scholarly journals Effects of short birth interval on neonatal, infant and under-five child mortality in Ethiopia: a nationally representative observational study using inverse probability of treatment weighting

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e047892
Author(s):  
Desalegn Markos Shifti ◽  
Catherine Chojenta ◽  
Elizabeth Holliday ◽  
Deborah Loxton

ObjectiveTo assess the effect of short birth interval (SBI) on neonatal, infant, and under-five mortality in Ethiopia.DesignA nationally representative cross-sectional survey.SettingThis study used data from the Ethiopia Demographic and Health Survey 2016.ParticipantsA total of 8448 women who had at least two live births during the 5 years preceding the survey were included in the analysis.Outcome measuresNeonatal mortality (death of the child within 28 days of birth), infant mortality (death between birth and 11 months) and under-five mortality (death between birth and 59 months) were the outcome variables.MethodsWeighted logistic regression analysis based on inverse probability of treatment weights was used to estimate exposure effects adjusted for potential confounders.ResultsThe adjusted ORs (AORs) of neonatal mortality were about 85% higher among women with SBI (AOR=1.85, 95% CI=1.19 to 2.89) than those without. The odds of infant mortality were twofold higher (AOR=2.16, 95% CI=1.49 to 3.11) among women with SBI. The odds of under-five child mortality were also about two times (AOR=2.26, 95% CI=1.60 to 3.17) higher among women with SBI.ConclusionSBI has a significant effect on neonatal, infant and under-five mortality in Ethiopia. Interventions targeting SBI are warranted to reduce neonatal, infant and under-five mortality.

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 911-911
Author(s):  
Paddy Ssentongo ◽  
Joseph Lewcun ◽  
Anna Ssentongo ◽  
Djibril Ba ◽  
Claudio Fronterre ◽  
...  

Abstract Objectives During the Millennium Development Goals (MDG) era, many low- and middle-income countries (LMICs) failed to achieve the MDG 4 of reducing neonatal, infant, and under-5 mortality. In this study, we aimed to assess whether reductions in early childhood undernutrition is associated with a reduction in neonatal, infant and under-5 mortality rate in LMICs. Methods We analyzed demographic and health household survey data from 62 LMICs collected between 2006 and 2018. The sample consisted of nationally representative cross-sectional surveys of children aged 0–59 months (n = 600,390). We examined country-level prevalence of stunting, wasting and underweight (based on z scores < −2 per the WHO Growth Standard) each as predictors of neonatal, infant and under-5 mortality incidence using multivariate Poisson regression models adjusted for country-level mean duration of breastfeeding and gross domestic product per capita. We also examined the association between breastfeeding and mortality. Results Overall, 28.4% (95% CI: 26.3%, 30.7%) of young children were stunted, 5.4% (95% CI: 4.5%, 6.6%) were wasted, 12.3% (95% CI: 10.4%, 14.6%) were underweight. Per 1000 live births, neonatal mortality was 23.6 (95% CI: 19.3–27.1), infant mortality was 43.4 (95% CI: 30.2–50.1) and under-5 mortality was 61.6 (95% CI: 55.3- 68.3). At the country level, a 10-fold decrease in stunting was associated with a relative risk (RR) of 0.81 (95% CI 0.66–0.98; P < 0.001) for neonatal mortality, 0.66 (95% CI 0.55–0.80; P < 0.001) for infant mortality, and 0.63 (95% CI 0.52–0.76; P < 0.001) for under-5 mortality. No association was seen between wasting or underweight and child mortality. Breastfeeding was associated with lower rates of child mortality. A one standard deviation (16 months) increase in breastfeeding was associated with a RR of 0.86 (95% CI 0.76–0.97; P = 0.015) for neonatal mortality, 0.79 (95% CI 0.70–0.89; P < 0.001) for infant mortality, and 0.75 (95% CI 0.67–0.85; P < 0.001) for under-5 mortality. Conclusions In a very large, multi-country sample of nationally-representative surveys in LMICs, stunting was strongly associated with child mortality from birth to 5 years. Stunting should be a focus in the effort to achieve the Sustainable Development Goal 3.2 target to reduce neonatal and under-5 mortality in all countries by 2030. Funding Sources National Institute of Health.


2020 ◽  
Author(s):  
Md. Zakiul Alam ◽  
Md. Syful Islam

Abstract Introduction: Child health, especially childhood mortality, is one of the critical indicators of human development. No child mortality is desirable, but it is still high in Bangladesh. We aimed to assess the effect of the child's desired status of mothers on childhood morbidity and mortality of Bangladesh. Data and Method: We used the data from nationally representative cross-sectional Bangladesh Demographic and Health Survey (BDHS) 2014 and restricted the analyses to children born in the past five years preceding the survey. We estimated the undesired status (excess in boy, girl, both, and parity) by subtracting an ideal number of children from the total live birth. We measured childhood mortality (neonatal, infant, and under-five mortality), morbidity (fever, diarrhea, cough, and ARI), and nutritional problems (stunting, wasting, and underweight). Finally, we utilized the chi-square test and multilevel logistic regression analyses. Findings: The prevalence of undesired children was 20.7%, 23.2%, 4.9%, and 30.3% for boys, girls, both boys and girls, and parity, respectively. Age, education, residence, division, and household wealth index were significantly associated with undesired children. The prevalence of under-five mortality was 3.1% among desired children, almost double (5.9%) among undesired children. The likelihood of under-five mortality was 85% (AOR) to 97% (COR) higher among undesired children than the desired one. Childhood malnutrition (stunting and underweight except wasting) was also higher and significantly associated with undesired children. We also found 17% (AOR: 0.83; 95% CI: 0.72, 0.96) lower postnatal checkup for undesired children. Despite lower under-five mortality among higher socioeconomic status, the relative contribution of undesired children to under-fiver mortality was larger. Conclusion: The share of childhood mortality and malnutrition was higher among undesired children. Every child should be wanted, and no unwanted pregnancies are desirable; thereby, the government should reemphasize the proper use of family planning methods to reduce child mortality and malnutrition.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Bin Jiang ◽  
Hongmei Liu ◽  
Dongling Sun ◽  
Haixin Sun ◽  
Xiaojuan Ru ◽  
...  

Abstract Background and purpose Epidemiological data on primary brain tumours (PBTs) are lacking due to the difficulty in case ascertainment among the population. Thus, we aimed to estimate mortality due to PBTs in China nationwide and the detection rate in people with suspected symptoms. Methods A multistage, complex sampling survey regarding mortality due to PBTs in Chinese individuals was carried out by reviewing all causes of death within a year. The detection rates in people with suspected symptoms were estimated based on PBT symptom screening and neurologist reviews and compared between groups by logistic regression analysis. Results Weighted mortality due to PBT was 1.6 (0.8–3.3) per 100,000 population in Chinese individuals, 1.8 (0.7–4.6) per 100,000 population in men, and 1.5 (0.5–4.5) per 100,000 population in women. Among 14,990 people with suspected symptoms, the PBT detection rate was 306.9 (95% CI 224.7–409.3) per 100,000 population in the total population, 233.0 (95% CI 135.7–373.1) per 100,000 population in men, and 376.9 (95% CI 252.4–546.3) per 100,000 population in women. People with an unsteady gait (OR 2.46; 95% CI 1.09–5.51; P=0.029), visual anomalies (3.84; 1.88–7.85; P<0.001), and headache (2.06; 1.10–3.86; P=0.023) were more likely to have a brain tumour than those without corresponding symptoms, while people with dizziness/vertigo were less likely to have a brain tumour than those without corresponding symptoms (0.45; 0.23–0.87; P=0.017). Conclusions Mortality due to PBT in China was low, with a nationwide estimate of 21,215 (10,427–43,165) deaths attributable to PBTs annually. However, the detection rate of PBTs can be greatly improved based on symptom screening in the population.


2021 ◽  
pp. 089011712110340
Author(s):  
Bhagyashree Katare ◽  
Shuoli Zhao ◽  
Joel Cuffey ◽  
Maria I. Marshall ◽  
Corinne Valdivia

Purpose: Describe preferences toward COVID-19 testing features (method, location, hypothetical monetary incentive) and simulate the effect of monetary incentives on willingness to test. Design: Online cross-sectional survey administered in July 2020. Subjects: 1,505 nationally representative U.S. respondents. Measures: Choice of preferred COVID-19 testing options in discrete choice experiment. Options differed by method (nasal-swab, saliva), location (hospital/clinic, drive-through, at-home), and monetary incentive ($0, $10, $20). Analysis: Latent class conditional logit model to classify preferences, mixed logit model to simulate incentive effectiveness. Results: Preferences were categorized into 4 groups: 34% (n = 517) considered testing comfort (saliva versus nasal swab) most important, 27% (n = 408) were willing to trade comfort for monetary incentives, 19% (n = 287) would only test at convenient locations, 20% (n = 293) avoided testing altogether. Relative to no monetary incentives, incentives of $100 increased the percent of testing avoiders (16%) and convenience seekers (70%) that were willing to test. Conclusion: Preferences toward different COVID-19 testing features vary, highlighting the need to match testing features with individuals to monitor the spread of COVID-19.


2021 ◽  
pp. 026010602098234
Author(s):  
Pradeep Kumar ◽  
Himani Sharma ◽  
Kamalesh Kumar Patel

Background: Despite various programmes initiated by the Government of India, the nutritional indicators are not encouraging, as several problems like undernutrition, malnutrition and anaemia – still persist in the country, especially in the Empowered Action Group (EAG) states. Aim: Because of the dearth of studies regarding anaemia among men in India, the present study aimed to determine its prevalence in this population in the EAG states and to analyse its geographical and socio-demographic determinants. Methods: The study utilized nationally representative, cross-sectional survey data from round 4 of the National Family Health Survey conducted in 2015–16. Bivariate analysis along with binary logistic regression were performed to assess the predictors of anaemia among men in the EAG states. Results: Around a quarter of the men in the EAG states suffered from anaemia. A similar high-prevalence pattern was observed across the EAG states. Wherein, Bihar and Jharkhand had the highest prevalence of anaemia while Uttarakhand showed the lowest. Age, place of residence, marital status and caste were positively associated with the likelihood of anaemia among men in the EAG states. Conclusions: Focusing on the EAG states, this study considered the severity of anaemia as a public health problem among men. Strategies to reduce the burden of anaemia among this population are needed. The government should formulate programmes targeting anaemia specifically, and improving the nutritional status among men in general in the EAG states.


Author(s):  
Ta-Chuan Yeh ◽  
Ya-Mei Bai ◽  
Shih-Jen Tsai ◽  
Tzeng-Ji Chen ◽  
Chih-Sung Liang ◽  
...  

Irritable bowel syndrome (IBS) is a functional bowel disorder that is highly comorbid with mental disorders. However, few studies have examined the risk of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), bipolar disorder, major depressive disorder (MDD), and schizophrenia in the offspring of parents with IBS. We used nationally representative cross-sectional survey data to analyze cross-generational transmission patterns of both IBS and major mental disorders. Odds ratio (OR) was calculated by using logistic regression models with adjustment for potential confounding factors. Offspring of parents with IBS were more likely to develop IBS themselves (OR = 2.41, 95% confidence interval (CI), 2.09–2.78), ADHD (OR = 1.33, 95% CI, 1.08–1.62), and MDD (OR = 1.32, 95% CI, 1.04–1.68) than the controls. Data stratification by parental sex revealed that paternal IBS increased risk of ADHD (OR = 1.34, 95% CI, 1.01–1.77) in the offspring, while maternal IBS increased the risk of MDD (OR = 1.51, 95% CI, 1.11–2.06). This is the first study to reveal parental IBS is associated with IBS, ADHD, and MDD among offspring, suggesting the necessity for early implementation of prevention strategies for at-risk children.


2020 ◽  
Author(s):  
Antonio Pedro Ramos ◽  
Robert Weiss ◽  
Simeon Nietcher ◽  
Leiwen Gao

Background: Various studies suggest that corruption affects public health systems across the world. However, the extant literature lacks causal evidence about whether anti-corruption interventions can improve health outcomes. We examine the impact of randomized anti-corruption audits on early-life mortality in Brazil. Methods: The Brazilian government conducted audits in 1,949 randomly selected municipalities between 2003 and 2015. To identify the causal effect of anti-corruption audits on early-life mortality, we analyse data on health outcomes from individual- level vital statistics (DATASUS) collected by Brazil government before and after the random audits. Data on the audit intervention are from the Controladoria-Geral da Uniao, the government agency responsible for the anti-corruption audits. Outcomes are neonatal mortality, infant mortality, child mortality, preterm births, and prenatal visits. Analyses examine aggregate effects for each outcome, as well as effects by race, cause of death, and years since the intervention. Results: Anti-corruption audits significantly decreased early-life mortality in Brazil. Expressed in relative terms, audits reduced neonatal mortality by 6.7% (95% CI -8.3%, -5.0%), reduced infant mortality by 7.3% (-8.6%, -5.9%), and reduced child mortality by 7.3% (-8.5%, -6.0%). This reduction in early mortality was higher for nonwhite Brazilians, who face significant health disparities. Effects are greater when we look at deaths from preventable causes, and show temporal persistence with large effects even a decade after audits. In addition, analyses show that the intervention led to a 12.1% (-13.4%, -10.6%) reduction in women receiving no prenatal care, as well as a 7.4% (-9.4%, -5.5%) reduction in preterm births; these effects are likewise higher for nonwhites and are persistent over time. All effects are robust to various alternative specifications. Interpretation: Governments have the potential to improve health outcomes through anti-corruption interventions. Such interventions can reduce early-life mortality and mitigate health disparities. The impact of anti-corruption audits should be investigated in other countries, and further research should further explore the mechanisms by which combating corruption affects the health sector.


PEDIATRICS ◽  
2007 ◽  
Vol 120 (1) ◽  
pp. 110-117 ◽  
Author(s):  
P. Due ◽  
E. H. Hansen ◽  
J. Merlo ◽  
A. Andersen ◽  
B. E. Holstein

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