Malnutrition and Socio-economic Factors in HIV Infected and Uninfected Under 5 Children in Zambia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M N Ng'andu ◽  
G M Moonga ◽  
J B Banda

Abstract Malnutrition contributes to more than one third of all child deaths, although hardly listed as the direct cause. In sub-Saharan Africa, malnutrition accounts for about 2% of deaths and 3% of Disability adjusted life years (DALYs) among under-5 children. In Zambia, 35% of under-5 children are stunted, 4% wasted, 12% underweight and 5% overweight. Malnutrition and HIV interact in complex ways that increase vulnerability to and worsen each condition therefore we sought to determine factors associated with malnutrition among under 5 children in Zambia. Using Stata version 14.2, we extracted and analysed sample data of 159 children aged 0-59 months from the 2016 ZAMPHIA population-based survey, that used a two-stage cluster sampling design. We used Generalised Linear Models to measure socio-economic factors associated with malnutrition. P-value of less than 0.05 was set as level of statistical significance. Factors associated with malnutrition included gender, child's HIV status and wealth index which showed an association with stunting, wasting and being underweight. The 16 (10%) under-5 children living with HIV were significantly more affected by stunting (38% vs 33%), wasting (19% vs 11%) and underweight prevalence (38% vs 10%) than the remaining 143 who were HIV negative. Our sample prevalence was similar to national stunting (33% vs 35%) and underweight prevalence (13% vs 12%) but had three times higher wasting prevalence (12% vs 4%). A high prevalence of malnutrition was found in HIV positive compared to negative under 5 children, wealth index showing an association with malnutrition. Eliminating malnutrition is key to attaining SDG 3 which is to end preventable deaths of newborns and children under 5 years of age. Key messages All types of malnutrition had a higher prevalence in HIV infected than uninfected under five children in Zambia. Wealth index is a socio-economic factor that is associated to all types of malnutrition in under-five children in Zambia.

2021 ◽  
Author(s):  
Delelegn Emwodew Yehualashet ◽  
Binyam Tariku Seboka ◽  
Getanew Aschalew Tesfa ◽  
Elias Seid ◽  
Samuel Hailegebreal ◽  
...  

Abstract Background: Childhood stunting is a major challenge to the growth and development of nations by affecting millions of children across the world. Although Ethiopia has made steady progress in reducing stunting, the prevalence of stunting is still one of the highest in the world. This study aimed to assess the spatial variation and factors associated with stunting among under-five children in Ethiopia.Methods: This study is a secondary data analysis of the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). The Getis-Ord statistics tool has been used to identify areas with high and low hotspots of stunting. A multilevel logistic regression model was used to identify factors associated with stunting. Adjusted odds ratios (AOR) with its 95% confidence intervals (CI) at p-value < 0.05 were used to declare statistical significance.Results: The result of this study shows that about 37% of under-five children were stunted. Statistically significant hotspots of stunting were found in northern parts of Ethiopia. Children in the age group between 24–35 months were more likely to be stunted than children whose age was less than one year [AOR = 3.74; 95 % CI: (3.04–4.59)]. Children with mothers who had completed higher education had lower odds of being stunted compared to children whose mothers had no formal education [AOR = 0.55; 95%CI: (0.38–0.82)]. Children from the poorest wealth quintile had higher odds of being stunted compared to children from the richest wealth quintiles [AOR = 2; 95 % CI: (1.46–2.73)]. Children living in Tigray (AOR =3.64; 95 % CI: 2.17–6.11), Afar (AOR 2.02; 95 % CI 1.19-3.39), Amhara (AOR =2.29; 95 % CI: 1.37–3.86), Benishangul Gumz (AOR=1.87; 95% CI: 1.10-3.17) and Harari (AOR=1.95; 95% CI: 1.17-3.25) regions were more likely to be stunted compared to children living in Addis Ababa.Conclusion: This study showed that both individual and community-level factors were significant predictors of stunting. Improving maternal education, improving the economic status of households, improving age-specific child feeding practice, and providing additional resources to regions with high hotspots of stunting are recommended.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Getasew Mulat Bantie ◽  
Zemene Meseret ◽  
Melkamu Bedimo ◽  
Abebayehu Bitew

Abstract Background Globally pneumonia is the leading cause of under-five child mortality. Several risk factors for pneumonia mortality have been identified, including delay in seeking health care. For successful reduction of delay in seeking healthcare, further evidence is crucial on its magnitude and factors associated with it in the country particularly in the study area. Therefore, this study aimed to determine the prevalence and root causes of delay in seeking health care among mothers of under-five children with pneumonia in hospitals of the Bahir Dar city, 2019. Methods A hospital-based cross-sectional study was conducted from March 15 to May 15, 2019 among 356 mothers of under-five children with pneumonia in hospitals of the Bahir Dar city. The study participants were selected by using a stratified sampling technique and data was collected through face to face interview. Binary logistic regression was used to identify the associated factors of delay in seeking healthcare. The P - value < 0.05 was considered statistically significant. Associations between outcome and exposure variables were expressed by the adjusted odds ratio with a 95% confidence interval (CI). Results A total of 356 mothers participated in the study yielded a response of 89.4%. The proportion of delay in seeking health care was 48.6%. Rural residence (AOR = 2. 3, 95% CI: 1.1, 4.9, seek healthcare in a governmental hospital (AOR = 3. 3, 95% CI: 1.8, 6.1), health care decision by mothers (AOR = 2. 9, 95% CI: 1.6, 5.4), poorest household (AOR = 2. 8, 95% CI: 1.1, 7.2), using self-medication (AOR = 7. 5, 95% CI: 3.8, 14.7), using traditional medicine before healthcare-seeking (AOR = 2. 7, 95% CI: 1.4, 5.1), and no information about early healthcare-seeking for childhood pneumonia treatment (AOR = 5. 1, 95% CI: 2.8, 9.1) were the identified determinants significantly associated with delay in seeking healthcare among mothers of under-five children with pneumonia. Conclusion This study showed that nearly half of the mothers delayed in seeking healthcare. Rural residence, healthcare seeking at government hospitals, healthcare decision by mothers, poorest household, using self-medication, using traditional medicine before health care seeking, and lack of information about early healthcare-seeking were factors associated with a delay in seeking healthcare for under-five children with pneumonia. Hence, the government and other concerned stakeholders should give due emphasis to tackle on the identified causes of delay in seeking health care for the under five children with pneumonia.


2021 ◽  
Vol 33 (1) ◽  
pp. 102-114
Author(s):  
S.N. Esomonu ◽  
E.N. Ossai ◽  
A.T. Onajole

Background: Malaria is a life-threatening parasitic disease caused by the plasmodium parasite and women and under-five children are more prone to its adverse consequences. The use of insecticide-treated nets (ITNs) is recommended to reduce malaria burden in endemic communities. The study aimed to determine knowledge of malaria and utilization of insecticide-treated nets (ITNs) amongst mothers of under-five children in rural communities of Nigeria’s Federal Capital Territory, and the predictors.Methods: A community-based cross-sectional design was used. Multi-stage sampling method was used to select 160 mothers of under-five children in two rural communities. A structured questionnaire was used for data collection. Data analysis was done using SPSS statistical software version 22.0 and level of statistical significance was determined by a p value of < 0.05.Results: Mean age of respondents was 29.0±5.4 years, and majority 144 (90%) of the women were married. Lower proportion of respondents had good knowledge of malaria 33 (20.6%). Ninety-four (58.8%) of respondents owned ITNs, but less than half 45 (47.9%) utilized the nets. Predictors of good knowledge of malaria were having attained tertiary education [Adjusted Odds Ratio (AOR); 2.7, 95% Confidence Interval (CI):1.1–8.1], p=0.042, and being self-employed, (AOR; 3.4, 95% CI: 1.1-13.1), p=0.043). Predictor of utilization of ITNs was being aged 30 years and above (AOR; 2.5, 95% CI: 1.1-6.1, p=0.031).Conclusion: Lower proportions of respondents had good knowledge of malaria and utilization of ITNs. Health education of mothers on malaria and benefits of ITNs use should be intensified in the study area.


PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257522
Author(s):  
Getu Debalkie Demissie ◽  
Yigizie Yeshaw ◽  
Wallelign Aleminew ◽  
Yonas Akalu

Introduction Diarrhea is responsible for the death of more than 90% of under-five children in low and lower-middle income countries. Regionally, South Asia and sub-Saharan Africa accounted for 88% of deaths with the same age group. Therefore, the aim of this study was to determine the prevalence and associated factors of diarrhea among children under-five years in sub-Saharan Africa. Methods The appended, most recent demographic and health survey datasets of 34 sub-Saharan African countries were used to determine the prevalence and associated factors of diarrhea among under-five children in the region. A total weighted sample of 330,866 under-five children were included in the study. Both bivariable and multivariable multilevel logistic regression were done to determine the associated factors of diarrhea among under five children in sub-Saharan Africa. The Odds Ratio (OR) with a 95% Confidence Interval (CI) was calculated for those potential factors included in the final model. Result The overall prevalence of diarrhea in this study was 15.3% (95% CI: 15.1–15.4). Those children of mothers aged 15–24 (AOR = 1.26; 95% CI: 1.23, 1.30) and 25–34 years (AOR = 1.15; 95%CI: 1.12, 1.18), those children of mothers with no education (AOR = 1.69; 95%CI: 1.57–1.82), primary education (AOR = 1.73; 95%CI: 1.61–1.86) and secondary education (AOR = 1.49; 95%CI: 1.38–1.59) had higher odds of having diarrhea. Those children from poorest (AOR = 1.14; 95%CI: 1.10, 1.19), poorer (AOR = 1.12; 95%CI: 1.08–1.17), middle (AOR = 1.06; 95%CI: 1.02, 1.10), and richer (AOR = 1.14; 95%CI: 1.04–1.12) households had higher chance of having diarrhea compared to their counterparts. Conclusion This study found that the prevalence of childhood diarrhea morbidity in sub-Saharan Africa was high. Maternal age, wealth index, maternal education, maternal occupation, age of child, time of initiation of breast feeding and time to get water source were significantly associated with diarrhea. Therefore, intervention through health education and health promotion for mothers/caretakers who are poor, less educated, and young should be designed to prevent diarrhea in the region.


2020 ◽  
Author(s):  
Obafemi Joseph Babalola ◽  
Olufemi Ajumobi ◽  
IkeOluwapo O. Ajayi

Abstract Background Fever in under-five children (U5) is the commonest presenting complaint in general practice and mothers’ recognition is an entry point for fever treatment including malaria. This study describes rural - urban disparity in fever prevalence, mothers’ malaria knowledge, and care seeking for fever in U5 and the associated factors. Methods A cross-sectional survey was conducted among 630 mother-child pairs [rural (300) and urban (330)] selected randomly using a multi-stage sampling from 63 villages in Igabi LGA, Kaduna State, Nigeria. Trained female data collectors administered a pre-tested structured questionnaire to collect information on mother-child demographic profiles, malaria knowledge, fever episodes in birth order last child in two weeks prior to survey, and care - seeking for fever within 48 hours of onset. Care sought for fever > 48 hours of onset was defined as delayed care seeking. Malaria knowledge was categorized into good, average and poor if the final scores is ≥ 75 th , 50 th - 74 th , and < 50 th percentiles, respectively. Frequency, proportions, and odds ratio were calculated. Statistically significant was set at p-value < 0.05. Results The median age (interquartile range) of rural mothers was 30 (IQR, 10) years compared to 27 (IQR, 6) years in urban. Of the 70.0% (441/629) U5 children with fever, 58.5% (258/441) were in rural settlements. A third of the mothers whose child had fever sought care. Mothers in rural settlement were 2.7 (CI: 1.8 – 4.2, p < 0.01) times more likely to delay care seeking for fever, and those with no knowledge of malaria transmission were 70% less likely to seek care (OR: 0.3, CI: 0.2 – 0.7). On the other hand, poor perception of malaria as a major health problem (OR: 2.1, CI: 1.4 – 3.1), and poor knowledge of cause of malaria (OR: 1.7, CI: 1.1 – 2.5) were associated with delayed seeking for fever among urban mothers. Conclusions Disparity existed between fever prevalence in U5 children, care -seeking practices by their mothers, and factors associated with delayed care seeking for fever. Fever treatment for high impact malaria elimination needs a context specific intervention rather than ‘one-size-fits-all’ approach. Also, intensify efforts to educate mothers on malaria.


2020 ◽  
Author(s):  
Erkihun Tadesse ◽  
Tiruneh Ayele

Abstract Introduction The magnitude of childhood anemia has increased from 44% in 2011 to 56% in 2016. Thus, even if the Ethiopian government tried remarkable solutions, anemia among under-five children still continues as a serious health issue. So, exploring spatial distribution and identifying factors associated with childhood anemia helps to design appropriate strategies for control and prevention.Methods For this study data from the recent 2016 Ethiopian Demographic Health Survey were employed. The sample size was 8602 children aged 6–59 months. They were selected by stratified two-stage cluster sampling techniques. Sat Scan version 9.4 was also used to identify childhood anemia by geographic clusters and ArcGIS version10.1 was used to show anemia cases through Regions of Ethiopia. Thus to declare factors that are statistically related with anemia among under-five children a Mixed effect logistic regression model was utilized.Result This study showed there is spatial clustering of childhood anemia throughout Ethiopia (Moran’s I: 0.65, p<0.001). Statistically significant clusters were detected in Somali, Afar, Harari and southern part of Oromia regions (P<0.001). Age of child, wealth index, mother’s current working status, maternal anemic status, number of living children in the family, history of fever, and stunting were significant factors associated with anemia among under-five children.Conclusion In the country childhood anemia showed spatial clustering. Regions high risk of childhood anemia should be emphasized by allocating additional resources and providing appropriate interventions which have public health implications.


2019 ◽  
Author(s):  
Veneranda M. Bwana ◽  
Edgar Simulundu ◽  
Leonard E.G. Mboera ◽  
Sayoki G. Mfinanga ◽  
Charles Michelo

AbstractBackgroundThere are evidences of the association between socio-economic factors and HIV prevalence in Sub-Saharan Africa. However, there is dearth of information on such relationship in Tanzania. Here, we present data on the relationship between household’s socio-economic factors and HIV prevalence among under five-year children in Muheza district, Tanzania.MethodsWe conducted a facility-based study from June 2015 to June 2016 in which we enrolled under five-year children born to HIV positive mothers. Information on HIV status of the child and socio-demographic characteristic of the head of the household was collected using a structured questionnaire. Data analysis was done using STATA version 13.0.ResultsA total of 576 mothers/guardians were interviewed each with respective HIV exposed under five-year child. Children who belonged to a head of household with at least a high education level (AOR= 0.4, 95% CI 0.2-0.8) and living in a relatively wealthy household (AOR = 0.5, 95% CI 0.2-0.9) was associated with reduced odds of HIV infection among children. Univariate analysis revealed that the odds of HIV infection was three-fold (COR = 2.9, 95% CI 1.2-7.0) higher among children living in rural than in urban areas. The heads of household living in rural areas (AOR=0.3 95% CI 0.1-0.9) had low education level compared to those living in urban areas.ConclusionChildren who belong to the head of households with high educational level, high household wealth were associated with reduced likelihood of HIV infection in Tanzania. Children living in rural areas had increased likelihood of acquiring HIV infection. These findings stress the need to focus on improving education status of the population and economically disadvantaged populations as a strategy for HIV prevention and control measures.


PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251239
Author(s):  
Sara Abera Bekele ◽  
Moges Zerihun Fetene

Background Childhood under-nutrition is a major global health problem. Although the rate of under-nutrition in Ethiopia has declined in the last decade, but it still remains being the major causes of morbidity and mortality of children under-five years. The problem is even worse in rural areas. The prevalence of underweight among rural children was 25% compared with 13% among urban children. To alleviate this problem, it is necessary to determine the magnitude and determinants of underweight. The study models non-Gaussian data analysis to identify risk factors associated with underweight among under-five children in rural Ethiopia. Methodology The data source for this study was secondary data, which was retrieved from EDHS 2016 database. It was analyzed using two model families; one with marginal models (GEE and ALR) in which responses are modeled and marginalized overall other responses, and the other is random effects model (GLMM) which is useful when the interest of the analyst lies in the individual’s response profiles as well as to evaluate within and between regional variations of underweight. Result From fitting non-Gaussian data analysis to identify risk factors associated with underweight among under five children in rural Ethiopia, the independent variable which have significant effect on underweight were:—Age of child, birth interval, mothers education, fathers education, wealth index, diarrhea in last two weeks, fever in last two weeks are significant and also father’s work status shows that difference in significance among the category. Conclusion Child age, preceding birth interval, mother’s education, household’s wealth index, fever, diarrhea, father’s education and father’s work status were associated with child underweight. Furthermore, there is both within and between regional heterogeneity of underweight among children in rural Ethiopia. Therefore, rigorous community-based interventions (such as uplifting mother’s education by providing formal education and preventing infectious diseases that cause diarrhea and fever) should be developed and executed throughout the country to improve this grave situation of underweight prevalence in rural areas of Ethiopia.


2020 ◽  
Author(s):  
Reta Lemessa ◽  
Ararso Tafese ◽  
Gudeta Aga

Abstract Background Majority of this world is concerned by malnutrition. Ethiopia is one of the Sub Saharan Africancountries 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 malnutritionin 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.


Sign in / Sign up

Export Citation Format

Share Document