scholarly journals Characteristics of severely malnourished under-five children immunized with Bacillus Calmette-Guérin following Expanded Programme on Immunization schedule and their outcomes during hospitalization at an urban diarrheal treatment centre, Bangladesh

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262391
Author(s):  
Mst. Mahmuda Ackhter ◽  
Abu Sadat Mohammad Sayeem Bin Shahid ◽  
Tahmeed Ahmed ◽  
Parag Palit ◽  
Irin Parvin ◽  
...  

Background Bacillus Calmette-Guérin (BCG) vaccination has recently been found to have beneficial effects among children infected other than Mycobacterium tuberculosis. Due to the paucity of data on the outcomes of children who had successful BCG vaccination following Expanded Programme on Immunization (EPI) schedule, we aimed to investigate the characteristics of such children and their outcomes who were hospitalized for severe malnutrition. Methods A prospective observational study was conducted to determine the viral etiology of pneumonia in severely malnourished children those were admitted to the Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) between April 2015 and December 2017, constituted the study population. Using a case-control design for the analysis, children having BCG vaccination prior hospital admission were treated as cases (n = 611) and those without vaccination, constituted as controls (n = 83). Bi-variate analysis was conducted using socio-demographic, clinical, laboratory, and treatment characteristics on admission and outcomes during hospitalization. Finally, log-linear binomial regression analysis was done to identify independent impact of BCG vaccination. Results The cases more often presented with older age, have had lower proportion of maternal illiteracy, higher rate of breastfeeding, severe wasting and lower rate of hypoglycemia, compared to the controls. The cases were also found to have lower risk of severe sepsis and deaths, compared to the controls (for all, p<0.05). However, in log-linear binomial regression analysis, after adjusting for potential confounders, BCG vaccination following EPI schedule (RR:0.54; 95%CI = 0.33–0.89; p = 0.015) and breastfeeding (RR:0.53; 95%CI = 0.35–0.81; p = 0.003) were found to be protective for the development of severe sepsis. Conclusion BCG vaccination and breastfeeding were found to be protective for the development of severe sepsis in hospitalized severely malnourished under-five children which underscores the importance of continuation of BCG vaccination at birth and breastfeeding up to two years of age.

Author(s):  
Siti Zakiah Zulfa ◽  
◽  
Cesa Septiana Pratiwi ◽  

Background: In developing country, malnutrition of under five children was still a severe problem because it may have an impact on the quality of human resources in the future. Various program has been tried in many places to overcome this problem, one of which is through a home visit program, which is very necessary for educational purposes to manage malnutrition. This study aimed to determine how to implement a home visit program to improve the nutritional status of under five children in developing countries. Subjects and Method: A scoping review method was conducted using Arksey and O’malley (2005) framework with five steps: (1) Identify the scoping review question; (2) Identify relevant articles; (3) Article selection; (4) Mapping; (5) Present the results, discussion and conclusion. The search included Pubmed, Wiley, Ebsco, Science Direct, and Google scholar databases. The inclusion criteria were original articles in Indonesian and English from developing countries published from 2010 to 2019. The data were reported by PRISMA flow chart. Results: Five of the 159 articles were selected, and found that five themes were summarized, namely: (1) effective implementation of home visits, (2) types of rehabilitation of nutritional status of under-five children on home visits, (3) home visit officers 4) time and activities for conducting home visits and 5 ) constraints on home visits for malnutrition education purposes. Conclusion: Home visit program is an effective and significant strategy to reduce the incidence of underweight, moderate and severe malnutrition, stunting and wasting in under five children only when combined with other programs. Several knowledge gaps identify which confirm through further research. Keywords: home visit, nutritional status of under-five children, malnutrition, developing countries Correspondence: Siti Zakiah Zulfa. Universitas ‘Aisyiyah Yogyakarta. Jl. Ringroad Barat No.63, Mlangi, Nogotirto, Gamping, Sleman, Yogyakarta. Email: [email protected]. Mobile: 085641349694. DOI: https://doi.org/10.26911/the7thicph.02.11


2016 ◽  
Vol 4 (1) ◽  
pp. 20-26
Author(s):  
Zaenab Ismail ◽  
Martha Irene Kartasurya ◽  
Atik Mawarni

The prevalence of under-five children with severe malnutrition in Sorong city West Papua in 2008, 2009 and 2010 consecutively was 3.59%, 1.1% and 1.9%. Implementation of a program could be influenced by many factors such as communication, resources, disposition and bureaucracy factors. The objective of this study was to know the implementation of severe malnutrition control program at primary healthcare centers (puskesmas) in the working area of Sorong city health office West Papua in 2010. This was a qualitative study with cross sectional approach. Data was collected through in-depth interview using interview guideline. There were 5 primary healthcare centers studied with program executors as main informants. Triangulation informants were family or parents of under-five children with severe malnutrition, head of puskesmas and head of nutrition section of Sorong city health office West Papua province. Results of the study showed implementation of the program had not run according to the standard of implementation from the Ministry of Health. It was caused by not optimal communication that was done by Sorong city health office through program socialization. The availability of resources such as human resource to implement the program was insufficient. Only those who had nutrition educational background implemented the program and other workers were not involved in the program. There was no nutrition care team in all puskesmas. Additionally, the majority of the workers had not received training yet. Management of program funding was not according to the unit cost. Facilities were inappropriate and there was still improper puskesmas. The executor workers were needed for implementing the program; unfortunately due to less transparency and socialization, commitment was also low. No authority or standard operating procedure (SOP) given by Sorong city health office to puskesmas. In addition there was no supervision to the nutrition program workers. It was concluded that the implementation of severe malnutrition control program in Puskesmas in the working area of Sorong city health office West Papua province was not optimal. It was suggested to Sorong city health office to improve socialization about severe malnutrition control program to all program executors including heads of puskesmas in the working area of Sorong city health office; to create nutrition care and training teams. Funding allocation should be given to the right target and facilities should be completed.   Supervision, monitoring and evaluation were done continuously.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amanuel Mengistu Merera

Abstract Introduction In low- and middle-income nations, acute respiratory infection (ARI) is the primary cause of morbidity and mortality. According to some studies, Ethiopia has a higher prevalence of childhood acute respiratory infection, ranging from 16 to 33.5%. The goal of this study was to determine the risk factors for acute respiratory infection in children under the age of five in rural Ethiopia. Methods A cross-sectional study involving 7911 children under the age of five from rural Ethiopia was carried out from January 18 to June 27, 2016. A two stage cluster sampling technique was used recruit study subjects and SPSS version 20 was used to extract and analyze data. A binary logistic regression model was used to identify factors associated with a childhood acute respiratory infection. The multivariable logistic regression analysis includes variables with a p-value less than 0.2 during the bivariate logistic regression analysis. Adjusted odds ratios were used as measures of effect with a 95% confidence interval (CI) and variables with a p-value less than 0.05 were considered as significantly associated with an acute respiratory infection. Results The total ARI prevalence rate among 7911 under-five children from rural Ethiopia was 7.8%, according to the findings of the study. The highest prevalence of ARI was found in Oromia (12.8%), followed by Tigray (12.7%), with the lowest frequency found in Benishangul Gumuz (2.4%). A multivariable logistic regression model revealed that child from Poor household (AOR = 2.170, 95% CI: 1.631–2.887), mother’s no education (AOR = 2.050,95% CI: 1.017–4.133), mother’s Primary education (AOR = 2.387, 95% CI:1.176–4.845), child had not received vitamin A (AOR = 1.926, 95% CI:1.578–2.351), child had no diarrhea (AOR = 0.257, 95% CI: 0.210–0.314), mothers not working (AOR = 0.773, 95% CI:0.630–0.948), not stunted (AOR = 0.663, 95% CI: 0.552–0.796), and not improved water source (AOR = 1.715, 95% CI: 1.395–2.109). Similarly, among under-five children, the age of the child, the month of data collection, anemia status, and the province were all substantially linked to ARI. Conclusions Childhood ARI morbidity is a serious health challenge in rural Ethiopia, according to this study, with demographic, socioeconomic, nutritional, health, and environmental factors all having a role. As a result, regional governments, healthcare staff, and concerned groups should place a priority on reducing ARI, and attempts to solve the issue should take these variables into account.


Author(s):  
Shaza O. H. Kanan ◽  
Abd Elmoneim O. Elkhalifa

Background: Malnutrition among under-five children have significant interest for the health authorities in Sudan. This is considered by the fact that the prevalence of underweight children in Sudan is among the highest in the world and it is essential to determine its prevalence and causes, as this problem affects the future of the under-five children and the community as general. This review aimed to assess the prevalence and causes of undernutrition among under-five children in Sudan. Methods: Published data such as peer-reviewed articles, published dissertations and official reports on malnutrition and its causes among under-five Sudanese children during the last twenty years, were collected from Science Direct, Google Scholar, PubMed, and others. The information restored was reviewed and analyzed for inconsistency. Results: Data shows that the prevalence of under-nutrition among under-five children was high and diverse widely, and the majority of the studies were carried out in Khartoum state, which showed the prevalence of wasting (3.3 to 21.1%) stunting (20.3 to 51.0%), severe stunting (12.9 to 25.2%) and underweight and severe underweight represent 24.4 to 35.0% and 6.6 to 48.0%, respectively. The prevalence rate of malnutrition was reported to be 14.1, 23.6, and 10.7% in South Darfur IDP camps, while in North Darfur it was 14.7, 48.9, and 35.6%, for wasting, stunting, and underweight, respectively. In El Fau, Gadarif state the prevalence of moderate and severe malnutrition of the under-five children were 6% and 3.3%. Many causes were reported for malnutrition among the under-five children including bad feeding practices, childhood diseases, hygiene and sanitation, and low socioeconomic status. Conclusion: The prevalence rate of undernutrition among the under-five Sudanese children was very high, and stunting is the main shape of malnutrition. Many causes were contributed to under-five malnutrition and improvement in infant feeding and better maternal education are significant to get a high nutritional status of the children.


2021 ◽  
Author(s):  
Amanuel Mengistu Merera

Abstract Introduction: In low- and middle-income nations, acute respiratory infection (ARI) is the primary cause of morbidity and mortality. According to some studies, Ethiopia has a higher prevalence of childhood acute respiratory infection, ranging from 16 % to 33.5 %. The goal of this study was to determine the risk factors for acute respiratory infection in children under the age of five in rural Ethiopia. Methods: A cross-sectional study involving 7,911 children under the age of five from rural Ethiopia was carried out from January 18 to June 27, 2016. A two stage cluster sampling technique was used recruit study subjects and SPSS version 20 was used to extract and analyze data. A binary logistic regression model was used to identify factors associated with a childhood acute respiratory infection. The multivariable logistic regression analysis includes variables with a p-value less than 0.2 during the bivariate logistic regression analysis. Adjusted odds ratios were used as measures of effect with a 95% confidence interval (CI) and variables with a p-value less than 0.05 were considered as significantly associated with an acute respiratory infection. Results: The total ARI prevalence rate among 7,911 under-five children from rural Ethiopia was 7.8%, according to the findings of the study. The highest prevalence of ARI was found in Oromia (12.8 %), followed by Tigray (12.7 %), with the lowest frequency found in Benishangul Gumuz (2.4 %). A multivariable logistic regression model revealed that child from Poor household (AOR=2.170, 95% CI: 1.631-2.887), mother’s no education (AOR=2.050,95% CI: 1.017-4.133), mother’s Primary education (AOR=2.387, 95% CI:1.176-4.845), child had not received vitamin A (AOR=1.926, 95% CI:1.578-2.351), child had no diarrhea (AOR=0.257, 95% CI: 0.210-0.314), mothers not working (AOR=0.773, 95% CI:0.630-0.948), not stunted (AOR=0.663, 95% CI: 0.552-0.796), and not improved water source (AOR=1.715, 95% CI: 1.395-2.109). Similarly, among under-five children, the age of the child, the month of data collection, anemia status, and the province were all substantially linked to ARI. Conclusions: Childhood ARI morbidity is a serious health challenge in rural Ethiopia, according to this study, with demographic, socioeconomic, nutritional, health, and environmental factors all having a role. As a result, regional governments, healthcare staff, and concerned groups should place a priority on reducing ARI, and attempts to solve the issue should take these variables into account.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Bereka Tefera Marie ◽  
Weldemariam Sintayehu Argaw ◽  
Bitewa Yibelu Bazezew

Abstract Background Human Immunodeficiency Virus (HIV) is infection which mainly attacks immune system of an individual. Its disease progress is rapid in children and if treatment is not initiated nearly half of infected children will die by the second year of infection. In Ethiopia, nearly twenty four percent of HIV related death is happen to under-five children; however studies done in this specific age group are limited are with poor evidence of predictors. Objectives To determine time to death and identify predictors of death in HIV infected under- five children on antiretroviral therapy in Amhara regional state, Oromia ‘liyu’ zone, Northeast Ethiopia, from 2014 to 2019. Methods Institution based retrospective follow up study was conducted in 376 under-five HIV- infected children on antiretroviral therapy from January 2014 to December 2019 in health institutions in Oromia Liyu Zone, Amhara region, Ethiopia. Multivariable Cox-proportional hazard regression model was used to identify independent predictors of mortality in HIV- infected under-five children on antiretroviral therapy. Result At the end of follow up, 304 (80.85%) of HIV-infected children were alive, 39 (10.95%) were lost to follow up, 12 (3.19%) were transferred out and 21 (5.59%) were reported dead due to HIV/AIDS. The cumulative survival probabilities of children after 3, 6, 12, 24 and 36 months were 0.99, 0.98, 0.97, 0.89 and 0.87 respectively. The overall mean time to death was 19.7 months (95%CI = 18.74–20.67) with incidence of 5.9 deaths per 100 child-months (95%CI: 3.89–9.09). Children with severe malnutrition at baseline (AHR = 4.9; 95 CI: 1.04, 23.50), advanced WHO clinical stage at enrolment (AHR = 3.9; CI: 1.37, 10.88), poor adherence to ART (AHR = 6.56; CI: 3.33, 10.14) and with no history of Isoniazide prophylaxis were significantly associated to higher mortality events (AHR = 3.6; CI: 1.24, 10.18). Conclusion Death of HIV-infected under-five children on ART is high within the first one year after enrolment. The risk of death increased if the child was malnourished at beginning of treatment, had poor ART adherence, with advanced WHO clinical stages and lack of Isoniazide prophylaxis during their age of infancy.


2018 ◽  
Vol 5 (2) ◽  
pp. 584 ◽  
Author(s):  
S. K. Gautam ◽  
Mahesh Verma ◽  
S. K. Barman ◽  
A. K. Arya

Background: In Kanpur, overall there were an estimated 43.6% stunted, 24.1% wasted and 41.8% underweight under-five children. There is a critical window of opportunity to prevent undernutrition by taking care of the nutrition of children in the first two years of life. With this background the present study was undertaken with the aim to assess the nutritional status in under five children in the slum area of Kanpur Nagar.Methods: The present study was conducted in 30 slums of Kanpur Nagar selected through 30 cluster sampling technique. The sample size was calculated as 390. From each cluster, approximate 13 study subjects aged 0-60 months were studied. Mothers of study subjects were interviewed to illicit the requisite information, using a predesigned and pretested questionnaire. Anthropometric measurements were taken using standard technique for each study subject. Data collected was analyzed using statistical tool.Results: Based on WHO classification, the prevalence of stunting and severe stunting was observed to be 31.28% and 13.59%. 14.62% study subjects were wasted while 6.15% subjects had severe wasting. 40.51% had mild-moderate malnutrition and 7.95% had severe malnutrition as per the criteria of mid upper arm circumference. Malnutrition was significantly associated with the age of the study subjects (p <0.05). The prevalence of malnutrition decreased significantly with higher maternal education and among those whose mother’s were housewives (p <0.05). Lower birth order and middle socio-economic class was associated with decreased prevalence of malnutrition (p <0.05). Conclusions: The nutritional status of children is dependent on maternal education and occupation and socioeconomic status. Nutrition education can have a significant effect in its reduction.


Cureus ◽  
2020 ◽  
Author(s):  
Medha Mathur ◽  
Navgeet Mathur ◽  
Nazmeen Khan ◽  
Dewesh Kumar ◽  
Anjana Verma

2021 ◽  
Author(s):  
Weldemariam Sintayehu Arega ◽  
Bereka Tefera Marie ◽  
Bitewa Yibelu Bazezew

Abstract Background: Human Immunodeficiency Virus (HIV) is infection which mainly attacks immune system of an individual. Its disease progress is rapid in children and if treatment is not initiated nearly half of infected children will die by the second year of infection. In Ethiopia, nearly twenty four percent of HIV related death is happen to under-five children; however studies done in this specific age group are limited are with poor evidence of predictors. Objectives: To determine time to death and identify predictors of death in HIV infected under-five children on antiretroviral therapy in Amhara regional state, Oromia ‘liyu’ zone, Northeast Ethiopia, from 2014 to 2019. Methods: Institution based retrospective follow up study was conducted in 376 under-five HIV-infected children on antiretroviral therapy from January 2014 to December 2019 in health institutions in Oromia Liyu Zone, Amhara region, Ethiopia. Multivariable Cox-proportional hazard regression model was used to identify independent predictors of Mortality in HIV-infected under-five children on antiretroviral therapy. Results: At the end of follow up, 285 (80.28%) of HIV-infected children were alive, 39 (10.99%) were lost to follow up, 11 (3.94%) were transferred out and 21 (5.59%) were reported dead due to HIV/AIDS. The cumulative survival probabilities of children after 3, 6, 12, 24 and 36 months were 0.99, 0.98, 0.97, 0.89 and 0.87 respectively. The overall mean time to death was 19.7 months (95%CI= 18.74-20.67) with incidence of 5.9 deaths per 100 child-months (95%CI: 3.89-9.09). Children with severe malnutrition at baseline (AHR=4.9; 95 CI: 1.04, 23.50), advanced WHO clinical stage at enrolment (AHR=3.9; CI: 1.37, 10.88), poor adherence to ART (AHR=6.56; CI: 3.33, 10.14) and with no history of Isoniazide prophylaxis were significantly associated to higher mortality events (AHR=3.6; CI: 1.24, 10.18). Conclusion: Death of HIV-infected under-five children on ART is high within the first one year after enrolment. The risk of death increased if the child was malnourished at begging of treatment, had poor ART adherence, with advanced WHO clinical stages and lack of Isoniazide prophylaxis during their age of infancy.


Jurnal NERS ◽  
2015 ◽  
Vol 10 (2) ◽  
pp. 195
Author(s):  
Ika Nur Fauziah ◽  
Lilik Djuari ◽  
Yuni Sufyanti Arief

Introduction: Child malnutrition still a major health problem in the world, including in Indonesia. According to World Health Organization (WHO) African Region and South-East Asia Region data, malnutrition affects nearly 20 million under five children and the main factors that affects about a third of child mortality worldwide. The aims of this study was to analyze and develop mother’s behavior model in severe malnutrition prevention for under five children based on Integration Health Belief Model and Health Promotion Model. Method: Type of this research was an explanatory observational with cross sectional design. Affordable population namely children under five’s years and cadres who visited Posyandu in April 2015 as many as 136 and 20 peoples. This study used proportional random sampling, with sample size 65 mothers; 10 children under five’s mothers and 10 Posyandu Balita’s cadres for FGD. Variables were personal factors, behavioral specific cognitions and affect, individual perceptions, commitment, cues to action and mother's behavior in severe malnutrition prevention. Data were collected by using questionnaires and food recall 24 hours, analyzed by Smart PLS. Result: Mother’s behavior model in severe malnutrition prevention for under five children can be formed by mother's commitment, behavioral specific cognition and affect and personal factors (income and motivation). Discussion: Nurse as a community health care providers have a role in improving community health status through health promotion. High commitment to behave in certain ways according to plan, improving the ability of individuals to maintain health promotion behavior all the timeKeywords: models, mother’s behavior, severe malnutrition prevention, Health Belief Model, Health Promotion Model


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