Methods for assessing seasonal and annual trends in wasting in Indian surveys (NFHS-3, 4, RSOC & CNNS)

Wasting in children under-five is a form of acute malnutrition, a predictor of under-five child mortality and of increased risk of future episodes of stunting and/or wasting. In India, national estimates of wasting are high compared to international standards with one in five children found to be wasted. National surveys are complex logistical operations and most often not planned or implemented in a manner to control for seasonality. Collection of survey data across differing months across states introduces seasonal bias. Cross-sectional surveys are not designed to collect data on seasonality, thus special methods are needed to analyse the effect of data collection by month. We developed regression models to estimate the mean weight for height (WHZ), prevalence of wasting for every month of the year for an average year and an overall weighted survey estimates controlling for the socio-demographic variation of data collection across states and populations over time. National level analyses show the mean WHZ starts at its highest in January, falls to the lowest in June/August and returns towards peak at year end. The prevalence of wasting is lowest in January and doubles by June/August. After accounting for seasonal patterns in data collection across surveys, the trends are significantly different and indicate a stagnant period followed by a decline in wasting. To avoid biased estimates, direct comparisons of acute malnutrition across surveys should not be made unless seasonality bias is appropriately addressed in planning, implementation or analysis. Eliminating the seasonal variation in wasting would reduce the prevalence by half and provide guidance towards further reduction in acute malnutrition.

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

Scientific Reports ◽

10.1038/s41598-021-87889-2 ◽

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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Time To Relapse of Severe Acute Malnutrition And Its Determinants Among Children Treated In The Health Posts of Hadiya Zone, Southern Ethiopia.

10.21203/rs.3.rs-718840/v1 ◽

2021 ◽

Author(s):

Abera Lambebo ◽

Desselegn Temiru ◽

Tefera Belachew

Keyword(s):

Severe Acute Malnutrition ◽

Statistical Significance ◽

Acute Malnutrition ◽

Southern Ethiopia ◽

Under Five ◽

Back Ground ◽

Relapse Time ◽

The Mean ◽

Time To Relapse ◽

Hadiya Zone

Abstract Back ground: In developing countries including Ethiopia, children under five years old are likely to suffer from repeated bouts of SAM. There is lack of study that documented time to relapse of SAM and its determinants. Objective: This study aimed to identify time of relapse and its determinants among children discharged after treatment for SAM in health facilities of Hadiya Zone, South, Ethiopia Methods: An institution based retrospective cohort study was carried out from data spanning from 2014/2015 to 2019/2020. After checking all the assumptions, multivariable CPH model was fitted to isolate independent determinants of time to relapse. All tests were two sided and statistical significance at P values <0.05. Result: The mean(±SD) time for relapse of SAM among under five children was 22(±9.9) weeks from discharge to relapse time. On multivariable CPH model, the hazard of relapse for SAM was significantly higher for children who had edema (AHR =2.02 ,95%, CI: 1.17-3.50), age of 6-11 months (AHR = 5.2, 95%, CI:1.95-13.87), had discharge low MUAC (AHR = 12,95%, CI: 7.90-19.52)Concussion: The finding showed that children discharged from SAM are likely to have relapse in 3 weeks.

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Abstract 3356: Does Severe Obesity Cause Progressive Impairment of Left Ventricular Systolic Function?

Circulation ◽

10.1161/circ.116.suppl_16.ii_757 ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Theophilus Owan ◽

Kimberly Morley ◽

Travis G Ault ◽

Ronny Jiji ◽

Nathaniel Hall ◽

...

Keyword(s):

Heart Failure ◽

Systolic Function ◽

Left Ventricular Systolic Function ◽

Left Ventricular ◽

Entire Group ◽

Obese Patients ◽

Cross Sectional ◽

Increased Risk ◽

Severely Obese ◽

The Mean

Background: Obesity is associated with an increased risk of developing heart failure. Based on cross sectional studies, it has been hypothesized that the duration of obesity is the key factor leading to impaired cardiac function. However, longitudinal data to confirm this hypothesis are not available. Methods: We prospectively studied 62 severely obese patients at baseline, 2 and 5 years after randomization to nonsurgical therapy (NonSurg, n = 25) or Rouxen-Y gastric bypass surgery (GBS, n = 37). Echocardiography was used to measure left ventricular (LV) size and ejection fraction (EF). Results: At enrollment, the mean BMI was 46±9 and the mean age was 47±11 years (range 25– 66). GBS subjects lost 96± 26 vs. 6±18 lbs at 2 years and 78±42 vs. 17±42 lbs at 5 years compared to NonSurg (p<0.0001 for both). At baseline LVEF was not different between GBS and nonsurg (67±9 vs. 64±8%) and it did not change at 2 years (64±9 vs. 63±9%) or 5 years (63±9 vs. 63±10%). LV diastolic dimension did not change over time in control (4.3±1.0 vs. 4.2±0.6 vs. 4.5±0.3) or GBS patients (4.4±0.6 vs. 4.3±0.7 vs. 4.4±0.4). Stratifying the entire group by quartiles of age or duration of obesity (quartile 1 avg duration = 16 years, quartile 4 average duration = 56 years), we found no evidence of time-dependent changes in LV size or function. Conclusion: In this, prospective study of severely obese patients we found no evidence of progressive changes in LV size or EF over a period of 5 years. Moreover, we find no relationship between age or duration of obesity and LV size or LVEF. These data argue strongly that other factors such as the development of coronary disease are the most likely causes of heart failure in obese patients.

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Evaluation of Serum Triglyceride and Total Cholesterol Status in Adolescent Smoker

Journal of Bangladesh Society of Physiologist ◽

10.3329/jbsp.v1i0.715 ◽

1970 ◽

Vol 1 ◽

pp. 14-18

Author(s):

L Afrin ◽

R Sultana ◽

S Ferdousi ◽

A Ahmed ◽

MR Amin

Keyword(s):

Total Cholesterol ◽

Serum Lipid ◽

Serum Triglyceride ◽

Adolescent Male ◽

Serum Triglyceride Level ◽

Cross Sectional ◽

Cholesterol Levels ◽

Increased Risk ◽

The Mean ◽

Dose Response Effect

Objectives: A cross sectional comparative study was performed to evaluate the changes of the serum lipid profile in apparently healthy adolescent male non smokers and smokers subjects. Method: This study was carried out in the department of Physiology of Dhaka Medical College from January to December 2005. For this purpose, total 80 subjects with age range 12-19 years were selected, of whom 20 were non smokers (control) and 60 were smokers (experimental) who smoked for at least one year. Again smokers were grouped according to the number of cigarettes smoked per week, ( mild < 19, moderate 20-59, heavy >60). Fasting serum Triglyceride and total Cholesterol levels of all subjects were measured. Data were compared between smokers and non smokers and between non smoker and mild moderate and heavy smokers and analyzed statistically by unpaired t test. Result: Mean ±SD Triglyceride levels were136.80mg/dl ± 42.18 vs. 153.12mg/dl ± 26.66 and Mean ±SD Total Cholesterol levels were 165.20mg/dl ± 15.13 vs165.36mg/dl ± 10.12 in non smokers and smokers respectively. there were no significant changes in the mean serum total cholesterol levels in adolescent smokers but the mean serum triglyceride level in smokers were significantly higher (p<0.01 )than that of non smokers. hyper Triglyceridemia (TG level> 150mg/dl) were observed in 56% of smoker subjects whereas 36% in non smokers. The dose response effect of smoking was observed in serum triglyceride levels of smoker subgroups. Mean ±SD TG levels in mild, moderate, heavy groups were 148.15mg/dl± 21.32,152.8mg/dl± 29.49,154.12mg/dl± 23.75 respectively. Conclusion: From the result of the present study it may be concluded that, cigarette smoking during adolescent period induces alteration in serum lipid levels in the direction of increased risk for coronary artery disease. J Bangladesh Soc Physiol. 2006 Dec;(1):14-18

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Vision Loss Among Delaware Nursing Home Residents

Gerontology and Geriatric Medicine ◽

10.1177/2333721420934245 ◽

2020 ◽

Vol 6 ◽

pp. 233372142093424 ◽

Cited By ~ 1

Author(s):

Robert B. Å. Andersson ◽

Mashael Al-Namaeh ◽

William A. Monaco ◽

Hongdao Meng

Keyword(s):

Nursing Home ◽

Data Collection ◽

Vision Loss ◽

National Level ◽

Nursing Home Residents ◽

Cross Sectional Study ◽

Vision Impairment ◽

Prevalence Rates ◽

Cross Sectional ◽

High Prevalence

Objectives: To determine the prevalence of vision loss among Delaware nursing home residents for further data collection to expand the existing evidence about the vision loss among nursing home residents on a national level. Methods: This cross-sectional study involved the statistical analysis of comprehensive eye examination records of 1,856 nursing residents residing in 20 Delaware nursing homes from 2005 to 2011. Descriptive statistical analyses were conducted to identify age-specific prevalence rates of vision loss (moderate-to-severe vision impairment and blindness). Results: The mean age of nursing home residents was 82.54 years (range: 65–111 years), and 61.70% were over the age of 80 years. The majority of nursing home residents were female (64.10%) and White (76.30%). The overall prevalence rates of moderate-to-severe vision impairment and blindness were 47.40% and 16.20%, respectively. Discussion: The high prevalence of vision loss among Delaware Nursing home residents indicates a demand for further data collection for expanding the existing evidence about the vision loss among nursing home residents on a national level.

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Polypharmacy Increases Risk of Dyspnea Among Adults With Serious, Life-Limiting Diseases

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909119877512 ◽

2019 ◽

Vol 37 (4) ◽

pp. 278-285 ◽

Cited By ~ 1

Author(s):

Kathleen M. Akgün ◽

Supriya Krishnan ◽

Shelli L. Feder ◽

Janet Tate ◽

Jean S. Kutner ◽

...

Keyword(s):

Symptom Assessment ◽

Assessment System ◽

Advanced Illness ◽

Cross Sectional ◽

Chronic Medication ◽

Parallel Group ◽

Increased Risk ◽

Dyspnea Score ◽

The Mean ◽

Using Data

Background: Polypharmacy is associated with dyspnea in cross-sectional studies, but associations have not been determined in longitudinal analyses. Statins are commonly prescribed but their contribution to dyspnea is unknown. We determined whether polypharmacy was associated with dyspnea trajectory over time in adults with advanced illness enrolled in a statin discontinuation trial, overall, and in models stratified by statin discontinuation. Methods: Using data from a parallel-group unblinded pragmatic clinical trial (patients on statins ≥3 months with life expectancy of 1 month to 1 year, enrolled in the parent study between June 3, 2011, and May 2, 2013, n = 308/381 [81%]), we restricted analyses to patients with available baseline medication count and ≥1 dyspnea score. Polypharmacy was assessed by self-reported chronic medication count. Dyspnea trajectory group, our primary outcome, was determined over 24 weeks using the Edmonton Symptom Assessment System. Results: The mean age of the patients was 73.8 years (standard deviation [SD]: ±11.0) and the mean medication count was 11.6 (SD: ±5.0). We identified 3 dyspnea trajectory groups: none (n = 108), mild (n = 130), and moderate–severe (n = 70). Statins were discontinued in 51.8%, 48.5%, and 42.9% of patients, respectively. In multivariable models adjusting for age, sex, diagnosis, and statin discontinuation, each additional medication was associated with 8% (odds ratio [OR] = 1.08 [1.01-1.14]) and 16% (OR = 1.16 [1.08-1.25]) increased risk for mild and moderate–severe dyspnea, respectively. In stratified models, polypharmacy was associated with dyspnea in the statin continuation group only (mild OR = 1.12 [1.01-1.24], moderate–severe OR = 1.24 [1.11-1.39]) versus statin discontinuation (mild OR = 1.03 [0.95-1.12], and moderate–severe OR = 1.09 [0.98-1.22]). Conclusion: Polypharmacy was strongly associated with dyspnea. Prospective interventions to decrease polypharmacy may impact dyspnea symptoms, especially for statins.

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Burden in family caregivers of the elderly: prevalence and association with characteristics of the elderly and the caregivers

Revista da Escola de Enfermagem da USP ◽

10.1590/s0080-623420130000500017 ◽

2013 ◽

Vol 47 (5) ◽

pp. 1129-1136 ◽

Cited By ~ 10

Author(s):

Lara de Sa Neves Loureiro ◽

Maria das Gracas Melo Fernandes ◽

Sueli Marques ◽

Maria Miriam Lima da Nobrega ◽

Rosalina A. Partezani Rodrigues

Keyword(s):

Data Collection ◽

Family Caregivers ◽

Emotional Support ◽

The Elderly ◽

Demographic Characteristics ◽

Spousal Caregivers ◽

Cross Sectional ◽

High Prevalence ◽

The Mean ◽

The City

A cross-sectional, epidemiological study aimed to estimate the prevalence of burden among family caregivers of impaired elderly residents in the city of João Pessoa, and to identify associations between the mean burden and social and demographic characteristics of the elderly and the caregivers. A total number of 240 elderly residents in a previously drawn census tract participated in this research. The sample was composed of 52 elderly and their caregivers. For data collection, a questionnaire was applied with questions on social and demographic characteristics of elderly and caregivers, and the Burden Interview Scale was used. Results showed a high prevalence of burden among caregivers (84.6%), in which a statistically significant association was found with the following characteristics: retired elderly, elderly as head of family, spousal caregivers, and caregivers with less education. The findings of this study may contribute to the development of activities focused on formal and emotional support for the caregivers.

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Serum Ferritin Levels and Morbidity in β-Thalassemia Intermedia: A 10-Year Cohort Study

Blood ◽

10.1182/blood.v120.21.1021.1021 ◽

2012 ◽

Vol 120 (21) ◽

pp. 1021-1021 ◽

Cited By ~ 6

Author(s):

Khaled M Musallam ◽

Maria D Cappellini ◽

Shahina Daar ◽

Mehran Karimi ◽

Amal El-Beshlawy ◽

...

Keyword(s):

Cohort Study ◽

Relative Risk ◽

Serum Ferritin ◽

Characteristic Curve ◽

Iron Chelation ◽

Effect Estimate ◽

Thalassemia Intermedia ◽

Cross Sectional ◽

Increased Risk ◽

The Mean

Abstract Abstract 1021 Background: An association between iron overload and morbidity in patients with β-thalassemia intermedia (TI) has been established. However, available studies relied on cross-sectional analysis (measures of prevalence rather than incidence) without a clear chronological relationship between risk factors and outcomes. Methods: We conducted a retrospective cohort study of TI patients treated at five comprehensive care centers in Italy, Lebanon, Oman, Iran and Egypt. We included all patients attending the centers since 01 January 2000 and regularly followed until 31 December 2009 or death. For each patient, we retrieved serum ferritin (SF) and total hemoglobin (Hb) levels for every year during the 10-year follow up period, and calculated the average SF and total Hb levels during the study period (10-year indices). Moreover, we retrieved data on the incidence of nine pre-defined morbidities during the study period. Data on splenectomy status was also retrieved. For this preliminary study, we analyzed data from the first 52 recruited patients. None of the patients were regularly transfused or iron chelated during the study period. Results: The mean age of patients at study entry was 24.1 ± 11.3 years with 48.1% of patients being males. Thirty (57.7%) patients were splenectomized. The mean SF-index was 714.3 ± 518.7 ng/ml (range: 38.4 to 1926.2 ng/ml) and the mean Hb-index was 8.9 ± 1.2 g/dl (range: 7–12 g/dl). None of the patients died during the study period. Thirty-six patients experienced a morbidity during the study period, giving a 10-year cumulative incidence of 69.2% (19 [36.5%] had a single morbidity while 17 [32.7%] had multiple morbidities). The most common morbidity was osteoporosis (48.1%) followed by extramedullary hematopoiesis (19.2%), liver disease (17.3%), hypothyroidism (9.6%), diabetes mellitus (7.7%), hypogonadism (7.7%), thrombosis (5.8%), pulmonary hypertension (1.9%), and hypoparathyroidism (1.9%). The mean SF-index was higher in patients who developed morbidity than those who did not (877.5 vs. 346.9 ng/ml, p<0.001). There was also a positive correlation between SF-index and the number of developed morbidities (r=0.507, p<0.001). On logistic regression analysis, the association between SF-index and the development of morbidity remained significant upon adjustment for age, sex, splenectomy and Hb-index (p=0.015). SF-index had a strong predictive power for morbidity (Area Under the Receiver Operating Characteristic Curve=0.816 ± 0.059, p<0.001). We also evaluated effect estimates for the development of morbidity for three SF-index thresholds, of clinical interest and representing quartile cut-offs. The relative risk of morbidity for patients with a SF-index of >300 ng/ml compared with ≤300 ng/ml was 8.00 (95% CI: 1.92 to 33.38); while it was 14.00 (95% CI: 2.73 to 71.86) for patients with a SF-index of >600 ng/ml compared with ≤600 ng/ml. The effect estimate for the >1000 ng/ml threshold was non-estimable (all patients with a SF-index of >1000 ng/ml developed a morbidity). Conclusion: There exists a clear association between elevations in SF level and an increased risk of morbidity in TI patients, further supporting the need for iron chelation therapy in this patient population. The relative risk becomes considerably high for increases beyond 300 ng/ml. Disclosures: Musallam: Novartis Pharmaceuticals: Honoraria. Cappellini:Novartis Pharmaceuticals: Speakers Bureau. Taher:Novartis: Honoraria, Research Funding.

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FAKTOR RISIKO STUNTING PADA BALITA

Jurnal Surya Muda ◽

10.38102/jsm.v3i1.77 ◽

2021 ◽

Vol 3 (1) ◽

pp. 33-45

Author(s):

Winarni Hamzah ◽

Haniarti Haniarti ◽

Rini Anggraeny

Keyword(s):

Data Collection ◽

Community Health ◽

Health Center ◽

Community Health Center ◽

Sampling Technique ◽

Survey Method ◽

Cross Sectional ◽

Children Under Five ◽

Under Five ◽

The World

Stunting is one of the nutritional problems experienced by toddlers in the world today. In 2017, 22.2% of children under five in the world were stunted. Indonesia is included in the third country with the highest prevalence in the Southeast Asia region, the prevalence of children under five with stunting in Indonesia in 2005-2017 was 36.4%. Aims to determine the risk factors for stunting in children under five in the working area of the Baraka Community Health Center, Enrekang Regency. This study used the analytical survey method with the Cross Sectional Study approach using the simple random sampling technique, which means that the sample taken is where each element or member of the population has the same opportunity to be selected as the sample. The sample size in this study was taken using the Slovin formula. The location was carried out in the working area of the Baraka Community Health Center, Enrekang Regency. The research time was 1 month. The sample in this study amounted to 94 people with the process of data collection and data collection was carried out by interview techniques. The results showed that exclusive breastfeeding (p = 0.002), complementary breastfeeding (p = 0.002) had a relationship with the incidence of stunting, while there was no relationship between LBW (p = 0.106), gestational age (p = 0.303), and maternal nutritional status ( KEK) (p = 0.229) with the incidence of stunting.

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Pengetahuan Ibu Dan Pemberian Asi Eksklusif Dengan Kejadian Stunting Pada Balita 2-5 Tahun Di Puskesmas Kawangkoan Minahasa

Jurnal GIZIDO ◽

10.47718/gizi.v11i01.750 ◽

2019 ◽

Vol 11 (01) ◽

pp. 17-22

Author(s):

Grace K.L. Langi ◽

I Made Djendra ◽

Rudolf B. Purba ◽

Ryan S.P. Todanggene

Keyword(s):

Health Center ◽

Motor Development ◽

Exclusive Breastfeeding ◽

Sampling Technique ◽

Maternal Knowledge ◽

Normal Height ◽

Cross Sectional ◽

Children Under Five ◽

Under Five ◽

Increased Risk

Nutrition is an important part of growth and development, because there is a connection and is related to health and intelligence, malnutrition. Stunting is a linear growth disorder that can affect the increased risk of illness, death, and impaired late motor development, and stunted mental growth. The type of this research is analytic observational with cross sectional study approach. The population in this study were all children under five in the work area of Kawangkoan Health Center in Minahasa Regency. Children under five 2-5 years. The respondent is mother. The number of samples of this study amounted to 41 people with a sampling technique that is using simple random sampling technique. The results of research on the level of maternal knowledge of 41 respondents were 39.0% who lacked knowledge, and 41.5% had sufficient knowledge, while 19.5% had good knowledge. the rate of exclusive breastfeeding is 41.5% which is less than exclusive breastfeeding, while 39.0% is good, 19.5% is enough to provide exclusive breastfeeding. Toddler respondents who have normal height category are 46%, and category is very short, 31.7%, while the short category is 22.0%. kawangkoan health center.

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