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Yirdaw BE, Debusho LK. Multilevel Bayesian network to model child morbidity using Gibbs sampling. Artif Intell Med 2024; 149:102784. [PMID: 38462284 DOI: 10.1016/j.artmed.2024.102784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 01/18/2024] [Accepted: 01/20/2024] [Indexed: 03/12/2024]
Abstract
Bayesian networks (BNs) are suitable models for studying complex interdependencies between multiple health outcomes, simultaneously. However, these models fail the assumption of independent observation in the case of hierarchical data. Therefore, this study proposes a two and three-level random intercept multilevel Bayesian network (MBN) models to study the conditional dependencies between multiple outcomes. The structure of MBN was learned using the connected three parent set block Gibbs sampler, where each local network was included based on Bayesian information criteria (BIC) score of multilevel regression. These models were examined using simulated data assuming features of both multilevel models and BNs. The estimated area under the receiver operating characteristics for both models were above 0.8, indicating good fit. The MBN was then applied to real child morbidity data from the 2016 Ethiopian Demographic Health Survey (EDHS). The result shows a complex causal dependencies between malnutrition indicators and child morbidities such as anemia, acute respiratory infection (ARI) and diarrhea. According to this result, families and health professionals should give special attention to children who suffer from malnutrition and also have one of these illnesses, as the co-occurrence of both can worsen the health of a child.
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Affiliation(s)
- Bezalem Eshetu Yirdaw
- Department of Statistics, University of South Africa, c/o Christiaan de Wet Road & Pioneer Avenue, Florida 1709, Johannesburg, South Africa.
| | - Legesse Kassa Debusho
- Department of Statistics, University of South Africa, c/o Christiaan de Wet Road & Pioneer Avenue, Florida 1709, Johannesburg, South Africa.
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Kikuchi M. Influence of sanitation facilities on diarrhea prevalence among children aged below 5 years in flood-prone areas of Bangladesh: a multilevel analysis. Environ Sci Pollut Res Int 2023; 30:97925-97935. [PMID: 37603245 PMCID: PMC10495509 DOI: 10.1007/s11356-023-29373-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 08/13/2023] [Indexed: 08/22/2023]
Abstract
Although the improvement of sanitation facilities has been a major contributor to improving public health, it is not guaranteed to prevent negative health outcomes. This is especially true in areas affected by severe natural disasters, such as flooding or extreme rainfall. Previous studies have examined the association between catastrophic natural disasters and negative health outcomes. However, studies on disaster-prone areas are limited. This study focused on the impact of flood risks and examined whether the improvement of sanitation facilities would be sufficient to suppress the prevalence of diarrhea in flood-prone areas. Two secondary datasets including geodata on flood-prone areas were used for the analysis: one each was obtained from the Bangladesh Demographic and Health Survey and Bangladesh Agricultural Research Council. Two models with categorizations of sanitation facilities based on containment type and excreta flow were applied for analysis. Results showed that the severe flood-prone areas and "diffused" type of sanitation, where the feces are diffused without any containment, had significant positive associations with diarrhea prevalence; however, the interaction between them was negative. Moderate flood-prone areas had a significant positive association with diarrhea prevalence; however, the interaction with unimproved sanitation, which includes containment without clear partition from feces, was significantly negative. These findings indicate that improved sanitation or containment type of sanitation may not positively contribute to the prevention of diarrhea in these severe- and moderate-flood prone areas. The urgent need for alternative sanitation technologies should be addressed in flood-prone regions.
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Affiliation(s)
- Michiko Kikuchi
- Graduate School of Frontier Sciences, The University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa City, Chiba Prefecture, 277-8561, Japan.
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Amadu I, Seidu AA, Mohammed A, Duku E, Miyittah MK, Ameyaw EK, Hagan JE, Musah MH, Ahinkorah BO. Assessing the combined effect of household cooking fuel and urbanicity on acute respiratory symptoms among under-five years in sub-Saharan Africa. Heliyon 2023; 9:e16546. [PMID: 37346351 PMCID: PMC10279788 DOI: 10.1016/j.heliyon.2023.e16546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 05/02/2023] [Accepted: 05/18/2023] [Indexed: 06/23/2023] Open
Abstract
Background This study sought to investigate the association between urbanicity (rural-urban residency), the use of solid biomass cooking fuels and the risk of Acute Respiratory Infections (ARIs) among children under the age of 5 in sub-Saharan Africa (SSA). Methods Cross-sectional data from the most recent surveys of the Demographic and Health Survey Program conducted in 31 sub-Saharan African countries were pooled for the analysis. The outcome variables, cough and rapid short breath were derived from questions that asked mothers if their children under the age of 5 suffered from cough and short rapid breath in the past two weeks preceding the survey. To examine the associations, multivariable negative log-log regression models were fitted for each outcome variable. Results Higher odds ratios of cough occurred among children in urban households that use unclean cooking fuel (aOR = 1.05 95% CI = 1.01, 1.08). However, lower odds ratios were observed for rural children in homes that use clean cooking fuel (aOR = 0.93 95% CI = 0.87, 0.99) relative to children in urban homes using clean cooking fuel. We also found higher odds ratios of short rapid breaths among children in rural households that use unclean cooking fuel compared with urban residents using clean cooking fuel (aOR = 1.12 95% CI = 1.08, 1.17). Conclusion Urbanicity and the use of solid biomass fuel for cooking were associated with an increased risk of symptoms of ARIs among children under five years in SSA. Thus, policymakers and stakeholders need to design and implement strategies that minimize children's exposure to pollutants from solid biomass cooking fuel. Such interventions could reduce the burden of respiratory illnesses in SSA and contribute to the realization of Sustainable Development Goal 3.9, which aims at reducing the number of diseases and deaths attributable to hazardous chemicals and pollution of air, water and soil.
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Affiliation(s)
- Iddrisu Amadu
- Africa Centre of Excellence in Coastal Resilience (ACECoR)-Centre for Coastal Management, University of Cape Coast, Cape Coast, Ghana
- Department of Fisheries and Aquatic Sciences, School of Biological Sciences, College of Agriculture and Natural Sciences, University of Cape Coast, Ghana
- Emperiks Research, NT0085, Tamale, Ghana
| | - Abdul-Aziz Seidu
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Box 256, Ghana
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Queensland, Australia
| | - Aliu Mohammed
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Eric Duku
- Africa Centre of Excellence in Coastal Resilience (ACECoR)-Centre for Coastal Management, University of Cape Coast, Cape Coast, Ghana
- Department of Fisheries and Aquatic Sciences, School of Biological Sciences, College of Agriculture and Natural Sciences, University of Cape Coast, Ghana
- Hen Mpoano (Our Coast), Takoradi P.O. Box AX 296, Ghana
| | - Michael K. Miyittah
- Africa Centre of Excellence in Coastal Resilience (ACECoR)-Centre for Coastal Management, University of Cape Coast, Cape Coast, Ghana
- Department of Environmental Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Edward Kwabena Ameyaw
- Institute of Policy Studies and School of Graduate Studies, Lingnan University, Hong Kong
| | - John Elvis Hagan
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Bielefeld University, Bielefeld, Germany
| | - Mohammed Hafiz Musah
- Department of Health Information Management, Tamale Teaching Hospital, Tamale, Ghana
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Dadras O, Hazratzai M, Dadras F. The association of child marriage with morbidities and mortality among children under 5 years in Afghanistan: findings from a national survey. BMC Public Health 2023; 23:32. [PMID: 36604673 PMCID: PMC9817260 DOI: 10.1186/s12889-023-14977-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 01/02/2023] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND There is still a gap in knowledge of the impact that child marriage could have on the mortality and morbidity of children in Afghanistan. This study used the data from the latest Afghanistan demographic health survey conducted in 2015 (ADHS) to address this gap and advance the current knowledge. METHODS A secondary analysis of the 2015 ADHS, including the births in the past 5 years to ever-married women aged 15-24 years old, was carried out. Logistic regression analyses were employed to examine the association of child marriage (< 18y) with morbidities (diarrhea, acute respiratory infection, and fever in the last 2 weeks), mortality (neonatal, infant, child), and size at birth among the children under 5 born to women aged 15-24 years, before and after adjusting for the effect of sociodemographic and structural inequalities. RESULTS Approximately two-thirds of births in the past 5 years belong to 15-24 years old mothers who married at ages < 18. The majority of them were born to mothers residing in rural areas (75.67%) with no education (51.68%) from poor households (39.39%). As compared to the births to women married at ages ≥ 18, there was a significantly higher likelihood of neonatal mortality among births to women married at ages < 18 (crude OR = 2.30, 95% CI: 1.52-3.49 & adjusted OR = 1.94, 95% CI: 1.25-3.01) and higher infant mortality among the births to the women married at ages ≤ 14y (crude OR = 1.94, 95% CI: 1.06-3.53). However, it disappeared for neonatal mortality after adjustment for adequacy of antenatal care (ANC) and infant mortality after adjustment for sociodemographic inequalities. CONCLUSION Although the births to women married as a child (< 18) were more likely to die at an early age, this association disappeared after adjustment for the adequacy of ANC. Given the unavoidable practice of child marriage in Afghanistan, this finding emphasizes the importance of providing adequate ANC for young brides to prevent child mortality. In addition, strong global advocacy is required to empower and support young Afghan women in negotiating their reproductive and maternity rights with their partners by reducing social and gender-based inequalities.
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Affiliation(s)
- Omid Dadras
- grid.7914.b0000 0004 1936 7443Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway ,grid.477239.c0000 0004 1754 9964Section Global Health and Rehabilitation, Høgskulen På Vestlandet (HVL), Bergen, Norway
| | - Mohammadsediq Hazratzai
- grid.27860.3b0000 0004 1936 9684Department of Public Health Sciences, School of Medicine, University of California, Davis (UC Davis), Davis, USA
| | - Fateme Dadras
- grid.411705.60000 0001 0166 0922Department of Gynecology and Obstetrics, Graduate School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Gabrhelík R, Skurtveit S, Nechanská B, Mravčík V, Handal M. Morbidity through 3 Years of Age in Children of Women Using Methamphetamine during Pregnancy: A National Registry Study. Eur Addict Res 2023; 29:19-29. [PMID: 36423599 PMCID: PMC9932820 DOI: 10.1159/000527238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 08/26/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is a lack of studies on methamphetamine (MA) exposure and morbidity in children beyond the perinatal period. OBJECTIVES We compared morbidity in children (0-3 years) with prenatal MA exposure to opioid-exposed and to non-exposed children. METHODS We used data from a Czech nationwide, registry-based cohort study (2000-2014). Children, who reached 3 years of age, of mothers hospitalized with (i) MA use disorder during pregnancy (MA; n = 194), (ii) opioid use disorder during pregnancy (opioids; n = 166), and (iii) general population (GP; n = 1,294,349) with no recorded history of substance use disorder (SUD). Information on inpatient contacts, length of stay, and diagnoses (International Statistical Classification of Diseases and Related Health Problems 10th Revision [ICD-10]) were assessed. Crude and adjusted odds ratios (aOR), 95% confidence interval (CI) for the risk of hospitalization, and for getting diagnosis from the ICD-10 diagnosis chapters were calculated using binary logistic regression. A stratified analysis on hospitalizations with SUD of mothers was performed. RESULTS No significant differences were found in the measures of hospitalization between the MA and opioid groups. Children prenatally exposed to MA and opioids had higher numbers of hospitalizations and diagnoses and longer stays in hospital than children in the GP. Increased risks of certain infectious and parasitic diseases were found in both MA (aOR = 1.6; CI: 1.1-2.3) and opioid (aOR = 1.9; 1.3-2.8) groups as compared to the GP group. The most pronounced difference in stratified analysis on maternal hospitalizations related to SUD after birth was observed for injury, poisoning, and certain other consequences of external causes in the strata of the MA group who had hospitalized mothers (aOR 6.3, 1.6-24.6) compared to the strata without maternal hospitalizations (aOR 1.4, 0.9-2.3). CONCLUSION This study suggests that children born to mothers using MA during pregnancy have similar morbidity during the first 3 years of life but higher than the GP. The excess of risk was primarily due to infections and injuries in the MA group.
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Affiliation(s)
- Roman Gabrhelík
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czechia,Department of Addictology, General University Hospital in Prague, Prague, Czechia,*Roman Gabrhelík,
| | - Svetlana Skurtveit
- Norwegian Institute of Public Health, Oslo, Norway,Norwegian Centre for Addiction Research at the University of Oslo, Oslo, Norway
| | - Blanka Nechanská
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czechia
| | - Viktor Mravčík
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czechia
| | - Marte Handal
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czechia,Norwegian Institute of Public Health, Oslo, Norway
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Cossa H, Dietler D, Macete E, Munguambe K, Winkler MS, Fink G. Assessing the effects of mining projects on child health in sub-Saharan Africa: a multi-country analysis. Global Health 2022; 18:7. [PMID: 35101058 PMCID: PMC8802519 DOI: 10.1186/s12992-022-00797-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/03/2022] [Indexed: 12/05/2022] Open
Abstract
Background The African continent hosts many industrial mining projects, and many more are planned due to recent prospecting discoveries and increasing demand for various minerals to promote a low-carbon future. The extraction of natural resources in sub-Saharan Africa (SSA) represents an opportunity for economic development but also poses a threat to population health through rapid urbanisation and environmental degradation. Children could benefit from improved economic growth through various channels such as access to high-quality food, better sanitation, and clean water. However, mining can increase food insecurity and trigger local competition over safe drinking water. Child health can be threatened by exposure to mining-related air, noise, and water pollution. To assess the impact of mines on child health, we analyse socio-demographic, health, and mining data before and after several mining projects were commissioned in SSA. Results Data of 90,951 children living around 81 mining sites in 23 countries in SSA were analysed for child mortality indicators, and 79,962 children from 59 mining areas in 18 SSA countries were analysed for diarrhoea, cough, and anthropometric indicators. No effects of the launch of new mining projects on overall under-five mortality were found (adjusted Odds Ratio (aOR): 0.88; 95% Confidence Interval (CI): 0.68–1.14). However, activation of mining projects reduced the mortality risk among neonates (0–30 days) by 45% (aOR: 0.55; 95% CI: 0.37–0.83) and risk for a child to develop diarrhoeal diseases by 32% (aOR: 0.68; 95% CI: 0,51–0.90). The timing analysis of observed changes showed that there is a significant decline in the risk for childhood diarrhoea (aOR: 0.69; 95% CI: 0.49–0.97), and the mean height-for-age z-scores by 28 percentage points, during the prospection and construction phase; i.e., within four years to the initiation of extraction activity. No effects were found for cough and weight-for-height. Conclusion The results presented suggest that the impacts of mining on child health vary throughout the mine’s life cycle. Mining development likely contributes positively to the income and livelihoods of the impacted communities in the initial years of mining operations, particularly the prospection and construction phase; these potential benefits are likely to be at least partially offset by food insecurity and environmental pollution during early and later mining stages, respectively. Further research is warranted to better understand these health impacts and to identify policies that can help sustain the positive initial health impacts of mining projects in the long term. Supplementary Information The online version contains supplementary material available at 10.1186/s12992-022-00797-6.
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Affiliation(s)
- Hermínio Cossa
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123, Switzerland. .,University of Basel, P.O. Box, CH-4003, Basel, Switzerland. .,Manhiça Health Research Centre, Maputo, 1929, Mozambique.
| | - Dominik Dietler
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Eusébio Macete
- Manhiça Health Research Centre, Maputo, 1929, Mozambique.,National Directorate of Public Health, Ministry of Health, Maputo, 264, Mozambique
| | - Khátia Munguambe
- Manhiça Health Research Centre, Maputo, 1929, Mozambique.,University Eduardo Mondlane, Faculty of Medicine, Maputo, 3453, Mozambique
| | - Mirko S Winkler
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Günther Fink
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
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Pettersson ML, Bladh M, Nedstrand E, Svanberg AS, Lampic C, Sydsjö G. Maternal advanced age, single parenthood, and ART increase the risk of child morbidity up to five years of age. BMC Pediatr 2022; 22:39. [PMID: 35031006 PMCID: PMC8759211 DOI: 10.1186/s12887-021-03103-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 12/28/2021] [Indexed: 12/02/2022] Open
Abstract
Background Advanced maternal age, single status and use of assisted reproductive technology (ART) are increasing in mothers in high-income countries, and all are known risk factors for negative obstetric outcomes. Less is known about their long-term consequences for childhood morbidity. Thus, the aim of this study was to investigate morbidity up to five years of age, in the children of older, single, and/or ART-treated mothers. Methods A cross-sectional using Swedish registers was performed comprising 23 772 children. The prevalence of diagnosis and the number of hospital visits for specialist care, were compared and analyzed in relation to maternal age at childbirth, maternal civil status, and mode of conception. The odds ratio for specialized care within each ICD-chapter were estimated using single and multiple logistic regression. Results Children born to single mothers and children conceived using ART had significantly more outpatient visits for specialist care and significantly more diagnoses compared to children with married/cohabiting mothers, and spontaneously conceived children. Children born to mothers of advanced maternal age (≥40) had fewer in- and outpatient visits. However, they were significantly more often diagnosed within ICD-chapters XVI, XVII i.e., they experienced more morbidity in the neonatal period. Conclusion The results indicate that children born to single mothers and children of ART-treated mothers have a higher morbidity and consume more specialist care than children of married/cohabiting and spontaneously pregnant mothers. We conclude that the use of ART, maternal single status and advanced maternal age are risk factors of importance to consider in pediatric care and when counseling women who are considering ART treatment.
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Affiliation(s)
- Malin Lindell Pettersson
- Department of Obstetrics and Gynecology, and Department of Biomedical and Clinical Sciences, Linköping University, SE-581 85, Linköping, Sweden.
| | - Marie Bladh
- Department of Obstetrics and Gynecology, and Department of Biomedical and Clinical Sciences, Linköping University, SE-581 85, Linköping, Sweden
| | - Elizabeth Nedstrand
- Department of Obstetrics and Gynecology, and Department of Biomedical and Clinical Sciences, Linköping University, SE-581 85, Linköping, Sweden
| | | | - Claudia Lampic
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Department of Psychology, Umeå University, Umeå, Sweden
| | - Gunilla Sydsjö
- Department of Obstetrics and Gynecology, and Department of Biomedical and Clinical Sciences, Linköping University, SE-581 85, Linköping, Sweden
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Roja VR, Narayanan P, Sekaran VC, Ajith Kumar MG. Living environment and health of under-five children in urban slums of a coastal region in South India. Ghana Med J 2021; 54:238-244. [PMID: 33883772 PMCID: PMC8042806 DOI: 10.4314/gmj.v54i4.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective The primary objective of the study was to determine the association between the living environment and morbidity, nutritional status, immunization status, and personal hygiene of under-five children living in urban slums in southern India. Methods This study included 224 mothers of under-five children living in urban slums of Udupi Taluk, Karnataka. A total of 17 urban slums were selected randomly using random cluster sampling. Results Undernutrition was high among children of illiterate mothers (63.8%), and the children of working mothers were affected by more morbidity (96.6%) as compared with housewives. Morbidity was also found to be high among children belonging to families with low incomes (66.1%) and low socio-economic backgrounds (93.1%). Safe drinking water, water supply, sanitation, hygiene, age of the child, mother's and father's education, mother's occupation and age, number of children in the family, use of mosquito nets, type of household, and family income were significantly associated with child morbidity, nutritional status, immunization status, and personal hygiene of under-five children living in urban slums. Conclusion Overall, in our study, family characteristics including parental education, occupation and income were significantly associated with outcomes among under-five children. The availability of safe drinking water and sanitation, and the use of mosquito nets to prevent vector-borne diseases are basic needs that need to be urgently met to improve child health. Funding Self-funded.
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Affiliation(s)
- V R Roja
- ICMR NTF HI project, Dept. of ENT & HNS, AIIMS Raipur, India
| | | | | | - M G Ajith Kumar
- Baby Memorial Hospital and Malabar Hospital, Calicut, Kerala, India
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Abstract
Objectives This study was aimed to illustrate the determents of consanguinity and inbreeding coefficient-F (ICF) in the population of Okara district of Pakistan and to elucidate the impact of consanguinity on fertility and birth outcome. Methods Through a cross-sectional sampling design, 1,521 married women were recruited from Okara district during 2016-2017. Data on demographic variables, marital union types, subject's fertility, and reproductive outcome, were gathered in face-to-face interviews. Descriptive statistics and multivariable logistic regression were employed. Results The prevalence of consanguineous unions (CU) was calculated to be 61% yielding ICF=0.0356. Multivariable regression analyses revealed that six variables including younger age at marriage, joint family structure, caste-system of spouse, exchange marriage, matrimonial distance, and parental consanguinity, were significant predictors of consanguinity. The women having CU had significantly higher mean fertility, mean live-births and mean live-born sons compared with subjects having non-consanguineous unions (NCU). However, there were no significant differences in the average mortalities, i.e., prenatal, postnatal and <5 years, between the mothers with CU and NCU. Conclusion The prevalence of consanguineous unions (CU) in Okara district is quite high like other inbred populations of Pakistan. The striking findings of this study are the higher mean fertility and mean live-births in women with CU. The likely reasons underlying this phenomenon have been discussed.
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Affiliation(s)
- Aqeela Nawaz
- Aqeela Nawaz, M.Phil. Human Genetics Program, Department of Zoology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Muhammad Zaman
- Muhammad Zaman, PhD. Department of Sociology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Sajid Malik
- Sajid Malik, PhD. Human Genetics Program, Department of Zoology, Quaid-i-Azam University, Islamabad, Pakistan
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Ullah MB, Mridha MK, Arnold CD, Matias SL, Khan MSA, Siddiqui Z, Hossain M, Paul RR, Dewey KG. Factors associated with diarrhea and acute respiratory infection in children under two years of age in rural Bangladesh. BMC Pediatr 2019; 19:386. [PMID: 31656181 PMCID: PMC6815354 DOI: 10.1186/s12887-019-1738-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 09/20/2019] [Indexed: 12/02/2022] Open
Abstract
Background Diarrhea and acute respiratory infection (ARI) are major causes of child mortality. We aimed to identify risk factors associated with diarrhea and ARI among children under 2 years of age in rural northern Bangladesh. Method We collected information on diarrhea and ARI in the previous 14 days and the previous 6 months at 6, 12, 18 and 24 months of age as part of a longitudinal, cluster randomized effectiveness trial, the Rang-Din Nutrition Study which enrolled 4011 pregnant women at ≤20 gestational weeks. Women and their children were followed up until 2 years postpartum. Information on household socioeconomic status, type of toilet, garbage disposal system, food insecurity, number of under-five children in the household, type of family, maternal characteristics and child characteristics was collected at baseline and/or at 6, 12, 18 and 24 months postpartum. Data on newborn health and feeding behaviors were collected within 72 h of delivery. Associations between potential risk factors and morbidity prevalence outcomes were assessed using logistic regression controlling for potential confounders. Results Out of 3664 live born children, we collected information from ~ 3350 children at 6, 12, 18 and 24 months of age. Diarrhea in the previous 14 days, and in the previous 6 months, was associated with maternal depression score and food insecurity; diarrhea in the previous 6 months was also associated with family type (nuclear vs. joint). ARI in the previous 14 days was associated with maternal depression score, type of toilet and garbage disposal, household food insecurity and sex. Cough or nasal discharge in the past 6 months was associated with maternal depression score, type of toilet and garbage disposal, household food insecurity, sex and perceived overall physical condition of the infant after birth. Conclusion Maternal depression and food insecurity appear to be important risk factors for diarrhea and respiratory infection among children under 2 years of age in this setting. These findings suggest that policies and programs that include strategies to address maternal mental health and household food insecurity may contribute to improved child health. Trial registration The trial was registered with the US National Institutes of Health at ClinicalTrials.gov, # NCT01715038, with registration completed October 26, 2012.
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Affiliation(s)
- Md Barkat Ullah
- Department of Nutrition, University of California, One Shields Ave., Davis, CA, 95616, USA.
| | - Malay K Mridha
- Center for Non-communicable Disease and Nutrition, James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Charles D Arnold
- Department of Nutrition, University of California, One Shields Ave., Davis, CA, 95616, USA
| | - Susana L Matias
- Department of Nutritional Sciences and Toxicology, University of California, 225 Morgan Hall, Berkeley, CA, 94720, USA
| | - Md Showkat A Khan
- Center for Non-communicable Disease and Nutrition, James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Zakia Siddiqui
- Health System and Population Studies Division, ICDDR,B, Dhaka, Bangladesh
| | - Mokbul Hossain
- Center for Non-communicable Disease and Nutrition, James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | | | - Kathryn G Dewey
- Department of Nutrition, University of California, One Shields Ave., Davis, CA, 95616, USA
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Abstract
This review summarizes the impact of parental age on children's health outcomes beyond the perinatal period. In the last decades, delayed parenthood with both men and women has become a public health issue. For women, in particular, the size of this delay is substantial. For a few medical conditions, older parental age has a pronounced effect on child morbidity. For most other outcomes, a more modest effect is evident. Although these effects might be limited on an individual level, they have a substantial impact at the level of population health.
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Affiliation(s)
- Christina Bergh
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Anja Pinborg
- Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ulla-Britt Wennerholm
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Sahlgrenska University Hospital East, Gothenburg, Sweden
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Luna-González DV, Sørensen M. Higher agrobiodiversity is associated with improved dietary diversity, but not child anthropometric status, of Mayan Achí people of Guatemala. Public Health Nutr 2018; 21:2128-41. [PMID: 29611490 DOI: 10.1017/S1368980018000617] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Child undernutrition remains one of the greatest challenges for public health nutrition in rural areas in developing countries. Interventions aiming to increase and conserve agrobiodiversity seem to be promising alternatives to improve child nutrition. However, the existing literature on these interventions is not conclusive about their effectiveness in combating child undernutrition. We tested the hypothesis that 'higher agrobiodiversity is associated with greater dietary diversity and better anthropometric status' in rural Guatemala.Design/Setting/SubjectsIn the summer of 2016, we conducted a cross-sectional study with a sample of 154 children (6-60 months). We conducted dietary recalls and structured interviews, measured children's weight and height, and visited food production systems (Milpas, home gardens, coffee plantations). Crop species richness, nutritional functional diversity, dietary diversity scores and anthropometric status were calculated. RESULTS Higher food self-sufficiency, nutritional functional diversity and dietary diversity scores were positively correlated with higher crop and animal species richness. Contrarily, remoteness to the local market was negatively correlated with dietary diversity scores. However, higher dietary diversity scores were not correlated with better child anthropometric status. Better child anthropometric status was positively correlated with improved sanitary conditions and maternal education; and negatively correlated with large household size and frequent child morbidity. CONCLUSIONS Agricultural diversification could diversify diets, increase nutrient availability and improve child anthropometry. However, these interventions need to be accompanied by sanitation improvements, family planning, nutritional education and women's empowerment to strengthen their positive effect on diet and nutrition.
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Kallioinen M, Ekström E, Khan AI, Lindström E, Persson LÅ, Rahman A, Selling KE. Prenatal early food and multiple micronutrient supplementation trial reduced infant mortality in Bangladesh, but did not influence morbidity. Acta Paediatr 2017; 106:1979-1986. [PMID: 28779492 DOI: 10.1111/apa.14009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 06/11/2017] [Accepted: 08/01/2017] [Indexed: 01/28/2023]
Abstract
AIM A previous maternal and infant nutrition intervention in rural Matlab, Bangladesh, showed that prenatal nutrient supplements improved child survival, but had no effect on size at birth. This secondary analysis examined whether prenatal multiple micronutrient supplements (MMS), on their own or combined with an early invitation to receive prenatal food supplements, affected child morbidity. METHODS This randomised trial enrolled 4436 pregnant women from November 2001 to October 2003 and allocated them to early or standard invitations to food supplements, in the ninth and 20th weeks of pregnancy, respectively, and supplements of either the standard 60 mg iron with 400 μg folic acid, 30 mg iron with 400 μg folic acid or MMS. Quasi-Poisson regression was used to analyse morbidity. RESULTS There were 3560 single live births and 3516 had morbidity data. The incidence rates of fever, diarrhoea and acute lower respiratory tract infection were 15.3, 3.6 and 2.3 episodes per person-year, respectively. The separate or combined interventions had no effect on morbidity up to 24 months. CONCLUSION Early invitations to prenatal food supplements or prenatal MMS had no effect on common infections in rural Bangladesh, suggesting that earlier findings on improved child survival were not mediated by an effect on child morbidity.
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Affiliation(s)
- Maija Kallioinen
- International Maternal and Child Health Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Eva‐Charlotte Ekström
- International Maternal and Child Health Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Ashraful Islam Khan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) Dhaka Bangladesh
| | - Emma Lindström
- International Maternal and Child Health Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Lars Åke Persson
- International Maternal and Child Health Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Anisur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) Dhaka Bangladesh
| | - Katarina Ekholm Selling
- International Maternal and Child Health Department of Women's and Children's Health Uppsala University Uppsala Sweden
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14
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Frankel H, Byberg S, Bjerregaard-Andersen M, Martins CL, Aaby P, Benn CS, Fisker AB. Different effects of BCG strains - A natural experiment evaluating the impact of the Danish and the Russian BCG strains on morbidity and scar formation in Guinea-Bissau. Vaccine 2016; 34:4586-4593. [PMID: 27491688 DOI: 10.1016/j.vaccine.2016.07.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Revised: 07/04/2016] [Accepted: 07/15/2016] [Indexed: 01/28/2023]
Abstract
BACKGROUND Different Bacillus Calmette-Guerin (BCG) vaccine strains may have different non-specific effects. We assessed the effect of two BCG strains (Danish and Russian) on childhood morbidity and BCG scarification in Guinea-Bissau. METHODS During 2011-2013, infants in the Bandim Health Project's urban study area received the Danish or Russian BCG in a natural experiment. Health center consultations were registered at point of care and scar status and size at age 4½ months. We assessed the effect of strain on consultation rates between vaccination and age 45days in Cox proportional hazards models. Scar prevalence and size were compared using binomial regression and ranksum tests. RESULTS Among 1206 children, 18% received Danish BCG (n=215) and 82% Russian BCG (n=991). The adjusted hazard ratio (aHR) for consultations was 0.94 (95% CI 0.60-1.46) for Danish BCG compared with Russian BCG. Girls vaccinated with Danish BCG tended to have lower consultation rates compared with girls vaccinated with Russian BCG (aHR 0.56 (0.25-1.24)), whereas the effect was opposite for boys (aHR 1.24 (0.74-2.11)), p=0.09. Children vaccinated with Danish BCG were more likely to develop a scar (97%) than children vaccinated with Russian BCG (87%), the relative risk (RR) being 1.11 (1.06-1.16). The effect was stronger in girls, and BCG scar size was larger among infants vaccinated with the Danish strain. CONCLUSION BCG strain influences scar prevalence and scar size, and may have sex differential effects on morbidity. BCG strains are currently used interchangeably, but BCG scarring has been linked to subsequent survival. Hence, more research into the health effects of different BCG strains is warranted. Small adjustments of BCG production could potentially lower childhood morbidity and mortality at low cost.
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Affiliation(s)
- H Frankel
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau; Research Center for Vitamins and Vaccines (CVIVA), Bandim Health Project Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark.
| | - S Byberg
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau; Research Center for Vitamins and Vaccines (CVIVA), Bandim Health Project Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark; OPEN, Odense Patient data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - M Bjerregaard-Andersen
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau; Research Center for Vitamins and Vaccines (CVIVA), Bandim Health Project Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark; Department of Endocrinology, Odense University Hospital, Odense, Denmark.
| | - C L Martins
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau.
| | - P Aaby
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau; Research Center for Vitamins and Vaccines (CVIVA), Bandim Health Project Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark.
| | - C S Benn
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau; Research Center for Vitamins and Vaccines (CVIVA), Bandim Health Project Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark; OPEN, Odense Patient data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - A B Fisker
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau; Research Center for Vitamins and Vaccines (CVIVA), Bandim Health Project Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark; OPEN, Odense Patient data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
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Riaz HF, Mannan S, Malik S. Consanguinity and its socio-biological parameters in Rahim Yar Khan District, Southern Punjab, Pakistan. J Health Popul Nutr 2016; 35:14. [PMID: 27206989 PMCID: PMC5026024 DOI: 10.1186/s41043-016-0049-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 04/12/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Rahim Yar Khan (RYK) District is a multi-ethnic assemblage of both ancient and migrated communities in Southern Punjab, Pakistan. There is a paucity of knowledge on the bio-demographic structure of this endogamous population. METHODS We have carried out a cross-sectional epidemiological study in RYK District and recruited 2174 random Muslim married females. Detailed account of marital union types, level of consanguinity, and subject's fertility, was taken. RESULTS The analyses of these data revealed that consanguineous unions (CU) were 58.46 %, rendering an inbreeding coefficient (IC-F) = 0.0355. The CU were observed to be significantly higher in subjects originating from rural areas, speaking Saraiki language, illiterate or having a religious/Madarsa education only, and belonging to nuclear family type. The rate of consanguinity was also higher in subjects whose husbands were engaged in unskilled manual or skilled manual jobs, and had consanguinity in the parental generation. Multivariate logistic regression analyses revealed that variables like Saraiki language, illiteracy, reciprocal marriages, and parental consanguinity, were the significant predictors of CU in the subject. Among the first cousin unions (which constituted 52 % of all marriages), parallel-cousin and patrilineal unions were in the majority (54 and 57 %, respectively), and father's brother's daughter type had the highest representation (31 %). The analyses further demonstrated that fertility and mean live-births were significantly higher in women who had CU compared to the non-consanguineous (NCU) group (p < 0.006); and significantly higher number of sons per women were born to the mothers who had CU compared with the NCU sample (p = 0.0002). However, there were no differences in the CU and NCU samples with respect to pre- or post-natal mortalities and child morbidities. CONCLUSIONS The scientific findings in RYK District are distinct from the observations in other Pakistani populations and clue to a unique nature of this population. This study presents a comprehensive account of consanguinity and IC-F in RYK District and would be helpful in getting an insight into the structure of this population.
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Affiliation(s)
- Hafiza Fizzah Riaz
- Department of Animal Sciences, Human Genetics Program, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, 45320, Pakistan
| | - Shaheen Mannan
- Department of Animal Sciences, Human Genetics Program, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, 45320, Pakistan
| | - Sajid Malik
- Department of Animal Sciences, Human Genetics Program, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, 45320, Pakistan.
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