Multivariate multilevel logistic regression results show that as the child grows older the likelihood of the child being underweight increases significantly (eg, children between 12 and 23 months are one and half times more likely to be underweight, whereas children between the ages of 36 and 47 months are two and a half times more likely to be underweight). Gender was found to be another significant factor contributing to underweight prevalence among children under the age of 5. The likelihood of a girl child being underweight is more than that of a boy child being underweight (OR 0.92, 95% CI 0.8 to 1.0). Similarly, a child whose birth order is three or more is two times more likely to be underweight (OR 1.96, 95% CI 1.5 to 2.5) relative to a child of a lower birth order. Moreover, diarrhoea also significantly increases the likelihood of the child being underweight (OR 1.31, 95% CI 1.1 to 1.5). Child size is another determinant for underweight prevalence among children under 5, for example, a child with a size smaller than average at the time of birth is 2.7 times more likely to be moderately underweight than a child with an average or larger than average size at the time of birth. CONCLUSION Rigorous community-based interventions should be developed and executed throughout the province to improve this grave situation of underweight prevalence in Punjab. Mother's education should be uplifted by providing them formal education and providing awareness about the importance of proper nutrition for children.
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Affiliation(s)
- Ramesh Kumar
- Health Systems and Policy Department, Health Services Academy, Islamabad, Pakistan
| | - Faisal Abbas
- Department of Economics, George August University, Goettingen, Germany
- Independant Researcher, and Development Consultant, Islamabad, Pakistan
| | - Tahir Mahmood
- Department of Economics, George August University, Goettingen, Germany
- Department of Economics, Chitral University, Chitral, Pakistan
| | - Ratana Somrongthong
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
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