scholarly journals Bayesian Spatial Modeling of Anemia among children under 5 years in Guinea

Author(s):  
Thierno Souleymane Barry ◽  
Oscar Ngesa ◽  
Nelson Owuor Onyango ◽  
Henry Mwambi

Abstract Bacground: Anemia is a major public health problem in Africa with an increasing number of children under 5years getting infected. Guinea is one of the most affected countries. In 2018, the prevalence rate was 75% inchildren under 5 years. This study sought to identify the factors associated with anemia and to map spatialvariation of anemia across the eight (8) regions in Guinea for children under 5 years, which can provideguidance for control programs for the reduction of the disease.Methods: Data from the Guinea Multiple Indicator Cluster Survey (MICS5) 2016 was used for this study. Atotal of 2609 children under 5 years who had full covariate information were used in the analysis. Spatialbinomial logistic regression methodology was undertaken via Bayesian estimation based on Markov chainMonte Carlo (McMC) using WinBUGS software version 1.4. Results: Our findings revealed that 77% of children under 5 years in Guinea had anemia and the prevalence inthe regions ranged from 70.32% (Conakry) to 83.60% (N’Zerekore) across the country. After adjusting for nonspatial and spatial random effects in the model, older children (48–59 months) (OR: 0.47, CI [0.29 0.70]) were less likely to be anemic compared to those who are younger (0-11 months). Children whose mothers havecompleted secondary education or more had a reduced chance of anemia infection by 33% (OR: 0.67, CI [0.490.90]) and Children from household heads from Kissi ethnic group are less likely to have anemia than theircounterparts whose leader is from Soussou (OR: 0.48, CI [0.22 0.91]). Conclusion: The spatial analysis allowed the identification of high-risk areas as well as the identification ofsocio-economic and demographic factors associated with anemia among children under 5 years. Such ananalysis is important in helping policy makers and health practitioners in developing programs geared towardscontrol and management of anemia among children under 5 years in the country.

Author(s):  
Thierno Souleymane Barry ◽  
Oscar Ngesa ◽  
Nelson Owuor Onyango ◽  
Henry Mwambi

Anemia is a major public health problem in Africa, affecting an increasing number of children under five years. Guinea is one of the most affected countries. In 2018, the prevalence rate in Guinea was 75% for children under five years. This study sought to identify the factors associated with anemia and to map spatial variation of anemia across the eight (8) regions in Guinea for children under five years, which can provide guidance for control programs for the reduction of the disease. Data from the Guinea Multiple Indicator Cluster Survey (MICS5) 2016 was used for this study. A total of 2609 children under five years who had full covariate information were used in the analysis. Spatial binomial logistic regression methodology was undertaken via Bayesian estimation based on Markov chain Monte Carlo (MCMC) using WinBUGS software version 1.4. The findings in this study revealed that 77% of children under five years in Guinea had anemia, and the prevalences in the regions ranged from 70.32% (Conakry) to 83.60% (NZerekore) across the country. After adjusting for non-spatial and spatial random effects in the model, older children (48–59 months) (OR: 0.47, CI [0.29 0.70]) were less likely to be anemic compared to those who are younger (0–11 months). Children whose mothers had completed secondary school or above had a 33% reduced risk of anemia (OR: 0.67, CI [0.49 0.90]), and children from household heads from the Kissi ethnic group are less likely to have anemia than their counterparts whose leaders are from Soussou (OR: 0.48, CI [0.23 0.92]).


2021 ◽  
Vol 104 (2) ◽  
pp. 233-239

ackground: Tuberculosis (TB) is a major public health problem, including Thailand. Anti-TB drugs are very effective treatment, but they can cause hepatotoxicity. Data on the prevalence of anti-TB drug-induced hepatotoxicity (DIH), as well as the contributing risk factors, are scarce in Thailand. Objective: To measure the prevalence and identify risk factors associated with first-line drugs (FLD) induced hepatoxicity in TB patients. Materials and Methods: The present study was a retrospective study design in TB clinic of Suratthani Hospital, in Southern Thailand. All patients diagnosed with TB and received FLD between January and December 2017, were eligible for the study. Hepatoxicity defined as the following criteria: serum aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels >5x upper limit of normal (ULN) without symptoms, or AST or ALT >3x ULN with clinical symptoms. Results: Of all the 198 TB cases, 18 were identified as DIH. Prevalence of DIH was 9.1%. Hepatitis after FLD was independently associated with age>60 years (adjusted OR [aOR] 28.49, 95% CI 2.68 to 302.95, p=0.005) and serum albumin <3.5 g/dL (aOR 20.97, 95% CI 2.11 to 208.51, p=0.009). Conclusion: Age of more than 60 years and low serum albumin of less than 3.5 g/dL were significant risk factors associated with first-line anti-TB drugs induced hepatoxicity. Keywords: Hepatoxicity, Anti-tuberculosis drug, Risk factor, Thailand


2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Ketema Bizuwork Gebremedhin ◽  
Tadesse Bedada Haye

Background. Globally, anemia, among people living with HIV/AIDS, is a major public health problem. It has a significant effect on the progression of HIV/AIDS to advanced stages and there are a number of factors that often affect anemia. However, there is little insight regarding factors affecting anemia among HIV/AIDS patients in developing countries, including Ethiopia. Objective. This study aimed at investigating factors affecting anemia among people living with HIV/AIDS taking ART drug at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods. A hospital based cross-sectional study design was used to assess factors affecting anemia among people living with HIV/AIDS. Structured checklist was used to gather information from charts of patients selected by simple random sampling method. We analyzed the data to identify factors associated with anemia among people with HIV/AIDS using logistic regression models. Results. A total of 301 selected charts were reviewed. The median age was 38 ± 10.38. The majority (62.5%) of the patients were taking ZDV-containing ART drug (ZDV/3TC/NVP). The overall anemia prevalence was 34.6%, while about 5%, 15.6%, and 14% of the patients had severe, moderate, and mild prevalence of anemia, respectively. Factors that were found to affect anemia among these patients include gender (OR = 2.26 [95% CI: 1.22, 4.16]), occupation (OR: 0.57 [95%CI: 0.35, 0.92]), WBC count (OR = 2.30 [95% CI: 1.29, 4.09]), platelet count (OR = 2.89 [95% CI: 0.99, 8.41]), nutritional status (OR = 2.05 [95% CI: 0.69, 6.02]), and WHO clinical stage of HIV/AIDS (OR = 3.69 [95% CI: 1.86, 7.31]). Conclusions. About one in three patients was found to be anemic. Intervention aimed at diagnosing and treating anemia among people living with HIV/AIDS should be considered.


2010 ◽  
Vol 40 (11) ◽  
pp. 1811-1819 ◽  
Author(s):  
E. M. McMahon ◽  
U. Reulbach ◽  
P. Corcoran ◽  
H. S. Keeley ◽  
I. J. Perry ◽  
...  

BackgroundDeliberate self-harm (DSH) is a major public health problem, with young people most at risk. Lifetime prevalence of DSH in Irish adolescents is between 8% and 12%, and it is three times more prevalent among girls than boys. The aim of the study was to identify the psychological, life-style and life event factors associated with self-harm in Irish adolescents.MethodA cross-sectional study was conducted, with 3881 adolescents in 39 schools completing an anonymous questionnaire as part of the Child and Adolescent Self-harm in Europe (CASE) study. There was an equal gender balance and 53.1% of students were 16 years old. Information was obtained on history of self-harm life events, and demographic, psychological and life-style factors.ResultsBased on multivariate analyses, important factors associated with DSH among both genders were drug use and knowing a friend who had engaged in self-harm. Among girls, poor self-esteem, forced sexual activity, self-harm of a family member, fights with parents and problems with friendships also remained in the final model. For boys, experiencing bullying, problems with schoolwork, impulsivity and anxiety remained.ConclusionsDistinct profiles of boys and girls who engage in self-harm were identified. Associations between DSH and some life-style and life event factors suggest that mental health factors are not the sole indicators of risk of self-harm. The importance of school-related risk factors underlines the need to develop gender-specific initiatives in schools to reduce the prevalence of self-harm.


2021 ◽  
Author(s):  
Tina Gao ◽  
Kingsley E Agho ◽  
Milan K Piya ◽  
David Simmons ◽  
Uchechukwu L Osuagwu

Abstract Background Diabetes is a major public health problem affecting about 1.4 million Australians, especially in South Western Sydney, a hotspot of diabetes with higher than average rates for hospitalisations. The current understanding of the international burden of diabetes and related complications is poor and there is paucity of data on hospital outcomes and/or what common factors influence mortality rate in people with diabetes in Australia. This study determined in-hospital mortality rate and the factors associated among people with and without diabetes. Methods Retrospective data for 554,421 adult inpatients was extracted from the population-based New South Wales (NSW) Admitted Patient Data over 3 financial years (from 2014-15 to 2016-17). The in-hospital mortality per 1000 admitted persons, standardised mortality ratios (SMR) were calculated. Binary logistic regression was performed, adjusting for potential covariates and co-morbidities for people with and without diabetes over three years. Results Over three years 8.7% (48,038 people) of admissions involved those with diabetes. This increased from 8.4% in 2014-15 to 8.9% in 2016-17 (p = 0.007). Across all age groups, in-hospital mortality rate was significantly greater in people with diabetes (20.6, 95% Confidence intervals CI 19.3–21.9 per 1000 persons) than those without diabetes (11.8, 95%CI 11.5–12.1) and more in men than women (23.1, 95%CI 21.2–25.0 vs 17.9, 95%CI 16.2–19.8) with diabetes. The SMR for those with and without diabetes were 3.13 (95%CI 1.78–4.48) and 1.79 (95%CI 0.77–2.82), respectively. There were similarities in the factors associated with in hospital mortality in both groups including: aged > 54years, men, the widowed, those who stayed longer than 4 days or received intensive care in admission and had respiratory and cardiovascular comorbidities. Conclusions The study found that in-patients with diabetes continue to have higher mortality rates than those without diabetes and the Australian population. Overall, similar factors influenced mortality rate in people with and without diabetes in this region indicating that continued improved management of all inpatients is needed in order to minimise the persistent poor outcomes.


2021 ◽  
Vol 14 (1) ◽  
pp. 501-508
Author(s):  
Bakhytzhan Kurmanov ◽  
Yolanda Pena-Boquete ◽  
Aizhan Samambayeva ◽  
Galym Makhmejanov

Background: During the last 10 years, the prevalence of underweight has decreased considerably in Kazakhstan and, nowadays, it is set under 3% for children under 5 years old. However, the prevalence of overweight, which was not important at all in the 90s, is reaching 10% for children under 5 nowadays. This means that there is a co-existence between being underweight and overweight in the same country and, in some cases, within the same region. In order to design policies addressing both problems and avoiding policies, which may solve underweight but worsening overweight, and vice versa, the aim of this paper is to analyse the socioeconomic determinants of the two problems. Methods: We estimate the probability of occurrence using the Multiple Indicator Cluster Survey (MICS) collected by the United Nations Children’s Fund (UNICEF) and Agency of Statistics of the Republic of Kazakhstan for the years 2006, 2010-2011 and 2015. This survey includes a questionnaire for children younger than 5 years old containing information on maternal and child health. We consider that a child is overweight if she/he falls over two standard deviations of the World Health Organization standards (WHO) for her/his age. Similarly, we consider that a child is underweight if she/he falls below the two standard deviations of the WHO standards. Results: Children of mothers with higher education have a higher probability of being overweight (6,8%) and less probability of being underweight (-5,5%). This effect disappears for children older than 2 years old. Children of Russian origin and other ethnic groups show a lower probability of being overweight in comparison with their Kazakh peers. Being born in the highest wealth quintile reduces the risk of a child under 2 years old being underweight (-2,9%). On the other side, children in rich families at age 2-4 years old have a higher probability of being overweight (3,7%). Conclusion: Health policy aimed to improve family and institution´s knowledge on child nutrition could be effective measures to reduce infant overweight.


2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Paschal Awingura Apanga ◽  
Maxwell Tii Kumbeni

Abstract Background Timely initiation of breastfeeding is putting the newborn to the breast within 1 h of birth. Its practice can prevent neonatal and under-5 mortality. This study aims to assess the prevalence and factors associated with timely initiation of breastfeeding among mothers in Ghana. Methods We used data from the 2017–2018 Ghana multiple indicator cluster survey and our analysis was restricted to 15,305 mothers who had a live birth within 2 years. Multivariable logistic regression was used to estimate the factors associated with timely initiation of breastfeeding whilst adjusting for potential confounders, and accounted for clustering, stratification, and sample weights. Results The prevalence of timely initiation of breastfeeding was 51.3% (95% CI 48.1, 54.6%). Mothers who received antenatal care were twice as likely to timely initiate breastfeeding compared to mothers who did not receive antenatal care (Adjusted prevalence odds ratios [aPOR] 2.01, 95% CI 1.03, 3.95). Mothers who were assisted by a skilled attendant at birth had 90% higher odds of timely initiation of breastfeeding compared to mothers who were not assisted by a skilled attendant (aPOR 1.90, 95% CI 1.41, 2.55). Mothers who delivered by caesarean section had 76% lower odds of timely initiation of breastfeeding compared to mothers who had a vaginal delivery (aPOR 0.24, 95, 95% CI 0.16, 0.36). Mothers who had planned their pregnancy had 45% higher odds of timely initiation of breastfeeding compared to mothers who had an unplanned pregnancy (aPOR 1.45, 95% CI 1.09, 1.92). There were also 84% and 55% higher odds of timely initiation of breastfeeding among mothers who perceived their baby was large (aPOR 1.84, 95% CI 1.32, 2.58), and of average size (aPOR 1.55, 95% CI 1.11, 2.17) at birth respectively, compared to mothers who perceived their baby was small. Conclusions Interventions to increase timely initiation of breastfeeding should provide breastfeeding support to mothers who have had a caesarean section or small sized babies, prevent unplanned pregnancies, and promote antenatal care attendance among pregnant women.


Author(s):  
Juliana Vasconcelos Lyra da Silva ◽  
Gilberto Fontes ◽  
Célia Dias dos Santos ◽  
Rafael Vital dos Santos ◽  
Eliana Maria Mauricio da Rocha

Background. Intestinal parasitic infections constitute a major public health problem that is frequently associated with poverty, inadequate sanitation, and the nutritional status of the population.Objective. The aim of the present study is to investigate the possible association of parasitic infections, sanitary conditions, hygiene practices, and the nutritional and socioeconomic status of a poor youth population.Methods. A cross-sectional study was conducted with 367 children and adolescents inhabiting a substandard settlement in the urban area of Maceió (Alagoas State, Brazil). Data collection included socioeconomic status, anthropometric measurements, fecal sample examinations, and laboratory blood analysis. The identification of factors associated with gastrointestinal parasitic infections was undertaken through bi- and multivariate analyses.Results. Stool sample analysis obtained from 300 individuals revealed that 204 (68%) were infected with at least one parasite species and of these 130 (63.7%) were polyparasitized. No significant associations were identified between low height for age (stunted), parasitic infections, and polyparasitism. There was also no association between family income and parasitosis. However, low socioeconomic status proved to be a potential risk factor for parasitic infections.Conclusion. Actions must be taken to improve sanitation, housing, and environmental conditions in order to eliminate the risk factors for parasitic infections, and thereby guarantee a better quality of life for this population.


2018 ◽  
Vol 44 (2) ◽  
pp. 145-152 ◽  
Author(s):  
Denise Rossato Silva ◽  
Marcela Muñoz-Torrico ◽  
Raquel Duarte ◽  
Tatiana Galvão ◽  
Eduardo Henrique Bonini ◽  
...  

ABSTRACT Tuberculosis continues to be a major public health problem. Although efforts to control the epidemic have reduced mortality and incidence, there are several predisposing factors that should be modified in order to reduce the burden of the disease. This review article will address some of the risk factors associated with tuberculosis infection and active tuberculosis, including diabetes, smoking, alcohol use, and the use of other drugs, all of which can also contribute to poor tuberculosis treatment results. Tuberculosis can also lead to complications in the course and management of other diseases, such as diabetes. It is therefore important to identify these comorbidities in tuberculosis patients in order to ensure adequate management of both conditions.


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