Nutritional and immunization status of under-five children of India and Bangladesh

Abstract Background The nutritional and immunization status of children can play an important role in determining their future health status of a particular country. The aim of the present study is to investigate the nutritional and immunization status of under-five children in India and Bangladesh, and to find the difference in the status between these two countries. Methods We have used the National Family Health Survey data, 2015–2016 of India and Bangladesh Demographic Health Survey, 2017–2018 datasets. The sample sizes are 222,418, among them 8759 and 8759 children for India and Bangladesh respectively. The nutritional status of under-five children is measured by standard anthropometric indicators of height-for-age (HAZ) and weight-for-age (WAZ). Regarding child immunization status, only BCG, DPT, polio and measles vaccinations are considered for the present study. Multiple binary logistic model has been used for analysing the data. Results This study reveals that the prevalence of stunting and underweight of under-five children in India are higher than Bangladeshi children. Secondary and higher educated mothers are more likely of having normal HAZ and WAZ children than up to primary educated mothers for both countries. Chances of having normal HAZ and WAZ are higher among non-poor category for both countries. The present study also shows that immunization status of Bangladeshi children is better than Indian children except measles. Religion of mother also shows influence on immunization status of children in India whereas Bangladesh shows no significant results regarding religion. Mother’s educational attainment and wealth index show influence on immunization status among children for both countries. Conclusions The study concludes that a remarkable number of under-five children are suffering from under nutrition for both countries, however Bangladeshi children have better nutritional and immunization status compared to Indian children. Higher wealth index, better educational attainment and lower unemployment of Bangladeshi mothers may be the causes for better nutritional and immunization status of children. Mother’s socio-economic factors have significant impact on determining the child’s health status. Our findings can help to government of Indian and Bangladesh for taking health policy to improve under-five children nutritional and immunization status.

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Occurrence of Diarrheal diseases among under-five children and associated socio-demographic and household environmental factors: An Investigation Based on National Family Health Survey-4 in Rural India

10.21203/rs.3.rs-1179622/v1 ◽

2021 ◽

Author(s):

Jay Saha ◽

Sabbir Mondal ◽

Pradip Chouhan

Keyword(s):

Environmental Factors ◽

Health Survey ◽

Diarrheal Disease ◽

Family Health ◽

Rural India ◽

National Family Health Survey ◽

Environmental Predictors ◽

Under Five ◽

Under Five Children ◽

National Family

Abstract Background: Diarrheal disease is a major population health problem that is the leading reason for mortality and morbidity among children aged 0-59 months in rural India. Therefore, the rationale of this study was to identify the socio-demographic, environmental predictors associated with diarrhea among under-five children in rural India. Methods: A total of 188,521 living children (0-59 months) were utilized from the National Family Health Survey-4, 2015–2016. Bivariate and binary logistic regression analysis was carried out from the available NFHS-4 data for selected socio-demographic and environmental predictors to identify the relationship of occurrence of diarrhea using STATA 13.1. Results: In rural India, children aged 12-23 months [AOR: 0.897, 95% CI (0.876, 0.983)], 24-35 months [AOR: 0.579, 95% CI (0.543, 0.617)], 36-47 months [AOR: 0.394, 95% CI (0.367, 0.424)], 48-59 months [AOR: 0.313, 95% CI (0.289, 0.339)] were significantly less likely to suffer diarrheal disease. Female children [AOR: 0.897, 95% CI (0.859, 0.937)], children belonged to Scheduled Tribe [AOR: 0.811, 95% CI (0.755, 0.872)], Other Backward Classes [AOR: 0.902, 95% CI (0.851, 0.956)] were less likelihood to experience diarrhea significantly. Diarrhea disease was also significantly more likely to occur among Muslim children [AOR: 1.217, 95% CI (1.128, 1.313)], other religion [AOR: 1.163, 95% CI (1.062, 1.272)] children in central region [AOR: 1.510, 95% CI (1.410, 1.617)], east region [AOR: 1.077, 95% CI (1.002, 1.157)], and west region [AOR: 1.201, 95% CI (1.095, 1.317)], children with low birth weight [AOR: 1.135, 95% CI (1.074, 1.149)], undernourished [AOR: 1.097, 95% CI (1.038, 1.197)], improper stool disposal [AOR: 1.061, 95% CI (1.002, 1.124)], and rudimentary roof materials [AOR: 1.113, 95% CI (1.048, 1.182)]. Conclusions: In the rural part of India, diarrhea has occurred frequently now. The different socio-demographic and environmental factors are influencing this disease. For reducing the vulnerability of diarrhea the socio-demographic and environmental factors should be improved or monitoring by effective community education. The government and different NGOs should focus on improved drinking water sources, sanitation facility which may reduce the vulnerability of the disease.

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Spatial Variations and Determinants of Acute Malnutrition among Under-Five Children in Ethiopia: Evidence from 2019 Ethiopian Demographic Health Survey

10.21203/rs.3.rs-680595/v1 ◽

2021 ◽

Author(s):

Binyam Tariku Seboka ◽

Tilahun Dessie Alene ◽

Habtamu Setegn Ngusie ◽

Samuel Hailegebreal ◽

Delelegn Emwodew Yehualashet ◽

...

Keyword(s):

Health Survey ◽

Public Health Problem ◽

Wealth Index ◽

Water Source ◽

Acute Malnutrition ◽

Cold Spot ◽

Multivariable Logistic Regression Model ◽

Statistical Tool ◽

Under Five ◽

Under Five Children

Abstract Background: Childhood acute malnutrition, in the form of wasting defined by a severe weight loss as a result of acute food shortage and/or illness. It is a critical public health problem that needs urgent attention in developing countries, like Ethiopia. Despite its variation between localities, the risk factors and its geospatial variation were not addressed enough across the various corner of the country. Therefore, the current study was undertaken to assess spatial variation and factors associated with acute malnutrition among under-five children in Ethiopia.Methods: A total weighted sample of 4,955 under-five children were included from the 2019 Demographic and Health Survey. Getis-Ord spatial statistical tool used to identify the hot and cold spot areas of severe and acute malnutrition. A multilevel multivariable logistic regression model using was used to examine predictors of acute malnutrition. In the multivariable multilevel analysis, Adjusted Odds Ratio with 95% CI was used to declare significant determinants of acute malnutrition among children.Result: Among 4,955 under-five children, 7% of them were wasted and 1% of them were severely wasted in Ethiopia during the 2019 national demographic survey. The distribution was followed some spatial geo-locations where most parts of Somali were severely affected (RR=1.46, P37 value < 0.001), and the distribution affected few areas of Afar, Gambella, and Benishangul Gumz regions. Factors that significantly associated with childhood wasting were: gender(male)1.9(1.3-2.7), age (above 36 months) 0.5 (0.2-0.9), wealth index(richest) 0.5(0.2-0.8), and water source(unimproved source) 1.5(1.0-2.3).Conclusion and Recommendation: Our finding implies, the distribution of childhood wasting was not random. Regions like Afar, Somali, and pocket areas in Gambella and SNNP should be considered as priority areas nutritional interventions for reducing acute malnutrition. The established socio-demographic and economic characteristics can be also used to develop strategies.

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Spatial variation and determinants of childhood anemia among children aged 6 to 59 months in Ethiopia: further analysis of Ethiopian demographic and health survey 2016

BMC Pediatrics ◽

10.1186/s12887-021-02901-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tiruneh Ayele Jember ◽

Destaw Fetene Teshome ◽

Lemma Derseh Gezie ◽

Chilot Desta Agegnehu

Keyword(s):

Spatial Distribution ◽

Spatial Variation ◽

Health Survey ◽

National Level ◽

Wealth Index ◽

Major Public Health Problem ◽

Under Five ◽

Under Five Children ◽

Determinant Factors ◽

Childhood Anemia

Abstract Background The magnitude of childhood anemia was increased from time to time. Thus, Even if the Ethiopian government applied tremendous efforts, anemia in children continues as a major public health problem. There is limited evidence on the spatial variation of and determinant factors of childhood anemia at the national level. Therefore, this study aimed to explore spatial distribution and determinants of anemia among children aged 6 to 59 months in Ethiopia. Method A stratified two-stage cluster sampling technique was used in Ethiopian Demographic Health Survey 2016 data. In this study 8602 children aged 6–59 months were included. Bernoulli model was used to explore the presence of purely spatial clusters of Anemia in children in age 6–59 months using Sat scan. ArcGIS version 10.3 was used to know the distribution of anemia cases across the country. A mixed-effects Logistic regression model was used to identify determinant factors of anemia. Results The finding indicates that the spatial distribution of childhood anemia was non-random in the country with Moran’s I: 0.65, p < 0.001. The SaT scan analysis identified a total of 180 significant primary clusters located in the Somali and Afar regions (LLR = 14.47, P-value< 0.001, RR = 1.47). Age of child 12–23 months (AOR = 0, 68, 95%CI: 0.55, 0.85), 24–35 months (AOR = 0.38, 95%CI: 0.31, 0.47), and36–47 months (AOR = 0.25, 95%CI, 0.20, 0.31), working mother (AOR = 0.87, 95%CI: 0.76, 0.99), anemic mother (AOR = 1.53, 95%CI, 1.35, 1.73), had fever in the last 2 weeks (AOR = 1.36,95%CI:1.13, 1.65), moderate stunting (AOR = 1.31,95%CI: 1.13, 1.50),Severely stunting (AOR = 1.82,95%CI: 1.54, 2.16), religion, wealth index, and number of under-five children in the household were statistically significant associated with childhood anemia. Conclusion Spatial variation of childhood anemia across the country was non-random. Age of the child, wealth index, stunting, religion, number of under-five children in the household, fever in the last 2 weeks, anemic mother, and working status of the mother were determinants of childhood anemia. Therefore, interventions should be a priority concern for high-risk (hot spot) areas regarding allocation of resources and improved access to health facilities, and to reduce the consequence of anemia among the generation policymakers and concerned bodies should be implemented these specific determinant factors.

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Bivariate binary analysis on composite index of anthropometric failure of under-five children and household wealth-index

BMC Pediatrics ◽

10.1186/s12887-021-02770-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Demeke Lakew Workie ◽

Lijalem Melie Tesfaw

Keyword(s):

Logistic Regression ◽

Composite Index ◽

Binary Logistic Regression ◽

Wealth Index ◽

Household Wealth ◽

Education Level ◽

Multiple Birth ◽

Under Five ◽

Under Five Children ◽

Study Results

Abstract Background Malnutrition is the most common cause of mortality and morbidity of children in low and middle income countries including Ethiopia and household wealth index shares the highest contribution. Thus, in this study it is aimed to conduct bivariate binary logistic regression analysis by accounting the possible dependency of child composite index anthropometric failure and household wealth index. Methods In this study the data from Ethiopian Demographic and Health Survey (EDHS) 2016 involved 9411 under five children was considered. Child Composite Index Anthropometric Failure (CIAF) measures the aggregate child undernourished derived from the conventional anthropometric indices (stunting, underweight and wasting). The correlation between CIAF and wealth index was checked and significant correlation found. To address the dependency between the two outcome variables bivariate binary logistic regression was used to analyze the determinants of child CAIF and household wealth index jointly. Results Study results show that region, place of residence, religion, education level of women and husband/partner, sex of child, source of drinking water, household size and number of under five children in the household, mothers body mass index, multiple birth and anemia level of child had significant association with child CIAF. Female children were 0.82 times less likely to be CIAF compared to male and multiple birth children were more likely to be CIAF compared to single birth. Children from Oromia, Somalie, Gambela, SNNPR, Harari and Addis Ababa region were 0.6, 0.56, 0.67, 0.52, 0.6 and 0.44 times less likely to be CIAF compared to Tigray. A household from rural area were 15.49 times more likely poor compared to a household. The estimated odds of children whose mothers attended primary, and secondary and higher education was 0.82, and 0.52 times respectively the estimated odds of children from mothers who had never attended formal education. Conclusion The prevalence of children with composite index anthropometric failure was high and closely tied with the household wealth index. Among the determinants, region, religion, family education level, and anemia level of child were statistically significant determinants of both CIAF and household wealth index. Thus, the authors recommend to concerned bodies and policymakers work on household wealth index to reduce the prevalence of child composite anthropometric failure.

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Child Undernutrition in the States of India: An Analysis Based on Change in Composite Index of Anthropometric Failure from 2006 to 2016

Review of Development and Change ◽

10.1177/09722661211010376 ◽

2021 ◽

pp. 097226612110103

Author(s):

J. R. Jith ◽

Rajshree Bedamatta

Keyword(s):

Child Nutrition ◽

Composite Index ◽

Family Health ◽

Wealth Index ◽

Household Wealth ◽

Population Projections ◽

Indian Children ◽

Indian States ◽

Child Undernutrition ◽

Low Weight

Stunting, wasting and underweight—the three traditional indicators of undernourishment among children—provide mutually non-exclusive categories of anthropometric failures: low height for age, low weight for height and low weight for age. Although these indicators are essential for designing specific clinical and child nutrition policy interventions, they fall short of estimating the prevalence of overall anthropometric failure, which provides a sense of the scale of the nutrition problem. This article estimates the alternative, more comprehensive measure Composite Index of Anthropometric Failure (CIAF) for Indian states, based on data from the National Family Health surveys of 2006 and 2016, for children under five years (Ch–U5). The CIAF-based undernutrition estimates show significantly high anthropometric failure levels among Indian children compared to only stunting, wasting and underweight. Based on population projections for Ch–U5, we also show that a sizeable number of states may have seen an increase in child undernutrition between 2006 and 2016. We also correlated CIAF with household wealth index scores and found a positive relationship with children facing no anthropometric failure.

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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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High prevalence of under-five child mortality in the pastoralist communities of Ethiopia: Evidence from the 2016 Ethiopian demographic and health survey data

10.21203/rs.3.rs-61694/v1 ◽

2020 ◽

Author(s):

Mesfin Wudu Kassaw ◽

Aele Mamo ◽

Biruk Abate ◽

Ayelign Kassie ◽

Seteamlak Masresha

Keyword(s):

Survey Data ◽

Child Mortality ◽

Health Survey ◽

Wealth Index ◽

Demographic And Health Survey ◽

Under Five ◽

Khat Chewing ◽

High Prevalence ◽

Health Survey Data ◽

The Government

Abstract Objective: The aim of this study was to assess the prevalence and association of child mortality in the pastoralist regions of Ethiopia. The study is a further analysis from 2016 Ethiopian Demographic and Health Survey data. Results: The prevalence of under-five child mortality in the pastoralist’s regions was 23.2%, 95%CI (21.4%, 24.6%). The prevalence of mortality among daughters was 15.4%, 95%CI (14.2, 16.6%), and sons 16.8%, 95%CI (15.6, 18.1%).In logistic regression, wealth index, head of household, Khat chewing, type of child birth, husband education, and child age in months were associated with under-five mortality irrespective of the deceased children’s gender. The prevalence of under-five child mortality in the pastoralist regions of Ethiopia was high, which was far highest in relative to the national under-five mortality prevalence. In assessing the effect of variables on under-five child mortality by gender, almost all the variables that have an effect on female or male child are similar. The government should emphasize on the pastoralists’ regions to decrease the high prevalence of under-five child mortality.

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Geographical disparities and determinants of childhood diarrheal illness in Ethiopia: Further Analysis of 2016 Ethiopian Demographic and Health Survey

10.21203/rs.2.22887/v1 ◽

2020 ◽

Author(s):

Asmamaw Atnafu ◽

Malede Mequanent Sisay ◽

Getu Debalkie Demissie ◽

Zemenu Tadesse Tessema

Keyword(s):

Health Survey ◽

Mixed Model ◽

Addis Ababa ◽

Demographic And Health Survey ◽

Sub Saharan Africa ◽

Childhood Diarrhea ◽

Mixed Effect ◽

Under Five ◽

Diarrheal Illness ◽

Under Five Children

Abstract Background: Childhood diarrheal illness is the second leading cause of child mortality in Sub Saharan Africa, including Ethiopia. Studies hypothesized that there are regional variations. Thus, the study aimed to examine the spatial variations and to identify the determinants of childhood diarrhea in Ethiopia. Methods: Data from the 2016 Ethiopia Demographic and Health Survey (EDHS) was analyzed. This nationwide survey involved 10,337 children below 5 years old. The survey was carried out using a two-stage stratified sampling design. Moran’s I and LISA were used to detect the spatial clustering of diarrhea cases and to test for clustering in the data. Descriptive statistics followed by a mixed-effect logistic regression was used to identify the factors associated with the prevalence of diarrhea. Results: Overall, 11.87% of children were experienced childhood diarrheal illness. The study reveals high-risk areas were Southern and central Ethiopia, while eastern and west were indicated as low-risk regions. Younger children were more likely to suffer from childhood diarrhea than their older counterparts: age 6 to 12, 12 to 23, and 24 to 35 months were (AOR = 2.66, (95% CI 2.01, 3.52)), (AOR = 2.45, (95% CI 1.89, 3.17)), and (AOR = 1.53, (95% CI 1.17, 2.01)), respectively. Children living in Tigray (AOR= 1.69 (95% CI, 1.01, 2.83)), Amhara (AOR = 1.80, (95% CI, 1.06, 3.06), SNNPR (AOR = 2.04, 95% CI 1.22, 3.42), and Gambela (AOR = 2.05, (95% CI 1.22, 3.42)), faced greater risk than Addis Ababa city. The odds of getting diarrhea is decreased by 24% among households having ≥3 under-five children as compared to households having only one under-five child (AOR = 0.76 (95% CI: 0.61, 0.94)). The odds of children getting diarrheal illness among working mothers increase by 19% as compared to not working (AOR = 1.19 (95% CI 1.03, 1.38)). Conclusions: childhood diarrheal illness is highly prevalent among under-five children, particularly in SNNP, Gambella, Oromia, and Benishangul Gumuz regions. Capacity building programs with best experience sharing and better household environment may prove effective in reducing the incidence of childhood diarrhea in Ethiopia. Keywords: Spatial statistics, Ethiopia, under-five children, Diarrhea, Generalized Mixed Model

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