Secondhand Smoking and Obesity Among Nonsmoking Adolescents Aged 12–15 Years From 38 Low- and Middle-Income Countries

Abstract Introduction Secondhand smoking (SHS) may be a risk factor for obesity in adolescence, but data on the association between SHS and obesity are scarce, especially from low- and middle-income countries (LMICs). Therefore, the aim of this study was to assess the association between SHS and obesity among adolescents aged 12–15 years from 38 LMICs. Methods Cross-sectional data from 38 LMICs that participated in the Global School-based Student Health Survey (GSHS) were analyzed. Body mass index was calculated based on measured weight and height. The 2007 WHO Child Growth reference was used to define obesity. SHS was categorized as no exposure, non-daily exposure (ie, 1–6 days), and daily exposure (ie, 7 days) based on the number of days exposed to secondhand smoke in the past 7 days. Multivariable logistic regression and meta-analyses were conducted to assess the associations. Results The analyzed sample consisted of 88 209 adolescents aged 12–15 years who never smoked. The overall prevalence of non-daily and daily SHS was 34.2% and 15.7%, respectively. After adjustment for potential confounders, compared with no SHS, there was no significant association between non-daily SHS and obesity (odds ratio [OR] = 0.94; 95% confidence interval [CI] = 0.86–1.02), but adolescents who reported daily SHS were significantly more likely to have obesity (OR = 1.19; 95% CI = 1.06–1.34). Conclusions The prevalence of SHS was high among adolescents in LMICs, and daily SHS was associated with a significant increase in odds of obesity. Future studies with longitudinal designs are warranted to assess causality and whether prevention of SHS can reduce the risk of obesity in adolescence. Implications In the present large multi-country study on adolescents aged 12–15 years from LMICs, nearly half of the students were exposed to non-daily or daily secondhand smoke. Overall, while non-daily SHS was not significantly associated with obesity, adolescents who reported daily SHS had a significant 1.19 (95% CI = 1.06–1.34) times higher odds of obesity than those who reported no exposure to secondhand smoke. To the best of our knowledge, this is the first multi-country study on SHS and obesity from LMICs, and also the largest study on this topic to date.

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Association between Household Crowding and Violent Discipline and Neglect of Children: Analysis of Multiple Indicator Cluster Surveys in 26 Low- and Middle-Income Countries

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041685 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1685

Author(s):

Yaqing Gao ◽

Xiaoyi Mi ◽

Yinping Wang ◽

Siyu Zou ◽

Hong Zhou

Keyword(s):

Child Neglect ◽

Physical And Mental Health ◽

Cross Sectional ◽

Middle Income ◽

Logistic Regression Models ◽

Middle Income Countries ◽

Multiple Indicator ◽

Household Crowding ◽

Meta Analyses ◽

Low And Middle Income

The influence of household crowding on physical and mental health has been well documented. However, research on the influence of household crowding on violent discipline and neglect of children is scarce. Therefore, we aimed to investigate whether household crowding was associated with violent discipline and neglect of children in low- and- middle-income countries (LMICs). Cross-sectional data for 280,005 and 73,030 children in 26 LMICs surveyed using the Multiple Indicator Cluster Survey were analyzed for (1) violent discipline and (2) neglect, respectively. In each country, we used logistic regression models to estimate the effects of household crowding on multiple forms of violent discipline and stimulation activities (as a proxy of the level of child neglect). Estimates were pooled using random effects meta-analyses. After adjusting for confounding variables, household crowding was associated with higher odds of any violent discipline (odds ratio (OR) = 1.09, 95% CI 1.03 to 1.15, p = 0.002) and lower odds of engaging in four or more stimulation activities (OR = 0.88, 95% CI 0.83 to 0.94, p < 0.001). The associations were stronger for urban children and children living in low- and lower-middle-income countries. The findings suggest that screenings and interventions aimed at reducing the effects of household crowding might be effective in preventing and controlling violent discipline and neglect of children in LMICs.

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Multimorbidity and Anxiety Symptoms among Adults Aged 50 Years and Over from Six Low- and Middle-Income Countries

Journal of Ageing and Longevity ◽

10.3390/jal1010005 ◽

2021 ◽

Vol 1 (1) ◽

pp. 36-47

Author(s):

Lee Smith ◽

Guillermo F. López Sánchez ◽

Jae Il Shin ◽

Pinar Soysal ◽

Nicola Veronese ◽

...

Keyword(s):

Chronic Conditions ◽

Meta Analysis ◽

Anxiety Symptoms ◽

Adult Health ◽

Cross Sectional ◽

Middle Income ◽

Middle Income Countries ◽

Nationally Representative ◽

Meta Analyses ◽

Low And Middle Income

Currently, there are limited data on the association between multimorbidity (i.e., ≥ 2 chronic conditions) and anxiety, especially among the older population in low- and middle-income countries (LMICs). Thus, the aim of the present study was to examine the association between multimorbidity and anxiety symptoms in a large sample of adults aged ≥ 50 years from six LMICs (China, India, Ghana, Mexico, Russia, South Africa). Cross-sectional, nationally representative, community-based data from the Study on Global Ageing and Adult Health (SAGE) were analysed. A total of 11 chronic physical conditions were assessed. Anxiety symptoms referred to extreme/severe problems with worry or anxiety in the past 30 days. Multivariable logistic regression and meta-analyses were conducted. Data on 34,129 adults aged ≥ 50 years were analysed (mean (SD) age 62.4 (16.0) years; 52.1% females). Compared with no chronic conditions, 2, 3, 4, and ≥ 5 chronic conditions were significantly associated with 1.47 (95% CI = 1.08–1.98), 2.46 (95% CI = 1.74–3.47), 3.04 (95% CI = 2.15–4.30), and 4.70 (95% CI = 2.99–7.38) times higher odds of anxiety symptoms, respectively. A country-wise analysis showed that multimorbidity was significantly associated with anxiety symptoms in all six countries (OR = 1.78–12.39) with the overall estimate based on a meta-analysis being OR = 2.29 (95% CI = 1.71–3.07). Multimorbidity was associated with higher odds of anxiety symptoms among older adults in LMICs. Future longitudinal studies are warranted to assess the temporal associations and mechanisms underlying this association.

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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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