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Dec 2018 DOI 10.14302/issn.2641-4538.jphi-18-2470
Takele Melku AbulieCorresponding author
Madda Walabu University Goba Referral Hospital School of Health Science Department of Nursing, Assistant Professor (PhD).
Background: Acute diarrheal diseases are the leading cause of preventable childhood death, especially in developing countries. It is the second leading cause of death in under-five year children nest to pneumonia. Objectives: The aim of this study was to determine the magnitude and associated factors of diarrhea in under-five in Harena Buluk district. Methods: A community based Cross sectional study was conducted in February, 2018. A two stage stratified sampling method was done to select the eligible households. Data was collected by trained data collectors using pretested questionnaire list which was prepared based on EDHS and WHO core questionnaires related to diarrhea. Data was entered in to a computer using Epi data 3.1 and exported to SPSS V.20 for further analysis. Logistic regression was used to determine level of association with 95% CI. A p-value <0.05 in the final model were considered as significant. Result: The two weeks period magnitude of diarrhea among under-five children was 28.4% with 95% CI (14.5-20.8) which was associated with households with one under five children (AOR: 0.268, 95% CI(.08,0.90)), living in the home with single room ((AOR = 6.01, 95% CI(1.01,36.01)), clean latrine/faces not seen around the pit or on the floor of latrine(AOR: 0.298, 95% CI(0.097,0.92)), long time take to fetch water from source (AOR: 0.046,95%CI(0.01,0.22)), home based water treatment ((AOR = 0.15, 95% CI: (0.04, 0.62)), living with animal in the same house(AOR: 8.31, 95% CI(2.46,28.06)), children who took gruel type of food(AOR: 0.24, 95% CI(0.07,0.81)), hand washing practice before cooking food (AOR: 0.195(0.066, 0.574)). Conclusion: The two weeks period magnitude of acute under-five diarrhea was relatively high and number of under five children in the household, cleanness latrine, time taking from the source of water, home based water treatment, number of rooms in the home, live with animal in the same house, type of food child take, hand washing before food preparation had significant association with the occurrence of under-five diarrhea. Improve community about home and environmental sanitation and hand practices were recommended.
Sep 2017 DOI 10.14302/issn.2474-3585.jpmc-17-1739
Tarkang ElvisCorresponding author
Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
Background: The use of Long Lasting Insecticide Nets (LLINs) is seen as a major public health intervention and has shown to have both direct and indirect effects on the dynamics of malaria transmission. This report assessed the methods used by mothers to prevent malaria infection among their children under five years in the Hohoe Municipality. Method: A cross-sectional survey carried out in February 2017 among 418 mothers with children under five. Data were collected in the form of interviews using questionnaires on the usage of LLIN alone, LLIN with other methods (LLIN+) and use of other methods only (OMs). Chi square test and multinomial logistic regression were used to determine the association between dependent and independent variables. Results: Of the 418 mothers, 28.5% used LLIN only, 50.7% used LLIN+ and 20.8% used OMs only to prevent malaria. Mothers aged 30-39 and 40-49 years were 3.87 and 5.55 times more likely to use LLIN only rather than OMs as compared to those aged less than 20 years (AOR=3.87, p=0.019) and (AOR=5.55, p=0.029) respectively. Similarly, mothers aged 30-39 and 40-49 years were 3.08 and 4.02 times more likely to use LLIN+ rather than OMs as compared to those aged less than 20 years (AOR=3.08, p=0.023) and (AOR=4.02, p=0.050) respectively. Mothers who attained a higher level of education were 2.08 times more likely to use LLIN+ rather than OMs as compared to those with no formal education (AOR=2.08, p=0.015). Those who resided in rural areas were 2.00 times more likely to use LLIN only and LLIN+ rather than OMs only as compared to urban dwellers (AOR=2.00, p=0.002) and (AOR=2.00, p=0.013) respectively. Conclusion: More than half of the mothers preferred using LLIN+. One out of 3 mothers used only LLIN while one out of 5 used OMs only to prevent malaria. Age, educational level and place of residence were significantly associated with methods used to prevent malaria. There is the need for targeted education on LLINs in order to improve usage among younger mothers and mothers residing in urban areas. Further investigations to determine reasons for using OMs only and also determine the added value of OMs to LLINs in preventing malaria are recommended.
Nov 2025 DOI 10.14302/issn.2379-7835.ijn-24-5360
Alam RashedCorresponding author
Background Malnutrition is a significant public health issue in Bangladesh, particularly impacting women and children. Rajshahi, marked by socio-economic disparities, offers a distinctive context to explore the nutritional status and health outcomes of these vulnerable groups. Objectives This study aims to assess the nutritional status of women and children in Rajshahi and investigate associated health outcomes. Additionally, it seeks to identify socio-economic and cultural factors that influence nutrition. Methods A mixed-methods approach was utilized, incorporating a cross-sectional survey of 460 households and in-depth interviews with mothers and caregivers. Anthropometric measurements were taken to evaluate the nutritional status of women and children, while dietary assessments measured nutrient intake and diversity. Logistic regression analysis was performed to determine the likelihood of malnutrition based on socio-economic characteristics, thereby identifying key risk factors. Results The findings indicate a troubling prevalence of malnutrition, with 36% of children under five classified as stunted and 25% as underweight. The analysis highlights critical factors contributing to chronic undernutrition, including maternal education, employment, and dietary diversity. Notably, mothers aged 27-37 exhibit a lower risk of undernutrition, and urban households with secure food access demonstrate better nutritional outcomes. Discussion Maternal education and employment were positively associated with better nutritional outcomes, as educated and employed mothers had higher chances of maintaining a normal BMI. Regular ANC visits (≥4 visits) were crucial for improved maternal nutrition. Household food security emerged as a significant determinant, with food-secure households showing better maternal nutritional status. Safe water access and adequate dietary diversity were also linked to improved maternal BMI. Additionally, factors such as child birth weight, exclusive breastfeeding, and childhood diarrhea significantly influenced maternal nutrition. Moreover, frequent antenatal care visits and a diverse diet are vital in mitigating undernutrition risks among children. Conclusion This study emphasizes the urgent need for targeted interventions to combat malnutrition in Rajshahi. Recommendations include implementing community-based nutrition education programs and improving access to healthcare services. By addressing the socio-economic and cultural determinants of nutrition, stakeholders can enhance health outcomes for women and children in the region, ultimately contributing to broader public health objectives in Bangladesh.
Mar 2023 DOI 10.14302/issn.2379-7835.ijn-22-4116
Shuja SabaCorresponding author
Background In Low Middle-Income Countries (LIMCs), malnutrition, especially undernutrition is one of the leading causes of childhood mortality and morbidity. Poor complementary feeding practices are among the most notable contributors to poor nutritional indicators in children under five. This article provides an output of secondary data analysis of the Cost of Diet (CoD) and Optifood component of National Complementary Feeding Assessment conducted by UNICEF Pakistan along with Pakistan Demographic Health Survey (PDHS) 2018. Methods For correlation of Optifood data and CoD data with PDHS data of CF, GraphPad software, MS Excel was used along with manual quantifications. The analysis of DHS-2018 data was conducted using STATA software. Univariate analysis included comparison of categorical variables i.e. various individual, household and community level parameters with that of outcome variables of minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum dietary diversity (MAD) using chi-square test. Findings The overall rate of MMF was 56.6% among children of 6-23 months of age with MDD in 18.6% and MAD in 13.8% of children. Percentage of annual cost spent on nutritious diet for MDD, MMF and MAD varies from 27.86% to 43.08% across all the provinces. Children aged 6–8 months and 9–11 months often consumed infant milk and cereals, while children aged 12–23 months often consumed eggs and grain products. Consumption of dairy products was highest in Punjab, Sindh, AJK, and Islamabad, that of grains roots and tubers was highest in KPK, FATA and GB. Conclusion Considering CF practices in Pakistan are inadequate as indicated by poor MDD, MMF, and MAD, therefore it is imperative that a holistic approach using both communication and non-communication based interventions is to be employed through active stakeholder engagement.
Aug 2020 DOI 10.14302/issn.2641-4538.jphi-20-3437
Rutayisire ErigeneCorresponding author
Department of public Health, Mount Kenya University Rwanda Kigali Rwanda
Acute malnutrition affects nearly 52 million of under five years children globally, 75% of them live in low to middle income countries. The treatment of acute malnutrition using supplement foods could help children recovering and could reduce the risk of sickness. The present study investigated the factors associated with recovery among children with moderate acute malnutrition (MAM) under a follow-up program at health facilities. A prospective study was conducted in 16 health centers of Kirehe District of Rwanda and included 200 children from 6 to 59 months. A semi-structured questionnaire was used for data collection. All children enrolled in the study spent three months in nutrition program at health centers. The results show that after 3 months in the program 77.5% recovered from MAM. Children aged above 36 to 59 months were recovered at 90% whereas children aged from 24-35 months were recovered at 73.5%. Micronutrients and deworming provided at health facility were contributed to the recovery as children who received them were recovered at 89.1% and for those who didn’t were recovery at 72.1%. The findings demonstrated that boys were 16 times more likely to recover from MAM in three months of intervention than girls (AOR=16.19, p<0.001, 95% CI: 5.39- 48.63). Children from moderate income families were 3 more likely to recover than those from very low income families (AOR=2.8, p=0.029, 95% CI: 1.11-7.51). Male gender, receiving micronutrients and deworming from health facilities and family income status were factors associated with MAM recovery status
Jul 2017 DOI 10.14302/issn.2379-7835.ijn-17-1607
PhadkeMCorresponding author
Senior Advisor, Govt;
Background Severe acute malnutrition (SAM) is rampant in the children of hilly and inaccessible tribal region of Nandurbar, Maharashtra in India. It is estimated that nearly 5% of the children under five years have SAM. Objectives To assess the therapeutic efficacy of 3 types of nutrition protocols administered largely at home in SAM children from Nandurbar, Maharashtra. Methodology This study is a part of a larger three arm open label trial using 3 therapeutic feeds i.e. C-RUTF (Centrally produced ready to use therapeutic food), L-RUTF (locally prepared ready to use therapeutic food) and ARF (locally prepared amylase rich food) in children of SAM who attended the health facility and completed the treatment protocols for 8 weeks (All ‘per protocol patients’) and were between 1 to 3 years of age. The larger study included children aged 6 months to 59 months who were given same therapeutic feeding protocol. Findings A total of 450 SAM babies between 12-36 months. attended the outpatient therapeutic program during the period of July 2014 to December 2015 and completed the given protocol of therapeutic feeding program. 242(53.7%) were males and 208(46.2%) females. Out of these, 150 received C-RUTF, 150 received L-RUTF and 150 received ARF. Out of C-RUTF group 83(55.3%) recovered, in L-RUTF 70(46.7%) recovered and from ARF group 69(46.0%) recovered. The difference was statistically significant.(p=0.03) Total recovery rate was 49.3% in comparison to another under publication study by our group on 3418 children aged 6 months to 59 months, where recovery was 36.8%. Average weight gain per day was 3.54 ± 2.36 g/kg/day, 2.61 ± 2.12 g/kg/day, 2.60 ± 1.50 g/kg/day in the 3 arms respectively. Conclusion This study proves that domiciliary treatment with 3 types of therapeutic feeds gives recovery rate of 49.3%, there by meaning that SAM Children without complications can be treated at home with visit to health facility once a week. Of all the therapeutic feeding protocols C-RUTF had best recovery rates (55.3%) compared to others, the difference being statistically significant. Average weight gain per kg per day inC-RUTF group was 35.8 % higher than the other 2 groups.
Feb 2016 DOI 10.14302/issn.2379-7835.ijn-16-924
Arlappa NimmathotaCorresponding author
Division of Community Studies, National Institute of Nutrition (NIN), Hyderabad, Telangana, India.
Objectives: Vitamin A deficiency (VAD) among the rural pre-school children in India is continues to be a major nutritional problem of public health significance, even after the implementation of national vitamin A prophylaxis programme for more than four decades. The aim of the study was to assess the prevalence of vitamin A deficiency among rural pre-school children of South India. Methodology: A community based cross-section study; adopting multi-stage random sampling procedure was carried out by the National Nutrition Monitoring Bureau (NNMB) among rural pre-school children of four South Indian states viz. Kerala, Tamil Nadu, Andhra Pradesh and Karnataka during 2003-05. A total of 35,480 (Boys: 18,216; Girls: 17,264) rural children of 1-5 year age group was covered for this study. Key Results: The prevalence of Bitot’s spot, an objective ocular sign of VAD among the rural pre-school children of South Indian was 0.6% (95%CI:0.5-0.7). Similarly, the proportion of children with sub-clinical VAD was 59.3%, suggestive of a severe public health problem. In general, the prevalence of VAD was significantly higher (p<0.001) among the children of socio-economically marginalized sections of the communities, labourers, illiterate mothers and those residing in the households with no sanitary latrine. Conclusion: The prevalence of clinical and sub-clinical VAD among the rural pre-school children of south India is suggestive of a public health concern. Therefore, rural communities are encouraged to consume diets rich in pre-formed and pro-vitamin A and administer periodic massive dose vitamin A solution to the children of under five for the prevention and control of VAD.
Dec 2015 DOI 10.14302/issn.2470-0436.jos-15-818
Arlappa NimmathotaCorresponding author
National Institute of Nutrition (Indian Council of Medical Research), Hyderabad, India.
Purpose: Vitamin A deficiency (VAD) is still a major nutritional problem of public health importance among the rural pre-school children in India, even after the implementation national vitamin A prophylaxis programme for prevention of nutritional blindness and ICDS have been in operation for more than three decades. The purpose of this communication is to assess the prevalence of ocular manifestations of vitamin A deficiency among rural pre-school children of north India. Methods: A community based cross-section study; adopting multi-stage random sampling procedure was carried out by NNMB among rural pre-school children of four north Indian states viz. Maharashtra, Madhya Pradesh, Orissa and West Bengal. A total of 36,111 rural pre-school children of 1-5years (Boys: 18408; Girls: 17703) were covered for this study. Results: The prevalence of conjunctival xerosis (2.5%), the first ocular sign of VAD and Bitot’s spot (0.9%), an objective ocular sign of VAD was higher than the cut-off values suggestive of public health nutritional problem among the rural children. While, the prevalence of night blindness, the first symptom VAD was reported among 0.5% of rural children. Similarly, the proportion of rural pre-school children with sub-clinical VAD was 64%, suggestive of severe public health importance. Conclusion: The prevalence of ocular manifestation and sub-clinical vitamin A deficiency was high among the rural children of north India. Therefore, rural communities are encouraged to consume diets rich in vitamin A and administer massive dose vitamin A solution to the children of under five for the prevention and control of vitamin A deficiency and its adverse impact on child morbidity and mortality.