Nutrition impacts of non-solid cooking fuel adoption on under-five children in developing countries

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.

Malaria Retinopathy among Under-Five Children with Severe and Uncomplicated Malaria in a Tertiary Health Institution in Southwest Nigeria: A Comparative Study

Introduction: Malaria retinopathy refers to retinal abnormalities unique to malaria resulting from prolonged parasitization by Plasmodium falciparum. Identifying these features and treating them promptly could prevent lethal complications of malaria. Therefore, this study was conducted to identify and compare retinal findings in severe and uncomplicated malaria. Methods: A cross-sectional study of 260 subjects was equally divided into two groups of severe and uncomplicated malaria. Direct ophthalmoscopy was done at recruitment for all subjects. Information on sociodemographics, physical examination, nutritional status, and retinal abnormalities were recorded. A p-value Results: There were 141 (54.2%) males and 70 (26.9%) aged between 13 - 24 months. Severe anaemia, multiple convulsions, prostration, and cerebral malaria were the predominant forms of severe malaria. Twenty-three (17.7%) subjects with severe malaria and none with uncomplicated malaria had retinopathy. Retinal whitening (17.7%), vessel changes (16.2%), and retinal haemorrhages (5.4%) were the major forms of retinopathy. Retinopathy occurred in 43.8% of those with cerebral malaria. Retinal whitening and vessel changes were significantly associated with multiple convulsions, cerebral malaria, and metabolic acidosis;retinal haemorrhage was associated with cerebral malaria and haemoglobinuria (p = 0.022) and vessel changes with hypoglycaemia (p = 0.037). Cerebral malaria was an independent predictor of retinal whitening (p = 0.004) and vessel changes (p = 0.008) while haemoglobinuria was an independent predictor of retinal haemorrhages (p = 0.007). Conclusion: Ophthalmoscopy is an important examination in children with severe malaria which could assist in early detection and with prompt treatment, reduce morbidities and mortalities.

Prevalence of Diarrhoea and Associated Factors among Under-Five Children in Jigjiga District, Somali Region, Eastern Ethiopia

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.

Availability,Management and Use of Priority Life-Saving Medicines for Under-Five Children in Two Health Districts in Senegal:A Cross-Sectional Study

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.

The relationship of family separation and nutrition status among under-five children: a cross-sectional study in Panti Public Health Center, Jember Regency of East Java, Indonesia

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.

Retrospective Evaluation of Intussusception in Under-Five Children in Nigeria

Background: Assessment of the safety profile of the new rotavirus vaccines in Africa requires base-line epidemiological data on intussusception. Hence, this study was aimed at describing the prevalence and associated factors of intussusception in under-five children in Enugu, Southeast, Nigeria. Methods: This was a retrospective descriptive study involving the sixty reported cases of intussusception in under-five children admitted in a hospital in Enugu between 2007 and 2012. Cases of intussusception were selected using the Brighton collaboration intussusception working group level I diagnostic criteria. Information sought from the patients’ folders included demographic characteristics and clinical manifestations including history of previous rotavirus vaccination, duration of illness prior to presentation, diarrhoea, vomiting, passage of red currant jelly-like stool, abdominal mass and distension, method of diagnosis, treatment option(s) employed and their outcomes. The data was analyzed using SPSS version 17.0. Results: The majority of the cases were aged less than one year (53;88.3%) while the average incidence of intussusception was 0.1 per 1000. None of the cases had received rotavirus vaccinations. The common clinical presentations were vomiting, 55 (17.2%), passage of red currant stool 50 (15.6%), fever 50 (15.6%) and abnormal/absent bowel sound 43 (15.9%). Diagnosis was essentially with the aid of abdominal ultrasonography, 38 (63.3%) while surgery (laparotomy) was the treatment of choice in most cases 48 (80.0%). The case fatality rate was 3 (5.0%). Conclusion: None of the cases studied could be directly linked to rotavirus vaccinations. But seasonal peak incidence coincided with rotavirus diarrhea peak incidence. Efforts should be made to institute post-rotavirus vaccine licensure prospective surveillance study in order to fully determine any relationship between rotavirus vaccination and intussusception in Enugu, South east, Nigeria.

Production, Storage and Evaluation of Homemade and Processed Diet, Based on Wheat, Legumes, Sesame and Dates;for Under-Five Children

This study aimed to formulate a nutritive diet enriched with protein, iron and energy for under-five children. It was conducted in Elhosh rural area, Gezira State, Sudan, 2010. The diet was formulated and blended using locally available foods, produced at home level, by a twin-roller drum dryer and in biscuit form. The raw materials included pigeon pea (Cajanus cajan) sesame (Sesamum indicum) and dates (Phoenix dactylifera). The three products were evaluated for their proximate composition, energy value, iron content and acceptability after storage at (4℃ - 6℃) and at room temperature for 5 months. The protein content of the products was (14.0 - 14.1 g/100g);the energy value ranged from 382 to 390 Kcal/100g, both in-line with many recommendations for children aged under five. The iron content was found in the range of 14.6 - 14.8 mg/100g, in agreement with the codex recommendation. Yeast, mold and salmonella were not detected while other microbes were found within acceptable values. Studied products were found nutritious and remained acceptable after storage for five months. Legumes, sesame seeds and dates can be effectively used in wheat-based baby foods as a source of protein and mineral supplement.

Erratum to “Retrospective Evaluation of Intussusception in Under-Five Children in Nigeria” [World Journal of Vaccines Vol.4 No.3 (August 2014) 123-132]

The original online version of this article (Tagbo, B. N., et al. 2014 “Retrospective Evaluation of Intussusception in Under-Five Children in Nigeria”, 2014, 4, 123-132, http://dx.doi.org/10.4236/wjv.2014.43015) was published in August 2014. The author wishes to correct the author’s name and the Table 3 in the text.

Nutritional Status of Under-five Children from Urban Low-income Families in Xiangtan and Jilin in China

There have been many studies on the nutrition and the growth status of children from rural and remote western regions of China, whereas researches on children from urban low-income families are scarce. This study aimed to investigate the growth and nutritional status of children under five years of age from urban low-income families in China. There were 169 children aged 25–60 months recruited from Xiangtan and Jilin, two cities with a population of 2.81 million and 4.26 million respectively, in China in this cluster cross-sectional study. Data were collected on demographic and socioeconomic characteristics, the feeding practices and the incidence of anemia and diarrhea. The results showed that the prevalence of low birth weight and macrosomia was 7.1% and 9.5% for the two cities, respectively, which was higher than that for other cities in China（1.5% and 5.9%）. Of all the sampled children, 14.6% and 8.2% suffered anemia and diarrhea, respectively. Multivariate analysis showed that legumes or nuts fed in a 24-h recall increased the risk of anemia（OR=4.9）. Children whose caregivers began to introduce complementary foods relatively late would have high diarrhea prevalence（OR=1.4）. In conclusion, the prevalence of anemia and diarrhea in under-five children from urban low-income families in China is relatively high. The growth and nutritional status of these children is greatly affected by feeding practices. A series of measures should be taken by relevant government departments to improve the health of these children.

Current Status and Predictors of Diarrhoeal Diseases among Under-Five Children in a Rapidly Growing Urban Setting: The Case of City Administration of Bahir Dar, Northwest Ethiopia

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.

Predictors of Malaria Prevalence and Coverage of Insecticide-Treated Bednets among Under-Five Children in the Buea Health District, South West Region, Cameroon

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.

Comparative Study on Malaria Preventive Practices among Under-Five Children in Three States in South-South Nigeria

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.

Determinants of Delay in Malaria Prompt Diagnosis and Timely Treatment among Under-Five Children in Shashogo Woreda, Hadiya Zone, Southern Ethiopia: A Case Control Study

Background: Ensuring prompt diagnosis and timely malaria treatment will prevent most cases of uncomplicated malaria from progressing to severe and fatal illness. To avoid this progression, treatment must begin as soon as possible, generally within 24 hours after symptoms onset. The reason why mothers/caretakers delay in malaria prompt diagnosis and timely treatment for under-five is not well studied in the study area as well as in Ethiopia. Objective: To assess determinants of delay in malaria prompt diagnosis and timely treatment among under-five children in Shashogo Woreda, Hadiya Zone, Southern Ethiopia, 2013. Methods: An unmatched case control study was conducted from March 25-April 25, 2013. A total sample size of 302 with 151 cases and 151 controls were selected by systematic random sampling techniques. Cases were under-five children who had clinical malaria and sought treatment after 24 hours of symptoms onset, and controls were under-five children who had clinical malaria and sought treatment within 24 hours of symptoms onset. Both bivariate and multivariate logistic regressions were done to identify determinant of delay in malaria prompt diagnosis and timely treatment. Results: A total of 151 mothers/caretakers of cases and 151 mothers/caretakers of controls were interviewed. Illiterate mothers (AOR = 7.14;95%CI: 1.10, 46.39), monthly income ≤500 ETB (AOR = 5.49;95%CI: 2.09, 14.45), females sex (AOR = 3.45;95%CI: 1.62, 7.34), distance from health facility >5 km (AOR = 4.31;95%CI: 1.22, 15.23), absence of history of child death (AOR = 4.21;95%CI: 1.514, 11.68), side effects of antimalarial drugs (AOR = 2.91;95%CI: 1.15, 7.33) and khat chewing (AOR = 2.38;95%CI: 1.28, 5.79) were determinants of delay in malaria prompt diagnosis and timely treatment of under-five children. Conclusion: Mother’s education, monthly income, distance from health facility, absence of history of child death, complained about side effects of drugs and khat chewing were predictors of delay of prompt diagnosis and timely malaria treatment. Effective malaria control programs revision would be required to avoid delay of prompt diagnosis and timely treatment for under-five children.

Antibiotics prescribed to febrile under-five children outpatients in urban public health services in Burkina Faso

Appropriate use of antibiotics remains critical for success in achieving MDG4. The aim of this study was to investigate antibiotics prescribing practices to febrile under-five children outpatients in urban public health services in a low income country. Methods: From March to April 2013, a cross-sectional epidemiological study of care facilities visit by under-five age, for febrile illness, was carried out in urban health services in Bobo-Dioulasso, Burkina Faso. Patient demographics, diagnoses and medications were recorded. We calculated for each diagnoses several indicators for antibiotics use. Results: Our study showed an over-prescription of antibiotics at the university teaching hospital (78.08%) and at the first level facilities (57.71%) for under-five outpatients for febrile illness. There was evidence of high antibiotic prescription in children with diarrhea (more than 9 on 10 at university teaching hospital of diarrhea cases and 60% at the first level facilities), in children with Upper respiratory tract infections (respectively 60% and 85.2% of cases at university teaching hospital and at the first level facilities) and in children with malaria (respectively 47.5% and 17.6% of cases at university teaching hospital and at the first level facilities). Overuse, misuse and inappropriately prescribed antibiotic coexisted in our results: at university teaching hospital 90.9% of diarrhea cases, 60% of URTI cases,?47.5% of malaria cases received antibiotic prescription;at first level heath care facilities 85.2% of URTI, 17.6% of malaria cases received an prescribed antibiotic and 11.8% of LRTI did not received a prescribed antibiotic. Developing countries have poor access to newer antibiotics and irrational antibiotics use remains a global problem. Overuse and misuse of antibiotics combat, rigorous infectious diseases diagnosis, antimicrobial resistance consequences education of users and health professional’s prescribers, and improved surveillance of antimicrobial resistance, must be strengthened.

Treatment of Uncomplicated Malaria among Under-Five Children: A Systematic Review

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.

Investigation of the Efficacy of Home-Based Oral Chloroquine Treatment among Under-Five Children with Plasmodium falciparum Malaria in Some Parts of Jos, Plateau State, Nigeria

Background: Nigeria is currently a malaria endemic country with an estimated 76% of her population at risk of contracting malaria [1]. According to a study in Nigeria, the first line of action mothers took when their children under 5 years have malaria showed that over 50% of them used non-prescription drugs they have at home or bought from pharmacy stores. And 60% of the most commonly used drugs for malaria treatment were chloroquine [2]. Many recent studies have demonstrated re-emergence of chloroquine-sensitive P. falciparum, suggesting a possible role in future malaria control [3]. Objective: The aim of this study was to investigate the effect of home-based oral chloroquine treatment among children under 5 years with Plasmodium falciparum malaria attending Jos University Teaching Hospital and OLA Hospital in Jos Metropolis. Method: This is a cross-sectional study of 93 malaria and non-malaria children. Malaria diagnosis was carried out using microscopical examination of Leishman’s stained thick and thin blood films, P. falciparum parasitemia was assessed by standard microscopy techniques and complete blood count was done using Beckman Coulter Analyzer. Results: The body temperature on admission was significantly lower (p ˚C ± 0.07˚C) than in the three malaria groups. The mean body temperature of chloroquine treated children with malaria was significantly lower (p Conclusion: The results obtained in this study demonstrate that there was significant positive impact of chloroquine treatment on Plasmodium falciparum parasitemia and degree of anemia in children under 5 years with Plasmodium falciparum in Jos Metropolis.

The association between malaria and malnutrition among under-five children in Shashogo District,Southern Ethiopia:a case-control study

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.

Assessment of Diarrheal Disease Management Practice in Under-Five-Year Children According to WHO Guideline in Health Facilities of Hawassa City, SNNPR, Ethiopia

Objective: 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. Methodology: 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 p-values of less than or equal to 0.05. Results: 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). Conclusions: 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.

Knowledge and practice of care-givers who have under-five diarrhoeal children:a quantitative cross-sectional study in Mataniko settlements in Honiara, Solomon Islands, 2016

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.

Prevalence of diarrhea and associated risk factors among children under-five years of age in Eastern Ethiopia: A cross-sectional study

Diarrhea remains a major cause of mortality in children under 5 years of age in Sub-Saharan countries in Africa. Risk factors for diarrhea vary by context and have important implications for developing appropriate strategies to reduce the burden of the disease. The objective of this study was to assess the prevalence of diarrhea and associated risk factors among children un-der 5 years of age in Kersa district, located in Eastern Ethiopia. A community-based cross-sectional study was conducted among 1456 randomly selected households with at least one child under 5 years of age. A questionnaire and an observational check list were used for col-lecting information on socio-economic charac-teristics, environmental hygiene and behavioral practices, and occurrence of diarrhea among children under 5 years of age. Logistic regres-sion was used to calculate the adjusted odds ratio of 95% confidence interval. The two-week prevalence of diarrhea among children under 5 years of age was 22.5% (95% CI: 20.3-24.6). Improper refuse disposal practices (OR = 2.22, 95% CI: 1.20-4.03), lack of hand washing facilities (OR = 1.92, 95%CI: 1.29-2.86), living in rural area (OR = 1.81, 95% CI: 1.12-3.31), the presence of two or more siblings in a household (OR = 1.74, 95% CI: 1.33-2.28), and age of the child (OR= 2.25, 95% CI;1.5-3.36) were the major risk factors for diarrhea. This study demonstrated that diarrhea morbidity was relatively high among children under 5 years of age residing in Eastern Ethiopia. Efforts to reduce childhood diarrhea should focus on improving household sanitation, personal hygiene, and child birth spacing.