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Azanaw J, Malede A, Yalew HF, Worede EA. Determinants of diarrhoeal diseases among under-five children in Africa (2013-2023): a comprehensive systematic review highlighting geographic variances, socioeconomic influences, and environmental factors. BMC Public Health 2024; 24:2399. [PMID: 39232730 PMCID: PMC11373296 DOI: 10.1186/s12889-024-19962-0] [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: 02/22/2024] [Accepted: 09/02/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND Diarrhea diseases continue to present a significant threat to the well-being of children under the age of five in Africa, thereby contributing substantially to both morbidity and mortality rates. The period spanning between January 2013 and December 2023 has witnessed persistent challenges in the fight against these diseases, thereby necessitating a thorough investigation into the factors that determine their occurrence. It is important to note that the burden of diarrhea diseases is not evenly distributed across the continent, with residence, socioeconomic, and environmental factors playing pivotal roles in shaping the prevalence and incidence rates. Consequently, this systematic review aimed to consolidate and analyze the existing body of literature on the determinants of diarrhea diseases among children under the age of five in Africa between January 2013 and December 2023. METHOD The systematic review employed a rigorous methodological approach to examine the determinants of diarrhea diseases among children under the age of five in Africa between January 2013 and December 2023. A comprehensive search strategy was implemented, utilizing databases such as PubMed, Scopus, and Web of Science, and incorporating relevant keywords. The inclusion criteria focused on studies published within the specified timeframe, with a specific focus on the determinants of diarrhea disease among children under the age of five in Africa. The study selection process involved a two-stage screening, with independent reviewers evaluating titles, abstracts, and full texts to determine eligibility. The quality assessment, employing a standardized tool, ensured the inclusion of studies with robust methodologies. Data extraction encompassed key study details, including demographics, residence factors, socioeconomic influences, environmental variables, and intervention outcomes. RESULTS The search yielded a total of 12,580 articles across 25 African countries; however, only 97 of these articles met the inclusion criteria and were ultimately included in the systematic review. The systematic review revealed geographic and seasonal disparities in the prevalence of diarrhoeal diseases across different countries in Africa. Factors such as age-related vulnerabilities, gender disparities, maternal occupation, disposal of young children's stools, and economic status were identified as significant determinants of the prevalence of diarrhea disease. CONCLUSION This systematic review provides a comprehensive understanding of the determinants of diarrhea diseases among children under the age of five in Africa between January 2013 and December 2023. The nuanced analysis of residence variations, socioeconomic influences, environmental factors, and intervention outcomes underscores the complex nature of this issue. The findings highlight the necessity for region-specific and context-sensitive interventions to address the unique challenges faced by diverse communities. This review serves as a valuable resource for policymakers, healthcare professionals, and researchers, guiding the development of evidence-based strategies aimed at reducing the burden of diarrhea diseases and improving child health outcomes in Africa.
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Affiliation(s)
- Jember Azanaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Asmamaw Malede
- 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 Yalew
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Eshetu Abera Worede
- 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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Alpaugh V, Ortigoza A, Braverman Bronstein A, Pérez-Ferrer C, Wagner-Gutierrez N, Pacifico N, Ezeh A, Caiaffa WT, Lovasi G, Bilal U. Association Between Household Deprivation and Living in Informal Settlements and Incidence of Diarrhea in Children Under 5 in Eleven Latin American Cities. J Urban Health 2024; 101:629-637. [PMID: 38652338 PMCID: PMC11189882 DOI: 10.1007/s11524-024-00854-y] [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] [Accepted: 03/08/2024] [Indexed: 04/25/2024]
Abstract
Diarrhea is a leading cause of death in children globally, mostly due to inadequate sanitary conditions and overcrowding. Poor housing quality and lack of tenure security that characterize informal settlements are key underlying contributors to these risk factors for childhood diarrhea deaths. The objective of this study is to better understand the physical attributes of informal settlement households in Latin American cities that are associated with childhood diarrhea. We used data from a household survey (Encuesta CAF) conducted by the Corporación Andina de Fomento (CAF), using responses from sampled individuals in eleven cities. We created a household deprivation score based on household water and sewage infrastructure, overcrowding, flooring and wall material, and security of tenure. We fitted a multivariable logistic regression model to estimate odds ratios (OR) and 95% confidence intervals (95% CI) to test the association between the deprivation score and its individual components and childhood diarrhea during the prior 2 weeks. We included a total of 4732 households with children, out of which 12.2% had diarrhea in the 2-week period prior to completing the survey. After adjusting for respondent age, gender, and city, we found a higher risk of diarrhea associated with higher household deprivation scores. Specifically, we found that the odds of diarrhea for children living in a mild and severe deprived household were 1.04 (95% CI 0.84-1.28) and 3.19 times (95% CI 1.80-5.63) higher, respectively, in comparison to households with no deprivation. These results highlight the connections between childhood health and deprived living conditions common in informal settlements.
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Affiliation(s)
- Victoria Alpaugh
- Urban Health Collaborative, Drexel Dornsife School of Public Health, 3600 Market St. Suite 730, Philadelphia, PA, 19104, USA
- Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, 3600 Market St. Suite 730, Philadelphia, PA, 19104, USA
| | - Ana Ortigoza
- Urban Health Collaborative, Drexel Dornsife School of Public Health, 3600 Market St. Suite 730, Philadelphia, PA, 19104, USA
- Department of Social and Environmental Determinants of Health Equity, Pan American Health Organization, Washington, D.C., USA
| | - Ariela Braverman Bronstein
- Urban Health Collaborative, Drexel Dornsife School of Public Health, 3600 Market St. Suite 730, Philadelphia, PA, 19104, USA
- Institute for Community Health, Cambridge Health Alliance, Malden, MA, USA
| | - Carolina Pérez-Ferrer
- Center for Research in Population Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | - Natalia Pacifico
- Institute of Collective Health, National University of Lanús, Remedios de Escalada, Argentina
- FJ Muñiz Infectious Hospital, Buenos Aires, Argentina
| | - Alex Ezeh
- Urban Health Collaborative, Drexel Dornsife School of Public Health, 3600 Market St. Suite 730, Philadelphia, PA, 19104, USA
- Department of Community Health and Prevention, Drexel Dornsife School of Public Health, Philadelphia, PA, USA
| | - Waleska Teixeira Caiaffa
- Observatory for Urban Health in Belo Horizonte, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Gina Lovasi
- Urban Health Collaborative, Drexel Dornsife School of Public Health, 3600 Market St. Suite 730, Philadelphia, PA, 19104, USA
- Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, 3600 Market St. Suite 730, Philadelphia, PA, 19104, USA
| | - Usama Bilal
- Urban Health Collaborative, Drexel Dornsife School of Public Health, 3600 Market St. Suite 730, Philadelphia, PA, 19104, USA.
- Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, 3600 Market St. Suite 730, Philadelphia, PA, 19104, USA.
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Afroz M, Bhuia MS, Rahman MA, Hasan R, Islam T, Islam MR, Chowdhury R, Khan MA, Antas E Silva D, Melo Coutinho HD, Islam MT. Anti-diarrheal effect of piperine possibly through the interaction with inflammation inducing enzymes: In vivo and in silico studies. Eur J Pharmacol 2024; 965:176289. [PMID: 38158111 DOI: 10.1016/j.ejphar.2023.176289] [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: 09/11/2023] [Revised: 12/02/2023] [Accepted: 12/14/2023] [Indexed: 01/03/2024]
Abstract
Piperine is a natural alkaloid that possesses a variety of therapeutic properties, including anti-inflammatory, antioxidant, antibacterial, and anticarcinogenic activities. The present study aims to assess the medicinal benefits of piperine as an anti-diarrheal agent in a chick model by utilizing in vivo and in silico techniques. For this, castor oil was administered orally to 2-day-old chicks to cause diarrhea. Bismuth subsalicylate (10 mg/kg), loperamide (3 mg/kg), and nifedipine (2.5 mg/kg) were used as positive controls, while the vehicle was utilized as a negative control. Two different doses (25 and 50 mg/kg b.w.) of the test sample (piperine) were administered orally, and the highest dose was tested with standards to investigate the synergistic activity of the test sample. In our findings, piperine prolonged the latent period while reducing the number of diarrheal feces in the experimental chicks during the monitoring period (4 h). At higher doses, piperine appears to reduce diarrheal secretion while increasing latency in chicks. Throughout the combined pharmacotherapy, piperine outperformed bismuth subsalicylate and nifedipine in terms of anti-diarrheal effects with loperamide. In molecular docking, piperine exhibited higher binding affinities towards different inflammatory enzymes such as cyclooxygenase 1 (-7.9 kcal/mol), cyclooxygenase 2 (-8.4 kcal/mol), nitric oxide synthases (-8.9 kcal/mol), and L-type calcium channel (-8.8 kcal/mol), indicating better interaction of PP with these proteins. In conclusion, piperine showed a potent anti-diarrheal effect in castor oil-induced diarrheal chicks by suppressing the inflammation and calcium ion influx induced by castor oil.
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Affiliation(s)
- Meher Afroz
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, 8100, Bangladesh.
| | - Md Shimul Bhuia
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, 8100, Bangladesh.
| | - Md Anisur Rahman
- Department of Pharmacy, Islamic University, Kushtia, 7003, Bangladesh.
| | - Rubel Hasan
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, 8100, Bangladesh.
| | - Tawhida Islam
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, 8100, Bangladesh.
| | - Md Rakibul Islam
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, 8100, Bangladesh.
| | - Raihan Chowdhury
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, 8100, Bangladesh.
| | - Md Ali Khan
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, 8100, Bangladesh.
| | | | | | - Muhammad Torequl Islam
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, 8100, Bangladesh.
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Akinlabi OC, Nwoko ESQ, Dada RA, Ekpo S, Omotuyi A, Nwimo CC, Adepoju A, Popoola O, Dougan G, Thomson NR, Okeke IN. Epidemiology and Risk Factors for Diarrheagenic Escherichia coli Carriage among Children in Northern Ibadan, Nigeria. Am J Trop Med Hyg 2023; 109:1223-1232. [PMID: 37903436 PMCID: PMC10793065 DOI: 10.4269/ajtmh.22-0618] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 08/14/2023] [Indexed: 11/01/2023] Open
Abstract
Diarrhea is a leading cause of childhood morbidity in Africa, but few studies, focus on bacterial diarrheal etiology including multicountry studies that typically excluded Nigeria. We collected stool specimens from 477 children under 5 years of age, 120 with diarrhea, who were enrolled in our prospective case-control study between November 2015 and August 2019. All were attending primary health clinics on the northern outskirts of Ibadan. Up to 10 Escherichia coli isolates were obtained per specimen, and at least three of them were sequenced using Illumina whole-genome sequence technology. Genomes were assembled using SPAdes and evaluated for quality using QUAST. VirulenceFinder was used to identify virulence genes. The microbiological quality of water from 14 wells within the study area was assessed using total and coliform counts. Diarrheagenic E. coli (DEC) were isolated from 79 (65.8%) cases and 217 (60.8%) control children. A number of hybrid DEC pathotypes, Salmonella spp., Yersinia spp., and all DEC pathotypes except Shiga toxin-producing E. coli were detected, but no pathogen showed association with disease (P > 0.05). Enterotoxigenic E. coli were more commonly recovered from children without diarrhea aged below 6 months but exclusively detected in children with diarrhea aged over 9 months. Temporally linked, genetically similar enteroaggregative E. coli were isolated from children in different households in eight instances. No well water sample drawn in the study was potable. Children in northern Ibadan were commonly colonized with DEC. Access to water, proper sanitation, and vaccination against the prevailing pathogens may be critical for protecting children from the less overt consequences of enteric pathogen carriage.
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Affiliation(s)
- Olabisi C. Akinlabi
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Oyo, Nigeria
| | - El-shama Q. Nwoko
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Oyo, Nigeria
| | - Rotimi A. Dada
- Medical Laboratory Science Program, College of Health Sciences, Bowen University, Iwo, Nigeria
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Ahmadu Bello University, Zaria, Nigeria
| | - Stella Ekpo
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Oyo, Nigeria
| | - Adeola Omotuyi
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Oyo, Nigeria
| | - Chukwuemeka C. Nwimo
- Department of Clinical Medicine, College of Medicine, University of Ibadan, Oyo, Nigeria
| | - Akinlolu Adepoju
- Department of Pediatrics, College of Medicine, University of Ibadan, Oyo, Nigeria
| | - Oluwafemi Popoola
- Department of Community Medicine, Faculty of Public Health, College of Medicine, University of Ibadan, Oyo, Nigeria
| | - Gordon Dougan
- Wellcome Sanger Institute, Saffron Walden, United Kingdom
- Department of Medicine, University of Cambridge, United Kingdom
| | | | - Iruka N. Okeke
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Oyo, Nigeria
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Lee TT, Dalvie MA, Röösli M, Merten S, Kwiatkowski M, Mahomed H, Sweijd N, Cissé G. Understanding diarrhoeal diseases in response to climate variability and drought in Cape Town, South Africa: a mixed methods approach. Infect Dis Poverty 2023; 12:76. [PMID: 37596648 PMCID: PMC10436439 DOI: 10.1186/s40249-023-01127-7] [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: 04/28/2023] [Accepted: 08/03/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND The climate of southern Africa is expected to become hotter and drier with more frequent severe droughts and the incidence of diarrhoea to increase. From 2015 to 2018, Cape Town, South Africa, experienced a severe drought which resulted in extreme water conservation efforts. We aimed to gain a more holistic understanding of the relationship between diarrhoea in young children and climate variability in a system stressed by water scarcity. METHODS Using a mixed-methods approach, we explored diarrhoeal disease incidence in children under 5 years between 2010 to 2019 in Cape Town, primarily in the public health system through routinely collected diarrhoeal incidence and weather station data. We developed a negative binomial regression model to understand the relationship between temperature, precipitation, and relative humidity on incidence of diarrhoea with dehydration. We conducted in-depth interviews with stakeholders in the fields of health, environment, and human development on perceptions around diarrhoea and health-related interventions both prior to and over the drought, and analysed them through the framework method. RESULTS From diarrhoeal incidence data, the diarrhoea with dehydration incidence decreased over the decade studied, e.g. reduction of 64.7% in 2019 [95% confidence interval (CI): 5.5-7.2%] compared to 2010, with no increase during the severe drought period. Over the hot dry diarrhoeal season (November to May), the monthly diarrhoea with dehydration incidence increased by 7.4% (95% CI: 4.5-10.3%) per 1 °C increase in temperature and 2.6% (95% CI: 1.7-3.5%) per 1% increase in relative humidity in the unlagged model. Stakeholder interviews found that extensive and sustained diarrhoeal interventions were perceived to be responsible for the overall reduction in diarrhoeal incidence and mortality over the prior decade. During the drought, as diarrhoeal interventions were maintained, the expected increase in incidence in the public health sector did not occur. CONCLUSIONS We found that that diarrhoeal incidence has decreased over the last decade and that incidence is strongly influenced by local temperature and humidity, particularly over the hot dry season. While climate change and extreme weather events especially stress systems supporting vulnerable populations such as young children, maintaining strong and consistent public health interventions helps to reduce negative health impacts.
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Affiliation(s)
- Tristan Taylor Lee
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Mohamed Aqiel Dalvie
- Centre for Environmental and Occupational Health Research, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Sonja Merten
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Marek Kwiatkowski
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Hassan Mahomed
- Metro Health Services, Western Cape Government: Health and Wellness, Western Cape, South Africa
- Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Neville Sweijd
- Alliance for Collaboration on Climate and Earth Systems Science, Council for Scientific and Industrial Research, Pretoria, South Africa
| | - Guéladio Cissé
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
- University of Basel, Basel, Switzerland.
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Determinants of diarrhoeal disease in children living in low-income households in a periurban community in Cape Town, South Africa. SOUTH AFRICAN JOURNAL OF CHILD HEALTH 2022. [DOI: 10.7196/sajch.2022.v16.i3.1876] [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. Water, sanitation and hygiene are critically important in reducing morbidity and mortality from childhood diarrhoeal disease and malnutrition in low-income settings.Objectives. To assess the association of diarrhoeal disease with factors relating to domestic hygiene, the environment, sociodemographic status and anthropometry in children <2 years of age.Methods. This was a case-control study conducted in a periurban community 35 km from the centre of Cape Town, South Africa. The study included 100 children with diarrhoeal disease and 100 age-matched controls without diarrhoea, who were recruited at primary healthcare clinics. Sociodemographic status, environmental factors and domestic hygiene were assessed using a structured questionnaire; anthropometry was assessed using the World Health Organization’s child growth standards. Univariate and multivariate logistic regression analyses were performed to identify the factors associated with diarrhoea. Results. The results of the univariate logistic regression showed significant susceptibility to diarrhoea in study cases compared with controls when the caregiver was ≥25 years old (odds ratio (OR) 1.82; 95% confidence interval (CI) 1.02 - 3.23; p=0.042); when children were in day care or cared for by a family member or a relative than when cared for by their mother (OR 1.97; 95% CI 1.06 - 3.65; p=0.032); and when the mothers were employed rather than at home (OR 2.23; 95% CI 1.21 - 4.12; p=0.01). Multivariate logistic regression analysis was used to identify predictors of diarrhoea, which entailed relaxing the inclusion criteria for the univariate analysis variables (p<0.25). The predictors significantly associated with diarrhoea were household problems relating to rat infestation (OR 2.44; 95% CI 1.13 - 5.28; p=0.027); maternal employment (OR 2.47; 95% CI 1.28 - 4.76; p=0.007); and children in day care or cared for by a relative (OR 2.34; 95% CI 1.21 - 4.54; p=0.01). Significantly more of the mothers who were employed than those who were unemployed had children in day care or cared for by a relative.Conclusion. Practices relating to employment, childcare and the domestic environment were significant predictors of diarrhoea. Effective policy implementation on water, sanitation and domestic hygiene could prevent diarrhoeal disease and reduce its impact on children’s growth, especially during the annual diarrhoeal surge season in this and similar periurban communities.
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Prevalence of Multidrug-Resistant Diarrheagenic Escherichia coli in Asia: A Systematic Review and Meta-Analysis. Antibiotics (Basel) 2022; 11:antibiotics11101333. [PMID: 36289991 PMCID: PMC9598397 DOI: 10.3390/antibiotics11101333] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/20/2022] [Accepted: 09/28/2022] [Indexed: 12/02/2022] Open
Abstract
Diarrhea is one of the leading causes of morbidity and mortality in developing countries. Diarrheagenic Escherichia coli (DEC) is an important bacterial agent for diarrhea in infants, children, and international travelers, and accounts for more than 30% of diarrheal cases in children less than 5 years old. However, the choices of antimicrobial agents are now being limited by the ineffectiveness of many first-line drugs, in relation to the emergence of antimicrobial-resistant E. coli strains. The aim of this systematic review and meta-analysis was to provide an updated prevalence of antimicrobial-resistant DEC in Asia. A comprehensive systematic search was conducted on three electronic databases (PubMed, ScienceDirect, and Scopus), where 40 eligible studies published between 2010 and 2022 were identified. Using meta-analysis of proportions and a random-effects model, the pooled prevalence of DEC in Asian diarrheal patients was 22.8% (95% CI: 16.5–29.2). The overall prevalence of multidrug-resistant (MDR) and extended-spectrum beta-lactamase (ESBL)-producing DEC strains was estimated to be 66.3% (95% CI: 58.9–73.7) and 48.6% (95% CI: 35.1–62.1), respectively. Considering antimicrobial drugs for DEC, the resistance prevalence was highest for the penicillin class of antibiotics, where 80.9% of the DEC isolates were resistant to amoxicillin and 73.5% were resistant to ampicillin. In contrast, resistance to carbapenems such as imipenem (0.1%), ertapenem (2.6%), and meropenem (7.9%) was the lowest. The relatively high prevalence estimation signifies that the multidrug-resistant DEC is a public health threat. Effective antibiotic treatment strategies, which may lead to better outcomes for the control of E. coli infections in Asia, are necessary.
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Nantege R, Kajoba D, Ddamulira C, Ndoboli F, Ndungutse D. Prevalence and factors associated with diarrheal diseases among children below five years in selected slum settlements in Entebbe municipality, Wakiso district, Uganda. BMC Pediatr 2022; 22:394. [PMID: 35799163 PMCID: PMC9264597 DOI: 10.1186/s12887-022-03448-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background Despite global interventions to prevent and control diarrhea, it still remains a public health problem leading to childhood morbidity and mortality majorly in developing countries. In Uganda, diarrhea is amongst the five leading causes of under-five mortality, contributing to more than 140,000 deaths every year and this accounts for 7.1% of all under-five mortalities in Uganda. Efforts to prevent and lower diarrheal diseases need to be informed by data on determinants of diarrhea. The study assessed factors associated with diarrheal diseases among children below five years in selected slum settlements in Entebbe municipality, Wakiso District, Uganda. Methods The study employed a cross-sectional study design covering 384 randomly selected households having children < 5 years old in the study area using quantitative research methods. Data was collected using close-ended questionnaires and diarrhea disease history was captured for the last month before the survey. Bivariate and multivariate logistic regression analyses were used to identify the risk factors associated with childhood diarrhea considering a 95% confidence level. Results The prevalence of Diarrhea disease in children among the selected slum settlements in Entebbe municipality was found to be at 62.4%. Access to water from a protected water source (deep well and borehole), presence of a vent in toilets, age, and child birth weight were found to be significantly associated with diarrheal diseases among children below five years in the selected slum settlements in Entebbe municipality. Conclusion The prevalence of childhood diarrhea among children < 5 years of age in selected slums of Entebbe municipality was found high. Use of water from a protected source, presence of a vent in toilets, age, child birth and weight were identified as predictors of diarrhea occurrence. These findings imply that community health education is urgently needed for fighting childhood diarrhea in the study area to eliminate the predisposing factors to diarrhea. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03448-2.
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Affiliation(s)
- Robinah Nantege
- Department of Public Health, School of Graduate Studies, Bugema University, Kampala, Uganda.,Ministry of Water and Environment, Kampala, Uganda
| | - Dickson Kajoba
- Department of Paediatrics and Child Health, Faculty of Clinical Medicine and Dentistry, Kampala International University, Kampala, Uganda.
| | - Christopher Ddamulira
- Department of Public Health, School of Graduate Studies, Bugema University, Kampala, Uganda
| | - Fred Ndoboli
- Department of Public Health, School of Graduate Studies, Bugema University, Kampala, Uganda
| | - David Ndungutse
- Department of Public Health, School of Graduate Studies, Bugema University, Kampala, Uganda
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Musuka G, Dzinamarira T, Murewanhema G, Cuadros D, Chingombe I, Herrera H, Takavarasha F, Mapingure M. Associations of diarrhea episodes and seeking medical treatment among children under five years: Insights from the Zimbabwe Demographic Health Survey (2015-2016). Food Sci Nutr 2021; 9:6335-6342. [PMID: 34760263 PMCID: PMC8565232 DOI: 10.1002/fsn3.2596] [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: 08/18/2021] [Revised: 09/08/2021] [Accepted: 09/12/2021] [Indexed: 12/24/2022] Open
Abstract
Diarrhea is a significant pediatric public health concern globally and places a significant burden on healthcare systems. In resource-limited settings, the problems of diarrhea could be worse than reported. Continuously monitoring and understanding the changing epidemiology of diarrhea, including risk factors, remain an important aspect necessary to design effective public health interventions to reduce the incidence, outcomes and strain on healthcare resources caused by diarrheal illness. We, therefore, undertook this study to understand the factors associated with diarrhea as well as describe determinants for seeking medical treatment in children under-five in Zimbabwe using the Zimbabwe Demographic and Health Survey 2015-2016 Data. Children with recent diarrhea were on average younger (mean age 22 months), compared to those who did not have an episode of diarrhea (mean age 30 months) p = .001. Incidence of recent diarrhea was lower among female children compared to their male counterparts (16% vs. 19%), p = .013. Incidence of diarrhea decreased with increasing maternal education level and so was the same for increasing wealth quintile. Those with unimproved sources of drinking water had a higher incidence of diarrhea. The wealth quintile remained the only factor associated with seeking medical attention for a recent diarrhea episode among children less than 6 years, with those in the highest wealth quintile being 2.49 times likely to do so, p = .031. The results are useful in informing pediatric public health policies and strategies for them to be successful in significantly reducing the incidence, morbidity, mortality and significant healthcare costs and burden to society associated with caring for children with diarrheal illnesses.
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Affiliation(s)
| | - Tafadzwa Dzinamarira
- ICAP at Columbia UniversityHarareZimbabwe
- School of Health Systems & Public HealthUniversity of PretoriaPretoriaSouth Africa
| | - Grant Murewanhema
- Unit of Obstetrics and GynaecologyFaculty of Medicine and Health SciencesUniversity of ZimbabweHarareZimbabwe
| | - Diego Cuadros
- Department of Geography and Geographic Information ScienceUniversity of CincinnatiUSA
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