Planning of births and childhood undernutrition in Nepal: evidence from a 2016 national survey

Abstract Background Childhood undernutrition is a significant public health issue in low-and middle-income countries, including Nepal. However, there is limited evidence showing the association between the planning of birth (PoB) and childhood undernutrition (stunting and underweight). We aimed to investigate the relationship between PoB and childhood undernutrition in the current study. Methods We used the Nepal Demographic and Health Survey (NDHS) 2016 data, a nationally representative cross-sectional household survey. We used two anthropometric indicators of childhood undernutrition as the outcome of this study. PoB is the main predictor. We used binary logistic regression with sampling weights to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) to examine the association between the PoB and childhood undernutrition. Unless stated, the significant association between the variables is calculated with p < 0.001. Results The overall prevalence of stunting was 35.8%, and underweight was 27.1% in children under 5 years of age in Nepal. We found a higher rate of stunting (52.7%) and underweight (41.1%) in children with birth order > 3 and < 2 years of the interval between birth and subsequent birth (IBBSB). The association between the children’s birth order and the prevalence of undernutrition had strong statistical significance. Mother’s age at marriage (p = 0.001), underweight mother, mother’s education, father’s education, wealth quintile, no exposure to mass media, children’s age, and place of residence(p = 0.001) were significantly associated with childhood undernutrition. The result of the multiple logistic regression showed that children with birth order one and 12–24 months of the interval between marriage and first birth (IBMFB) had significantly decreased odds of stunting than those children with birth order one and < 12 months of IBMFB (OR 0.6, 95% CI 0.4–0.9). Conclusion The findings of the study demonstrate that PoB has a protective effect on childhood undernutrition. Delaying of childbirth until 12–24 months after marriage was found to be associated with reduced childhood stunting odds. To mitigate childhood undernutrition, Nepal’s government needs to promote delayed childbearing after marriage while focusing on uplifting the household economics status and wide coverage of and utilization of mass media.

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Planning of Births and Childhood Undernutrition in Nepal: Evidence from a 2016 National Survey

10.21203/rs.3.rs-40329/v1 ◽

2020 ◽

Author(s):

Ishwar Tiwari ◽

Kiran Acharya ◽

Yuba Raj Paudel ◽

Bhim Prasad Sapkota ◽

Ramesh Babu Kafle

Keyword(s):

Logistic Regression ◽

Mass Media ◽

Birth Order ◽

Statistical Significance ◽

Household Survey ◽

Wealth Quintile ◽

Public Health Issue ◽

Sampling Weights ◽

Cross Sectional ◽

Childhood Undernutrition

Abstract Background Childhood undernutrition is a significant public health issue in low-and middle-income countries, including Nepal. However, there is limited evidence showing the association between the planning of birth (PoB) and childhood undernutrition (stunting and underweight). We aim to investigate the relationship between PoB and childhood undernutrition in the current study. Methods We used the Nepal Demographic Health Survey 2016 data, which is a nationally representative cross-sectional household survey. We used two common anthropometric indicators of childhood undernutrition as the outcome of this study. PoB is the main predictor of interest. Binary logistic regression with sampling weights was used to estimate adjusted odds ratios (OR) and 95% confidence intervals to examine the association between the PoB and childhood undernutrition. Results The overall prevalence of stunting was 35.8%, and underweight was 27.1% in under-five children in Nepal. We found a higher rate of stunting (52.7%) and underweight (41.1%) in children with birth order > 3 and < 2 years of interval between birth and subsequent birth (IBBSB). The association between the birth order of children and the prevalence of undernutrition had strong statistical significance (p < 0.001). Mother’s age at marriage (p = 0.001), underweight mother (p < 0.001), mother’s education (p < 0.001), father’s education (p < 0.001), wealth quintile (p < 0.001), no exposure to mass media (p < 0.001), children’s age (p < 0.001), area of residence(p = 0.001) were significantly associated with childhood undernutrition. The result of the multiple logistic regression showed that children with birth order one and 12–24 months of interval between marriage and first birth (IBMFB) had significantly decreased odds of stunting as compared to those children with birth order one and < 12 months of IBMFB (OR 0.6, 95% CI 0.4–0.9). Conclusion The findings of the study demonstrate that PoB has a protective effect on childhood undernutrition. Delaying of childbirth until 12–24 months after marriage was found to be associated with reduced odds of childhood stunting. To mitigate childhood undernutrition, Nepal’s government needs to promote delayed childbearing after marriage while focusing on uplifting the household economics status and wide coverage of and utilization of mass media.

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Planning of births and childhood undernutrition in Nepal: evidence from a 2016 national survey

10.21203/rs.3.rs-40329/v3 ◽

2020 ◽

Author(s):

Ishwar Tiwari ◽

Kiran Acharya ◽

Yuba Raj Paudel ◽

Bhim Prasad Sapkota ◽

Ramesh Babu Kafle

Keyword(s):

Logistic Regression ◽

Mass Media ◽

Birth Order ◽

Statistical Significance ◽

Household Survey ◽

Wealth Quintile ◽

Public Health Issue ◽

Sampling Weights ◽

Cross Sectional ◽

Childhood Undernutrition

Abstract Background: Childhood undernutrition is a significant public health issue in low-and middle-income countries, including Nepal. However, there is limited evidence showing the association between the planning of birth (PoB) and childhood undernutrition (stunting and underweight). We aimed to investigate the relationship between PoB and childhood undernutrition in the current study.Methods: We used the Nepal Demographic and Health Survey 2016 data, a nationally representative cross-sectional household survey. We used two anthropometric indicators of childhood undernutrition as the outcome of this study. PoB is the main predictor. We used binary logistic regression with sampling weights to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) to examine the association between the PoB and childhood undernutrition. Unless stated, the significant association between the variables is calculated with p<0.001.Results: The overall prevalence of stunting was 35.8%, and underweight was 27.1% in children under five years of age in Nepal. We found a higher rate of stunting (52.7%) and underweight (41.1%) in children with birth order >3 and <2 years of the interval between birth and subsequent birth (IBBSB). The association between the children’s birth order and the prevalence of undernutrition had strong statistical significance. Mother’s age at marriage (p=0.001), underweight mother, mother’s education, father’s education, wealth quintile, no exposure to mass media, children’s age, and place of residence(p=0.001) were significantly associated with childhood undernutrition. The result of the multiple logistic regression showed that children with birth order one and 12-24 months of the interval between marriage and first birth (IBMFB) had significantly decreased odds of stunting than those children with birth order one and <12 months of IBMFB (OR 0.6, 95% CI 0.4-0.9). Conclusion: The findings of the study demonstrate that PoB has a protective effect on childhood undernutrition. Delaying of childbirth until 12-24 months after marriage was found to be associated with reduced childhood stunting odds. To mitigate childhood undernutrition, Nepal's government needs to promote delayed childbearing after marriage while focusing on uplifting the household economics status and wide coverage of and utilization of mass media.

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Planning of births and childhood undernutrition in Nepal: evidence from a 2016 national survey

10.21203/rs.3.rs-40329/v2 ◽

2020 ◽

Author(s):

Ishwar Tiwari ◽

Kiran Acharya ◽

Yuba Raj Paudel ◽

Bhim Prasad Sapkota ◽

Ramesh Babu Kafle

Keyword(s):

Logistic Regression ◽

Mass Media ◽

Birth Order ◽

Statistical Significance ◽

Household Survey ◽

Wealth Quintile ◽

Public Health Issue ◽

Sampling Weights ◽

Cross Sectional ◽

Childhood Undernutrition

Abstract Background: Childhood undernutrition is a significant public health issue in low-and middle-income countries, including Nepal. However, there is limited evidence showing the association between the planning of birth (PoB) and childhood undernutrition (stunting and underweight). We aimed to investigate the relationship between PoB and childhood undernutrition in the current study.Methods: We used the Nepal Demographic and Health Survey 2016 data, which is a nationally representative cross-sectional household survey. We used two common anthropometric indicators of childhood undernutrition as the outcome of this study. PoB is the main predictor of interest. Binary logistic regression with sampling weights was used to estimate adjusted odds ratios (OR) and 95% confidence intervals to examine the association between the PoB and childhood undernutrition.Results: The overall prevalence of stunting was 35.8%, and underweight was 27.1% in under-five children in Nepal. We found a higher rate of stunting (52.7%) and underweight (41.1%) in children with birth order >3 and <2 years of interval between birth and subsequent birth (IBBSB). The association between the birth order of children and the prevalence of undernutrition had strong statistical significance (p<0.001). Mother’s age at marriage (p=0.001), underweight mother (p<0.001), mother’s education (p<0.001), father’s education (p<0.001), wealth quintile (p<0.001), no exposure to mass media (p<0.001), children’s age (p<0.001), and place of residence(p=0.001) were significantly associated with childhood undernutrition. The result of the multiple logistic regression showed that children with birth order one and 12-24 months of interval between marriage and first birth (IBMFB) had significantly decreased odds of stunting as compared to those children with birth order one and <12 months of IBMFB (OR 0.6, 95% CI 0.4-0.9). Conclusion: The findings of the study demonstrate that PoB has a protective effect on childhood undernutrition. Delaying of childbirth until 12-24 months after marriage was found to be associated with reduced odds of childhood stunting. To mitigate childhood undernutrition, Nepal's government needs to promote delayed childbearing after marriage while focusing on uplifting the household economics status and wide coverage of and utilization of mass media.

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POS0765 LABORATORY RATIOS: A SUBROGATE BIOMARKER FOR DETECTION OF INFECTION IN SLE PATIENTS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3184 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 636.1-636

Author(s):

Y. Santamaria-Alza ◽

J. Sanchez-Bautista ◽

T. Urrego Callejas ◽

J. Moreno ◽

F. Jaimes ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Logistic Regression ◽

Roc Curve ◽

Lupus Erythematosus ◽

Statistical Significance ◽

C Reactive Protein ◽

Systemic Lupus ◽

Predictive Capacity ◽

Cross Sectional ◽

Reactive Protein

Background:The most common complication in patients with SLE is infection, and its clinical presentation is often indistinguishable from SLE flares. Therefore, laboratory ratios have been evaluated to differentiate between those events. Among them, ESR/CRP1, neutrophil/lymphocyte (NLR)2, and platelet/lymphocyte (PLR)3 ratios have been previously assessed with acceptable performance; however, there is no validation of those ratios in our SLE population.Objectives:To examine the predictive capacity of infection of the lymphocyte/C4 (LC4R), lymphocyte/C3 (LC3R), and ferritin/ESR (FER) ratios in SLE patients, and to evaluate the performance of ESR/CRP, NLR, AND PLR ratios in our SLE population.Methods:We conducted a cross-sectional study of SLE patients admitted to the emergency service at Hospital San Vicente Fundación (HSVF). The HSVF ethics committee approved the execution of the project.Patients were categorized into four groups according to the main cause of hospitalization: (1) infection, (2) flare, (3) infection and flare and, (4) neither infection nor flare.We calculated the median values of the ratios and their respective interquartile ranges for each group. Then, we compared those summary measures using the Kruskal-Wallis test. Subsequently, we assessed the predictive capacity of infection of each ratio using ROC curve. Finally, we carried out a logistic regression model.Results:A total of 246 patients were included, among them 90.7% were women. The median age was 28 years (IQR: 20-35 years). Regarding the outcomes, 37.0% of the patients had flares, 30.9% had neither infection nor flare, 16.7% had an infection and, 15.5% had simultaneously infection and flare. When compared the four groups, statistical significance (p<0.05) was observed. Area under the ROC curve (AUC) for infection prediction was as follows: 0.752 (sensitivity 60.5%, specificity 80.5%) for LC4R, 0.740 (sensitivity 73.2%, specificity 68.3%) for FER, 0.731 (sensitivity 77.6%, specificity 80.5%) for LC3R.In the logistic regression modeling, we observed that an increase in the risk of infection was associated with an LC4R below 66.7 (OR: 6.3, CI: 2.7 – 14.3, p <0.0001), a FER greater than 13.6 (OR: 5.9, CI: 2.8 – 12.1, p <0.0001) and an LC3R below 11.2 (OR: 4.9, CI: 2.4 – 9.8, p <0.0001).The ESR/CRP and PLR performed poorly with an AUC of 0.580 and 0.655, respectively. In contrast, the NLR showed better performance (AUC of 0.709, with a sensitivity of 80.2% and specificity of 55.7%).Figure 1.ROC curves of the evaluated ratiosConclusion:These laboratory ratios could be easy to assay and inexpensive biomarkers to differentiate between infection and activity in SLE patients. The LC4R, FER, and LC3R have a significant diagnostic performance for detecting infection among SLE patients. Of the ratios previously evaluated, ESR/CRP, LPR, NLR, only the latest has an adequate performance in our population.References:[1]Littlejohn E, Marder W, Lewis E, et al. The ratio of erythrocyte sedimentation rate to C-reactive protein is useful in distinguishing infection from flare in systemic lupus erythematosus patients presenting with fever. Lupus. 2018;27(7):1123-1129.[2]Broca-Garcia BE, Saavedra MA, Martínez-Bencomo MA, et al. Utility of neutrophil-to-lymphocyte ratio plus C-reactive protein for infection in systemic lupus erythematosus. Lupus. 2019;28(2):217-222.[3]Soliman WM, Sherif NM, Ghanima IM, EL-Badawy MA. Neutrophil to lymphocyte and platelet to lymphocyte ratios in systemic lupus erythematosus: Relation with disease activity and lupus nephritis. Reumatol Clin. 2020;16(4):255-261s.Disclosure of Interests:None declared

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Knowledge, attitudes, practices, and influencing factors of anxiety among pregnant women in Wuhan during the outbreak of COVID-19: a cross-sectional study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03561-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wenping Ding ◽

Jianmei Lu ◽

Yan Zhou ◽

Weizhong Wei ◽

Zhihong Zhou ◽

...

Keyword(s):

Logistic Regression ◽

Pregnant Women ◽

Influencing Factors ◽

Information Source ◽

Influential Factors ◽

Public Health Issue ◽

Cross Sectional ◽

Factors Associated ◽

Attitudes And Practices ◽

Prenatal Anxiety

Abstract Background Prenatal anxiety has been a significant public health issue globally, leading to adverse health outcomes for mothers and children. The study aimed to evaluate the sociodemographic characteristics, knowledge, attitudes, and practices (KAP), and anxiety level of pregnant women during the coronavirus disease 2019 (COVID-19) epidemic in Wuhan and investigate the influencing factors for prenatal anxiety in this specific context. Methods Pregnant subjects’ KAP towards COVID-19 and their sociodemographics and pregnancy information were collected using questionnaires. The Zung Self-Rating Anxiety Scale (SAS) was used to assess anxiety status. Factors associated with the level of prenatal anxiety were analyzed by Pearson’s chi-square test and multivariable logistic regression analyses. Results The prenatal anxiety prevalence in this population was 20.8%. The mean score of knowledge was 13.2 ± 1.1 on a 0 ~ 14 scale. The attitudes and practices data showed that 580/ 817 (71.0%) were very concerned about the news of COVID-19, 455/817 (55.7%) considered the official media to be the most reliable information source for COVID-19, and 681/817 (83.4%) were anxious about the possibility of being infected by COVID-19. However, only 83/817 (10.2%) worried about contracting COVID-19 infection through the ultrasound transducer during a routing morphology scan. About two-thirds 528/817 (64.6%) delayed or canceled the antenatal visits. Approximately half of them 410/817 (50.2%) used two kinds of personal protection equipments (PPEs) during hospital visits. Logistic regression analysis revealed that the influential factors for prenatal anxiety included previous children in the family, knowledge score, media trust, worry of contracting the COVID-19 infection and worry about getting infected with COVID-19 from the ultrasound probe antenatal care (ANC) schedule. Conclusion Prenatal anxiety was prevalent among pregnant women in Wuhan during the outbreak of COVID-19. The current findings identified factors associated with the level of prenatal anxiety that could be targeted for psychological care.

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Trends in stunting and overweight in Peruvian pre-schoolers from 1991 to 2011: findings from the Demographic and Health Surveys

Public Health Nutrition ◽

10.1017/s1368980014000275 ◽

2014 ◽

Vol 17 (11) ◽

pp. 2407-2418 ◽

Cited By ~ 16

Author(s):

Helga Bjørnøy Urke ◽

Maurice B Mittelmark ◽

Martín Valdivia

Keyword(s):

Urban Areas ◽

Health Surveys ◽

Maternal Education ◽

Wealth Quintile ◽

Household Wealth ◽

Demographic And Health Surveys ◽

Sampling Weights ◽

Cross Sectional ◽

Growth Standards ◽

Low Educated

AbstractObjectiveTo examine trends in stunting and overweight in Peruvian children, using 2006 WHO Multicentre Growth Reference Study criteria.DesignTrend analyses using nationally representative cross-sectional surveys from Demographic and Health Surveys (1991–2011). We performed logistic regression analyses of stunting and overweight trends in sociodemographic groups (sex, age, urban–rural residence, region, maternal education and household wealth), adjusted for sampling design effects (strata, clusters and sampling weights).SettingPeru.SubjectsChildren aged 0–59 months surveyed in 1991–92 (n 7999), 1996 (n 14 877), 2000 (n 11 754), 2007–08 (n 8232) and 2011 (n 8186).ResultsChild stunting declined (F(1, 5149) = 174·8, P ≤ 0·00) and child overweight was stable in the period 1991–2011 (F(1, 5147) = 0·4, P ≤ 0·54). Over the study period, levels of stunting were highest in rural compared with urban areas, the Andean and Amazon regions compared with the Coast, among children of low-educated mothers and among children living in households in the poorest wealth quintile. The trend in overweight rose among males in coastal areas (F(1, 2250) = 4·779, P ≤ 0·029) and among males in the richest wealth quintile (F(1, 1730) = 5·458, P ≤ 0·020).ConclusionsThe 2011 levels of stunting and overweight were eight times and three and a half times higher, respectively, than the expected levels from the 2006 WHO growth standards. The trend over the study period in stunting declined in most sociodemographic subgroups. The trend in overweight was stable in most sociodemographic subgroups.

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Prevalence of Onchocerciasis and Associated Factors among Adults Aged ≥ 15 Years in Semen Bench District, Bench Maji Zone, Southwest Ethiopia: Community Based Cross-Sectional Study

Advances in Public Health ◽

10.1155/2019/7276230 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Bedilu Kifle ◽

Kifle Woldemichael ◽

Mamo Nigatu

Keyword(s):

Logistic Regression ◽

Associated Factors ◽

Statistical Significance ◽

Health Department ◽

Cross Sectional Study ◽

Sectional Study ◽

Community Based ◽

Cross Sectional ◽

Southwest Ethiopia ◽

Bivariate Logistic Regression

Background. Though onchocerciasis control and elimination through community directed treatment with ivermectin were conducted for the last fifteen years, prevalence of onchocerciasis and factors associated with it in the study area are yet not known. The aim of the current study is to assess prevalence of onchocerciasis and associated factors among adults aged greater than or equal to fifteen years in Semen Bench district, Bench Maji zone, southwest Ethiopia: community based cross-sectional study 2018. Methods. Community based cross-sectional study was conducted on 553 study participants selected by multistage sampling in April 2018. Data were collected using a pretested interviewer-administered questionnaire. Data were entered using EpiData version 3.1 and exported to SPSS version 20 for statistical analysis. Descriptive statistics were done to summarize dependent and independent variables. Bivariate logistic regression was done to select candidate variables. Multivariable logistic regression was performed to identify independent predictors of onchocerciasis infection. Adjusted odds ratios with 95% CI were calculated to assess association and statistical significance, respectively. Confidence interval was used to declare statistical significance. Result. The overall prevalence of onchocerciasis infection in the study area was 6.32%. Age category of 35-44 years (AOR: 13.48, 95%CI: 3.51, 51.76), age of 45 years and above (AOR: 9.41, 95% CI: 2.26, 39.06), male sex (AOR 4.568, 95% C.I: 1.622, 12.861), not being compliant with ivermectin treatment (AOR: 3.804, 95%CI: 1.524, 9.49), and residing at less than 2Km from the river (AOR: 9.15, 95%CI: 3.9, 21.49) were significantly associated with onchocerciasis infection. Conclusion and Recommendation. After more than a decade of treatment with ivermectin, onchocerciasis in the study area is still hypoendemic. Zonal health department and other stakeholders should evaluate therapeutic coverage and community directed treatment with ivermectin in the study area. Zonal health department with other stokeholds should give community based information education communication, giving due attention to older ages, male residents, and those living near the rivers. Further community based study should also be done to identify factors hindering the community compliance with the treatment.

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Individual-, Household-, and Community-Level Determinants of Childhood Undernutrition in Bangladesh

Health Services Research and Managerial Epidemiology ◽

10.1177/2333392819876555 ◽

2019 ◽

Vol 6 ◽

pp. 233339281987655 ◽

Cited By ~ 2

Author(s):

Moriam Khanam ◽

Shafiun N. Shimul ◽

Abdur Razzaque Sarker

Keyword(s):

Public Health ◽

Nutritional Status ◽

Diarrheal Disease ◽

Public Health Problem ◽

Community Level ◽

Public Health Issue ◽

Wealth Status ◽

Cross Sectional ◽

Individual Household ◽

Childhood Undernutrition

Introduction: Childhood undernutrition is a crucial public health problem globally. The objective of this study is to measure the prevalence of childhood undernutrition and assess the distinct role of various factors on childhood undernutrition in Bangladesh. Methods: This study utilized the latest cross-sectional data from Bangladesh Demographic and Health Survey 2014. A total of 7256 data on children younger than 5 years old were analyzed. The undernutrition status of children was assessed by stunting (height-for-age), wasting (weight-for-height), and underweight (weight-for-age), while bivariate and multivariate analyses were performed to identify various individual-, household-, and community-level factors of childhood undernutrition. Results: The prevalence of stunting, wasting, and underweight were 36.5%, 14.6%, and 32.5%, respectively. Along with various individual- and household-level factors (eg, age, recent diarrheal disease, fever, number of under-5 children in the household, mother’s education and nutritional status, and wealth status), community index, particularly regional and geographic variation of community, had significant role for childhood undernutrition in Bangladesh. Conclusion: Childhood undernutrition is an overwhelming public health issue in Bangladesh. In order to improve the nutritional status of under-5 children, interventions should take into account the various predictors discussed in this study. Indeed, a joint effort by the government, nongovernmental organizations, and the community is necessary to improve the childhood nutritional status in Bangladesh.

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Risk and Triggering Factors Associated with Bronchial Asthma Among School-Going Children in an Urban City of Coastal Karnataka

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v37i1.16634 ◽

2017 ◽

Vol 37 (1) ◽

pp. 59-66

Author(s):

Sowmini P. Kamath ◽

Shrividya Shrishakumar ◽

Animesh Jain ◽

Anand Ramakrishna ◽

Shantharam B Baliga

Keyword(s):

Risk Factors ◽

Statistical Significance ◽

Cross Sectional Study ◽

Public Health Issue ◽

Trigger Factors ◽

Cross Sectional ◽

Factors Associated ◽

Urban City ◽

Triggering Factors ◽

At Home

Introduction: Asthma is common in childhood and is a major public health issue. The objectives of this study were to identify risk and triggering factors associated with asthma among school children.Material and Methods: A prospective cross sectional study was conducted among 6-15 years old children, over two months in two private schools at Mangalore city. Trigger factors were assessed as per asthma trigger inventory (ATI). Responses were graded from 0-5 score based on ‘never’,’ rarely’, ‘sometimes’, ‘most of the time’ and ‘always’. A predesigned questionnaire suiting the city environment was prepared and used to assess the risk and triggering factors. Analysis was done using SPSS version 16.Results: Asthma and allergic rhinitis in parents (34.1%,40.7%), smoking at home(24.2%), exclusive breast feeding absence (27.5%),early weaning(24.2%), living in a flat (37.4%) and pets at home(37.4%) were risk factors noted. As per ATI, it was found that ‘having a cold’ was the most frequently selected trigger at 94.5% (47.3% ‘sometimes’, 2.2% ‘always’), followed by ‘running’ at 79.1% (27.5% ‘sometimes’, 13.2% ‘always’), and ‘house dust’ at 69.2% (31.9% ‘sometimes’, 6.6% ‘always’). The highest mean was for infections, (2.228, SD=0.546), followed by physical exercise (2.167, SD=0.331). Animal allergens had lowest mean (1.527, SD=0.104), followed by psychological triggers at second lowest (1.579, SD=0.181). However none of the risk and trigger factors had statistical significance with asthma.Conclusion: Avoiding exposure to probable triggers and identifying risk factors would aid in planning effective strategic measures with better quality of life.

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Prevalence and factors associated with underweight children: a population-based subnational analysis from Pakistan

BMJ Open ◽

10.1136/bmjopen-2019-028972 ◽

2019 ◽

Vol 9 (7) ◽

pp. e028972 ◽

Cited By ~ 3

Author(s):

Ramesh Kumar ◽

Faisal Abbas ◽

Tahir Mahmood ◽

Ratana Somrongthong

Keyword(s):

Logistic Regression ◽

Birth Order ◽

Formal Education ◽

Multivariate Logistic Regression Analysis ◽

Population Based ◽

Community Based Interventions ◽

Cross Sectional ◽

Household Level ◽

Factors Associated ◽

Children Under 5

ObjectivesThis study aims to determine the prevalence of and factors associated with underweight children under the age of 5 in Punjab, Pakistan.DesignWe analysed cross-sectional household-level subnationally representative Multiple Indicator Cluster Survey.SettingsPunjab province, Pakistan.Participants24 042 children under 5 years of age.Data analysisMultilevel multivariate logistic regression analysis.ResultsPrevalence of moderately and severely underweight children was found to be (33.3% and 11.3%, respectively). Multivariate multilevel logistic regression results show that as the child grows older the likelihood of the child being underweight increases significantly (eg, children between 12 and 23 months are one and half times more likely to be underweight, whereas children between the ages of 36 and 47 months are two and a half times more likely to be underweight). Gender was found to be another significant factor contributing to underweight prevalence among children under the age of 5. The likelihood of a girl child being underweight is more than that of a boy child being underweight (OR 0.92, 95% CI 0.8 to 1.0). Similarly, a child whose birth order is three or more is two times more likely to be underweight (OR 1.96, 95% CI 1.5 to 2.5) relative to a child of a lower birth order. Moreover, diarrhoea also significantly increases the likelihood of the child being underweight (OR 1.31, 95% CI 1.1 to 1.5). Child size is another determinant for underweight prevalence among children under 5, for example, a child with a size smaller than average at the time of birth is 2.7 times more likely to be moderately underweight than a child with an average or larger than average size at the time of birth.ConclusionRigorous community-based interventions should be developed and executed throughout the province to improve this grave situation of underweight prevalence in Punjab. Mother’s education should be uplifted by providing them formal education and providing awareness about the importance of proper nutrition for children.

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