1155Effect of household air pollution on infant and child-mortality in Myanmar

Abstract Background Household air pollution (HAP) from solid fuel use (SFU) for cooking has been considered as a public health threat, particularly for women and children in low and middle-income countries (LMICs), with limited evidence. Hence, this study investigated the effects of HAP on neonatal, infant, and under-five child mortality in Myanmar. Methods The cross-sectional study employed data from the Myanmar Demographic and Health Survey (MDHS), the first nationally representative survey conducted in 2016. The sample consists of 3249 ever-married mothers with under-five children in the household with a 98% response rate. HAP (coal and biomass), and level of exposure to HAP (no exposure, moderate and high exposure) were exposures. Outcomes were self-reported neonatal, infant, and under-five mortality. Results The prevalence of SFU was 79.0%. The neonatal, infant, and the under-five mortality rates were 26, 45, and 49 per 1,000 live births, respectively. The odds of infant (aOR 2.17, 95% CI: 1.21, 3.88) and under-five child (aOR 2.22, 95% CI: 1.24, 3.95) mortality were higher in households with SFU compared with clean fuel use. When applying an augmented measure of exposure to HAP by incorporating both SFU and the kitchen’s location, the likelihoods of infant and under-five mortality were even higher among moderate and highly exposed children compared with unexposed children with similar trends. Conclusion Infants and under-five children are at higher risk of mortality from exposure to HAP. Key messages Increasing access to cookstoves and clean fuels is imperative to reduce the risk of infants and under-five child mortality in LMICs, including Myanmar.

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Association Between Household Air Pollution and Infant and Child Mortality in Myanmar: Evidence From The First Demographic and Health Survey

10.21203/rs.3.rs-152520/v1 ◽

2021 ◽

Author(s):

Juwel Rana ◽

Md Nuruzzaman Khan ◽

Rakibul M Islam ◽

Razia Aliani ◽

Youssef Oulhote

Keyword(s):

Air Pollution ◽

Child Mortality ◽

Health Survey ◽

Rural Areas ◽

Demographic And Health Survey ◽

Household Air Pollution ◽

Cluster Sampling ◽

High Exposure ◽

Under Five ◽

Under Five Children

Abstract Background: Household air pollution (HAP) from solid fuel use (SFU) for cooking has been considered a public health threat, particularly for women and children in low and middle-income countries (LMICs), with limited evidence. This study was undertaken to investigate the effects of HAP on neonatal, infant, and under-five child mortality in Myanmar. Methods: This cross-sectional study employed data from the Myanmar Demographic and Health Survey (MDHS), the first nationally representative survey conducted in 2016. Data were collected from MDHS based on stratified two-stage cluster sampling design applied in urban and rural areas. The sample consists of 3249 under-five children in the household with a 98% response rate. Exposure measures were HAP (coal and biomass) and level of exposure to HAP (no exposure, moderate and high exposure). The main outcomes were neonatal, infant, and under-five child mortality reported by mothers presented in rates and risk ratios with 95% confidence intervals, accounting for survey weight and cluster variation. Results: The prevalence of SFU was 79.0%. The neonatal, infant and under-five child mortality rates were 26, 45, and 49 per 1,000 live births, respectively. The risks of infant (aRR 2.02; 95% CI: 1.01-4.05) and under-five mortality (aRR 2.16; 95% CI: 1.07-4.36) mortality were higher among children from households with SFU compared to children from households using clean fuel. When applying an augmented measure of exposure to HAP by incorporating SFU and the kitchen's location, the likelihoods of infant and under-five mortality were even higher among moderate and highly exposed children than unexposed children with similar trends. Neonatal mortality was not associated with either HAP exposure or levels of exposure to HAP.Conclusion: Infants and under-five children are at higher risk of mortality from exposure to HAP. Increasing access to cookstoves and clean fuels is imperative to reduce the risk of infant and under-five child mortality in LMICs, including Myanmar.

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Effect of indoor air pollution on infant and child-mortality in Myanmar: Evidence from the first Demographic and Health Survey

10.1101/19010801 ◽

2019 ◽

Cited By ~ 1

Author(s):

Juwel Rana ◽

Md Nuruzzaman Khan ◽

Razia Aliani ◽

Rakibul M Islam

Keyword(s):

Air Pollution ◽

Child Mortality ◽

Health Survey ◽

Indoor Air ◽

Indoor Air Pollution ◽

Demographic And Health Survey ◽

Fuel Use ◽

High Exposure ◽

Under Five ◽

Under Five Children

AbstractBackgroundIndoor air pollution (IAP) from solid fuels for cooking has been considered as a public health threat, particularly for women and children in low- and lower-middle-income countries (LMICs). We investigated the effects of solid fuel use (SFU) on neonatal, infant and under-five child mortality in Myanmar.Materials and MethodsWe used data from Myanmar’s first Demographic and Health Survey conducted in 2016. The sample consists of ever-married mothers with under-five children in the household (n=3249). We calculated the adjusted odds ratio (aOR) to investigate the effects of SFU on neonatal, infant, and under-five mortality using multivariable logistic regression model accounting for survey weight and clustering. Additional analysis was conducted using an augmented measure of the exposure to IAP accounting for both SFU and the location of cooking (high exposure, moderate, and unexposed).ResultsThe prevalence of SFU was 79.0%, and the neonatal, infant and the under-five mortality rates were 26, 45 and 49 per 1,000 live births, respectively. The odds of infant (aOR 2.17, 95% CI: 1.21, 3.88) and under-five child mortality (aOR 2.22, 95% CI: 1.24, 3.95) were higher in households with SFU compared with households with clean fuel use. When applying an augmented measure of exposure to IAP by incorporating both SFU and the kitchen’s location, the likelihood of infant and under-five mortality was higher among moderately and highly exposed children compared to unexposed children with similar trends. Neonatal mortality was not associated with both SFU and levels of exposure to IAP.ConclusionInfants and under-five children are at higher risk of mortality from exposure to IAP. The findings suggest that the risk of infants and under-five child mortality may be reduced by increasing access to clean cookstoves and clean fuels in LMICs, especially in Myanmar.

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Association between household air pollution and child mortality in Myanmar using a multilevel mixed-effects Poisson regression with robust variance

Scientific Reports ◽

10.1038/s41598-021-92193-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Juwel Rana ◽

Rakibul M. Islam ◽

Md Nuruzzaman Khan ◽

Razia Aliani ◽

Youssef Oulhote

Keyword(s):

Air Pollution ◽

Child Mortality ◽

Survey Design ◽

Household Air Pollution ◽

P Value ◽

Middle Income ◽

Under Five ◽

Middle Income Countries ◽

Relative Risks ◽

Clean Cookstoves

AbstractHousehold air pollution (HAP) from solid fuel use (SFU) for cooking is a major public health threat for women and children in low and middle-income countries. This study investigated the associations between HAP and neonatal, infant, and under-five child mortality in Myanmar. The study consisted of 3249 sample of under-five children in the households from the first Myanmar Demographic and Health Survey 2016. Fuel types and levels of exposure to SFU (no, moderate and high) were proxies for HAP. We estimated covariate-adjusted relative risks (aRR) of neonatal, infant, and under-five child mortality with 95% confidence intervals, accounting for the survey design. The prevalence of SFU was 79.0%. The neonatal, infant, and under-five child mortality rates were 26, 45, and 49 per 1000 live births, respectively. The risks of infant (aRR 2.02; 95% CI 1.01–4.05; p-value = 0.048) and under-five mortality (aRR 2.16; 95% CI 1.07–4.36; p-value = 0.031), but not neonatal mortality, were higher among children from households with SFU compared to children from households using clean fuel. Likewise, children highly exposed to HAP had higher risks of mortality than unexposed children. HAP increases the risks of infant and under-five child mortality in Myanmar, which could be reduced by increasing access to clean cookstoves and fuels.

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Impact of Community-Led Total Sanitation and Hygiene on Prevalence of Diarrheal Disease and Associated Factors among Under-Five Children: A Comparative Cross-Sectional Study in Selected Woredas of Gamo Gofa Zone, Southern Ethiopia

Advances in Public Health ◽

10.1155/2020/8237101 ◽

2020 ◽

Vol 2020 ◽

pp. 1-12

Author(s):

Agune Ashole Alto ◽

Wanzahun Godana ◽

Genet Gedamu

Keyword(s):

Drinking Water ◽

Diarrheal Disease ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Under Five ◽

Under Five Children ◽

Sanitation And Hygiene ◽

The Impact ◽

Gamo Gofa

Background. Diarrheal diseases are still one of the major causes of morbidity in under-five children in sub-Saharan Africa. In Ethiopia, diarrhea is responsible for 9% of all deaths and is the major cause of under-five mortality. Objective. To assess the impact of community-led total sanitation and hygiene on the prevalence of diarrheal disease and factors associated among under-five children in Gamo Gofa Zone. Methods. Community-based comparative cross-sectional study design was used to compare the impact of community-led total sanitation and hygiene intervention on under-five diarrheal disease. Multistage sampling method was employed. The data were collected by using pretested structured questionnaires. Data quality was ensured by daily supervision completeness and consistency. The data were coded, entered, and cleaned by using Epi Info version 7 and were analyzed by using SPSS version 20. Bivariate and multivariable analyses were carried out by using binary logistic regression. Significance was declared by using p value of <0.05 and AOR with 95% confidence intervals. Results. The response rate of this study was 93.3%. The overall diarrhea prevalence was 27.5% (CI = (24.06, 30.97)) which was 18.9% (CI = (14.94, 23.2)) in implemented and 36.2%. (CI = (30.41, 41.59)) in nonimplemented woredas. Children whose age was between 12 and 23 months (AOR = 1.6) and greater than 24 months (AOR = 5), availability of handwashing facilities (AOR = 4), disposal of waste in open field (AOR = 9.7), unimproved source of drinking water (AOR = 6.5), using only water for handwashing (AOR = 6), children who started complementary feeding less than 6 months (AOR = 5.6) and greater than 6 months (AOR = 5.2), and utensils used to feed children such as bottle (AOR = 3.9) were the factors positively associated with diarrhea. Conclusion. The overall prevalence of under-five diarrhea was 27.5%. The prevalence was low in CLTSH woredas as compared with non-CLTSH woredas. The study showed that handwashing facility, using only water for handwashing, open refuse disposal, and unimproved source of drinking water among under-five had a statistically significant association with diarrhea occurrence in CLTSH nonimplemented areas. Integrated efforts are needed from the Ministry of Health together with the WASH Project in improving drinking water, handwashing facilities, and solid waste disposal practices.

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Hierarchical disentanglement of contextual from compositional risk factors of diarrhoea among under-five children in low- and middle-income countries

Scientific Reports ◽

10.1038/s41598-021-87889-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Adeniyi Francis Fagbamigbe ◽

A. Olalekan Uthman ◽

Latifat Ibisomi

Keyword(s):

Risk Factors ◽

National Level ◽

Cross Sectional ◽

Middle Income ◽

Contextual Risk ◽

Under Five ◽

Factors Associated ◽

Under Five Children ◽

Middle Income Countries ◽

Low And Middle Income

AbstractSeveral studies have documented the burden and risk factors associated with diarrhoea in low and middle-income countries (LMIC). To the best of our knowledge, the contextual and compositional factors associated with diarrhoea across LMIC were poorly operationalized, explored and understood in these studies. We investigated multilevel risk factors associated with diarrhoea among under-five children in LMIC. We analysed diarrhoea-related information of 796,150 under-five children (Level 1) nested within 63,378 neighbourhoods (Level 2) from 57 LMIC (Level 3) using the latest data from cross-sectional and nationally representative Demographic Health Survey conducted between 2010 and 2018. We used multivariable hierarchical Bayesian logistic regression models for data analysis. The overall prevalence of diarrhoea was 14.4% (95% confidence interval 14.2–14.7) ranging from 3.8% in Armenia to 31.4% in Yemen. The odds of diarrhoea was highest among male children, infants, having small birth weights, households in poorer wealth quintiles, children whose mothers had only primary education, and children who had no access to media. Children from neighbourhoods with high illiteracy [adjusted odds ratio (aOR) = 1.07, 95% credible interval (CrI) 1.04–1.10] rates were more likely to have diarrhoea. At the country-level, the odds of diarrhoea nearly doubled (aOR = 1.88, 95% CrI 1.23–2.83) and tripled (aOR = 2.66, 95% CrI 1.65–3.89) among children from countries with middle and lowest human development index respectively. Diarrhoea remains a major health challenge among under-five children in most LMIC. We identified diverse individual-level, community-level and national-level factors associated with the development of diarrhoea among under-five children in these countries and disentangled the associated contextual risk factors from the compositional risk factors. Our findings underscore the need to revitalize existing policies on child and maternal health and implement interventions to prevent diarrhoea at the individual-, community- and societal-levels. The current study showed how the drive to the attainment of SDGs 1, 2, 4, 6 and 10 will enhance the attainment of SDG 3.

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Pattern of Thalassemia and Hemoglobinopathies Among Anemic Under-Five Children of Northern Bangladesh: A Hospital Based Cross Sectional Study

10.21203/rs.3.rs-157764/v1 ◽

2021 ◽

Author(s):

Md. Abdur Rafi ◽

M. Morsed Zaman ◽

Md. Golam Hossain

Keyword(s):

Cross Sectional Study ◽

Severe Form ◽

Health Concern ◽

Sectional Study ◽

Cross Sectional ◽

Hemoglobin E ◽

Under Five ◽

Under Five Children ◽

Thalassemia Minor ◽

Different Types

Abstract Background Congenital hemoglobin defects are significant global health concern affecting more than 330,000 newborns every year. In Bangladesh more than half of the under-five children are anemic, but the contribution of hemoglobin disorders to childhood anemia is quite unexplored. Hence, the objective of the present study was to investigate the prevalence and pattern of hemoglobinopathies among anemic under-five (age 6–59 months) children visiting the hematology department of Rajshahi Medical College Hospital (RMCH). Methods This was a retrospective cross-sectional study among anemic patients aged between 6 to 59 months conducted in the hematology department of RMCH from July 2018 to June 2020. The guideline of WHO was used to define the severity of anemia. Hemoglobinopathies was measured using standard methods. Chi-square test was used to find the association between two categorical factors. Results Female and younger children included in the study were more likely to suffer from moderate to severe form of anemia compared to their counterparts. Out of 534 patients 183 were suffering from different types of hemoglobinopathies (prevalence 34.3%). E-β-Thalassemia was the most common type of hemoglobinopathy (14%) followed by Hemoglobin E trait (11%) and β-Thalassemia minor (5.6%). Prevalence of these hemoglobin disorders was comparatively higher among female and older children (p < 0.05). Patients with E-β-Thalassemia and β-Thalassemia major of our study were mostly suffering from severe form of anemia while patients with hemoglobin E trait and β-Thalassemia minor were mostly suffering from mild anemia (p < 0.01). Conclusions A remarkable number of children were suffering from severe anemia and different types of hemoglobinopathies. Gender and age group were the risk factors of anemia and hemoglobinopathies among under-five children. Health authorities of Bangladesh should especially take care of anemic children in this country.

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Household air pollution and the lung microbiome of healthy adults in Malawi: a cross-sectional study

BMC Microbiology ◽

10.1186/s12866-016-0803-7 ◽

2016 ◽

Vol 16 (1) ◽

Cited By ~ 17

Author(s):

Jamie Rylance ◽

Anstead Kankwatira ◽

David E. Nelson ◽

Evelyn Toh ◽

Richard B. Day ◽

...

Keyword(s):

Air Pollution ◽

Cross Sectional Study ◽

Healthy Adults ◽

Household Air Pollution ◽

Sectional Study ◽

Cross Sectional ◽

Lung Microbiome

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ASSESSMENT OF NUTRITIONAL STATUS AND ITS DETERMINANTS AMONG CHILDREN IN AGE GROUP OF 1-5 YEARS IN A TRIBAL POPULATION OF COIMBATORE DISTRICT-A CROSS SECTIONAL STUDY

10.36106/paripex/4501862 ◽

2020 ◽

pp. 51-54

Author(s):

T. Pravin ◽

P.K. Govindarajan ◽

A. John William Felix

Keyword(s):

Nutritional Status ◽

Maternal Education ◽

Cross Sectional Study ◽

Age Group ◽

Sectional Study ◽

Cross Sectional ◽

Under Five ◽

Under Five Children ◽

Malnourished Children ◽

Coimbatore District

Background: Under-five children are more vulnerable to malnutrition especially in rural areas resulting in more morbidity and mortality among them. The present study is aimed to assess the prevalence of malnutrition among children of 1-5 years of age in tribal hamlets of Valparai block, Coimbatore district in Tamil Nadu. Methods: A community-based, cross-sectional study was conducted among 95 children in the age group of 1-5 years during December-January 2020. Anthropometric measurements were taken. The indicators of nutritional status of children like stunting, underweight, and wasting were expressed using WHO growth standards. Results: The overall prevalence of malnutrition in our study was 31.6%. Among the 30 (31.6%) malnourished children, 40% were underweight, and 6.67% were severely underweight. 40% were stunted, of which 13.3% were severely stunted. Wasting was present in 23.3% of malnourished children. Severe wasting was not seen. Socio-demographic factors including the type of house, maternal education, BMI of the mother, age of mother at childbirth and place of delivery had significant association with malnutrition among under-five tribal children. Conclusions: Malnutrition poses a serious threat to under-five children. Though many known risk factors of malnutrition have been studied, understanding the local factors linked with malnutrition is so crucial while planning information, education, and communication programs in this area.

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Diarrheal Diseases in Under-Five Children and Associated Factors among Farta District Rural Community, Amhara Regional State, North Central Ethiopia: A Comparative Cross-Sectional Study

Journal of Environmental and Public Health ◽

10.1155/2020/6027079 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Yilkal Tafere ◽

Bedilu Abebe Abate ◽

Habtamu Demelash Enyew ◽

Amsalu Belete Mekonnen

Keyword(s):

Cross Sectional Study ◽

Sectional Study ◽

Diarrheal Diseases ◽

Open Defecation ◽

Cross Sectional ◽

North Central ◽

Central Ethiopia ◽

Under Five ◽

Factors Associated ◽

Under Five Children

Background. Diarrheal diseases are the major cause of morbidity and mortality among under-five children in low- and middle-income countries including Ethiopia. One of the national initiatives to reduce its burden is an implementation of an open-defecation-free program. However, information related to the comparison of diarrheal diseases among residents in open-defecation-free and non-open-defecation-free. Hence, this study assessed the magnitude of diarrheal diseases among residents in open-defecation-free and non-open-defecation-free areas of Farta District, North Central Ethiopia. Methods. A community-based comparative cross-sectional study was conducted among 758 households (378 in open-defecation-free and 380 in non-open-defecation-free kebeles) who have under-five children using a structured questionnaire. A systematic sampling technique was used to select study participants. Binary logistic regression was used to analyze factors associated with diarrheal diseases in the district. Results. Overall, 29.9% of children had diarrheal diseases in the last two weeks prior to the study. The magnitude of diarrheal diseases among under-five children living in open-defecation-free and non-open-defecation-free residents was 19.3% and 40.5%, respectively. Lack of functional handwashing facilities (AOR: 11, 95% CI (8.1–29.6)), improper excreta disposal (AOR: 3.84, 95% CI (2.15–5.65)), and residing in non-open-defecation-free areas (AOR: 2.4, 95% CI (1.72–3.23)) were factors associated with diarrheal diseases. Conclusions. The prevalence of diarrhea among children residing in open-defecation-free areas was lower than that among children those who resided in non-open-defecation-free areas. Lack of functional handwashing facilities, residing in non-open-defecation-free areas, and improper excreta disposal were significantly associated with diarrheal diseases in the district. Strengthening health promotion on non-open defecation, maintaining functional handwashing facilities, and preparing additional handwashing facilities are necessary. Continuous engagement of the community health extension workers is recommended, sustaining the implementation of open-defecation-free programs in the district.

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Socioeconomic Predictors of Intestinal Parasitic Infections Among Under-Five Children in Rural Dembiya, Northwest Ethiopia: A Community-Based Cross-sectional Study

Environmental Health Insights ◽

10.1177/1178630219896804 ◽

2019 ◽

Vol 13 ◽

pp. 117863021989680

Author(s):

Zemichael Gizaw ◽

Ayenew Addisu ◽

Mulat Gebrehiwot

Keyword(s):

Parasitic Infection ◽

Cross Sectional Study ◽

Northwest Ethiopia ◽

Parasitic Infections ◽

Intestinal Parasitic Infection ◽

Cross Sectional ◽

Intestinal Parasitic Infections ◽

Under Five ◽

Under Five Children ◽

Health Supervision

Background: Soil-transmitted helminths and protozoan parasitic infections are endemic throughout the world. The problem of intestinal parasitic infection is higher among developing countries where children are the most vulnerable groups. Although health information related to parasitic infections is available globally, it is often limited in rural setups in least developed countries. This study was, therefore, conducted to assess socioeconomic predictors of intestinal parasitic infections among under-five children in rural Dembiya, Northwest Ethiopia. Methods: This cross-sectional study was conducted among 224 randomly selected households with under-five children. We used questionnaire to collect data and direct stool examination to identify intestinal parasitic infections. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and P < .05 was used to identify socioeconomic predictors of parasitic infections. Results: We found that 25.4% (95% CI = [20.2, 31.1]) under-five children had intestinal parasitic infection. Ascaris lumbricoides was the leading infection, which accounted 44 of 224 (19.6%). The prevalence of childhood intestinal parasitic infections was higher among households with no members whose education level is secondary and above (AOR = 3.36, 95% CI = [1.23, 9.17]). Similarly, intestinal parasitic infections were statistically associated with presence of 2 under-five children in a household (AOR = 3.56, 95% CI = [1.29, 9.82]), absence of frequent health supervision (AOR = 3.49, 95% CI = [1.72, 7.09]), larger family size (AOR = 2.30, 95% CI = [1.09, 4.85]), and poor household economic status (AOR = 2.58, 95% CI = [1.23, 5.41]). Conclusions: Significant proportion of children was infected with intestinal parasitic infection in rural Dembiya. Educational status of family members, number of under-five children in a household, health supervision, family size, and wealth index were statistically associated with parasitic infections. Provision of anthelmintic drugs, health supervision, and health education targeted with transmission and prevention of infections are recommended.

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