Risk Factors Associated with Under-Five Stunting, Wasting, and Underweight Based on Ethiopian Demographic Health Survey Datasets in Tigray Region, Ethiopia

Background. Stunting, wasting, and underweight among children are major problems in most regions of Ethiopia, including the Tigray region. The main objective of this study was to assess the risk factors associated with stunting, wasting, and underweight of children in the Tigray region. Methods. The information collected from 1077 children born 5 years before the survey was considered in the analysis. Multivariable binary logistic regression analysis was fitted to identify significant risk factors associated with stunting, wasting, and underweight. Results. Male children and rural born were having a higher burden of both severe and moderate stunting, wasting, and underweight than females and urban born. Among male children, 27.6%, 4.10%, and 14.2% of them were stunted, wasted, and underweight, respectively. Protected drinking water (odds ratio (OR) = 0.68; 95% confidence interval (CI): (0.50, 0.92)) was associated with stunting. Maternal age at birth less than 20 years (OR = 0.66; 95% CI: (0.45, 0.97)) and being male (OR = 2.04; 95% CI: (1.13, 3.68)) were associated with high risk of underweight. No antenatal care follow-up (OR = 2.20; 95% CI: (1.04, 4.64)) was associated with wasting, while the poor wealth index, diarrhea, low weight at birth (<2.5 kg), lower age of a child, and 3 or more under-five children in a household were significantly associated with stunting, wasting, and underweight. Conclusions. Being born in rural, being male, unprotected drinking water, smaller weight at birth, no antenatal follow-ups, diarrhea, and poor household wealth were factors associated with increased stunting, wasting, and underweight. Thus, interventions that focus on utilization of antenatal care services, improving household wealth, and improving access to protected drinking water were required by policymakers to decrease stunting, wasting, and underweight more rapidly.

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A Scoping Review of the Risk Factors Associated with Anaemia among Children Under Five Years in Sub-Saharan African Countries

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17238829 ◽

2020 ◽

Vol 17 (23) ◽

pp. 8829

Author(s):

Phillips Edomwonyi Obasohan ◽

Stephen J. Walters ◽

Richard Jacques ◽

Khaled Khatab

Keyword(s):

Risk Factors ◽

Scoping Review ◽

Household Wealth ◽

Sub Saharan Africa ◽

Cochrane Library ◽

Children Under Five ◽

Contextual Risk ◽

Under Five ◽

Factors Associated ◽

Sub Saharan

Background/Purpose: Globally, anaemia is a severe public health condition affecting over 24% of the world’s population. Children under five years old and pregnant women are the most vulnerable to this disease. This scoping review aimed to evaluate studies that used classical statistical regression methods on nationally representative health survey data to identify the individual socioeconomic, demographic and contextual risk factors associated with developing anaemia among children under five years of age in sub-Saharan Africa (SSA). Methods/Design: The reporting pattern followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. The following databases were searched: MEDLINE, EMBASE (OVID platform), Web of Science, PUBMED, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Scopus, Cochrane library, African Journal of online (AJOL), Google Scholar and Measure DHS. Results: The review identified 20 relevant studies and the risk factors for anaemia were classified as child-related, parental/household-related and community- or area-related factors. The risk factors for anaemia identified included age, birth order, sex, comorbidities (such as fever, diarrhoea and acute respiratory infection), malnutrition or stunting, maternal education, maternal age, mother’s anaemia status, household wealth and place of residence. Conclusion: The outcome of this review is of significant value for health policy and planners to enable them to make informed decision that will correct any imbalances in anaemia across socioeconomic, demographic and contextual characteristics, with the view of making efficient distributions of health interventions.

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Asymptomatic Intestinal Parasitic Infestations among Children Under Five Years in Selected Communities in the Ho Municipality, Ghana

Ethiopian Journal of Health Sciences ◽

10.4314/ejhs.v30i6.3 ◽

2020 ◽

Vol 30 (6) ◽

Author(s):

G.E. Kpene ◽

S.Y. Lokpo ◽

J.G. Deku ◽

E. Agboli ◽

P.K. Owiafe

Keyword(s):

Risk Factors ◽

Rural Communities ◽

Intestinal Parasites ◽

P Value ◽

Binary Logistic Regression Analysis ◽

Children Under Five ◽

Under Five ◽

Factors Associated ◽

Asymptomatic Children ◽

Children Under 5

BACKGROUND፡ The study investigated intestinal parasitic infestations (IPIs) and possible risk factors associated with asymptomatic children under five (5) years in five (5) selected communities in the Ho Municipality.METHODS: The study design was cross- sectional, with a simple random sampling technique involving 150 asymptomatic children under 5 years from 5 selected communities (Klave, Hoe, Freetown, Dave and Godokpe) in the Ho Municipality. A questionnaire was used to obtain socio-demographics and other relevant parameters. Direct wet preparation, formol-ether concentration and Modified ZN staining techniques were used for the identification of intestinal parasites from participants’ stool samples. The Fisher’s exact test and binary logistic regression analysis were used to determine the difference in IPIs proportions and assess the risk factors associated with IPIs respectively.RESULTS: The overall IPIs cases was 14% (21/150). Cryptosporidium spp was most predominant [5.3% (8/150)], followed by Entamoeba spp [3.3% (5/150)], Cyclospora cayetenensis [2.7% (4/150)], Ascaris lumbricoides [1.3% (2/150)], Giardia lamblia [0.7% (1/150)] and Strongyloides stercoralis [0.7% (1/150)]. Children in rural communities (23.4%) recorded significantly higher case rate compared to those in urban communities (9.8%0), (p=0.04). Lower educational attainment of mother [OR=0.55, 95% CI (0.37 – 0.83), p-value = 0.015] andresidence in rural communities [OR = 0.53, 95% CI (0.33 –0.88)], p-value = 0.025] were significantly associated with IPIs.CONCLUSION: Asymptomatic IPIs are quite prevalent among children under 5 years in the Ho Municipality. The study thus recommends active sensitization programs for parents/guardians on preventive measures and school health programs should be instituted in rural communities.

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Bayesian Multilevel Analysis of Determinants of Acute Respiratory Infection in Children under the Age of Five Years in Ethiopia

10.21203/rs.3.rs-120356/v1 ◽

2020 ◽

Author(s):

Amanuel Merera ◽

Tilahun Asena ◽

Mebratu Senbeta

Keyword(s):

Drinking Water ◽

Vitamin A ◽

Respiratory Infection ◽

Prevalence Rate ◽

Acute Respiratory Infection ◽

Wealth Index ◽

Household Wealth ◽

Children Under Five ◽

Under Five ◽

Under Five Children

Abstract Background: Acute respiratory tract infection (ARI) is a leading cause of morbidity and mortality in children under the age of five years in the world. ARIs, principally pneumonia, account for approximately 1.9 million (1.6 - 2.2 million) deaths globally in children under the age of five years in Ethiopia. Among these deaths majority occur in the developing world. The share for low and middle-income countries takes the highest indeed. In Ethiopia, the prevalence rate of ARI was 7% according to 2016 EDHS estimates. Method: Bayesian multilevel approach was employed to assess possible factors associated with the prevalence of acute respiratory infection (ARI) among under-five children in Ethiopia. The data was collected from 10,641 children under the age of five years out of which 9,918 children were considered in this study. Result: The ARI prevalence rate for children under five years was estimated as 8.4%, which was slightly higher than the estimated prevalence level of the country. The highest proportion of the prevalence of ARI was observed for children whose mothers had no education. The major health, environmental and nutritional related background characteristics of the proportion of children who had ARI varied from one region to another. The highest prevalence of ARI was observed in Tigray (15.31%) followed by Oromia (14.40%) as opposed to the low prevalence which was recorded in Benishangul Gumuz (2.58%). The utilization of vitamin A was analyzed and the results shows that about 43.10% who received vitamin A had the lowest proportion on the prevalence of ARI (7.75%) compared to not having vitamin A. About 11.13% of under-five children had Diarrhea with the highest prevalence of ARI (24.64%) and the highest prevalence of ARI was observed for the child whose source of drinking water were unprotected/unimproved (9.39%). Conclusion: The age of the child, household wealth index, mother educational level, and vitamin A supplement, history of diarrhea, maternal work, stunting and source of drinking water were found to be significantly affecting the prevalence of ARI among children under five years. Furthermore, the study revealed that there is a significant variation of incidence of ARI between and within the regions of Ethiopia. Attention should be given to those predictor variables while planning to increase the health status of children in Ethiopia.

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Risk Factors Associated With Frequency of Antenatal Visits, Number of Items of Antenatal Care Contents Received and Timing of First Antenatal Care Visits in Ethiopia: Multilevel Mixed-Effects Analysis

10.21203/rs.3.rs-110214/v1 ◽

2020 ◽

Author(s):

Berhanu Woldeamanuel ◽

Tadesse Belachew

Keyword(s):

Risk Factors ◽

Decision Making ◽

Antenatal Care ◽

Household Wealth ◽

Mixed Effects ◽

Care Utilization ◽

Rural Residence ◽

Wealth Status ◽

Factors Associated ◽

Antenatal Care Utilization

Abstract Background: An improved quality Antenatal care (ANC) from skilled providers is essential to pregnant women so that ensure the key health circumstances for mother and child during pregnancy. Thus, this study attempted to assess which risk factors are significantly associated with the timing of antenatal care, the number of antenatal care visits, and the number of items of antenatal care contents received from skilled providers in the recent pregnancy among mothers in Ethiopia. Methods: Data was extracted from the 2016 Ethiopian Demographic and Health Survey. A total of 4,685 mothers was included in the analysis. Multilevel mixed-effects logistic regression analysis and multilevel mixed Negative binomial models were fitted to find the factors associated with antenatal care utilization. A 95% Confidence Interval of Odds ratio/Incidence rate ratio excluding one was reported as significant association with timely initiation of the ANC, numbers of ANC visits, numbers of items of antenatal care contents received and predictor variables.Results: About 20% of the mothers initiated ANC within the first trimester, 36.3% visits at least four ANCs, 3.6% have visited at least eight ANCs, and only 53% received at least four items of antenatal care contents. Rural residence (IRR = 0.81; 95%CI: 0.80-0.89), wanted no more children (IRR = 0.83; 95%CI: 0.75-0.91), mother without decision making power (IRR = 0.90; 95%CI: 0.83-0.98) associated with reduced frequency of ANC visits, while being rural residents (IRR = 0.82; 95%CI: 0.75-0.90), wanted no more children (IRR = 0.87; 95%CI: 0.79-0.96), husband alone decision maker of mothers health care (IRR = 0.88; 95%CI: 0.81-0.96) associated with reduced items of ANC content received. Further, birth order six or more (IRR = 0.74; 95%CI: 0.56-0.96), rural residence (IRR = 0.0.41; 95%CI: 0.34-0.51), wanted no more children (IRR = 0.61; 95%CI: 0.48-0.77) associated with delayed antenatal care utilization. Moreover, higher household wealth status, primary or secondary or higher education of mothers and partner, listening to the radio and watching television at least once a week, and a short distance to health facility were positively significantly associated with the frequency of antenatal care visits, numbers of items of ANC contents received and early initiation of ANC visit for the recent pregnancy during the last five years before the survey. Conclusions: Rural residence, poorest household wealth status, no education level of mothers or partners, unexposed to mass media, unwanted pregnancy, mothers without decision making power, and big distance to the nearest health facility, have a significant impact in delaying the timing of ANC visits, reducing the number of ANC visits and items of ANC received in Ethiopia. We ought to timely initiate an ANC visit for a frequent antenatal care visit during pregnancy. Educating girls and encouraging mothers to use modern contraceptives in order to prevent unwanted pregnancies are vital ingredients that should be included in all policies aiming to reduce maternal and neonatal deaths through improved quality of antenatal care utilization.

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Prevalence and Determinants of Under-nutrition Among Children Under Five Years of Age in Afar Region, Ethiopia: Evidence From 2016 Ethiopian Demographic and Health Survey

10.21203/rs.3.rs-910460/v1 ◽

2021 ◽

Author(s):

Damitie Kebede Mengesha

Keyword(s):

Public Health ◽

Health Survey ◽

Wealth Index ◽

Household Wealth ◽

Demographic And Health Survey ◽

Binary Logistic Regression Analysis ◽

Health Concerns ◽

Under Five ◽

Under Nutrition ◽

Afar Region

Abstract BackgroundUndernutrition is one of the major public health concerns among infants and young children in the country. Childhood under-nutrition is widespread in low and middle-income countries. This study was initiated to assess the prevalence of under-nutrition and its associated factors among under-five children in Afar Region, Ethiopia. MethodsThe data for this study were extracted from the Ethiopian Demographic and Health Survey (EDHS) 2016. The information collected from 937 children born 5 years before the survey was considered in the analysis. A multivariable binary logistic regression analysis was used at a 5% level of significance to determine the individual- and community-level factors associated with childhood malnutrition.ResultsThe prevalence of stunting, underweight and wasting in Afar region were 41.1%, 36.2% and 17.7%, respectively. About 26.7% of children in Afar region were both stunting and underweight, 12.7% were both underweight and wasting, 7.6% were both stunting and wasting and only 7.0% of children had all the three under-nutrition conditions. Among the factors considered in this study, age of a child in months, anemia level, mothers’ BMI, household wealth index, size of child at birth, number of living children and place of residence were significantly associated with stunting, underweight and wasting in Afar Region. ConclusionsThe prevalence of all stunting, underweight and wasting was relatively high. Undernutrition is one of the major public health concerns among children in Afar Region. The effect of these factors should be considered to develop strategies to reduce under-nutrition in the study area. Thus, intervention should be focused on improving the under-nutrition determinants of the children to improve the child's nutritional status and reduce child morbidity and mortality.

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Simultaneous quantile regression and determinants of under-five severe chronic malnutrition in Ghana.

10.21203/rs.2.14233/v2 ◽

2020 ◽

Author(s):

Justice Moses K. Aheto

Keyword(s):

Risk Factors ◽

Quantile Regression ◽

Significant Risk ◽

Household Wealth ◽

Public Health Issue ◽

Wealth Status ◽

Chronic Malnutrition ◽

Severe Stunting ◽

Under Five ◽

The Impact

Abstract Background Under-five malnutrition is a major public health issue contributing to mortality and morbidity, especially in developing countries like Ghana where the rates remain unacceptably high. Identification of critical risk factors of under-five malnutrition using appropriate and advanced statistical methods can help formulate appropriate health programmes and policies aimed at achieving the United Nations SDG Goal 2 target 2. This study attempts to develop a simultaneous quantile regression, an in-depth statistical model to identify critical risk factors of under-five severe chronic malnutrition (severe stunting). Methods Based on the nationally representative data from the 2014 Ghana Demographic and Health Survey, height-for-age z-score (HAZ) was estimated. Multivariable simultaneous quantile regression modelling was employed to identify critical risk factors for severe stunting based on HAZ (a measure of chronic malnutrition in populations). Quantiles of HAZ with focus on severe stunting were modelled and the impact of the risk factors determined. Significant test of the difference between slopes at different selected quantiles of severe stunting and other quantiles were performed. A quantile regression plots of slopes were developed to visually examine the impact of the risk factors across these quantiles. Results Data on a total of 2716 children were analysed out of which 144 (5.3%) were severely stunted. The models identified child level factors such as type of birth, sex, age, place of delivery and size at birth as significant risk factors of under-five severe stunting. Maternal and household level factors identified as significant predictors of under-five severe stunting were maternal age and education, maternal national health insurance status, household wealth status, and number of children under-five in households. Highly significant differences exist in the slopes between 0.1 and 0.9 quantiles. The quantile regression plots for the selected quantiles from 0.1 to 0.9 showed substantial differences in the impact of the covariates across the quantiles of HAZ considered. Conclusion Critical risk factors that can aid formulation of child nutrition and health policies and interventions that will improve child nutritional outcomes and survival were identified. Modelling under-five severe stunting using multivariable simultaneous quantile regression models could be beneficial to addressing the under-five severe stunting.

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Assessment of the Quality of Antenatal Care Services and the Associated Risk Factors in Tanzania

10.21203/rs.3.rs-30567/v1 ◽

2020 ◽

Author(s):

Abdalla Hussein ◽

Jackline Mbishi

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Antenatal Care ◽

Regression Model ◽

Service Provision ◽

Logistic Regression Model ◽

Wealth Index ◽

Factors Associated ◽

Associated Risk Factors

Abstract Background This study gives the finding of the assessment made on the quality of antenatal care (ANC) services received by women in Tanzania during pregnancy and the associated risk factors. Methods We used the data from the 2015-16Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS). The sample included 6,924 women who gave birth in the five years before the survey and having at least one ANC visit in the most current pregnancy. The quality of ANC services provided was assessed using six questions on receipt of recommended components of ANC services. The responses of the individual components were summed up to generate the ANC service provision score. In so doing, the women who received all six components were considered to receive good quality ANC services. A weighted logistic regression model was employed in the examination of the factors associated with the quality of ANC services. Results The average service provision score was 4.4 out of a total of 6. Approximately, 31% of the women received good quality ANC services. The most provided ANC components were blood sample measurement (87%) and iron tablets/syrup (82.1%). The urine sample (60%) was the least offered ANC service. The results of the adjusted logistic regression model revealed that age, place of residence, education level, the time of the first ANC visit, number of ANC visits, and family wealth index were significant factors associated with the quality of ANC services. Conclusions In terms of service provision, the quality of ANC service in Tanzania is suboptimal. With differences by observed risk factors, there must be more efforts to strengthen the quality of ANC services and to remove the differences.

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Clinical profile and risk factors for persistent diarrhoea in children under five years of age in an urban referral centre

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20174156 ◽

2017 ◽

Vol 4 (6) ◽

pp. 1986

Author(s):

Prabakar Durairaj ◽

Sasivarathan Raju ◽

Sivaraman Thirumalaikumarasamy

Keyword(s):

Risk Factors ◽

Drinking Water ◽

Protein Energy Malnutrition ◽

Significant Risk ◽

Antibiotic Use ◽

Clinical Profile ◽

Persistent Diarrhoea ◽

Factors Associated ◽

Protein Energy ◽

Study Population

Background: Persistent diarrhoea is a known cause of childhood mortality, morbidity and malnutrition in developing countries. The present study was conducted with the aim to study the clinical profile of persistent diarrhoea in children under 5 years of age and to find the possible host and environmental risk factors associated with persistent diarrhoea.Methods: The present descriptive study was conducted on 70 children with persistent diarrhoea, between age of 1 month and 5 years who admitted to DTTU, ICH & HC, Chennai during the period from February 2005 to September 2006. Detailed history was elicited from the parents usually mother regarding illness and risk factors were noted. The children were subjected to detailed clinical examination to assess dehydration, malnutrition, parenteral infections, and nutritional status. Univariable and multivariable logistic regression analyses were used to find risk factors associated with the incidence of diarrhoea.Results: Most of the children (35.71%) were under the age of 6 months to one year. Male (55.71%) children are more affected than female (44.29%) children. Undernutrition was observed in 85.71% of cases. Parenteral infection (44.28%) was noticed as major risk factor among children. E. coli was the organism isolated from stool culture in about 73.91% of cases with gut infection. The total fatality rate in the study population was 10%. Multivariable regression revealed significant associations between persistent diarrhoeal disease in children and protein energy malnutrition (OR- 1.812; 95% CI- 1.406-2.335), irrational antibiotic use (OR- 2.414; 95% CI- 1.195-4.877), parenteral infection (OR- 2.275; 95% CI-1.165-4.443) and use of unsafe drinking water (OR- 2.738; 95% CI- 1.221-6.143) and were found to be independent risk factors. Other factors found to be insignificant.Conclusion: The results of the study conclude that protein energy malnutrition, irrational antibiotic use, use of unsafe drinking water and parenteral infections are the significant risk factors for the incidence of diarrhea in the present study population. Hence, it is important to increase the awareness in parents regarding nutrition and safe drinking water use for children. Prompt diagnosis and appropriate treatment by the doctors can decrease the fatality rates.

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Simultaneous quantile regression and determinants of under-five severe chronic malnutrition in Ghana.

10.21203/rs.2.14233/v1 ◽

2019 ◽

Author(s):

Justice Moses K. Aheto

Keyword(s):

Risk Factors ◽

Quantile Regression ◽

Significant Risk ◽

Household Wealth ◽

Public Health Issue ◽

Wealth Status ◽

Chronic Malnutrition ◽

Severe Stunting ◽

Under Five ◽

The Impact

Abstract Background Under-five malnutrition is a major public health issue contributing to mortality and morbidity, especially in developing countries like Ghana where the rates remain unacceptably high. Identification of critical risk factors of under-five malnutrition using appropriate and advanced statistical methods can help formulate appropriate health programmes and policies aimed at achieving the United Nations SDG Goal 2 target 2. This study attempts to develop a simultaneous quantile regression, an in-depth statistical model to identify critical risk factors of under-five severe chronic malnutrition (severe stunting).Methods Based on the nationally representative data from the 2014 Ghana Demographic and Health Survey, height-for-age z-score (HAZ) was estimated. Multivariable simultaneous quantile regression modelling was employed to identify critical risk factors for severe stunting based on HAZ (a measure of chronic malnutrition in populations). Quantiles of HAZ with focus on severe stunting were modelled and the impact of the risk factors determined. Significant test of the difference between slopes at different selected quantiles of severe stunting and other quantiles were performed. A quantile regression plots of slopes were developed to visually examine the impact of the risk factors across these quantiles.Results Data on a total of 2716 children were analysed out of which 144 (5.3%) were severely stunted. The models identified child level factors such as type of birth, sex, age, place of delivery and size at birth as significant risk factors of under-five severe stunting. Maternal and household level factors identified as significant predictors of under-five severe stunting were maternal age and education, maternal national health insurance status, household wealth status, and number of children under-five in households. Highly significant differences exist in the slopes between 0.1 and 0.9 quantiles. The quantile regression plots for the selected quantiles from 0.1 to 0.9 showed substantial differences in the impact of the covariates across the quantiles of HAZ considered.Conclusion Critical risk factors that can aid formulation of child nutrition and health policies and interventions that will improve child nutritional outcomes and survival were identified. Modelling under-five severe stunting using multivariable simultaneous quantile regression models could be beneficial to addressing the under-five severe stunting.

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Determinants of the Stunting of Children Under Two Years Old in Indonesia: A Multilevel Analysis of the 2013 Indonesia Basic Health Survey

Nutrients ◽

10.3390/nu11051106 ◽

2019 ◽

Vol 11 (5) ◽

pp. 1106 ◽

Cited By ~ 10

Author(s):

Christiana R. Titaley ◽

Iwan Ariawan ◽

Dwi Hapsari ◽

Anifatun Muasyaroh ◽

Michael J. Dibley

Keyword(s):

Antenatal Care ◽

Health Survey ◽

Wealth Index ◽

Household Wealth ◽

Children Under Five ◽

Household Level ◽

Individual Level ◽

Under Five ◽

Basic Health ◽

Care Services

Indonesia is ranked fifth among countries with the highest burden of stunting in children under five. This study aims to examine the determinants of stunting in children aged 0–2 years in Indonesia using data derived from the 2013 Indonesia Basic Health Survey. Twenty potential predictors of stunting, categorized into household and housing characteristics; maternal and paternal characteristics; antenatal care services and child characteristics were analyzed. Multilevel analyses were performed to examine the role of cluster/district/provincial differences, as well as individual/household level characteristics and stunting status. Of 24,657 children analyzed, 33.7% (95%CI: 32.8%–34.7%) were stunted. The odds of stunting increased significantly among children living in households with three or more children under five-years-old (aOR = 1.33, 95%CI: 1.03–1.72), households with five to seven household members (aOR =1.11; 95%CI: 1.03–1.20), children whose mothers during pregnancy attended less than four antenatal care services (aOR = 1.22, 95%CI: 1.08–1.39), boys (aOR = 1.33, 95%CI: 1.22–1.45), children aged 12–23 months (aOR = 1.89; 95%CI: 1.54–2.32), and children who weighed <2500 g at birth (aOR = 2.55; 95%CI: 2.05–3.15). The odds also increased significantly with the reduction of household wealth index. Integrated interventions to address environment, an individual level associated with stunting in Indonesia, from the environment- to individual-level factors are important.

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