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Birhan NA, Workineh AY, Wolde ZM, Abich E, Alemayehu GM, Nigussie A, Alemu Y, Messfin CA, Belay DB. Determinants of community-acquired pneumonia among under-five children in Awi Zone, Northwest Ethiopia. Front Public Health 2025; 13:1511263. [PMID: 40376063 PMCID: PMC12078130 DOI: 10.3389/fpubh.2025.1511263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Accepted: 04/14/2025] [Indexed: 05/18/2025] Open
Abstract
Background Globally, community-acquired pneumonia is the leading cause of death in under-five children, accounting for 7.6 million deaths. Among these deaths, approximately 99% occur in low and middle-income countries. The present study aimed to assess the magnitude of community-acquired pneumonia and its associated factors among under-five children in Awi Zone. Methods A community cross-sectional study was conducted on 1,368 participants from March to July 2023. A multistage sampling method was used. Data were entered into Epi-Data and exported to STATA for analysis. Bivariable and multivariable logistic regressions were used. Variables with a p-value of < 0.05 were considered statistically significant. Results The percentage of community-acquired pneumonia among under-five children was 11.33% (95% CI: 9.75-13.12%). Primary education [AOR = 0.38; 95% CI:0.15, 0.95], stunting [AOR = 4.80; 95% CI: 2.31, 9.94], diarrhea [AOR = 3.75; 95% CI: 1.96, 7.18], acute lower respiratory tract infection [AOR = 14.57, 95% CI: 3.18, 66.78], acute upper respiratory tract infection [AOR = 9.06; 95% CI: 2.03, 40.42], and presence of separate kitchen [AOR = 0.38, 95% CI: 0.20, 0.72] were associated with community-acquired pneumonia. Conclusion In this study, the percentage of community-acquired pneumonia was relatively high. Hence, we recommend adequate health education in areas such as nutritional intervention, the prevention and early treatment of diarrhea and acute respiratory tract infections (ARTI), and preventing indoor air pollution to reduce the risk of community-acquired pneumonia.
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Affiliation(s)
- Nigussie Adam Birhan
- Department of Statistics, College of Natural and Computational Science, Injibara University, Injibara, Ethiopia
| | | | - Zelalem Meraf Wolde
- Department of Statistics, College of Natural and Computational Science, Injibara University, Injibara, Ethiopia
| | - Emebiet Abich
- Department of Statistics, College of Natural and Computational Science, Injibara University, Injibara, Ethiopia
| | - Gedif Mulat Alemayehu
- Department of Statistics, College of Natural and Computational Science, Injibara University, Injibara, Ethiopia
| | - Atalaye Nigussie
- Department of Statistics, College of Natural and Computational Science, Injibara University, Injibara, Ethiopia
| | - Yenew Alemu
- Department of Statistics, College of Natural and Computational Science, Injibara University, Injibara, Ethiopia
| | | | - Denekew Bitew Belay
- Department of Statistics, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
- Department of Statistics, University of Pretoria, Pretoria, South Africa
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Cygu SB, Nabukeera B, English L, Babirye S, Gyezaho C, Ng'etich M, Ochola M, Amadi D, Odero HO, Banturaki G, Kadengye DT, Kiragga A, Kajungu D. Understanding the demographic and socioeconomic determinants of morbidity in Eastern Uganda: a retrospective analysis of the Iganga-Mayuge health and demographic surveillance data. BMJ PUBLIC HEALTH 2024; 2:e000898. [PMID: 40018598 PMCID: PMC11816860 DOI: 10.1136/bmjph-2024-000898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 10/29/2024] [Indexed: 03/01/2025]
Abstract
Introduction Understanding the determinants of disease burden is imperative in enhancing population health outcomes. This study uses data from the Iganga-Mayuge Health and Demographic Surveillance Site, to understand demographic and socioeconomic factors influencing morbidity. Methods We analysed secondary data from 2018 to 2023. We employed graphs and tables to present morbidity patterns across different sociodemographic factors and applied mixed-effects multinomial multivariate logistic regression model to understand the correlates of morbidity. Results The findings reveal a predominant prevalence of malaria, lower respiratory tract infections, coryza, gastric acid-related and urinary tract infections, collectively constituting 83% of diagnosed diseases. Noteworthy demographic variations, particularly gender and age, significantly impact disease distribution, revealing higher diagnosis rates among females. Additionally, socioeconomic factors, including education and wealth status, contribute to discernible differences in disease burden. Conclusion This research provides crucial insights into the implications of demographic and socioeconomic factors on disease burden in Uganda. The results contribute to evidence-based policy-making, highlighting the necessity for targeted interventions addressing specific health challenges encountered by diverse populations. The study advocates for continuous assessment of the epidemiological landscape to inform more tailored and effective health strategies, ultimately enhancing resilience in disease control efforts.
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Affiliation(s)
- Steve Bicko Cygu
- Data Science Program, African Population and Health Research Center, Nairobi, Kenya
| | - Betty Nabukeera
- Centre for Health and Population Research (MUCHAP), Iganga, Makerere University, Kampala, Uganda
| | - Lindsey English
- Data Science Program, African Population and Health Research Center, Nairobi, Kenya
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Shakira Babirye
- Statistics, Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Collins Gyezaho
- Centre for Health and Population Research (MUCHAP), Iganga, Makerere University, Kampala, Uganda
| | - Maureen Ng'etich
- Data Science Program, African Population and Health Research Center, Nairobi, Kenya
- Informatics and Data Science, The University of Manchester Faculty of Medical and Human Sciences, Manchester, UK
| | - Michael Ochola
- Data Science Program, African Population and Health Research Center, Nairobi, Kenya
| | - David Amadi
- Data Science Program, African Population and Health Research Center, Nairobi, Kenya
| | - Henry Owoko Odero
- Data Science Program, African Population and Health Research Center, Nairobi, Kenya
| | - Grace Banturaki
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Damazo Twebaze Kadengye
- Data Science Program, African Population and Health Research Center, Nairobi, Kenya
- Department of Economics and Statistics, Kabale University, Kabale, Uganda
| | - Agnes Kiragga
- Data Science Program, African Population and Health Research Center, Nairobi, Kenya
| | - Dan Kajungu
- Centre for Health and Population Research (MUCHAP), Makerere University, Kampala, Uganda
- Department of Global Health, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa
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Kassaw AK, Bekele G, Kassaw AK, Yimer A. Prediction of acute respiratory infections using machine learning techniques in Amhara Region, Ethiopia. Sci Rep 2024; 14:27968. [PMID: 39543232 PMCID: PMC11564824 DOI: 10.1038/s41598-024-76847-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 10/17/2024] [Indexed: 11/17/2024] Open
Abstract
Many studies have shown that infectious diseases are responsible for the majority of deaths in children under five. Among these children, Acute Respiratory Infections is the most prevalent illness and cause of death worldwide. Acute respiratory infections continue to be the leading cause of death in developing countries, including Ethiopia. In order to predict the main factors contributing to acute respiratory infections in the Amhara regional state of Ethiopia, a machine learning technique was employed. This study utilized data from the 2016 Ethiopian Demographic and Health Survey. Seven machine learning models, including logistic regression, random forests, decision trees, Gradient Boosting, support vector machines, Naïve Bayes, and K-nearest neighbors, were employed to forecast the factors influencing acute respiratory infections. The accuracy of each model was assessed using receiver operating characteristic curves and various metrics. Among the seven models used, the Random Forest algorithm demonstrated the highest accuracy in predicting acute respiratory infections, with an accuracy rate of 90.35% and Area under the Curve of 94.80%. This was followed by the Decision Tree model with an accuracy rate of 88.69%, K-nearest neighbors with 86.35%, and Gradient Boosting with 82.69%. The Random Forest algorithm also exhibited positive and negative predictive values of 92.22% and 88.83%, respectively. Several factors were identified as significantly associated with ARI among children under five in the Amhara regional state, Ethiopia. These factors, included families with a poorer wealth status (log odds of 0.18) compared to their counterparts, families with four to six children (log odds of 0.1) compared to families with fewer than three living children, children without a history of diarrhea (log odds of -0.08), mothers who had occupation(log odds of 0.06) compared mothers who didn't have occupation, children under six months of age (log odds of -0.05) compared to children older than six months, mothers with no education (log odds of 0.04) compared to mothers with primary education or higher, rural residents (log odds of 0.03) compared to non-rural residents, families using wood as a cooking material (log odds of 0.03) compared to those using electricity. Through Shapley Additive exPlanations value analysis on the Random Forest algorithm, we have identified significant risk factors for acute respiratory infections among children in the Amhara regional state of Ethiopia. The study found that the family's wealth index, the number of children in the household, the mother's occupation, the mother's educational level, the type of residence, and the fuel type used for cooking were all associated with acute respiratory infections. Additionally, the research emphasized the importance of children being free from diarrhea and living in households with fewer children as essential factors for improving children's health outcomes in the Amhara regional state, Ethiopia.
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Affiliation(s)
- Abdulaziz Kebede Kassaw
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
| | - Gashaw Bekele
- Department of Software Engineering, College of Informatics, Kombolcha Institute of Technology, Wollo University, Kombolcha, Ethiopia
| | - Ahmed Kebede Kassaw
- Department of Information System, College of Informatics, Kombolcha Institute of Technology, Wollo University, Kombolcha, Ethiopia
| | - Ali Yimer
- Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
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Purnama TB, Wagatsuma K, Pane M, Saito R. Effects of the Local Environment and Nutritional Status on the Incidence of Acute Respiratory Infections Among Children Under 5 Years Old in Indonesia. J Prev Med Public Health 2024; 57:461-470. [PMID: 39139094 PMCID: PMC11471337 DOI: 10.3961/jpmph.24.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 07/11/2024] [Accepted: 07/15/2024] [Indexed: 08/15/2024] Open
Abstract
OBJECTIVES This study aimed to map the incidence of acute respiratory infections (ARIs) among under-5 children in Indonesia, address the triple burden of malnutrition, and analyze the impact of malnutrition on ARIs, taking into account the environmental and wealth disparities in Indonesia. METHODS This study utilized an ecological design, analyzing aggregate data from the Indonesia Nutrition Survey, 2022. It encompassed 33 provinces and 486 districts/cities, involving a total of 334 878 children under 5 years of age. Partial least squares structural equation modeling was employed to investigate the relationships among wealth, environment, malnutrition (stunting, wasting, and underweight), and ARIs. RESULTS The proportion of ARI cases in Indonesia was generally concentrated in central Sumatra, the western and eastern parts of Java, and eastern Papua. In contrast, the northern part of Sumatra, central Kalimantan, central Sulawesi, and central Papua had a higher proportion of malnutrition cases compared to other regions. Negative associations were found between malnutrition and ARIs (path coefficient =-0.072; p<0.01) and between wealth and environment (path coefficient =-0.633; p<0.001), malnutrition (path coefficient=-0.399; p<0.001), and ARIs (path coefficient=-0.918; p<0.001). CONCLUSIONS An increasing wealth index is expected to contribute to reducing ARIs, malnutrition and environmental burdens in the future. This study emphasizes the necessity for focused strategies that address both immediate health challenges and the underlying socioeconomic determinants to improve child health outcomes in the Indonesian context.
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Affiliation(s)
- Tri Bayu Purnama
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Faculty of Public Health, Universitas Islam Negeri Sumatera Utara, Medan, Indonesia
| | - Keita Wagatsuma
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Masdalina Pane
- National Research and Innovation Agency, Jakarta, Indonesia
| | - Reiko Saito
- Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Verma M, Sangeeta K, Verma BK, Dubey DK, Mondal M, Mazumder MN, Khan HT, Verma V. The association between anti-smoking legislation and prevalence of acute respiratory illnesses in Indian children. PUBLIC HEALTH IN PRACTICE 2024; 7:100481. [PMID: 38419738 PMCID: PMC10901132 DOI: 10.1016/j.puhip.2024.100481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/22/2024] [Accepted: 02/09/2024] [Indexed: 03/02/2024] Open
Abstract
Objective Exposure to tobacco smoke causes numerous health problems in children, and create burden on the population in terms of economy, morbidity and mortality. In order to protect the child from exposure to tobacco smoke in the outdoor environment, sufficient legislative enactments are available in Indian legislation. The objective of the present study is to investigate the fact that in absence of any specific laws stating about protection of children from exposure to tobacco smoke in indoor environment, whether outdoor related legislations are sufficient to protect children from exposureand to explore the scope for enforcement of both state and central laws in improving health of children in India. Study design The study considered cross-sectional survey data of Demographic and Health Survey Data on India, National Family and Health Survey fourth round (NFHS-4) for the year 2015-16 on Indian children (below age of four). Methods Both bivariate and multivariate logistic regression models were used to assess the impact of anti-smoking laws on the prevalence of acute respiratory infection (ARI) based on the place of residence, indoor tobacco smoke exposure and age of the child. Results The results have shown an inclination of ARI among children in association with states having single law, rural area resident, exposure to indoor tobacco smoke and age of the child, both as independent or in combination are quite conspicuous, and are found to be underestimated. The logistic regression also revealed the influence of these factors both as independent and even in interaction with other. Conclusions Legislative intervention through both at central (or national)and state levels through anti-smoking laws will decrease the indoor tobacco smoke exposure as a result ARI prevalence will also decrease among children in India.
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Affiliation(s)
- Mamta Verma
- Department of Law, Kazi Nazrul University, West Bengal, 713340, India
| | - K. Sangeeta
- HRC HOSPITAL, Hyderabad, 500016, Telangana, India
| | | | - Dharmendra Kumar Dubey
- Department of Biostatistics, School of Allied Health Sciences (SAHS), Sharda Hospital, Sharda University, Uttar Pradesh, 201310, India
| | - Mukul Mondal
- Department of Law, Kazi Nazrul University, West Bengal, 713340, India
| | - Mousumi Nath Mazumder
- Indian Council of Social Science Research (ICSSR), JNU Institutional Area, Aruna Asaf Ali Marg, New Delhi, 110067, India
| | - Hafiz T.A. Khan
- Health Promotion and Public Health, College of Nursing, Midwifery and Healthcare, University of West London, Paragon House, Boston Manor Road, Brentford, TW8 9GB, United Kingdom
| | - Vivek Verma
- Department of Statistics, Assam University, Silchar, Assam, 788011, India
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Kalayou MH, Kassaw AAK, Shiferaw KB. Empowering child health: Harnessing machine learning to predict acute respiratory infections in Ethiopian under-fives using demographic and health survey insights. BMC Infect Dis 2024; 24:338. [PMID: 38515014 PMCID: PMC10956296 DOI: 10.1186/s12879-024-09195-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 03/05/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND A dearth of studies showed that infectious diseases cause the majority of deaths among under-five children. Worldwide, Acute Respiratory Infection (ARI) continues to be the second most frequent cause of illness and mortality among children under the age of five. The paramount disease burden in developing nations, including Ethiopia, is still ARI. OBJECTIVE This study aims to determine the magnitude and predictors of ARI among under-five children in Ethiopia using used state of the art machine learning algorithms. METHODS Data for this study were derived from the 2016 Ethiopian Demographic and Health Survey. To predict the determinants of acute respiratory infections, we performed several experiments on ten machine learning algorithms (random forests, decision trees, support vector machines, Naïve Bayes, and K-nearest neighbors, Lasso regression, GBoost, XGboost), including one classic logistic regression model and an ensemble of the best performing models. The prediction ability of each machine-learning model was assessed using receiver operating characteristic curves, precision-recall curves, and classification metrics. RESULTS The total ARI prevalence rate among 9501 under-five children in Ethiopia was 7.2%, according to the findings of the study. The overall performance of the ensemble model of SVM, GBoost, and XGBoost showed an improved performance in classifying ARI cases with an accuracy of 86%, a sensitivity of 84.6%, and an AUC-ROC of 0.87. The highest performing predictive model (the ensemble model) showed that the child's age, history of diarrhea, wealth index, type of toilet, mother's educational level, number of living children, mother's occupation, and type of fuel they used were an important predicting factor for acute respiratory infection among under-five children. CONCLUSION The intricate web of factors contributing to ARI among under-five children was identified using an advanced machine learning algorithm. The child's age, history of diarrhea, wealth index, and type of toilet were among the top factors identified using the ensemble model that registered a performance of 86% accuracy. This study stands as a testament to the potential of advanced data-driven methodologies in unraveling the complexities of ARI in low-income settings.
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Affiliation(s)
- Mulugeta Hayelom Kalayou
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
| | - Abdul-Aziz Kebede Kassaw
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Kirubel Biruk Shiferaw
- Department of Medical Informatics, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
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Pronyk PM, de Alwis R, Rockett R, Basile K, Boucher YF, Pang V, Sessions O, Getchell M, Golubchik T, Lam C, Lin R, Mak TM, Marais B, Twee-Hee Ong R, Clapham HE, Wang L, Cahyorini Y, Polotan FGM, Rukminiati Y, Sim E, Suster C, Smith GJD, Sintchenko V. Advancing pathogen genomics in resource-limited settings. CELL GENOMICS 2023; 3:100443. [PMID: 38116115 PMCID: PMC10726422 DOI: 10.1016/j.xgen.2023.100443] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
Genomic sequencing has emerged as a powerful tool to enhance early pathogen detection and characterization with implications for public health and clinical decision making. Although widely available in developed countries, the application of pathogen genomics among low-resource, high-disease burden settings remains at an early stage. In these contexts, tailored approaches for integrating pathogen genomics within infectious disease control programs will be essential to optimize cost efficiency and public health impact. We propose a framework for embedding pathogen genomics within national surveillance plans across a spectrum of surveillance and laboratory capacities. We adopt a public health approach to genomics and examine its application to high-priority diseases relevant in resource-limited settings. For each grouping, we assess the value proposition for genomics to inform public health and clinical decision-making, alongside its contribution toward research and development of novel diagnostics, therapeutics, and vaccines.
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Affiliation(s)
- Paul Michael Pronyk
- Centre for Outbreak Preparedness, Duke-NUS Medical School, Singapore 169857, Singapore.
| | - Ruklanthi de Alwis
- Centre for Outbreak Preparedness, Duke-NUS Medical School, Singapore 169857, Singapore; Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Rebecca Rockett
- Sydney Infectious Diseases Institute, The University of Sydney, Camperdown, NSW 2006, Australia; Centre for Infectious Diseases and Microbiology - Public Health, Westmead Hospital, Westmead, NSW 2145, Australia
| | - Kerri Basile
- Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology - Institute of Clinical Pathology and Medical Research, Westmead, NSW 2145, Australia
| | - Yann Felix Boucher
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; Infectious Diseases Translational Research Programme, Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 117549, Singapore; Singapore Centre for Environmental Life Sciences Engineering, National University of Singapore, Singapore 117549, Singapore; Nanyang Technological University, Singapore 639798, Singapore
| | - Vincent Pang
- Centre for Outbreak Preparedness, Duke-NUS Medical School, Singapore 169857, Singapore
| | - October Sessions
- Sydney Infectious Diseases Institute, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Marya Getchell
- Centre for Outbreak Preparedness, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Tanya Golubchik
- Sydney Infectious Diseases Institute, The University of Sydney, Camperdown, NSW 2006, Australia; Centre for Infectious Diseases and Microbiology - Public Health, Westmead Hospital, Westmead, NSW 2145, Australia; Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7LF, UK
| | - Connie Lam
- Sydney Infectious Diseases Institute, The University of Sydney, Camperdown, NSW 2006, Australia; Centre for Infectious Diseases and Microbiology - Public Health, Westmead Hospital, Westmead, NSW 2145, Australia
| | - Raymond Lin
- National Public Health Laboratory, National Centre for Infectious Diseases, Singapore 308442, Singapore
| | - Tze-Minn Mak
- Bioinformatics Institute, Agency for Science, Technology and Research, Singapore 138671, Singapore
| | - Ben Marais
- Sydney Infectious Diseases Institute, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Rick Twee-Hee Ong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore
| | - Hannah Eleanor Clapham
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore
| | - Linfa Wang
- Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore 169857, Singapore; Programme for Research in Epidemic Preparedness and Response (PREPARE), Ministry of Health, Singapore 169854, Singapore
| | - Yorin Cahyorini
- Center for Health Resilience and Resource Policy, Ministry of Health, Jakarta 12950, Indonesia
| | - Francisco Gerardo M Polotan
- Molecular Biology Laboratory, Research Institute for Tropical Medicine, Muntinlupa 1781, Metro Manila, Philippines
| | - Yuni Rukminiati
- Center for Health Resilience and Resource Policy, Ministry of Health, Jakarta 12950, Indonesia
| | - Eby Sim
- Sydney Infectious Diseases Institute, The University of Sydney, Camperdown, NSW 2006, Australia; Centre for Infectious Diseases and Microbiology - Public Health, Westmead Hospital, Westmead, NSW 2145, Australia
| | - Carl Suster
- Sydney Infectious Diseases Institute, The University of Sydney, Camperdown, NSW 2006, Australia; Centre for Infectious Diseases and Microbiology - Public Health, Westmead Hospital, Westmead, NSW 2145, Australia
| | - Gavin J D Smith
- Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Vitali Sintchenko
- Sydney Infectious Diseases Institute, The University of Sydney, Camperdown, NSW 2006, Australia; Centre for Infectious Diseases and Microbiology - Public Health, Westmead Hospital, Westmead, NSW 2145, Australia; Centre for Infectious Diseases and Microbiology Laboratory Services, NSW Health Pathology - Institute of Clinical Pathology and Medical Research, Westmead, NSW 2145, Australia
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Gebrerufael GG, Hagos BT. Prevalence and predictors of acute respiratory infection among children under-five years in Tigray regional state, northern Ethiopia: a cross sectional study. BMC Infect Dis 2023; 23:743. [PMID: 37904115 PMCID: PMC10614314 DOI: 10.1186/s12879-023-08701-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 10/12/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Acute respiratory infection is still one of the leading causes of child morbidity and mortality worldwide. Developing countries, especially in Sub-Saharan Africa including Ethiopia continue to share an overburden of this infection. Studies showed that different predictor factors were associated with the occurrence of childhood acute respiratory infection. Therefore, the main aim of this study was to assess the prevalence and associated predictor factors of acute respiratory infection among children under-five years in the Tigray Regional State, northern Ethiopia. METHODS A retrospective cross-sectional study design was done from January 18, 2016, to June 27, 2016. A total of 986 children under-five years were selected for this study. The logistic regression model analysis was employed to examine the predictor factors of childhood acute respiratory infection. Both bi-variable and multivariable data analysis was performed using STATA version 14.0. RESULTS Overall, the study showed that the two weeks prevalence of acute respiratory infection among children under-five years was 16.10% [95%CI: 13.80-18.40]. According to the multivariable logistic regression model analysis, children aged (24-60) months (AOR: 0.59, 95%CI: 0.352-0.98), rich wealth index of households (AOR: 0.60, 95%CI: 0.378-0.959), diarrhea status of children (AOR: 3, 95%CI: 1.97-4.73), and mothers smoking cigarettes (AOR: 4, 95%CI: 1.15-16.50), were significant predictors of acute respiratory infection. CONCLUSION The prevalence of ARI displays that Tigray regional state was experiencing a higher ARI rate than the national level. The current study identified the low wealth index of households, children aged (24-60 months), mothers smoking cigarettes, and diarrhea status of the children as crucial predictor factors for ARI. Interventions should be improved to these modifiable major predictor factors that significantly decrease the ARI problem among under-five children.
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Affiliation(s)
| | - Bsrat Tesfay Hagos
- Department of Statistics, College of Natural and Computational Science, Mekelle University, Mekelle, Ethiopia
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Sarfo JO, Amoadu M, Gyan TB, Osman AG, Kordorwu PY, Adams AK, Asiedu I, Ansah EW, Amponsah-Manu F, Ofosu-Appiah P. Acute lower respiratory infections among children under five in Sub-Saharan Africa: a scoping review of prevalence and risk factors. BMC Pediatr 2023; 23:225. [PMID: 37149597 PMCID: PMC10163812 DOI: 10.1186/s12887-023-04033-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 04/25/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND Acute lower respiratory tract infections (ALRTIs) among children under five are still the leading cause of mortality among this group of children in low and middle-income countries (LMICs), especially countries in sub-Saharan Africa (SSA). This scoping review aims to map evidence on prevalence and risk factors associated with ALRTIs among children under 5 years to inform interventions, policies and future studies. METHODS A thorough search was conducted via four main databases (PubMed, JSTOR, Web of Science and Central). In all, 3,329 records were identified, and 107 full-text studies were considered for evaluation after vigorous screening and removing duplicates, of which 43 were included in this scoping review. FINDINGS Findings indicate a high prevalence (between 1.9% to 60.2%) of ALRTIs among children under five in SSA. Poor education, poverty, malnutrition, exposure to second-hand smoke, poor ventilation, HIV, traditional cooking stoves, unclean fuel usage, poor sanitation facilities and unclean drinking water make children under five more vulnerable to ALRTIs in SSA. Also, health promotion strategies like health education have doubled the health-seeking behaviours of mothers of children under 5 years against ALRTIs. CONCLUSION ALRTIs among children under five still present a significant disease burden in SSA. Therefore, there is a need for intersectoral collaboration to reduce the burden of ALRTIs among children under five by strengthening poverty alleviation strategies, improving living conditions, optimising child nutrition, and ensuring that all children have access to clean water. There is also the need for high-quality studies where confounding variables in ALRTIs are controlled.
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Affiliation(s)
- Jacob Owusu Sarfo
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Mustapha Amoadu
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana.
| | - Thomas Boateng Gyan
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Abdul-Ganiyu Osman
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Peace Yaa Kordorwu
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Abdul Karim Adams
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Immanuel Asiedu
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Edward Wilson Ansah
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
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Tesfaye SH, Seboka BT, Sisay D. Spatial patterns and spatially-varying factors associated with childhood acute respiratory infection: data from Ethiopian demographic and health surveys (2005, 2011, and 2016). BMC Infect Dis 2023; 23:293. [PMID: 37147575 PMCID: PMC10163815 DOI: 10.1186/s12879-023-08273-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 04/22/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND In Ethiopia, acute respiratory infections (ARIs) are a leading cause of morbidity and mortality among children under five years. Geographically linked data analysis using nationally representative data is crucial to map spatial patterns of ARIs and identify spatially-varying factors of ARI. Therefore, this study aimed to investigate spatial patterns and spatially-varying factors of ARI in Ethiopia. METHODS Secondary data from the Ethiopian Demographic Health Survey (EDHS) of 2005, 2011, and 2016 were used. Kuldorff's spatial scan statistic using the Bernoulli model was used to identify spatial clusters with high or low ARI. Hot spot analysis was conducted using Getis-OrdGi statistics. Eigenvector spatial filtering regression model was carried out to identify spatial predictors of ARI. RESULTS Acute respiratory infection spatially clustered in 2011 and 2016 surveys year (Moran's I:-0.011621-0.334486). The magnitude of ARI decreased from 12.6% (95%, CI: 0.113-0.138) in 2005 to 6.6% (95% CI: 0.055-0.077) in 2016. Across the three surveys, clusters with a high prevalence of ARI were observed in the North part of Ethiopia. The spatial regression analysis revealed that the spatial patterns of ARI was significantly associated with using biomass fuel for cooking and children not initiating breastfeeding within 1-hour of birth. This correlation is strong in the Northern and some areas in the Western part of the country. CONCLUSION Overall there has been a considerable decrease in ARI, but this decline in ARI varied in some regions and districts between surveys. Biomass fuel and early initiation of breastfeeding were independent predictors of ARI. There is a need to prioritize children living in regions and districts with high ARI.
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Affiliation(s)
| | - Binyam Tariku Seboka
- School of Public Health, college of health sciences and medicine, Dilla University, Dilla, Ethiopia
| | - Daniel Sisay
- School of Public Health, college of health sciences and medicine, Dilla University, Dilla, Ethiopia
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Fontalvo-Rivera D, Mazenett E, Àlvarez-Zambrano C, Gómez-Camargo D. Vitamin D3 in acute respiratory infections in patients under five years old (Cartagena de Indias, Colombia). JOURNAL OF MEDICAL SCIENCE 2022. [DOI: 10.20883/medical.e679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background and Aim. Low serum levels of 25-hydroxyvitamin D3 are associated with an increased risk of Acute Respiratory Infection (ARI) that is among the most important causes of morbidity and mortality in children under 5 years old. We describe the clinical behavior of acute respiratory infections in patients under five years ago in one sanitary institution in Colombia after VD3 supplementation.
Material and Methods. A case series was conducted on 38 patients of both genders aged less to 5 years ago was included. Participants were supplied 50,000 units of VD3 orally each month for three months. The number of events, consultations for emergency services, and hospitalization due to acute respiratory infections (ARIs) before and after VD3 administration were described.
Results. The average age of the participants was 25.81 ± 17.50 months. The average clinical ARIs per month was 4.02 (95% CI 3.64-4.40) before VD3 administration. Fewer episodes at the end of the three cycles was found at 2.23/month (95% CI 1.81-2.65; p=0.0230). The average consultations for emergency services during the three months before VD3 administration was 2.15 (95% CI 1.77-2.53). After three months of treatment, the average use of emergency services decreased to 0.52 (95% CI 0.37-0.72; p=0.0180). After the administration of the three doses of VD3, only one patient required hospitalization (2.63%; : 0.026 (IC95% 0.02-0.03; p=0.0368)).
Conclusions. The administration of vitamin D3 could have a benefit in decreasing the number of episodes, emergencies, and hospitalization for ARI in children under five years old. Trial studies are required to determine this potential benefit.
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Nshimiyimana Y, Zhou Y. Analysis of risk factors associated with acute respiratory infections among under-five children in Uganda. BMC Public Health 2022; 22:1209. [PMID: 35715771 PMCID: PMC9205046 DOI: 10.1186/s12889-022-13532-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 05/20/2022] [Indexed: 11/25/2022] Open
Abstract
Background Globally, infectious diseases are the major cause of death in children under the age of 5 years. Sub-Saharan Africa and South Asia account for 95% of global child mortalities every year, where acute respiratory infections (ARI) remain the leading cause of child morbidity and mortality. The aim of this study is to analyze the risk factors of ARI disease symptoms among children under the age of 5 years in Uganda. Methods A cross-sectional design was used to analyze 2016 Uganda Demographic and Health Survey (UDHS) data collected on 13,493 children under the age of 5 years in Uganda. Various methods, such as logistic regression, elastic net logistic regression, decision tree, and random forest, were compared and used to predict 75% of the symptom outcomes of ARI disease. Well-performing methods were used to determine potential risk factors for ARI disease symptoms among children under the age of 5 years. Results In Uganda, about 40.3% of children were reported to have ARI disease symptoms in the 2 weeks preceding the survey. Children under the age of 24 months were found to have a high prevalence of ARI disease symptoms. By considering 75% of the sample, the random forest was found to be a well-performing method (accuracy = 88.7%; AUC = 0.951) compared to the logistic regression method (accuracy = 62.0%; AUC = 0.638) and other methods in predicting childhood ARI symptoms. In addition, one-year old children (OR: 1.27; 95% CI: 1.12–1.44), children whose mothers were teenagers (OR: 1.28; 95% CI: 1.06–1.53), and farm workers (1.25; 95% CI: 1.11–1.42) were most likely to have ARI disease symptoms than other categories. Furthermore, children aged 48–59 months (OR: 0.69; 95% CI: 0.60–0.80), breastfed children (OR: 0.83; 95% CI: 0.76–0.92), usage of charcoal in cooking (OR: 0.77; 95% CI: 0.69–0.87), and the rainy season effect (OR: 0.66; 95% CI: 0.61–0.72) showed a low risk of developing ARI disease symptoms among children under the age of 5 years in Uganda. Conclusion Policy-makers and health stakeholders should initiate target-oriented approaches to address the problem regarding poor children’s healthcare, improper environmental conditions, and childcare facilities. For the sake of early child care, the government should promote child breastfeeding and maternal education. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13532-y.
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Affiliation(s)
| | - Yingchun Zhou
- KLATASDS-MOE, School of Statistics, East China Normal University, Shanghai, China.
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Hossain MS, Tasnim S, Chowdhury MA, Chowdhury FIF, Hossain D, Rahman MM. Under five children's acute respiratory infection dropped significantly in Bangladesh: an evidence from Bangladesh demographic and health survey (BDHS), 1996-2018. Acta Paediatr 2022; 111:1981-1994. [PMID: 35678484 DOI: 10.1111/apa.16447] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 05/29/2022] [Accepted: 06/07/2022] [Indexed: 11/29/2022]
Abstract
AIM This study aims to systematically identify and review the most significant risk factors and the trends that follow Acute Respiratory Infection (ARI) among children under five in Bangladesh. METHODS A total of 6863 under-five children were eligible for our analysis, retrieved from Bangladesh Demographic and Health Survey, 2014. ARI cases were defined if a child experienced of coughing with short and rapid breathing at the chest that occurred during two weeks prior to the study. Logistic regression and systematic review methods were appraised to explore the various risk factors involving ARI in Bangladesh. Furthermore, a trend analysis was performed to overlook the historical trend of ARI prevalence and affiliated determinants from 1996/97 to 2017/18 in Bangladesh. RESULTS Over the past two decades, Bangladesh experienced a significant drop in ARI prevalence from 12.8% in 1996 to only 3.0% in 2018. The cross-sectional findings revealed that boys (OR=1.35, 95% CI: 1.03-1.78), stunted children (OR=1.35, 95% CI: 1.03-1.78) and mothers with primary or no education (OR=2.53, 95% CI: 1.43-4.90) and secondary education (OR=1.77, 95% CI: 1.00-3.44) has the higher odds of ARI than their counterparts. CONCLUSION ARI prevalence significantly declined in Bangladesh while boys, stunted children and uneducated or primary educated mothers were identified as potential risk factors.
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Affiliation(s)
- Md Sabbir Hossain
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Sumaiya Tasnim
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
| | - Md Alamgir Chowdhury
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
| | | | - Daluwar Hossain
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
| | - Mohammad Meshbahur Rahman
- Department of Biostatistics, National Institute of Preventive and Social Medicine, Mohakhali, Dhaka, -1212, Bangladesh
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Morita N, Tanaka Y, Takeuchi K, Kitagawa Y, Sakuma R, Koide N, Komatsu T. SeV C Protein Plays a Role in Restricting Macrophage Phagocytosis by Limiting the Generation of Intracellular Double-Stranded RNA. Front Microbiol 2022; 13:780534. [PMID: 35265056 PMCID: PMC8899396 DOI: 10.3389/fmicb.2022.780534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/19/2022] [Indexed: 11/23/2022] Open
Abstract
Macrophages play a central role in the innate immune response to respiratory viral infections through pro-inflammatory factor secretion and phagocytosis. However, as a countermeasure, viral pathogens have evolved virulence factors to antagonize macrophage function. In our recent in vitro analyses of murine macrophage cell lines, Sendai virus (SeV) accessory protein C inhibited the secretion of pro-inflammatory factors, and C gene-knockout SeV (SeVΔC) caused drastic morphological changes in RAW264.7 macrophages, similar to those observed after stimulation with Lipid A, a well-known activator of actin-rich membrane ruffle formation and phagocytosis. Hence, we sought to determine whether the C protein limits phagocytosis in SeV-infected macrophages through the suppression of membrane ruffling. Phagocytosis assays indicated an upregulation of phagocytosis in both SeVΔC-infected and Lipid A-stimulated macrophages, but not in SeV WT-infected cells. Further, the observed membrane ruffling was associated with phagocytosis. RIG-I is essential for Lipid A-induced phagocytosis; its deficiency inhibited SeVΔC-stimulated phagocytosis and ruffling, confirming the essential role of RIG-I. Moreover, treatment with interferon (IFN)-β stimulation and neutralizing antibodies against IFN-β suggested that SeVΔC-induced phagocytosis and ruffling occurred in an IFN-β-independent manner. A newly isolated SeVΔC strain that does not generate dsRNA further highlighted the importance of dsRNA in the induction of phagocytosis and ruffling. Taken together, the current results suggest that SeV C protein might limit phagocytosis-associated membrane ruffling in an RIG-I-mediated but IFN-independent manner via limiting the generation of intracellular dsRNA.
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Affiliation(s)
- Naoko Morita
- Department of Microbiology and Immunology, Aichi Medical University School of Medicine, Aichi, Japan
| | - Yukie Tanaka
- Department of Integrative Vascular Biology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kenji Takeuchi
- Department of Genome Science and Microbiology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yoshinori Kitagawa
- Division of Microbiology and Infectious Diseases, Department of Pathology, Shiga University of Medical Science, Shiga, Japan
| | - Ryusuke Sakuma
- Department of Microbiology and Immunology, Aichi Medical University School of Medicine, Aichi, Japan
| | - Naoki Koide
- Department of Microbiology and Immunology, Aichi Medical University School of Medicine, Aichi, Japan
| | - Takayuki Komatsu
- Department of Microbiology and Immunology, Aichi Medical University School of Medicine, Aichi, Japan
- *Correspondence: Takayuki Komatsu,
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Association of Acute Respiratory Infections with Indoor Air Pollution from Biomass Fuel Exposure among Under-Five Children in Jimma Town, Southwestern Ethiopia. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2021:7112548. [PMID: 34976075 PMCID: PMC8718271 DOI: 10.1155/2021/7112548] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/07/2021] [Accepted: 12/07/2021] [Indexed: 11/30/2022]
Abstract
Background Most of the households in developing countries burn biomass fuel in traditional stoves with incomplete combustion that leads to high indoor air pollution and acute respiratory infections. Acute respiratory infection is the most common cause of under-five morbidity and mortality accounting for 2 million deaths worldwide and responsible for 18% of deaths among under-five children in Ethiopia. Although studies were done on acute respiratory infections, the majority of studies neither clinically diagnose respiratory infections nor use instant measurement of particulate matter. Methods The community-based cross-sectional study design was employed among under-five children in Jimma town from May 21 to June 7, 2020. A total of 265 children through systematic random sampling were included in the study. The data were collected using a pretested semistructured questionnaire and laser pm 2.5 meter for indoor particulate matter concentration. Associations among factors were assessed through correlation analysis, and binary logistic regression was done to predict childhood acute respiratory infections. Variables with p-value less than 0.25 in bivariate regression were the candidate for the final multivariate logistic regression. Two independent sample t-tests were done to compare significant mean difference between concentrations of particulate matter. Results Among 265 under-five children who were involved in the study, 179 (67.5%) were living in households that predominantly use biomass fuel. Prevalence of acute respiratory infections in the study area was 16%. Children living in households that use biomass fuel were four times more likely to develop acute respiratory infections than their counterparts (AOR: 4.348; 95% CI: 1.632, 11.580). The size of household was significantly associated with the prevalence of acute respiratory infections. Under-five children living in households that have a family size of six and greater had odds of 1.7 increased risk of developing acute respiratory infections than their counterparts (AOR: 1.7; 95% CI: 1.299, 2.212). The other factor associated with acute respiratory infection was separate kitchen; children living in households in which there were no separate kitchen were four times at increased risk of developing acute respiratory infection than children living in households which have separate kitchen (AOR: 4.591; 95% CI: 1.849, 11.402). The concentration of indoor particulate matter was higher in households using biomass fuel than clean fuel. There was statistically higher particulate matter concentration in the kitchen than living rooms (t = 4.509, p ≤ 0.001). Particulate matter 2.5 concentrations (μg/m3) of the households that had parental smoking were significantly higher than their counterparts (AOR: 20.224; 95% CI: 1.72, 12.58). Conclusion There is an association between acute respiratory infections and biomass fuel usage among under-five children. Focusing on improved energy sources is essential to reduce the burden and assure the safety of children.
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Abayneh M, Muleta D, Simieneh A, Duguma T, Asnake M, Teressa M, Endalkachew B, Toru M. Acute respiratory infections (ARIs) and factors associated with their poor clinical outcome among children under-five years attending pediatric wards of public hospital in Southwest district of Ethiopia: A prospective observational cohort study. EUR J INFLAMM 2022. [DOI: 10.1177/1721727x221139266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
This study was designed to assess the prevalence and factors associated with poor clinical outcome of acute respiratory infections (ARIs) among children less than five years of age at Mizan-Tepi university teaching public hospital in southwest district of Ethiopia. A prospective observational cohort study design was conducted from 01 June to August 30, 2020. Data related to socio-demographics, child nutritional status, clinical and environmental characteristics of patients were collected with structured questionnaire. Follow-up data were gathered from patient’s medical records using standard data collection tool. The data were analyzed using SPSS versions 25.0. In this study, 305 children of age less than five years were included. Of these, 124 (40.7%) of children were diagnosed with ARIs, of which 66 (53.2%) were female and 69 (55.6%) were age of 24–59 months. Of children diagnosed with ARIs, 21 (16.9%) were ended with poor clinical outcomes after completion of their treatment. In the multivariate analysis, age of children and presence of any other disease conditions (OR = 0.331; 95% CI: 0.123– 0.880; p= 0.024), exposure to indoor air pollution (OR = 0.344; 95% CI: 0.128– 0.925; p= 0.030), malnutrition (OR = 0.175; 95% CI: 0.058– 0.523; p= 0.002) and end point pneumonia (OR = 0.305; 95% CI: 0.113–0.821; p= 0.015) were found to be independent factors for poor outcome of under-five children with ARIs. Our findings highlight that timely detection, proper management and treatments as well as addressing other contributing factors are essentials in order to reduce prevalence and poor clinical outcomes of under five children with ARIs.
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Affiliation(s)
- Mengistu Abayneh
- College of Medicine and Health Science, Department of Medical Laboratory Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Dassaleng Muleta
- College of Medicine and Health Science, Department of Medical Laboratory Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Asnake Simieneh
- College of Medicine and Health Science, Department of Medical Laboratory Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Tadesse Duguma
- College of Medicine and Health Science, Department of Medical Laboratory Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Molla Asnake
- College of Medicine and Health Science, Department of Medicine, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Murtii Teressa
- College of Medicine and Health Science, Department of Medicine, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Biruk Endalkachew
- College of Medicine and Health Science, Department of Biomedical Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Milkiyas Toru
- College of Health Science, Department of Medical Laboratory Sciences, Debre Markos University, Debre Marqos, Ethiopia
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Chanie ES, Dagne Z, Jimma MS, Eyayu T, Nebiyu S, Wondifraw EB, GebreEyesus FA, Yemata GA, Melkie A. The effect of timely initiation of complementary feeding and vitamin A supplementation on acute malnutrition among children aged 6-59 months attending Hamusit Health Centre, Northwest Ethiopia, 2021: A cross-sectional study. Heliyon 2021; 7:e08449. [PMID: 34901501 PMCID: PMC8637469 DOI: 10.1016/j.heliyon.2021.e08449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/03/2021] [Accepted: 11/17/2021] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Acute malnutrition is a nutritional deficiency that results either from inadequate energy or protein intake. It is more prevalent in low- and middle-income countries. Even though efforts have been carried out at the global and national level, the burden is still intolerable and it attracts the attention of the government and researchers. Hence, this study aims to assess the magnitude of acute malnutrition and its associated factors among under-five children who attended Hamusit Health Centre from 1st September to 30th January 2021. MATERIALS AND METHODS This institution-based cross-sectional study was conducted from 1st September to 30th January on 404 randomly selected under-five children who visited the health centre. Samples were selected using a simple random sampling technique, and the data were obtained using a pre-tested standardized questionnaire. For data entry and analysis, Epi-info 7 and SPSS 21 applications were used, respectively. Bivariable and multivariable binary logistic regression were used to identify associated factors at a 95% confidence interval. Significance was considered at p-value<0.05. RESULTS The present research involved a total of 404 children aged 6-59 months. The magnitude of acute malnutrition in this study was 14.4%. Children aged 6-23 months [AOR: 2.92; 95%CI (1.46, 5.85)], vitamin A supplementation [AOR: 0.49; 95%CI (0.25, 0.95)], not timely initiation of complementary feeding [AOR: 2.02; 95%CI (1.06, 3.82)] and children with diarrhea prior to two weeks of the survey [AOR: 2.47; 95% CI (1.28, 4.87)] were significantly associated with acute malnutrition. CONCLUSION A significant number of children aged 6-59 months were affected by acute malnutrition. Younger children, vitamin A supplementation, not timely initiation of complementary feeding, and children with diarrhoea were other factors associated with acute malnutrition.
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Affiliation(s)
| | | | | | - Tahir Eyayu
- Debre Tabor University, Debre Tabor, Ethiopia
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Structural Insight into the Interaction of Sendai Virus C Protein with Alix To Stimulate Viral Budding. J Virol 2021; 95:e0081521. [PMID: 34287046 DOI: 10.1128/jvi.00815-21] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The Sendai virus (SeV), belonging to the Respirovirus genus of the family Paramyxoviridae, harbors an accessory protein, named C protein, which facilitates the viral pathogenicity in mice. In addition, the C protein is known to stimulate the budding of virus-like particles through the binding to the host ALG-2 interacting protein X (Alix), a component of the endosomal sorting complexes required for transport (ESCRT) machinery. However, siRNA-mediated gene knockdown studies suggested that neither Alix nor C protein are related to the SeV budding. In the present study, we determined the crystal structure of a complex comprising of the C-terminal half of the C protein (Y3) and the Bro1 domain of Alix at a resolution of 2.2 Å, to investigate the role of the association in the SeV budding. The structure revealed that a novel consensus sequence, LxxW, which is conserved among the Respirovirus C proteins, is important for the Alix-binding. SeV possessing a mutated C protein with a reduced Alix-binding affinity showed impaired virus production, which correlated with the binding affinity. Infectivity analysis showed a 160-fold reduction at 12 h post-infection compared with non-mutated virus, while C protein competes with CHMP4, one subunit of the ESCRT-III complex, on the binding to Alix. Altogether, these results highlight the critical role of C protein in the SeV budding. IMPORTANCE Human parainfluenza virus type I (hPIV1) is a respiratory pathogen affecting in young children, immunocompromised patients, and the elderly, with no available vaccines or antiviral drugs. Sendai virus (SeV), a murine counterpart of hPIV1, has been extensively studied to determine the molecular and biological properties of hPIV1. These viruses possess a multifunctional accessory protein, C protein, which is essential for stimulating the viral reproduction, however, its role in budding remains controversial. In the present study, the crystal structure of the C-terminal half of the SeV C protein associated with the Bro1 domain of Alix, a component of a cell membrane modulating machinery ESCRT, was elucidated. Based on the structure, we designed mutated C proteins with different binding affinity to Alix, and showed that the interaction between C and Alix is vital for the viral budding. These findings provide new insights into the development of a new antiviral drugs against hPIV1.
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Chanie MG, Melaku MS, Yalew M, Arefaynie M, Bitew G, Amsalu ET, Kefale B, Muche A, Fentaw Z, Dewau R, Adane B, Damtie Y, Ayele WM, Ewunetie GE, Adane M. Predictors of community acquired childhood pneumonia among 2-59 months old children in the Amhara Region, Ethiopia. BMC Pulm Med 2021; 21:179. [PMID: 34034726 PMCID: PMC8152354 DOI: 10.1186/s12890-021-01548-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 05/17/2021] [Indexed: 11/16/2022] Open
Abstract
Background Worldwide, pneumonia is the third leading cause of death in under 5 years children. Ethiopia is ranked 4th out of 15 countries having the highest burdens of the death rate among under-five children due to pneumonia. Regardless of this fact, efforts to identify determinants of pneumonia have been limited yet in Amhara region. This study was aimed to identify predictors of community-acquired childhood pneumonia among 2–59 months old children in the Amhara region, Ethiopia. Methods Facility-based case–control study was conducted in the Amhara region from June 4 to July 15, 2018, among 28 health centers distributed across the region. The total sample size used was 888 (296 cases and 592 controls) children whose age were 2–59 months. At first, multistage sampling technique was employed. Data were collected on a face-to-face interview. Epi data v. 4.6 for data entry and statistical packages for social sciences version 23 for data analysis were used. Multivariable logistic regression analyses were used to test the associations between the study variables at P-value < 0.05 with 95% CI. As a result, determinants were identified for CAP. Results Among 888 enrolled children (296 cases and 592 controls), who experienced a community-acquired pneumonia had an increased risk of maternal age of 18–24 years (AOR 0.03, at 95%CI (0.01, 0.14), Government employee (AOR 0.19, at 95% CI (0.07,0.54), lack of separate kitchen (AOR 5.37; at 95% CI (1.65, 17.43), history of diarrhea in the past two weeks (AOR 10.2; at 95% CI (5.13, 20.18), previous respiratory tract infections (AOR 8.3, at 95% CI (3.32, 20.55) and history of parental asthma (AOR 4.9, at 95% CI (2.42, 10.18). Conclusion Maternal age of 18–24 years and government employee, lack of separate kitchen, history of diarrhea in the past two weeks; previous respiratory tract infection and history of parental asthma were found statistically significant. Health personnel’s needs to focus on creating awareness to the community on the merit of the separate kitchen for reduction of Community-acquired childhood pneumonia, and focus on prevention and management of childhood diarrheal and acute respiratory tract infections.
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Affiliation(s)
- Muluken Genetu Chanie
- Department of Health Systems and Policy, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mequannent Sharew Melaku
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Yalew
- Department of Reproductive Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mastewal Arefaynie
- Department of Reproductive Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Gedamnesh Bitew
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Erkihun Tadesse Amsalu
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Bereket Kefale
- Department of Reproductive Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Amare Muche
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Zinabu Fentaw
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
| | - Reta Dewau
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Bezawit Adane
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Yitayish Damtie
- Department of Reproductive Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Wolde Melese Ayele
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | | | - Metadel Adane
- Department of Environmental Health Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Enyew HD, Mereta ST, Hailu AB. Biomass fuel use and acute respiratory infection among children younger than 5 years in Ethiopia: a systematic review and meta-analysis. Public Health 2021; 193:29-40. [PMID: 33713984 DOI: 10.1016/j.puhe.2020.12.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/14/2020] [Accepted: 12/18/2020] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The objective of this study was to estimate the magnitude of acute respiratory infection (ARI) among children younger than 5 years (under-five children) and its association with biomass fuel use for domestic purposes and other behavioural and housing characteristics in Ethiopia. STUDY DESIGN Systematic review and meta-analysis. METHODS PubMed, Google Scholar, MEDLINE and the Cochrane Library were systematically searched (using the Preferred Items for Systematic Review and Meta-analysis guideline) for studies that reported an association between biomass fuel use for domestic purposes and ARI. Grey literature and other sources of unpublished information, which were subjected to the same extraction methods and quality appraisal as published studies, were also identified. A meta-analysis was performed to combine the quantitative measures from eligible individual studies into a summary estimate. Quality assessment was conducted using the modified Newcastle-Ottawa Scale quality assessment tool for cross-sectional and case-control studies. Funnel and Doi plots were used to detect potential publication bias. Statistical analyses were performed using Comprehensive Meta-Analysis and MetaXL, version 5.3, software. RESULTS A total of 21 (18 cross-sectional and 3 case-control) eligible studies with their combined 30,013 participants were reviewed. The overall pooled prevalence of ARI among under-five children in households where biomass fuel was the main source of energy was estimated to be 22% (95% confidence interval [CI]: 17-29). In the subgroup analysis by area of residence, the highest prevalence was found in urban regions 26% (95% CI: 24-28). Based on the preceding 2 weeks before the interview, a significant association was found between biomass fuel use and ARI (odds ratio [OR] = 2.6, 95% CI: 2.05-3.30). In addition to biomass fuel use, being female (OR = 1.57, 95% CI: 1.06-2.33), absence of a window in the kitchen (OR = 2.89, 95% CI: 2.11-3.96), being carried on the back or in lap during cooking (OR = 2.76, 95% CI: 1.96-3.89) and non-separated kitchen from the main house (OR = 1.99, 95% CI: 1.49-2.68) were associated with ARI. CONCLUSIONS Based on the results of this review, ARI among under-five children remains high. The present study also revealed that ARI is associated with biomass fuel use, child's gender, absence of a window in the kitchen, non-separated kitchen and carrying the child while cooking. Improved solid fuel stoves, advanced combustion designs, windows or chimneys, separating the kitchen from the main house are all measures required to reduce ARI in under-five children. SYSTEMATIC REVIEW REGISTRATION The review has been registered with PROSPERO (registration number CRD42020181372).
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Affiliation(s)
- H D Enyew
- Debre Tabor University, College of Health Sciences, Department of Public Health, Ethiopia.
| | - S T Mereta
- Jimma University Institution of Health, Department of Environmental Health Science and Technology, Ethiopia
| | - A B Hailu
- Jimma University Institution of Health, Department of Environmental Health Science and Technology, Ethiopia
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Spatial patterns of lower respiratory tract infections and their association with fine particulate matter. Sci Rep 2021; 11:4866. [PMID: 33649419 PMCID: PMC7921673 DOI: 10.1038/s41598-021-84435-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 02/16/2021] [Indexed: 01/31/2023] Open
Abstract
This study aimed to identify the spatial patterns of lower respiratory tract infections (LRIs) and their association with fine particulate matter (PM2.5). The disability-adjusted life year (DALY) database was used to represent the burden each country experiences as a result of LRIs. PM2.5 data obtained from the Atmosphere Composition Analysis Group was assessed as the source for main exposure. Global Moran's I and Getis-Ord Gi* were applied to identify the spatial patterns and for hotspots analysis of LRIs. A generalized linear mixed model was coupled with a sensitivity test after controlling for covariates to estimate the association between LRIs and PM2.5. Subgroup analyses were performed to determine whether LRIs and PM2.5 are correlated for various ages and geographic regions. A significant spatial auto-correlated pattern was identified for global LRIs with Moran's Index 0.79, and the hotspots of LRIs were clustered in 35 African and 4 Eastern Mediterranean countries. A consistent significant positive association between LRIs and PM2.5 with a coefficient of 0.21 (95% CI 0.06-0.36) was identified. Furthermore, subgroup analysis revealed a significant effect of PM2.5 on LRI for children (0-14 years) and the elderly (≥ 70 years), and this effect was confirmed to be significant in all regions except for those comprised of Eastern Mediterranean countries.
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Geremew A, Gebremedhin S, Mulugeta Y, Yadeta TA. Place of food cooking is associated with acute respiratory infection among under-five children in Ethiopia: multilevel analysis of 2005-2016 Ethiopian Demographic Health Survey data. Trop Med Health 2020; 48:95. [PMID: 33292790 PMCID: PMC7702671 DOI: 10.1186/s41182-020-00283-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 11/04/2020] [Indexed: 01/05/2023] Open
Abstract
Background Globally, acute respiratory infections are among the leading causes of under-five child mortality, especially in lower-income countries; it is associated with indoor exposure to toxic pollutants from solid biomass fuel. In Ethiopia, 90% of the population utilizes solid biomass fuel; respiratory illness is a leading health problem. However, there is a paucity of nationally representative data on the association of household cooking place and respiratory infections. Besides, evidence on the variability in the infection based on the data collected at different times is limited. Therefore, this study is intended to assess the association of food cooking place with acute respiratory infections and the variability in households and surveys. Methods The current analysis is based on the Ethiopian Demographic and Health Survey data collected in 2005, 2011, and 2016 and obtained via online registration. The association of food cooking place with acute respiratory infection was assessed using multilevel modeling after categorizing all factors into child level and survey level, controlling them in a full model. The analyses accounted for a complex survey design using a Stata command “svy.” Result A total of 30,895 under-five children were included in this study, of which 3677 (11.9%) children had an acute respiratory infection, with 12.7% in 2005, 11.9% in 2011, and 11.1% in 2016. The risk of having an infection in under-five children in households that cooked food outdoors was 44% lower (AOR = 0.56, 95% CI = 0.40, 0.75) compared to those households that cooked the food inside the house. There was a statistically significant difference among the children among surveys to have an acute respiratory infection. Conclusion The risk of having children with acute respiratory infection is lower in the households of cooking food outdoor compared to indoor. The infection difference in different surveys suggests progress in the practices in either food cooking places or the fuel types used that minimize food cooking places location or the fuel types used that minimizes the risk. But, the infection is still high; therefore, measures promoting indoor cooking in a well-ventilated environment with alternative energy sources should take place.
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Affiliation(s)
- Abraham Geremew
- Department of Environmental Health, College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia.
| | - Selamawit Gebremedhin
- Department of Environmental Health, College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Yohannes Mulugeta
- Department of Environmental Health, College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
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Adedokun ST, Yaya S. Childhood morbidity and its determinants: evidence from 31 countries in sub-Saharan Africa. BMJ Glob Health 2020; 5:bmjgh-2020-003109. [PMID: 33046457 PMCID: PMC7552796 DOI: 10.1136/bmjgh-2020-003109] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/02/2020] [Accepted: 08/20/2020] [Indexed: 12/16/2022] Open
Abstract
Background Although under-five mortality reduced globally from 93 per 1000 live births in 1990 to 39 in 2018, sub-Saharan Africa witnessed an increase from 31% in 1990 to 54% in 2018. Morbidity has been reported to contribute largely to these deaths. This study examined the factors that are associated with childhood morbidity in sub-Saharan Africa. Methods Demographic and Health Surveys of 31 countries in sub-Saharan Africa were used in this study. The study involved 189 069 children who had or did not have fever, cough or diarrhoea in the 2 weeks preceding the surveys. Descriptive statistics and binary logistic regression were applied in the analysis. Results About 22% of the children suffered from fever, 23% suffered from cough and 16% suffered from diarrhoea. While the odds of experiencing fever increased by 37% and 18%, respectively, for children from poorest and poorer households, children of women aged 15–24 and 25–34 years are 47% and 23%, respectively, more likely to experience diarrhoea. The probability of suffering from morbidity increased for children who are 12–23 months, of higher order birth, small in size at birth and from households with non-improved toilet facility. Conclusions This study has shown that childhood morbidity remains a major health challenge in sub-Saharan Africa with socioeconomic, maternal, child’s and environmental factors playing significant roles. Efforts at addressing this problem should consider these factors.
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Affiliation(s)
- Sulaimon T Adedokun
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Osun, Nigeria
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada .,The George Institute for Global Health, Imperial College London, London, United Kingdom
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