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Xiong Y, Hu X, Cao J, Shang L, Niu B. A predictive model for stunting among children under the age of three. Front Pediatr 2024; 12:1441714. [PMID: 39290596 PMCID: PMC11405321 DOI: 10.3389/fped.2024.1441714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Accepted: 08/16/2024] [Indexed: 09/19/2024] Open
Abstract
Background In light of the global effort to eradicate stunting in childhood, the objective of this research endeavor was to assess the prevalence of stunting and associated factors, simultaneously construct and validate a risk prediction model for stunting among children under the age of three in Shenzhen, China. Methods Using the stratified random sampling method, we selected 9,581 children under the age of three for research and analysis. The dataset underwent a random allocation into training and validation sets, adhering to a 8:2 split ratio. Within the training set, a combined approach of LASSO regression analysis and binary logistic regression analysis was implemented to identify and select the predictive variables for the model. Subsequently, model construction was conducted in the training set, encompassing model evaluation, visualization, and internal validation procedures. Finally, to assess the model's generalizability, external validation was performed using the validation set. Results A total of 684 (7.14%) had phenotypes of stunt. Utilizing a combined approach of LASSO regression and logistic regression, key predictors of stunting among children under three years of age were identified, including sex, age in months, mother's education, father's age, birth order, feeding patterns, delivery mode, average daily parent-child reading time, average time spent in child-parent interactions, and average daily outdoor time. These variables were subsequently employed to develop a comprehensive prediction model for childhood stunting. A nomogram model was constructed based on these factors, demonstrating excellent consistency and accuracy. Calibration curves validated the agreement between the nomogram predictions and actual observations. Furthermore, ROC and DCA analyses indicated the strong predictive performance of the nomograms. Conclusions The developed model for forecasting stunt risk, which integrates a spectrum of variables. This analytical framework presents actionable intelligence to medical professionals, laying down a foundational framework and a pivot for the conception and execution of preemptive strategies and therapeutic interventions.
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Affiliation(s)
- Yuxiang Xiong
- Department of Medical Information, School of Public Health, Jilin University, Jilin, China
| | - Xuhuai Hu
- Research Development, Shenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong, China
| | - Jindan Cao
- Department of Medical Information, School of Public Health, Jilin University, Jilin, China
| | - Li Shang
- Research Development, Shenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong, China
| | - Ben Niu
- Department of Software Technology, School of Software Engineering, Shenzhen Institute of Information Technology, Shenzhen, Guangdong, China
- Department of Management Science, College of Management, Shenzhen University, Shenzhen, Guangdong, China
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Viegas da Silva E, Hartwig FP, Santos TM, Yousafzai A, Santos IS, Barros AJD, Bertoldi AD, Freitas da Silveira M, Matijasevich A, Domingues MR, Murray J. Predictors of early child development for screening pregnant women most in need of support in Brazil. J Glob Health 2024; 14:04143. [PMID: 39173149 PMCID: PMC11341113 DOI: 10.7189/jogh.14.04143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2024] Open
Abstract
Background Home visiting programmes can support child development and reduce inequalities, but failure to identify the most vulnerable families can undermine such efforts. We examined whether there are strong predictors of poor child development that could be used to screen pregnant women in primary health care settings to target early interventions in a Brazilian population. Considering selected predictors, we assessed coverage and focus of a large-scale home visiting programme named Primeira Infância Melhor (PIM). Methods We undertook a prospective cohort study on 3603 children whom we followed from gestation to age four years. We then used 27 potential socioeconomic, psychosocial, and clinical risk factors measurable during pregnancy to predict child development, which was assessed by the Battelle Developmental Inventory (BDI) at the age of four years. We compared the results from a Bonferroni-adjusted conditional inference tree with exploratory linear regression and principal component analysis (PCA), and we conducted external validation using data from a second cohort from the same population. Lastly, we assessed PIM coverage and focus by linking 2015 cohort data with PIM databases. Results The decision tree analyses identified maternal schooling as the most important variable for predicting BDI, followed by paternal schooling. Based on these variables, a group of 214 children who had the lowest mean BDI (BDI = -0.48; 95% confidence interval (CI) = -0.63, -0.33) was defined by mothers with ≤5 years and fathers with ≤4 years of schooling. Maternal and paternal schooling were also the strongest predictors in the exploratory analysis using regression and PCA, showing linear associations with the outcome. However, their capacity to explain outcome variance was low, with an adjusted R2 of 5.3% and an area under the receiver operating characteristic curve of 0.62 (95% CI = 0.60, 0.64). External validation showed consistent results. We also provided an online screening tool using parental schooling data to support programme's targeting. PIM coverage during pregnancy was low, but the focus was adequate, especially among families with longer enrolment, indicating families most in need received higher dosage. Conclusions Information on maternal and paternal schooling can improve the focus of home visiting programmes if used for initial population-level screening of pregnant women in Brazil. However, enrolment decisions require complementary information on parental resources and direct interactions with families to jointly decide on inclusion.
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Affiliation(s)
- Eduardo Viegas da Silva
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
- Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Fernando Pires Hartwig
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Thiago Melo Santos
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Aisha Yousafzai
- Global Health and Population Department, Harvard School of Public Health, Boston, USA
| | - Iná S Santos
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Aluísio J D Barros
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Andréa Dâmaso Bertoldi
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | | | - Alicia Matijasevich
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Marlos Rodrigues Domingues
- Postgraduate Programme in Physical Education, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Joseph Murray
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
- Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
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Marshall J, Wylie K, McLeod S, McAllister L, Barrett H, Owusu NA, Hettiarachchi S, Atherton M. Communication disability in low and middle-income countries: a call to action. BMJ Glob Health 2024; 9:e015289. [PMID: 38991579 PMCID: PMC11288154 DOI: 10.1136/bmjgh-2024-015289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/31/2024] [Indexed: 07/13/2024] Open
Affiliation(s)
- Julie Marshall
- Health Professions Department, Manchester Metropolitan University, Manchester, UK
| | - Karen Wylie
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
- School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
| | - Sharynne McLeod
- School of Education, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Lindy McAllister
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Helen Barrett
- CBM Global Inclusion Advisory Group, Amstelveen, The Netherlands
| | - Nana Akua Owusu
- School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
- AwaaWaa2, Accra, Ghana
| | - Shyamani Hettiarachchi
- Department of Disability Studies, University of Kelaniya, Faculty of Medicine, Colombo, Sri Lanka
| | - Marie Atherton
- Australian Catholic University, Faculty of Health Sciences, Melbourne, Victoria, Australia
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Bliznashka L, Nwabuikwu O, Ahun M, Becker K, Nnensa T, Roschnik N, Kachinjika M, Mvula P, Munthali A, Ndolo V, Katundu M, Maleta K, Quisumbing A, Gladstone M, Gelli A. Understanding modifiable caregiver factors contributing to child development among young children in rural Malawi. MATERNAL & CHILD NUTRITION 2024:e13698. [PMID: 38960410 DOI: 10.1111/mcn.13698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/23/2024] [Accepted: 06/23/2024] [Indexed: 07/05/2024]
Abstract
This study examined modifiable caregiver factors influencing child development in Malawi using baseline data from 1,021 mothers and their children <2 years of age participating in a cluster-randomized controlled trial implemented in rural Malawi (2022-2025). We fit an evidence-based theoretical model using structural equation modelling examining four caregiver factors: (1) diet diversity (sum of food groups consumed in the past 24 h), (2) empowerment (assessed using the project-level Women's Empowerment in Agriculture Index), (3) mental health (assessed using the Self-Reported Questionnaire, SRQ-20), and (4) stimulation (number of stimulation activities the mother engaged in the past 3 days). Child development was assessed using the Malawi Development Assessment Tool (norm-referenced aggregate Z-score). The model controlled for child, caregiver, and household socioeconomic characteristics. Results showed that caregiver dietary diversity was directly associated with higher child development scores (standardized coefficient 0.091 [95% CI 0.027, 0.153]) and lower SRQ-20 scores -0.058 (-0.111, -0.006). Empowerment was directly associated with higher child development scores (0.071 [0.007, 0.133]), higher stimulation score (0.074 [0.013, 0.140]), higher dietary diversity (0.085 [0.016, 0.145]), and lower SRQ-20 scores (-0.068 [-0.137, -0.002]). Further, higher empowerment was indirectly associated with improved child development through enhancement of caregiver dietary diversity, with an indirect effect of 0.008 (0.002, 0.018). These findings highlight the important role that caregiver diet and empowerment play in directly influencing child development and other aspects of caregiver well-being. Interventions aimed at enhancing child development should consider these factors as potential targets to improve outcomes for children and caregivers.
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Affiliation(s)
- Lilia Bliznashka
- International Food Policy Research Institute, Washington, District of Columbia, USA
- Global Academy of Agriculture and Food Systems, University of Edinburgh, Edinburgh, Scotland
| | - Odiche Nwabuikwu
- International Food Policy Research Institute, Washington, District of Columbia, USA
| | - Marilyn Ahun
- Department of Medicine, McGill University, Montréal, Canada
| | - Karoline Becker
- Department of International Development, University of Oxford, Oxford, UK
| | - Theresa Nnensa
- Department of Nutrition and Dietetics, Kamuzu University of Health Sciences, Blantyre, Malawi
| | | | | | | | | | - Victoria Ndolo
- Department of Human Ecology, University of Malawi, Zomba, Malawi
| | - Mangani Katundu
- Department of Human Ecology, University of Malawi, Zomba, Malawi
| | - Kenneth Maleta
- Department of Nutrition and Dietetics, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Agnes Quisumbing
- International Food Policy Research Institute, Washington, District of Columbia, USA
| | - Melissa Gladstone
- Department of Women and Children's Health, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Aulo Gelli
- International Food Policy Research Institute, Washington, District of Columbia, USA
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Rao N, Cohrssen C, Bala M. The Power of Research and Stakeholder Collaboration in Enhancing Early Childhood Care and Education in Low- and Middle-Income Countries. CHILDREN (BASEL, SWITZERLAND) 2024; 11:698. [PMID: 38929277 PMCID: PMC11201566 DOI: 10.3390/children11060698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024]
Abstract
The early years of a child's life are crucial in laying the foundations of learning and development that shape life trajectories [...].
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Affiliation(s)
- Nirmala Rao
- Faculty of Education, The University of Hong Kong, Hong Kong, China
| | - Caroline Cohrssen
- Faculty of Education, The University of Hong Kong, Hong Kong, China
- School of Education, University of New England, Armidale, NSW 2350, Australia
| | - Manya Bala
- Faculty of Education, The University of Hong Kong, Hong Kong, China
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Vikhe CS, Sharath HV, Raghuveer R, Ramteke SU. Effect of a Tailored Physiotherapy Rehabilitation on Developmental Delay Primary to Non-communicating Hydrocephalus: A Case Study. Cureus 2024; 16:e61588. [PMID: 38962643 PMCID: PMC11221501 DOI: 10.7759/cureus.61588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 06/03/2024] [Indexed: 07/05/2024] Open
Abstract
This case report presents the physiotherapy intervention of a one-year-old male child diagnosed with non-communicating hydrocephalus primary to developmental delay. Hydrocephalus is marked by an accumulation of cerebrospinal fluid and often leads to significant developmental delays and neurological impairments in affected infants. The physiotherapy intervention aimed to achieve head and trunk control, improve sensory awareness, and enhance overall body coordination and balance. Various techniques, including neurodevelopmental techniques, sensory stimulation, hippotherapy, and sensory integration therapy, were utilized to target specific developmental milestones and functional abilities. Outcome measures, including the Gross Motor Function Measure, Infant Neurological International Battery, Hammersmith Infant Neurological Examination, and New Ballard Score, were used to assess the patient's progress pre- and post-intervention. Significant improvements were observed across all outcome measures following four months of physiotherapy rehabilitation. The patient demonstrated substantial gains in gross motor function, neurological examination scores, and overall developmental milestones. These findings underscore the effectiveness of physiotherapy rehabilitation in addressing developmental delays associated with non-communicating hydrocephalus. This case underscores the significance of early physiotherapy intervention, which plays a vital role in enhancing outcomes and improving the quality of life for affected children.
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Affiliation(s)
- Chaitali S Vikhe
- Department of Sports Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - H V Sharath
- Department of Paediatric Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Raghumahanti Raghuveer
- Department of Neurophysiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Swapnil U Ramteke
- Department of Sports Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
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Rodríguez-Rabassa M, Appleton AA, Rosario-Villafañe V, Repollet-Carrer I, Borges-Rodríguez M, Dedós-Peña L, González M, Velázquez-González P, Muniz-Rodriguez K, Mántaras-Ortiz C, Rivera-Amill V, Olivieri-Ramos O, Alvarado-Domenech LI. Associations between the social environment and early childhood developmental outcomes of Puerto Rican children with prenatal Zika virus exposure: a cross-sectional study. BMC Pediatr 2024; 24:342. [PMID: 38755525 PMCID: PMC11100158 DOI: 10.1186/s12887-024-04806-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 05/02/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Prenatal exposure to the Zika virus can lead to microcephaly and adverse developmental outcomes, even in children without evident birth defects. The social environment plays a crucial role in infant health and developmental trajectories, especially during periods of heightened brain plasticity. The study aimed to assess socioenvironmental factors as predictors of developmental outcomes of 36-month-old children exposed to Zika virus prenatally. STUDY DESIGN This cross-sectional study included 53 mothers and 55 children enrolled in the Pediatric Outcomes of Prenatal Zika Exposure cohort study in Puerto Rico. The study performs follow-up developmental assessments of children born to mothers with confirmed and probable Zika virus infection during pregnancy. Mothers completed socioenvironmental questionnaires (e.g., Perceived Neighborhood Scale and US Household Food Insecurity Survey). Children's developmental outcomes were assessed with the Bayley Scales of Infant and Toddler Development: Third Edition, the Ages and Stages Questionnaires: Third Edition, the Ages and Stages Questionnaire-Socioemotional: Second Edition, and the Child Adjustment and Parent Efficacy Scale. RESULTS Linear regression models, adjusting for a child's sex and age and maternal education, revealed that early life exposure to food insecurity and maternal pregnancy stressors were significantly associated with poorer developmental outcomes in Zika virus-exposed children at 36 months of age. Maternal resilience representation of adaptive ability was associated with the preservation of adequate developmental outcomes in children. CONCLUSIONS Pregnancy and early childhood are critical life periods for ensuring optimal brain development in children. While the mechanisms in the interaction of children with their environment are complex, the risk and protective factors identified in the study are modifiable through public policy and preventive initiatives. Implementation of comprehensive strategies that improve access to social support programs, educational and nutritional interventions, and mental health services during pregnancy and early childhood can enhance the developmental potential of vulnerable children.
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Affiliation(s)
- Mary Rodríguez-Rabassa
- Department of Pediatrics, Ponce Health Sciences University, Ponce, PR, Puerto Rico.
- RCMI Center for Research Resources, Ponce Health Sciences University, Ponce, PR, Puerto Rico.
- Clinical Psychology Program, Ponce Health Sciences University, Ponce, PR, 00732-7004, Puerto Rico.
| | - Allison A Appleton
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, Rensselaer, NY, USA
| | | | | | | | - Lydiet Dedós-Peña
- Ponce Research Institute, Ponce Health Sciences University, Ponce, PR, Puerto Rico
| | - Marielly González
- Clinical Psychology Program, Ponce Health Sciences University, Ponce, PR, 00732-7004, Puerto Rico
| | - Paola Velázquez-González
- Clinical Psychology Program, Ponce Health Sciences University, Ponce, PR, 00732-7004, Puerto Rico
| | | | - Claudia Mántaras-Ortiz
- Clinical Psychology Program, Ponce Health Sciences University, Ponce, PR, 00732-7004, Puerto Rico
| | - Vanessa Rivera-Amill
- RCMI Center for Research Resources, Ponce Health Sciences University, Ponce, PR, Puerto Rico
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Monir ZM, El-Din EMS, Kandeel WA, Sallam SF, Elsheikh E, Abushady MM, Allah FH, Tawfik S, Zeid DA. Evaluation of apparently healthy Egyptian infants and toddlers on the bayley-III scales according to age and sex. Ital J Pediatr 2024; 50:68. [PMID: 38616286 PMCID: PMC11017649 DOI: 10.1186/s13052-024-01635-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 03/23/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Child development is shaped throughout the first years of life through the interaction of genetics and the environment. Bayley-III is valuably used to determine early developmental delay (DD). The aim of this study was to detect the differences in performance of a sample of apparently healthy Egyptian infants and toddlers on the Bayley-III scales in relation to their age and gender. METHODS This was a cross-sectional study. Bayley scales were applied to 270 of the 300 recruited children following the inclusion criteria; to avoid potential risk factors affecting development. Assessment included cognitive, language and motor skills. Engaged children aged 18-42 months were divided into 4 age groups with six-month intervals. RESULTS Approximately 78.4%, 76.2%, and 72% of the participants had average and above average scores in the cognitive, motor, and language domains, respectively. The language domain was characteristically impacted. The oldest age group (36-42 months) scored the highest means composite scores, while the 2nd group aged 24 - <30 months, scored the lowest means in the three evaluated domains. In general, girls had non-significantly higher composite scores than boys, with a small effect size (d = 0.2-0.4). In the language domain, girls aged 30 to < 36 months scored significantly higher composite scores than boys (p < 0.05), with a medium effect size (d = 0.73). CONCLUSION The study indicates that the performance of apparently healthy Egyptian children on the Bayley III evaluation differs in relation to age and sex. The most vulnerable age group at potential risk of DD was children aged 24-30 months. Efforts must be directed to investigate the nutritional, physical, psychological and safety needs of this group. Attention must be paid to early childhood intervention programs that stimulate development, especially language development, and they must be tailored on the basis of age and gender. Gender-specific norms may be needed in the evaluation of language development.
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Affiliation(s)
- Zeinab M Monir
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt
| | - Ebtissam M Salah El-Din
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt
| | - Wafaa A Kandeel
- Biological Anthropology Department/Medical Research and Clinical Studies Institute, National Research Centre, 60014618, Cairo, Dokki, Egypt
| | - Sara F Sallam
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt
| | - Eman Elsheikh
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt
| | - Mones M Abushady
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt
| | - Fawzia Hasseb Allah
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt
| | - Sawsan Tawfik
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt
| | - Dina Abu Zeid
- Child Health Department/Medical Research and Clinical Studies Institute, National Research Centre, 33 El Bohouth st, 60014618, Cairo, Dokki, Egypt.
- Child Health Department Medical Research and Clinical Studies Institute, National Research Centre, P.O.12622, Cairo, Egypt.
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Wondmagegn T, Girma B, Habtemariam Y. Prevalence and determinants of developmental delay among children in low- and middle-income countries: a systematic review and meta-analysis. Front Public Health 2024; 12:1301524. [PMID: 38628845 PMCID: PMC11018911 DOI: 10.3389/fpubh.2024.1301524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 03/14/2024] [Indexed: 04/19/2024] Open
Abstract
Background Developmental delay is a public health problem in low- and middle-income countries. However, there is no summarized evidence in low- and middle-income countries on developmental delay, and primary studies on this issue show varied and inconclusive results. This systematic review and meta-analysis aimed to assess the pooled magnitude of confirmed developmental delay and its determinants among children in low- and middle-income countries. Methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to write this systematic review and meta-analysis. Primary studies were searched from PubMed, PsycINFO, Hinari, Science Direct, African Journal of Online, Web of Science, and Google Scholar databases. The Newcastle-Ottawa Scale, adapted for the cross-sectional studies, was used to assess the quality of the included studies. Heterogeneity and publication bias were assessed by the I2 and Eggers tests, respectively. Due to the high heterogeneity, the random effects model was used for analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to show the association between developmental delay and its determinants. Results The pooled prevalence of confirmed developmental delay was 18.83, 95% CI (15.53-22.12). In the subgroup analysis, a high prevalence of developmental delay [26.69% (95% CI, 15.78-37.60)] was observed in studies performed in Africa. Maternal education [3.04; 95% CI (2.05, 4.52)] and low birth weight [3.61; 95% CI (1.72, 7.57)] were significant determinants of developmental delay. Conclusion The pooled prevalence of developmental delay in low- and middle-income countries was high as compared to that in high-income countries. Maternal education level and weight at birth were significantly associated with developmental delays. Therefore, strategies should be designed to decrease the rate of low birth weight and the number of illiterate mothers living in low- and middle-income countries. Systematic review registration PROSPERO, CRD42024513060.
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Affiliation(s)
- Tesfaye Wondmagegn
- School of Medicine, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Bekahegn Girma
- Department of Nursing, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Yosef Habtemariam
- School of Medicine, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
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10
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Olabumuyi OO, Uchendu OC, Green PA. Prevalence, Pattern and Factors Associated with Developmental Delay amongst Under-5 Children in Nigeria: Evidence from Multiple Indicator Cluster Survey 2011-2017. Niger Postgrad Med J 2024; 31:118-129. [PMID: 38826015 DOI: 10.4103/npmj.npmj_51_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/06/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND Children develop dynamically, and when a child fails to reach age-appropriate developmental milestones compared to their peers, it is considered a developmental delay. In developing nations like Nigeria, several demographics, socioeconomic, childcare and external factors may influence the highly individualised process. This study assessed the prevalence and pattern of developmental delay, across Nigeria's geopolitical zones including identified factors associated with developmental delay, providing insight for appropriate interventions to prevent disability in affected children. METHODS This was a secondary analysis of data from the Multiple Indicator Cluster Survey (MICS), which was carried out in rounds 4 (2011) and 5 (2016/2017). Every 5 years, the UNICEF-supported MICS cross-sectional household survey is carried out using the cluster sampling method. A semi-structured, questionnaire administered by the interviewer was used to obtain individual and household-level data. This study comprised a weighted sample of 17,373 under-5 children who had complete data from both survey rounds on characteristics deemed significant for the study. Data were analysed using SPSS version 23. Using the Chi-square test and multivariate binomial logistic regression, factors linked to developmental delay were identified, with 95% confidence intervals (CIs) provided and the significance level set at 5%. RESULTS The mean age and sex distribution of the children surveyed in both rounds was comparable, with a male preponderance of 51.2% in round 4 and 50.4% in round 5. In both round 4 (51.2%) and round 5 (49.0%), the Northeast zone had the highest prevalence of overall developmental delay while the least prevalence was seen in the Southwest zone (20.3%) and the Southeast zone (14.7%) in round 4 and round 5, respectively. Across all the zones, delay in the literacy-numeracy domain of development was the most prevalent, with the highest (91.3% and 86.7%, respectively) in the Northeast zone during both rounds of the survey. Delay in the physical domain was, however, the least prevalent form of developmental delay across the zones, with the least in South South (20.6%) and Southeast (5.4%) in rounds 4 and 5. The odds of developmental delay were 1.5 and 1.7 times higher amongst children 4 years old than 3 years old in both rounds of the survey. The likelihood of having developmental delay was found to increase with the severity of stunting amongst the children during both rounds of the survey (odds ratio [OR] =1.5; 95% CI = 1.20-1.78 in round 4 and OR = 1.4; 95% CI = 1.16-1.58 in round 5). Children from the poorest wealth index had higher odds of developmental delay (OR = 5.8; 95% CI = 4.92-6.82 in round 4 and OR = 2.5; 95% CI = 1.99-3.10 in round 5). CONCLUSION The prevalence of developmental delay is high across all zones; however, the burden varies amongst them. The age of the child, nutritional status and wealth index were indicators of developmental delay in Nigerian under-5 children. This underscores the need for surveillance and interventions focussed on improving child literacy, nutritional status and household standard of living across the zones.
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Affiliation(s)
| | - Obioma Chukwudi Uchendu
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
- Department of Community Medicine, University College Hospital, Ibadan, Oyo State, Nigeria
| | - Pauline Aruoture Green
- Department of Community Medicine, Rivers State University, Nkpolu-Oroworukwo, Rivers State, Nigeria
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11
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Tangviriyapaiboon D, Thaineua V, Sirithongthaworn S, Kanshana S, Damrongtamwattana S, Prasitwattanaseree S, Srikummoon P, Thongsak N, Thumronglaohapun S, Traisathit P. Factors Associated with Suspected Developmental Delay in Thai Children Born with Low Birth Weight or Asphyxia. Matern Child Health J 2024; 28:631-640. [PMID: 37938440 DOI: 10.1007/s10995-023-03814-1] [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] [Accepted: 10/23/2023] [Indexed: 11/09/2023]
Abstract
OBJECTIVES The aim of the study was to identify factors associated with a risk of suspected developmental delay (SDD) in high-risk children in Thailand. METHODS We used data on children enrolled for developmental delay (DD) screening across Thailand collected by the Rajanagarindra Institute of Child Development, Department of Mental Health, Ministry of Public Health, Thailand. Children who were under 5 years of age with a birth weight of fewer than 2500 g and/or birth asphyxia in Thailand with high risk of DD were assessed using the Developmental Assessment for Intervention Manual (DAIM) between August 2013 and November 2019 (N = 14,314). RESULTS The high-risk children who had a gestational age at birth of < 37 weeks (adjusted odds ratio = 1.54; 95% confidence interval = 1.39-1.70) and/or had a birth weight < 2500 g (1.22; 1.02-1.45), or had mothers who were not government officers (1.46; 1.11-1.93), had a low education level (1.36; 1.19-1.55), had a poor nutritional status (1.34; 1.09-1.65), and/or who were living in a high-altitude area (1.59; 1.32-1.91) were at a higher risk of SDD. CONCLUSIONS FOR PRACTICE Children with a low birth weight and/or asphyxia during birth had a high risk of DD. SDD monitoring of children by community health workers and/or by developing outreach strategies, especially in underserved regions, should be considered. In addition, developing policies and guidelines, and intervention for high-risk children ought to be conducted to reduce the subsequent problems caused by the late detection of DD.
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Affiliation(s)
- Duangkamol Tangviriyapaiboon
- Rajanagarindra Institute of Child Development, Chiang Mai, Thailand
- Department of Mental Health, Ministry of Public Health, Nonthaburi, Thailand
| | - Vallop Thaineua
- Department of Health, Ministry of Public Health, Nonthaburi, Thailand
| | | | - Siripon Kanshana
- Department of Health, Ministry of Public Health, Nonthaburi, Thailand
| | | | | | - Pimwarat Srikummoon
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Natthapat Thongsak
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | | | - Patrinee Traisathit
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand.
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12
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Gemuhay HM, Ali S, Kibusi S. Experiences and Challenges of Mothers in Caring for Infants with Delayed Developmental Milestones: A Case of Dodoma Region, Tanzania. East Afr Health Res J 2024; 8:86-98. [PMID: 39234343 PMCID: PMC11371068 DOI: 10.24248/eahrj.v8i1.753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 02/20/2024] [Indexed: 09/06/2024] Open
Abstract
Background Delayed Developmental Milestones is a physical disability affecting the child development, occurs when the child fails to attain normal milestones compared to other children. Globally, 180-200 million infants have signs of developmental delay, and 86% are from developing countries. In Dar es Salaam, proportion of children with cognitive delay is 12.3%. Objectives This study explored the experiences and challenges of mothers in caring for infants with delayed developmental milestones. Methods In-depth interviews with ten mothers explored their experiences and identified challenges they encountered while caring for infants with delayed developmental milestones. NVIVO plus software was used for content analysis. Results Results showed that parents raising infants with delayed developmental milestones had negative experiences on the cause and types of delayed milestones. They lost hope. They were facing different challenges like lack of specialists, conflict in marriage and stigma. Conclusion Mothers of infants with delayed developmental milestones had negative experiences about this problem and they face many challenges in caring the infants.
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Affiliation(s)
| | - Saada Ali
- Department of Clinical Nursing, School of Nursing and Public Health
| | - Stephen Kibusi
- Department of Public Health, School of Nursing and Public Health, University of Dodoma, Dodoma, Tanzania
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13
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Oflu A, Yalçın SS. Relations of maternal health literacy and parenting practices with early childhood development: a cross-sectional study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:1540-1550. [PMID: 37356053 DOI: 10.1080/09603123.2023.2227582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 06/16/2023] [Indexed: 06/27/2023]
Abstract
This study aimed to examine the relations of early childhood development with maternal health literacy and mothers' early parenting practices. This cross-sectional study was conducted on mothers with children aged 36-59 months (n = 503) with a survey form, Early Childhood Development Index (ECDI) and Turkish Health Literacy Scale-32. Children of mothers with sufficient/excellent health literacy levels, children who are breastfed for 12 months and longer, and children with a screen time of 2 h or less were more likely to be ECDI-on-track (AOR (CI) = 2.52 (1.53-4.15); 2.28 (1.41-3.70); 2.04 (1.18-3.50); respectively). In conclusion, children whose mothers were adequately health literate, who were breastfed longer and who had less screen time were better on ECDI indicators. Increasing the knowledge and skills of mothers on early parenting practices and supporting them to be good health literacy will contribute positively to the early development of children.
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Affiliation(s)
- Ayse Oflu
- Department of Pediatrics, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Sıddika Songul Yalçın
- Department of Social Pediatrics, Institute of Child Health, Hacettepe University, Ankara, Turkey
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14
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Giacomini I, Martins MRO, Matijasevich A, Cardoso MA. Internal consistency of the Strengths and Difficulties Questionnaire in Amazonian children. Rev Saude Publica 2024; 57Suppl 2:4s. [PMID: 38422333 PMCID: PMC10897965 DOI: 10.11606/s1518-8787.2023057005562] [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: 05/19/2023] [Accepted: 10/02/2023] [Indexed: 03/02/2024] Open
Abstract
OBJECTIVE To describe the frequency of behavioral problems and the internal consistency of the parent version of the Strengths and Difficulties Questionnaire (SDQ-P) in Amazonian preschool children during the covid-19 pandemic. METHODS Data from the Maternal and Child Health and Nutrition in Acre (MINA-Brazil) study, a population-based birth cohort in the Western Brazilian Amazon, were used. The SDQ-P was applied in 2021 at the five-year follow-up visit to parents or caregivers of 695 children (49.4% of which were girls). This instrument is a short behavioral screening questionnaire composed of 25 items reorganized into five subscales: emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behavior. Cases of behavioral problems were defined according to the original SDQ cut-offs based on United Kingdom norms. Moreover, cut off points were estimated based on the SDQ-P percentile results of our study sample. Internal consistency was assessed by calculating Cronbach's alpha coefficient and McDonald's omega for each scale. RESULTS According to the cut-offs based on our studied population distribution, 10% of all children had high or very high total difficulty scores, whereas it was almost twice when the original SDQ cut-offs based on United Kingdom norms, were applied (18%). Differences were also observed in the other scales. Compared to girls, boys showed higher means of externalizing problem and lower means of prosocial behavior. The five-factor model showed a moderate internal consistency of the items for all scales (0.60 ≤ α ≤ 0.40), except for total difficulty scores, which it considered substantial (α > 0.61). CONCLUSIONS Our results support the usefulness of SDQ in our study population and reinforce the need for strategies and policy development for mental health care in early life in the Amazon.
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Affiliation(s)
- Isabel Giacomini
- Universidade de São PauloFaculdade de Saúde PúblicaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. Programa de Pós-Graduação em Nutrição em Saúde Pública. São Paulo, SP, Brasil
| | - Maria Rosário O. Martins
- Universidade NOVA de LisboaInstituto de Higiene e Medicina TropicalLisboaPortugalUniversidade NOVA de Lisboa. Instituto de Higiene e Medicina Tropical, Saúde Global e Medicina Tropical. Lisboa, Portugal
| | - Alicia Matijasevich
- Universidade de São PauloFaculdade de MedicinaDepartamento de Medicina PreventivaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Preventiva. São Paulo, SP, Brasil
| | - Marly A. Cardoso
- Universidade de São PauloFaculdade de Saúde PúblicaDepartamento de NutriçãoSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. Departamento de Nutrição. São Paulo, SP, Brasil
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15
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Adjei ES, Osei E, Edusei AK, Nakua EK. A systematic review of academic performance of Children with Disabilities (CWDs) in inclusive education schools in Low and Middle-Income Countries (LMICs). Heliyon 2024; 10:e25216. [PMID: 38322967 PMCID: PMC10844053 DOI: 10.1016/j.heliyon.2024.e25216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 01/17/2024] [Accepted: 01/23/2024] [Indexed: 02/08/2024] Open
Abstract
Globally it is estimated that about 150 million children are living with disabilities. Inclusive education inspires the participation of all students in the learning process in the same classroom. However, it is really difficult to find thorough, credible accounts of disabled children's access to education, enrolment, attendance, and results. This review evaluated academic performance, including access to school, enrolment, attendance, and results of Children with disabilities (CWD) in LMICs. In reporting this systematic review, the researchers followed the recommended Reporting Items for Systematic Review and Meta-Analysis (PRISMA) reporting standards. The authors conducted searches using Science Direct, PubMed, Scopus, and Google Scholar electronic databases. The study's major findings indicate that CWDs in inclusive schools perform poorly academically compared to their non-disabled peers. Consequently, the researchers recommend more primary research to evaluate the academic performance of CWDs and the progress of inclusive education in LMICs.
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Affiliation(s)
- Evelyn Serwaa Adjei
- Department of Health Promotion and Disability Studies, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ernest Osei
- Department of Public Health, School of Public Health and Allied Sciences, Catholic University of Ghana, Sunyani, Ghana
| | - Anthony K. Edusei
- Department of Health Promotion and Disability Studies, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel K. Nakua
- Department of Health Promotion and Disability Studies, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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16
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Almahmoud OH, Abushaikha L. Developmental delay and its demographic and social predictors among preschool-age children in Palestine. J Pediatr Nurs 2024; 74:101-109. [PMID: 38035460 DOI: 10.1016/j.pedn.2023.11.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/19/2023] [Accepted: 11/19/2023] [Indexed: 12/02/2023]
Abstract
PURPOSE This study was designed to assess the developmental outcomes among preschool-aged children and its associated factors in Palestine. METHODS A cross-sectional, descriptive-correlational design involved a representative sample of preschool-aged children from kindergarten in Ramallah governorate. Data were collected using the Ages and Stages Questionnaire, Arabic version-3. Associations between developmental delay (DD), parent, child and family characteristics were analyzed utilizing SPSS-25 version. RESULTS A total of 249 preschoolers participated in the study. The overall rate of children with Global Developmental Delay (GDD) was 23.7%. The most prevalent DD were in gross motor, personal social, and fine motor skills (25.3%, 17.7%, and 16.5%, respectively). Binary logistic regression analysis revealed that the male gender of a child (OR = 2.66, 95% CI [1.37, 5.19]), the mother's part-time work (OR = 6.01, 95% CI [1.68, 21.52]), low family income (OR = 3.67, 95% CI [1.05, 12.73]), and families with three or more children (OR = 1.43, 95% CI [1.15, 1.781]) were statistically significant independent predictors of GDD. CONCLUSION The study findings revealed higher rate of DD among preschoolers in Palestine than regional areas, especially in gross motor, fine motor, and personal social skills, which has consequences for both national and global health. According to the results, factors related to the child, the mother and the family are associated with the cumulative risk of preschoolers having DD. IMPLICATIONS It is a crucial role for pediatric nurses to detect DD early and its related risk factors through screening programs to limit the burden of problems in childhood and later adulthood.
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Affiliation(s)
- Omar H Almahmoud
- Nursing Department, Pharmacy, Nursing and Health Professions College, Birzeit University, Birzeit, Palestine.
| | - Lubna Abushaikha
- School of Nursing, Maternal and Child Health Nursing, The University of Jordan, Amman, Jordan.
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17
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van Slobbe M, van Haeringen A, Vissers LELM, Bijlsma EK, Rutten JW, Suerink M, Nibbeling EAR, Ruivenkamp CAL, Koene S. Reanalysis of whole-exome sequencing (WES) data of children with neurodevelopmental disorders in a standard patient care context. Eur J Pediatr 2024; 183:345-355. [PMID: 37889289 PMCID: PMC10858114 DOI: 10.1007/s00431-023-05279-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/20/2023] [Accepted: 10/11/2023] [Indexed: 10/28/2023]
Abstract
This study aims to inform future genetic reanalysis management by evaluating the yield of whole-exome sequencing (WES) reanalysis in standard patient care in the Netherlands. Single-center data of 159 patients with a neurodevelopmental disorder (NDD), in which WES analysis and reanalysis were performed between January 1, 2014, and December 31, 2021, was retrospectively collected. Patients were included if they were under the age of 18 years at initial analysis and if this initial analysis did not result in a diagnosis. Demographic, phenotypic, and genotypic characteristics of patients were collected and analyzed. The primary outcomes of our study were (i) diagnostic yield at reanalysis, (ii) reasons for detecting a new possibly causal variant at reanalysis, (iii) unsolicited findings, and (iv) factors associated with positive result of reanalysis. In addition, we conducted a questionnaire study amongst the 7 genetic department in the Netherlands creating an overview of used techniques, yield, and organization of WES reanalysis. The single-center data show that in most cases, WES reanalysis was initiated by the clinical geneticist (65%) or treating physician (30%). The mean time between initial WES analysis and reanalysis was 3.7 years. A new (likely) pathogenic variant or VUS with a clear link to the phenotype was found in 20 initially negative cases, resulting in a diagnostic yield of 12.6%. In 75% of these patients, the diagnosis had clinical consequences, as for example, a screening plan for associated signs and symptoms could be devised. Most (32%) of the (likely) causal variants identified at WES reanalysis were discovered due to a newly described gene-disease association. In addition to the 12.6% diagnostic yield based on new diagnoses, reclassification of a variant of uncertain significance found at initial analysis led to a definite diagnosis in three patients. Diagnostic yield was higher in patients with dysmorphic features compared to patients without clear dysmorphic features (yield 27% vs. 6%; p = 0.001). CONCLUSIONS Our results show that WES reanalysis in patients with NDD in standard patient care leads to a substantial increase in genetic diagnoses. In the majority of newly diagnosed patients, the diagnosis had clinical consequences. Knowledge about the clinical impact of WES reanalysis, clinical characteristics associated with higher yield, and the yield per year after a negative WES in larger clinical cohorts is warranted to inform guidelines for genetic reanalysis. These guidelines will be of great value for pediatricians, pediatric rehabilitation specialists, and pediatric neurologists in daily care of patients with NDD. WHAT IS KNOWN • Whole exome sequencing can cost-effectively identify a genetic cause of intellectual disability in about 30-40% of patients. • WES reanalysis in a research setting can lead to a definitive diagnosis in 10-20% of previously exome negative cases. WHAT IS NEW • WES reanalysis in standard patient care resulted in a diagnostic yield of 13% in previously exome negative children with NDD. • The presence of dysmorphic features is associated with an increased diagnostic yield of WES reanalysis.
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Affiliation(s)
- Michelle van Slobbe
- Department of Clinical Genetics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Arie van Haeringen
- Department of Clinical Genetics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Lisenka E L M Vissers
- Department of Human Genetics, Donders Centre for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Emilia K Bijlsma
- Department of Clinical Genetics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Julie W Rutten
- Department of Clinical Genetics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Manon Suerink
- Department of Clinical Genetics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Esther A R Nibbeling
- Department of Clinical Genetics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Claudia A L Ruivenkamp
- Department of Clinical Genetics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Saskia Koene
- Department of Clinical Genetics, Leiden University Medical Centre, Leiden, The Netherlands.
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18
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Emerson E, Llewellyn G. The prevalence of significant cognitive delay among 3- to 4-year-old children growing up in low- and middle-income countries: results from 126 nationally representative surveys undertaken in 73 countries. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:1200-1215. [PMID: 36109168 DOI: 10.1111/jir.12976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND We sought to (1) update estimates of the prevalence of significant cognitive delay (SCD) among nationally representative samples of young children overall, and in upper-middle, lower-middle and low-income countries; (2) investigate whether variation in prevalence between countries was systematically associated with national wealth and other country characteristics; (3) investigate the stability of prevalence estimates over time; (4) examine the correlation between SCD and 2019 Global Burden of Disease estimates on the prevalence of the impairment of developmental intellectual disability under 5 years of age; and (5) investigate the extent to which risk of SCD within countries varies with child age and gender, maternal education and household wealth. METHODS Secondary analysis of data collected in 126 nationally representative Multiple Cluster Indicators Surveys (MICS) conducted under the supervision of UNICEF in 73 countries involving a total of 396 596 3- to 4-year-old children. RESULTS The overall prevalence of SCD was 9.7% (95% CI 8.6-10.9%). Between-country variation in prevalence was strongly related to national wealth, the Human Development Index, the Human Inequality-adjusted Development Index and the Multidimensional Poverty Index, but not income inequality. In the 46 countries in which more than one survey was available prevalence estimates were reasonably stable over time (r = 0.80, P < 0.001). There were strong independent associations between increased risk of cognitive delay and younger child age, lower levels of maternal education and lower levels of household wealth (but not male gender). There was only a weak association across countries between the estimated prevalence of SCD and Global Burden of Disease estimates of the under 5 prevalence of the impairment of developmental intellectual disability. CONCLUSIONS UNICEF's MICS data are readily (and freely) available to researchers and provide a cost-effective opportunity for researchers who are concerned about better understanding the situation of young children growing up in the world's LMICs with a marked loss of developmental potential in areas of cognition and learning.
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Affiliation(s)
- E Emerson
- Centre for Disability Research and Policy, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - G Llewellyn
- Centre for Disability Research and Policy, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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Khan N, Khan MA, Khan MA, Ejaz A, Warraitch A, Ishaq S, Salahuddin E, Khan HJ, Walley JD. Is Early Childhood Development Care at Public Health Facilities in Pakistan Effective? A Cluster Randomized Controlled Trial. GLOBAL HEALTH, SCIENCE AND PRACTICE 2023; 11:e2300037. [PMID: 37903571 PMCID: PMC10615232 DOI: 10.9745/ghsp-d-23-00037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 09/25/2023] [Indexed: 11/01/2023]
Abstract
BACKGROUND Significant brain development in children occurs from birth to 2 years, with environment playing an important role. Stimulation interventions are widely known to be effective in enhancing early childhood development (ECD). This study aims to assess the feasibility and effectiveness of integrating ECD care delivered by lady health visitors (LHVs) at public health facilities in rural Pakistan. METHOD A cluster randomized controlled trial was conducted through public health facilities in 2 districts of Punjab, Pakistan. A total of 22 clusters (rural health centers and subdistrict hospitals) were randomly allocated to receive routine care (control: n=11 clusters, 406 mother-child pairs) or counseling (intervention: n=11 clusters, 398 mother-child pairs). All children aged 11-12 months without any congenital abnormality were eligible for enrollment. The intervention was delivered by the LHVs to mothers with children aged 12-24 months in 3 quarterly sessions. RESULTS The primary outcome was the prevention of ECD delays in children aged 24 months (assessed with the Ages and Stages Questionnaire-3). Analysis was done on an intention-to-treat basis. A total of 804 mother-child pairs were registered in the study, of which 26 (3.3%) pairs were lost to follow-up at the endpoint. The proportion of children with 2 or more developmental delays was significantly less in the intervention arm (13%) as compared to the control arm (41%) at an endpoint (odds ratio=0.21; 95% confidence interval=0.11, 0.42). Children in the intervention arm also had significantly better anthropometric measurements when aged 24 months than the children in the control arm. CONCLUSION The integrated ECD care intervention for children aged 12-24 months at public health facilities was found to be effective in enhancing ECD and reducing the proportion of children with global development delays.
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Affiliation(s)
- Nida Khan
- Association for Social Development, Islamabad, Pakistan.
| | | | | | - Amna Ejaz
- Association for Social Development, Islamabad, Pakistan
| | | | - Sehrish Ishaq
- Association for Social Development, Islamabad, Pakistan
| | | | | | - John D Walley
- Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, United Kingdom
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Metwally AM, Abdallah AM, El-Din EMS, Zeid DA, Khadr Z, Elshaarawy GA, Elkhatib AA, Elsaied A, Ashaat EA, Elghareeb NA, Abdou MH, Fathy AM, Eldeeb SE, AbdAllah M, Soliman MAT, El Banna RAS, Hassanein AK, Rabah TM, Abdelrahman M, Sallam SF. Screening and determinant of suspected developmental delays among Egyptian preschool-aged children: a cross-sectional national community-based study. BMC Pediatr 2023; 23:521. [DOI: ttps:/doi.org/10.1186/s12887-023-04335-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/29/2023] [Indexed: 10/31/2023] Open
Abstract
Abstract
Background
Early childhood life is critical for optimal development and is the foundation of future well-being. Genetic, sociocultural, and environmental factors are important determinants of child development.
Aim
The objectives were to screen for suspected developmental delays (DDs) among Egyptian preschool children, and to explore the determinants of these delays based on sociodemographic, epidemiological, maternal, and child perinatal risk factors.
Methods
A national Egyptian cross-sectional developmental screening of a representative sample of preschool children (21,316 children) aged 12 to 71 months. The Revised Denver Prescreening Developmental Questionnaire (R-PDQ) followed by the Denver Developmental Screening Test, 2nd edition (DDST) was used.
Results
Each screened child manifested at least one of six developmental categories. Either typical development, gross motor delay (GM), fine motor adaptive delay (FMA), Language delay (L), Personal-social delay (PS), or multiple DDs. The prevalence of preschool children with at least one DD was 6.4%, while 4.5% had multiple DDs. Developmental language delay was the most prevalent, affecting 4.2% of children. The least affected domain was GM (1.9% of children). Boys were more likely to have DD than girls. Children in urban communities were more likely to have at least one DD than those in rural areas (OR = 1.28, 95%CI: 1.14–1.42), and children of middle social class than of low or high social class (OR = 1.49, 95%CI: 1.30–1.70 & OR = 1.40, 95%CI: 1.23–1.59 respectively). The strong perinatal predictors for at least one DD were children with a history of postnatal convulsions (OR = 2.68, 95%CI: 1.97–3.64), low birth weight (OR = 2.06, 95%CI: 1.69–2.52), or history of postnatal cyanosis (OR = 1.77, 95%CI: 1.26–2.49) and mothers had any health problem during pregnancy (OR = 1.73, 95%CI: 1.44–2.07). Higher paternal and maternal education decreased the odds of having any DD by 43% (OR = 0.57, 95% CI: 0.47–0.68) and 31% (OR = 0.69, 95%CI: 0.58–0.82) respectively.
Conclusion
This study demonstrates a considerable attempt to assess the types and the prevalence of DD among preschool children in Egypt. Perinatal factors are among the most common determinants of DD in preschool children and the majority could be preventable risk factors.
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21
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Metwally AM, Abdallah AM, El-Din EMS, Zeid DA, Khadr Z, Elshaarawy GA, Elkhatib AA, Elsaied A, Ashaat EA, Elghareeb NA, Abdou MH, Fathy AM, Eldeeb SE, AbdAllah M, Soliman MAT, El Banna RAS, Hassanein AK, Rabah TM, Abdelrahman M, Sallam SF. Screening and determinant of suspected developmental delays among Egyptian preschool-aged children: a cross-sectional national community-based study. BMC Pediatr 2023; 23:521. [PMID: 37858055 PMCID: PMC10585886 DOI: 10.1186/s12887-023-04335-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/29/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Early childhood life is critical for optimal development and is the foundation of future well-being. Genetic, sociocultural, and environmental factors are important determinants of child development. AIM The objectives were to screen for suspected developmental delays (DDs) among Egyptian preschool children, and to explore the determinants of these delays based on sociodemographic, epidemiological, maternal, and child perinatal risk factors. METHODS A national Egyptian cross-sectional developmental screening of a representative sample of preschool children (21,316 children) aged 12 to 71 months. The Revised Denver Prescreening Developmental Questionnaire (R-PDQ) followed by the Denver Developmental Screening Test, 2nd edition (DDST) was used. RESULTS Each screened child manifested at least one of six developmental categories. Either typical development, gross motor delay (GM), fine motor adaptive delay (FMA), Language delay (L), Personal-social delay (PS), or multiple DDs. The prevalence of preschool children with at least one DD was 6.4%, while 4.5% had multiple DDs. Developmental language delay was the most prevalent, affecting 4.2% of children. The least affected domain was GM (1.9% of children). Boys were more likely to have DD than girls. Children in urban communities were more likely to have at least one DD than those in rural areas (OR = 1.28, 95%CI: 1.14-1.42), and children of middle social class than of low or high social class (OR = 1.49, 95%CI: 1.30-1.70 & OR = 1.40, 95%CI: 1.23-1.59 respectively). The strong perinatal predictors for at least one DD were children with a history of postnatal convulsions (OR = 2.68, 95%CI: 1.97-3.64), low birth weight (OR = 2.06, 95%CI: 1.69-2.52), or history of postnatal cyanosis (OR = 1.77, 95%CI: 1.26-2.49) and mothers had any health problem during pregnancy (OR = 1.73, 95%CI: 1.44-2.07). Higher paternal and maternal education decreased the odds of having any DD by 43% (OR = 0.57, 95% CI: 0.47-0.68) and 31% (OR = 0.69, 95%CI: 0.58-0.82) respectively. CONCLUSION This study demonstrates a considerable attempt to assess the types and the prevalence of DD among preschool children in Egypt. Perinatal factors are among the most common determinants of DD in preschool children and the majority could be preventable risk factors.
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Affiliation(s)
- Ammal M Metwally
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Public Health and Community Medicine, Dokki, P.O. 12622, Giza, Egypt.
| | - Ali M Abdallah
- Quantitative Methods Department - Aswan University, Aswan, Egypt
| | - Ebtissam M Salah El-Din
- Child Health Department/ Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Dokki, Giza, Egypt
| | - Dina Abu Zeid
- Child Health Department/ Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Dokki, Giza, Egypt
| | - Zeinab Khadr
- Department of Statistics, Faculty of Economics and Political Science, Cairo University, Cairo, Egypt
- The Social Research Center of the American University in Cairo, Cairo, Egypt
| | - Ghada A Elshaarawy
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Public Health and Community Medicine, Dokki, P.O. 12622, Giza, Egypt
| | - Alshaimaa A Elkhatib
- Child Health Department/ Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Dokki, Giza, Egypt
| | - Amal Elsaied
- Child With Special Needs Department/ Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Dokki, Giza, Egypt
| | - Engy A Ashaat
- Clinical Genetics Department/ Human Genetics and Genome Research Institute, National Research Centre (Affiliation ID: 60014618), Dokki, Giza, Egypt
| | - Nahed A Elghareeb
- Prevention of Disability General Directorate, Ministry of Health and Population, Cairo, Egypt
| | - Mohamed H Abdou
- Mansoura Health Directorate, Ministry of Health and Population, Mansoura, Dakahlia, Egypt
| | - Asmaa M Fathy
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Public Health and Community Medicine, Dokki, P.O. 12622, Giza, Egypt
| | - Sherif E Eldeeb
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Public Health and Community Medicine, Dokki, P.O. 12622, Giza, Egypt
| | - Mohamed AbdAllah
- Complementary Medicine Department/ Medical Research and Clinical Studies Institute/National Research Centre (Affiliation ID: 60014618), Dokki, Giza, Egypt
| | - Muhammed Al-Tohamy Soliman
- Biological Anthropology Department/ Medical Research and Clinical Studies Institute/National Research Centre (Affiliation ID: 60014618), Dokki, Giza, Egypt
| | - Rokia AbdElshafy S El Banna
- Biological Anthropology Department/ Medical Research and Clinical Studies Institute/National Research Centre (Affiliation ID: 60014618), Dokki, Giza, Egypt
| | - Abdelrahman K Hassanein
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Public Health and Community Medicine, Dokki, P.O. 12622, Giza, Egypt
| | - Thanaa M Rabah
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Public Health and Community Medicine, Dokki, P.O. 12622, Giza, Egypt
| | - Mohamed Abdelrahman
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Public Health and Community Medicine, Dokki, P.O. 12622, Giza, Egypt
| | - Sara F Sallam
- Child Health Department/ Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Dokki, Giza, Egypt
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Komanchuk J, Cameron JL, Kurbatfinski S, Duffett-Leger L, Letourneau N. A realist review of digitally delivered child development assessment and screening tools: Psychometrics and considerations for future use. Early Hum Dev 2023; 183:105818. [PMID: 37413949 DOI: 10.1016/j.earlhumdev.2023.105818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/18/2023] [Accepted: 06/27/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Developmental screening improves the detection of developmental concerns, yet numerous children are not screened/assessed. Remote child developmental tool administration has been utilized to increase screening and assessment accessibility. METHOD We conducted a realist review to: (1) identify existing multi-domain child development assessment and screening tools for children 0-5 years; (2) review psychometric data on their digital (i.e., only administered remotely) administration; and (3) explore contextual factors relevant to their digital administration. We searched APA PsycInfo, MEDLINE, CINAHL, and ERIC to identify tools and papers on their psychometrics. We reference-searched included articles and searched Google for relevant grey literature. RESULTS Of 33 multi-domain child development tools identified in objective one, five tools (in five studies) were delivered digitally and compared to traditional (e.g., paper) delivery (i.e., objective two). Studies evaluated within-group equivalence reliability (k = 2) and between-group equivalence (k = 3). Within-group equivalence reliability was established for the Vineland Adaptive Behavior Scales, and domains (e.g., gross motor) of the Ages and Stages Questionnaires 2nd edition (ASQ-2) and Revised Prescreening Denver Questionnaire (R-PDQ). Between group equivalence was demonstrated for Developmental Neuropsychological Assessment, 2nd Edition (NEPSY-II) subtests and Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-3) items. In another between group evaluation, web-based and paper versions of the ASQ-2 were deemed generally equivalent. Digital Bayley-3 inter-observer reliability ranged from 0.82 to 1.0. Examiner support, time, tool modifications, family resources, and comfort promotion supported digital administration. CONCLUSION Digitally delivered ASQ-2, R-PDQ, Vineland, and Bayley-3 and NEPSY-II components show promise for equivalence with traditional administration.
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Affiliation(s)
| | - Judy L Cameron
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
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23
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Wei Y, Liu K, Kang L, Behrman JR, Richter LM, Stein A, Song Y, Lu C. Assessing household financial burdens for preprimary education and associated socioeconomic inequalities: a case study in China. BMJ Paediatr Open 2023; 7:e001971. [PMID: 37562923 PMCID: PMC10423832 DOI: 10.1136/bmjpo-2023-001971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/30/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Providing young children with universal access to preprimary education (PPE) is considered a powerful tool for human capital development and eliminating the intergenerational transmission of poverty. To remove household financial barrier for achieving universal PPE, this study proposed a measure to identify households incurring 'heavy financial burdens from paying for PPE' (HBPPE) and conducted a case study in China. METHODS Using nationally representative data in 2019, we estimated the percentage of households with HBPPE (spent 7% or more of their total annual expenditure) and associated socioeconomic inequalities. We also applied a three-level logit regression model to investigate the factors associated with the probabilities of households incurring HBPPE. RESULTS Half of the sampled households spent 7% or more of their expenditures on PPE. Households in the lowest wealth quintile (54%) or households with children attending private PPE (55%) had higher percentages of HBPPE than households in other wealth quintiles (eg, 51% in the highest wealth quintile) or households with children attending public kindergartens (41%). Logit regression analysis shows that the poorest households and households with children attending private kindergarten were more likely to incur HBPPE than their counterparts. CONCLUSION To ensuring universal access to PPE in China, future policy should consider increasing the enrolment of children from low-income families in public kindergartens and increasing governmental investments in low-income households by subsidising children attending PPE.
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Affiliation(s)
- Yi Wei
- China Institute for Educational Finance Research, Peking University, Beijing, China
| | - Kai Liu
- School of Labor and Human Resources, Renmin University of China, Beijing, China
| | - Le Kang
- Institute of Education, Nanjing University, Nanjing, Jiangsu, China
| | - Jere R Behrman
- Department of Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Linda M Richter
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand Johannesburg, Johannesburg, Gauteng, South Africa
| | - Alan Stein
- Department of Psychiatry, Oxford University, Oxford, Oxfordshire, UK
| | - Yingquan Song
- China Institute for Educational Finance Research, Peking University, Beijing, China
| | - Chunling Lu
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Weigel MM, Armijos RX. Association of household food insecurity with developmental delay in preschool children: 2018 Ecuadorian Nutrition and Health National Survey. J Nutr Sci 2023; 12:e89. [PMID: 37587973 PMCID: PMC10425761 DOI: 10.1017/jns.2023.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/02/2023] [Accepted: 07/04/2023] [Indexed: 08/18/2023] Open
Abstract
We investigated the association of household food insecurity (HFI) with developmental delays in 36-59-month-old preschool children (n 7005) using cross-sectional data from the 2018 Ecuadorian National Health and Nutrition Survey. HFI was assessed with the Food Insecurity Experience Scale and developmental delays with the Early Childhood Development Index. Log-binomial regression models estimated the association of HFI with global (overall) developmental delay (GDD) and delays in four individual developmental domains, adjusting for covariates. Nearly half of the children lived in households with marginal (24⋅5 %) or moderate-severe HFI (21⋅7 %). Eighteen percent were identified with GDD. Delays in the individual domains of literacy-numeracy, social-emotional, physical and cognitive development were identified for 64, 21⋅5, 3⋅3 and 3⋅1 %, respectively. GDD was more likely among preschool children from households with marginal (aPR = 1⋅29; 95 % C.I. = 1⋅10, 1⋅49) and moderate-severe HFI (aPR = 1⋅30; 95 % C.I. = 1⋅11, 1⋅51). Social-emotional development delays were also more likely among those from households with marginal (aPR = 1⋅36; 95 % C.I. = 1⋅19, 1⋅56) and moderate-severe HFI (aPR = 1⋅33; 95 % C.I. = 1⋅15, 1⋅54) different from the other three domains. Several other potentially modifiable risk (violent discipline, maternal depressive symptoms) and protective factors (adequate child stimulation, higher maternal education, handwashing with soap/detergent) were also independently associated with GDD and/or literacy-numeracy and cognitive delays. Our findings suggest that HFI is an independent risk factor for GDD and social-emotional developmental delays in Ecuadorian preschoolers. They underscore the importance of strengthening and expanding poverty reduction, food security and early childhood development policies and interventions to improve the opportunities for children to achieve their full developmental potential.
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Affiliation(s)
- M. Margaret Weigel
- Department of Environmental & Occupational Health, Indiana University Bloomington, Bloomington, IN, USA
- Global Environmental Health Research Laboratory, Indiana University-Bloomington School of Public Health, Bloomington, IN, USA
- Center for Latin American and Caribbean Studies, Indiana University, Bloomington, IN, USA
- Indiana University Center for Global Health Equity, Indianapolis, IN, USA
| | - Rodrigo X. Armijos
- Department of Environmental & Occupational Health, Indiana University Bloomington, Bloomington, IN, USA
- Global Environmental Health Research Laboratory, Indiana University-Bloomington School of Public Health, Bloomington, IN, USA
- Center for Latin American and Caribbean Studies, Indiana University, Bloomington, IN, USA
- Indiana University Center for Global Health Equity, Indianapolis, IN, USA
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25
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Fernandes M, Krebs NF, Westcott J, Tshefu A, Lokangaka A, Bauserman M, Garcés AL, Figueroa L, Saleem S, Aziz SA, Goldenberg RL, Goudar SS, Dhaded SM, Derman RJ, Kemp JF, Koso-Thomas M, Sridhar A, M McClure E, Hambidge KM. Neurodevelopment, vision and auditory outcomes at age 2 years in offspring of participants in the 'Women First' maternal preconception nutrition randomised controlled trial. Arch Dis Child 2023; 108:622-631. [PMID: 37142335 PMCID: PMC10423475 DOI: 10.1136/archdischild-2023-325352] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 04/10/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Maternal nutrition in preconception and early pregnancy influences fetal growth. Evidence for effects of prenatal maternal nutrition on early child development (ECD) in low-income and middle-income countries is limited. OBJECTIVES To examine impact of maternal nutrition supplementation initiated prior to or during pregnancy on ECD, and to examine potential association of postnatal growth with ECD domains. DESIGN Secondary analysis regarding the offspring of participants of a maternal multicountry, individually randomised trial. SETTING Rural Democratic Republic of the Congo, Guatemala, India and Pakistan. PARTICIPANTS 667 offspring of Women First trial participants, aged 24 months. INTERVENTION Maternal lipid-based nutrient supplement initiated preconceptionally (arm 1, n=217), 12 weeks gestation (arm 2, n=230) or not (arm 3, n=220); intervention stopped at delivery. MAIN OUTCOME MEASURES The INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA) cognitive, language, gross motor, fine motor, positive and negative behaviour scores; visual acuity and contrast sensitivity scores and auditory evoked response potentials (ERP). Anthropometric z-scores, family care indicators (FCI) and sociodemographic variables were examined as covariates. RESULTS No significant differences were detected among the intervention arms for any INTER-NDA scores across domains, vision scores or ERP potentials. After adjusting for covariates, length-for-age z-score at 24 months (LAZ24), socio-economic status, maternal education and FCI significantly predicted vision and INTER-NDA scores (R2=0.11-0.38, p<0.01). CONCLUSIONS Prenatal maternal nutrition supplementation was not associated with any neurodevelopmental outcomes at age 2 years. Maternal education, family environment and LAZ24 predicted ECD. Interventions addressing multiple components of the nurturing care model may offer greatest impact on children's developmental potential. TRIAL REGISTRATION NUMBER NCT01883193.
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Affiliation(s)
- Michelle Fernandes
- MRC Lifecourse Epidemiology Centre and Human Development and Health Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK
- Nuffield Department of Women's and Reproductive Health, John Radcliffe Hospital, University of Oxford, Oxford, UK
- Oxford Maternal and Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, UK
| | - Nancy F Krebs
- Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, USA
| | - Jamie Westcott
- Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, USA
| | - Antoinette Tshefu
- Kinshasa School of Public Health, Kinshasa, The Democratic Republic of the Congo
| | - Adrien Lokangaka
- Kinshasa School of Public Health, Kinshasa, The Democratic Republic of the Congo
| | - Melissa Bauserman
- The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Ana L Garcés
- Instituto de Nutricion de Centroamerica y Panama, Guatemala, Guatemala
| | - Lester Figueroa
- Instituto de Nutricion de Centroamerica y Panama, Guatemala, Guatemala
| | - Sarah Saleem
- Community Health Sciences, Aga Khan University, Karachi, Sindh, Pakistan
| | - Sumera A Aziz
- Community Health Sciences, Aga Khan University, Karachi, Sindh, Pakistan
| | | | - Shivaprasad S Goudar
- KLE Academy of Higher Education and Research (Deemed-to-be-University) Jawaharlal Nehru Medical College, Belagavi, Karnataka, India
| | - Sangappa M Dhaded
- KLE Academy of Higher Education and Research (Deemed-to-be-University) Jawaharlal Nehru Medical College, Belagavi, Karnataka, India
| | | | - Jennifer F Kemp
- Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, USA
| | - Marion Koso-Thomas
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | | | | | - K Michael Hambidge
- Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, USA
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Hasan MN, Babu MR, Chowdhury MAB, Rahman MM, Hasan N, Kabir R, Uddin MJ. Early childhood developmental status and its associated factors in Bangladesh: a comparison of two consecutive nationally representative surveys. BMC Public Health 2023; 23:687. [PMID: 37046226 PMCID: PMC10099688 DOI: 10.1186/s12889-023-15617-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 04/06/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Inadequate cognitive and socio-emotional development in children leads to physical and mental illness. We aimed to investigate the status of early childhood development (ECD) and its associated factors. Additionally, aimed to compare the changes of significantly associated factors using two multiple indicator cluster surveys (MICS) in Bangladesh. METHODS We used data from the Multiple Indicator Cluster Surveys (MICS) 2012 and 2019 nationally representative surveys. A total of 17,494 children aged 36-59 months were included in the analysis. The outcome variable was ECD status: either developmentally on-track or not. We used bivariable analysis and crude and adjusted multivariable logistic models to assess the ECD status and its associated factors. RESULTS Comparing both MICS surveys, the overall and individual domains of ECD status improved from 2012 (65.46%) to 2019 (74.86%), and the indicators of child literacy-numeracy domain improved from 21.2 to 28.8%, physical domain improved from 92.2 to 98.4%, and social-emotional domain improved from 68.4 to 72.7%. The learning approach domain was 87.5% in 2012 and increased to 91.4% in 2019. According to the adjusted logistic model in both surveys (2012 and 2019), the age of 4 years had an adjusted odds ratio (AOR) of 1.61 and 1.78 times higher developmentally on track than the age of 3. Female children were 1.42 (in 2012) and 1.44 (in 2019) times more developmentally on track than males. Compared to mothers with only primary education, children raised by mothers with secondary or higher education were 1.77 and 1.50 times more on track in their development. Moreover, Children from affluent families had 1.32- and 1.26 times higher odds- on track than those from the poorest families. Families with books had 1.50 and 1.53 times higher developmentally on track than their counterparts. CONCLUSION AND RECOMMENDATION In summary, our study shows that the overall ECD status improved between MICS 2012 and MICS 2019. Important factors influence ECD status, including early childhood education programs, families' possession of children's books, mothers' educational level, and wealth index. The findings of our study will help making necessary public health-related initiatives in Bangladesh to improve ECD program.
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Affiliation(s)
- Mohammad Nayeem Hasan
- Department of Statistics, Shahjalal University of Science and Technology, 3114, Sylhet, Bangladesh
| | - Md Rashed Babu
- Department of Statistics, Shahjalal University of Science and Technology, 3114, Sylhet, Bangladesh
| | | | | | - Nafiul Hasan
- Department of Statistics, Shahjalal University of Science and Technology, 3114, Sylhet, Bangladesh
| | - Russell Kabir
- School of Allied Health, Anglia Ruskin University, Essex, UK
| | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science and Technology, 3114, Sylhet, Bangladesh.
- Department of General Educational Development (GED), Daffodil International University, Dhaka, Bangladesh.
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Almahmoud OH, Abushaikha L. Prevalence and risk factors of developmental disabilities among preschool children in the Arab world: a narrative literature review. CHILD HEALTH NURSING RESEARCH 2023; 29:101-110. [PMID: 37170489 PMCID: PMC10183763 DOI: 10.4094/chnr.2023.29.2.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/22/2022] [Indexed: 05/13/2023] Open
Abstract
PURPOSE Developmental disabilities (DDs) are a global childhood problem whose prevalence is rising, with a disproportionate impact on individuals in low-and middle-income countries. However, data on the prevalence of DDs in the Arab world are limited. This review highlights what is currently known about the prevalence and risk factors of DDs in preschool children in the Arab world. METHODS PubMed, Cochrane Library, Scopus, CINAHL, Science Direct, and Google Scholar were searched for publications on DDs among preschool children in the Arab world. Only 14 studies were identified in the literature, from 12 Arab countries. RESULTS The overall estimated prevalence of DDs among preschool children in the Arab world is 27.5%. An analysis of risk factors for DDs showed that child-related, maternal, and family-related factors account for a significant cumulative risk of developing DDs in preschool children. Maternal factors, such as antenatal and perinatal complications, were the most common risk factors. CONCLUSION The prevalence of DDs among preschoolers is significantly high in the Arab world, which emphasizes the importance of the early detection and diagnosis of DD, as well as its associated risk factors.
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Affiliation(s)
- Omar H Almahmoud
- Doctoral Candidate, Faculty of Nursing, University of Jordan, Amman, Jordan ․ Nursing Department, Faculty of Pharmacy, Nursing and Health Profession College, Birzeit University, Birzeit, West Bank, Palestine
| | - Lubna Abushaikha
- Professor, Faculty of Nursing, University of Jordan, Amman, Jordan
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Acharya K, Rahman MS, Islam MR, Gilmour S, Dhungel B, Parajuli RP, Nishimura T, Senju A, Tsuchiya KJ. Socioeconomic and education-based inequality in suspected developmental delays among Nepalese children: a subnational level assessment. Sci Rep 2023; 13:4750. [PMID: 36959346 PMCID: PMC10036624 DOI: 10.1038/s41598-023-31629-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 03/15/2023] [Indexed: 03/25/2023] Open
Abstract
Failure to meet early childhood developmental milestones leads to difficulty in schooling and social functioning. Evidence on the inequality in the burden of developmental delays across population groups, and identification of potential risk factors for suspected developmental delays (SDD) among younger children, are essential for designing appropriate policies and programs. This study explored the level of socioeconomic and maternal education-based inequality in the prevalence of SDD among Nepalese children at subnational level and identified potential risk factors. Individual-level data from the 2019 Nepal Multiple Indicator Cluster Survey was used to estimate the prevalence of SDD among children aged 3-4 years. Regression-based slope index of inequality (SII) and relative index of inequality were used to measure the magnitude of inequality, in terms of household socioeconomic status (SES) and mother's education, in the prevalence of SDD. In addition, a multilevel logistic regression model was used to identify potential risk factors for SDD. The national prevalence of SDD was found to be 34.8%, with relatively higher prevalence among children from rural areas (40.0%) and those from Karnali Province (45.0%) followed by Madhesh province (44.2%), and Sudhurpashchim Province (40.1%). The prevalence of SDD was 32 percentage points higher (SII: -0.32) among children from the poorest households compared to their rich counterparts at the national level. At the subnational level, such inequality was found to be highest in Lumbini Province (SII = -0.47) followed by Karnali Province (SII = -0.37), and Bagmati Province (SII = -0.37). The prevalence of SDD was 36 percentage points higher (SII: -0.36) among children whose mother had no formal education compared to children of higher educated mothers. The magnitude of education-based absolute inequality in SDD was highest in Lumbini Province (SII = -0.44). Multilevel logistic regression model identified lower levels of mother's education, disadvantaged SES and childhood stunting as significant risk factors for SDD. One in each three children in Nepal may experience SDD, with relatively higher prevalence among children from rural areas. Subnational level variation in prevalence, and socioeconomic and education-based inequality in SDD highlight the urgent need for province-specific tailored interventions to promote early childhood development in Nepal.
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Affiliation(s)
| | - Md Shafiur Rahman
- Research Centre for Child Mental Development, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan.
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka, Japan.
| | - Md Rashedul Islam
- Department of Global Health Policy, The University of Tokyo, Tokyo, Japan
- National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Stuart Gilmour
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Bibha Dhungel
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
- Department of Health Policy, National Centre for Child Health and Development, Tokyo, Japan
| | - Rajendra P Parajuli
- Central Department of Zoology, Central Campus, Institute of Science and Technology (IOST), Tribhuvan University, Kritipur‑1, Kathmandu, Nepal
| | - Tomoko Nishimura
- Research Centre for Child Mental Development, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka, Japan
| | - Atsushi Senju
- Research Centre for Child Mental Development, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka, Japan
| | - Kenji J Tsuchiya
- Research Centre for Child Mental Development, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka, Japan
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Odo DB, Yang IA, Dey S, Hammer MS, van Donkelaar A, Martin RV, Dong GH, Yang BY, Hystad P, Knibbs LD. A cross-sectional analysis of long-term exposure to ambient air pollution and cognitive development in children aged 3-4 years living in 12 low- and middle-income countries. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 318:120916. [PMID: 36563987 DOI: 10.1016/j.envpol.2022.120916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 08/31/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
Exposure to ambient air pollution may affect cognitive functioning and development in children. Unfortunately, there is little evidence available for low- and middle-income countries (LMICs), where air pollution levels are highest. We analysed the association between exposure to ambient fine particulate matter (≤2.5 μm [PM2.5]) and cognitive development indicators in a cross-sectional analysis of children (aged 3-4 years) in 12 LMICs. We linked Demographic and Health Survey data, conducted between 2011 and 2018, with global estimates of PM2.5 mass concentrations to examine annual average exposure to PM2.5 and cognitive development (literacy-numeracy and learning domains) in children. Cognitive development was assessed using the United Nations Children's Fund's early child development indicators administered to each child's mother. We used multivariable logistic regression models, adjusted for individual- and area-level covariates, and multi-pollutant models (including nitrogen dioxide and surface-level ozone). We assessed if sex and urban/rural status modified the association of PM2.5 with the outcome. We included 57,647 children, of whom, 9613 (13.3%) had indicators of cognitive delay. In the adjusted model, a 5 μg/m3 increase in annual all composition PM2.5 was associated with greater odds of cognitive delay (OR = 1.17; 95% CI: 1.13, 1.22). A 5 μg/m3 increase in anthropogenic PM2.5 was also associated with greater odds of cognitive delay (OR = 1.05; 95% CI: 1.00, 1.10). These results were robust to several sensitivity analyses, including multi-pollutant models. Interaction terms showed that urban-dwelling children had greater odds of cognitive delay than rural-dwelling children, while there was no significant difference by sex. Our findings suggest that annual average exposure to PM2.5 in young children was associated with adverse effects on cognitive development, which may have long-term consequences for educational attainment and health.
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Affiliation(s)
- Daniel B Odo
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia; College of Health Sciences, Arsi University, Asela, Ethiopia.
| | - Ian A Yang
- Thoracic Program, The Prince Charles Hospital, Metro North Hospital and Health Service, Brisbane, Australia; UQ Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Sagnik Dey
- Centre for Atmospheric Sciences, Indian Institute of Technology Delhi, New Delhi, India; Arun Duggal Centre of Excellence for Research in Climate Change and Air Pollution, Indian Institute of Technology Delhi, New Delhi, India
| | - Melanie S Hammer
- Department of Energy, Environmental & Chemical Engineering, Washington University in St. Louis, St. Louis, MO, United States
| | - Aaron van Donkelaar
- Department of Energy, Environmental & Chemical Engineering, Washington University in St. Louis, St. Louis, MO, United States
| | - Randall V Martin
- Department of Energy, Environmental & Chemical Engineering, Washington University in St. Louis, St. Louis, MO, United States
| | - Guang-Hui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Bo-Yi Yang
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, USA
| | - Luke D Knibbs
- School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia
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McLeod S, Marshall J. Communication for all and the Sustainable Development Goals. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:1-8. [PMID: 36856150 DOI: 10.1080/17549507.2022.2160494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
PURPOSE Communication is central to the accomplishment of each of the United Nations' 17 Sustainable Development Goals (SDGs) and is a fundamental human right. METHOD This special issue of the International Journal of Speech-Language Pathology (IJSLP, vol. 25, no. 1) is dedicated to communication, swallowing and the SDGs; particularly focussing on people with communication and/or swallowing disability and those who support them. RESULT The papers in the special issue of IJSLP demonstrate that successful communication is necessary for realisation of all 17 SDGs at both a global and an individual level and advance the international call for SDG 18: Communication for All. The 36 papers address all 17 goals, focussing on poverty, hunger, health, education, work, innovation, climate, cities, land, oceans, justice, and partnerships. Authors worked and undertook their research in Australia, Austria, Benin, Cambodia, Cameroon, Canada, China, Columbia, Denmark, Egypt, Ethiopia, Ghana, Greece, Iceland, India, Iraq, Ireland, Italy, Jordan, Kenya, Lebanon, Maldives, Mozambique, Nepal, New Zealand, Nigeria, State of Palestine, Peru, Philippines, Rwanda, Serbia, South Africa, Uganda, UK, USA, Vietnam. CONCLUSION Communication for all is essential for the achievement of the SDGs, "peace and prosperity for people and the planet" (United Nations, 2015a). Achievement of the SDGs is the role of all; including communication specialists, people with communication/swallowing disability, their families and communities.
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Islam MM, Khan MN. Early childhood development and its association with maternal parity. Child Care Health Dev 2023; 49:80-89. [PMID: 35384014 PMCID: PMC10084392 DOI: 10.1111/cch.13011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 03/18/2022] [Accepted: 03/23/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Maternal parity, which is usually measured as the number of children born to a mother, has a substantial impact on the social and environmental factors around children and their development. This paper estimates the Early Childhood Development Index (ECDI) of 3- and 4-year-old children in Bangladesh and examines the relationship between maternal parity and early childhood development. METHODS The study analysed nationally representative data from the Bangladesh Multiple Indicator Cluster Survey 2019. The dataset had 9453 children aged from 36 to 59 months. The ECDI was computed following the UNICEF's approach involving psychometric computation of four domains of development: physical, literacy-numeracy, learning and social-emotional. Since the dataset has a hierarchical structure, we used multilevel logistic regression. RESULTS A quarter (25%) of the children were not on track in their early childhood development. Seventy-one percent were not developmentally on track in the literacy-numeracy domain, 27% were not in the social-emotional and smaller percentages were not in learning (9%) and physical (1%) domains. There was a significant negative association between maternal parity and ECDI (adjusted odds ratio [AOR] 0.95; 95% CI: 0.91-0.99). Attendance at early childhood education programmes was significantly associated with early childhood development (AOR 1.73; 95% CI: 1.47-2.03). Also, female children, those who were not stunted, located in rural areas, received parental stimulation activities, lived in relatively wealthy households or had mothers who had received secondary or further education were more likely than others to be on track of early childhood development. CONCLUSIONS Early childhood development is negatively correlated with maternal parity. The literacy-numeracy domain constitutes the major developmental delay. Programmes for parental awareness should be widely expanded.
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Affiliation(s)
- M Mofizul Islam
- Department of Public Health, La Trobe University, Melbourne, Victoria
| | - Md Nuruzzaman Khan
- Department of Population Sciences, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
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Gondim EC, Scorzafave LGDDS, dos Santos DD, Henrique NCP, Pereira FDM, de Mello DF. Matching between maternal knowledge about infant development and care for children under one year old. Rev Lat Am Enfermagem 2022; 30:e3675. [PMID: 36287398 PMCID: PMC9580992 DOI: 10.1590/1518-8345.5967.3675] [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: 01/11/2022] [Accepted: 06/05/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE to analyze maternal knowledge about infant development and its matching to the care offered to children during their first year of life. METHOD a longitudinal and prospective study, in the stages of pregnancy and of the child's 12th/13th month of life. Interviews were applied to 121 women in a Brazilian city, based on 21 items selected from the Knowledge of Infant Development Inventory, related to the first year of life. Calculation of rates of correct answers was used, as well as regression by Ordinary Least Squares and White's standard error. RESULTS the participants who answered correctly more aspects have more years of study, are older and present high family incomes. When the "having a partner or not" variable was considered, the correct answers presented a discrete fluctuation. Regarding the themes, there were more correct answers to aspects about health, safety and infant development milestones. Primiparous mothers were more likely to wean, overprotect and have children using electronic devices, and less likely to seek information about child care. CONCLUSION there was matching between some maternal knowledge and execution of child care. The connection between them is relevant to indicate in detail the unknowns and uncertainties and to improve positive knowledge, contributing to promoting early childhood development.
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Affiliation(s)
- Ellen Cristina Gondim
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | | | - Daniel Domingues dos Santos
- Universidade de São Paulo, Faculdade de Economia, Administração e Contabilidade de Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | - Nayara Cristina Pereira Henrique
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Fabrícia de Magalhães Pereira
- Universidade de São Paulo, Faculdade de Economia, Administração e Contabilidade de Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | - Débora Falleiros de Mello
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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Emerson E, Llewellyn G. The association between household wealth and the prevalence of child disability and specific functional limitations: Analysis of nationally representative cross-sectional surveys in 40 low- and middle-income countries. Disabil Health J 2022; 15:101364. [PMID: 35977866 DOI: 10.1016/j.dhjo.2022.101364] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 07/13/2022] [Accepted: 07/13/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND It is commonly stated that people with disabilities are at significantly greater risk of living in poverty than their non-disabled peers. However, most evidence supporting this assertion is drawn from studies in high-income countries and studies of adults. There is relatively little robust evidence on the association between poverty/wealth and the prevalence of child disability in low- and middle-income countries (LMICs). OBJECTIVE/HYPOTHESIS To estimate the strength of association between an indicator of wealth (household assets) and the prevalence of disability among children in a range of LMICs. METHODS Secondary analysis of data collected in Round 6 of UNICEF's Multiple Indicator Cluster Surveys. Nationally representative data were available for 40 countries with a total sample size of 473,578 children aged 2-17. Disability was ascertained by responses to the Washington Group for Disability Statistics module on functional limitations. RESULTS There were significant dose-dependent relationships between household wealth quintile and the prevalence of disability and 13 of the 15 specific functional difficulties associated with disability. Children living in the poorest 20% of households were 35% more likely to have a disability than children living in the most affluent 20% of households. The strength of the association between household wealth and the prevalence of child disability was markedly lower in low-income countries than in middle-income countries. r CONCLUSIONS: Our results provide robust evidence that in LMICs the prevalence of child disability is disproportionately concentrated in poorer households. Further research is required to better understand why this association appears to be weaker in low-income countries. c.
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Affiliation(s)
- Eric Emerson
- Centre for Disability Research and Policy, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia; Centre of Research Excellence in Disability and Health, University of Sydney, Sydney, NSW, 2006, Australia; Centre for Disability Research, Faculty of Health & Medicine, Lancaster University, Lancaster, LA1 4YW, UK.
| | - Gwynnyth Llewellyn
- Centre for Disability Research and Policy, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia; Centre of Research Excellence in Disability and Health, University of Sydney, Sydney, NSW, 2006, Australia
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Abboah-Offei M, Amboka P, Nampijja M, Owino GE, Okelo K, Kitsao-Wekulo P, Chumo I, Muendo R, Oloo L, Wanjau M, Mwaniki E, Mutisya M, Haycraft E, Hughes R, Griffiths P, Elsey H. Improving early childhood development in the context of the nurturing care framework in Kenya: A policy review and qualitative exploration of emerging issues with policy makers. Front Public Health 2022; 10:1016156. [PMID: 36238244 PMCID: PMC9551223 DOI: 10.3389/fpubh.2022.1016156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/09/2022] [Indexed: 01/28/2023] Open
Abstract
Introduction The Nurturing Care Framework (NCF) describes "nurturing care" as the ability of nations and communities to support caregivers and provide an environment that ensures children's good health and nutrition, protects them from threats, and provides opportunities for early learning through responsive and emotionally supportive interaction. We assessed the extent to which Kenyan government policies address the components of the NCF and explored policy/decision makers' views on policy gaps and emerging issues. Methods A search strategy was formulated to identify policy documents focusing on early childhood development (ECD), health and nutrition, responsive caregiving, opportunities for early learning and security and safety, which are key components of the NCF. We limited the search to policy documents published since 2010 when the Kenya constitution was promulgated and ECD functions devolved to county governments. Policy/decision-maker interviews were also conducted to clarify emerging gaps from policy data. Data was extracted, coded and analyzed based on the components of the NCF. Framework analysis was used for interview data with NCF being the main framework of analysis. The Jaccard's similarity coefficient was used to assess similarities between the themes being compared to further understand the challenges, successes and future plans of policy and implementation under each of the NCF domains. Results 127 policy documents were retrieved from government e-repository and county websites. Of these, n = 91 were assessed against the inclusion criteria, and n = 66 were included in final analysis. The 66 documents included 47 County Integrated Development Plans (CIDPs) and 19 national policy documents. Twenty policy/decision-maker interviews were conducted. Analysis of both policy and interview data reveal that, while areas of health and nutrition have been considered in policies and county level plans (coefficients >0.5), the domains of early learning, responsive caregiving and safety and security face significant policy and implementation gaps (coefficients ≤ 0.5), particularly for the 0-3 year age group. Inconsistencies were noted between county level implementation plans and national policies in areas such as support for children with disabilities and allocation of budget to early learning and nutrition domains. Conclusion Findings indicate a strong focus on nutrition and health with limited coverage of responsive caregiving and opportunities for early learning domains. Therefore, if nurturing care goals are to be achieved in Kenya, policies are needed to support current gaps identified with urgent need for policies of minimum standards that provide support for improvements across all Nurturing Care Framework domains.
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Affiliation(s)
- Mary Abboah-Offei
- School of Health and Life Sciences, University of the West of Scotland, London, United Kingdom,*Correspondence: Mary Abboah-Offei
| | - Patrick Amboka
- African Population and Health Research Center, APHRC Campus, Nairobi, Kenya
| | - Margaret Nampijja
- African Population and Health Research Center, APHRC Campus, Nairobi, Kenya
| | | | - Kenneth Okelo
- African Population and Health Research Center, APHRC Campus, Nairobi, Kenya
| | | | - Ivy Chumo
- African Population and Health Research Center, APHRC Campus, Nairobi, Kenya
| | - Ruth Muendo
- African Population and Health Research Center, APHRC Campus, Nairobi, Kenya
| | - Linda Oloo
- African Population and Health Research Center, APHRC Campus, Nairobi, Kenya
| | - Maryann Wanjau
- Community Engagement Associate, UNICEF, Greater Houston, TX, United States
| | - Elizabeth Mwaniki
- African Population and Health Research Center, APHRC Campus, Nairobi, Kenya
| | - Maurice Mutisya
- African Population and Health Research Center, APHRC Campus, Nairobi, Kenya
| | - Emma Haycraft
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Robert Hughes
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Paula Griffiths
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Helen Elsey
- Department of Health Sciences, University of York, York, United Kingdom
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Metwally AM, Abdallah AM, Salah El-Din EM, Khadr Z, Raouf ERA, Elghareeb NA, Saleh RM, Abuelela MH, Amer HA, Hasanin HM, Mawla MAA, Sallam SF, El-Alameey IR, Sami SM, Abdel-Latif GA, Abdelrahman M, Shehata MA. A national prevalence and profile of single and multiple developmental delays among children aged from 1 year up to 12 years: an Egyptian community-based study. Child Adolesc Psychiatry Ment Health 2022; 16:63. [DOI: https:/doi.org/10.1186/s13034-022-00498-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/18/2022] [Indexed: 10/31/2023] Open
Abstract
Abstract
Objective
This study aimed at providing a national prevalence of single and multiple developmental delays (DDs) among 41,640 Egyptian children aged 1 to 12 years and exploring DDs’ associated risk and protective factors.
Methods
A national household survey from eight governorates of Egypt representing the four major subdivisions of Egypt was conducted through systematic probability proportionate to size. All enrolled children were assessed according to Vineland Adaptive Behavior Scales, (VABS) as a reliable screening questionnaire for identifying categories of DDs that were verified by pediatrics’ specialists.
Results
The overall prevalence of children with DDs was 6.7%. The prevalence of a single DD was 3.9% versus 2.8% multiple DDs. Communication deficit was the most prevalent type (5.3%). Lower prevalence was identified for fine motor delay (1.0%), gross motor delay, and socialization deficit (1.5% each). Whereas deficits in daily life skills (self-help and adaptive behavior delay) amounted to 2.3%. Living without mothers and/or fathers in homes was associated with increased odds of having DDs by one and a half times (OR = 1.72 and OR = 1.34 respectively). Multiple logistic regression analysis revealed the most predictors for DDs including children who suffer from convulsions after birth (OR = 3.10), low birth weight babies (OR = 1.94), male sex (OR = 1.75), mothers having health problems during pregnancy (OR = 1.70) and belonging to middle socioeconomic status (OR = 1.41). Children who suffered from cyanosis after birth was found to be at risk for any or multiple DDs. Difficult labor was significantly associated with increased odds for multiple DDs (OR = 1.55). Higher paternal and maternal education was associated with decreased odds to have any DDs by 40% (OR = 0.60 and OR = 0.58 respectively).
Conclusions
The detected prevalence of DDs is within the estimated range of prevalence of DDs for the pediatric population. The majority of the detected risk factors are preventable. Developmental screening is recommended to be implemented in all primary care settings as a routine practice.
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Metwally AM, Abdallah AM, Salah El-Din EM, Khadr Z, Raouf ERA, Elghareeb NA, Saleh RM, Abuelela MH, Amer HA, Hasanin HM, Mawla MAA, Sallam SF, El-Alameey IR, Sami SM, Abdel-Latif GA, Abdelrahman M, Shehata MA. A national prevalence and profile of single and multiple developmental delays among children aged from 1 year up to 12 years: an Egyptian community-based study. Child Adolesc Psychiatry Ment Health 2022; 16:63. [PMID: 35932037 PMCID: PMC9356393 DOI: 10.1186/s13034-022-00498-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE This study aimed at providing a national prevalence of single and multiple developmental delays (DDs) among 41,640 Egyptian children aged 1 to 12 years and exploring DDs' associated risk and protective factors. METHODS A national household survey from eight governorates of Egypt representing the four major subdivisions of Egypt was conducted through systematic probability proportionate to size. All enrolled children were assessed according to Vineland Adaptive Behavior Scales, (VABS) as a reliable screening questionnaire for identifying categories of DDs that were verified by pediatrics' specialists. RESULTS The overall prevalence of children with DDs was 6.7%. The prevalence of a single DD was 3.9% versus 2.8% multiple DDs. Communication deficit was the most prevalent type (5.3%). Lower prevalence was identified for fine motor delay (1.0%), gross motor delay, and socialization deficit (1.5% each). Whereas deficits in daily life skills (self-help and adaptive behavior delay) amounted to 2.3%. Living without mothers and/or fathers in homes was associated with increased odds of having DDs by one and a half times (OR = 1.72 and OR = 1.34 respectively). Multiple logistic regression analysis revealed the most predictors for DDs including children who suffer from convulsions after birth (OR = 3.10), low birth weight babies (OR = 1.94), male sex (OR = 1.75), mothers having health problems during pregnancy (OR = 1.70) and belonging to middle socioeconomic status (OR = 1.41). Children who suffered from cyanosis after birth was found to be at risk for any or multiple DDs. Difficult labor was significantly associated with increased odds for multiple DDs (OR = 1.55). Higher paternal and maternal education was associated with decreased odds to have any DDs by 40% (OR = 0.60 and OR = 0.58 respectively). CONCLUSIONS The detected prevalence of DDs is within the estimated range of prevalence of DDs for the pediatric population. The majority of the detected risk factors are preventable. Developmental screening is recommended to be implemented in all primary care settings as a routine practice.
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Affiliation(s)
- Ammal M Metwally
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Dokki, Cairo, Egypt.
- Public Health and Community Medicine, Medical Research and Clinical Studies Institute, National Research Centre (ID: 60014618), P.O. 12622, Dokki, Giza, Egypt.
| | - Ali M Abdallah
- Quantitative Methods Department, Aswan University, Giza, Egypt
| | - Ebtissam M Salah El-Din
- Child Health Department/ Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Dokki, Cairo, Egypt
| | - Zeinab Khadr
- Department of Statistics, Faculty of Economics and Political Science, Cairo University, Giza, Egypt
- The Social Research Center of the American University in Cairo, Cairo, Egypt
| | - Ehab R Abdel Raouf
- Department of Child with Special Needs/Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Dokki, Cairo, Egypt
| | - Nahed A Elghareeb
- Prevention of Disability General Directorate, Ministry of Health and Population, Giza, Egypt
| | - Rehan M Saleh
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Dokki, Cairo, Egypt
| | - Manal H Abuelela
- Public Health Department, Research Institute of Ophthalmology, Giza, Egypt
| | - Hala A Amer
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Dokki, Cairo, Egypt
- Department of Infection Control, King Saud Medical City, Riyadh, Saudi Arabia
| | - Hasanin M Hasanin
- Pediatrics Dept., Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Dokki, Cairo, Egypt
| | - Mohamed A Abdel Mawla
- Pediatrics Dept., Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Dokki, Cairo, Egypt
| | - Sara F Sallam
- Child Health Department/ Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Dokki, Cairo, Egypt
| | - Inas R El-Alameey
- Child Health Department/ Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Dokki, Cairo, Egypt
- Faculty of Applied Medical Sciences, Clinical Nutrition Department, Taibah University, Riyadh, Saudi Arabia
| | - Samia M Sami
- Child Health Department/ Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Dokki, Cairo, Egypt
| | - Ghada A Abdel-Latif
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Dokki, Cairo, Egypt
| | - Mohamed Abdelrahman
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Dokki, Cairo, Egypt
| | - Manal A Shehata
- Child Health Department/ Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Dokki, Cairo, Egypt
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Bliznashka L, Perumal N, Yousafzai A, Sudfeld C. Diet and development among children aged 36-59 months in low-income countries. Arch Dis Child 2022; 107:719-725. [PMID: 34952837 PMCID: PMC9304107 DOI: 10.1136/archdischild-2021-323218] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/07/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess the associations between diet, stimulation and development among children 36-59 months of age in low-income and middle-income countries (LMICs). DESIGN We pooled Demographic and Health Survey data on 12 126 children aged 36-59 months from 15 LMICs. Child diet indicators included dietary diversity score (DDS, range 0-7), minimum dietary diversity (MDD, defined as DDS ≥4) and animal source foods (ASFs) consumption. Child development was assessed using the Early Childhood Development Index and stimulation by the number of stimulation activities (range 0-6). Associations were assessed using generalised linear models. RESULTS In our sample, 18% of children met MDD and 50% received ≥4 stimulation activities. The prevalence of suboptimal cognitive, socioemotional, literacy-numeracy and physical development was 24%, 32%, 87% and 11%, respectively. Higher DDS, meeting MDD and consuming ASFs were associated with 8%-13% more stimulation activities. Children who met MDD were slightly less likely to have suboptimal literacy-numeracy development compared with children who did not meet MDD: relative risk 0.97 (95% CI 0.95 to 1.00). DDS, meeting MDD and ASFs consumption were not associated with cognitive, socioemotional or physical development. However, there was evidence of positive associations between MDD and cognitive and literacy-numeracy development among subgroups of children, including those who received ≥4 stimulation activities or attended an early childhood care and education programme. CONCLUSIONS Child diet was associated with more stimulation activities. However, independent of stimulation, socioeconomic status and other factors, child diet appeared to be a prominent determinant only of literacy-numeracy development among children 36-59 months of age.
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Affiliation(s)
- Lilia Bliznashka
- Global Academy of Agriculture and Food Security, The University of Edinburgh, Edinburgh, UK .,Department of Global Health and Population, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Nandita Perumal
- Department of Global Health and Population, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Aisha Yousafzai
- Department of Global Health and Population, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Christopher Sudfeld
- Department of Global Health and Population, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, USA,Department of Nutrition, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Hernández-Vásquez A, Vargas-Fernández R, Chavez-Ecos F, Mendoza-Correa I, Del Carmen Sara J. Association between maternal depression and emotion and behavior regulation in Peruvian children: a population-based study. Prev Med Rep 2022; 28:101879. [PMID: 35813400 PMCID: PMC9260607 DOI: 10.1016/j.pmedr.2022.101879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 12/01/2022] Open
Abstract
Depression is more frequent in women, affecting the early stages of child development. This study aimed to determine the association between maternal depression and self-regulation of emotions and behaviors in Peruvian children under five years. A cross-sectional analytical study of data collected by the 2019 Demographic and Family Health Survey (ENDES) was conducted. The outcome variable was emotion and behavior regulation in children aged 24 to 59 months, and exposure was the presence of depression in women aged 15 to 49 years during the 14 days prior to the survey using the Patient Health Questionnaire (PHQ-9). A generalized linear model of the binomial family was used for reporting crude prevalence ratios and adjusted. The overall prevalence of children who did not self-regulate their emotions and behaviors was 68.8%, while 3.8% of the mothers had moderate depressive symptoms and 2.2% severe symptoms. Regarding the association of interest, moderate and severe depressive symptoms of mothers decreased the probability of children regulating emotions and behaviors in the first model, whereas in the second model, an association was only found with severe depressive symptoms. In conclusion, children of mothers with moderate and severe depressive symptoms had a lower probability of self-regulating their emotions and behaviors. Therefore, it is necessary to develop maternal education, nutritional and social support programs and mental health strategies from the first level of care aimed at reducing social, economic and child factors to reduce the risk of depression in mothers and low early childhood development, which could reduce the risk of developing mental health disorders in adolescence and adulthood.
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She X, Perera S, Andre M, St. Fleur J, Hilaire J, Evans A, Long J, Wing D, Carpenter C, Wilson K, Palfrey J, Stulac S. Associations Between Parental Depression, Self-efficacy, and Early Childhood Development in Malnourished Haitian Children. Glob Pediatr Health 2022; 9:2333794X221098311. [PMID: 35592789 PMCID: PMC9112296 DOI: 10.1177/2333794x221098311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/16/2022] [Indexed: 11/16/2022] Open
Abstract
Background. Haiti lacks early childhood development data and guidelines in malnourished populations. Literature shows that developmental interventions are crucial for improving developmental outcomes malnourished children. This study examines the prevalence of early childhood development delays in a cohort of malnourished Haitian children and their associations with parental depression and self-efficacy. Methods. We used cross-sectional data from 42 patients 6 months to 2 years old in Saint-Marc, Haiti. We assessed their developmental status using the Ages and Stages Questionnaire. Parents were surveyed on depression symptoms and self-efficacy using validated surveys developed for low-resource settings. Demographic and socio-economic data were included. Prevalence of early childhood development delays and high parental depression risk were calculated. Multivariable logistic regression analyses were used to test whether parental depression risk and low self-efficacy were associated with a higher risk for childhood developmental delays. Results. Among participants, 45.2% (SD = 7.7%) of children with a recorded ASQ met age-specific cutoffs for developmental delay in one or more domains. 64.3% (SD = 7.4%) of parents were at high risk for depression. 47.6% (SD = 7.7%) of parents reported relatively low self-efficacy. Multivariable analysis showed that low parental self-efficacy was strongly associated with developmental delays (OR 17.5, CI 1.1-270.0) after adjusting for socioeconomic factors. Parental risk for depression was associated with higher odds (OR 4.6, CI 0.4-50.6) of children having developmental delays but did not reach statistical significance in this study. Conclusion. Parental self-efficacy was protectively associated with early childhood developmental delays in malnourished Haitian children. More research is needed to design contextually appropriate interventions.
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Affiliation(s)
- Xinshu She
- Stanford U School of Medicine,
Stanford, CA, USA
| | | | | | | | | | - Andrea Evans
- Toronto University School of Medicine,
Toronto, ON, Canada
| | - Jack Long
- University of Vermont Robert Larner
College of Medicine, Burlington, VT, USA
| | - Delight Wing
- University of Vermont Robert Larner
College of Medicine, Burlington, VT, USA
| | | | - Kim Wilson
- Harvard U Medical School, Boston, MA,
USA
| | | | - Sara Stulac
- Boston U School of Medicine, Boston,
MA, USA
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Bishwokarma A, Shrestha D, Bhujel K, Chand N, Adhikari L, Kaphle M, Wagle A, Karmacharya I. Developmental delay and its associated factors among children under five years in urban slums of Nepal. PLoS One 2022; 17:e0263105. [PMID: 35143516 PMCID: PMC8830665 DOI: 10.1371/journal.pone.0263105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 01/12/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Children from low-resource settings are more likely to encounter those factors that adversely influence their ability to acquire developmental potential. This study was conducted to assess the developmental status and its associated factors among children under five years of slum areas of Butwal Sub Metropolitan City, Rupandehi, Nepal. METHODS AND FINDINGS We conducted a community-based cross-sectional descriptive study using Developmental Milestone Chart (DMC) among 165 children under five years. Ethical approval was obtained from Ethical Review Board of Nepal Health Research Council. R software was used for data analysis. The association between developmental status and associated factors were examined with Chi-square and followed by logistic regression. Notably, more than half of the children (56.4%) had delayed development across two or more domains of gross motor, fine motor, language/ speech, and social development. Age, sex, socio-economic status, availability of learning materials, the occurrence of infectious diseases, and height-for-age of children were found to be significantly associated with the developmental status of children under study (p<0.05). CONCLUSIONS More than half of the children taken under the study had delayed development on different four domains. Findings from the study suggest that there should be similar studies conducted among children living in slum-like conditions. Additionally, programs should be designed as such which aims to mitigate the effect of socio-economic status on child development and has learning and nutritional aspects embedded central to its deliverance.
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Affiliation(s)
- Anupama Bishwokarma
- Department of Public Health, CiST College, Pokhara University, Kathmandu, Nepal
| | - Diwash Shrestha
- Department of Computer Science and Information Technology, Asian College of Higher Studies, Tribhuvan University, Kathmandu, Nepal
| | - Kshitiz Bhujel
- Neuro Surgery Department, Annapurna Neurological Institute & Allied Sciences, Kathmandu, Nepal
| | - Natasha Chand
- Integrated Health Information Management Section, Department of Health Services Nepal, Kathmandu, Nepal
| | - Laxmi Adhikari
- Department of Public Health, CiST College, Pokhara University, Kathmandu, Nepal
| | - Maheshor Kaphle
- Department of Public Health, CiST College, Pokhara University, Kathmandu, Nepal
| | - Ayurma Wagle
- Department of Public Health, CiST College, Pokhara University, Kathmandu, Nepal
| | - Isha Karmacharya
- Department of Public Health, CiST College, Pokhara University, Kathmandu, Nepal
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Araujo WRM, Malta MB, Faggiani LD, Cardoso MA, Matijasevich A. Suspected neuropsychomotor developmental delay in the first 2 years of life in a birth cohort in the Brazilian Amazon: Incidence, persistence and risk factors. INFANT AND CHILD DEVELOPMENT 2022. [DOI: 10.1002/icd.2287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | - Maíra Barreto Malta
- Department of Nutrition, School of Public Health Universidade de São Paulo São Paulo Brazil
| | - Lucas Damasio Faggiani
- Department of Nutrition, School of Public Health Universidade de São Paulo São Paulo Brazil
| | - Marly Augusto Cardoso
- Department of Nutrition, School of Public Health Universidade de São Paulo São Paulo Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP Universidade de São Paulo São Paulo Brazil
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Gondim EC, Scorzafave LGDDS, Santos DDD, Henrique NCP, Pereira FDM, Mello DFD. Correspondencia entre el conocimiento materno sobre el desarrollo infantil y el cuidado de los niños menores de un año. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.5967.3674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Resumen Objetivo: analizar el conocimiento materno sobre el desarrollo infantil y su correspondencia con el cuidado que se le brinda al niño en el primer año de vida. Método: estudio longitudinal, prospectivo, en las etapas de gestación y de los 12/13 meses del niño. Se les realizaron entrevistas a 121 mujeres de un municipio brasileño, basadas en 21 ítems seleccionados del Inventario de Conocimiento sobre Desarrollo Infantil, relacionados con el primer año de vida. Se utilizó el cálculo de las tasas de aciertos, la regresión de Mínimos Cuadrados Ordinarios y el error estándar de White. Resultados: las participantes que tuvieron una mayor cantidad de aciertos tienen más escolaridad, más edad e ingreso familiar alto. Los aciertos vinculados a la variable “tener pareja o no” mostraron una ligera oscilación. En cuanto a los temas, se registraron más aciertos en los ítems sobre salud, seguridad e hitos del desarrollo infantil. Las madres primíparas presentaron mayor probabilidad de destete, sobreprotección y de que el niño estuviera en contacto con dispositivos electrónicos, y menor probabilidad de buscar información sobre el cuidado infantil. Conclusión: hubo correspondencia entre algunos conocimientos maternos y los cuidados que le brindaron al niño. La conexión entre ellos es importante para indicar detalladamente las incógnitas y las dudas y mejorar el conocimiento positivo, que contribuye a promover el desarrollo infantil temprano.
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Viegas da Silva E, Hartwig FP, Barros F, Murray J. Effectiveness of a large-scale home visiting programme (PIM) on early child development in Brazil: quasi-experimental study nested in a birth cohort. BMJ Glob Health 2022; 7:e007116. [PMID: 35074788 PMCID: PMC8788193 DOI: 10.1136/bmjgh-2021-007116] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 12/16/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND A large-scale parenting programme with weekly home visits (Primeira Infância Melhor (PIM)) has been implemented in the south of Brazil for nearly two decades, but lacks evaluation of its effects on early childhood development (ECD). This quasi-experimental study aimed to assess the effects of PIM in real-life settings within a population-based birth cohort study. METHODS Data from the 2015 Pelotas Birth Cohort Study and the state programme information system were linked to identify study children who received PIM. Propensity score matching was used to create a comparable control group (using one-to-one matching) to estimate the effect of PIM on ECD measured at age 4 years. First, the impact of any enrolment in PIM was evaluated; then the intervention group was stratified according to whether enrolment occurred during pregnancy or after birth. Double adjustment was applied in linear regression to analyse child development scores, and Poisson regression for delayed development (below the 10th percentile of whole cohort). Effect modification due to family income was explored. RESULTS There was no evidence that any enrolment in PIM (601 pairs) by age 4 years was associated with child development. However, PIM starting during pregnancy (estimated for 121 pairs) predicted higher development scores (0.27 SD; 95% CI 0.02 to 0.52), and 71% lower prevalence of delayed development (prevalence ratio=0.29; 95% CI 0.13 to 0.69), compared with the control group. There was strong statistical evidence (p=0.003, test of interaction) that the effect of PIM starting in pregnancy was larger than when starting after birth (480 pairs). The effect of PIM starting during pregnancy was found to be restricted to poorer families. CONCLUSIONS In a real-life setting, PIM was effective only when starting during pregnancy and only for poorer families. A higher-quality programme might be more effective with a broader population.
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Affiliation(s)
- Eduardo Viegas da Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, RS, Brazil
- State Health Surveillance Centre of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Fernando Pires Hartwig
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Fernando Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, RS, Brazil
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Gondim EC, Scorzafave LGDDS, Santos DDD, Henrique NCP, Pereira FDM, Mello DFD. Correspondência entre conhecimentos maternos sobre desenvolvimento infantil e cuidados de crianças menores de um ano. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.5967.3676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Resumo Objetivo: analisar os conhecimentos maternos sobre o desenvolvimento infantil e sua correspondência aos cuidados ofertados à criança no primeiro ano de vida. Método: estudo longitudinal, prospectivo, nas etapas da gestação e 12º/13º mês da criança. Foram aplicadas entrevistas a 121 mulheres de um município brasileiro, baseadas em 21 itens selecionados do Inventário de Conhecimento sobre o Desenvolvimento Infantil, relativos ao primeiro ano de vida. Utilizou-se o cálculo de taxas de acertos, regressão por Mínimos Quadrados Ordinários e erro padrão de White. Resultados: as participantes que acertaram mais aspectos possuem mais anos de estudo, mais idade e renda familiar elevada. Os acertos quando considerada a variável “ter ou não companheiro/a” apresentaram discreta oscilação. Quanto às temáticas, acertaram mais aspectos sobre saúde, segurança e marcos do desenvolvimento infantil. Mães primíparas apresentaram maior probabilidade de desmame, superproteção e da criança ter contato com aparelhos eletrônicos, e menor probabilidade de buscar informações sobre cuidados infantis. Conclusão: houve correspondência entre alguns conhecimentos maternos e a execução dos cuidados da criança. A conexão entre eles é relevante para indicar detalhadamente os desconhecimentos e as incertezas e aprimorar os saberes positivos, contribuindo para promover o desenvolvimento na primeira infância.
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Oumer A, Fikre Z, Girum T, Bedewi J, Nuriye K, Assefa K. Stunting and Underweight, but not Wasting are Associated with Delay in Child Development in Southwest Ethiopia. Pediatric Health Med Ther 2022; 13:1-12. [PMID: 35046749 PMCID: PMC8761030 DOI: 10.2147/phmt.s344715] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 12/16/2021] [Indexed: 11/23/2022] Open
Affiliation(s)
- Abdu Oumer
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
- Correspondence: Abdu Oumer Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, EthiopiaTel +251 966365785 Email
| | - Zinash Fikre
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Tadele Girum
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Jemal Bedewi
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Keyredin Nuriye
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Kenzudin Assefa
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
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Zhang Y, Kang L, Zhao J, Song PY, Jiang PF, Lu C. Assessing the Inequality of Early Child Development in China - A Population-Based Study. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2021; 14:100221. [PMID: 34671753 PMCID: PMC8484893 DOI: 10.1016/j.lanwpc.2021.100221] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 07/02/2021] [Accepted: 07/08/2021] [Indexed: 11/30/2022]
Abstract
Background As a country with the second largest child population in the world, China has little population-level evidence on who has been left behind in early childhood development (ECD). Knowledge of inequalities in ECD will inform the Chinese government in policies on promoting ECD and guide global-level monitoring on ECD progress. Methods Using data from the first wave of ECD surveys conducted in China at the least-developed region, most-developed region, and a megacity (Shanghai) in 2017 and 2018, we measured population-level ECD with early Human Capability Index for a total of 63,559 children aged 36-59 months old. A child was classified as developmentally on track if his/her overall development score was above the 20th percentile of the pooled populations. We measured inequalities in ECD with the absolute inequality in five domains: gender/sex, family income, maternal schooling, residential Hukou, and migrant- or left-behind status. Besides observed inequalities, we used a multilevel logistic regression model to generate adjusted inequalities. Findings Children developmentally on track ranges from 71% (95% CI 70 to 72%) in the least-developed region, 82% (95% CI 81 to 83%) in the most-developed region, and 86% (95% CI 85 to 87%) in Shanghai. Significant unadjusted inequalities in ECD were observed in all five dimensions. After controlling for other socioeconomic factors, significant differences remained in three dimensions: those living in the poorest families, or with lower maternal schooling, or boys were less likely to be developmentally on track than their counterparts (lower by 10[95% CI 8 to 11]-15[95% CI 13 to 17], 7[95% CI 5 to 10]-10[95% CI 7 to 12], and 5[95% CI 4 to 6]-6[95% CI 5 to 8] percentage points respectively). Interpretation Efforts of reducing ECD inequalities in China shall focus primarily on reducing poverty and improving maternal education. Funding National Natural Science Foundation of China (81773443), Shanghai Committee of Science and Technology (2018SHZDZX05), Shanghai Municipal Health Commission (GWV-10.1-XK07; GDEK201708), Shanghai Education Committee, Chinese Social Science Foundation (BFA140046), Macao Tong Chai Charity Association, Beijing Sany Charitable Foundation, China Medical Board (#20-388), UNICEF, Faculty Grant of Brigham & Women's Hospital, Economic and Social Research Council [grant reference number ES/T003936/1’] as a UKRI Collective Fund Award “UKRI GCRF Harnessing the Power of Global Data to Support Young Children's Learning and Development Collaborative."
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Affiliation(s)
- Yunting Zhang
- Child Health Advocacy Institute, National Children's Medical Center, Shanghai Children's Medical Center, affiliated to School of Medicine Shanghai Jiao Tong University.,School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Le Kang
- China Institute for Educational Finance Research, Peking University
| | - Jin Zhao
- Department of Developmental and Behavioral Pediatrics, National Children's Medical Center, Shanghai Children's Medical Center, affiliated to School of Medicine Shanghai Jiao Tong University
| | | | - Prof Fan Jiang
- Department of Developmental and Behavioral Pediatrics, National Children's Medical Center, Shanghai Children's Medical Center, affiliated to School of Medicine Shanghai Jiao Tong University.,Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, affiliated to School of Medicine Shanghai Jiao Tong University
| | - Chunling Lu
- Division of Global Health Equity, Brigham & Women's Hospital and Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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Bliznashka L, Udo IE, Sudfeld CR, Fawzi WW, Yousafzai AK. Associations between women's empowerment and child development, growth, and nurturing care practices in sub-Saharan Africa: A cross-sectional analysis of demographic and health survey data. PLoS Med 2021; 18:e1003781. [PMID: 34529666 PMCID: PMC8483356 DOI: 10.1371/journal.pmed.1003781] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 09/30/2021] [Accepted: 08/25/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Approximately 40% of children 3 to 4 years of age in low- and middle-income countries have suboptimal development and growth. Women's empowerment may help provide inputs of nurturing care for early development and growth by building caregiver capacity and family support. We examined the associations between women's empowerment and child development, growth, early learning, and nutrition in sub-Saharan Africa (SSA). METHODS AND FINDINGS We pooled data on married women (15 to 49 years) and their children (36 to 59 months) from Demographic and Health Surveys that collected data on child development (2011 to 2018) in 9 SSA countries (N = 21,434): Benin, Burundi, Cameroon, Chad, Congo, Rwanda, Senegal, Togo, and Uganda. We constructed a women's empowerment score using factor analysis and assigned women to country-specific quintile categories. The child outcomes included cognitive, socioemotional, literacy-numeracy, and physical development (Early Childhood Development Index), linear growth (height-for-age Z-score (HAZ) and stunting (HAZ <-2). Early learning outcomes were number of parental stimulation activities (range 0 to 6) and learning resources (range 0 to 4). The nutrition outcome was child dietary diversity score (DDS, range 0 to 7). We assessed the relationship between women's empowerment and child development, growth, early learning, and nutrition using multivariate generalized linear models. On average, households in our sample were large (8.5 ± 5.7 members) and primarily living in rural areas (71%). Women were 31 ± 6.6 years on average, 54% had no education, and 31% had completed primary education. Children were 47 ± 7 months old and 49% were female. About 23% of children had suboptimal cognitive development, 31% had suboptimal socioemotional development, and 90% had suboptimal literacy-numeracy development. Only 9% of children had suboptimal physical development, but 35% were stunted. Approximately 14% of mothers and 3% of fathers provided ≥4 stimulation activities. Relative to the lowest quintile category, children of women in the highest empowerment quintile category were less likely to have suboptimal cognitive development (relative risk (RR) 0.89; 95% confidence interval (CI) 0.80, 0.99), had higher HAZ (mean difference (MD) 0.09; 95% CI 0.02, 0.16), lower risk of stunting (RR 0.93; 95% CI 0.87, 1.00), higher DDS (MD 0.17; 95% CI 0.06, 0.29), had 0.07 (95% CI 0.01, 0.13) additional learning resources, and received 0.16 (95% CI 0.06, 0.25) additional stimulation activities from their mothers and 0.23 (95% CI 0.17 to 0.29) additional activities from their fathers. We found no evidence that women's empowerment was associated with socioemotional, literacy-numeracy, or physical development. Study limitations include the possibility of reverse causality and suboptimal assessments of the outcomes and exposure. CONCLUSIONS Women's empowerment was positively associated with early child cognitive development, child growth, early learning, and nutrition outcomes in SSA. Efforts to improve child development and growth should consider women's empowerment as a potential strategy.
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Affiliation(s)
- Lilia Bliznashka
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- * E-mail:
| | - Ifeyinwa E. Udo
- Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, Connecticut, United States of America
| | - Christopher R. Sudfeld
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Wafaie W. Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Aisha K. Yousafzai
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
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Emmers D, Jiang Q, Xue H, Zhang Y, Zhang Y, Zhao Y, Liu B, Dill SE, Qian Y, Warrinnier N, Johnstone H, Cai J, Wang X, Wang L, Luo R, Li G, Xu J, Liu M, Huang Y, Shan W, Li Z, Zhang Y, Sylvia S, Ma Y, Medina A, Rozelle S. Early childhood development and parental training interventions in rural China: a systematic review and meta-analysis. BMJ Glob Health 2021; 6:e005578. [PMID: 34417271 PMCID: PMC8381307 DOI: 10.1136/bmjgh-2021-005578] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 06/19/2021] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Inadequate care during early childhood can lead to long-term deficits in skills. Parenting programmes that encourage investment in young children are a promising tool for improving early development outcomes and long-term opportunities in low-income and middle-income regions, such as rural China. METHODS We conducted a systematic review and a meta-analysis to investigate the prevalence of early developmental delays and stimulating parenting practices as well as the effect of parental training programmes on child development outcomes in rural China. We obtained data in English from EconPapers, PubMed, PsycARTICLES, Cochrane Library, Web of Science and Scopus (Elsevier) and in Chinese from China National Knowledge Infrastructure, Wanfang Data and VIP Information. We conducted frequentist meta-analyses of aggregate data and estimated random-effects meta-regressions. Certainty of evidence was rated according to the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS We identified 19 observational studies on the prevalence of developmental delays and stimulating parenting practices for children under 5 years of age (n=19 762) and ten studies on the impact of parental training programmes on early child development (n=13 766). Children's risk of cognitive, language and social-emotional delays in the rural study sites (covering 14 provinces mostly in Central and Western China) was 45%, 46%, and 36%, respectively. Parental training programmes had a positive impact on child cognition, language and social-emotional development. CONCLUSION There is evidence to suggest that early developmental delay and the absence of stimulating parenting practices (ie, reading, storytelling and singing with children) may be prevalent across rural, low-income and middle-income regions in Central and Western China. Results support the effectiveness of parental training programmes to improve early development by encouraging parental engagement. TRIAL REGISTRATION NUMBER This study was registered with PROSPERO (CRD42020218852).
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Affiliation(s)
- Dorien Emmers
- LICOS Centre for Institutions and Economic Performance, KU Leuven, Leuven, Belgium
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies & Stanford Institute for Economic Policy Research, Stanford University, Stanford, California, USA
| | - Qi Jiang
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies & Stanford Institute for Economic Policy Research, Stanford University, Stanford, California, USA
| | - Hao Xue
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies & Stanford Institute for Economic Policy Research, Stanford University, Stanford, California, USA
| | - Yue Zhang
- National Center for Women and Children Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yunting Zhang
- Child Health Advocacy Institute, Department of Developmental and Behavioral Pediatrics, National Children's Medical Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Bin Liu
- Xinhe Foundation, Beijing, China
| | - Sarah-Eve Dill
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies & Stanford Institute for Economic Policy Research, Stanford University, Stanford, California, USA
| | - Yiwei Qian
- Department of Economics, University of Southern California, Los Angeles, California, USA
| | - Nele Warrinnier
- LICOS Centre for Institutions and Economic Performance, KU Leuven, Leuven, Belgium
- School of Economics and Finance, Queen Mary University of London, London, UK
| | - Hannah Johnstone
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies & Stanford Institute for Economic Policy Research, Stanford University, Stanford, California, USA
| | - Jianhua Cai
- Administrators of Training Center of the National Health Commission of the PRC, Beijing, China
| | - Xiaoli Wang
- School of Public Health, Peking University Health Science Centre, Beijing, China
| | - Lei Wang
- International Business School, Shaanxi Normal University, Xi'an, Shaanxi, China
| | - Renfu Luo
- School of Advanced Agricultural Sciences, Peking University, Beijing, China
| | - Guirong Li
- International Center for Action Research on Education, Henan University School of Education, Kaifeng, Henan, China
| | - Jiajia Xu
- International Center for Action Research on Education, Henan University School of Education, Kaifeng, Henan, China
| | - Ming Liu
- Save the Children International China Program, Beijing, China
| | - Yaqing Huang
- Save the Children International China Program, Beijing, China
| | - Wenjie Shan
- Child Health Advocacy Institute, Department of Developmental and Behavioral Pediatrics, National Children's Medical Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhihui Li
- Child Health Advocacy Institute, Department of Developmental and Behavioral Pediatrics, National Children's Medical Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yu Zhang
- Hupan Modou Foundation, Hangzhou, China
| | - Sean Sylvia
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Yue Ma
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies & Stanford Institute for Economic Policy Research, Stanford University, Stanford, California, USA
| | - Alexis Medina
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies & Stanford Institute for Economic Policy Research, Stanford University, Stanford, California, USA
| | - Scott Rozelle
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies & Stanford Institute for Economic Policy Research, Stanford University, Stanford, California, USA
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Afiaz A, Masud MS, Mansur M. Impact of child's cognitive and social-emotional difficulties on child abuse: Does mother's justification of intimate partner violence also play a role? CHILD ABUSE & NEGLECT 2021; 117:105028. [PMID: 33774516 DOI: 10.1016/j.chiabu.2021.105028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 01/20/2021] [Accepted: 03/09/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Violence against children has been a persistent problem in developing nations. The adverse effects of physical violence bear a considerable impact on children's physical and psychological development resulting in both short and long-term issues. OBJECTIVE The aim of this study was to explore whether children with cognitive and social-emotional difficulties (CSEDs) were at a higher risk of experiencing physical abuse and whether mothers' views on intimate partner violence (IPV) were also related to physical abuse against children. PARTICIPANTS AND SETTING The Bangladesh Multiple Indicator Cluster Survey-2019 was used with a sample of 27,086 children aged 5-14. METHODS Generalized linear modelling along with a machine learning method of classification trees was employed to investigate the important sociodemographic characteristics and identify the most vulnerable groups of children based on their likelihood of exposure to household-violence. RESULTS Nearly 62.5 % of the children were physically abused by their mothers. Children with CSEDs were 53 % (OR 1.53; 95 % CI: 1.41, 1.67) more likely to experience physical abuse and mothers' justification of IPV was associated with a 16 % higher risk (OR 1.16; 95 % CI: 1.08, 1.26). Moreover, younger children aged 11 or below belonged to the high-risk groups of experiencing abuse. CONCLUSIONS The findings suggest that violence against children is widespread in Bangladesh, especially in children having CSEDs. Mothers' acceptance of IPV was also associated with increased abusive practice against children. Sincere focus on these issues is imperative if Bangladesh intends to achieve the sustainable development goal 16.2 of eradicating all forms of violence against children and ensure their safe development.
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Affiliation(s)
- Awan Afiaz
- Institute of Statistical Research and Training (ISRT), University of Dhaka, Dhaka, 1000, Bangladesh.
| | - Mohammad Shahed Masud
- Institute of Statistical Research and Training (ISRT), University of Dhaka, Dhaka, 1000, Bangladesh.
| | - Mohaimen Mansur
- Institute of Statistical Research and Training (ISRT), University of Dhaka, Dhaka, 1000, Bangladesh.
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50
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Leão OADA, Mielke GI, da Silveira MF, Domingues MR, Murray J, Neumann NA, Dalabona CC, Bertoldi AD. Influence of center-based child care on development of two-year-olds in a Brazilian cohort. Rev Saude Publica 2021; 55:32. [PMID: 34190898 PMCID: PMC8225318 DOI: 10.11606/s1518-8787.2021055002958] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 09/23/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To investigate the association between child care attendance since birth and development in two-years-old Brazilian children. METHODS The study used longitudinal data from the 2015 Pelotas Birth Cohort. The childhood development (cognitive, fine and gross motor skills, and language) at two-years-old children was assessed using INTER-NDA (INTERGROWTH-21st Neurodevelopment Assessment). The child care attendance was measured at ages one and two years and categorized as: a) never attended child care; b) attended some child care (one or two years); and c) always attended child care (one and two years). Demographic, socioeconomic, health, and child stimulation variables were considered as confounders. Crude and adjusted analyses of child care attendance and development were carried out using linear regression. RESULTS Out of the 3,870 infants included in the analyses, around 1/3 attended center-based child care. In crude analyses, attending center-based child care was associated with positive developmental outcomes, except in motor domains. In adjusted analyses, compared to those children that have never attended child care, children who did attend presented higher scores for cognitive development (always in child care: β: 2.44, 95%CI: 0.83-4.05; some child care: β: 1.35, 95%CI: 0.17-2.53). CONCLUSIONS This study suggests that center-based child care may help improve child cognitive development in the Brazilian context. Furthermore, the association was higher for early and continued attendance. Considering the low prevalence of children in external care, it is recommended to improve child care opportunities in early childhood.
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Affiliation(s)
- Otávio Amaral de Andrade Leão
- Univerisdade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniverisdade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Gregore Iven Mielke
- The University of QueenslandSchool of Human Movement and Nutrition SciencesBrisbaneQueenslandAustraliaThe University of Queensland. School of Human Movement and Nutrition Sciences. Brisbane, Queensland, Australia
| | - Mariângela Freitas da Silveira
- Univerisdade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniverisdade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Marlos Rodrigues Domingues
- Universidade Federal de PelotasEscola Superior de Educação FísicaPrograma de Pós-Graduação em Educação FísicaPelotasRSBrasilUniversidade Federal de Pelotas. Escola Superior de Educação Física. Programa de Pós-Graduação em Educação Física. Pelotas, RS, Brasil
| | - Joseph Murray
- Univerisdade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniverisdade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
- Human Development and Violence Research CentrePelotasRSBrasilHuman Development and Violence Research Centre (DOVE). Pelotas, RS, Brasil
| | - Nelson Arns Neumann
- Coordenação Nacional da Pastoral da CriançaCuritibaPRBrasilCoordenação Nacional da Pastoral da Criança. Curitiba, PR, Brasil
| | - Caroline Caus Dalabona
- Coordenação Nacional da Pastoral da CriançaCuritibaPRBrasilCoordenação Nacional da Pastoral da Criança. Curitiba, PR, Brasil
| | - Andréa Dâmaso Bertoldi
- Univerisdade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniverisdade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
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