scholarly journals Unsafe child feces disposal status in Ethiopia: what factors matter? analysis of pooled data from four demographic and health surveys

2020 ◽  
Author(s):  
Biniyam Sahiledengle
Keyword(s):  
Logistic Regression ◽  
Health Surveys ◽  
Demographic And Health Surveys ◽  
Multivariable Logistic Regression Model ◽  
Lower Odds ◽  
Paternal Education ◽  
Factors Associated ◽  
Pooled Data ◽  
Multivariable Logistic Regression ◽  
Toilet Facility

Abstract Background: The only safest way to dispose of a child’s feces is to help the child use a toilet or, for very young children, to put or rinse their feces into a toilet; whereas all other disposals are considered unsafe (feces put/rinsed into a drain or ditch, bush or thrown into the garbage, buried or left on the ground, and not disposed of). The study aims to determine the magnitude and factors associated with unsafe child feces disposal in Ethiopia.Methods: The study is cross-sectional in nature and based on the pooled data from the four rounds of Demographic and Health Surveys (DHS) conducted in Ethiopia (2000-16). Data on child feces disposal practice was collected for all children born during the five years preceding survey. To get detail about the disposal of children’s feces, mothers of under-five children were asked, “The last time passed stools, what was done to dispose of the stools?” with respect to the youngest child born. Descriptive statistics were computed to illustrate the given data. Multivariable logistic regression was performed to identify factors associated with unsafe child feces disposal. Results: The pooled dataset contains data for 40,520 children younger than 5 years, male accounts 20,629 (50.9%). Overall, 77.7% (95%CI: 76.3-79.0) of children feces disposed of unsafely. In the multivariable logistic regression model, those mothers whose child was 13-24 months [AOR: 0.68, 95% CI: (0.60-0.78)] and ≥ 25 months [AOR: 0.66, 95% CI: (0.60-0.72)] were lower odds of unsafe child’s feces disposal. Children born into households having two or fewer children were 33% lower [AOR: 0.67, 95% CI: (0.56-0.79)] odds of unsafe child’s feces disposal than their counterparts. The odds of disposing of feces unsafely among households having improved toilet facility was 76% lower [AOR: 0.24, 95% CI: (0.19-0.29)] that of households lacking such facilities. Further, being an urban resident, having improved drinking water facility, a high level of maternal and paternal education, paternal occupational status (work in non-agriculture), and maternal age (25-34 and ≥ 35 years) were factors associated with lower odds of unsafe child's feces disposal.Conclusions: Three in four Ethiopian children feces disposed of unsafely. Household and socio-demographic factors, such as access to improved water and toilet facility, area of a resident (urban), the child’s age (older age), and both higher maternal and paternal education levels were significantly associated with lower odds of unsafe child feces disposal.

scholarly journals Unsafe child feces disposal status in Ethiopia: what factors matter? analysis of pooled data from four demographic and health surveys

2020 ◽  
Author(s):  
Biniyam Sahiledengle
Keyword(s):  
Logistic Regression ◽  
Urban Areas ◽  
Demographic And Health Surveys ◽  
Multivariable Logistic Regression Model ◽  
Lower Odds ◽  
Paternal Education ◽  
Factors Associated ◽  
Multivariable Logistic Regression ◽  
Toilet Facility ◽  
High Level

Abstract Background: Unsafe child feces disposal has compounding effects on children’s wellbeing. In Ethiopia and many other countries, still, there is a common misconception that children’s feces are not harmful, and not end up in a toilet. Objective: The study aims to determine the magnitude and factors associated with unsafe child feces disposal in Ethiopia. Methods: The study is cross-sectional in nature and the analysis was based on data from 1st to 4th rounds of the population-based Ethiopian Demographic and Health Survey (EDHS) conducted between 2000 and 2016. Descriptive statistics were computed to illustrate the given data. Multivariable logistic regression was performed, adjusted odds ratio (AOR) with a 95% confidence interval (CI) were used to identify factors associated with unsafe child feces disposal. Results: The pooled dataset contained information on 40,520 children younger than 5 years, male accounts 20,629 (50.9%). Overall, 77.7% (95%CI: 76.3-79.0) of children feces disposed of unsafely. In the multivariable logistic regression model, those mothers whose child was 13-24 months [AOR: 0.68, 95% CI: (0.60-0.78)] and ≥ 25 months [AOR: 0.66, 95% CI: (0.60-0.72)] were lower odds of unsafe child’s feces disposal. Children born into households having two or fewer children were 33% lower [AOR: 0.67, 95% CI: (0.56-0.79)] odds of unsafe child’s feces disposal than their counterparts. The odds of disposing of feces unsafely among households having improved toilet facility was 76% lower [AOR: 0.24, 95% CI: (0.19-0.29)] that of households lacking such facilities. Being an urban resident, having improved drinking water facility, a high level of maternal and paternal education, paternal occupational status (work in non-agriculture), and maternal age were factors associated with lower odds of unsafe child's feces disposal. Conclusions: Three in four Ethiopian children feces disposed of unsafely. Unsafe child feces disposal is less prevalent among households that had improved water and toilet facility, those in urban areas, those with older children, those with a high level of maternal and paternal education, and those with a lower number of under-five children. There is a need for more attention to be paid to curtail the significant burden of unsafe child feces disposal in Ethiopia.

Non-iodized salt consumption among women of reproductive age in sub-Saharan Africa: a population-based study

2020 ◽  
Vol 23 (15) ◽  
pp. 2759-2769
Author(s):  
Djibril M Ba ◽  
Paddy Ssentongo ◽  
Duanping Liao ◽  
Ping Du ◽  
Kristen H Kjerulff
Keyword(s):  
Logistic Regression ◽  
Iodized Salt ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Women Of Reproductive Age ◽  
Cross Sectional ◽  
Factors Associated ◽  
Multivariable Logistic Regression ◽  
Sub Saharan

AbstractObjective:To identify countries in sub-Saharan Africa (SSA) that have not yet achieved at least 90 % universal salt iodization and factors associated with the consumption of non-iodized salt among women of reproductive age.Design:A cross-sectional study using data from Demographic and Health Surveys (DHS). The presence of iodine in household salt (iodized or non-iodized), which was tested during the survey process, was the study outcome. Multivariable logistic regression models were used to determine independent factors associated with the consumption of non-iodized salt among women of reproductive age.Setting:There were eleven countries in SSA that participated in the DHS since 2015 and measured the presence of iodine in household salt.Participants:Women (n 108 318) aged 15–49 years.Results:Countries with the highest rate of non-iodized salt were Senegal (29·5 %) followed by Tanzania (21·3 %), Ethiopia (14·0 %), Malawi (11·6 %) and Angola (10·8 %). The rate of non-iodized salt was less than 1 % in Rwanda (0·3 %), Uganda (0·5 %) and Burundi (0·8 %). Stepwise multivariable logistic regression showed that women were more likely to be using non-iodized salt (adjusted OR; 95 % CI) if they were poor (1·62; 1·48, 1·78), pregnant (1·16; 1·04, 1·29), aged 15–24 years (v. older: 1·14; 1·04, 1·24) and were not literate (1·14; 1·06, 1·23).Conclusions:The use of non-iodized salt varies among SSA countries. The higher level of use of non-iodized salt among poor, young women and pregnant women is particularly concerning.

scholarly journals 62. Factors Associated with 30-Day ED Readmission Following Initial ED Discharge for Suspected Sepsis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S51-S51
Author(s):  
Anna E Moscowitz ◽  
Esther Y Bae ◽  
Ricardo M La Hoz ◽  
James B Cutrell ◽  
Marguerite Monogue
Keyword(s):  
Logistic Regression ◽  
Medical Center ◽  
Multivariable Analysis ◽  
P Value ◽  
Multivariable Logistic Regression Model ◽  
Suspected Sepsis ◽  
Screening Criteria ◽  
Factors Associated ◽  
Multivariable Logistic Regression ◽  
Increased Risk

Abstract Background Given the increased mortality associated with delayed recognition of sepsis, emergency departments (ED) often use protocols to rapidly identify and treat suspected sepsis. However, screening criteria such as systemic inflammatory response syndrome (SIRS) lack specificity and may over-diagnose sepsis in patients otherwise stable for discharge. Our study describes outcomes and identifies factors associated with ED readmission in those initially discharged directly from the ED who met sepsis criteria. Methods This retrospective cohort study evaluated adult patients (≥ 18 years) seen in the ED at UTSW Medical Center from January to June 2018 who met all the following: ≥ 2 SIRS criteria; received ≥ 1 dose of intravenous (IV) broad-spectrum antibiotic(s) in the ED; were discharged home. A multivariable logistic regression model identified factors associated with 30-day re-admission to our ED, using clinically significant variables parsimoniously. A two-sided P value < 0.05 was considered significant. Results A total of 179 patients were included. Forty-four patients (25%) returned to the ED within 30 days of their initial visit; of those 44, 63.6% (28) returned for issues related to their prior visit, and 50% (22) were admitted to the hospital. Table 1 compares baseline demographics of patients with suspected sepsis readmitted to the ED with those not readmitted within 30 days after initial ED discharge. In univariable analysis, quick Sequential Organ Failure Assessment (qSOFA), and length of antibiotic therapy (ED plus discharge antibiotics) were associated with ED re-admission (table 1). Receipt of antibiotics on discharge was not significant. In the final multivariable analysis (table 2), initial qSOFA ≥ 2 alone was associated with increased risk of ED re-admission (OR 7.5, p=0.01). Table 1. Baseline demographics of patients readmitted and not readmitted to the ED within 30 days after ED discharge with suspected sepsis Table 2. Multivariable logistic regression of risk factors for patients readmitted and not readmitted to the ED within 30 days after ED discharge with suspected sepsis Conclusion In this cohort, 25% of patients with suspected sepsis initially discharged from the ED were readmitted to our ED within 30 days. A qSOFA ≥ 2 at the initial ED visit was associated with increased risk of readmission, suggesting a potential use of qSOFA to triage those warranting admission or closer follow-up. Larger prospective studies are warranted in this understudied population of patients who meet screening sepsis criteria but are discharged from the ED. Disclosures All Authors: No reported disclosures

scholarly journals Development of a new sternal dehiscence prediction scale for decision making in sternal closure techniques after cardiac surgery

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ehab Nooh ◽  
Colin Griesbach ◽  
Johannes Rösch ◽  
Michael Weyand ◽  
Frank Harig
Keyword(s):  
Logistic Regression ◽  
Risk Score ◽  
Characteristic Curve ◽  
Multivariable Analysis ◽  
Individual Risk ◽  
Dependent Diabetes Mellitus ◽  
Analysis Model ◽  
Multivariable Logistic Regression Model ◽  
Sternal Dehiscence ◽  
Multivariable Logistic Regression

Abstract Background After sternotomy, the spectrum for sternal osteosynthesis comprises standard wiring and more complex techniques, like titanium plating. The aim of this study is to develop a predictive risk score that evaluates the risk of sternum instability individually. The surgeon may then choose an appropriate sternal osteosynthesis technique that is risk- adjusted as well as cost-effective. Methods Data from 7.173 patients operated via sternotomy for all cardiovascular indications from 2008 until 2017 were retrospectively analyzed. Sternal dehiscence occurred in 2.5% of patients (n = 176). A multivariable analysis model examined pre- and intraoperative factors. A multivariable logistic regression model and a backward elimination based on the Akaike Information Criterion (AIC) a logistic model were selected. Results The model showed good sensitivity and specificity (area under the receiver-operating characteristic curve, AUC: 0.76) and several predictors of sternal instability could be evaluated. Multivariable logistic regression showed the highest Odds Ratios (OR) for reexploration (OR 6.6, confidence interval, CI [4.5–9.5], p < 0.001), obesity (body mass index, BMI > 35 kg/m2) (OR 4.23, [CI 2.4–7.3], p < 0.001), insulin-dependent diabetes mellitus (IDDM) (OR 2.2, CI [1.5–3.2], p = 0.01), smoking (OR 2.03, [CI 1.3–3.08], p = 0.001). After weighting the probability of sternum dehiscence with each factor, a risk score model was proposed scaling from − 1 to 5 points. This resulted in a risk score ranging up to 18 points, with an estimated risk for sternum complication up to 74%. Conclusions A weighted scoring system based on individual risk factors was specifically created to predict sternal dehiscence. High-scoring patients should receive additive closure techniques.

scholarly journals Risk factors for symptomatic Avascular Necrosis (AVN) in a multi-ethnic Systemic Lupus Erythematosus (SLE) cohort

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248845
Author(s):  
Syahrul Sazliyana Shaharir ◽  
Siew Huoy Chua ◽  
Rozita Mohd ◽  
Ruslinda Mustafar ◽  
Malehah Mohd Noh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Avascular Necrosis ◽  
Lupus Erythematosus ◽  
Osteoporotic Fractures ◽  
Protective Effects ◽  
Regression Analyses ◽  
Mobility Limitations ◽  
Factors Associated ◽  
Multivariable Logistic Regression

Avascular necrosis of bone (AVN) is increasingly being recognized as a complication of SLE and causes significant disability due to pain and mobility limitations. We studied the prevalence and factors associated with avascular necrosis (AVN) in a multiethnic SLE cohort. SLE patients who visited the outpatient clinic from October 2017 to April 2019 were considered eligible. Their medical records were reviewed to identify patients who developed symptomatic AVN, as confirmed by either magnetic resonance imaging or plain radiography. Subsequently, their SLE disease characteristics and treatment were compared with the characteristics of patients who did not have AVN. Multivariable logistic regression analyses were performed to determine the independent factors associated with AVN among the multiethnic SLE cohort. A total of 390 patients were recruited, and the majority of them were females (92.6%); the patients were predominantly of Malay ethnicity (59.5%), followed by Chinese (35.9%) and Indian (4.6%). The prevalence of symptomatic AVN was 14.1%, and the mean age of AVN diagnosis was 37.6 ± 14.4 years. Both univariate and multivariable logistic regression analyses revealed that a longer disease duration, high LDL-C (low density lipoprotein cholesterol), positive anti-cardiolipin (aCL) IgG and anti-dsDNA results, a history of an oral prednisolone dose of more than 30 mg daily for at least 4 weeks and osteoporotic fractures were significantly associated with AVN. On the other hand, hydroxychloroquin (HCQ), mycophenolate mofetil (MMF) and bisphosphonate use were associated with a lower risk of AVN. No associations with ethnicity were found. In conclusion, several modifiable risk factors were found to be associated with AVN, and these factors may be used to identify patients who are at high risk of developing such complications. The potential protective effects of HCQ, MMF and bisphosphonates warrant additional studies.

scholarly journals Time trends in and factors associated with repeat adolescent birth in Uganda: Analysis of six demographic and health surveys

PLoS ONE ◽  
2020 ◽  
Vol 15 (4) ◽  
pp. e0231557 ◽  
Author(s):  
Dinah Amongin ◽  
Annettee Nakimuli ◽  
Claudia Hanson ◽  
Mary Nakafeero ◽  
Frank Kaharuza ◽  
...  
Keyword(s):  
Time Trends ◽  
Health Surveys ◽  
Demographic And Health Surveys ◽  
Factors Associated ◽  
Adolescent Birth

scholarly journals Prehospital factors associated with death on hospital arrival after traffic crash in Japan: a national observational study

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e025350
Author(s):  
Yusuke Katayama ◽  
Tetsuhisa Kitamura ◽  
Kosuke Kiyohara ◽  
Junya Sado ◽  
Tomoya Hirose ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Rural Area ◽  
Multivariable Logistic Regression Analysis ◽  
Night Time ◽  
Hospital Arrival ◽  
Traffic Crash ◽  
Factors Associated ◽  
Back Seat ◽  
Multivariable Logistic Regression ◽  
Male Sex

ObjectiveAlthough it is important to assess prehospital factors associated with traffic crash fatalities to decrease them as a matter of public health, such factors have not been fully revealed.MethodsUsing data from the Japanese Trauma Data Bank, a large hospital-based trauma registry in Japan, we retrospectively analysed traffic crash patients transported to participating facilities that treated patients with severe trauma from 2004 to 2015. This study defined registered emergency patients whose systolic blood pressure was 0 mm Hg or heart rate was 0 bpm at hospital arrival as being in prehospital cardiopulmonary arrest (CPA). Prehospital factors associated with prehospital CPA due to traffic crash were assessed with multivariable logistic regression analysis.ResultsIn total, 66 243 patients were eligible for analysis. Of them, 3390 (5.1%) patients were in CPA at hospital arrival. A multivariable logistic regression model showed the following factors to be significantly associated with prehospital CPA: ages 60–74 years (adjusted OR (AOR) 1.256, 95% CI 1.142 to 1.382) and ≥75 years (AOR 1.487, 95% CI 1.336 to 1.654), male sex (AOR 1.234, 95% CI 1.139 to 1.338), night-time (AOR 1.575, 95% CI 1.458 to 1.702), weekend including holiday (AOR 1.078, 95% CI 1.001 to 1.161), rural area (AOR 1.181, 95% CI 1.097 to 1.271), back seat passenger (AOR 1.227, 95% CI 0.985 to 1.528) and pedestrian (AOR 1.754, 95% CI 1.580 to 1.947) as types of patients.ConclusionIn this population, factors associated with prehospital CPA due to a traffic crash were elderly people, male sex, night-time, weekend/holiday, back seat passenger, pedestrian and rural area. These fundamental data may be of help in reducing and preventing traffic crash deaths.

scholarly journals Factors Associated with Stunting among Children under 5 Years in Five South Asian Countries (2014–2018): Analysis of Demographic Health Surveys

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3875
Author(s):  
Nidhi Wali ◽  
Kingsley E. Agho ◽  
Andre M.N. Renzaho
Keyword(s):  
South Asia ◽  
Health Surveys ◽  
Age Groups ◽  
Demographic And Health Surveys ◽  
Sampling Weights ◽  
Factors Associated ◽  
Child Undernutrition ◽  
The Common ◽  
Nutrition Sensitive ◽  
Children Under 5

South Asia continues to be the global hub for child undernutrition with 35% of children still stunted in 2017. This paper aimed to identify factors associated with stunting among children aged 0–23 months, 24–59 months, and 0–59 months in South Asia. A weighted sample of 564,518 children aged 0–59 months from the most recent Demographic and Health Surveys (2014–2018) was combined of five countries in South Asia. Multiple logistic regression analyses that adjusted for clustering and sampling weights were used to examine associated factors. The common factors associated with stunting in three age groups were mothers with no schooling ([adjusted odds ratio (AOR) for 0–23 months = 1.65; 95% CI: (1.29, 2.13)]; [AOR for 24–59 months = AOR = 1.46; 95% CI: (1.27, 1. 69)] and [AOR for 0–59 months = AOR = 1.59; 95% CI: (1.34, 1. 88)]) and maternal short stature (height < 150 cm) ([AOR for 0–23 months = 2.00; 95% CI: (1.51, 2.65)]; [AOR for 24–59 months = 3.63; 95% CI: (2.87, 4.60)] and [AOR for 0–59 months = 2.87; 95% CI: (2.37, 3.48)]). Study findings suggest the need for a balanced and integrated nutrition strategy that incorporates nutrition-specific and nutrition-sensitive interventions with an increased focus on interventions for children aged 24–59 months.

scholarly journals Tocilizumab for patients with COVID-19 pneumonia. The single-arm TOCIVID-19 prospective trial

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Francesco Perrone ◽  
◽  
Maria Carmela Piccirillo ◽  
Paolo Antonio Ascierto ◽  
Carlo Salvarani ◽  
...  
Keyword(s):  
Logistic Regression ◽  
A Priori ◽  
Prospective Trial ◽  
Respiratory Support ◽  
Validation Dataset ◽  
Multivariable Logistic Regression Analysis ◽  
Phase 2 ◽  
Multivariable Logistic Regression Model ◽  
Intention To Treat ◽  
Multivariable Logistic Regression

Abstract Background Tocilizumab blocks pro-inflammatory activity of interleukin-6 (IL-6), involved in pathogenesis of pneumonia the most frequent cause of death in COVID-19 patients. Methods A multicenter, single-arm, hypothesis-driven trial was planned, according to a phase 2 design, to study the effect of tocilizumab on lethality rates at 14 and 30 days (co-primary endpoints, a priori expected rates being 20 and 35%, respectively). A further prospective cohort of patients, consecutively enrolled after the first cohort was accomplished, was used as a secondary validation dataset. The two cohorts were evaluated jointly in an exploratory multivariable logistic regression model to assess prognostic variables on survival. Results In the primary intention-to-treat (ITT) phase 2 population, 180/301 (59.8%) subjects received tocilizumab, and 67 deaths were observed overall. Lethality rates were equal to 18.4% (97.5% CI: 13.6–24.0, P = 0.52) and 22.4% (97.5% CI: 17.2–28.3, P < 0.001) at 14 and 30 days, respectively. Lethality rates were lower in the validation dataset, that included 920 patients. No signal of specific drug toxicity was reported. In the exploratory multivariable logistic regression analysis, older age and lower PaO2/FiO2 ratio negatively affected survival, while the concurrent use of steroids was associated with greater survival. A statistically significant interaction was found between tocilizumab and respiratory support, suggesting that tocilizumab might be more effective in patients not requiring mechanical respiratory support at baseline. Conclusions Tocilizumab reduced lethality rate at 30 days compared with null hypothesis, without significant toxicity. Possibly, this effect could be limited to patients not requiring mechanical respiratory support at baseline. Registration EudraCT (2020-001110-38); clinicaltrials.gov (NCT04317092).

scholarly journals Demand- and supply-side factors associated with the use of contraceptive methods in Pakistan: a comparative study of demographic and health surveys, 1990–2018

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sadia Jabeen ◽  
Adnan Rathor ◽  
Maria Riaz ◽  
Rubeena Zakar ◽  
Florian Fischer
Keyword(s):  
Family Planning ◽  
Health Surveys ◽  
Media Exposure ◽  
Data Series ◽  
Demographic And Health Surveys ◽  
Supply Side ◽  
Contraceptive Methods ◽  
Demand And Supply ◽  
Factors Associated ◽  
Supply Side Factors

Abstract Background A remarkable decline in fertility rates has been observed in many countries, with a primary determinant being an increase in the use of contraceptives. However, the birth rate in Pakistan is still higher compared to the other countries of the region. Therefore, this study aims to assess the effect of demand- and supply-side factors associated with the use of contraceptive measures in Pakistan. Methods Secondary data analysis of four data series of the Pakistan Demographic and Health Surveys (PDHS 1990–1991, 2006–2007, 2012–2013 and 2017–2018) were used. The data includes ever-married women aged 15–49 years who had given birth in the previous five years and participated in the family planning module of the PDHS. A total of 25,318 women were included in the analysis. Data were analysed by investigating the associations between independent variables (demand- and supply-side factors) and the use of contraceptive measures through unadjusted odds ratios (OR) and adjusted OR (AOR). Results The results among demand-side factors indicated that in 2012–2013, women without media exposure were less likely to use contraceptives and the trend remains almost constant for 2017–2018 (AOR = 0.664, 95% CI 0.562–0.784) in 2012–2013 and (AOR = 0.654, 95% CI 0.483–0.885) in 2017–2018. However, they still show a lower likelihood of using contraceptives without media exposure. The results among supply-side factors indicated that absence of transport (2012–2013) and limited visits by family planning workers over the previous 12 months (2006–2007, 2012–2013 and 2017–2018) remained significant factors for not using contraceptive methods. Conclusions The results of the study indicate that certain demand- and supply-side factors are associated with the use of contraceptive measures in Pakistan. It highlights the need for the provision of family planning resources and further structural factors, particularly in remote areas.

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