Iron-rich food consumption and associated factors among children aged 6–23 months in sub-Saharan Africa: A multilevel analysis of Demographic and Health Surveys

Introduction Anemia remains a major public health problem for children in sub-Saharan Africa (SSA). Iron-rich foods consumption has a determinant role on the anemia status. Hence, this study aimed to determine the prevalence of good consumption of iron-rich foods and its associated factors among children aged 6–23 months in SSA. Materials and methods The recent Demographic and Health Survey data sets of thirty-five SSA countries were used. Data were analyzed using STATA/MP version 16.0 and all statistical analyses were done after weighting the data. A generalized linear mixed model using Poisson regression with robust error variance was used to determine factors associated with good consumption of iron-rich food. Association of variables was declared at a p-value of ≤0.05 and adjusted prevalence ratio (aPR) ratio with its 95% confidence interval (CI) was calculated for each variable. Results The total weighted samples of 77,001 children aged 6–23 months were included. The prevalence of consumption of iron rich foods was 42.1% (95% CI: 41.78–42.48). Children with age of 12–17 (adjusted prevalence ratio (aPR) = 1.96, 95% CI: 1.89–2.04) and 18–23 months (aPR = 2.05, 95% CI: 1.97–2.14), who took drugs for intestinal parasites (aPR = 1.30, 95% CI: 1.26–1.34), with postnatal check within 2 months (aPR = 1.09, 95% CI: 1.06–1.13), and children from women with ANC visit of 1–3 (aPR = 1.31, 95% CI: 1.24–1.37) and ≥4 (aPR = 1.41, 95% CI: 1.34–1.48) had higher prevalence of good consumption of iron rich foods. Moreover, the prevalence of consumptions of iron rich foods was higher among children from; family with rich (aPR = 1.36, 95%CI: 1.30–1.42) and middle (aPR = 1.14 95% CI: 1.09–1.19) wealth index, and mother with media exposure (aPR = 1.26, 95%CI: 1.22–1.31). Conclusion The prevalence of good consumption of iron-rich foods among children aged 6–23 months in SSA countries is low. Child factors, family factors, and community-level factors were significantly associated with consumption of iron rich foods. Strategies to increase the consumption of iron-rich foods during this critical stage of growth and development should be designed in SSA.

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Preterm birth and associated factors among mothers who gave birth in Dire Dawa, Ethiopia

British Journal of Midwifery ◽

10.12968/bjom.2021.29.6.338 ◽

2021 ◽

Vol 29 (6) ◽

pp. 338-345

Author(s):

Alekaw Sema ◽

Nigus Kassie ◽

Bezabih Amsalu ◽

Yalelet Belay ◽

Alemu Guta ◽

...

Keyword(s):

Preterm Birth ◽

Associated Factors ◽

Public Health Problem ◽

Cross Sectional Study ◽

Sub Saharan Africa ◽

Major Public Health Problem ◽

Cross Sectional ◽

Eastern Ethiopia ◽

Dire Dawa ◽

Sub Saharan

Background The highest rate of preterm birth in the world is in Sub-Saharan Africa and Asia. However, there is limited data in this study area. Therefore, this study aims to assess the prevalence and associated factors of preterm birth in Dire Dawa City, Eastern Ethiopia. Method An institutional-based, cross-sectional study was conducted with 420 respondents. Conclusion Preterm birth is still a major public health problem in Dire Dawa City.

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Is improvement in indicators of women’s empowerment associated with uptake of WHO recommended IPTp-SP levels in sub-Saharan Africa? A multilevel approach

BMJ Open ◽

10.1136/bmjopen-2020-047606 ◽

2021 ◽

Vol 11 (10) ◽

pp. e047606

Author(s):

Edward Kwabena Ameyaw ◽

Carolyne Njue ◽

Roberta Mensima Amoah ◽

Francis Appiah ◽

Linus Baatiema ◽

...

Keyword(s):

Pregnant Women ◽

Low Income ◽

Community Level ◽

Sub Saharan Africa ◽

Outcome Variable ◽

Demographic And Health Surveys ◽

Major Public Health Problem ◽

Country Level ◽

Sub Saharan ◽

Ssa Countries

ObjectivesThe global burden of malaria has reduced considerably; however, malaria in pregnancy remains a major public health problem in sub-Saharan Africa (SSA), where about 32 million pregnant women are at risk of acquiring malaria. The WHO has recommended that pregnant women in high malaria transmission locations, including SSA, have intermittent preventive treatment of malaria during pregnancy with at least three doses of sulphadoxine-pyrimethamine (IPTp-SP). Therefore, we investigated the prevalence of IPTp-SP uptake and associated individual-level, community-level and country-level predictors in SSA.DesignA cross-sectional survey was conducted using recent Demographic and Health Surveys datasets of 20 SSA countries. A total of 96 765 women were included. Optimum uptake of IPTp-SP at most recent pregnancy was the outcome variable. We fitted three-level multilevel models: individual, community and country parameters at 95% credible interval.ResultsIn all, 29.2% of the women had optimal IPTp-SP uptake ranging from 55.1% (in Zambia) to 6.9% (in Gambia). The study revealed a high likelihood of optimum IPTp-SP uptake among women with high knowledge (aOR=1.298, Crl 1.206 to 1.398) relative to women with low knowledge. Women in upper-middle-income countries were more than three times likely to have at least three IPTp-SP doses compared with those in low-income countries (aOR=3.268, Crl 2.392 to 4.098). We found that community (σ2=1.999, Crl 1.088 to 2.231) and country (σ2=1.853, Crl 1.213 to 2.831) level variations exist in optimal uptake of IPTp-SP. According to the intracluster correlation, 53.9% and 25.9% of the variation in optimum IPTp-SP uptake are correspondingly attributable to community-level and country-level factors.ConclusionsThe outcome of our study suggests that low-income SSA countries should increase budgetary allocation to maternal health, particularly for IPTp-SP interventions. IPTp-SP advocacy behavioural change communication strategies must focus on women with low knowledge, rural dwellers, married women and those who do not meet the minimum of eight antenatal care visits.

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Preterm birth and its associated factors among reproductive aged women in sub-Saharan Africa: evidence from the recent demographic and health surveys of sub-Sharan African countries

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04233-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tesfa Sewunet Alamneh ◽

Achamyeleh Birhanu Teshale ◽

Misganaw Gebrie Worku ◽

Zemenu Tadesse Tessema ◽

Yigizie Yeshaw ◽

...

Keyword(s):

Preterm Birth ◽

Health Surveys ◽

Associated Factors ◽

Sub Saharan Africa ◽

Eastern Africa ◽

Demographic And Health Surveys ◽

Pooled Prevalence ◽

Sub Saharan ◽

Reproductive Aged Women ◽

Ssa Countries

Abstract Background Globally, preterm birth is the leading cause of neonatal and under-five children mortality. Sub-Saharan African (SSA) accounts for the majority of preterm birth and death following its complications. Despite this, there is limited evidence about the pooled prevalence and associated factors of preterm birth at SSA level using nation-wide representative large dataset. Therefore, this study aimed to determine the pooled prevalence and associated factors of preterm birth among reproductive aged women. Methods The recent Demographic and Health Surveys (DHSs) data of 36 SSA countries were used. We included a total weighted sample of 172,774 reproductive-aged women who were giving birth within five years preceding the most recent survey of SSA countries were included in the analysis. We used a multilevel logistic regression model to identify the associated factors of preterm birth in SSA. We considered a statistical significance at a p-value less than 0.05. Results In this study, 5.33% (95% CI: 5.23, 5.44%) of respondents in SSA had delivered preterm baby. Being form eastern Africa, southern Africa, rural area, being educated, substance use, having multiple pregnancy, currently working history, having history of terminated pregnancy, and previous cesarean section delivery, primi-parity, and short birth interval were associated with higher odds of preterm birth among reproductive aged women. However, having better wealth index, being married, wanted pregnancy, and having four or more antenatal care visit were associated with lower odds for a preterm birth among reproductive aged women. Conclusion The prevalence of preterm birth among reproductive-aged women remains a major public health problem in SSA. Preterm birth was affected by various socio-economic and obstetrical factors. Therefore, it is better to consider the high-risk groups during intervention to prevent the short-term and long-term consequences of preterm birth.

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Intimate Partner Violence against Women Living in Inadequate Conditions in Sub-Saharan Africa: A Meta-Analysis of Demographic and Health Survey Data

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph181910138 ◽

2021 ◽

Vol 18 (19) ◽

pp. 10138

Author(s):

Yaqing Gao ◽

Yinping Wang ◽

Xiaoyi Mi ◽

Mo Zhou ◽

Siyu Zou ◽

...

Keyword(s):

Intimate Partner Violence ◽

Partner Violence ◽

Meta Analysis ◽

Intimate Partner ◽

Living Conditions ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Major Public Health Problem ◽

Sub Saharan ◽

Country Specific

Intimate partner violence (IPV) against women is a major public health problem and is widespread in sub-Saharan Africa (SSA). However, little is known about its environmental determinants. This study aimed to investigate whether inadequate living conditions are associated with IPV victimization in women in SSA. We analyzed cross-sectional data for 102,714 women in 25 SSA countries obtained from the Demographic and Health Surveys Program. Logistic regression was used to estimate the country-specific effects of inadequate living conditions (housing with at least one of four characteristics of unimproved water, unimproved sanitation, insufficient space, and unfinished materials) on multiple forms of IPV. Random effects meta-analysis was used to combined the country-specific estimates. We found an association between inadequate living conditions and a higher likelihood of experiencing any (OR = 1.12, 95% CI 1.03 to 1.23, p = 0.012), sexual (OR = 1.18, 95% CI 1.05 to 1.34, p = 0.008), emotional (OR = 1.12, 95% CI 1.02 to 1.23, p = 0.023), and physical (OR = 1.15, 95% CI 1.03 to 1.28, p = 0.010) IPV. The associations were stronger for rural and less-educated women. These findings suggest that future research to establish a causal link between living conditions and IPV and to elucidate the underlying pathways is crucial to design IPV interventions in SSA.

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A multi-state spatio-temporal Markov model for categorized incidence of meningitis in sub-Saharan Africa

Epidemiology and Infection ◽

10.1017/s0950268812001926 ◽

2012 ◽

Vol 141 (8) ◽

pp. 1764-1771 ◽

Cited By ~ 5

Author(s):

L. AGIER ◽

M. STANTON ◽

G. SOGA ◽

P. J. DIGGLE

Keyword(s):

Positive Predictive Value ◽

Predictive Value ◽

Public Health Problem ◽

Incidence Rates ◽

Sub Saharan Africa ◽

Major Public Health Problem ◽

Temporal Dependence ◽

Spatio Temporal ◽

Sub Saharan ◽

Annual Scale

SUMMARYMeningococcal meningitis is a major public health problem in the African Belt. Despite the obvious seasonality of epidemics, the factors driving them are still poorly understood. Here, we provide a first attempt to predict epidemics at the spatio-temporal scale required for in-year response, using a purely empirical approach. District-level weekly incidence rates for Niger (1986–2007) were discretized into latent, alert and epidemic states according to pre-specified epidemiological thresholds. We modelled the probabilities of transition between states, accounting for seasonality and spatio-temporal dependence. One-week-ahead predictions for entering the epidemic state were generated with specificity and negative predictive value >99%, sensitivity and positive predictive value >72%. On the annual scale, we predict the first entry of a district into the epidemic state with sensitivity 65·0%, positive predictive value 49·0%, and an average time gained of 4·6 weeks. These results could inform decisions on preparatory actions.

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Adherence to Iron Supplementation in 22 Sub-Saharan African Countries and Associated Factors among Pregnant Women: A Large Population-Based Study

Current Developments in Nutrition ◽

10.1093/cdn/nzz120 ◽

2019 ◽

Vol 3 (12) ◽

Cited By ~ 5

Author(s):

Djibril M Ba ◽

Paddy Ssentongo ◽

Kristen H Kjerulff ◽

Muzi Na ◽

Guodong Liu ◽

...

Keyword(s):

Pregnant Women ◽

Iron Supplementation ◽

Population Based ◽

Sub Saharan Africa ◽

Deficiency Anemia ◽

Demographic And Health Surveys ◽

Factors Associated ◽

Sub Saharan ◽

Ssa Countries ◽

Antenatal Visits

ABSTRACT Background Iron deficiency anemia during pregnancy is a significant public health problem in sub-Saharan Africa (SSA) and is associated with serious adverse health outcomes. Although it is recommended that all women receive iron supplementation during pregnancy, little research has been conducted to measure overall compliance with this recommendation or variation across SSA countries. Objectives To assess prevalence and sociodemographic-economic factors associated with adherence to iron supplementation among pregnant women in SSA. Methods This was a weighted population-based cross-sectional study of 148,528 pregnant women aged 15–49 y in 22 SSA countries that participated in the Demographic and Health Surveys (DHS) in 2013–2018 and measured iron supplementation during pregnancy. Adherence to iron supplementation was defined as using iron supplementation for ≥90 d during pregnancy of the most recent birth. Results The overall prevalence of adherence to ≥90 d of iron supplementation during pregnancy was 28.7%, ranging from 1.4% in Burundi to 73.0% in Senegal. Factors associated with adherence included receiving ≥4 antenatal care visits [adjusted Prevalence Ratio (aPR): 25.73; 95% CI: 22.36, 29.60] compared with no antenatal visits; secondary or higher education (aPR: 1.17; 95% CI: 1.14, 1.19) compared with no education; wealthy (aPR: 1.13; 95% CI: 1.10, 1.16) compared with poor; and older women aged 35–49 y (aPR: 1.07; 95% CI: 1.05, 1.10) compared with younger women aged 15–24 y. Conclusions Adherence to iron supplementation during pregnancy in SSA is low and varies substantially across countries and in relation to factors such as number of antenatal visits, education, and level of family wealth. These results underscore the need for increased efforts to improve the uptake of iron supplementation for pregnant women in SSA.

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Molecular epidemiology and phylogeography of Schistosoma mansoni around Lake Victoria

Parasitology ◽

10.1017/s0031182010000788 ◽

2010 ◽

Vol 137 (13) ◽

pp. 1937-1949 ◽

Cited By ~ 28

Author(s):

C. J. STANDLEY ◽

N. B. KABATEREINE ◽

C. N. LANGE ◽

N. J. S. LWAMBO ◽

J. R. STOTHARD

Keyword(s):

Population Genetics ◽

Schistosoma Mansoni ◽

Molecular Epidemiology ◽

Lake Victoria ◽

Public Health Problem ◽

Human Migration ◽

Sub Saharan Africa ◽

Major Public Health Problem ◽

Sub Saharan ◽

Coi Sequences

SUMMARYIntestinal schistosomiasis continues to be a major public health problem in sub-Saharan Africa, and is endemic in communities around Lake Victoria. Interest is growing in the molecular evolution and population genetic structure of Schistosoma mansoni and we describe a detailed analysis of the molecular epidemiology and phylogeography of S. mansoni from Lake Victoria. In total, 388 cytochrome oxidase 1 (COI) sequences were obtained from 25 sites along the Ugandan, Tanzanian and Kenyan shorelines of Lake Victoria, and 122 unique barcodes were identified; 9 corresponded to previously discovered barcodes from Lakes Victoria and Albert. A subset of the data, composed of COI sequences from miracidia from 10 individual children, was used for population genetics analyses; these results were corroborated by microsatellite analysis of 4 isolates of lab-passaged adult worms. Overall, 12 barcodes were found to be shared across all 3 countries, whereas the majority occurred singly and were locally restricted. The population genetics analyses were in agreement in revealing high diversity at the level of the human host and negligible population structuring by location. The lack of correlation between genetic distance and geographical distance in these data may be attributed to the confounding influence of high intra-individual diversity as well as human migration between communities.

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Women’s decision-making capacity and HIV testing in sub-Saharan Africa: A multi-country analysis of Demographic and Health Surveys

10.21203/rs.2.22504/v1 ◽

2020 ◽

Author(s):

Abdul-Aziz Seidu ◽

Joseph Kojo Oduro ◽

Bright Opoku Ahinkorah ◽

Eugene Budu ◽

Francis Appiah ◽

...

Keyword(s):

Decision Making ◽

Hiv Testing ◽

Health Surveys ◽

Demographic Characteristics ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Odds Ratios ◽

Decision Making Capacity ◽

Sub Saharan ◽

Ssa Countries

Abstract IntroductionGlobal commitment to stop HIV and ensure access to HIV treatment call for women empowering as these efforts play a major role in mother to child transmission. We explored the association between women decision-making capacity and HIV testing in sub-Saharan Africa (SSA). Materials and methodsWe used data from current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2016 in 30 countries within SSA. At the descriptive level, we calculated the prevalence of women who had undergone HIV testing and decision-making capacity in each of the countries as well as prevalence of HIV testing across their socio-demographic characteristics. We used Binary Logistic Regression to explore the likelihood of HIV testing by decision-making capacity and socio-demographic characteristics at 5% margin of error. The results were presented as Crude Odds Ratios (CORs) and Adjusted Odds Ratios (AORs). ResultsWe found that overall, 10.0% of women had decision-making with Nigeria (4.5%) and Zimbabwe (21.3%) recording the least and the highest respectively. In terms of HIV testing, the prevalence of HIV testing in the 30 SSA countries was 64.4%, with Guinea (12.8%) having the least. The highest occurred in Lesotho (99%) and Rwanda (99%). Women who had capacity to make decisions had higher likelihood of HIV testing [AOR=1.04, CI=1.02–1.09]. Women from Rwanda had the highest likelihood of HIV testing [AOR=53.92, CI=41.31–70.37] with women from Guinea having the least likelihood [AOR=0.10, CI=0.08–0.11]. Other determinants to HIV testing were level of education, wealth status, believing that a healthy-looking person can have HIV, watching television almost every day, age and place of residence.Conclusion SSA countries intending to improve HIV testing need to incorporate women decision-making capacity strategies in terms of education and counselling into the available policies. This is essential because our study indicates that as women are able to make decisions in their households, the possibility for them to test for their HIV status increases.

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Diarrhea and associated factors among under five children in sub-Saharan Africa: Evidence from demographic and health surveys of 34 sub-Saharan countries

PLoS ONE ◽

10.1371/journal.pone.0257522 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0257522

Author(s):

Getu Debalkie Demissie ◽

Yigizie Yeshaw ◽

Wallelign Aleminew ◽

Yonas Akalu

Keyword(s):

Associated Factors ◽

Maternal Education ◽

Wealth Index ◽

Water Source ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

African Countries ◽

Under Five ◽

Under Five Children ◽

Sub Saharan

Introduction Diarrhea is responsible for the death of more than 90% of under-five children in low and lower-middle income countries. Regionally, South Asia and sub-Saharan Africa accounted for 88% of deaths with the same age group. Therefore, the aim of this study was to determine the prevalence and associated factors of diarrhea among children under-five years in sub-Saharan Africa. Methods The appended, most recent demographic and health survey datasets of 34 sub-Saharan African countries were used to determine the prevalence and associated factors of diarrhea among under-five children in the region. A total weighted sample of 330,866 under-five children were included in the study. Both bivariable and multivariable multilevel logistic regression were done to determine the associated factors of diarrhea among under five children in sub-Saharan Africa. The Odds Ratio (OR) with a 95% Confidence Interval (CI) was calculated for those potential factors included in the final model. Result The overall prevalence of diarrhea in this study was 15.3% (95% CI: 15.1–15.4). Those children of mothers aged 15–24 (AOR = 1.26; 95% CI: 1.23, 1.30) and 25–34 years (AOR = 1.15; 95%CI: 1.12, 1.18), those children of mothers with no education (AOR = 1.69; 95%CI: 1.57–1.82), primary education (AOR = 1.73; 95%CI: 1.61–1.86) and secondary education (AOR = 1.49; 95%CI: 1.38–1.59) had higher odds of having diarrhea. Those children from poorest (AOR = 1.14; 95%CI: 1.10, 1.19), poorer (AOR = 1.12; 95%CI: 1.08–1.17), middle (AOR = 1.06; 95%CI: 1.02, 1.10), and richer (AOR = 1.14; 95%CI: 1.04–1.12) households had higher chance of having diarrhea compared to their counterparts. Conclusion This study found that the prevalence of childhood diarrhea morbidity in sub-Saharan Africa was high. Maternal age, wealth index, maternal education, maternal occupation, age of child, time of initiation of breast feeding and time to get water source were significantly associated with diarrhea. Therefore, intervention through health education and health promotion for mothers/caretakers who are poor, less educated, and young should be designed to prevent diarrhea in the region.

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Prenatal care coverage and correlates of HIV testing in sub-Saharan Africa: Insight from demographic and health surveys of 16 countries

PLoS ONE ◽

10.1371/journal.pone.0242001 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0242001

Author(s):

Oluwafemi Emmanuel Awopegba ◽

Amarachi Kalu ◽

Bright Opoku Ahinkorah ◽

Abdul-Aziz Seidu ◽

Anthony Idowu Ajayi

Keyword(s):

Prenatal Care ◽

Pregnant Women ◽

Hiv Testing ◽

Health Surveys ◽

Central Africa ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

West And Central Africa ◽

Sub Saharan ◽

Ssa Countries

Background Prenatal screening of pregnant women for HIV is central to eliminating mother-to-child-transmission (MTCT) of HIV. While some countries in sub-Saharan Africa (SSA) have scaled up their prevention of MTCT programmes, ensuring a near-universal prenatal care HIV testing, and recording a significant reduction in new infection among children, several others have poor outcomes due to inadequate testing. We conducted a multi-country analysis of demographic and health surveys (DHS) to assess the coverage of HIV testing during pregnancy and also examine the factors associated with uptake. Methods We analysed data of 64,933 women from 16 SSA countries with recent DHS datasets (2015–2018) using Stata version 16. Adjusted and unadjusted logistic regression models were used to examine correlates of prenatal care uptake of HIV testing. Statistical significance was set at p<0.05. Results Progress in scaling up of prenatal care HIV testing was uneven across SSA, with only 6.1% of pregnant women tested in Chad compared to 98.1% in Rwanda. While inequality in access to HIV testing among pregnant women is pervasive in most SSA countries and particularly in West and Central Africa sub-regions, a few countries, including Rwanda, South Africa, Zimbabwe, Malawi and Zambia have managed to eliminate wealth and rural-urban inequalities in access to prenatal care HIV testing. Conclusion Our findings highlight the between countries and sub-regional disparities in prenatal care uptake of HIV testing in SSA. Even though no country has universal coverage of prenatal care HIV testing, East and Southern African regions have made remarkable progress towards ensuring no pregnant woman is left untested. However, the West and Central Africa regions had low coverage of prenatal care testing, with the rich and well educated having better access to testing, while the poor rarely tested. Addressing the inequitable access and coverage of HIV testing among pregnant women is vital in these sub-regions.

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