scholarly journals Overweight and/or obesity and its determinants among under-five children in East African countries: A multilevel analysis using Bayesian approach

Heliyon ◽  
2021 ◽  
pp. e08643
Author(s):  
Sofonyas Abebaw Tiruneh ◽  
Alemayehu Digssie Gebremariam ◽  
Melaku Tadege Engidaw ◽  
Desalegn Tesfa Asnakew ◽  
Fentaw Teshome Dagnaw ◽  
...  
Keyword(s):  
Multilevel Analysis ◽  
Bayesian Approach ◽  
East African ◽  
African Countries ◽  
Under Five ◽  
Under Five Children

scholarly journals Pooled prevalence and associated factors of chronic undernutrition among under-five children in East Africa: A multilevel analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248637
Author(s):  
Getayeneh Antehunegn Tesema ◽  
Yigizie Yeshaw ◽  
Misganaw Gebrie Worku ◽  
Zemenu Tadesse Tessema ◽  
Achamyeleh Birhanu Teshale
Keyword(s):  
East Africa ◽  
Pooled Analysis ◽  
East African ◽  
African Countries ◽  
Mixed Effect ◽  
Under Five ◽  
Under Five Children ◽  
Pooled Prevalence ◽  
Chronic Undernutrition ◽  
Size At Birth

Background Childhood undernutrition is the leading cause of under-five mortality and morbidity in the world particularly in East African countries. Although there are studies on child undernutrition in different East African countries, our search of the literature revealed that there is limited evidence of a pooled analysis of these studies. Therefore, this study aimed to investigate the pooled prevalence and associated factors of chronic undernutrition (i.e. stunting) among under-five children in East Africa. Methods A pooled analysis of the Demographic and Health Surveys (DHSs) in 12 East African countries was conducted. A total weighted sample of 79744 under-five children was included in the study. Mixed-effect logistic regression analysis was used to identify significant factors associated with chronic undernutrition since the DHS data has a hierarchical structure. The intra-class correlation coefficient (ICC), Median Odds Ratio (MOR), Likelihood Ratio (LR)-test, and deviance was used for model comparison. Variables with p-value <0.2 in the bivariable mixed-effect logistic regression analysis were considered for the multivariable analysis. In the multivariable multilevel analysis model, the Adjusted Odds Ratio (AOR) with the 95% Confidence Interval (CI) were reported for significant factors. Results The pooled prevalence of chronic undernutrition among underfive children in East Africa was 33.3% (95% CI: 32.9%, 35.6%) ranging from 21.9% in Kenya to 53% in Burundi. Children whose mothers lived in rural area (AOR = 1.11, 95% CI: 1.06, 1.16), born to mother who had no formal education (AOR = 1.42, 95% CI: 1.34, 1.50) and primary education (AOR = 1.37, 95% CI: 1.31, 1.44), being in poor household (AOR = 1.66, 95% CI: 1.58, 1.74), and middle household (AOR = 1.42, 95% CI: 1.35, 1.49), child aged 36–48 months (AOR = 1.09, 95% CI: 1.04, 1.14), being male (AOR = 1.19, 95% CI: 1.15, 1.23), 2nd - 4th birth order (AOR = 1.08, 95% CI: 1.03, 1.13), and above 4th 1.27 (AOR = 1.27, 95% CI: 1.19, 1.35), home delivery 1.09 (AOR = 1.09, 95% CI: 1.05, 1.13), small size at birth (AOR = 1.35, 95% CI: 1.29, 1.40) and being multiple births (AOR = 1.98, 95% CI: 1.81, 2.17) were associated with increased odds of stunting. While, antenatal care visit (AOR = 0.89, 95% CI: 0.86, 0.93), mothers aged 25–34 (AOR = 0.83, 95% CI: 0.79, 0.86) and ≥ 35 years (AOR = 0.76, 95% CI: 0.72, 0.81), large size at birth (AOR = 0.85, 95% CI: 0.81, 0.88), and family size >8 (AOR = 0.92, 95% CI: 0.87, 0.98) were associated with decreased odds of stunting. Conclusion The study revealed that stunting among under-five children remains a major public health problem in East Africa. Therefore, to improve child nutrition status the governmental and non-governmental organizations should design public health interventions targeting rural residents, and the poorest households. Furthermore, enhancing health facility delivery, ANC visit, and maternal health education is vital for reducing child chronic undernutrition.

scholarly journals Trends and Determinants of Diarrhea Among Under-Five Children in Ethiopia: Cross-Sectional Study Design: Multivariate Decomposition and Multilevel Analysis Based on Bayesian Approach Evidenced by EDHS 2000-2016 Data.

2020 ◽  
Author(s):  
Yilkal Negesse ◽  
Asefa Adimasu ◽  
Ayenew Negesse ◽  
Tadesse Awoke
Keyword(s):  
Health Insurance ◽  
Multilevel Analysis ◽  
Health Facility ◽  
Bayesian Approach ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Wealth Status ◽  
Cross Sectional ◽  
Under Five ◽  
Under Five Children

Abstract Background: Despite significant progress in the reduction of under-five child deaths over the last decades in Ethiopia, still diarrhea remains the second cause of morbidity and mortality among under five children next to pneumonia. Objective: To show trends and determinants of diarrhea among under five children in Ethiopia based on the four Ethiopian Demographic and health surveys data (2000- 2016).Methods: Community-based cross-sectional study design was used. A total of 10753 in 2000, 10039 in 2005, 10946 in 2011 and 10337 in 2016 under five age children were involved. Multivariate decomposition and multilevel analysis based on Bayesian approach was performed.Results: Ninety seven percent of the change in diarrhea prevalence over time was attributable to difference in behavior. Being twin (AOR=1.3; 95% CrI 1.1-1.5), big weight (AOR=1.63; 95 % CrI 1.62–2.02), not vaccinated for rotavirus (AOR= 1.44; 95 % CrI 1.12–1.9) and for measles (AOR= 1.2; 95 % CrI 1.1–1.33), poor wealth status (AOR 2.6; 95 % CrI 1.7–4.06), having more than three under-five children(AOR 1.3; 95 % CrI 1.1–1.61), member of health insurance(AOR 2.2; 95 % CrI 1.3–3.8) and long distance from the health facility (AOR 2.7; 95 % CrI 2.2–3.5) were more likely to experience diarrhea. Conclusion: The prevalence of diarrhea was significantly declined over the last sixteen years and the decline was due to difference in coefficients between the surveys. Being twin , weight of child at birth, vaccinated for measles and rotavirus, number of under-five children, wealth status, distance to health facility, health insurance and child waste disposal method were significantly associated with diarrhea among under five children in Ethiopia. Therefore Ethiopian government should primarily focus on the strengthening and scaling up of behavioral change packages to prevent diarrheal disease.

scholarly journals Zinc utilization and associated factors among under-five children with diarrhea in East Africa: A generalized linear mixed modeling

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243245
Author(s):  
Yigizie Yeshaw ◽  
Misganaw Gebrie Worku ◽  
Zemenu Tadesse Tessema ◽  
Achamyeleh Birhanu Teshale ◽  
Getayeneh Antehunegn Tesema
Keyword(s):  
East Africa ◽  
Associated Factors ◽  
Maternal Education ◽  
Media Exposure ◽  
Wealth Index ◽  
East African ◽  
African Countries ◽  
Under Five ◽  
Under Five Children ◽  
Zinc Utilization

Introduction Diarrhea is the leading cause of illness and death among under-five children in low and middle income countries. Through the provision of zinc supplements has been shown to reduce the severity and duration of diarrhea, as well as the risk of mortality, the use of zinc for the treatment of diarrhea is still very low in low-income countries. Therefore, this study was conducted to determine the prevalence and associated factors of zinc utilization among under-five children with diarrhea in East Africa. Methods A secondary data analysis of the recent Demographic and Health Surveys (DHS) of East African countries were used to determine the prevalence and associated factors of zinc utilization among under-five children with diarrhea in East Africa. A total weighted samples of 16,875 under-five children with diarrhea were included in the study. A generalized linear mixed model (using Poisson regression with robust error variance) was used. Prevalence Ratios (PR) with their 95% confidence interval (CI) were calculated for those variables included in the final model. Results The overall prevalence of zinc utilization among under-five children with diarrhea in this study was 21.54% (95% CI = 20.92–22.16). Of East African countries, Uganda had the highest prevalence of zinc utilization (40.51%) whereas Comoros had the lowest (0.44%). Maternal primary education (Adjusted Prevalence Ratio(aPR) = 1.29, 95% CI: 1.16–1.44), secondary education (aPR = 1.36, 95% CI = 1.19–1.55) and higher education (aPR = 1.91, 95% CI = 1.52–2.40), high community women education (aPR = 1.12, 95% CI = 1.02–1.24), high wealth index (aPR = 1.12, 95% CI = 1.01–1.24), high community media exposure (aPR = 1.17, 95% CI = 1.06–1.29) were associated with a higher prevalence of zinc utilization. Conclusion The prevalence of zinc utilization among under-five children was found to be low in East Africa. Maternal education, wealth index, community women education, and community media exposure were significantly associated with zinc utilization. Increased mass media exposure, maternal education and wealth index is recommended to improve zinc utilization among under-five children with diarrhea.

scholarly journals Trends and determinants of diarrhea among under-five children in Ethiopia: cross-sectional study: multivariate decomposition and multilevel analysis based on Bayesian approach evidenced by EDHS 2000–2016 data

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yilkal Negesse ◽  
Asefa Adimasu Taddese ◽  
Ayenew Negesse ◽  
Tadesse Awoke Ayele
Keyword(s):  
Health Insurance ◽  
Multilevel Analysis ◽  
Health Facility ◽  
Bayesian Approach ◽  
Diarrheal Disease ◽  
Demographic And Health Surveys ◽  
Wealth Status ◽  
Long Distance ◽  
Under Five ◽  
Under Five Children

Abstract Background Despite significant progress in the reduction of under-five child deaths over the last decades in Ethiopia, still diarrhea remains the second cause of morbidity and mortality among under five children next to pneumonia. Objective To show trends and determinants of diarrhea among under five children in Ethiopia based on the four Ethiopian Demographic and health surveys data (2000–2016). Methods A total of 10,753 in 2000, 10,039 in 2005, 10,946 in 2011 and 10,337 in 2016 under five age children were involved in this study. Multivariate decomposition and multilevel analysis based on Bayesian approach was performed. Results Ninety seven percent of the change in diarrhea prevalence over time was attributable to difference in behavior. Being twin (AOR = 1.3; 95% CrI 1.1–1.5), big weight (AOR = 1.63; 95% CrI 1.62–2.02), not vaccinated for rotavirus (AOR = 1.44; 95% CrI 1.12–1.9) and for measles (AOR = 1.2; 95% CrI 1.1–1.33), poor wealth status (AOR 2.6; 95% CrI 1.7–4.06), having more than three under-five children (AOR 1.3; 95% CrI 1.1–1.61), member of health insurance (AOR 2.2; 95% CrI 1.3–3.8) and long distance from the health facility (AOR 2.7; 95% CrI 2.2–3.5) were more likely to experience diarrhea. Conclusion The prevalence of diarrhea was significantly declined over the last sixteen years and the decline was due to difference in behavior between the surveys. Being twin, weight of child at birth, vaccinated for measles and rotavirus, number of under-five children, wealth status, distance to health facility, health insurance and child waste disposal method were significantly associated with diarrhea among under five children in Ethiopia. Therefore Ethiopian government should focus on the strengthening and scaling up of behavioral change packages of the community regarding to keeping hygiene and sanitation of the community and their environment, vaccinating their children, accessing health care services to prevent diarrheal disease.

scholarly journals Complete basic childhood vaccination and associated factors among children aged 12–23 months in East Africa: a multilevel analysis of recent demographic and health surveys

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Getayeneh Antehunegn Tesema ◽  
Zemenu Tadesse Tessema ◽  
Koku Sisay Tamirat ◽  
Achamyeleh Birhanu Teshale
Keyword(s):  
East Africa ◽  
Multilevel Analysis ◽  
Birth Interval ◽  
Associated Factors ◽  
Wealth Index ◽  
Childhood Vaccination ◽  
Demographic And Health Surveys ◽  
East African ◽  
African Countries ◽  
Vaccine Preventable Diseases

Abstract Background Complete childhood vaccination remains poor in Sub-Saharan Africa, despite major improvement in childhood vaccination coverage worldwide. Globally, an estimated 2.5 million children die annually from vaccine-preventable diseases. While studies are being conducted in different East African countries, there is limited evidence of complete basic childhood vaccinations and associated factors in East Africa among children aged 12–23 months. Therefore, this study aimed to investigate complete basic childhood vaccinations and associated factors among children aged 12–23 months in East Africa. Methods Based on the Demographic and Health Surveys (DHSs) of 12 East African countries (Burundi, Ethiopia, Comoros, Uganda, Rwanda, Tanzania, Mozambique, Madagascar, Zimbabwe, Kenya, Zambia, and Malawi), secondary data analysis was performed. The study included a total weighted sample of 18,811 children aged 12–23 months. The basic childhood vaccination coverage was presented using a bar graph. Multilevel binary logistic regression analysis was fitted for identifying significantly associated factors because the DHS has a hierarchical nature. The Intra-class Correlation Coefficient (ICC), Median Odds Ratio (MOR), Proportional Change in Variance (PCV), and deviance (−2LLR) were used for checking model fitness, and for model comparison. Variable with p-value ≤0.2 in the bi-variable multilevel analysis were considered for the multivariable analysis. In the multivariable multilevel analysis, the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were reported to declare the significance and strength of association with full vaccination. Results Complete basic childhood vaccination in East Africa was 69.21% (95% CI, 69.20, 69.21%). In the multivariable multilevel analysis; Mothers aged 25–34 years (AOR = 1.21, 95% CI: 1.10, 1.32), mothers aged 35 years and above (AOR = 1.50, 95% CI: 1.31, 1.71), maternal primary education (AOR = 1.26, 95% CI: 1.15, 1.38), maternal secondary education and above (AOR = 1.54, 95% CI: 1.36, 1.75), husband primary education (AOR = 1.25, 95% CI: 1.13, 1.39), husband secondary education and above (AOR = 1.24, 95% CI: 1.11, 1.40), media exposure (AOR = 1.23, 95% CI: 1.13, 1.33), birth interval of 24–48 months (AOR = 1.28, 95% CI: 1.15, 1.42), birth interval greater than 48 months (AOR = 1.35, 95% CI: 1.21, 1.50), having 1–3 ANC visit (AOR = 3.24, 95% CI: 2.78, 3.77), four and above ANC visit (AOR = 3.68, 95% CI: 3.17, 4.28), PNC visit (AOR = 1.34, 95% CI: 1.23, 1.47), health facility delivery (AOR = 1.48, 95% CI: 1.35, 1.62), large size at birth 1.09 (AOR = 1.09, 95% CI: 1.01, 1.19), being 4–6 births (AOR = 0.83, 95% CI: 0.75, 0.91), being above the sixth birth (AOR = 0.60, 95% CI: 0.52, 0.70), middle wealth index (AOR = 1.16, 95% CI: 1.06, 1.28), rich wealth index (AOR = 1.20, 95% CI: 1.09, 1.33), community poverty (AOR = 1.21, 95% CI: 1.11, 1.32) and country were significantly associated with complete childhood vaccination. Conclusions In East Africa, full basic childhood vaccine coverage remains a major public health concern with substantial differences across countries. Complete basic childhood vaccination was significantly associated with maternal age, maternal education, husband education, media exposure, preceding birth interval, number of ANC visits, PNC visits, place of delivery, child-size at birth, parity, wealth index, country, and community poverty. Public health interventions should therefore target children born to uneducated mothers and fathers, poor families, and those who have not used maternal health services to enhance full childhood vaccination to reduce the incidence of child mortality from vaccine-preventable diseases.

scholarly journals Spatial Distribution and Modeling of malnutrition among under-five Children in Ethiopia

2020 ◽  
Author(s):  
Reta Lemessa ◽  
Ararso Tafese ◽  
Gudeta Aga
Keyword(s):  
Socioeconomic Factors ◽  
Multilevel Model ◽  
Health Workers ◽  
National Level ◽  
Spatial Variations ◽  
P Value ◽  
African Countries ◽  
Under Five ◽  
Under Five Children ◽  
Regional Clusters

Abstract Background Majority of this world is concerned by malnutrition. Ethiopia is one of the Sub Saharan African countries known by poverty, childhood diseases, high mortality and poor infrastructures and technology. The study aimed to examine differences within individuals and between clusters in nutritional status of under-five children and to identify socioeconomic factors using adequate nutrition of children in Ethiopia. Method: Data was obtained from Ethiopian 2019 Mini Demographic and Health Survey surveyed by Ethiopian Public Health Institute. A weighted sub- sample of 8768 under-five children was drawn from the dataset. Spatial statistics was used to analysis spatial variations of malnutrition of children in clusters of regional areas of Ethiopia. Multilevel modeling was used to look at demographic, socioeconomic factors at individuals and clusters levels. Result At national level the proportion of stunting, underweight and wasting among under-five children were 39.5 percent, 29.8 percent and 15.4 percent respectively. The Global Moran Index’s value for children malnutrition result in Ethiopia was (for stunting I = 0.204, P-value = < 0.0001, for underweight I = 0.195, P-value = < 0.0001 and for wasting I = 0.152, P-value = < 0.0001). Spatial variability of malnutrition of under-five children across the clusters of Ethiopia observed. Result of heterogeneity between clusters obtained was {X}^{2}=147.25, {X}^{2}=211.43 and {X}^{2}=201.43 respectively for stunting, underweight and wasting with P = < 0.0001 providing evidences of variation among regional clusters with respect to the status of nutrition of under-five children. Multilevel model result revealed that high differences of malnutrition in individual households and regional clusters in the under-five children in Ethiopia. Conclusion The model showed that there were spatial variations in malnutrition among clusters in Ethiopia. Child age in month, breast feeding, family educational level, wealth index, place of residence, media access and region were highly significantly associated with childhood malnutrition. Inclusion of explanatory variables in multilevel model has shown that a significant impact on variation in malnutrition among individual households and regional clusters. Accessible resources, promoting education, use media to expand activities regarding nutritional and health services and through health workers and health institutions in Ethiopia is significant.

scholarly journals Prevalence of diarrhoea and associated risk factors among children under five years old in Pader district, Northern Uganda

2019 ◽  
Author(s):  
Stephen Omona ◽  
Geoffrey Maxwell Malinga ◽  
Robert Opoke ◽  
Geoffrey Openy ◽  
Robert Opiro
Keyword(s):  
Risk Factors ◽  
Family Size ◽  
Sub Saharan Africa ◽  
Rural Setting ◽  
Northern Uganda ◽  
African Countries ◽  
Under Five ◽  
Childhood Diarrhoea ◽  
Under Five Children ◽  
Pader District

Abstract Background : Diarrhoea remains a major cause of morbidity and mortality in under-five children in sub-Saharan Africa. Of the three East African countries, Uganda has the worst mortality rate in children < 5 years, with 22% of these deaths attributed to diarrhoea. For proper planning and implementation of control, an understanding of the prevalence and determinants of the disease is crucial. This study assessed the prevalence of diarrhoea and related risk factors among children < 5 years in Pajule sub-county, Pader district in northern Uganda. Methods : A cross-sectional survey was conducted in April 2018, covering 244 randomly selected households having children < 5 years old in the study area. A semi-structured questionnaire was used to interview the households about diarrhoeal history in their children in the last two weeks preceding the survey, and on the risk factors predisposing children to diarrhoeal infections. Bivariate and multivariate logistic regression analyses with a 95% confidence interval and p < 0.05 was used to identify the risk factors associated with childhood diarrhoeal disease. Results : We found a prevalence of diarrhoea of 29.1% [95% CI (23.7–35.0)] among under-five children in Pajule sub-county during the two weeks preceding the survey. Use of unprotected water source, age of child caretaker, child weaning time and family size had significant associations with diarrheal morbidity. Conclusion : The prevalence of childhood diarrhoea among children < 5 years of age in a rural setting of Pajule sub-county was higher than the Ugandan national average. Use of unprotected water sources, age of child caretaker, child weaning time and family size were identified as predictors of diarrhoeal occurrence. These findings underscore the need for improving access to clean water and providing community health education as the best methods for fighting childhood diarrhoea in the study area.

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