scholarly journals Paediatric morbidity and mortality in Sierra Leone. Have things changed after the 2014/2015 Ebola outbreak?

F1000Research ◽  
2020 ◽  
Vol 8 ◽  
pp. 796
Author(s):  
Tom Sesay ◽  
Olga Denisiuk ◽  
Rony Zachariah
Keyword(s):  
Sierra Leone ◽  
Health Information System ◽  
Case Fatality ◽  
Health Facilities ◽  
Morbidity And Mortality ◽  
Watery Diarrhoea ◽  
District Health ◽  
Cross Sectional ◽  
Under Five ◽  
Under Five Children

Background: Sierra Leone was severely affected by the 2014/2015 Ebola outbreak which is likely to have had longer term repercussions on the health system including on paediatric morbidity and mortality. We thus assessed under-five morbidity and mortality for malaria, acute respiratory Infections (ARI)/pneumonia, watery diarrhoea and measles during the post-Ebola period in Sierra Leone and compared this with the pre- and intra-Ebola periods. Methods: This was a retrospective cross-sectional study using program data from the District Health Information system (DHIS2) and sourced from 14 districts in Sierra Leone. It included under-five children from 1,250 health facilities country-wide. Study periods included: before (June 1 st, 2013-April 30 th, 2014); during (June 1 st, 2014-April 30 th, 2015); and after Ebola (June 1 st, 2016-April 30 th, 2017). Results: Malaria, ARI/pneumonia and diarrhoea consultations declined during Ebola but recovered to pre-Ebola levels in the post-Ebola period.  During the post-Ebola period, there was a highly significant reduction in case-fatality for the first three morbidities compared to the pre-Ebola period (P<0.0001). Average number of measles cases increased from 48/month in the pre-Ebola period to 568/month (12-fold increase) post-Ebola. Although there was no difference in measles case-fatality between the pre- and post-Ebola periods, case-fatality post-Ebola was significantly lower than during Ebola (Relative Risk: 0.05, 95% confidence interval 0.02-0.15, P<0.0001). Conclusions: Consultations for under-five children at health facilities in Sierra Leone recovered to pre-Ebola levels and case-fatality for common childhood illnesses declined significantly. This is a change for the better. However, the high level of reported measles cases in the post-Ebola period indicates gaps in immune status and needs focused attention.

scholarly journals Paediatric morbidity and mortality in Sierra Leone. Have things changed after the 2014/2015 Ebola outbreak?

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 796
Author(s):  
Tom Sesay ◽  
Olga Denisiuk ◽  
Rony Zachariah
Keyword(s):  
Sierra Leone ◽  
Health Information System ◽  
Case Fatality ◽  
Health Facilities ◽  
Morbidity And Mortality ◽  
Watery Diarrhoea ◽  
District Health ◽  
Cross Sectional ◽  
Under Five ◽  
Under Five Children

Background: Sierra Leone was severely affected by the 2014/2015 Ebola outbreak and is likely to have had longer term repercussions on the health system including on paediatric morbidity and mortality. We thus assessed under-five morbidity and mortality for malaria, acute respiratory Infections (ARI)/pneumonia, watery diarrhoea and measles during the post-Ebola period in Sierra Leone and compared this with the pre- and intra-Ebola periods. Methods: This was a retrospective cross-sectional study using program data from the District Health Information system (DHIS2) and sourced from 14 districts in Sierra Leone. It included under-five children from 1,200 health facilities country-wide. Study periods included: before (June 1st, 2013-April 30th, 2014); during (June 1st, 2014-April 30th, 2015); and after Ebola (June 1st, 2016-April 30th, 2017). Results: Malaria, ARI/pneumonia and diarrhoea consultations declined during Ebola but recovered to pre-Ebola levels in the post-Ebola period.  During the post-Ebola period, there was a highly significant reduction in case-fatality for the first three morbidities compared to the pre-Ebola period (P<0.0001). Average number of measles cases increased from 48/month in the pre-Ebola period to 568/month (12-fold increase) post-Ebola. Although there was no difference in measles case-fatality between the pre- and post-Ebola periods, case-fatality post-Ebola was significantly lower than during Ebola (Relative Risk: 0.05, 95% confidence interval 0.02-0.15, P<0.0001). Conclusions: Consultations for under-five children at health facilities in Sierra Leone recovered to pre-Ebola levels and case-fatality for common childhood illnesses declined significantly. This is a change for the better. However, the high level of reported measles cases in the post-Ebola period indicates gaps in immune status and needs focused attention.   

scholarly journals Prevalence of rotavirus infection and its association with socio-demographic characteristics among under-five children admitted with acute diarrhoea in a tertiary care hospital of Bangladesh

2021 ◽  
Vol 11 (3) ◽  
pp. 186-190
Author(s):  
Farjana Binte Habib ◽  
Mohammed Mirazur Rahman ◽  
Rafaat Choudhury ◽  
Tarun Kanti Paul ◽  
Md Moynul Haque
Keyword(s):  
Tertiary Care ◽  
Acute Diarrhoea ◽  
Watery Diarrhoea ◽  
Enzyme Linked Immunosorbent Assay ◽  
High Morbidity ◽  
Care Hospital ◽  
Cross Sectional ◽  
Rotavirus Infection ◽  
Under Five ◽  
Under Five Children

Background: Rotavirus has been recognized as the most common cause of acute watery diarrhoea among under-five children worldwide. It is considered as a major cause of childhood morbidity and mortality particularly in developing countries like Bangladesh. Considering the high morbidity and significant mortality, this study was designed to evaluate the prevalence of rotaviral diarrhoea among children less than five years in Sylhet region of Bangladesh. Methods: This cross-sectional study was conducted in the Department of Microbiology, Sylhet MAG Osmani Medical College from 1st January to 31st December, 2018. Total 184 under-five children admitted in paediatrics department of the same institute with acute watery diarrhoea were enrolled in this study by convenient sampling. Stool samples were obtained and assayed for rotavirus antigen by sandwich type enzyme linked immunosorbent assay (ELISA). Results: Rotaviral antigen was found positive in 86 cases and disease prevalence was 46.74%. The rotavirus infection was found highest in age group of 7 to 12 months (50.56%) and in male (59.30%) children. Prevalence of infection was associated with age (p= 0.004), socio-economic condition (p=0.001) and exclusive breastfeeding of children (p=0.01). Conclusion: Rotavirus was a significant cause of acute watery diarrhoea and mainly affected children below 12 months age. BIRDEM Med J 2021; 11(3): 186-190

scholarly journals Socioeconomic and cultural factors associated with mortality in Malaria induced anaemia among under-five children in Benin city, Nigeria

2014 ◽  
Vol 14 (1) ◽  
pp. 32-38
Author(s):  
Blessing Imuetinyan Abhulimhen-Iyoha ◽  
Yetunde Tinuola Israel-Aina
Keyword(s):  
Parental Education ◽  
Medical Science ◽  
Case Fatality ◽  
Cultural Factors ◽  
Health Seeking ◽  
Cross Sectional ◽  
Under Five ◽  
Factors Associated ◽  
Under Five Children ◽  
Benin City

Background: Children under the age of five years bear the brunt of malaria infection. Malaria induced anaemia (MIA) is the most prevalent presentation of malaria and a major cause of morbidity and mortality in Nigeria. Objective: To determine the socioeconomic and cultural factors associated with mortality in under-five children presenting with malaria induced anaemia. Methods: This is a cross-sectional descriptive study conducted at the Children Emergency Room of the University of Benin Teaching Hospital, Benin City, Nigeria. Questionnaires which were researcher-administered were used to collect information on the child’s age, gender, parents’ or caregiver’s education, occupation, recognition of symptoms of malaria and anaemia, cultural practices during child’s illness and patients’ outcome. Results: The case fatality rate was 3.1%. Poor parental education, low social class and lack of skilled job amongst the parents were associated with high mortality. Other factors associated with mortality include high patronage of chemists and prayer houses as well as poor recognition of pallor by mothers. Conclusion/Recommendations: Improvement in socioeconomic status especially female education and empowerment is again emphasized. This and other socioeconomic boost should be targeted alongside malaria-control programmes in order to reduce mortality associated with malaria induced anaemia. Parental enlightenment on recognition of symptoms of malaria and anaemia will improve their health-seeking behaviour, promote early diagnosis and prompt institution of effective antimalarial therapy.DOI: http://dx.doi.org/10.3329/bjms.v14i1.17274 Bangladesh Journal of Medical Science Vol.14(1) 2015 p.32-38

scholarly journals Prevalence and Determinants of Malnutrition in under Five Children in Selected Health Facilities in Egume, Kogi State, Nigeria

2019 ◽  
pp. 182-191
Author(s):  
Achadu Abraham Eleojo ◽  
Umeh Chisom Charles ◽  
Onoja Inikpi
Keyword(s):  
General Hospital ◽  
Health Facilities ◽  
Anthropometric Measurement ◽  
Cross Sectional ◽  
Under Five ◽  
Under Five Children ◽  
Validated Questionnaire ◽  
Standard Procedures ◽  
Historic Data ◽  
And Gender

Aims: This study was conducted to determine the prevalence and determinants of malnutrition in under five children in selected health facilities in Egume, Dekina LGA, Kogi State. Study Design: This was a cross-sectional descriptive study with historic data that assessed the Prevalence and determinants of malnutrition of under-five children in selected health facilities in Egume Dekina Local Government Area, Kogi State. Study Area: The study was conducted at General Hospital and St. Luke clinic in Egume, Dekina LGA, Kogi State. Methodology: The study focused on Mothers and their under five children who were treated as in- or out- patients at the General Hospital and St. luke clinic Egume within the past five years, Interview was conducted with the aid of a validated, questionnaire, after obtaining informed consent from mothers and ethical clearance from the Health Research Ethics Committee, Kogi State Ministry of Health. Data was obtained through reviews of available health records. Anthropometric measurement was carried out following standard procedures. Results: The study showed that 21.3%, 25.6%, 47.4% and 5.7% of the sampled children were mildly undernourished, moderately undernourished, severely undernourished and healthy respectively. Conclusion: The present study further revealed that a child’s age and gender, mother’s education and nutrition and other health variables such as clean water and toilet are determinants of child malnutrition.

scholarly journals Water, Sanitation, and Hygiene Risk Factors on the Prevalence of Diarrhea among Under-Five Children in the Rural Community of Dangila District, Northwest Ethiopia

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Bizuayehu Hailu ◽  
Wu Ji-Guo ◽  
Tadesse Hailu
Keyword(s):  
Rural Community ◽  
Statistical Significance ◽  
Northwest Ethiopia ◽  
Morbidity And Mortality ◽  
Clean Water ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Under Five ◽  
Under Five Children ◽  
Sanitation And Hygiene

Background. Under-five diarrhea is one of the major causes of morbidity and mortality in developing countries. Despite the tremendous achievement in reducing child mortality and morbidity in the last two decades, diarrhea is still the major causes of morbidity and mortality in resource-limited countries like Ethiopia due to the absence of clean water and poor sanitation and hygiene. Objective. This study aimed to assess the association of water, sanitation, and hygiene on the prevalence of diarrhea among under-five children in the rural community of Ethiopia. Methods. A cross-sectional study was conducted among randomly selected 419 under-five children from October to December 2021 in Dangila district, Northwest Ethiopia. A structured questionnaire was used to collect sociodemographic, environmental, and behavioral data. Data were entered into Epi Info and analyzed using SPSS software. Descriptive analysis was used to calculate the prevalence of diarrhea. Univariate and multivariate logistic regression were used to compute the association of water, sanitation, and hygiene with diarrhea. Statistical significance was considered if P < 0.05 . Results. Among 419 participants, the prevalence of diarrhea was 106 (25.3%). The absence of handwashing habit of children (AOR = 7.70; 95% CI: 2.71–21.79) and caregivers after toilet (AOR = 19.10; 95% CI: 5.46–66.52), absence of latrine (AOR = 3.87; 95% CI: 1.24–12.08), playing with soil (AOR = 8.40; 95% CI: 4.58–36.66), and eating soil (AOR = 6.24; 95% CI: 1.99–19.78) were significantly associated with under-five diarrhea. Children who drink unprotected water were 2.21 times (AOR = 2.21; 95% CI: 0.51–9.69) more exposed to under-five diarrhea than who drink protected water, but it is not statistically significant ( P = 0.29 ). Conclusion. The prevalence of under-five diarrhea is high in Dangila district. The absence of clean water and poor handwashing practice and the absence of latrine are the main factors associated with diarrhea. Therefore, strengthening water, sanitation, and hygiene strategy in the rural community should be prioritized.

scholarly journals Nutritional survey among under five children at Tamyia district in Fayoum, Egypt

2017 ◽  
Vol 4 (6) ◽  
pp. 1813 ◽  
Author(s):  
Asmaa Younis Elsary ◽  
Ahmed Mahmoud Abd El-moktader ◽  
Alkassem Elgameel ◽  
Wael Sayed Mohammed ◽  
Mohamed Masoud ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care Facilities ◽  
P Value ◽  
District Health ◽  
Community Based ◽  
Cross Sectional ◽  
Under Five ◽  
Under Five Children ◽  
High Prevalence ◽  
Sick Children

Background: Malnutrition is involved in half of the deaths of under-five children as in many developing countries. In Egypt, malnutrition remains an important issue as 5.5% of under-five children are underweight, 8.4% are wasted and 21.4% are stunted. The present study was carried out to assess the prevalence and risk factors of malnutrition among sick under five children seeking medical advice at Tamiya District health care facilities in Fayoum.Methods: This cross-sectional descriptive study included 400 under five children at Tamiya district in Fayoum. It was carried out over a period of 5 months from June to October 2014. All patients were subjected to the following: History taking, anthropometric measurements including weight and length/height.Results: Our study shows that 23.2%, 18.5% and 19.3% of children were underweight, stunted and wasted, respectively. Stunting was more common in females than males. Also, our results reveal that risk factors of malnutrition were 70.6% parasitic infestation and 15.7% for gastroenteritis with statistically significant high prevalence of positive parasitic, helminthic infestation, and gastroenteritis with p-value <0.05 among wasted, stunted, and underweighted children.Conclusions: Prevalence of malnutrition was high among under five sick children. These findings indicate the need for implementing hospital and community-based intervention nutritional program.

scholarly journals Evaluation of Risk Factors Associated with Rotaviral Diarrhoea among Under Five Children in Sylhet Region of Bangladesh

2019 ◽  
Vol 48 (2) ◽  
pp. 32-37
Author(s):  
Farjana Binte Habib ◽  
Mohammed Mirazur Rahman ◽  
Md Moynul Haque ◽  
Probhat Ranjan Dey ◽  
Premananda Das ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cross Sectional Study ◽  
Bottle Feeding ◽  
Watery Diarrhoea ◽  
Enzyme Linked Immunosorbent Assay ◽  
College Hospital ◽  
Cross Sectional ◽  
Under Five ◽  
Factors Associated ◽  
Under Five Children

Retrovirus is the major cause of acute severe diarrhea in under five children and contributing 10,000 to 27000 deaths each year in Bangladesh. This cross-sectional study was designed to determine the risk factors associated with Rotaviral among under five children admitted in the Department of Paediatrics, Sylhet MAG Osmani Medical College Hospital, Sylhet and was carried out in the Department of Microbiology during the period from 1st January to 31st December, 2018. Total 184 under five children with acute watery diarrhoea were enrolled in this study by convenient sampling. Stool samples were obtained and assayed for rotavirus antigens by enzyme linked immunosorbent assay (ELISA). Rotaviral antigen was found positive in 86 cases.The Rotavirus infection was found highest in age group of 7 to 12 months (50.56%) and in male (59.30%) children. It was found significantly higher in patients from lower socio-economic condition (64.00%), those who were from rural area (48.75%) and children who were not exclusively breastfed (83.87%). Bottle feeding, lower educational level of mother and overweight of children may serve as predisposing factors of rotavirus disease in these children. Bangladesh Med J. 2019 May; 48 (2): 32-37

Digital health solutions and state of interoperability: Sierra Leone’s Landscape analysis (Preprint)

2021 ◽  
Author(s):  
Emeka Chukwu ◽  
Edward Foday ◽  
Abdul Konomanyi ◽  
Royston Wright ◽  
Lalit Garg ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Big Data ◽  
Sierra Leone ◽  
Health Management ◽  
Digital Health ◽  
Health Information System ◽  
Implementation Strategies ◽  
Health Facilities ◽  
Successful Implementation ◽  
District Health

BACKGROUND Government and partners have invested heavily in the health information system (HIS) for service delivery, surveillance, reporting, and monitoring. Sierra Leone government launched her first digital health strategy in 2018. In 2019, a broader National Innovation and digital strategy was launched. The health-pillar direction will use Big data and Artificial Intelligence (AI) to improve healthcare in general, and maternal and child health in particular. Understanding the number, distribution, and interoperability of digital health solutions is crucial for successful implementation strategies. OBJECTIVE This paper presents the state of digital health solutions in Sierra Leone, and how these solutions currently interoperate. This study further presents opportunities for big data and AI application. METHODS All the district health management teams, Digital health implementing organizations, and sample Seventy-two health facilities representatives were surveyed. RESULTS Health facility survey shows that 94% of health facilities had at least one digital health project being implemented. The National Health Management Information (NHMIS) aggregate reporting solution was by far the most used. Half of health facilities had more than two digital health solutions in use. Data was not being exchanged among the surveyed digital health systems. CONCLUSIONS The different digital health software solutions do not share data amongst one another, though reporting data is sent as necessary. The vision of using big data for healthcare is achievable if stakeholders prioritize these healthcare exchange using agreed use cases from the national strategies. Many digital health solutions are currently used at health facilities in Sierra Leone. Government can leverage current investment in HIS from surveillance and reporting for using big data and artificial intelligence for care. This study has shown evidence of distribution, types, and scale of digital health solutions in health facilities, and opportunities for leveraging big data to fill critical gap necessary to achieve the national digital health vision.

scholarly journals Impact of Community-Led Total Sanitation and Hygiene on Prevalence of Diarrheal Disease and Associated Factors among Under-Five Children: A Comparative Cross-Sectional Study in Selected Woredas of Gamo Gofa Zone, Southern Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Agune Ashole Alto ◽  
Wanzahun Godana ◽  
Genet Gedamu
Keyword(s):  
Drinking Water ◽  
Diarrheal Disease ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Under Five ◽  
Under Five Children ◽  
Sanitation And Hygiene ◽  
The Impact ◽  
Gamo Gofa

Background. Diarrheal diseases are still one of the major causes of morbidity in under-five children in sub-Saharan Africa. In Ethiopia, diarrhea is responsible for 9% of all deaths and is the major cause of under-five mortality. Objective. To assess the impact of community-led total sanitation and hygiene on the prevalence of diarrheal disease and factors associated among under-five children in Gamo Gofa Zone. Methods. Community-based comparative cross-sectional study design was used to compare the impact of community-led total sanitation and hygiene intervention on under-five diarrheal disease. Multistage sampling method was employed. The data were collected by using pretested structured questionnaires. Data quality was ensured by daily supervision completeness and consistency. The data were coded, entered, and cleaned by using Epi Info version 7 and were analyzed by using SPSS version 20. Bivariate and multivariable analyses were carried out by using binary logistic regression. Significance was declared by using p value of <0.05 and AOR with 95% confidence intervals. Results. The response rate of this study was 93.3%. The overall diarrhea prevalence was 27.5% (CI = (24.06, 30.97)) which was 18.9% (CI = (14.94, 23.2)) in implemented and 36.2%. (CI = (30.41, 41.59)) in nonimplemented woredas. Children whose age was between 12 and 23 months (AOR = 1.6) and greater than 24 months (AOR = 5), availability of handwashing facilities (AOR = 4), disposal of waste in open field (AOR = 9.7), unimproved source of drinking water (AOR = 6.5), using only water for handwashing (AOR = 6), children who started complementary feeding less than 6 months (AOR = 5.6) and greater than 6 months (AOR = 5.2), and utensils used to feed children such as bottle (AOR = 3.9) were the factors positively associated with diarrhea. Conclusion. The overall prevalence of under-five diarrhea was 27.5%. The prevalence was low in CLTSH woredas as compared with non-CLTSH woredas. The study showed that handwashing facility, using only water for handwashing, open refuse disposal, and unimproved source of drinking water among under-five had a statistically significant association with diarrhea occurrence in CLTSH nonimplemented areas. Integrated efforts are needed from the Ministry of Health together with the WASH Project in improving drinking water, handwashing facilities, and solid waste disposal practices.

scholarly journals Hierarchical disentanglement of contextual from compositional risk factors of diarrhoea among under-five children in low- and middle-income countries

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Adeniyi Francis Fagbamigbe ◽  
A. Olalekan Uthman ◽  
Latifat Ibisomi
Keyword(s):  
Risk Factors ◽  
National Level ◽  
Cross Sectional ◽  
Middle Income ◽  
Contextual Risk ◽  
Under Five ◽  
Factors Associated ◽  
Under Five Children ◽  
Middle Income Countries ◽  
Low And Middle Income

AbstractSeveral studies have documented the burden and risk factors associated with diarrhoea in low and middle-income countries (LMIC). To the best of our knowledge, the contextual and compositional factors associated with diarrhoea across LMIC were poorly operationalized, explored and understood in these studies. We investigated multilevel risk factors associated with diarrhoea among under-five children in LMIC. We analysed diarrhoea-related information of 796,150 under-five children (Level 1) nested within 63,378 neighbourhoods (Level 2) from 57 LMIC (Level 3) using the latest data from cross-sectional and nationally representative Demographic Health Survey conducted between 2010 and 2018. We used multivariable hierarchical Bayesian logistic regression models for data analysis. The overall prevalence of diarrhoea was 14.4% (95% confidence interval 14.2–14.7) ranging from 3.8% in Armenia to 31.4% in Yemen. The odds of diarrhoea was highest among male children, infants, having small birth weights, households in poorer wealth quintiles, children whose mothers had only primary education, and children who had no access to media. Children from neighbourhoods with high illiteracy [adjusted odds ratio (aOR) = 1.07, 95% credible interval (CrI) 1.04–1.10] rates were more likely to have diarrhoea. At the country-level, the odds of diarrhoea nearly doubled (aOR = 1.88, 95% CrI 1.23–2.83) and tripled (aOR = 2.66, 95% CrI 1.65–3.89) among children from countries with middle and lowest human development index respectively. Diarrhoea remains a major health challenge among under-five children in most LMIC. We identified diverse individual-level, community-level and national-level factors associated with the development of diarrhoea among under-five children in these countries and disentangled the associated contextual risk factors from the compositional risk factors. Our findings underscore the need to revitalize existing policies on child and maternal health and implement interventions to prevent diarrhoea at the individual-, community- and societal-levels. The current study showed how the drive to the attainment of SDGs 1, 2, 4, 6 and 10 will enhance the attainment of SDG 3.

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