scholarly journals Developmental Delay and its Predictors among Under-Five Uncomplicated Severe Acute Malnourished Children: A Cross-Sectional Study in Rural Areas of Pakistan

2021 ◽  
Author(s):  
Javeria Saleem ◽  
Rubeena Zakaar ◽  
Gul Mehar Javaid Bukhari ◽  
Aneela Fatima ◽  
Florian Fischer
Keyword(s):  
Developmental Delay ◽  
Rural Areas ◽  
Developmental Delays ◽  
Cross Sectional Study ◽  
Fine Motor ◽  
Global Development ◽  
Sectional Study ◽  
Cross Sectional ◽  
Under Five ◽  
Malnourished Children

Abstract Background: In developing countries, malnutrition in children and developmental delays are two major challenges for public health. To achieve the vision of the Sustainable Development Goals in the broader perspective of child health, an early identification of developmental delays and timely intervention is crucial. The aim of this study is to assess the prevalence of suspected developmental delay and their predictors in under-five uncomplicated severe acute malnourished children in rural areas of Pakistan.Methods: A multicenter cross-sectional study has been conducted among 185 uncomplicated severe acute malnourished children. We screened 6–59 months aged children for their nutritional status and clinical complications. Children fulfilling the inclusion criteria underwent the Denver Development Screening Tool II (DDSTII). The global developmental profile of children was calculated according to established protocols of DDSTII based on four important domains of development: personal and social behaviour, language, gross motor adaptive and fine motor adaptive skills. A pretested structured questionnaire on socio-demographic and nutritional factors was used for assessing predictors of developmental delay, which were analysed in a multivariate logistic regression model.Results: Out of 177 severe acute malnourished children, 69 (38.9%) had normal global development and 108 (61.1%) had delayed global development. Significant associations with global development delay were found for lower aged children (6-24 months vs. 25-59 month; AOR=4.53, 95% CI: 1.56–13.10, p<0.01), not exclusively breastfeed children (AOR=3.07, 95% CI: 1.24–7.56, p=0.01), and a history of contact with tuberculosis smear positive adult (AOR=2.67, 95% CI: 1.30–5.49, p<0.01).Conclusion: With about two thirds of study participants showing delayed or unstable global development, there is a high prevalence of suspected developmental delay among under-five uncomplicated severe acute malnourished children in rural areas Pakistan. Particularly children in their first two years of life with insufficient breastfeeding are at high risk. This emphasizes the need for providing adequate infrastructure and information to parents in remote areas.

scholarly journals Developmental Delay and Its Predictors Among Under-Five Uncomplicated Severe Acute Malnourished Children: a Cross-Sectional Study in Rural Areas of Pakistan

2020 ◽  
Author(s):  
Javeria Saleem ◽  
Rubeena Zakar ◽  
Gul Mehar Javaid Bukhari ◽  
Aneela Fatima ◽  
Florian Fischer
Keyword(s):  
Developmental Delay ◽  
Rural Areas ◽  
Developmental Delays ◽  
Cross Sectional Study ◽  
Fine Motor ◽  
Global Development ◽  
Sectional Study ◽  
Cross Sectional ◽  
Under Five ◽  
Malnourished Children

Abstract Background: In developing countries, malnutrition in children and developmental delays are two major challenges for public health. To achieve the vision of the Sustainable Development Goals in the broader perspective of child health, an early identification of developmental delays and timely intervention is crucial. The aim of this study is to assess the prevalence of suspected developmental delay and their predictors in under-five uncomplicated severe acute malnourished children in rural areas of Pakistan.Methods: A multicentre cross-sectional study has been conducted among 185 uncomplicated severe acute malnourished children. We screened 6–59 months aged children for their nutritional status and clinical complications. Children fulfilling the inclusion criteria underwent the Denver Development Screening Tool II (DDSTII). The global developmental profile of children was calculated according to established protocols of DDSTII based on four important domains of development: personal and social behaviour, language, gross motor adaptive and fine motor adaptive skills. A pretested structured questionnaire on socio-demographic and nutritional factors was used for assessing predictors of developmental delay, which were analysed in a multivariate logistic regression model.Results: Out of 177 severe acute malnourished children, 69 (38.9%) had normal global development and 108 (61.1%) had delayed global development. Significant associations with global development delay were found for lower aged children (6-24 months vs. 25-59 month; AOR=4.53, 95% CI: 1.56–13.10, p<0.01), not exclusively breastfeed children (AOR=3.07, 95% CI: 1.24–7.56, p=0.01), and a history of contact with tuberculosis smear positive adult (AOR=2.67, 95% CI: 1.30–5.49, p<0.01). Conclusion: With about two thirds of study participants showing delayed or unstable global development, there is a high prevalence of suspected developmental delay among under-five uncomplicated severe acute malnourished children in rural areas Pakistan. Particularly children in their first two years of life with insufficient breastfeeding are at high risk. This emphasizes the need for providing adequate infrastructure and information to parents in remote areas.

scholarly journals Developmental Delay and its Predictors among Under-Five Uncomplicated Severe Acute Malnourished Children: A Cross-Sectional Study in Rural Areas of Pakistan

2020 ◽  
Author(s):  
Javeria Saleem ◽  
Rubeena Zakaar ◽  
Gul Mehar Javaid Bukhari ◽  
Aneela Fatima ◽  
Florian Fischer
Keyword(s):  
Developmental Delay ◽  
Rural Areas ◽  
Developmental Delays ◽  
Cross Sectional Study ◽  
Fine Motor ◽  
Global Development ◽  
Sectional Study ◽  
Cross Sectional ◽  
Under Five ◽  
Malnourished Children

Abstract Background: In developing countries, malnutrition in children and developmental delays are two major challenges for public health. To achieve the vision of the Sustainable Development Goals in the broader perspective of child health, an early identification of developmental delays and timely intervention is crucial. The aim of this study is to assess the prevalence of suspected developmental delay and their predictors in under-five uncomplicated severe acute malnourished children in rural areas of Pakistan.Methods: A multicentre cross-sectional study has been conducted among 185 uncomplicated severe acute malnourished children. We screened 6–59 months aged children for their nutritional status and clinical complications. Children fulfilling the inclusion criteria underwent the Denver Development Screening Tool II (DDSTII). The global developmental profile of children was calculated according to established protocols of DDSTII based on four important domains of development: personal and social behaviour, language, gross motor adaptive and fine motor adaptive skills. A pretested structured questionnaire on socio-demographic and nutritional factors was used for assessing predictors of developmental delay, which were analysed in a multivariate logistic regression model.Results: Out of 177 severe acute malnourished children, 69 (38.9%) had normal global development and 108 (61.1%) had delayed global development. Significant associations with global development delay were found for lower aged children (6-24 months vs. 25-59 month; AOR=4.53, 95% CI: 1.56–13.10, p<0.01), not exclusively breastfeed children (AOR=3.07, 95% CI: 1.24–7.56, p=0.01), and a history of contact with tuberculosis smear positive adult (AOR=2.67, 95% CI: 1.30–5.49, p<0.01). Conclusion: With about two thirds of study participants showing delayed or unstable global development, there is a high prevalence of suspected developmental delay among under-five uncomplicated severe acute malnourished children in rural areas Pakistan. Particularly children in their first two years of life with insufficient breastfeeding are at high risk. This emphasizes the need for providing adequate infrastructure and information to parents in remote areas.

scholarly journals Developmental delay and its predictors among children under five years of age with uncomplicated severe acute malnutrition: a cross-sectional study in rural Pakistan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Javeria Saleem ◽  
Rubeena Zakar ◽  
Gul Mehar Javaid Bukhari ◽  
Aneela Fatima ◽  
Florian Fischer
Keyword(s):  
Developmental Delay ◽  
Rural Areas ◽  
Developmental Delays ◽  
Severe Acute Malnutrition ◽  
Cross Sectional Study ◽  
Acute Malnutrition ◽  
Adaptive Skills ◽  
Global Development ◽  
Sectional Study ◽  
Cross Sectional

Abstract Background In developing countries, malnutrition in children and developmental delays are two major challenges for public health. To achieve the vision of the Sustainable Development Goals from the broader perspective of child health, early identification of developmental delays and timely intervention are crucial. The aim of this study is to assess the prevalence of suspected developmental delay and their predictors in children under the age of 5 years with uncomplicated severe acute malnutrition in rural areas of Pakistan. Methods A multicentre cross-sectional study was conducted among 185 children with uncomplicated severe acute malnutrition. We screened children aged 6–59 months for their nutritional status and clinical complications. Children fulfilling the inclusion criteria underwent the Denver Development Screening Tool II (DDST-II). The children’s global developmental profile was calculated according to the established protocols of DDST-II, which are based on four important domains of development: personal and social behaviour, language, gross motor adaptive skills and fine motor adaptive skills. A pretested questionnaire was used to collect data on socio-demographic and nutritional factors for assessing predictors of developmental delay, which were analysed using a multivariate logistic regression model. Results Out of 177 children with severe acute malnutrition, 69 (38.9%) had normal global development and 108 (61.1%) had delayed global development. Significant associations were found between global developmental delay and younger children (6–24 months vs. 25–59 months; AOR = 4.53, 95% CI: 1.56–13.10, p < 0.01), children who were not exclusively breastfed (AOR = 3.07, 95% CI: 1.24–7.56, p = 0.01), and a history of contact with a tuberculosis smear-positive adult (AOR = 2.67, 95% CI: 1.30–5.49, p < 0.01). Conclusion About two thirds of the study participants showed delayed or unstable global development. Thus, according to DDST-II-established protocols, there is a high prevalence of suspected developmental delay among children under the age of five years with uncomplicated severe acute malnutrition in rural areas of Pakistan. Children in their first 2 years of life were at particularly high risk due to insufficient breastfeeding. This emphasizes the need to provide adequate infrastructure and information to parents for the prevention of developmental delay in remote areas.

scholarly journals ASSESSMENT OF NUTRITIONAL STATUS AND ITS DETERMINANTS AMONG CHILDREN IN AGE GROUP OF 1-5 YEARS IN A TRIBAL POPULATION OF COIMBATORE DISTRICT-A CROSS SECTIONAL STUDY

2020 ◽  
pp. 51-54
Author(s):  
T. Pravin ◽  
P.K. Govindarajan ◽  
A. John William Felix
Keyword(s):  
Nutritional Status ◽  
Maternal Education ◽  
Cross Sectional Study ◽  
Age Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Under Five ◽  
Under Five Children ◽  
Malnourished Children ◽  
Coimbatore District

Background: Under-five children are more vulnerable to malnutrition especially in rural areas resulting in more morbidity and mortality among them. The present study is aimed to assess the prevalence of malnutrition among children of 1-5 years of age in tribal hamlets of Valparai block, Coimbatore district in Tamil Nadu. Methods: A community-based, cross-sectional study was conducted among 95 children in the age group of 1-5 years during December-January 2020. Anthropometric measurements were taken. The indicators of nutritional status of children like stunting, underweight, and wasting were expressed using WHO growth standards. Results: The overall prevalence of malnutrition in our study was 31.6%. Among the 30 (31.6%) malnourished children, 40% were underweight, and 6.67% were severely underweight. 40% were stunted, of which 13.3% were severely stunted. Wasting was present in 23.3% of malnourished children. Severe wasting was not seen. Socio-demographic factors including the type of house, maternal education, BMI of the mother, age of mother at childbirth and place of delivery had significant association with malnutrition among under-five tribal children. Conclusions: Malnutrition poses a serious threat to under-five children. Though many known risk factors of malnutrition have been studied, understanding the local factors linked with malnutrition is so crucial while planning information, education, and communication programs in this area.

scholarly journals A cross-sectional study to assess the socio-demographic and morbidity profile among under-five children in a resettlement colony of Bihar

2021 ◽  
Vol 8 (3) ◽  
pp. 1295
Author(s):  
Navin Kumar ◽  
Ravi Ranjan Jha ◽  
Animesh Gupta
Keyword(s):  
Rural Areas ◽  
Cross Sectional Study ◽  
Special Focus ◽  
Sectional Study ◽  
Cross Sectional ◽  
Under Five ◽  
Under Five Children ◽  
Number Of Children ◽  
The World ◽  
Female Children

Background: The development of our society and the world largely depends on the health of the children in their first five years. These first five years lay down the foundation of their future mental and physical health. India has the largest number of children in the world. India also contributes to more than 20% of the child deaths in the world. children who are born in rural areas, poor household or illiterate families, are at major risk of dying before turning six years of age. Aim was to assess the health risk profile of under-five children and to find out its relation with socio-demographic, nutritional, cultural health care practices and other factors.Methods: This was a community based cross-sectional study, carried out from January, 2019 till July, 2019 in a resettlement colony of Rohtas district, Sasaram, Bihar. The study population comprised of all the under-five children. The study tools used for data collection included a semi-structured proforma and clinical anthropometric examination.Results: When presence of morbidity was seen among male and female children, it was more (71%) in males as compared to 58% in female children. The difference in the two groups was found to be statistically significant. (p=0.05). Respiratory system was most commonly involved (68.4%).Conclusions: There is high proportion of under nutrition and other morbidities among under five children in our country. Special focus needs to be put in resettlement colonies, as these residential colonies remain neglected.

scholarly journals Comparative analysis of developmental profile between normal and severe acute malnourished under-five children in Pakistan: a multicentre cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e048644
Author(s):  
Javeria Saleem ◽  
Rubeena Zakar ◽  
Faisal Mushtaq ◽  
Gul Mehar Javaid Bukhari ◽  
Florian Fischer
Keyword(s):  
Risk Factors ◽  
Developmental Delay ◽  
Motor Development ◽  
Significant Risk ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Developmental Profile ◽  
Cross Sectional ◽  
Under Five ◽  
Gross Motor Development

ObjectivesThis study aims to compare the developmental profile of severe acute malnourished (SAM) and normal under-five children and to find sociodemographic determinants accountable for their developmental disabilities.SettingWe conducted a multi-centre cross-sectional study in three basic health units and one rural health centre in Pakistan.Participants200 children (SAM and healthy) aged 6–59 months.Primary and secondary measuresWe screened for nutritional status and clinical complications. Children underwent for developmental assessment by Denver Development Screening Tool II. A pretested structured questionnaire on sociodemographic characteristics and nutrition was used for collecting data about determinants of developmental delay.ResultsWe observed statistically significant differences in anthropometric measurements among SAM compared with normal nourished in weight, height, mid-upper arm circumference and weight-for-height z-scores. SAM serves as a significant risk factors (p<0.001) for delayed personal or social development (69% vs 11%; OR (95% CI)=18.01 (8.45 to 38.37)), delayed fine motor development (39% vs 8%; OR (95% CI)=7.35 (3.22 to 16.81)), delayed language development (32% vs 8%; OR (95% CI)=5.41 (2.35 to 12.48)), delayed gross motor development (34% vs 10%; OR (95% CI)=4.64 (2.14 to 10.05)) and delayed global development (66% vs 20%; OR (95% CI)=7.77 (4.09 to 14.74)). Applying logistic regression, personal or social development (p<0.001) and language development (p<0.05), under-five siblings was a risk factor, while among gross motor development, mother’s educational status (p<0.05) was a significant risk factor for developmental delay.ConclusionsOur analysis indicates that children with malnutrition have a high frequency of developmental delays. Missing maternal education and a higher number of under-five siblings are also potential risk factors for developmental delay.

scholarly journals Impact of Community-Led Total Sanitation and Hygiene on Prevalence of Diarrheal Disease and Associated Factors among Under-Five Children: A Comparative Cross-Sectional Study in Selected Woredas of Gamo Gofa Zone, Southern Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Agune Ashole Alto ◽  
Wanzahun Godana ◽  
Genet Gedamu
Keyword(s):  
Drinking Water ◽  
Diarrheal Disease ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Under Five ◽  
Under Five Children ◽  
Sanitation And Hygiene ◽  
The Impact ◽  
Gamo Gofa

Background. Diarrheal diseases are still one of the major causes of morbidity in under-five children in sub-Saharan Africa. In Ethiopia, diarrhea is responsible for 9% of all deaths and is the major cause of under-five mortality. Objective. To assess the impact of community-led total sanitation and hygiene on the prevalence of diarrheal disease and factors associated among under-five children in Gamo Gofa Zone. Methods. Community-based comparative cross-sectional study design was used to compare the impact of community-led total sanitation and hygiene intervention on under-five diarrheal disease. Multistage sampling method was employed. The data were collected by using pretested structured questionnaires. Data quality was ensured by daily supervision completeness and consistency. The data were coded, entered, and cleaned by using Epi Info version 7 and were analyzed by using SPSS version 20. Bivariate and multivariable analyses were carried out by using binary logistic regression. Significance was declared by using p value of <0.05 and AOR with 95% confidence intervals. Results. The response rate of this study was 93.3%. The overall diarrhea prevalence was 27.5% (CI = (24.06, 30.97)) which was 18.9% (CI = (14.94, 23.2)) in implemented and 36.2%. (CI = (30.41, 41.59)) in nonimplemented woredas. Children whose age was between 12 and 23 months (AOR = 1.6) and greater than 24 months (AOR = 5), availability of handwashing facilities (AOR = 4), disposal of waste in open field (AOR = 9.7), unimproved source of drinking water (AOR = 6.5), using only water for handwashing (AOR = 6), children who started complementary feeding less than 6 months (AOR = 5.6) and greater than 6 months (AOR = 5.2), and utensils used to feed children such as bottle (AOR = 3.9) were the factors positively associated with diarrhea. Conclusion. The overall prevalence of under-five diarrhea was 27.5%. The prevalence was low in CLTSH woredas as compared with non-CLTSH woredas. The study showed that handwashing facility, using only water for handwashing, open refuse disposal, and unimproved source of drinking water among under-five had a statistically significant association with diarrhea occurrence in CLTSH nonimplemented areas. Integrated efforts are needed from the Ministry of Health together with the WASH Project in improving drinking water, handwashing facilities, and solid waste disposal practices.

scholarly journals Characteristics of Confidence and Preparedness in Paramedics in Metropolitan, Regional, and Rural Australia to Manage Mental-Health-Related Presentations: A Cross-Sectional Study

2021 ◽  
Vol 18 (4) ◽  
pp. 1882
Author(s):  
Kate Emond ◽  
Melanie Bish ◽  
Michael Savic ◽  
Dan I. Lubman ◽  
Terence McCann ◽  
...  
Keyword(s):  
Mental Health ◽  
Rural Areas ◽  
Cross Sectional Study ◽  
Categorical Variables ◽  
Considerable Proportion ◽  
Sectional Study ◽  
Cross Sectional ◽  
Health Related ◽  
Manage Mental ◽  
Manage Mental Health

Mental-health-related presentations account for a considerable proportion of the paramedic’s workload in prehospital care. This cross-sectional study aimed to examine the perceived confidence and preparedness of paramedics in Australian metropolitan and rural areas to manage mental-health-related presentations. Overall, 1140 paramedics were surveyed. Pearson chi-square and Fisher exact tests were used to compare categorical variables by sex and location of practice; continuous variables were compared using the non-parametric Mann–Whitney and Kruskal–Wallis tests. Perceived confidence and preparedness were each modelled in multivariable ordinal regressions. Female paramedics were younger with higher qualifications but were less experienced than their male counterparts. Compared to paramedics working in metropolitan regions, those working in rural and regional areas were generally older with fewer qualifications and were significantly less confident and less prepared to manage mental health presentations (p = 0.001). Compared to male paramedics, females were less confident (p = 0.003), although equally prepared (p = 0.1) to manage mental health presentations. These results suggest that higher qualifications from the tertiary sector may not be adequately preparing paramedics to manage mental health presentations, which signifies a disparity between education provided and workforce preparedness. Further work is required to address the education and training requirements of paramedics in regional and rural areas to increase confidence and preparedness in managing mental health presentations.

scholarly journals Factors Influencing HIV Drug Resistance among Pregnant Women in Luanda, Angola: Findings from a Cross-Sectional Study

2021 ◽  
Vol 6 (1) ◽  
pp. 29
Author(s):  
Cruz S. Sebastião ◽  
Joana Morais ◽  
Miguel Brito
Keyword(s):  
Drug Resistance ◽  
Pregnant Women ◽  
Rural Areas ◽  
Cross Sectional Study ◽  
Drug Resistant ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hiv Drug Resistance ◽  
Hiv 1 ◽  
High Educational

The increase in HIV infection and drug-resistant strains is an important public health concern, especially in resource-limited settings. However, the identification of factors related to the propagation of infectious diseases represents a crucial target offering an opportunity to reduce health care costs as well as deepening the focus on preventing infection in high-risk groups. In this study, we investigate the factors related to drug resistance among HIV-infected pregnant women in Luanda, the capital city of Angola. This was a part of a cross-sectional study conducted with 42 HIV-positive pregnant women. A blood sample was collected, and HIV-1 genotyping was carried out using an in-house method. Multivariate analyses were performed to determine the interaction between sociodemographic characteristics and drug resistance. HIV drug resistance was detected in 44.1% of the studied population. High probabilities of drug resistance were observed for HIV-infected pregnant women living in rural areas (AOR: 2.73; 95% CI: 0.50–14.9) with high educational level (AOR: 6.27; 95% CI: 0.77–51.2) and comorbidities (AOR: 5.47; 95% CI: 0.28–106) and infected with a HIV-1 non-B subtype other than subtype C (AOR: 1.60; 95% CI: 0.25–10.3). The present study reports high HIV drug resistance. Furthermore, older-age, rural areas, high educational levels, unemployed status, having comorbidities, and HIV-1 subtypes were factors related to drug resistance. These factors impact on drug susceptibility and need to be urgently addressed in order to promote health education campaigns able to prevent the spread of drug-resistant HIV strains in Angola.

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