Investigation of Nutritional Status of Children based on Machine Learning Techniques using Indian Demographic and Health Survey Data

Identifying determinants of malnutrition in under-five children in Bangladesh: insights from the BDHS-2022 cross-sectional study

Malnutrition remains one of the most pressing global health challenges, particularly in developing countries like Bangladesh, where it continues to significantly impact child health and contribute to chronic illness and high child mortality. Despite the potential of machine learning to improve malnutrition predictions, research in this area remains limited in the country. This study utilizes Bangladesh Demographic and Health Survey (BDHS) 2022 data to identify and quantify key determinants of under-five malnutrition (underweight, wasting, stunting) and evaluates various machine learning models for predicting malnutrition. By addressing a critical gap, this research provides deeper insights into the root causes of malnutrition in Bangladesh. Descriptive statistics were conducted to summarize the key characteristics of the dataset. Boruta algorithm was employed to identify important features related to malnutrition which were then used to evaluate several machine learning models, including K-Nearest Neighbors (KNN), Neural Networks (NN), Classification and Regression Trees (CART), XGBoost (XGBM), Support Vector Machines (SVM), and Random Forest (RF), in addition to the traditional logistic regression (LR) model. The best-performing model was selected to identify the most important factors contributing to malnutrition. The significance of these variables was further assessed using Feature Importance plot (Based on Gini Importance) and Shapley Additive Explanation (SHAP) values. Model performance was evaluated through various metrics, including accuracy, 95% Confidence Interval (CI), Cohen's kappa, sensitivity, specificity, F1 score and precision. The study examined a cohort of 7,910 children, reporting prevalence rates of 19% for stunting, 8% for wasting, and 17% for underweight. The Boruta algorithm identified 18 confirmed features for stunting, 22 for wasting, and 19 for underweight. For stunting, the Random Forest (RF) model outperformed other methods with an accuracy of 64.19%, 95% CI of (0.623, 0.666), Cohen's kappa of 0.158, sensitivity of 56.25%, specificity of 66.00%, F1 score of 0.750 and precision of 0.60. In wasting prediction, RF achieved the highest accuracy at 76.68%, 95% CI of (0.743, 0.787), Cohen's kappa of 0.049, sensitivity of 27.22%, specificity of 80.98%, F1 score of 0.865 and precision of 0.810. Similarly, for underweight, RF demonstrated superior performance with an accuracy of 68.18%, 95% CI of (0.662, 0.703), Cohen's kappa of 0.130, sensitivity of 43.02%, specificity of 73.48%, F1 score of 0.792 and precision of 0.735. Across all malnutrition types, the RF model consistently outperformed traditional logistic regression (LR) and other ML techniques in terms of accuracy, sensitivity, specificity, and other performance metrics. For stunting, key predictors identified in both the Shapley and Gini importance plots included mother's education, father's occupation, place of delivery, wealth index, birth order, and toilet facility; for wasting, significant predictors were antenatal care, unmet family planning, mother's BMI, birth interval, father's occupation, and television ownership; and for underweight, important factors included father's occupation, mother's education, child's age, birth order, wealth index, and place of delivery. This study highlights the effectiveness of Random Forest (RF) in predicting malnutrition outcomes-stunting, wasting, and underweight-using key features identified by the Boruta algorithm. While RF demonstrates moderate performance in predicting stunting and underweight, it shows strong predictive ability for wasting. This underscores RF's potential in guiding targeted interventions for wasting, though further improvements are needed for stunting and underweight predictions. Moreover, the study identifies key contributors for each malnutrition outcome. By pinpointing these determinants, the study provides actionable insights for designing targeted interventions to combat malnutrition more effectively. These findings align with the global development agenda, particularly Sustainable Development Goal (SDG) 2: Zero Hunger and SDG 3: Good Health and Well-being, reinforcing efforts to reduce malnutrition and improve child health outcomes in Bangladesh.

Unveiling predictive factors for household-level stunting in India: A machine learning approach using NFHS-5 and satellite-driven data

OBJECTIVES

Childhood stunting remains a significant public health issue in India, affecting approximately 35% of children under 5. Despite extensive research, existing prediction models often fail to incorporate diverse data sources and address the complex interplay of socioeconomic, demographic, and environmental factors. This study bridges this gap by employing machine learning methods to predict stunting at the household level, using data from the National Family Health Survey combined with satellite-driven datasets.

METHODS

We used four machine learning models-random forest regression, support vector machine regression, K-nearest neighbors regression, and regularized linear regression-to examine the impact of various factors on stunting. The random forest regression model demonstrated the highest predictive accuracy and robustness.

RESULTS

The proportion of households below the poverty line and the dependency ratio consistently predicted stunting across all models, underscoring the importance of economic status and household structure. Moreover, the educational level of the household head and environmental variables such as average temperature and leaf area index were significant contributors. Spatial analysis revealed significant geographic clustering of high-stunting districts, notably in central and eastern India, further emphasizing the role of regional socioeconomic and environmental factors. Notably, environmental variables like average temperature and leaf area index emerged as strong predictors of stunting, highlighting how regional climate and vegetation conditions shape nutritional outcomes.

CONCLUSIONS

These findings underline the importance of comprehensive interventions that not only address socioeconomic inequities but also consider environmental factors, such as climate and vegetation, to effectively combat childhood stunting in India.

Machine Learning in Predicting Child Malnutrition: A Meta-Analysis of Demographic and Health Surveys Data

BACKGROUND

Childhood malnutrition remains a significant global public health concern. The Demographic and Health Surveys (DHS) program provides specific data on child health across numerous countries. This meta-analysis aims to comprehensively assess machine learning (ML) applications in DHS data to predict malnutrition in children.

METHODS

A comprehensive search of the peer-reviewed literature in PubMed, Embase, and Scopus databases was conducted in January 2024. Studies employing ML algorithms on DHS data to predict malnutrition in children under 5 years were included. Using PROBAST (Prediction model Risk Of Bias Assessment Tool), the quality of the listed studies was evaluated. To conduct meta-analyses, Review Manager 5.4 was used.

RESULTS

A total of 11 out of 789 studies were included in this review. The studies were published between 2019 and 2023, with the major contribution from Bangladesh (n = 6, 55%). Of these, ten studies reported stunting, three reported wasting, and four reported underweight. A meta-analysis of ten studies reported a pooled accuracy of 68.92% (95% CI: 66.04, 71.80; I2 = 100%) among ML models for predicting stunting in children. Three studies indicated a pooled accuracy of 84.39% (95% CI: 80.90, 87.87; I2 = 100%) in predicting wasting. A meta-analysis of four studies indicated a pooled accuracy of 73.60% (95% CI: 70.01, 77.20; I2 = 100%) for ML models predicting underweight status in children.

CONCLUSIONS

This meta-analysis indicated that ML models were observed to have moderate to good performance metrics in predicting malnutrition using DHS data among children under five years.

A deep learning approach for classifying and predicting children's nutritional status in Ethiopia using LSTM-FC neural networks

BACKGROUND

This study employs a LSTM-FC neural networks to address the critical public health issue of child undernutrition in Ethiopia. By employing this method, the study aims classify children's nutritional status and predict transitions between different undernutrition states over time. This analysis is based on longitudinal data extracted from the Young Lives cohort study, which tracked 1,997 Ethiopian children across five survey rounds conducted from 2002 to 2016. This paper applies rigorous data preprocessing, including handling missing values, normalization, and balancing, to ensure optimal model performance. Feature selection was performed using SHapley Additive exPlanations to identify key factors influencing nutritional status predictions. Hyperparameter tuning was thoroughly applied during model training to optimize performance. Furthermore, this paper compares the performance of LSTM-FC with existing baseline models to demonstrate its superiority. We used Python's TensorFlow and Keras libraries on a GPU-equipped system for model training.

RESULTS

LSTM-FC demonstrated superior predictive accuracy and long-term forecasting compared to baseline models for assessing child nutritional status. The classification and prediction performance of the model showed high accuracy rates above 93%, with perfect predictions for Normal (N) and Stunted & Wasted (SW) categories, minimal errors in most other nutritional statuses, and slight over- or underestimations in a few instances. The LSTM-FC model demonstrates strong generalization performance across multiple folds, with high recall and consistent F1-scores, indicating its robustness in predicting nutritional status. We analyzed the prevalence of children's nutritional status during their transition from late adolescence to early adulthood. The results show a notable decline in normal nutritional status among males, decreasing from 58.3% at age 5 to 33.5% by age 25. At the same time, the risk of severe undernutrition, including conditions of being underweight, stunted, and wasted (USW), increased from 1.3% to 9.4%.

CONCLUSIONS

The LSTM-FC model outperforms baseline methods in classifying and predicting Ethiopian children's nutritional statuses. The findings reveal a critical rise in undernutrition, emphasizing the need for urgent public health interventions.

Machine Learning Approach for Predicting the Impact of Food Insecurity on Nutrient Consumption and Malnutrition in Children Aged 6 Months to 5 Years

BACKGROUND

Food insecurity significantly impacts children's health, affecting their development across cognitive, physical, and socio-emotional dimensions. This study explores the impact of food insecurity among children aged 6 months to 5 years, focusing on nutrient intake and its relationship with various forms of malnutrition.

METHODS

Utilizing machine learning algorithms, this study analyzed data from 819 children in the West Bank to investigate sociodemographic and health factors associated with food insecurity and its effects on nutritional status. The average age of the children was 33 months, with 52% boys and 48% girls.

RESULTS

The analysis revealed that 18.1% of children faced food insecurity, with household education, family income, locality, district, and age emerging as significant determinants. Children from food-insecure environments exhibited lower average weight, height, and mid-upper arm circumference compared to their food-secure counterparts, indicating a direct correlation between food insecurity and reduced nutritional and growth metrics. Moreover, the machine learning models observed vitamin B1 as a key indicator of all forms of malnutrition, alongside vitamin K1, vitamin A, and zinc. Specific nutrients like choline in the "underweight" category and carbohydrates in the "wasting" category were identified as unique nutritional priorities.

CONCLUSION

This study provides insights into the differential risks for growth issues among children, offering valuable information for targeted interventions and policymaking.

Employing advanced supervised machine learning approaches for predicting micronutrient intake status among children aged 6-23 months in Ethiopia

Background

Although micronutrients (MNs) are important for children's growth and development, their intake has not received enough attention. MN deficiency is a significant public health problem, especially in developing countries like Ethiopia. However, there is a lack of empirical evidence using advanced statistical methods, such as machine learning. Therefore, this study aimed to use advanced supervised algorithms to predict the micronutrient intake status in Ethiopian children aged 6-23 months.

Methods

A total weighted of 2,499 children aged 6-23 months from the Ethiopia Demographic and Health Survey 2016 data set were utilized. The data underwent preprocessing, with 80% of the observations used for training and 20% for testing the model. Twelve machine learning algorithms were employed. To select best predictive model, their performance was assessed using different evaluation metrics in Python software. The Boruta algorithm was used to select the most relevant features. Besides, seven data balancing techniques and three hyper parameter tuning methods were employed. To determine the association between independent and targeted feature, association rule mining was conducted using the a priori algorithm in R software.

Results

According to the 2016 Ethiopia Demographic and Health Survey, out of 2,499 weighted children aged 12-23 months, 1,728 (69.15%) had MN intake. The random forest, catboost, and light gradient boosting algorithm outperformed in predicting MN intake status among all selected classifiers. Region, wealth index, place of delivery, mothers' occupation, child age, fathers' educational status, desire for more children, access to media exposure, religion, residence, and antenatal care (ANC) follow-up were the top attributes to predict MN intake. Association rule mining was identified the top seven best rules that most frequently associated with MN intake among children aged 6-23 months in Ethiopia.

Conclusion

The random forest, catboost, and light gradient boosting algorithm achieved a highest performance and identifying the relevant predictors of MN intake. Therefore, policymakers and healthcare providers can develop targeted interventions to enhance the uptake of micronutrient supplementation among children. Customizing strategies based on identified association rules has the potential to improve child health outcomes and decrease the impact of micronutrient deficiencies in Ethiopia.

Machine learning prediction of nutritional status among pregnant women in Bangladesh: Evidence from Bangladesh demographic and health survey 2017-18

AIM

Malnutrition in pregnant women significantly affects both mother and child health. This research aims to identify the best machine learning (ML) techniques for predicting the nutritional status of pregnant women in Bangladesh and detect the most essential features based on the best-performed algorithm.

METHODS

This study used retrospective cross-sectional data from the Bangladeshi Demographic and Health Survey 2017-18. Different feature transformations and machine learning classifiers were applied to find the best transformation and classification model.

RESULTS

This investigation found that robust scaling outperformed all feature transformation methods. The result shows that the Random Forest algorithm with robust scaling outperforms all other machine learning algorithms with 74.75% accuracy, 57.91% kappa statistics, 73.36% precision, 73.08% recall, and 73.09% f1 score. In addition, the Random Forest algorithm had the highest precision (76.76%) and f1 score (71.71%) for predicting the underweight class, as well as an expected precision of 82.01% and f1 score of 83.78% for the overweight/obese class when compared to other algorithms with a robust scaling method. The respondent's age, wealth index, region, husband's education level, husband's age, and occupation were crucial features for predicting the nutritional status of pregnant women in Bangladesh.

CONCLUSION

The proposed classifier could help predict the expected outcome and reduce the burden of malnutrition among pregnant women in Bangladesh.

Predicting and identifying factors associated with undernutrition among children under five years in Ghana using machine learning algorithms

BACKGROUND

Undernutrition among children under the age of five is a major public health concern, especially in developing countries. This study aimed to use machine learning (ML) algorithms to predict undernutrition and identify its associated factors.

METHODS

Secondary data analysis of the 2017 Multiple Indicator Cluster Survey (MICS) was performed using R and Python. The main outcomes of interest were undernutrition (stunting: height-for-age (HAZ) < -2 SD; wasting: weight-for-height (WHZ) < -2 SD; and underweight: weight-for-age (WAZ) < -2 SD). Seven ML algorithms were trained and tested: linear discriminant analysis (LDA), logistic model, support vector machine (SVM), random forest (RF), least absolute shrinkage and selection operator (LASSO), ridge regression, and extreme gradient boosting (XGBoost). The ML models were evaluated using the accuracy, confusion matrix, and area under the curve (AUC) receiver operating characteristics (ROC).

RESULTS

In total, 8564 children were included in the final analysis. The average age of the children was 926 days, and the majority were females. The weighted prevalence rates of stunting, wasting, and underweight were 17%, 7%, and 12%, respectively. The accuracies of all the ML models for wasting were (LDA: 84%; Logistic: 95%; SVM: 92%; RF: 94%; LASSO: 96%; Ridge: 84%, XGBoost: 98%), stunting (LDA: 86%; Logistic: 86%; SVM: 98%; RF: 88%; LASSO: 86%; Ridge: 86%, XGBoost: 98%), and for underweight were (LDA: 90%; Logistic: 92%; SVM: 98%; RF: 89%; LASSO: 92%; Ridge: 88%, XGBoost: 98%). The AUC values of the wasting models were (LDA: 99%; Logistic: 100%; SVM: 72%; RF: 94%; LASSO: 99%; Ridge: 59%, XGBoost: 100%), for stunting were (LDA: 89%; Logistic: 90%; SVM: 100%; RF: 92%; LASSO: 90%; Ridge: 89%, XGBoost: 100%), and for underweight were (LDA: 95%; Logistic: 96%; SVM: 100%; RF: 94%; LASSO: 96%; Ridge: 82%, XGBoost: 82%). Age, weight, length/height, sex, region of residence and ethnicity were important predictors of wasting, stunting and underweight.

CONCLUSION

The XGBoost model was the best model for predicting wasting, stunting, and underweight. The findings showed that different ML algorithms could be useful for predicting undernutrition and identifying important predictors for targeted interventions among children under five years in Ghana.

Assessing risk factors for malnutrition among women in Bangladesh and forecasting malnutrition using machine learning approaches

BACKGROUND

This paper presents an in-depth examination of malnutrition in women in Bangladesh. Malnutrition in women is a major public health issue related to different diseases and has negative repercussions for children, such as premature birth, decreased infection resistance, and an increased risk of death. Moreover, malnutrition is a severe problem in Bangladesh. Data from the Bangladesh Demographic Health Survey (BDHS) conducted in 2017-18 was used to identify risk factors for malnourished women and to create a machine learning-based strategy to detect their nutritional status.

METHODS

A total of 17022 women participants are taken to conduct the research. All the participants are from different regions and different ages. A chi-square test with a five percent significance level is used to identify possible risk variables for malnutrition in women and six machine learning-based classifiers (Naïve Bayes, two types of Decision Tree, Logistic Regression, Random Forest, and Gradient Boosting Machine) were used to predict the malnutrition of women. The models are being evaluated using different parameters like accuracy, sensitivity, specificity, positive predictive value, negative predictive value, [Formula: see text] score, and area under the curve (AUC).

RESULTS

Descriptive data showed that 45% of the population studied were malnourished women, and the chi-square test illustrated that all fourteen variables are significantly associated with malnutrition in women and among them, age and wealth index had the most influence on their nutritional status, while water source had the least impact. Random Forest had an accuracy of 60% and 60.2% for training and test data sets, respectively. CART and Gradient Boosting Machine also had close accuracy like Random Forest but based on other performance metrics such as kappa and [Formula: see text] scores Random Forest got the highest rank among others. Also, it had the highest accuracy and [Formula: see text] scores in k-fold validation along with the highest AUC (0.604).

CONCLUSION

The Random Forest (RF) approach is a reasonably superior machine learning-based algorithm for forecasting women's nutritional status in Bangladesh in comparison to other ML algorithms investigated in this work. The suggested approach will aid in forecasting which women are at high susceptibility to malnutrition, hence decreasing the strain on the healthcare system.

Predictors of micronutrient deficiency among children aged 6-23 months in Ethiopia: a machine learning approach

Introduction

Micronutrient (MN) deficiencies are a major public health problem in developing countries including Ethiopia, leading to childhood morbidity and mortality. Effective implementation of programs aimed at reducing MN deficiencies requires an understanding of the important drivers of suboptimal MN intake. Therefore, this study aimed to identify important predictors of MN deficiency among children aged 6-23 months in Ethiopia using machine learning algorithms.

Methods

This study employed data from the 2019 Ethiopia Mini Demographic and Health Survey (2019 EMDHS) and included a sample of 1,455 children aged 6-23 months for analysis. Machine Learning (ML) methods including, Support Vector Machine (SVM), Logistic Regression (LR), Random Forest (RF), Neural Network (NN), and Naïve Bayes (NB) were used to prioritize risk factors for MN deficiency prediction. Performance metrics including accuracy, sensitivity, specificity, and Area Under the Receiver Operating Characteristic (AUROC) curves were used to evaluate model prediction performance.

Results

The prediction performance of the RF model was the best performing ML model in predicting child MN deficiency, with an AUROC of 80.01% and accuracy of 72.41% in the test data. The RF algorithm identified the eastern region of Ethiopia, poorest wealth index, no maternal education, lack of media exposure, home delivery, and younger child age as the top prioritized risk factors in their order of importance for MN deficiency prediction.

Conclusion

The RF algorithm outperformed other ML algorithms in predicting child MN deficiency in Ethiopia. Based on the findings of this study, improving women's education, increasing exposure to mass media, introducing MN-rich foods in early childhood, enhancing access to health services, and targeted intervention in the eastern region are strongly recommended to significantly reduce child MN deficiency.

Machine learning algorithms' application to predict childhood vaccination among children aged 12-23 months in Ethiopia: Evidence 2016 Ethiopian Demographic and Health Survey dataset

INTRODUCTION

Childhood vaccination is a cost-effective public health intervention to reduce child mortality and morbidity. But, vaccination coverage remains low, and previous similar studies have not focused on machine learning algorithms to predict childhood vaccination. Therefore, knowledge extraction, association rule formulation, and discovering insights from hidden patterns in vaccination data are limited. Therefore, this study aimed to predict childhood vaccination among children aged 12-23 months using the best machine learning algorithm.

METHODS

A cross-sectional study design with a two-stage sampling technique was used. A total of 1617 samples of living children aged 12-23 months were used from the 2016 Ethiopian Demographic and Health Survey dataset. The data was pre-processed, and 70% and 30% of the observations were used for training, and evaluating the model, respectively. Eight machine learning algorithms were included for consideration of model building and comparison. All the included algorithms were evaluated using confusion matrix elements. The synthetic minority oversampling technique was used for imbalanced data management. Informational gain value was used to select important attributes to predict childhood vaccination. The If/ then logical association was used to generate rules based on relationships among attributes, and Weka version 3.8.6 software was used to perform all the prediction analyses.

RESULTS

PART was the first best machine learning algorithm to predict childhood vaccination with 95.53% accuracy. J48, multilayer perceptron, and random forest models were the consecutively best machine learning algorithms to predict childhood vaccination with 89.24%, 87.20%, and 82.37% accuracy, respectively. ANC visits, institutional delivery, health facility visits, higher education, and being rich were the top five attributes to predict childhood vaccination. A total of seven rules were generated that could jointly determine the magnitude of childhood vaccination. Of these, if wealth status = 3 (Rich), adequate ANC visits = 1 (yes), and residency = 2 (Urban), then the probability of childhood vaccination would be 86.73%.

CONCLUSIONS

The PART, J48, multilayer perceptron, and random forest algorithms were important algorithms for predicting childhood vaccination. The findings would provide insight into childhood vaccination and serve as a framework for further studies. Strengthening mothers' ANC visits, institutional delivery, improving maternal education, and creating income opportunities for mothers could be important interventions to enhance childhood vaccination.

Feature selection and association rule learning identify risk factors of malnutrition among Ethiopian schoolchildren

Introduction

Previous studies have sought to identify risk factors for malnutrition in populations of schoolchildren, depending on traditional logistic regression methods. However, holistic machine learning (ML) approaches are emerging that may provide a more comprehensive analysis of risk factors.

Methods

This study employed feature selection and association rule learning ML methods in conjunction with logistic regression on epidemiological survey data from 1,036 Ethiopian school children. Our first analysis used the entire dataset and then we reran this analysis on age, residence, and sex population subsets.

Results

Both logistic regression and ML methods identified older childhood age as a significant risk factor, while females and vaccinated individuals showed reduced odds of stunting. Our machine learning analyses provided additional insights into the data, as feature selection identified that age, school latrine cleanliness, large family size, and nail trimming habits were significant risk factors for stunting, underweight, and thinness. Association rule learning revealed an association between co-occurring hygiene and socio-economical variables with malnutrition that was otherwise missed using traditional statistical methods.

Discussion

Our analysis supports the benefit of integrating feature selection methods, association rules learning techniques, and logistic regression to identify comprehensive risk factors associated with malnutrition in young children.

Prediction of Stunting Among Under-5 Children in Rwanda Using Machine Learning Techniques

OBJECTIVES

Rwanda reported a stunting rate of 33% in 2020, decreasing from 38% in 2015; however, stunting remains an issue. Globally, child deaths from malnutrition stand at 45%. The best options for the early detection and treatment of stunting should be made a community policy priority, and health services remain an issue. Hence, this research aimed to develop a model for predicting stunting in Rwandan children.

METHODS

The Rwanda Demographic and Health Survey 2019-2020 was used as secondary data. Stratified 10-fold cross-validation was used, and different machine learning classifiers were trained to predict stunting status. The prediction models were compared using different metrics, and the best model was chosen.

RESULTS

The best model was developed with the gradient boosting classifier algorithm, with a training accuracy of 80.49% based on the performance indicators of several models. Based on a confusion matrix, the test accuracy, sensitivity, specificity, and F1 were calculated, yielding the model's ability to classify stunting cases correctly at 79.33%, identify stunted children accurately at 72.51%, and categorize non-stunted children correctly at 94.49%, with an area under the curve of 0.89. The model found that the mother's height, television, the child's age, province, mother's education, birth weight, and childbirth size were the most important predictors of stunting status.

CONCLUSIONS

Therefore, machine-learning techniques may be used in Rwanda to construct an accurate model that can detect the early stages of stunting and offer the best predictive attributes to help prevent and control stunting in under five Rwandan children.

On AI Approaches for Promoting Maternal and Neonatal Health in Low Resource Settings: A Review

A significant challenge for hospitals and medical practitioners in low- and middle-income nations is the lack of sufficient health care facilities for timely medical diagnosis of chronic and deadly diseases. Particularly, maternal and neonatal morbidity due to various non-communicable and nutrition related diseases is a serious public health issue that leads to several deaths every year. These diseases affecting either mother or child can be hospital-acquired, contracted during pregnancy or delivery, postpartum and even during child growth and development. Many of these conditions are challenging to detect at their early stages, which puts the patient at risk of developing severe conditions over time. Therefore, there is a need for early screening, detection and diagnosis, which could reduce maternal and neonatal mortality. With the advent of Artificial Intelligence (AI), digital technologies have emerged as practical assistive tools in different healthcare sectors but are still in their nascent stages when applied to maternal and neonatal health. This review article presents an in-depth examination of digital solutions proposed for maternal and neonatal healthcare in low resource settings and discusses the open problems as well as future research directions.

Identification of Risk Factors for Suicidal Ideation and Attempt Based on Machine Learning Algorithms: A Longitudinal Survey in Korea (2007-2019)

Investigating suicide risk factors is critical for socioeconomic and public health, and many researchers have tried to identify factors associated with suicide. In this study, the risk factors for suicidal ideation were compared, and the contributions of different factors to suicidal ideation and attempt were investigated. To reflect the diverse characteristics of the population, the large-scale and longitudinal dataset used in this study included both socioeconomic and clinical variables collected from the Korean public. Three machine learning algorithms (XGBoost classifier, support vector classifier, and logistic regression) were used to detect the risk factors for both suicidal ideation and attempt. The importance of the variables was determined using the model with the best classification performance. In addition, a novel risk-factor score, calculated from the rank and importance scores of each variable, was proposed. Socioeconomic and sociodemographic factors showed a high correlation with risks for both ideation and attempt. Mental health variables ranked higher than other factors in suicidal attempts, posing a relatively higher suicide risk than ideation. These trends were further validated using the conditions from the integrated and yearly dataset. This study provides novel insights into suicidal risk factors for suicidal ideations and attempts.

Geographic Pattern of Typhoid Fever in India: A Model-Based Estimate of Cohort and Surveillance Data

BACKGROUND

Typhoid fever remains a major public health problem in India. Recently, the Surveillance for Enteric Fever in India program completed a multisite surveillance study. However, data on subnational variation in typhoid fever are needed to guide the introduction of the new typhoid conjugate vaccine in India.

METHODS

We applied a geospatial statistical model to estimate typhoid fever incidence across India, using data from 4 cohort studies and 6 hybrid surveillance sites from October 2017 to March 2020. We collected geocoded data from the Demographic and Health Survey in India as predictors of typhoid fever incidence. We used a log linear regression model to predict a primary outcome of typhoid incidence.

RESULTS

We estimated a national incidence of typhoid fever in India of 360 cases (95% confidence interval [CI], 297-494) per 100 000 person-years, with an annual estimate of 4.5 million cases (95% CI, 3.7-6.1 million) and 8930 deaths (95% CI, 7360-12 260), assuming a 0.2% case-fatality rate. We found substantial geographic variation of typhoid incidence across the country, with higher incidence in southwestern states and urban centers in the north.

CONCLUSIONS

There is a large burden of typhoid fever in India with substantial heterogeneity across the country, with higher burden in urban centers.

A machine learning classifier approach for identifying the determinants of under-five child undernutrition in Ethiopian administrative zones

BACKGROUND

Undernutrition is the main cause of child death in developing countries. This paper aimed to explore the efficacy of machine learning (ML) approaches in predicting under-five undernutrition in Ethiopian administrative zones and to identify the most important predictors.

METHOD

The study employed ML techniques using retrospective cross-sectional survey data from Ethiopia, a national-representative data collected in the year (2000, 2005, 2011, and 2016). We explored six commonly used ML algorithms; Logistic regression, Least Absolute Shrinkage and Selection Operator (L-1 regularization logistic regression), L-2 regularization (Ridge), Elastic net, neural network, and random forest (RF). Sensitivity, specificity, accuracy, and area under the curve were used to evaluate the performance of those models.

RESULTS

Based on different performance evaluations, the RF algorithm was selected as the best ML model. In the order of importance; urban-rural settlement, literacy rate of parents, and place of residence were the major determinants of disparities of nutritional status for under-five children among Ethiopian administrative zones.

CONCLUSION

Our results showed that the considered machine learning classification algorithms can effectively predict the under-five undernutrition status in Ethiopian administrative zones. Persistent under-five undernutrition status was found in the northern part of Ethiopia. The identification of such high-risk zones could provide useful information to decision-makers trying to reduce child undernutrition.

Machine learning algorithms for predicting undernutrition among under-five children in Ethiopia

OBJECTIVE

Child undernutrition is a global public health problem with serious implications. In this study, we estimate predictive algorithms for the determinants of childhood stunting by using various machine learning (ML) algorithms.

DESIGN

This study draws on data from the Ethiopian Demographic and Health Survey of 2016. Five ML algorithms including eXtreme gradient boosting, k-nearest neighbours (k-NN), random forest, neural network and the generalised linear models were considered to predict the socio-demographic risk factors for undernutrition in Ethiopia.

SETTING

Households in Ethiopia.

PARTICIPANTS

A total of 9471 children below 5 years of age participated in this study.

RESULTS

The descriptive results show substantial regional variations in child stunting, wasting and underweight in Ethiopia. Also, among the five ML algorithms, xgbTree algorithm shows a better prediction ability than the generalised linear mixed algorithm. The best predicting algorithm (xgbTree) shows diverse important predictors of undernutrition across the three outcomes which include time to water source, anaemia history, child age greater than 30 months, small birth size and maternal underweight, among others.

CONCLUSIONS

The xgbTree algorithm was a reasonably superior ML algorithm for predicting childhood undernutrition in Ethiopia compared to other ML algorithms considered in this study. The findings support improvement in access to water supply, food security and fertility regulation, among others, in the quest to considerably improve childhood nutrition in Ethiopia.

Artificial Intelligence Approach for Analyzing Anaemia Prevalence in Children and Adolescents in BRICS Countries: A Review

Anemia prevalence, especially among children and adolescents, is a serious public health burden in the BRICS countries. This article gives an overview of the current anaemia status in children and adolescents in three BRICS countries, as part of a study that utilizes an artificial intelligence approach for analyzing anaemia prevalence in children and adolescents in South Africa, India and Russia. It posits that the use of machine learning in this area of health research is still novel. The weightage assessment of the crosslink between anaemia risk indicators using a machine learning approach will assist policy makers in identifying the areas of priority to intervene in the BRICS participating countries. Health interventions utilizing artificial intelligence and more specifically, machine learning techniques, remains nascent in LMICs but could lead to improved health outcomes.

Learning Bayesian networks from demographic and health survey data

Child mortality from preventable diseases such as pneumonia and diarrhoea in low and middle-income countries remains a serious global challenge. We combine knowledge with available Demographic and Health Survey (DHS) data from India, to construct Causal Bayesian Networks (CBNs) and investigate the factors associated with childhood diarrhoea. We make use of freeware tools to learn the graphical structure of the DHS data with score-based, constraint-based, and hybrid structure learning algorithms. We investigate the effect of missing values, sample size, and knowledge-based constraints on each of the structure learning algorithms and assess their accuracy with multiple scoring functions. Weaknesses in the survey methodology and data available, as well as the variability in the CBNs generated by the different algorithms, mean that it is not possible to learn a definitive CBN from data. However, knowledge-based constraints are found to be useful in reducing the variation in the graphs produced by the different algorithms, and produce graphs which are more reflective of the likely influential relationships in the data. Furthermore, valuable insights are gained into the performance and characteristics of the structure learning algorithms. Two score-based algorithms in particular, TABU and FGES, demonstrate many desirable qualities; (a) with sufficient data, they produce a graph which is similar to the reference graph, (b) they are relatively insensitive to missing values, and (c) behave well with knowledge-based constraints. The results provide a basis for further investigation of the DHS data and for a deeper understanding of the behaviour of the structure learning algorithms when applied to real-world settings.

Machine learning algorithms for predicting malnutrition among under-five children in Bangladesh

OBJECTIVE

The aim of this study was is to predict malnutrition status in under-five children in Bangladesh by using various machine learning (ML) algorithms.

METHODS

For analysis purposes, the nationally representative secondary records from the 2014 Bangladesh Demographic and Health Survey (BDHS) were used. Five well-known ML algorithms such as linear discriminant analysis (LDA), k-nearest neighbors (k-NN), support vector machines (SVM), random forest (RF), and logistic regression (LR) have been considered to accurately predict malnutrition status among children. Additionally, a systematic assessment of the algorithms was performed by using accuracy, sensitivity, specificity, and Cohen's κ statistic.

RESULTS

Based on various performance parameters, the best results were accomplished with the RF algorithm, which demonstrated an accuracy of 68.51%, a sensitivity of 94.66%, and a specificity of 69.76%. Additionally, a most extreme discriminative ability appeared by RF classification (Cohen's κ = 0.2434).

CONCLUSION

On the basis of the findings, we can presume that the RF algorithm was moderately superior to any other ML algorithms used in this study to predict malnutrition status among under-five children in Bangladesh. Finally, the present research recommends applying RF classification with RF feature selection when the prediction of malnutrition is the core interest.

Malnutrition, Health and the Role of Machine Learning in Clinical Setting

Nutrition plays a vital role in health and the recovery process. Deficiencies in macronutrients and micronutrients can impact the development and progression of various disorders. However, malnutrition screening tools and their utility in the clinical setting remain largely understudied. In this study, we summarize the importance of nutritional adequacy and its association with neurological, cardiovascular, and immune-related disorders. We also examine general and specific malnutrition assessment tools utilized in healthcare settings. Since the implementation of the screening process in 2016, malnutrition data from hospitalized patients in the Geisinger Health System is presented and discussed as a case study. Clinical data from five Geisinger hospitals shows that ~10% of all admitted patients are acknowledged for having some form of nutritional deficiency, from which about 60-80% of the patients are targeted for a more comprehensive assessment. Finally, we conclude that with a reflection on how technological advances, specifically machine learning-based algorithms, can be integrated into electronic health records to provide decision support system to care providers in the identification and management of patients at higher risk of malnutrition.