This paper examines the nutrition impacts of using non-solid cooking fuel on under-five children in developing countries.We draw on data from more than 1.12 million children in 62 developing countries from the Demogra...This paper examines the nutrition impacts of using non-solid cooking fuel on under-five children in developing countries.We draw on data from more than 1.12 million children in 62 developing countries from the Demographic and Health Surveys(DHS).Results from both fixed effects(FE)and instrumental variable(IV)estimates show that using non-solid cooking fuel significantly improves the nutrition outcomes of under-five children.Compared with their peers from households mainly using solid fuel,children from households mainly using non-solid fuel exhibit a lower probability of experiencing stunting(by 5.9 percentage points)and being underweight(by 1.2 percentage points).Our further investigation provides evidence for several underlying mechanisms,such as improved indoor air quality,induced reduction in children’s respiratory symptoms,benefits on maternal health,and reduction in maternal time spent on fuel collection or cooking.Heterogenous analyses suggest that the nutrition benefits of using non-solid cooking fuel are more prominent among boys,children above three years old,and those from households of lower socioeconomic status,rural areas,and Southeast Asia.展开更多
Despite considerable efforts to reduce under-five mortality nationwide,Nigeria has fallen short of achieving the Millennium Development Goals(MDGs)target of 67 deaths per 1,000 live births by 2015.Of all the documente...Despite considerable efforts to reduce under-five mortality nationwide,Nigeria has fallen short of achieving the Millennium Development Goals(MDGs)target of 67 deaths per 1,000 live births by 2015.Of all the documented factors of under-five mortality,little evidence exists on the impact of systemic barriers and individual factors(maternal health-seeking behaviour)on under-five mortality in Nigeria.The study used a nationally representative sample from Nigeria Demographic and Health Survey(NDHS)2013 dataset.The target population was 20,192 women aged 15-59 years who had given birth to 31,480 children five years before the survey.Stata software was used for data analysis.The risk of death was estimated using Cox proportional hazard models and results are presented as hazards ratios(HR)with 95%confidence intervals(CI).Findings from the overall Model I-IV revealed individual factors(maternal health-seeking indicators)as significant factors of under-five deaths(p<0.05).Children whose mothers received antenatal care coverage(ANC)outside health care facilities(HCF)(HR:1.60,CI:1.0-2.4,p<0.05);or delivered outside HCF(HR:1.02,CI:0.7-1.5,p<0.05)had elevated hazard risk of death before age five.Conversely,children who were presented for postnatal check within two weeks of delivery(HR:0.60,CI:0.5-0.8,p<0.05),or delivered within the longer birth interval(HR:0.67,CI:0.6-0.8,p<0.001)had significantly lower hazard risk of death before age five.As part of systemic factors,children whose mothers were covered by health insurance scheme had significantly(HR:0.52,CI:0.2-1.2,p<0.001)lower risk of death when compared with their counterparts without health insurance coverage.The study emphasized the need to revitalize strategies and programs to improve women health seeking behaviour and investment in the health sector through health insurance,infrastructure,and supplies.展开更多
Background: Diarrheal disease is a major cause of morbidity and mortality among children in many developing countries, including Ethiopia and is a leading cause of morbidity in Pastoralist Ethiopian-Somali region. Dia...Background: Diarrheal disease is a major cause of morbidity and mortality among children in many developing countries, including Ethiopia and is a leading cause of morbidity in Pastoralist Ethiopian-Somali region. Diarrheal disease is not purely medical, but huge part of this should be traced back to the social, economic, environmental and behavioural aspects of the family. Determining these interactions is relevant to prevent and control diarrhoea. Objective: The objective of this study was to measure the prevalence of diarrhoea and describe associated factors relating to diarrheal disease among under-five children in Jigjiga district. Methods: A cross-sectional study was conducted in Jigjiga district from June 12 to 26 in 2014 using a structured and pretested questionnaire. A total of 1807 primary care takers were interviewed. Proportionate to size allocation was done and simple random selection was used to select sample units. Diarrheal morbidity occurred in the under-five children in the past 14 days were registered to determine prevalence. Data were entered using Epi Info version 3.5.3 and analysed in SPSS version 20. Odds ratio with 95% CI in a multivariate logistic regression was employed to control confounding factors. Results: The findings of this study showed that the overall two-week period prevalence of diarrhoea in under-five children was 27.3%: 95% CI (26.9%, 27.4%). Education of the primary caretaker, occupation of the father, birth order of the child, maternal diarrhoea, and hand washing during critical times, water source, type of water storage container, latrine availability, frequency of household solid waste water disposal, availability of liquid waste water drainage system and the type of the kitchen floor material showed as independent predictors of under-five child hood diarrhoea. Conclusion: This study revealed that diarrhoea morbidity was relatively high among children under-five years of age residing in Somali region. Efforts to reduce childhood diarrhoea should focus mainly on water, sanitation and hygiene interventions including health education.展开更多
Background: Under-five mortality is one of the indicators of the millennium development goals (MDGs) for the child mortality reduction goal. Understanding the social determinants of under-five mortality is helpful to ...Background: Under-five mortality is one of the indicators of the millennium development goals (MDGs) for the child mortality reduction goal. Understanding the social determinants of under-five mortality is helpful to narrow the gap between different social classes. Therefore, this study focused on the social determinants of under-five mortality inEthiopiausing EDHS 2011 data. Methods: The data source for this analysis was the 2011 EDHS which was undertaken over a five-month period from 27 December, 2010 to 3 June, 2011. The sample was selected using a stratified, two-stage cluster design. Samples of 16,515 women of reproductive age were interviewed. The questionnaire used to collect information from these women who?had among other things such as?background characteristics of women, birth history of these women and the survival of each birth at the time of the interview. Births that had occurred to women in the last 10 years prior to the date of the?interview were extracted for the analysis. Descriptive statistical methods were used to describe the distribution of the characteristics of the data. Kaplan Meier plots and incidence rates per 1000 person years were used to compare survival across different categories of the risk factors. The effect of the risk factors on survival was analyzed using Cox proportional hazards regression. Data management and analysis were carried out using STATA 10. Results: A total of 23,581 under-five children were included in the study. The under-five mortality incidence rate in Ethiopia for the last ten years was 29.6 per 1000 person years. Maternal education beyond primary level of education reduced the risk of under-five mortality by about half. A significant reduction in risk of under-five mortality was observed among births to mothers residing in richest households. The hazard ratio (HR) was higher for under-five mortality among boys than daughters, twins than singleton, teen age mother than higher ages and short births than optimal. Conclusions: Empowering mothers with education and making them productive for improving their income are important aspects for reducing under-five mortality. Emerging regions were disadvantaged on the incidence of under-five mortality;however, there was a positive result in narrowing the urban-rural under-five mortality risks. Being teenage mother at birth, short birth interval and twin births were identified risk factors for increased under-five mortality in Ethiopia. Interventions targeted at empowering women and much effort in emerging regions are required. Preventing teenage motherhood and promoting optimal birth spacing are also required to reduce under-five mortality in Ethiopia.展开更多
Introduction:Diarrhoea remains the second most serious health problem among children below five years old in Solomon Islands and is one of the leading causes of infant mortality,which caused about one in every ten chi...Introduction:Diarrhoea remains the second most serious health problem among children below five years old in Solomon Islands and is one of the leading causes of infant mortality,which caused about one in every ten children dying before the age of five years.Globally,around 6 million children (<5 years) suffer from diarrhoea each year.Because of lack of previous studies,this study aims to assess the predictors of knowledge and practice of caregivers towards diarrhoea among under-five children in Mataniko informal settlements in Honiara,Solomon Islands,2016.Methods:This quantitative study was conducted at three randomly selected settlements in Honiara,Solomon Islands from June to July 2016.This study was conducted among both male and female caregivers who had children under five years of age,were aged 18 and over,live in Solomon Islands and were willing to participate in the study.A validated structured questionnaire was used to collect the data based on a 2-week recall of diarrhoea episodes.To avoid double-counting,each surveyed household was geo-referenced using global positioning system (GPS).The collected data were entered and analysed using SPSS (version 23.0) and descriptive and analytical statistics.P<0.05 was considered as statistically significant.This study was approved by relevant ethical committees.Results:A total of 205 caregivers with at least one child under-five years participated in the study.The mean ages of caregivers and the under-five children were (30.7+8.2) years and (2.6+1.5) years,respectively.Among 205 caregivers,94 of them had reported that their children (<5 years) had suffered with at least one episode of diarrhoea within the last 2 weeks prior to the survey.This gave a prevalence rate of 45.9%.The caregiver's knowledge about the causes (99.0%) and prevention (98.0%) of under-five diarrhoea was extremely high.Nevertheless,less than half had regularly practiced essential hygiene habits.The factors which appeared to be significantly associated with under-five diarrhoea were irregular hand washing (odds ratio [OR] 2.07,95% confidence interval [CI]:1.12-3.81,P=0.020),inappropriate methods of disposing of children's fecal waste (OR 1.88,95% CIL 1.06-3.33,P=0.030),and using the river for bathing (OR 1.83,95% CI:1.04-3.23,P=0.036),and laundry (OR 2.17,95% CI:1.23-3.84,P=0.008).Conclusion:Diarrhoea is a major public health problem among children below five years in Mataniko informal settlements.To address these exposures,relevant programs and projects should be designed,especially in areas like family planning,household economic allocation and political commitment.Awareness and advocacy programs on birth spacing,food hygiene and potential health risks about the river should be ongoing at the community level.展开更多
This paper examines determinants of under-five mortality in Bangladesh. The study utilizes the data extracted from the 2007 Bangladesh demographic and health survey. Chi-square test for independence and multivariate p...This paper examines determinants of under-five mortality in Bangladesh. The study utilizes the data extracted from the 2007 Bangladesh demographic and health survey. Chi-square test for independence and multivariate proportional hazard analysis reflects that father’s education, place of residence, region of residence, number of children under five years of age, previous death of sibling, mother’s age and breastfeeding have significant influence on under-five mortality. The proximate determinants are found to have stronger influence on under-five mortality than the socioeconomic factors considered in the study do.展开更多
Bangladesh is on target for achieving the Millennium Development Goal 4 relating to infant and under-five mortality because of very rapid reduction in mortality in recent years. But this rate of reduction may be diffi...Bangladesh is on target for achieving the Millennium Development Goal 4 relating to infant and under-five mortality because of very rapid reduction in mortality in recent years. But this rate of reduction may be difficult to sustain and may hamper the achievement of Millennium Development Goal 4. Therefore, the main objective of this paper is to discuss and compare the dif- ferent covariates of infant and under-five mortality in the context of overall country, urban and rural levels of Bangladesh using discriminant analysis. For this, the data are taken from Bangladesh Demographic and Health Survey, 2004. In discriminant analysis, the stepwise procedure has been picked up and only the significant variables are ranked according to the rank of Wilk's Lambda val- ues. The canonical discriminant function coefficients (unstandard- ized and standardized) for the predictor variables have also been calculated. Both the results show that breastfeeding is the most important variable in discriminating the two groups of mothers, i.e., mothers experiencing to infant mortality or not and mothers experiencing to under-five mortality or not. The related results of discriminant function also indicate that the discriminant func- tion is statistically significant and discriminates well. Therefore, improvements in the health system are essential for promoting the breastfeeding practices (both inclusive and exclusive), which may be the effective strategies to reach families and communities with targeted messages and information.展开更多
Most uncomplicated malaria dominated countries have embraced the recommended first-line treatment of uncomplicated malaria. Artemisinin-based combination therapies such as Artemether-Lumefantrine, Artesunate + Amodiaq...Most uncomplicated malaria dominated countries have embraced the recommended first-line treatment of uncomplicated malaria. Artemisinin-based combination therapies such as Artemether-Lumefantrine, Artesunate + Amodiaquine and Dihydroartemisinin-Piperaquine have shown to be effective with Artemether-Lumefantrine and considered the most effective and approved by WHO. The study collected and reviewed recent randomized controlled trials for the treatment of uncomplicated malaria under five children. Eligibility criteria for the selected studies were based on the use of tools such as PICO (T) and data extraction tools such as REPOSE guidelines, PRISMA statement and eligibility criteria. This study includes only RCTs on the treatment of uncomplicated malaria under 5 s. Data was analyzed through comparative-narrative analysis. This study found 8 studies. Selected studies had a total of 10,682 participants within the age range of 0 - 59 months with the diagnosis of uncomplicated malaria and an MCP range of 2000 - 200,000 treated with different antimalarial drugs. Artesunate + Amodiaquine and Dihydroartemisinin-Piperaquine and Artemether-Lumefantrine drugs were found to be consistent in the treatment of uncomplicated malaria under 5 s within three days. Findings show that Artemether-Lumefantrine, Artesunate + Amodiaquine and Dihydroartemisinin-Piperaquine were the best drugs of choice due to their fast rate in fever reduction and parasite clearance. The efficacy of Artesunate + Amodiaquine and Dihydroartemisinin-Piperaquine is comparable to Dihydroartemisinin-Piperaquine. The study concludes that Artesunate + Amodiaquine and Dihydroartemisinin-Piperaquine can also be drugs of choice along with the well-known and utilized Artemether-Lumefantrine combination because of the fever reduction and parasite clearance within the first three days duration.展开更多
<strong>Objective:</strong> To explore the practice of management of diarrhea in under-5-year children at health facilities found in Hawassa town, and associated factors with malpractice in comparison.<...<strong>Objective:</strong> To explore the practice of management of diarrhea in under-5-year children at health facilities found in Hawassa town, and associated factors with malpractice in comparison.<strong> Methodology:</strong> Cross Sectional study was conducted in 2 hospitals, 2 health centers and 2 private clinics that are found in Hawassa city which is found in Southern Nations, Nationalities and peoples (SNNP), 275 KM to south from Addis Ababa, capital city of Ethiopia from august 2017-October 2017. Structured checklist was used to retrieve the required information from the patients on arrival and stay in pediatrics OPDs and wards. The data analysis carried out using SPSS version 20.0. Logistic regression was carried out to analyze the association between the independent and dependent variables. Statistically significant associations were declared at <em>p</em>-values of less than or equal to 0.05. <strong>Results:</strong> Out of 420, about 397 (94.5%) children with diarrheal disease between the ages of 3 - 59 months were studied. The study subjects were from governmental hospitals (35.5%), health centers (34.5%) and private clinics (30%) that are found in Hawassa City. Sign of dehydration was 66 (17%) of which majority 59 (83%) of them were rehydrated. As to Zink supplementation, only 180 (45%) received it;antibiotics were the commonly (59.1%) prescribed drugs. Only 43.3% of children were appropriately managed. Hospitals had higher odds of inappropriate management of diarrhea with AOR = 1.61 (95% CI: 1.04 - 2.5) and children one year or younger were more inappropriately managed for diarrhea at the health facilities with AOR of 2.3 (95% CI: 1.57 - 4.41). <strong>Conclusions:</strong> In the current study the management of diarrhea at the health facilities is unsatisfactory as only less than half of children with diarrhea were properly managed. Treatment of diarrhea at hospital level and the patient’s age being less than 1 year were found to significantly affect the level of mismanagement of the diarrheal disease. Therefore, orientation and trainings for health care providers especially GPs and Residents should be given to adhere to recommended zinc therapy, Oral Rehydration Salts (ORS) replacement therapy and rational antibiotics prescription.展开更多
Introduction: Cameroon is a hyperendemic country to malaria where it remains a major public health concern, especially amongst children under-five. Insecticide-treated bednets (ITBNs) is the main control strategies. T...Introduction: Cameroon is a hyperendemic country to malaria where it remains a major public health concern, especially amongst children under-five. Insecticide-treated bednets (ITBNs) is the main control strategies. This study aimed at determining the predictors of malaria prevalence and coverage of ITBNs among under-five children in the Buea Health District (BHD), South West Region of Cameroon in other to reduce the morbidity and mortality of malaria. Methods: A cross-sectional study was carried out in the BHD which is a malaria-hyperendemic area. Every head (female/male) of the household who was present at home at the time of data collection was randomly interviewed using a structured questionnaire. Under-five children were ascertained for malaria using microscopy, with a temperature of ≥37.50°C. Results: Out of 391 children (mean age = 19.7 month, SD = 2.5) who were selected and ascertained for malaria, the overall malaria prevalence was 13.04% (95% CI: 10.04 - 16.78). In a multivariate analysis after adjusting for confounders, female parents/guardians (AOR = 0.53, 95% CI: 0.29 - 0.91) was associated with low risk of malaria while parents/guardians with no formal/primary educational (AOR = 3.3, 95% CI: 1.76 - 4.04) and children who did not use ITBN (AOR = 1.40, 95% CI: 1.08 - 2.51) were associated with an increased risk of malaria. Out of the selected children, 84.4% possessed ITBN (95% CI: 80.4 - 87.7) while 72.6% (95% CI: 67.9 - 76.8) used ITBN. In a multivariate after adjusting for confounders, Bova health area showed a significantly lower usage of ITBNs (χ 2 = 14.053, p = 0.003). Conclusion: The findings indicate that increased ITBN usage, increased parents/guardians’ educational level and good knowledge of ITBN is required to lower the risk of under-five children being infected with malaria. Health area of residence greatly influences the direct relationship between bednets possession and usage. These, therefore, indicates the possession of ITBN doesn’t mean their usage. The Cameroon National malaria control programs should consider the realities of the living conditions of the population for the implementation of better policies.展开更多
Background: Diarrhoeal disease in under-five children is a serious public health challenge especially in low income countries including Ethiopia. In Ethiopia, several interventions are going on to reduce morbidity, an...Background: Diarrhoeal disease in under-five children is a serious public health challenge especially in low income countries including Ethiopia. In Ethiopia, several interventions are going on to reduce morbidity, and mortality of children. The objective of the study was to assess the prevalence and associated factors of diarrhoeal diseases among under-five children in the City Administration of Bahir Dar. Methods: A community based cross-sectional study was conducted on a sample size of 667 mothers/caregivers having under-five children. Participants were selected through multistage sampling technique. Structured questionnaire and observation checklist were used to collect data. It was analyzed using SPSS version 16 for windows. Logistic regression was applied to measure possible associations. Strength of association, and statistical significance was measured using odds ratio and confidence interval at 95% confidence level. Results: A total of 667 mothers/ caregivers with under-five children were included in the study. Two-week prevalence of diarrhoea was 21.6%. Households in rural part of the city (OR: 2.82, 95%CI: 1.66 - 4.81), monthly income ≤ birr 500 (OR: 2.27, 95%CI: 1.44 - 3.57, failure to use separate container for storing drinking water (OR: 1.78, 95%CI: 1.17 - 2.70), presence of human excreta in the compound (OR: 1.88, 95% (1.15 - 3.06) were found to be predictors of childhood diarrhoea. Conclusion: Diarrhoeal diseases remain serious public health challenge in rural as well as urban set ups in Ethiopia with particular reference to Bahir Dar City, despite several interventions over decades. Therefore, interventions, and strategies applied so far to eliminate diseases of poverty including diarrhoeal diseases should be re-visited.展开更多
Introduction: Domestic accidents are a public health problem, and under-fives are particularly affected. We report these accidents’ epidemiology, diagnosis, management, and outcomes through this study. Patients and M...Introduction: Domestic accidents are a public health problem, and under-fives are particularly affected. We report these accidents’ epidemiology, diagnosis, management, and outcomes through this study. Patients and Methods: We conducted a prospective descriptive study for four months in the Albert Royer National Children’s Hospital Center pediatric surgery department in Dakar, Senegal. Of the 149 cases of domestic accidents, 109 were included in this study. Results: Infants (59.6%) were the most affected, with a slight male predominance (50.5%). Accidents occurred on Tuesday in 22.9% of cases and the afternoon in 38.5% of cases. Playing (59.6%) was the main activity, and falling (44%) was the most found mechanism. 78.9% of accidents occurred in the house, with the bedroom (27.5%) being the most represented place. In most cases (67.9%), the consultation was done within the first 24 hours. The upper limbs (48.6%) were the most affected, and fractures (31.2%) were the most frequent injuries. The outcomes were unremarkable in 94.5% of cases, as complications occurred in five patients with three who had an infection, one a persistent limping, and the last, a dental avulsion. No mortality was recorded. Conclusion: Domestic accidents among under-fives are frequent in our environment. Compared to those in older children, they occur similarly in both sexes, more often in the bedroom, and have a better prognosis.展开更多
Background: Malaria has remained one of the leading causes of morbidity and mortality in children despite effective preventive and treatment modalities. This study is aimed at looking at the malaria preventive practic...Background: Malaria has remained one of the leading causes of morbidity and mortality in children despite effective preventive and treatment modalities. This study is aimed at looking at the malaria preventive practices among under-five children in three Niger Delta states in Nigeria and comparing the differences among them if any. Methods: This was a cross sectional study carried out over six months from 1st January to 30th June 2019 in public health facilities among under-five children in three South-South states (Akwa Ibom, Delta and Rivers) of Nigeria. Using a stratified sampling method, children were recruited from 36 health facilities in the three states. A pretested interviewer administered questionnaire was used to harvest relevant information on socio-demographic characteristics of the subjects and informants and malaria preventive practices. Obtained data was analysed using SPSS version 22 and results are presented in prose and frequency tables. Chi-square and Fischer’s exact were used for comparison of categorical variables, while a p-value of Results: A total of 3144 children participated in the study: 1661 (52.8%) were males while 1483 (47.2%) were females. Children less than 2 years represented 77.6% of the study participants while the mean age was 1.72 ± 1.06 years. Mothers constituted over 80% of the informants in all the states. More of the informants had secondary education in Akwa Ibom and Delta states, while in Rivers state, more of them had tertiary education. Malaria prevention method practiced in the three states included;use of insecticide treated bed net (ITNs), insecticide spray, anti-malarial drugs, clearing of bushes and disposal of mosquito breeding cans and use of mosquito repellents. Indoor residual spraying (IRS) was not practiced in any of the states. Use of ITN was practiced more in Rivers state (53.2%) than in Delta (20.3%) and Akwa Ibom (8.2%) states, while use of insecticide spray was commoner in Akwa Ibom state (77.2%) than in Delta (56.3%) and Rivers (42.4%). This difference in the prevention techniques practiced among the states was statistically significant (Fischers exact?−724.2, p-value = 0.0001). Conclusion: In conclusion, the practice of ITNs use is low in South-South Nigeria with IRS not being practiced at all. Introduction of IRS as a method of malaria vector control and public health education on ITNs ownership and use is advocated.展开更多
Little studies and analysis have been undertaken to investigate the housing determinants of under-five mortality in Ethiopia. This study, therefore, explores the impacts of urban housing variables on the levels and pa...Little studies and analysis have been undertaken to investigate the housing determinants of under-five mortality in Ethiopia. This study, therefore, explores the impacts of urban housing variables on the levels and patterns of under-five mortality in the country based on the SPSS (Statistic Package for Social Science) file of the 2005 Ethiopian Demographic and Health Survey (EDHS). This survey covered a sample of about 4,420 households/housing units of urban Ethiopia. The under-five deaths are computed for women in the age group 15-49 by subtracting the number of children living from children ever born (CEB) and established the proportion dead by dividing deaths by CEB corresponding to the categorical variables of housing structure, facilities, and household durables. The analytical techniques of the study included univariate, bivariate, and multivariate data analysis of the proportional variations of childhood mortality patterns being manifested by "bar graphs" with respect to housing situations as well as household durables. Amongst the categorical variables of the housing structures, facilities, and household durables with the highest no prevalence of under-five mortality levels are found to be the units of unconventional walls, thatched/leaf/reed roofing, animal dung flooring, shared pit latrine/use of bucket/bush, using kerosene, firewood/straw/charcoal for cooking, unconventional lighting, unprotected water supply, households with no durables.展开更多
Under-five mortality remains a major concern in the world and in Senegal. It is mainly due to preventable and treatable diseases with priority life-saving medicines for under-five children. This study evaluated the av...Under-five mortality remains a major concern in the world and in Senegal. It is mainly due to preventable and treatable diseases with priority life-saving medicines for under-five children. This study evaluated the availability, management and use of these drugs in two health districts in Senegal. A descriptive cross-sectional study was conducted in the health districts of Guediawaye and Pete from 01 November 2018 to 31 January 2019. The health district of Guediawaye is in the region hosting the Senegalese capital while that of Pete is located in the region of Saint Louis, northern Senegal. Nine drugs that can prevent and treat malaria, diarrhea, pneumonia and malnutrition were selected. An inventory form and a self-administered questionnaire were used to collect data that was analyzed with SPSS and expressed as a percentage and average. Drug availability was 50.4% and 54.3% in Guediawaye and in Pete, respectively. Average stock-out duration in the past three months was estimated at 22.6 and 26 days, respectively. The drug management was marked, on the one hand, by a good availability of stock cards in the two districts with proportions equal to 100% and 94.1%, respectively, and on the other hand, by the presence of expired stocks in Pete (12.2%). About 79% and 88% of prescribers reported prescribing the basket drug, respectively. These results show that access to priority life-saving medicines for children remains a challenge. Measures to be taken should include improving the distribution channels and training of health professionals. Further studies should be conducted in other health districts to better understand the barriers to access to child health services.展开更多
Background:Nowdays,both of parents are working to fulfill their family needs and family financial.However,this condition effected separation of family that have a negative impact for children.Children can lose of a pr...Background:Nowdays,both of parents are working to fulfill their family needs and family financial.However,this condition effected separation of family that have a negative impact for children.Children can lose of a primary caregiver who can endanger the welfare of children.Purpose:To analyzed the relationship between family separation and nutritional status of under-five children aged in Panti District of Jember Regency.Methods:A cross-sectional design was conducted among 53 families using total sampling.A family background questionnaire was used to measure sociodemographics and separation of family.Among 53 families were 78.2%of separation with father,while 38.6%of children with a good nutrition status.Kruskal Wallis and One-Way Anova was performed to answer the objective of this study.Results:The result showed that,there were no correlation between length of separation with nutritional status(F=0.377;P-value=0,688).Meanwhile,distance of separation wascorrelated with nutritional status(c2=8.310;P-value=0,016).Conclusion:Parents need to improve relationships,communication and the distribution of proper autonomy in family.It can make the nutritional status and health level of the child becomes better.展开更多
Background:Recent studies have presented conflicting findings about whether malaria is associated with an increased or decreased risk of malnutrition.Therefore,assessing the relationship between these two disastrous d...Background:Recent studies have presented conflicting findings about whether malaria is associated with an increased or decreased risk of malnutrition.Therefore,assessing the relationship between these two disastrous diseases in the most vulnerable groups,such as in children aged below 5 years(under-five children),may lead to the discovery of new low-cost and effective aides to current methods of malnutrition prevention in malariaendemic areas.Therefore,this study was conducted to assess the relationship between malaria and malnutrition among under five children in an area with a high degree of malaria transmission.Methods:The study involved comparing malnourished children aged 6-59 months and nourished children of the same age for their past exposure to malaria,in Shashogo District,Southern Ethiopia.A validated structured questionnaire was used to collect home to home socioeconomic data and anthropometric instruments for clinical data.The collected data were analysed using descriptive and inferential statistics by means of EpiData entry software and STATA data analysis software.Results:A total of 356(89 malnourished and 267 nourished)under-five children participated in the study.Previous exposure to Plasmodium infection was found to be a predictor for the manifestation of malnutrition in under-five children(P=0.02[OR=1.87,CI=1.115-3.138]).Children from a household with a monthly income of less than USD 15 were 4.5 more likely to be malnourished as compared to the other children(P=0.001[OR=0.422,CI=0.181-0.978]).Conclusion:This study found that exposure to Plasmodium has a significant impact on the nutritional status of children.In addition,socio-demographic factors,such as family income,may play a role in determining whether children are malnourished or not and may lead to increased morbidity due to malnourishment in children living in malaria-endemic areas.Therefore,malnutrition control interventions should be consolidated with malaria prevention strategies particularly in high malaria transmission areas.展开更多
基金This work was supported by the National Natural Science Foundation of China(71861147003 and 71925009).
文摘This paper examines the nutrition impacts of using non-solid cooking fuel on under-five children in developing countries.We draw on data from more than 1.12 million children in 62 developing countries from the Demographic and Health Surveys(DHS).Results from both fixed effects(FE)and instrumental variable(IV)estimates show that using non-solid cooking fuel significantly improves the nutrition outcomes of under-five children.Compared with their peers from households mainly using solid fuel,children from households mainly using non-solid fuel exhibit a lower probability of experiencing stunting(by 5.9 percentage points)and being underweight(by 1.2 percentage points).Our further investigation provides evidence for several underlying mechanisms,such as improved indoor air quality,induced reduction in children’s respiratory symptoms,benefits on maternal health,and reduction in maternal time spent on fuel collection or cooking.Heterogenous analyses suggest that the nutrition benefits of using non-solid cooking fuel are more prominent among boys,children above three years old,and those from households of lower socioeconomic status,rural areas,and Southeast Asia.
文摘Despite considerable efforts to reduce under-five mortality nationwide,Nigeria has fallen short of achieving the Millennium Development Goals(MDGs)target of 67 deaths per 1,000 live births by 2015.Of all the documented factors of under-five mortality,little evidence exists on the impact of systemic barriers and individual factors(maternal health-seeking behaviour)on under-five mortality in Nigeria.The study used a nationally representative sample from Nigeria Demographic and Health Survey(NDHS)2013 dataset.The target population was 20,192 women aged 15-59 years who had given birth to 31,480 children five years before the survey.Stata software was used for data analysis.The risk of death was estimated using Cox proportional hazard models and results are presented as hazards ratios(HR)with 95%confidence intervals(CI).Findings from the overall Model I-IV revealed individual factors(maternal health-seeking indicators)as significant factors of under-five deaths(p<0.05).Children whose mothers received antenatal care coverage(ANC)outside health care facilities(HCF)(HR:1.60,CI:1.0-2.4,p<0.05);or delivered outside HCF(HR:1.02,CI:0.7-1.5,p<0.05)had elevated hazard risk of death before age five.Conversely,children who were presented for postnatal check within two weeks of delivery(HR:0.60,CI:0.5-0.8,p<0.05),or delivered within the longer birth interval(HR:0.67,CI:0.6-0.8,p<0.001)had significantly lower hazard risk of death before age five.As part of systemic factors,children whose mothers were covered by health insurance scheme had significantly(HR:0.52,CI:0.2-1.2,p<0.001)lower risk of death when compared with their counterparts without health insurance coverage.The study emphasized the need to revitalize strategies and programs to improve women health seeking behaviour and investment in the health sector through health insurance,infrastructure,and supplies.
文摘Background: Diarrheal disease is a major cause of morbidity and mortality among children in many developing countries, including Ethiopia and is a leading cause of morbidity in Pastoralist Ethiopian-Somali region. Diarrheal disease is not purely medical, but huge part of this should be traced back to the social, economic, environmental and behavioural aspects of the family. Determining these interactions is relevant to prevent and control diarrhoea. Objective: The objective of this study was to measure the prevalence of diarrhoea and describe associated factors relating to diarrheal disease among under-five children in Jigjiga district. Methods: A cross-sectional study was conducted in Jigjiga district from June 12 to 26 in 2014 using a structured and pretested questionnaire. A total of 1807 primary care takers were interviewed. Proportionate to size allocation was done and simple random selection was used to select sample units. Diarrheal morbidity occurred in the under-five children in the past 14 days were registered to determine prevalence. Data were entered using Epi Info version 3.5.3 and analysed in SPSS version 20. Odds ratio with 95% CI in a multivariate logistic regression was employed to control confounding factors. Results: The findings of this study showed that the overall two-week period prevalence of diarrhoea in under-five children was 27.3%: 95% CI (26.9%, 27.4%). Education of the primary caretaker, occupation of the father, birth order of the child, maternal diarrhoea, and hand washing during critical times, water source, type of water storage container, latrine availability, frequency of household solid waste water disposal, availability of liquid waste water drainage system and the type of the kitchen floor material showed as independent predictors of under-five child hood diarrhoea. Conclusion: This study revealed that diarrhoea morbidity was relatively high among children under-five years of age residing in Somali region. Efforts to reduce childhood diarrhoea should focus mainly on water, sanitation and hygiene interventions including health education.
文摘Background: Under-five mortality is one of the indicators of the millennium development goals (MDGs) for the child mortality reduction goal. Understanding the social determinants of under-five mortality is helpful to narrow the gap between different social classes. Therefore, this study focused on the social determinants of under-five mortality inEthiopiausing EDHS 2011 data. Methods: The data source for this analysis was the 2011 EDHS which was undertaken over a five-month period from 27 December, 2010 to 3 June, 2011. The sample was selected using a stratified, two-stage cluster design. Samples of 16,515 women of reproductive age were interviewed. The questionnaire used to collect information from these women who?had among other things such as?background characteristics of women, birth history of these women and the survival of each birth at the time of the interview. Births that had occurred to women in the last 10 years prior to the date of the?interview were extracted for the analysis. Descriptive statistical methods were used to describe the distribution of the characteristics of the data. Kaplan Meier plots and incidence rates per 1000 person years were used to compare survival across different categories of the risk factors. The effect of the risk factors on survival was analyzed using Cox proportional hazards regression. Data management and analysis were carried out using STATA 10. Results: A total of 23,581 under-five children were included in the study. The under-five mortality incidence rate in Ethiopia for the last ten years was 29.6 per 1000 person years. Maternal education beyond primary level of education reduced the risk of under-five mortality by about half. A significant reduction in risk of under-five mortality was observed among births to mothers residing in richest households. The hazard ratio (HR) was higher for under-five mortality among boys than daughters, twins than singleton, teen age mother than higher ages and short births than optimal. Conclusions: Empowering mothers with education and making them productive for improving their income are important aspects for reducing under-five mortality. Emerging regions were disadvantaged on the incidence of under-five mortality;however, there was a positive result in narrowing the urban-rural under-five mortality risks. Being teenage mother at birth, short birth interval and twin births were identified risk factors for increased under-five mortality in Ethiopia. Interventions targeted at empowering women and much effort in emerging regions are required. Preventing teenage motherhood and promoting optimal birth spacing are also required to reduce under-five mortality in Ethiopia.
文摘Introduction:Diarrhoea remains the second most serious health problem among children below five years old in Solomon Islands and is one of the leading causes of infant mortality,which caused about one in every ten children dying before the age of five years.Globally,around 6 million children (<5 years) suffer from diarrhoea each year.Because of lack of previous studies,this study aims to assess the predictors of knowledge and practice of caregivers towards diarrhoea among under-five children in Mataniko informal settlements in Honiara,Solomon Islands,2016.Methods:This quantitative study was conducted at three randomly selected settlements in Honiara,Solomon Islands from June to July 2016.This study was conducted among both male and female caregivers who had children under five years of age,were aged 18 and over,live in Solomon Islands and were willing to participate in the study.A validated structured questionnaire was used to collect the data based on a 2-week recall of diarrhoea episodes.To avoid double-counting,each surveyed household was geo-referenced using global positioning system (GPS).The collected data were entered and analysed using SPSS (version 23.0) and descriptive and analytical statistics.P<0.05 was considered as statistically significant.This study was approved by relevant ethical committees.Results:A total of 205 caregivers with at least one child under-five years participated in the study.The mean ages of caregivers and the under-five children were (30.7+8.2) years and (2.6+1.5) years,respectively.Among 205 caregivers,94 of them had reported that their children (<5 years) had suffered with at least one episode of diarrhoea within the last 2 weeks prior to the survey.This gave a prevalence rate of 45.9%.The caregiver's knowledge about the causes (99.0%) and prevention (98.0%) of under-five diarrhoea was extremely high.Nevertheless,less than half had regularly practiced essential hygiene habits.The factors which appeared to be significantly associated with under-five diarrhoea were irregular hand washing (odds ratio [OR] 2.07,95% confidence interval [CI]:1.12-3.81,P=0.020),inappropriate methods of disposing of children's fecal waste (OR 1.88,95% CIL 1.06-3.33,P=0.030),and using the river for bathing (OR 1.83,95% CI:1.04-3.23,P=0.036),and laundry (OR 2.17,95% CI:1.23-3.84,P=0.008).Conclusion:Diarrhoea is a major public health problem among children below five years in Mataniko informal settlements.To address these exposures,relevant programs and projects should be designed,especially in areas like family planning,household economic allocation and political commitment.Awareness and advocacy programs on birth spacing,food hygiene and potential health risks about the river should be ongoing at the community level.
文摘This paper examines determinants of under-five mortality in Bangladesh. The study utilizes the data extracted from the 2007 Bangladesh demographic and health survey. Chi-square test for independence and multivariate proportional hazard analysis reflects that father’s education, place of residence, region of residence, number of children under five years of age, previous death of sibling, mother’s age and breastfeeding have significant influence on under-five mortality. The proximate determinants are found to have stronger influence on under-five mortality than the socioeconomic factors considered in the study do.
文摘Bangladesh is on target for achieving the Millennium Development Goal 4 relating to infant and under-five mortality because of very rapid reduction in mortality in recent years. But this rate of reduction may be difficult to sustain and may hamper the achievement of Millennium Development Goal 4. Therefore, the main objective of this paper is to discuss and compare the dif- ferent covariates of infant and under-five mortality in the context of overall country, urban and rural levels of Bangladesh using discriminant analysis. For this, the data are taken from Bangladesh Demographic and Health Survey, 2004. In discriminant analysis, the stepwise procedure has been picked up and only the significant variables are ranked according to the rank of Wilk's Lambda val- ues. The canonical discriminant function coefficients (unstandard- ized and standardized) for the predictor variables have also been calculated. Both the results show that breastfeeding is the most important variable in discriminating the two groups of mothers, i.e., mothers experiencing to infant mortality or not and mothers experiencing to under-five mortality or not. The related results of discriminant function also indicate that the discriminant func- tion is statistically significant and discriminates well. Therefore, improvements in the health system are essential for promoting the breastfeeding practices (both inclusive and exclusive), which may be the effective strategies to reach families and communities with targeted messages and information.
文摘Most uncomplicated malaria dominated countries have embraced the recommended first-line treatment of uncomplicated malaria. Artemisinin-based combination therapies such as Artemether-Lumefantrine, Artesunate + Amodiaquine and Dihydroartemisinin-Piperaquine have shown to be effective with Artemether-Lumefantrine and considered the most effective and approved by WHO. The study collected and reviewed recent randomized controlled trials for the treatment of uncomplicated malaria under five children. Eligibility criteria for the selected studies were based on the use of tools such as PICO (T) and data extraction tools such as REPOSE guidelines, PRISMA statement and eligibility criteria. This study includes only RCTs on the treatment of uncomplicated malaria under 5 s. Data was analyzed through comparative-narrative analysis. This study found 8 studies. Selected studies had a total of 10,682 participants within the age range of 0 - 59 months with the diagnosis of uncomplicated malaria and an MCP range of 2000 - 200,000 treated with different antimalarial drugs. Artesunate + Amodiaquine and Dihydroartemisinin-Piperaquine and Artemether-Lumefantrine drugs were found to be consistent in the treatment of uncomplicated malaria under 5 s within three days. Findings show that Artemether-Lumefantrine, Artesunate + Amodiaquine and Dihydroartemisinin-Piperaquine were the best drugs of choice due to their fast rate in fever reduction and parasite clearance. The efficacy of Artesunate + Amodiaquine and Dihydroartemisinin-Piperaquine is comparable to Dihydroartemisinin-Piperaquine. The study concludes that Artesunate + Amodiaquine and Dihydroartemisinin-Piperaquine can also be drugs of choice along with the well-known and utilized Artemether-Lumefantrine combination because of the fever reduction and parasite clearance within the first three days duration.
文摘<strong>Objective:</strong> To explore the practice of management of diarrhea in under-5-year children at health facilities found in Hawassa town, and associated factors with malpractice in comparison.<strong> Methodology:</strong> Cross Sectional study was conducted in 2 hospitals, 2 health centers and 2 private clinics that are found in Hawassa city which is found in Southern Nations, Nationalities and peoples (SNNP), 275 KM to south from Addis Ababa, capital city of Ethiopia from august 2017-October 2017. Structured checklist was used to retrieve the required information from the patients on arrival and stay in pediatrics OPDs and wards. The data analysis carried out using SPSS version 20.0. Logistic regression was carried out to analyze the association between the independent and dependent variables. Statistically significant associations were declared at <em>p</em>-values of less than or equal to 0.05. <strong>Results:</strong> Out of 420, about 397 (94.5%) children with diarrheal disease between the ages of 3 - 59 months were studied. The study subjects were from governmental hospitals (35.5%), health centers (34.5%) and private clinics (30%) that are found in Hawassa City. Sign of dehydration was 66 (17%) of which majority 59 (83%) of them were rehydrated. As to Zink supplementation, only 180 (45%) received it;antibiotics were the commonly (59.1%) prescribed drugs. Only 43.3% of children were appropriately managed. Hospitals had higher odds of inappropriate management of diarrhea with AOR = 1.61 (95% CI: 1.04 - 2.5) and children one year or younger were more inappropriately managed for diarrhea at the health facilities with AOR of 2.3 (95% CI: 1.57 - 4.41). <strong>Conclusions:</strong> In the current study the management of diarrhea at the health facilities is unsatisfactory as only less than half of children with diarrhea were properly managed. Treatment of diarrhea at hospital level and the patient’s age being less than 1 year were found to significantly affect the level of mismanagement of the diarrheal disease. Therefore, orientation and trainings for health care providers especially GPs and Residents should be given to adhere to recommended zinc therapy, Oral Rehydration Salts (ORS) replacement therapy and rational antibiotics prescription.
文摘Introduction: Cameroon is a hyperendemic country to malaria where it remains a major public health concern, especially amongst children under-five. Insecticide-treated bednets (ITBNs) is the main control strategies. This study aimed at determining the predictors of malaria prevalence and coverage of ITBNs among under-five children in the Buea Health District (BHD), South West Region of Cameroon in other to reduce the morbidity and mortality of malaria. Methods: A cross-sectional study was carried out in the BHD which is a malaria-hyperendemic area. Every head (female/male) of the household who was present at home at the time of data collection was randomly interviewed using a structured questionnaire. Under-five children were ascertained for malaria using microscopy, with a temperature of ≥37.50°C. Results: Out of 391 children (mean age = 19.7 month, SD = 2.5) who were selected and ascertained for malaria, the overall malaria prevalence was 13.04% (95% CI: 10.04 - 16.78). In a multivariate analysis after adjusting for confounders, female parents/guardians (AOR = 0.53, 95% CI: 0.29 - 0.91) was associated with low risk of malaria while parents/guardians with no formal/primary educational (AOR = 3.3, 95% CI: 1.76 - 4.04) and children who did not use ITBN (AOR = 1.40, 95% CI: 1.08 - 2.51) were associated with an increased risk of malaria. Out of the selected children, 84.4% possessed ITBN (95% CI: 80.4 - 87.7) while 72.6% (95% CI: 67.9 - 76.8) used ITBN. In a multivariate after adjusting for confounders, Bova health area showed a significantly lower usage of ITBNs (χ 2 = 14.053, p = 0.003). Conclusion: The findings indicate that increased ITBN usage, increased parents/guardians’ educational level and good knowledge of ITBN is required to lower the risk of under-five children being infected with malaria. Health area of residence greatly influences the direct relationship between bednets possession and usage. These, therefore, indicates the possession of ITBN doesn’t mean their usage. The Cameroon National malaria control programs should consider the realities of the living conditions of the population for the implementation of better policies.
文摘Background: Diarrhoeal disease in under-five children is a serious public health challenge especially in low income countries including Ethiopia. In Ethiopia, several interventions are going on to reduce morbidity, and mortality of children. The objective of the study was to assess the prevalence and associated factors of diarrhoeal diseases among under-five children in the City Administration of Bahir Dar. Methods: A community based cross-sectional study was conducted on a sample size of 667 mothers/caregivers having under-five children. Participants were selected through multistage sampling technique. Structured questionnaire and observation checklist were used to collect data. It was analyzed using SPSS version 16 for windows. Logistic regression was applied to measure possible associations. Strength of association, and statistical significance was measured using odds ratio and confidence interval at 95% confidence level. Results: A total of 667 mothers/ caregivers with under-five children were included in the study. Two-week prevalence of diarrhoea was 21.6%. Households in rural part of the city (OR: 2.82, 95%CI: 1.66 - 4.81), monthly income ≤ birr 500 (OR: 2.27, 95%CI: 1.44 - 3.57, failure to use separate container for storing drinking water (OR: 1.78, 95%CI: 1.17 - 2.70), presence of human excreta in the compound (OR: 1.88, 95% (1.15 - 3.06) were found to be predictors of childhood diarrhoea. Conclusion: Diarrhoeal diseases remain serious public health challenge in rural as well as urban set ups in Ethiopia with particular reference to Bahir Dar City, despite several interventions over decades. Therefore, interventions, and strategies applied so far to eliminate diseases of poverty including diarrhoeal diseases should be re-visited.
文摘Introduction: Domestic accidents are a public health problem, and under-fives are particularly affected. We report these accidents’ epidemiology, diagnosis, management, and outcomes through this study. Patients and Methods: We conducted a prospective descriptive study for four months in the Albert Royer National Children’s Hospital Center pediatric surgery department in Dakar, Senegal. Of the 149 cases of domestic accidents, 109 were included in this study. Results: Infants (59.6%) were the most affected, with a slight male predominance (50.5%). Accidents occurred on Tuesday in 22.9% of cases and the afternoon in 38.5% of cases. Playing (59.6%) was the main activity, and falling (44%) was the most found mechanism. 78.9% of accidents occurred in the house, with the bedroom (27.5%) being the most represented place. In most cases (67.9%), the consultation was done within the first 24 hours. The upper limbs (48.6%) were the most affected, and fractures (31.2%) were the most frequent injuries. The outcomes were unremarkable in 94.5% of cases, as complications occurred in five patients with three who had an infection, one a persistent limping, and the last, a dental avulsion. No mortality was recorded. Conclusion: Domestic accidents among under-fives are frequent in our environment. Compared to those in older children, they occur similarly in both sexes, more often in the bedroom, and have a better prognosis.
文摘Background: Malaria has remained one of the leading causes of morbidity and mortality in children despite effective preventive and treatment modalities. This study is aimed at looking at the malaria preventive practices among under-five children in three Niger Delta states in Nigeria and comparing the differences among them if any. Methods: This was a cross sectional study carried out over six months from 1st January to 30th June 2019 in public health facilities among under-five children in three South-South states (Akwa Ibom, Delta and Rivers) of Nigeria. Using a stratified sampling method, children were recruited from 36 health facilities in the three states. A pretested interviewer administered questionnaire was used to harvest relevant information on socio-demographic characteristics of the subjects and informants and malaria preventive practices. Obtained data was analysed using SPSS version 22 and results are presented in prose and frequency tables. Chi-square and Fischer’s exact were used for comparison of categorical variables, while a p-value of Results: A total of 3144 children participated in the study: 1661 (52.8%) were males while 1483 (47.2%) were females. Children less than 2 years represented 77.6% of the study participants while the mean age was 1.72 ± 1.06 years. Mothers constituted over 80% of the informants in all the states. More of the informants had secondary education in Akwa Ibom and Delta states, while in Rivers state, more of them had tertiary education. Malaria prevention method practiced in the three states included;use of insecticide treated bed net (ITNs), insecticide spray, anti-malarial drugs, clearing of bushes and disposal of mosquito breeding cans and use of mosquito repellents. Indoor residual spraying (IRS) was not practiced in any of the states. Use of ITN was practiced more in Rivers state (53.2%) than in Delta (20.3%) and Akwa Ibom (8.2%) states, while use of insecticide spray was commoner in Akwa Ibom state (77.2%) than in Delta (56.3%) and Rivers (42.4%). This difference in the prevention techniques practiced among the states was statistically significant (Fischers exact?−724.2, p-value = 0.0001). Conclusion: In conclusion, the practice of ITNs use is low in South-South Nigeria with IRS not being practiced at all. Introduction of IRS as a method of malaria vector control and public health education on ITNs ownership and use is advocated.
文摘Little studies and analysis have been undertaken to investigate the housing determinants of under-five mortality in Ethiopia. This study, therefore, explores the impacts of urban housing variables on the levels and patterns of under-five mortality in the country based on the SPSS (Statistic Package for Social Science) file of the 2005 Ethiopian Demographic and Health Survey (EDHS). This survey covered a sample of about 4,420 households/housing units of urban Ethiopia. The under-five deaths are computed for women in the age group 15-49 by subtracting the number of children living from children ever born (CEB) and established the proportion dead by dividing deaths by CEB corresponding to the categorical variables of housing structure, facilities, and household durables. The analytical techniques of the study included univariate, bivariate, and multivariate data analysis of the proportional variations of childhood mortality patterns being manifested by "bar graphs" with respect to housing situations as well as household durables. Amongst the categorical variables of the housing structures, facilities, and household durables with the highest no prevalence of under-five mortality levels are found to be the units of unconventional walls, thatched/leaf/reed roofing, animal dung flooring, shared pit latrine/use of bucket/bush, using kerosene, firewood/straw/charcoal for cooking, unconventional lighting, unprotected water supply, households with no durables.
文摘Under-five mortality remains a major concern in the world and in Senegal. It is mainly due to preventable and treatable diseases with priority life-saving medicines for under-five children. This study evaluated the availability, management and use of these drugs in two health districts in Senegal. A descriptive cross-sectional study was conducted in the health districts of Guediawaye and Pete from 01 November 2018 to 31 January 2019. The health district of Guediawaye is in the region hosting the Senegalese capital while that of Pete is located in the region of Saint Louis, northern Senegal. Nine drugs that can prevent and treat malaria, diarrhea, pneumonia and malnutrition were selected. An inventory form and a self-administered questionnaire were used to collect data that was analyzed with SPSS and expressed as a percentage and average. Drug availability was 50.4% and 54.3% in Guediawaye and in Pete, respectively. Average stock-out duration in the past three months was estimated at 22.6 and 26 days, respectively. The drug management was marked, on the one hand, by a good availability of stock cards in the two districts with proportions equal to 100% and 94.1%, respectively, and on the other hand, by the presence of expired stocks in Pete (12.2%). About 79% and 88% of prescribers reported prescribing the basket drug, respectively. These results show that access to priority life-saving medicines for children remains a challenge. Measures to be taken should include improving the distribution channels and training of health professionals. Further studies should be conducted in other health districts to better understand the barriers to access to child health services.
文摘Background:Nowdays,both of parents are working to fulfill their family needs and family financial.However,this condition effected separation of family that have a negative impact for children.Children can lose of a primary caregiver who can endanger the welfare of children.Purpose:To analyzed the relationship between family separation and nutritional status of under-five children aged in Panti District of Jember Regency.Methods:A cross-sectional design was conducted among 53 families using total sampling.A family background questionnaire was used to measure sociodemographics and separation of family.Among 53 families were 78.2%of separation with father,while 38.6%of children with a good nutrition status.Kruskal Wallis and One-Way Anova was performed to answer the objective of this study.Results:The result showed that,there were no correlation between length of separation with nutritional status(F=0.377;P-value=0,688).Meanwhile,distance of separation wascorrelated with nutritional status(c2=8.310;P-value=0,016).Conclusion:Parents need to improve relationships,communication and the distribution of proper autonomy in family.It can make the nutritional status and health level of the child becomes better.
基金The study was fully funded by Hosanna College of Health SciencesThe college also provided experts for supervisory,advisory and facilitation activities during the study period。
文摘Background:Recent studies have presented conflicting findings about whether malaria is associated with an increased or decreased risk of malnutrition.Therefore,assessing the relationship between these two disastrous diseases in the most vulnerable groups,such as in children aged below 5 years(under-five children),may lead to the discovery of new low-cost and effective aides to current methods of malnutrition prevention in malariaendemic areas.Therefore,this study was conducted to assess the relationship between malaria and malnutrition among under five children in an area with a high degree of malaria transmission.Methods:The study involved comparing malnourished children aged 6-59 months and nourished children of the same age for their past exposure to malaria,in Shashogo District,Southern Ethiopia.A validated structured questionnaire was used to collect home to home socioeconomic data and anthropometric instruments for clinical data.The collected data were analysed using descriptive and inferential statistics by means of EpiData entry software and STATA data analysis software.Results:A total of 356(89 malnourished and 267 nourished)under-five children participated in the study.Previous exposure to Plasmodium infection was found to be a predictor for the manifestation of malnutrition in under-five children(P=0.02[OR=1.87,CI=1.115-3.138]).Children from a household with a monthly income of less than USD 15 were 4.5 more likely to be malnourished as compared to the other children(P=0.001[OR=0.422,CI=0.181-0.978]).Conclusion:This study found that exposure to Plasmodium has a significant impact on the nutritional status of children.In addition,socio-demographic factors,such as family income,may play a role in determining whether children are malnourished or not and may lead to increased morbidity due to malnourishment in children living in malaria-endemic areas.Therefore,malnutrition control interventions should be consolidated with malaria prevention strategies particularly in high malaria transmission areas.