scholarly journals Examining the Role of Health Facilities in Supporting Iron Folic Acid Supplementation Adherence Among Women in Malawi (OR25-03-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Rukundo Benedict ◽  
Wenjuan Wang ◽  
Lindsay Mallick
Keyword(s):  
Folic Acid ◽  
Side Effects ◽  
Rural Areas ◽  
Urban Areas ◽  
Public Health Problem ◽  
Health Facilities ◽  
Health System Strengthening ◽  
Gps Data ◽  
Major Public Health Problem ◽  
Iron Folic Acid

Abstract Objectives Maternal anemia is a major public health problem in many low and middle income countries. In Malawi, consumption of iron folic acid supplements (IFA) has remained low and unchanged since 2004, even with the support of national policy and programs. To understand program implementation challenges, our study examined the relationship between the IFA-related health service environment (HSE) during antenatal care (ANC) and women's adherence to IFA supplementation guidelines. Methods Data from the 2015–16 Malawi Demographic and Health Survey (DHS) and the 2013–14 Malawi Service Provision Assessment (SPA), both of which collect GPS data of clusters or health facilities, were used. Each DHS cluster was linked to SPA facilities within a specified buffer distance (5 km for urban and 10 km for rural) using GPS data. IFA-related HSE was defined as availability of IFA, observed prescription of IFA, and observed counseling on IFA in health facilities within the buffer. The HSE variables were aggregated to the cluster-level and classified as low, medium, or high. Multilevel logistic regressions, stratified by urban and rural locale, were used to model associations between consumption of IFA and HSE variables controlling for individual-level factors. Results In Malawi 44% of women in urban and 32% in rural areas reported IFA consumption for at least 90 days during their most recent pregnancy. IFA supplements were available in the majority of health facilities (94%) providing ANC. Among clients, 85% received IFA or were given a prescription, 59% were counseled on how to use IFA, and 3% were counseled on side effects. In rural areas, regression models showed that high levels of IFA availability in facilities (OR = 2.07; 95% CI: 1.13–3.80) and IFA counseling (OR = 1.42; 95% CI: 1.12–1.78) were associated with IFA consumption. No associations with any HSE variables were observed in urban areas. Conclusions Despite widespread availability and prescription of IFA supplements from health facilities, receipt of counseling was low, particularly for side effects. Findings in rural areas reinforce the importance of health system strengthening to ensure IFA availability and counseling to support IFA consumption during pregnancy. Further research is warranted to investigate factors that affect IFA consumption in urban areas. Funding Sources United States Agency for International Development (USAID) through the DHS Program (7200AA18C00083).

scholarly journals The Role of Health Facilities in Supporting Adherence to Iron-folic Acid in Haiti and Malawi: A Study Linking Health Facility Survey and Population Survey Data

2020 ◽  
Author(s):  
Wenjuan Wang ◽  
Rukundo Benedict ◽  
Lindsay Mallick
Keyword(s):  
Folic Acid ◽  
Health Facility ◽  
Rural Areas ◽  
Urban Areas ◽  
Health Facilities ◽  
Demographic And Health Surveys ◽  
Related Services ◽  
Iron Folic Acid ◽  
Facility Survey ◽  
High Level

Abstract Background: Iron-folic acid (IFA) supplementation during pregnancy is key to prevent maternal anemia. In Malawi and Haiti, consumption of IFA supplements remains suboptimal. This study examined the IFA-related services provided in health facilities and their association with women’s adherence to IFA supplementation during pregnancy.Methods: This study used data from the Demographic and Health surveys (DHS) and the Service Provision Assessment (SPA) in Haiti and Malawi. Using GPS data collected in both surveys, each DHS cluster was linked to health facilities surveyed in the SPA within a specified buffer distance (5 km for urban areas and 10 km for rural areas). IFA-related services were examined for health facilities within the buffer, including the availability of IFA supplements, prescription of IFA, and client counseling on IFA. Adherence to IFA supplementation was examined for women who received antenatal care (ANC) for their most recent live birth in the 2 years preceding the DHS survey. Multilevel logistic regressions stratified by urban and rural locale were used to model associations between women’s consumption of IFA supplements and the health facility service environment, controlling for relevant covariates.Results: More than two-thirds of facilities with ANC services in Haiti and almost all ANC facilities in Malawi had IFA supplements available. Over 60% of ANC clients in Haiti and over 80% in Malawi received IFA supplements or an IFA prescription. Counseling on IFA was less common and focused on how to use IFA; few women were counseled on side effects. Only 42% of women in Haiti and 35% of women in Malawi took IFA supplements for at least 90 days. Multivariable models indicated that in both countries, adherence to IFA supplementation in rural areas was significantly associated with a high level of availability of ANC facilities offering IFA. IFA counseling was also positively associated with the IFA supplement adherence in rural Malawi but not in Haiti. IFA supplement adherence was consistently associated with the completion of four or more ANC visits in both countries.Conclusions: Continued efforts are required to address access to IFA supplements through improving both the use of ANC services and their quality, particularly in provider counseling.

scholarly journals SEANUTS: the nutritional status and dietary intakes of 0.5–12-year-old Thai children

2013 ◽  
Vol 110 (S3) ◽  
pp. S36-S44 ◽  
Author(s):  
Nipa Rojroongwasinkul ◽  
Kallaya Kijboonchoo ◽  
Wanphen Wimonpeerapattana ◽  
Sasiumphai Purttiponthanee ◽  
Uruwan Yamborisut ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin A ◽  
Nutritional Status ◽  
Rural Areas ◽  
Urban Areas ◽  
Vitamin A Deficiency ◽  
Public Health Problem ◽  
Rural Children ◽  
Major Public Health Problem ◽  
Serum Retinol

In the present study, we investigated nutritional status and health-related factors in a multistage cluster sample of 3119 Thai urban and rural children aged 0·5–12·9 years. In a subsample, blood samples were collected for the measurement of Hb, transferrin receptor, vitamin A and vitamin D concentrations. The prevalence of stunting and underweight was higher in rural children than in urban children, whereas the wasting rate was similar in both rural and urban areas. Among children aged 3·0–5·9 years, the prevalence of overweight was significantly higher in urban areas than in rural areas and so was the obesity rate in children aged 6·0–12·9 years. Protein intakes of all age groups were relatively high in both the areas. Intakes of Ca, Fe, Zn and vitamin C were significantly higher in urban areas than in rural areas. The prevalence of anaemia in rural areas was twice as high as that in urban areas, particularly in infants and young children. However, the prevalence of Fe-deficiency anaemia was similar in both urban and rural areas. While the prevalence of vitamin A deficiency (by serum retinol cut-off < 0·7 μmol/l) seemed to be very low, vitamin A insufficiency (by serum retinol cut-off < 1·05 μmol/l) was more prevalent (29·4–31·7 %) in both the areas. The prevalence of vitamin D insufficiency ranged between 27·7 and 45·6 % among the children. The present study indicates that the double burden of malnutrition is still a major public health problem in Thailand. Further studies need to explore the associated risk factors for these nutrient deficiencies. Effective strategies and actions are needed to tackle the nutritional problems in Thai children.

scholarly journals Food consumption and nutritional and biochemical status of 0·5–12-year-old Indonesian children: the SEANUTS study

2013 ◽  
Vol 110 (S3) ◽  
pp. S11-S20 ◽  
Author(s):  
Sandjaja Sandjaja ◽  
Basuki Budiman ◽  
Heryudarini Harahap ◽  
Fitrah Ernawati ◽  
Moesijanti Soekatri ◽  
...  
Keyword(s):  
Food Consumption ◽  
Rural Areas ◽  
Urban Areas ◽  
Age Groups ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Dietary Intakes ◽  
Nutrition Survey ◽  
Double Burden ◽  
Urban And Rural Areas

Indonesia is currently facing the double burden of malnutrition. While undernutrition is still a major public health problem, the prevalence of overnutrition is increasing. The objective of the South East Asian Nutrition Survey (SEANUTS) was to provide up-to-date data on nutritional status, food consumption and biochemical parameters related to nutrition for children aged 0·5–12 years. The SEANUTS study in Indonesia was conducted in a nationwide representative sample of 7·211 children using multistage cluster sampling based on probability proportional to size, stratified for geographical location, in forty-eight out of 440 districts/cities. The results show that the growth (weight for age, height for age, weight for height and BMI for age) of Indonesian pre-school- and school-aged children is below the WHO standards. The older the children, the more the deviation from the WHO standard curves. Underweight was more prevalent in rural areas (28·9 v. 19·2 %) and overweight/obesity was observed to be more widespread in urban areas (5·6 v. 3·2 %). The prevalence varied with age groups and sexes. The overall prevalence of stunting was 25·2 and 39·2 % in urban and rural areas, respectively. The prevalence of anaemia was nearly 55 % in children aged 0·5–1·9 years and ranged from 10·6 to 15·5 % in children aged 2–12 years. Fe deficiency was observed in 4·1–8·8 % of the children. The percentage of children with dietary intakes of energy, protein, and vitamins A and C below the Indonesian RDA was high and differed across urban and rural areas and age groups.

scholarly journals Variation in Prescription Opioid Dispensing across Neighborhoods of Diverse Socioeconomic Disadvantages in Victoria, Australia

2018 ◽  
Vol 11 (4) ◽  
pp. 116 ◽  
Author(s):  
M Islam ◽  
Dennis Wollersheim
Keyword(s):  
Public Health ◽  
Rural Areas ◽  
Urban Areas ◽  
Public Health Problem ◽  
Neighborhood Disadvantage ◽  
Prescription Opioid ◽  
Major Public Health Problem ◽  
Defined Daily Dose ◽  
Very High ◽  
Neighborhood Level

The study examined the relationship between dispensing patterns of prescription opioids, neighborhood-disadvantage-index, and standardized doses dispensed. Three-year’s dispensing data drawn from 80 local government areas (LGAs) within Victoria, Australia’s second most populous state, was analyzed. Quantities dispensed in defined daily dose (DDD)/1000-people/day were computed for LGAs of low, moderate, high, and very high socio-economic disadvantage. LGAs with various levels of dispensing, and neighborhood disadvantage were identified and mapped. A multivariable regression model examined the effect of neighborhood level disadvantage and identified other factors that are associated with standardized doses dispensed. More women were dispensed opioids than men. Dispensing increased with increasing age. Most of the LGAs with relatively high dispensing were socioeconomically disadvantaged and located outside the major cities. Dispensing gradually increased from low disadvantage to very high disadvantage areas. Dispensing of standardized doses were consistently higher in rural areas than in urban areas. Neighborhood level disadvantage, age, sex, and urbanization were significant factors in the standardized doses dispensed. As inappropriate dispensing of opioids is a major public health problem, research should facilitate understanding of utilization in small areas to enable tailored public health programs. Nationwide and consistent introduction of real-time prescription drug-monitoring programs, and structural interventions to reduce the fundamental causes of socioeconomic disadvantage and isolation are recommended.

scholarly journals Dietary Intake and Prevalence of Dental Caries among Five-Year-Old Children in Urban and Rural Areas of Uasin-Gishu County, Kenya

2020 ◽  
Vol 2 (4) ◽  
Author(s):  
Hillary K. Wakhungu ◽  
Gertrude M. Were ◽  
Charlotte A. Serrem ◽  
Caroline J. Kibosia
Keyword(s):  
Dental Caries ◽  
Vitamin A ◽  
Dietary Intake ◽  
Rural Areas ◽  
Urban Areas ◽  
Economic Status ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Caries Prevalence ◽  
Urban And Rural Areas

Dental caries is a major public health problem associated with diet and nutrition affecting 60-90% of children globally with the burden in both industrialized and less industrialized countries undergoing nutrition transition. The aim of this study was to assess the relation between the dietary intake and nutritional status on dental caries prevalence of 5-year-old school children in urban and rural areas of Uasin-Gishu County.  In this study, 382 five year old children and their parents/caregivers were sampled from urban and rural schools in Uasin-Gishu County to participate in the study. Dental caries status was assessed based on the criteria proposed by WHO for oral health surveys. Structured questionnaires was used to gather information on demographic and socio-economic status. A quantitative food frequency questionnaire was used to collect data on dietary intake. Dietary intake data was analyzed using ENA for SMART computer programmes and the rest of the data was analyzed using the Statistical Package for Social Sciences (SPSS) Version 21 (2007). The prevalence of dental caries stood at 39.3% with a mean dft of 1.55 and 60.7% being dental caries free. Children met their nutrient requirements for protein, vitamin C, calcium, and phosphorus, but did not meet the requirements for energy, folate, vitamin A, and iron. Many children from urban than rural areas consumed sweets/candies at 33.5% and 15.3% respectively.  Children from urban areas (288) had the highest mean dft of 1.83±1.37 while those from rural areas (154) had a mean dft score of 1.16±1.13. This was significantly different (p<0.05). Overweight was higher in the urban population compared to the rural population at 13.64% and 8.96% respectively. The prevalence of underweight was higher in rural areas at 10.7%, stunting at 14.6% and wasting at 6.8%. There is inadequate intake of Energy, Vitamin A and Iron in the diet consumed by the 5-year-old which might be contributing to dental caries prevalence both in the urban and rural areas of Uasin – Gishu County, Kenya. Children should be fed on nutrient rich foods and cariogenic foods should be consumed occasionally.

scholarly journals A study of prevalence of hypertension and socio-demographic factors in urban slum, Maharashtra

2019 ◽  
Vol 6 (2) ◽  
pp. 585 ◽  
Author(s):  
Gautam B. Sawase ◽  
Sunayana G. Kumthekar ◽  
Shweta N. Salphale ◽  
Mohan K. Doibale
Keyword(s):  
Sex Education ◽  
Rural Areas ◽  
Urban Areas ◽  
Statistical Tests ◽  
Demographic Factors ◽  
Public Health Problem ◽  
Urban Slum ◽  
Major Public Health Problem ◽  
Cross Sectional ◽  
Socio Demographic Factors

Background: Hypertension is the commonest cardiovascular disorder, posting a major public health problem of the world and especially to population in socio-economic and epidemiological transition. Around 7.5 million deaths or 12.8% of the total of all annual deaths worldwide occur due to high blood pressure. It is predicted to be increased to 1.56 billion adults with hypertension in 2025. In India there is 24-30% of prevalence of hypertension in urban areas and 12-14% in rural areas. The objectives of the study were to find out the prevalence of hypertension in study population of 18 years and above and to study some socio-demographic factors affecting hypertension.Methods: A community based cross sectional study was carried out in urban slum area, under urban field practice area of a Govt. Medical College & hospital. Sample size of 360 participants of age more than 18 yrs residing in study area taken. Data collected by using systematic random sampling by house to house visit. A semi-structured & pretested questionnaire used to interview the patients after obtaining their consent. The data was analyzed using SPSS version 23. Appropriate statistical tests were applied.Results: The overall prevalence of hypertension was 30.5%. Out of 360 subjects, 47 (13%) found elevated hypertensive. Out of 110 hypertensive population nearly 53 (48%) were in older age group, nearly 60 (55%) were illiterate and 53 (48%) were unskilled workers out of 110 was found statistically significant (p<0.05).Conclusions: Prevalence of hypertension found to be 30.5%. Some socio-demographic factors like age, sex, education, occupation were statistically significant (p<0.05).

scholarly journals Assessment of multiple factors affecting intelligence quotient of children of rural and urban areas of Rajasthan, India

2020 ◽  
Vol 8 (7) ◽  
pp. 2557
Author(s):  
Shreyans D. Singhvi ◽  
Preksha T. Singh ◽  
Gautam Bhandari
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Intelligence Quotient ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Factors Affecting ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Group 3 ◽  
Urban And Rural Areas

Background: Children are the future of our country and hence their mental and physical wellbeing should be our upmost priority. Undernutrition is a major public health problem in our country and is one of the most common reasons for morbidity and mortality in children under 5yrs of age. The first few years of life are particularly important because vital development occurs in all domains. Therefore, this study has aimed to study the Intelligence Quotient (IQ) of the children of the age group 3-5 in urban and rural areas and study the factors associated with it.Methods: A cross section study of the children group of population was performed. Two sections of the children group were taken for the study- children population residing in an urban area and children population residing in a rural community of Rajasthan, India. The data was compiled and analyzed using appropriate statistical methods.Results: In our study, we have found that The following chosen demographic factors were found associated with children Intelligence quotient (IQ) - nutritional status, socioeconomic status, and age, while gender was not found to be associated with IQ.Conclusions: As, cognitive development is fairly important to children and their future, it should be paid more acknowledgment, as well as early preventive methods of it’s associated factors. 

scholarly journals Isolation and Immunological Detection of Mycobacterium Tuberculosis from HIV and Non-HIV Patients in Benue State, Nigeria

2020 ◽  
Vol 30 (1) ◽  
Author(s):  
Francis Enenche Ejeh1 ◽  
Ann Undiandeye ◽  
Kenneth Okon ◽  
Haruna Moshud Kazeem ◽  
Ayuba Caleb Kudi
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Rural Areas ◽  
Urban Areas ◽  
Age Groups ◽  
Public Health Problem ◽  
Rifampicin Resistance ◽  
Major Public Health Problem ◽  
Mycobacterium Tuberculosis Infection ◽  
Hiv Patients ◽  
Lowenstein Jensen

BACKGROUND: Immunological techniques are important tools for tuberculosis epidemiology; although its use is underutilized in Nigeria. In this study, we report the epidemiological outlook of Mycobacterium tuberculosis among HIV patients in Benue State, Nigeria.METHODS: Sputum samples were collected from 425 suspected TB patients from July 2016 to February 2018 and subjected to acid-fast microscopy, GeneXpert MTB/RIF, processed using NALC-NaOH and cultured on Lowenstein-Jensen media. The isolates obtained were identified by SD-Bioline® assay.RESULTS: The prevalence of TB by acid-fast microscopy was 35(15.9%). The prevalence of TB by acid-fast bacilli was significantly (χ2 = 8.458; P = 0.003) highest among the 15-34 years age group (22.0%) compared with other age groups. TB prevalence was significantly (χ2 = 4.751; P = 0.029) higher among patients from rural areas than those from urban center (23.8% vs 14.1%). GeneXpert assay detected 64(15.1%) TB cases of which patients from rural areas had significantly (χ2 = 8.104; P = 0.017) higher prevalence of TB than patients from urban areas (23.8% vs 12.9%). The overall rifampicin resistance TB was 3.1%. Also, patients from rural areas had significantly (χ2 = 10.625; P = 0.005) higher rifampicin resistance compared with patient from urban areas (8.3% vs 1.3%). Of the 126(29.7%) mycobacterial isolates, 42(33.33%) were identified as MTBC and 84 (66.67%) as NTM by SD-Bioline®assay.CONCLUSIONS: The study revealed that Mycobacterium tuberculosis infection is still a major public health problem, with relatively high prevalence rate of rifampicin resistance among HIV positive patients. Further studies are needed for early detection and treatment intervention necessary for infection control.

scholarly journals Prevalence of hypertension and its determinants in an urbanized village of East Delhi

2017 ◽  
Vol 4 (5) ◽  
pp. 1704 ◽  
Author(s):  
Raghavendra A. H. ◽  
Monika Singh ◽  
Pragti Chabra ◽  
Arun Kumar Sharma
Keyword(s):  
Urban Area ◽  
Rural Areas ◽  
Urban Areas ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Major Public Health Problem ◽  
Age Group ◽  
Cross Sectional ◽  
Duration Of Stay ◽  
Rural And Urban Areas

Background: Hypertension is the major public health problem both in developing and developed nations. There is disparity in prevalence of hypertension in rural and urban areas. Data is available on the prevalence of hypertension in both urban and rural areas but studies on migratory population are limited. Methods: A community based cross sectional study conducted in urbanized village of east Delhi.  WHO STEPS questionnaire was used collect the data. Total of 451 persons were interviewed by stratified random sampling method.  Data analysis was done using SPSS version 16. Results: Prevalence of hypertension was 16.4%, high age group, high income, body mass index more than 23 and duration of stay in urban area were significantly associated with prevalence of hypertension. Conclusions: Older age group, higher BMI and longer duration of stay in urban area have significant associations with the higher prevalence of hypertension. 

scholarly journals Hepatitis B infection in the general population of China: a systematic review and meta-analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Huai Wang ◽  
Peixuan Men ◽  
Yufeng Xiao ◽  
Pei Gao ◽  
Min Lv ◽  
...  
Keyword(s):  
Systematic Review ◽  
General Population ◽  
Hepatitis B ◽  
Rural Areas ◽  
Urban Areas ◽  
Meta Analysis ◽  
Public Health Problem ◽  
Hbv Infection ◽  
Control Measures ◽  
Major Public Health Problem

Abstract Background Hepatitis B virus (HBV) infection is a major public health problem in China. Over a decade has passed since the last National Hepatitis Seroepidemiological Survey was conducted in 2006. The lack of updated data on hepatitis B in China makes assessing the current prevalence and burden of the disease inadequate. In response to the above situation, a systematic review and meta-analysis was conducted to provide a better understanding of hepatitis B epidemiology in the general population of China. Methods A systematic search was conducted in international databases (Medline through PubMed, EMBASE, Cochrane, Web of Science) and national databases (CBM, CNKI, WanFang Data) to retrieve primary studies published between January 1, 2013 and December 31, 2017. The pooled prevalence of HBV infection and 95% confidence intervals were calculated. Quality assessment, heterogeneity testing and publication bias assessment were also performed. Results Of the 27 studies included in the meta-analysis, the pooled estimated prevalence of HBV infection in the general population of China from 2013 to 2017 was 6.89% (95% CI:5.84–7.95%), which could be extrapolated to an estimated population of 84 million living with HBsAg in 2018. The prevalence of HBV infection in males was higher than that in females (5.88% vs 5.05%), and rural areas had a higher prevalence than urban areas (5.86% vs 3.29%). The highest prevalence of HBV infection was reported in Western provinces (8.92, 95% CI: 7.19–10.64%). In adults older than 20 years, the prevalence of HBV infection was approximately 7%, which was higher than that in children. Conclusion The prevalence of HBV infection in the general population of China was classified as higher intermediate prevalence (5–7.99%), of which more than 90% of the HBV infection population included adults older than 20 years. The blocking of mother-to-infant hepatitis B transmission and plans involving timely birth dose of hepatitis B vaccine within 24 h should be implemented. Additionally, improving the quality of life and survival rate of the infected population through antiviral therapy and high-risk adult vaccination will be the priority of our future work. Moreover, various control measures should be implemented in different provinces across China.

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