scholarly journals Association of Parental Height With Offspring Stunting in 14 Low- and Middle-Income Countries

2021 ◽  
Vol 8 ◽  
Author(s):  
Han Wu ◽  
Chuanwei Ma ◽  
Liu Yang ◽  
Bo Xi
Keyword(s):  
Survey Design ◽  
Demographic And Health Surveys ◽  
Maternal Height ◽  
Complex Survey ◽  
Middle Income ◽  
Under Five ◽  
Middle Income Countries ◽  
Parental Height ◽  
Complex Survey Design ◽  
Low And Middle Income

Background: Maternal height has been confirmed to be associated with offspring stunting in low- and middle-income countries (LMICs), but only limited studies have examined the paternal-offspring association, and few studies have examined the joint effect of maternal and paternal height on stunting.Objective: To investigate the association between parental height and stunting of children aged under five in LMICs.Methods: We obtained data from the Demographic and Health Surveys (DHS) conducted in 14 LMICs from 2006 to 2016. The association between maternal and paternal height and height-for-age z score (HAZ) of children aged under five was analyzed using a linear regression model in consideration of complex survey design, and regression coefficients (β) with 95% confidence intervals (CIs) were reported. Then, the association between maternal and paternal height quintile and child stunting was analyzed using a modified Poisson regression approach with robust error variance in consideration of complex survey design with adjustment for covariates. The effect estimates were expressed as relative risks (RRs) with 95% CIs.Results: A total of 50,372 singleton children were included and the weighted prevalence of stunting was 34.5%. Both maternal height and paternal height were associated with child HAZ (β = 0.047; 95% CI, 0.043, 0.050; and β = 0.022; 95% CI, 0.018, 0.025, respectively). Compared with those born to the tallest mothers and fathers, children from the shortest mothers and the shortest fathers had higher risks of stunting (adjusted RR = 1.89; 95% CI, 1.78, 2.01; adjusted RR = 1.56; 95% CI, 1.47, 1.65, respectively). The mother-offspring associations are substantively larger than the father-offspring associations for each corresponding height quintile. Children from the shortest parents had the highest risk of stunting compared with children from the tallest parents (adjusted RR = 3.23; 95% CI, 2.83, 3.68).Conclusions: Offspring born to short parents are at increased risk of stunting in LMICs, and this intergenerational effect is partly driven by maternal intrauterine influence. This suggests the importance of improving the nutritional status of children and adults in LMICs, especially female caregivers.

scholarly journals Exploring the socio-economic determinants of educational inequalities in diarrhoea among under-five children in low- and middle-income countries: a Fairlie decomposition analysis

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Adeniyi Francis Fagbamigbe ◽  
Olukemi Grace Adebola ◽  
Natisha Dukhi ◽  
Omon Stellamaris Fagbamigbe ◽  
Olalekan A. Uthman
Keyword(s):  
Risk Factors ◽  
Household Wealth ◽  
Risk Difference ◽  
Demographic And Health Surveys ◽  
Educational Inequalities ◽  
Middle Income ◽  
Under Five ◽  
Under Five Children ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Background What explains the underlying causes of educational inequalities in diarrhoea among under-five children in low- and middle-income countries (LMIC) is poorly exploited, operationalized, studied and understood. This paper aims to assess the magnitude of educational-related inequalities in the development of diarrhoea and decompose risk factors that contribute to these inequalities among under-five children (U5C) in LMIC. Methods Secondary data of 796,150 U5C from 63,378 neighbourhoods in 57 LMIC was pooled from the Demographic and Health Surveys (DHS) conducted between 2010 and 2019. The main determinate variable in this decomposition study was mothers’ literacy levels. Descriptive and inferential statistics comprising of bivariable analysis and binary logistic multivariable Fairlie decomposition techniques were employed at p = 0.05. Results Of the 57 countries, we found a statistically significant pro-illiterate odds ratio in 6 countries, 14 showed pro-literate inequality while the remaining 37 countries had no statistically significant educational-related inequality. The countries with pro-illiterate inequalities are Burundi (OR = 1.11; 95% CI: 1.01–1.21), Cameroon (OR = 1.84; 95% CI: 1.66–2.05), Egypt (OR = 1.26; 95% CI: 1.12–1.43), Ghana (OR = 1.24; 95% CI: 1.06–1.47), Nigeria (OR = 1.80; 95% CI: 1.68–1.93), and Togo (OR = 1.21; 95% CI: 1.06–1.38). Although there are variations in factors that contribute to pro-illiterate inequality across the 6 countries, the overall largest contributors to the inequality are household wealth status, maternal age, neighbourhood SES, birth order, toilet type, birth interval and place of residence. The widest pro-illiterate risk difference (RD) was in Cameroon (118.44/1000) while the pro-literate risk difference was widest in Albania (− 61.90/1000). Conclusions The study identified educational inequalities in the prevalence of diarrhoea in children with wide variations in magnitude and contributions of the risk factors to pro-illiterate inequalities. This suggests that diarrhoea prevention strategies is a must in the pro-illiterate inequality countries and should be extended to educated mothers as well, especially in the pro-educated countries. There is a need for further studies to examine the contributions of structural and compositional factors associated with pro-educated inequalities in the prevalence of diarrhoea among U5C in LMIC.

scholarly journals Estimating the Double Burden of Malnutrition among 595,975 Children in 65 Low- and Middle-Income Countries: A Meta-Analysis of Demographic and Health Surveys

2019 ◽  
Vol 16 (16) ◽  
pp. 2886 ◽  
Author(s):  
Blessing J. Akombi ◽  
Stanley Chitekwe ◽  
Berhe W. Sahle ◽  
Andre M.N. Renzaho
Keyword(s):  
Health Surveys ◽  
Meta Analysis ◽  
Demographic And Health Surveys ◽  
Double Burden ◽  
Middle Income ◽  
Children Under Five ◽  
Under Five ◽  
Middle Income Countries ◽  
Double Burden Of Malnutrition ◽  
Low And Middle Income

Introduction: Given the changing global nutrition landscape, the double burden of malnutrition is a major public health challenge in many developing countries. The main aim of this study is to estimate the double burden of malnutrition among children in low- and middle-income countries (LMICs). Methods: This study used cross-sectional data from Demographic and Health Surveys (2001–2016). A meta-analysis was conducted to estimate the prevalence of malnutrition indicators in 595,975 children under five years from 65 LMICs. Significant heterogeneity was detected among the various surveys (I2 >50%), hence a random-effect model was used. Sensitivity analysis was also performed, to examine the effects of outliers. Results: The pooled estimate for stunting, wasting, underweight, and overweight/obesity was 29.0%, 7.5%, 15.5%, and 5.3% respectively. Countries with the highest coexistence of undernutrition and overweight/obesity were: South Africa (stunting 27.4% (95% CI: 25.1, 29.8); overweight/obesity 13.3% (95% CI: 11.5, 15.2)), Sao Tome and Principe (stunting 29.0% (95% CI: 26.8, 31.4); overweight/obesity 10.5% (95% CI: 9.0, 12.1)), Swaziland (stunting 28.9% (95% CI: 27.3, 30.6); overweight/obesity 10.8% (95% CI: 9.7, 12.0)), Comoros (stunting 30.0% (95% CI: 28.3, 31.8); overweight/obesity 9.3% (95% CI: 8.3, 10.5)), and Equatorial Guinea (stunting 25.9% (95% CI: 23.4, 28.7); overweight/obesity 9.7% (95% CI: 8.0, 11.6)). Conclusions: There is an urgent need to strengthen existing policies on child malnutrition to integrate and scale up opportunities for innovative approaches which address the double burden of malnutrition in children under five years in LMICs.

scholarly journals Hierarchical disentanglement of contextual from compositional risk factors of diarrhoea among under-five children in low- and middle-income countries

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Adeniyi Francis Fagbamigbe ◽  
A. Olalekan Uthman ◽  
Latifat Ibisomi
Keyword(s):  
Risk Factors ◽  
National Level ◽  
Cross Sectional ◽  
Middle Income ◽  
Contextual Risk ◽  
Under Five ◽  
Factors Associated ◽  
Under Five Children ◽  
Middle Income Countries ◽  
Low And Middle Income

AbstractSeveral studies have documented the burden and risk factors associated with diarrhoea in low and middle-income countries (LMIC). To the best of our knowledge, the contextual and compositional factors associated with diarrhoea across LMIC were poorly operationalized, explored and understood in these studies. We investigated multilevel risk factors associated with diarrhoea among under-five children in LMIC. We analysed diarrhoea-related information of 796,150 under-five children (Level 1) nested within 63,378 neighbourhoods (Level 2) from 57 LMIC (Level 3) using the latest data from cross-sectional and nationally representative Demographic Health Survey conducted between 2010 and 2018. We used multivariable hierarchical Bayesian logistic regression models for data analysis. The overall prevalence of diarrhoea was 14.4% (95% confidence interval 14.2–14.7) ranging from 3.8% in Armenia to 31.4% in Yemen. The odds of diarrhoea was highest among male children, infants, having small birth weights, households in poorer wealth quintiles, children whose mothers had only primary education, and children who had no access to media. Children from neighbourhoods with high illiteracy [adjusted odds ratio (aOR) = 1.07, 95% credible interval (CrI) 1.04–1.10] rates were more likely to have diarrhoea. At the country-level, the odds of diarrhoea nearly doubled (aOR = 1.88, 95% CrI 1.23–2.83) and tripled (aOR = 2.66, 95% CrI 1.65–3.89) among children from countries with middle and lowest human development index respectively. Diarrhoea remains a major health challenge among under-five children in most LMIC. We identified diverse individual-level, community-level and national-level factors associated with the development of diarrhoea among under-five children in these countries and disentangled the associated contextual risk factors from the compositional risk factors. Our findings underscore the need to revitalize existing policies on child and maternal health and implement interventions to prevent diarrhoea at the individual-, community- and societal-levels. The current study showed how the drive to the attainment of SDGs 1, 2, 4, 6 and 10 will enhance the attainment of SDG 3.

scholarly journals Association between household air pollution and child mortality in Myanmar using a multilevel mixed-effects Poisson regression with robust variance

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Juwel Rana ◽  
Rakibul M. Islam ◽  
Md Nuruzzaman Khan ◽  
Razia Aliani ◽  
Youssef Oulhote
Keyword(s):  
Air Pollution ◽  
Child Mortality ◽  
Survey Design ◽  
Household Air Pollution ◽  
P Value ◽  
Middle Income ◽  
Under Five ◽  
Middle Income Countries ◽  
Relative Risks ◽  
Clean Cookstoves

AbstractHousehold air pollution (HAP) from solid fuel use (SFU) for cooking is a major public health threat for women and children in low and middle-income countries. This study investigated the associations between HAP and neonatal, infant, and under-five child mortality in Myanmar. The study consisted of 3249 sample of under-five children in the households from the first Myanmar Demographic and Health Survey 2016. Fuel types and levels of exposure to SFU (no, moderate and high) were proxies for HAP. We estimated covariate-adjusted relative risks (aRR) of neonatal, infant, and under-five child mortality with 95% confidence intervals, accounting for the survey design. The prevalence of SFU was 79.0%. The neonatal, infant, and under-five child mortality rates were 26, 45, and 49 per 1000 live births, respectively. The risks of infant (aRR 2.02; 95% CI 1.01–4.05; p-value = 0.048) and under-five mortality (aRR 2.16; 95% CI 1.07–4.36; p-value = 0.031), but not neonatal mortality, were higher among children from households with SFU compared to children from households using clean fuel. Likewise, children highly exposed to HAP had higher risks of mortality than unexposed children. HAP increases the risks of infant and under-five child mortality in Myanmar, which could be reduced by increasing access to clean cookstoves and fuels.

scholarly journals Finding Children with High Risk of Non-Vaccination in 92 Low- and Middle-Income Countries: A Decision Tree Approach

Vaccines ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 646
Author(s):  
Thiago M. Santos ◽  
Bianca O. Cata-Preta ◽  
Cesar G. Victora ◽  
Aluisio J. D. Barros
Keyword(s):  
High Risk ◽  
Decision Tree ◽  
Immunization Coverage ◽  
Risk Groups ◽  
Demographic And Health Surveys ◽  
Middle Income ◽  
Agenda 2030 ◽  
Middle Income Countries ◽  
Tree Approach ◽  
Low And Middle Income

Reducing vaccination inequalities is a key goal of the Immunization Agenda 2030. Our main objective was to identify high-risk groups of children who received no vaccines (zero-dose children). A decision tree approach was used for 92 low- and middle-income countries using data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys, allowing the identification of groups of children aged 12–23 months at high risk of being zero dose (no doses of the four basic vaccines—BCG, polio, DPT and measles). Three high-risk groups were identified in the analysis combining all countries. The group with the highest zero-dose prevalence (42%) included 4% of all children, but almost one in every four zero-dose children in the sample. It included children whose mothers did not receive the tetanus vaccine during and before the pregnancy, who had no antenatal care visits and who did not deliver in a health facility. Separate analyses by country presented similar results. Children who have been missed by vaccination services were also left out by other primary health care interventions, especially those related to antenatal and delivery care. There is an opportunity for better integration among services in order to achieve high and equitable immunization coverage.

scholarly journals Co-morbid anaemia and stunting among children of pre-school age in low- and middle-income countries: a syndemic

2018 ◽  
Vol 22 (1) ◽  
pp. 35-43 ◽  
Author(s):  
Thach Duc Tran ◽  
Beverley-Ann Biggs ◽  
Sara Holton ◽  
Hau Thi Minh Nguyen ◽  
Sarah Hanieh ◽  
...  
Keyword(s):  
Rural Areas ◽  
Secondary Analysis ◽  
Logistic Models ◽  
Demographic And Health Surveys ◽  
Healthy Children ◽  
Middle Income ◽  
Disadvantaged Children ◽  
Middle Income Countries ◽  
Co Morbidity ◽  
Low And Middle Income

AbstractObjectiveTo determine the prevalence of co-morbidity of two important global health challenges, anaemia and stunting, among children aged 6–59 months in low- and middle-income countries.DesignSecondary analysis of data from Demographic and Health Surveys (DHS) conducted 2005–2015. Child stunting and anaemia were defined using current WHO classifications. Sociodemographic characteristics of children with anaemia, stunting and co-morbidity of these conditions were compared with those of ‘healthy’ children in the sample (children who were not stunted and not anaemic) using multiple logistic models.SettingLow- and middle-income countries.SubjectsChildren aged 6–59 months.ResultsData from 193 065 children from forty-three countries were included. The pooled proportion of co-morbid anaemia and stunting was 21·5 (95 % CI 21·2, 21·9) %, ranging from the lowest in Albania (2·6 %; 95 % CI 1·8, 3·7 %) to the highest in Yemen (43·3; 95 % CI 40·6, 46·1 %). Compared with the healthy group, children with co-morbidity were more likely to be living in rural areas, have mothers or main carers with lower educational levels and to live in poorer households. Inequality in children who had both anaemia and stunting was apparent in all countries.ConclusionsCo-morbid anaemia and stunting among young children is highly prevalent in low- and middle-income countries, especially among more disadvantaged children. It is suggested that they be considered under a syndemic framework, the Childhood Anaemia and Stunting (CHAS) Syndemic, which acknowledges the interacting nature of these diseases and the social and environmental factors that promote their negative interaction.

PP124 Health Technology Assessment And Feedback For Healthy Workplace Culture In Malaria Care In Low And Middle Income Countries

2018 ◽  
Vol 34 (S1) ◽  
pp. 114-114
Author(s):  
Patrick Okwen ◽  
Raphael Cheabum ◽  
Etienne Che ◽  
Joy Ngwemsi Mbunu ◽  
Miriam Nkangu
Keyword(s):  
Workplace Culture ◽  
Evidence Based ◽  
Middle Income ◽  
Mortality And Morbidity ◽  
Children Under Five ◽  
Under Five ◽  
Middle Income Countries ◽  
Percent Improvement ◽  
Evidence Based Care ◽  
Low And Middle Income

Introduction:Malaria is a leading cause of mortality and morbidity in children under five in low and middle income countries (LMICs). Management of malaria in children under five years of age is challenging. One challenge faced by clinical practice in LMICs is lack of evidence to guide practice. This challenge is further compounded by different training backgrounds of team members. In the management of malaria in Cameroon, conflicts usually arise between clinicians, lab technicians and pharmacists resulting in over diagnosis and treatment of malaria. The patient's view is usually not considered. This leads to over diagnosis and over prescriptions for malaria in children under five years of age.Methods:We used the Joanna Briggs Institute (JBI) approach of getting research into practice to organize stakeholder meetings, assess existing evidence in malaria care, develop evidence criteria for management based on levels of evidence, assess the gamut of care for malaria, provide feedback to clinicians and re-assess practice. We used the JBI practical application of clinical evidence system (PACES) and getting research into practice (GRiP) evidence implementation tools in the process to facilitate teamwork, collaboration on evidence and provide feedback.Results:A collaborative approach to assessments and feedback including all healthcare stakeholders significantly improved workplace culture of evidence-based care and staff-to-staff relationships as well as staff-to-patient relationships. Over a period of twelve months, we reported eighty-four percent fewer conflicts between staff and ninety-eight percent fewer conflicts between staff and patients. For malaria management, overall criteria showed a thirty-one percent improvement in compliance with best practice recommendations with evidence levels of Grade 1.Conclusions:The project demonstrated that local leadership and evidence-based care can significantly improve practice in resource limited settings.

Sign in / Sign up

Export Citation Format

Share Document