scholarly journals Spatial heterogeneity and determinants of childhood anaemia in Nigeria

2020 ◽  
Author(s):  
Chigozie Louisa Jane Ugwu ◽  
Temesgen Zewotir
Keyword(s):  
Spatial Heterogeneity ◽  
National Level ◽  
Credible Interval ◽  
Household Wealth ◽  
Influential Factors ◽  
World Health ◽  
Targeted Interventions ◽  
Malaria Indicator Survey ◽  
Additive Regression ◽  
Structured Additive Regression

Abstract Background Childhood anaemia is highly prevalent in Nigeria. According to the 2015 Nigeria Malaria Indicator Survey (NMIS) report, more than 68% of children aged 6-59 months were found to be anaemic. This estimate is far above the World Health Organization’s 40% cut off point which classifies anaemia a severe public health challenge in the country. Identifying environmental, health, socioeconomic and demographic influential factors and mapping the prevalence of anaemia can help guide geographically targeted intervention programmes to reduce the risk of anaemia associated morbidity among vulnerable children in Nigeria. Methods Geographically linked national level datasets obtained from the 2015 Nigeria Demographic and Health Survey (NDHS) and Malaria Indicator Survey (NMIS) programmes were used for this study. For the analysis, a binary structured additive regression (BSAR) model was explored. This model incorporated a Markov Random Field (MRF) prior, with posterior parameters estimated via Bayesian framework. Results After accounting for the spatial heterogeneity, we found a strong negative association between the odds of anaemia and the child’s demographic variables in terms of increasing age and being female. Increased odds of anaemia were also associated with child’s malaria and fever status, living in a rural environment, lower household wealth quintile, having younger and illiterate mothers. We also found that a decreased distance to vegetated areas was associated with increased childhood anaemia risk, while the odds of anaemia decreased as cluster altitude increased at 95% credible interval. The maps of the posterior means of the spatial random effects revealed evidence of spatial variation in the odds of childhood anaemia, while accounting for the model covariates (Fig. 4). Greater risk of anaemia was observed for children who resided in Adamawa, Ebonyi, Edo, Cross river, FCT, Jigawa, Kaduna, Kano and Kebbi states in Nigeria. Conclusions In this study, a binary structured additive regression model was utilized, allowing for a flexible semiparametric predictor that accounted for the effects of different types of covariates, while simultaneously incorporating spatial variables directly. Our results revealed significant spatial variability of childhood anaemia, suggesting that spatially targeted interventions could result in efficiency gains for anaemia control in Nigeria.

A(H1N1)v cases of the 2009/2010 and 2010/2011 influenza seasons in the Medical and Health Sciences Centre of Debrecen University

2012 ◽  
Vol 153 (17) ◽  
pp. 649-654
Author(s):  
Piroska Orosi ◽  
Judit Szidor ◽  
Tünde Tóthné Tóth ◽  
József Kónya
Keyword(s):  
High Risk ◽  
Influenza Season ◽  
National Level ◽  
Organ Transplant ◽  
High Risk Patient ◽  
Risk Groups ◽  
Health Sciences ◽  
World Health ◽  
Transplant Patients ◽  
Health Organization

The swine-origin new influenza variant A(H1N1) emerged in 2009 and changed the epidemiology of the 2009/2010 influenza season globally and at national level. Aims: The aim of the authors was to analyse the cases of two influenza seasons. Methods: The Medical and Health Sciences Centre of Debrecen University has 1690 beds with 85 000 patients admitted per year. The diagnosis of influenza was conducted using real-time polymerase chain reaction in the microbiological laboratories of the University and the National Epidemiological Centre, according to the recommendation of the World Health Organization. Results: The incidence of influenza was not higher than that observed in the previous season, but two high-risk patient groups were identified: pregnant women and patients with immunodeficiency (oncohematological and organ transplant patients). The influenza vaccine, which is free for high-risk groups and health care workers in Hungary, appeared to be effective for prevention, because in the 2010/2011 influenza season none of the 58 patients who were administered the vaccination developed influenza. Conclusion: It is an important task to protect oncohematological and organ transplant patients. Orv. Hetil., 2012, 153, 649–654.

Defining Preterm Birth and Stillbirth in the Western Pacific: A Systematic Review

2021 ◽  
pp. 101053952110260
Author(s):  
Mairead Connolly ◽  
Laura Phung ◽  
Elise Farrington ◽  
Michelle J. L. Scoullar ◽  
Alyce N. Wilson ◽  
...  
Keyword(s):  
Preterm Birth ◽  
National Level ◽  
Health Indicators ◽  
Western Pacific ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Definition Of ◽  
Health Organization ◽  
The Impact

Preterm birth and stillbirth are important global perinatal health indicators. Definitions of these indicators can differ between countries, affecting comparability of preterm birth and stillbirth rates across countries. This study aimed to document national-level adherence to World Health Organization (WHO) definitions of preterm birth and stillbirth in the WHO Western Pacific region. A systematic search of government health websites and 4 electronic databases was conducted. Any official report or published study describing the national definition of preterm birth or stillbirth published between 2000 and 2020 was eligible for inclusion. A total of 58 data sources from 21 countries were identified. There was considerable variation in how preterm birth and stillbirth was defined across the region. The most frequently used lower gestational age threshold for viability of preterm birth was 28 weeks gestation (range 20-28 weeks), and stillbirth was most frequently classified from 20 weeks gestation (range 12-28 weeks). High-income countries more frequently used earlier gestational ages for preterm birth and stillbirth compared with low- to middle-income countries. The findings highlight the importance of clear, standardized, internationally comparable definitions for perinatal indicators. Further research is needed to determine the impact on regional preterm birth and stillbirth rates.

scholarly journals Physical Activity, Sedentary Behavior, Sleep and Self-Regulation in Spanish Preschoolers during the COVID-19 Lockdown

2021 ◽  
Vol 18 (2) ◽  
pp. 693
Author(s):  
Alicia M. Alonso-Martínez ◽  
Robinson Ramírez-Vélez ◽  
Yesenia García-Alonso ◽  
Mikel Izquierdo ◽  
Antonio García-Hermoso
Keyword(s):  
Physical Activity ◽  
Sedentary Time ◽  
Self Regulation ◽  
National Level ◽  
Global Strategy ◽  
World Health ◽  
Lifestyle Behaviors ◽  
Public Health Response ◽  
Validated Questionnaire ◽  
Health Organization

Background: A better understanding of the effects of the lockdown on lifestyle behaviors may help to guide the public health response to COVID-19 at a national level and to update the global strategy to respond COVID-19 pandemic. The aim of the study was to examine the effects of the COVID-19 lockdown on device-measured physical activity (PA), sedentary time, sleep and self-regulation; and to determine whether PA and sleep are related to self-regulation problems during the lockdown. Methods: PA, sedentary time and sleep were assessed using accelerometry in the week in which the Spanish national state of alarm was declared (n = 21). Parents reported preschooler’s self-regulation difficulties (internalizing and externalizing) before (n = 268) and during the lockdown (n = 157) by a validated questionnaire. Results: Preschoolers showed a decrease in total PA (mean difference [MD] = −43.3 min per day, 95% CI −68.1 to −18.5), sleep efficiency (MD = −2.09%, 95% CI −4.12 to −0.05), an increase in sedentary time (MD = 50.2 min per day, 95% CI 17.1 to 83.3) internalizing (MD = 0.17, 95% CI 0.06 to 0.28) and externalizing (MD = 0.33, 95% CI 0.23 to 0.44) problems. Preschoolers who met the World Health Organization recommendations for PA had lower internalizing scores than non-active peers (MD = −1.28, 95% CI −2.53 to −0.03). Conclusions: Our findings highlight the importance of meeting PA recommendations to reduce psychosocial difficulties during a lockdown situation.

scholarly journals The National Immunization Technical Advisory Group in Israel

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Chen Stein-Zamir ◽  
Shmuel Rishpon
Keyword(s):  
National Health ◽  
National Level ◽  
Vaccination Schedule ◽  
World Health ◽  
Advisory Group ◽  
Health Coverage ◽  
Ministry Of Health ◽  
Independent Evidence ◽  
Main Challenge ◽  
National Immunization

AbstractNational Immunization Technical Advisory Groups (NITAGs) are defined by the World Health Organization as multidisciplinary groups of health experts who are involved in the development of a national immunization policy. The NITAG has the responsibility to provide independent, evidence-informed advice to the policy makers and national programme managers, on policy issues and questions related to immunization and vaccines.This paper aims to describe the NITAG in Israel. The Israeli NITAG was established by the Ministry of Health in1974. The NITAG’s full formal name is “the Advisory Committee on Infectious Diseases and Immunizations in Israel”. The NITAG is charged with prioritizing choices while granting maximal significance to the national public health considerations. Since 2007, the full minutes of the NITAG’s meetings have been publicly available on the committee’s website (at the Ministry of Health website, in Hebrew).According to the National Health Insurance Law, all residents of Israel are entitled to receive universal health coverage. The health services basket includes routine childhood immunizations, as well as several adult and post - exposure vaccinations. The main challenge currently facing the NITAG is establishing a process for introducing new vaccines and updating the vaccination schedule through the annual update of the national health basket. In the context of the annual update, vaccines have to “compete” with multiple medications and technologies which are presented to the basket committee for inclusion in the national health basket. Over the years, the Israeli NITAG’s recommendations have proved essential for vaccine introduction and scheduling and for communicable diseases control on a national level. The NITAG has established structured and transparent working processes and a decision framework according to WHO standards, which is evidence-based and country-specific to Israel.The recent global COVID-19 pandemic is a major concern for all countries as well as a challenge for NITAGs. Currently, the NITAGs have a key role in advising both on sustainment of the routine immunization programs and on planning of the COVID-19 vaccination campaigns, with ongoing updates and collaboration with the Ministry of Health and health organizations.

scholarly journals Assessment of surveillance core and support functions regarding neglected tropical diseases in Kenya

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Arthur K. S. Ng’etich ◽  
Kuku Voyi ◽  
Clifford M. Mutero
Keyword(s):  
Data Analysis ◽  
Surveillance System ◽  
Qualitative Data ◽  
Neglected Tropical Diseases ◽  
National Level ◽  
World Health ◽  
Tropical Diseases ◽  
Support Functions ◽  
Specimen Handling ◽  
Surveillance And Response

Abstract Background Effective surveillance and response systems are vital to achievement of disease control and elimination goals. Kenya adopted the revised guidelines of the integrated disease surveillance and response system in 2012. Previous assessments of surveillance system core and support functions in Africa are limited to notifiable diseases with minimal attention given to neglected tropical diseases amenable to preventive chemotherapy (PC-NTDs). The study aimed to assess surveillance system core and support functions relating to PC-NTDs in Kenya. Methods A mixed method cross-sectional survey was adapted involving 192 health facility workers, 50 community-level health workers and 44 sub-national level health personnel. Data was collected using modified World Health Organization generic questionnaires, observation checklists and interview schedules. Descriptive summaries, tests of associations using Pearson’s Chi-square or Fisher’s exact tests and mixed effects regression models were used to analyse quantitative data. Qualitative data derived from interviews with study participants were coded and analysed thematically. Results Surveillance core and support functions in relation to PC-NTDs were assessed in comparison to an indicator performance target of 80%. Optimal performance reported on specimen handling (84%; 100%), reports submission (100%; 100%) and data analysis (84%; 80%) at the sub-county and county levels respectively. Facilities achieved the threshold on reports submission (84%), reporting deadlines (88%) and feedback (80%). However, low performance reported on case definitions availability (60%), case registers (19%), functional laboratories (52%) and data analysis (58%). Having well-equipped laboratories (3.07, 95% CI: 1.36, 6.94), PC-NTDs provision in reporting forms (3.20, 95% CI: 1.44, 7.10) and surveillance training (4.15, 95% CI: 2.30, 7.48) were associated with higher odds of functional surveillance systems. Challenges facing surveillance activities implementation revealed through qualitative data were in relation to surveillance guidelines and reporting tools, data analysis, feedback, supervisory activities, training and resource provision. Conclusion There was evidence of low-performing surveillance functions regarding PC-NTDs especially at the peripheral surveillance levels. Case detection, registration and confirmation, reporting, data analysis and feedback performed sub-optimally at the facility and community levels. Additionally, support functions including standards and guidelines, supervision, training and resources were particularly weak at the sub-national level. Improved PC-NTDs surveillance performance sub-nationally requires strengthened capacities.

scholarly journals Beyond national indicators: adapting the Demographic and Health Surveys’ sampling strategies and questions to better inform subnational malaria intervention policy

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Ifeoma D. Ozodiegwu ◽  
Monique Ambrose ◽  
Katherine E. Battle ◽  
Caitlin Bever ◽  
Ousmane Diallo ◽  
...  
Keyword(s):  
Health Surveys ◽  
Survey Design ◽  
National Level ◽  
National Policy ◽  
Sampling Strategy ◽  
Epidemiological Data ◽  
Malaria Prevalence ◽  
Demographic And Health Surveys ◽  
Malaria Indicator Survey ◽  
Narrow Scope

AbstractIn malaria-endemic countries, prioritizing intervention deployment to areas that need the most attention is crucial to ensure continued progress. Global and national policy makers increasingly rely on epidemiological data and mathematical modelling to help optimize health decisions at the sub-national level. The Demographic and Health Surveys (DHS) Program is a critical data source for understanding subnational malaria prevalence and intervention coverage, which are used for parameterizing country-specific models of malaria transmission. However, data to estimate indicators at finer resolutions are limited, and surveys questions have a narrow scope. Examples from the Nigeria DHS are used to highlight gaps in the current survey design. Proposals are then made for additional questions and expansions to the DHS and Malaria Indicator Survey sampling strategy that would advance the data analyses and modelled estimates that inform national policy recommendations. Collaboration between the DHS Program, national malaria control programmes, the malaria modelling community, and funders is needed to address the highlighted data challenges.

Content of antenatal care and perception about services provided by primary hospitals in Nepal: a convergent mixed methods study

2021 ◽  
Vol 33 (2) ◽  
Author(s):  
Yubraj Acharya ◽  
Nigel James ◽  
Rita Thapa ◽  
Saman Naz ◽  
Rishav Shrestha ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Mixed Methods ◽  
Antenatal Care ◽  
Quality Care ◽  
National Level ◽  
Poor Quality ◽  
Public Hospitals ◽  
World Health ◽  
Outcome Variable

Abstract Background Nepal has made significant strides in maternal and neonatal mortality over the last three decades. However, poor quality of care can threaten the gains, as maternal and newborn services are particularly sensitive to quality of care. Our study aimed to understand current gaps in the process and the outcome dimensions of the quality of antenatal care (ANC), particularly at the sub-national level. We assessed these dimensions of the quality of ANC in 17 primary, public hospitals across Nepal. We also assessed the variation in the ANC process across the patients’ socio-economic gradient. Methods We used a convergent mixed methods approach, whereby we triangulated qualitative and quantitative data. In the quantitative component, we observed interactions between providers (17 hospitals from all 7 provinces) and 198 women seeking ANC and recorded the tasks the providers performed, using the Service Provision Assessments protocol available from the Demographic and Health Survey program. The main outcome variable was the number of tasks performed by the provider during an ANC consultation. The tasks ranged from identifying potential signs of danger to providing counseling. We analyzed the resulting data descriptively and assessed the relationship between the number of tasks performed and users’ characteristics. In the qualitative component, we synthesized users’ and providers’ narratives on perceptions of the overall quality of care obtained through focus group discussions and in-depth interviews. Results Out of the 59 tasks recommended by the World Health Organization, providers performed only 22 tasks (37.3%) on average. The number of tasks performed varied significantly across provinces, with users in province 3 receiving significantly higher quality care than those in other provinces. Educated women were treated better than those with no education. Users and providers agreed that the overall quality of care was inadequate, although providers mentioned that the current quality was the best they could provide given the constraints they faced. Conclusion The quality of ANC in Nepal’s primary hospitals is poor and inequitable across education and geographic gradients. While current efforts, such as the provision of 24/7 birthing centers, can mitigate gaps in service availability, additional equipment, infrastructure and human resources will be needed to improve quality. Providers also need additional training focused on treating patients from different backgrounds equally. Our study also points to the need for additional research, both to document the quality of care more objectively and to establish key determinants of quality to inform policy.

scholarly journals Premarital mental disorders and physical violence in marriage: cross-national study of married couples

2011 ◽  
Vol 199 (4) ◽  
pp. 330-337 ◽  
Author(s):  
E. Miller ◽  
J. Breslau ◽  
M. Petukhova ◽  
J. Fayyad ◽  
J. Greif Green ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Physical Violence ◽  
Population Attributable Risk ◽  
Married Couples ◽  
Marital Violence ◽  
World Health ◽  
National Study ◽  
Targeted Interventions ◽  
Externalising Disorders ◽  
Cross National

BackgroundMental disorders may increase the risk of physical violence among married couples.AimsTo estimate associations between premarital mental disorders and marital violence in a cross-national sample of married couples.MethodA total of 1821 married couples (3642 individuals) from 11 countries were interviewed as part of the World Health Organization's World Mental Health Survey Initiative. Sixteen mental disorders with onset prior to marriage were examined as predictors of marital violence reported by either spouse.ResultsAny physical violence was reported by one or both spouses in 20% of couples, and was associated with husbands' externalising disorders (OR = 1.7, 95% CI 1.2–2.3). Overall, the population attributable risk for marital violence related to premarital mental disorders was estimated to be 17.2%.ConclusionsHusbands' externalising disorders had a modest but consistent association with marital violence across diverse countries. This finding has implications for the development of targeted interventions to reduce risk of marital violence.

scholarly journals Prevalence of Underweight, Overweight and Obesity in School-Aged Children in the Urban Area of the Northwestern Part of Romania

2021 ◽  
Vol 18 (10) ◽  
pp. 5176
Author(s):  
Tudor Lucian Pop ◽  
Dana Maniu ◽  
Daniela Rajka ◽  
Cecilia Lazea ◽  
Gabriel Cismaru ◽  
...  
Keyword(s):  
Urban Area ◽  
Urban Areas ◽  
Severe Obesity ◽  
Task Force ◽  
National Level ◽  
Overweight And Obesity ◽  
Excess Weight ◽  
World Health ◽  
Northwestern Part ◽  
Obesity In Children

Introduction: During the last three decades, there has been an excess weight epidemic due to changes in nutrition and lifestyle. Few data on the prevalence of overweight and obesity in children in Romania were published, without a single study representative at the national level. There are reports on the higher level of overweight and obesity in urban areas compared to rural ones. This study aimed to estimate the prevalence of underweight, overweight, obesity and severe obesity in children enrolled in schools from the urban area. Material and methods: For this cross-sectional study, children from 177 schools from the urban area of five counties from the northwestern part of Romania were included after the parents signed written informed consent. Anthropometric data were recorded (weight, height) based on World Health Organization (WHO) recommendations and Body-Mass-Index (BMI), and the z-score for BMI were calculated. The nutritional status was estimated using three reference criteria: WHO, International Obesity Task Force (IOTC) and the Center for Disease Control and Prevention (CDC). Results: We analyzed data of 21,650 children (48.19% boys) age between 7 and 18 years. The prevalence of overweight was 13.8%, 16.2% and 20.3%, of obesity was 10.7%, 10.0% and 5.7% and of severe obesity was 5.1%, 1.2% and 1.6% (using WHO, CDC and IOTF cut-offs). Underweight was present in 5.2% (WHO), 6% (CDC) and 2.6% (IOTF). The highest prevalence of overweight (including obesity) was found in children aged 10 years, and the lowest in adolescents at 18 years. Boys have a higher prevalence of excess weight than girls. Using IOTF cut-offs, the prevalence of obesity and severe obesity was lower than using WHO criteria. Conclusions: The prevalence of overweight (including obesity) in children from the urban area of Western Romania was recorded at alarming levels, higher in boys and at the pre-puberty ages. There are significant differences based on the reference system used. It is important to correctly choose the reference for the definition of overweight and obesity to have the correct estimation of the target for public health measures.

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