scholarly journals Association between Non-Typhoidal Salmonella Infection and Growth in Children under 5 Years of Age: Analyzing Data from the Global Enteric Multicenter Study

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 392
Author(s):  
Rina Das ◽  
Md. Ahshanul Haque ◽  
Mohammod Jobayer Chisti ◽  
Abu Sayed Golam Faruque ◽  
Tahmeed Ahmed
Keyword(s):  
Multicenter Study ◽  
Child Nutrition ◽  
Wealth Index ◽  
Asymptomatic Infection ◽  
Sub Saharan Africa ◽  
Outcome Variable ◽  
P Value ◽  
Severe Diarrhea ◽  
Number Of Children ◽  
Child Undernutrition

Non-typhoidal Salmonella (NTS) is one of the less focused on infections and is often associated with faulty child nutrition in the developing world. This study aimed to evaluate the association of NTS infection with growth faltering among children under the age of five. We analyzed data from 378 fecal NTS positive children with both moderate-to-severe diarrhea (MSD) and asymptomatic infection from the seven countries of South Asia and sub-Saharan Africa during enrolment and on day 60 follow up in the Global Enteric Multicenter Study (GEMS) for the period of December 2007 to March 2011. Children not associated with fecal NTS (n = 1134) were randomly selected from the same dataset (1:3 ratio) as a comparison group. The association between an explanatory variable and the outcome variable was longitudinally tested using generalized estimating equations (GEE), where the dependent variables were height-for-age (HAZ), weight-for-age (WAZ), and weight-for-height (WHZ) z-score, and the independent variable was the presence of fecal NTS. The GEE multivariable model identified a negative association between fecal NTS and WAZ (coefficient: −0.19; 95% CI (confidence interval): −0.33, −0.04, and p value = 0.010), WHZ (coef: −0.19; 95% CI: −0.34, −0.05, and p value = 0.007), and HAZ (coef: −0.13; 95% CI: −0.27, −0.01, and p value = 0.073) after adjusting for age, gender, diarrhea, breastfeeding status, mothers’ education, number of children under the age of five, household size by the number of people regularly sleep at the home, handwashing practice, source of drinking water, wealth index, presence of co-pathogens, comorbidity, and study sites. In the GEMS, where children were followed during 50–90 days of enrolment, the presence of fecal NTS harmed the child’s anthropometric outcomes. Minimizing potential exposure to NTS is needed to curb worsening child undernutrition.

Child Undernutrition in the States of India: An Analysis Based on Change in Composite Index of Anthropometric Failure from 2006 to 2016

2021 ◽  
pp. 097226612110103
Author(s):  
J. R. Jith ◽  
Rajshree Bedamatta
Keyword(s):  
Child Nutrition ◽  
Composite Index ◽  
Family Health ◽  
Wealth Index ◽  
Household Wealth ◽  
Population Projections ◽  
Indian Children ◽  
Indian States ◽  
Child Undernutrition ◽  
Low Weight

Stunting, wasting and underweight—the three traditional indicators of undernourishment among children—provide mutually non-exclusive categories of anthropometric failures: low height for age, low weight for height and low weight for age. Although these indicators are essential for designing specific clinical and child nutrition policy interventions, they fall short of estimating the prevalence of overall anthropometric failure, which provides a sense of the scale of the nutrition problem. This article estimates the alternative, more comprehensive measure Composite Index of Anthropometric Failure (CIAF) for Indian states, based on data from the National Family Health surveys of 2006 and 2016, for children under five years (Ch–U5). The CIAF-based undernutrition estimates show significantly high anthropometric failure levels among Indian children compared to only stunting, wasting and underweight. Based on population projections for Ch–U5, we also show that a sizeable number of states may have seen an increase in child undernutrition between 2006 and 2016. We also correlated CIAF with household wealth index scores and found a positive relationship with children facing no anthropometric failure.

scholarly journals Nontyphoidal Salmonella among Children under 5 Years Old in Sub-Saharan Africa and South Asia in the Global Enteric Multicenter Study

2021 ◽  
Author(s):  
Rina Das ◽  
Md. Ahshanul Haque ◽  
Mohammod Jobayer Chisti ◽  
Tahmeed Ahmed ◽  
Abu Syed Golam Faruque
Keyword(s):  
South Asia ◽  
Multicenter Study ◽  
Control Strategies ◽  
Sub Saharan Africa ◽  
Severe Diarrhea ◽  
Asymptomatic Children ◽  
Toilet Facility ◽  
Sub Saharan ◽  
And Control ◽  
Children Under 5

Factors associated with nontyphoidal Salmonella (NTS) infection have not been well characterized to date. We aimed to compare the associated factors among children under age 5 years with NTS infection in sub-Saharan Africa and South Asia. Data from children having moderate-to-severe diarrhea (MSD) and asymptomatic children with NTS isolated from fecal specimens were extracted from the Global Enteric Multicenter Study (GEMS), conducted from December 2007 to March 2011. Compared with NTS-negative children, NTS-associated MSD cases in South Asia were associated with the presence of goat in the house (adjusted odds ratio [aOR]: 2.15; 95% confidence interval [CI]: 1.25–3.70) and handwashing after handling an animal (aOR: 2.26; 95% CI: 1.36–3.74). In sub-Saharan Africa, children with NTS associated MSD had a greater association with stunting (1.21 95% CI: 1.01–1.45), longer duration of diarrhea (aOR: 1.25 95% CI: 1.19–1.31); presence of cow in house (aOR: 1.54 95% CI: 1.09–2.16), handwashing after handling animal (aOR: 2.41 95% CI: 1.74–3.33). Drinking tube well water (aOR: 0.54 95% CI: 0.32–0.91), availability of toilet facility (aOR: 0.58 95% CI: 0.53–0.65), and handwashing before eating (aOR: 0.76 95% CI: 0.57–1.00) and after defecation (aOR: 0.80 95% CI: 0.69, 0.94) were found to be protective. The differentials between children of both regions having fecal NTS are distinct and underscore the need for policymaking for preventive and control strategies targeting stunted children.

scholarly journals Characteristics of Salmonella recovered from stools of children enrolled in the Global Enteric Multicenter Study

2021 ◽  
Author(s):  
Irene N Kasumba ◽  
Caisey V Pulford ◽  
Blanca M Perez-Sepulveda ◽  
Sunil Sen ◽  
Nurulla Sayed ◽  
...  
Keyword(s):  
Salmonella Typhimurium ◽  
Multicenter Study ◽  
Antimicrobial Susceptibility ◽  
Sequence Data ◽  
Sub Saharan Africa ◽  
Whole Genome Sequence ◽  
Diffusion Method ◽  
Whole Genome ◽  
Disk Diffusion Method ◽  
Severe Diarrhea

Abstract Background The Global Enteric Multicenter Study (GEMS) determined the etiologic agents of moderate-to-severe diarrhea (MSD) in children under 5 years old in Africa and Asia. Here, we describe the prevalence and antimicrobial susceptibility of non-typhoidal Salmonella (NTS) serovars in GEMS and examine the phylogenetics of Salmonella Typhimurium ST313 isolates. Methods Salmonella isolated from children with MSD or diarrhea-free controls were identified by classical clinical microbiology and serotyped using antisera and/or whole genome sequence data. We evaluated antimicrobial susceptibility using the Kirby-Bauer disk diffusion method. Salmonella Typhimurium sequence types were determined using multi-locus sequence typing and whole genome sequencing was performed to assess the phylogeny of ST313. Results Out of 370 Salmonella-positive individuals, 190 (51.4%) were MSD cases and 180 (48.6%) were diarrhea-free controls. The most frequent Salmonella serovars identified were Salmonella Typhimurium, serogroup O:8 (C2-C3), serogroup O:6,7 (C1), Salmonella Paratyphi B Java and serogroup O:4 (B). The prevalence of NTS was low but similar across sites, regardless of age, and was similar amongst both cases and controls except in Kenya, where Salmonella Typhimurium was more commonly associated with cases than controls. Phylogenetic analysis showed that these Salmonella Typhimurium isolates, all ST313, were highly genetically related to isolates from controls. Generally, Salmonella isolates from Asia were resistant to ciprofloxacin and ceftriaxone but African isolates were susceptible to these antibiotics. Conclusion Our data confirms that NTS is prevalent, albeit at low levels, in Africa and South Asia. Our findings provide further evidence that multi-drug resistant Salmonella Typhimurium ST313 can be carried asymptomatically by humans in sub-Saharan Africa.

scholarly journals Pathogens associated with linear growth faltering in children with diarrhea and impact of antibiotic treatment: The Global Enteric Multicenter Study

2021 ◽  
Author(s):  
Dilruba Nasrin ◽  
William C Blackwelder ◽  
Halvor Sommerfelt ◽  
Yukun Wu ◽  
Tamer H Farag ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Multicenter Study ◽  
Linear Growth ◽  
Diarrheal Disease ◽  
Treatment Strategies ◽  
Sub Saharan Africa ◽  
Severe Diarrhea ◽  
Growth Faltering ◽  
The Impact

Abstract Background The association between childhood diarrheal disease and linear growth faltering in developing countries is well-described. However, the impact attributed to specific pathogens has not been elucidated, nor has the impact of recommended antibiotic treatment. Methods The Global Enteric Multicenter Study (GEMS) enrolled children seeking healthcare with moderate-to-severe diarrhea (MSD) at seven sites in sub-Saharan Africa and South Asia. At enrollment, we collected stool samples to identify enteropathogens. Length/height was measured at enrollment and follow-up, ~60 days later, to calculate change in length/height for age Z scores (ΔHAZ). The association of pathogens with ΔHAZ was tested by linear mixed effects regression models. Results Among 8,077 MSD cases analyzed, the proportion with stunting (HAZ<-1) increased from 59% at enrollment to 65% at follow-up (p<.0001). Pathogens significantly associated with linear growth decline were Cryptosporidium (p<0.001), typical enteropathogenic Escherichia coli (p=0.013), and untreated Shigella (p=0.009) among infants (0-11 months), and enterotoxigenic E. coli encoding heat stable toxin (p<0.001) and Cryptosporidium (p=0.03) among toddlers (12-23 months). Shigella-infected toddlers given antibiotics had improved linear growth (p=0.02). Conclusion Linear growth faltering among children aged 0-23 months with MSD is associated with specific pathogens and can be mitigated with targeted treatment strategies, as demonstrated for Shigella.

Malnutrition and Socio-economic Factors in HIV Infected and Uninfected Under 5 Children in Zambia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M N Ng'andu ◽  
G M Moonga ◽  
J B Banda
Keyword(s):  
Statistical Significance ◽  
Wealth Index ◽  
Sub Saharan Africa ◽  
P Value ◽  
Economic Factors ◽  
Under Five ◽  
Factors Associated ◽  
Under Five Children ◽  
Life Years ◽  
Socio Economic Factors

Abstract Malnutrition contributes to more than one third of all child deaths, although hardly listed as the direct cause. In sub-Saharan Africa, malnutrition accounts for about 2% of deaths and 3% of Disability adjusted life years (DALYs) among under-5 children. In Zambia, 35% of under-5 children are stunted, 4% wasted, 12% underweight and 5% overweight. Malnutrition and HIV interact in complex ways that increase vulnerability to and worsen each condition therefore we sought to determine factors associated with malnutrition among under 5 children in Zambia. Using Stata version 14.2, we extracted and analysed sample data of 159 children aged 0-59 months from the 2016 ZAMPHIA population-based survey, that used a two-stage cluster sampling design. We used Generalised Linear Models to measure socio-economic factors associated with malnutrition. P-value of less than 0.05 was set as level of statistical significance. Factors associated with malnutrition included gender, child's HIV status and wealth index which showed an association with stunting, wasting and being underweight. The 16 (10%) under-5 children living with HIV were significantly more affected by stunting (38% vs 33%), wasting (19% vs 11%) and underweight prevalence (38% vs 10%) than the remaining 143 who were HIV negative. Our sample prevalence was similar to national stunting (33% vs 35%) and underweight prevalence (13% vs 12%) but had three times higher wasting prevalence (12% vs 4%). A high prevalence of malnutrition was found in HIV positive compared to negative under 5 children, wealth index showing an association with malnutrition. Eliminating malnutrition is key to attaining SDG 3 which is to end preventable deaths of newborns and children under 5 years of age. Key messages All types of malnutrition had a higher prevalence in HIV infected than uninfected under five children in Zambia. Wealth index is a socio-economic factor that is associated to all types of malnutrition in under-five children in Zambia.

scholarly journals Estimating Yields of Household Fields in Rural Subsistence Farming Systems to Study Food Security in Burkina Faso

2020 ◽  
Vol 12 (11) ◽  
pp. 1717
Author(s):  
Isabel G. Karst ◽  
Isabel Mank ◽  
Issouf Traoré ◽  
Raissa Sorgho ◽  
Kim-Jana Stückemann ◽  
...  
Keyword(s):  
Climate Change ◽  
Food Security ◽  
Burkina Faso ◽  
Child Nutrition ◽  
Prediction Models ◽  
Smallholder Farmers ◽  
Management Strategies ◽  
Sub Saharan Africa ◽  
Household Level ◽  
Child Undernutrition

Climate change has an increasing impact on food security and child nutrition, particularly among rural smallholder farmers in sub-Saharan Africa. Their limited resources and rainfall dependent farming practices make them sensitive to climate change-related effects. Data and research linking yield, human health, and nutrition are scarce but can provide a basis for adaptation and risk management strategies. In support of studies on child undernutrition in Burkina Faso, this study analyzed the potential of remote sensing-based yield estimates at household level. Multi-temporal Sentinel-2 data from the growing season 2018 were used to model yield of household fields (median 1.4 hectares (ha), min 0.01 ha, max 12.6 ha) for the five most prominent crops in the Nouna Health and Demographic Surveillance (HDSS) area in Burkina Faso. Based on monthly metrics of vegetation indices (VIs) and in-situ harvest measurements from an extensive field survey, yield prediction models for different crops of high dietary importance (millet, sorghum, maize, and beans) were successfully generated producing R² between 0.4 and 0.54 (adj. R² between 0.32 and 0.5). The models were spatially applied and resulted in a yield estimation map at household level, enabling predictions of up to 2 months prior to harvest. The map links yield on a 10-m spatial resolution to households and consequently can display potential food insecurity. The results highlight the potential for satellite imagery to provide yield predictions of smallholder fields and are discussed in the context of health-related studies such as child undernutrition and food security in rural Africa under climate change.

scholarly journals Treatment Outcome Of Malaria And Associated Factors Among Adults Admitted In Arba Minch General Hospital 2015-2018, Southern Nation Nationality And People Region, Ethiopia

2020 ◽  
Author(s):  
Gesila Endashaw Yesera ◽  
Hussen Mekonnen Asfaw ◽  
Solomon Kassa Bekele ◽  
Negalegn e Getahun Dinegd
Keyword(s):  
General Hospital ◽  
Severe Malaria ◽  
Sub Saharan Africa ◽  
Prognostic Indicators ◽  
Outcome Variable ◽  
P Value ◽  
Statistical Association ◽  
Impaired Consciousness ◽  
Infected Female ◽  
Co Morbidity

Abstract Background: Malaria is a protozoan disease transmitted by the bite of infected female Anopheles mosquitoes. Progression to severe and fatal disease is largely but not entirely confined to Plasmodium falciparum infections. Despite remarkable progress in recent years, malaria remains a leading cause of sickness and death across much of sub-Saharan Africa. Malaria disproportionately impacts the rural poor, typically people who must walk for miles to seek treatment. Methods: Institution based retrospective cross-sectional study was conducted in Arba Minch General Hospital on February 2019. Data was collected from patient record whom admitted with severe malaria in the past 4 years from Sep. 2015 – September 2018. Data was entered to Epidata 3.1. And then exported to SPSS version 25 for analysis. Bivariate and multivariate logistic regression was computed to assess statistical association between the outcome variable and independent variables using Odds Ratio; significant of statistical association was tested using 95% confidence interval (CI) and p value (<0.05). Result: Out of 422 patients with severe malaria intended to be included in the study, 387 cases were actually involved with response rate of 91.7%. The mortality rate associated with severe malaria in the year between 2015-2018 at Arba Minch General Hospital was 5.7%. Co-morbidity, impaired consciousness and acidosis were significantly associated with mortality, at significant level of P <0.05. Conclusion: co-morbidity, impaired consciousness and Acidosis were found to be poor prognostic indicators for patients with severe malaria, so priority should be given for those patients who came with such manifestations.

scholarly journals Drivers of desire for more children among childbearing women in sub-Saharan Africa: implications for fertility control

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Ebenezer Kwesi Armah-Ansah ◽  
Eugene Budu ◽  
Edward Kwabena Ameyaw ◽  
...  
Keyword(s):  
Higher Education ◽  
Fertility Control ◽  
Sub Saharan Africa ◽  
Outcome Variable ◽  
Demographic And Health Surveys ◽  
Number Of Children ◽  
Ideal Number ◽  
Sub Saharan ◽  
Living Children ◽  
Childbearing Women

Abstract Background Despite the extensive research on fertility desires among women the world over, there is a relative dearth of literature on the desire for more children in sub-Saharan Africa (SSA). This study, therefore, examined the desire for more children and its predictors among childbearing women in SSA. Methods We pooled data from 32 sub-Saharan African countries’ Demographic and Health Surveys. A total of 232,784 married and cohabiting women with birth history, who had complete information on desire for more children made up the sample for the study. The outcome variable for the study was desire for more children. Multilevel logistic regression analysis was conducted. Results were presented using adjusted odds ratios (aOR), with their corresponding 95% confidence intervals (CI). Results The overall prevalence of the desire for more children was 64.95%, ranging from 34.9% in South Africa to 89.43% in Niger. Results of the individual level predictors showed that women aged 45–49 [AOR = 0.04, CI = 0.03–0.05], those with higher education [AOR = 0.80, CI = 0.74–0.87], those whose partners had higher education [AOR = 0.88; CI = 0.83–0.94], women with four or more births [AOR = 0.10, CI = 0.09–0.11], those who were using contraceptives [AOR = 0.68, CI = 0.66–0.70] and those who had four or more living children [AOR = 0.09 CI = 0.07–0.12] were less likely to desire for more children. On the other hand, the odds of desire for more children was high among women who considered six or more children as the ideal number of children [AOR = 16.74, CI = 16.06–17.45] and women who did not take decisions alone [AOR = 1.58, CI = 1.51–1.65]. With the contextual factors, the odds of desire for more children was high among women who lived in rural areas compared to urban areas [AOR = 1.07, CI = 1.04–1.13]. Conclusions This study found relatively high prevalence of women desiring more children. The factors associated with desire for more children are age, educational level, partners’ education, parity, current contraceptive use, ideal number of children, decision-making capacity, number of living children and place of residence. Specific public health interventions on fertility control and those aiming to design and/or strengthen existing fertility programs in SSA ought to critically consider these factors.

scholarly journals The risk to child nutrition during and after COVID-19 pandemic: what to expect and how to respond

2021 ◽  
pp. 1-18
Author(s):  
James Ntambara ◽  
Minjie Chu
Keyword(s):  
Nutrition Education ◽  
Child Nutrition ◽  
Food Distribution ◽  
Sub Saharan Africa ◽  
Cochrane Library ◽  
Strategic Responses ◽  
Financial Investment ◽  
Under Five ◽  
Child Undernutrition ◽  
Wide Range

Abstract Objective: This study aimed to address the key areas of concern for child nutrition, both during and after the COVID-19 pandemic, and proposes strategic responses to reduce child undernutrition in the short and long term. Design: A descriptive literature review was performed. The search of the literature was conducted through using electronic databases including PubMed, Web of science, google scholar, and Cochrane library. Setting: A wide range of published articles focused on child malnutrition were reviewed. Participants: The study was focused on children especially those under five years. Results: This study proposes strategic responses to reduce child undernutrition. These responses include strengthening access to community-based nutrition services that support the early detection and treatment of undernourished children and emergency food distribution, including fortified foods with vitamins and minerals, to vulnerable households, particularly those with children under five years. Moreover, counseling and promotion programs should be reinforced to revitalize community nutrition education in areas such as gestation, exclusive breastfeeding, and complementary feeding, and hygienic practices involving handwashing, proper sanitation, and other basic behavioral changes. Conclusions: The COVID-19 pandemic has affected many countries especially those in the regions of South Asia and sub-Saharan Africa in which there has been an ongoing burden of child undernutrition. However, malnutrition is preventable and can be eliminated through a multisectoral strategic approach. The effective execution of a multisectoral approach toward preventing childhood malnutrition will require not only a financial investment but also the collective efforts from different ministries of the governments, UN-affiliated agencies, and nongovernmental organizations.

scholarly journals Maternal healthcare utilsation and complete childhood vaccination in sub-Saharan Africa: a cross-sectional study of 29 nationally representative surveys

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e045992
Author(s):  
Eugene Budu ◽  
Bright Opoku Ahinkorah ◽  
Richard Gyan Aboagye ◽  
Ebenezer Kwesi Armah-Ansah ◽  
Abdul-Aziz Seidu ◽  
...  
Keyword(s):  
Healthcare Utilisation ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Childhood Vaccination ◽  
Outcome Variable ◽  
Service Utilisation ◽  
Sectional Study ◽  
Maternal Healthcare ◽  
Cross Sectional ◽  
Sub Saharan

ObjectiveThe objective of the study was to examine the association between maternal healthcare utilisation and complete childhood vaccination in sub-Saharan Africa.DesignOur study was a cross-sectional study that used pooled data from 29 countries in sub-Saharan Africa.ParticipantsA total of 60 964 mothers of children aged 11–23 months were included in the study.Outcome variablesThe main outcome variable was complete childhood vaccination. The explanatory variables were number of antenatal care (ANC) visits, assistance during delivery and postnatal care (PNC).ResultsThe average prevalence of complete childhood vaccination was 85.6%, ranging from 67.0% in Ethiopia to 98.5% in Namibia. Our adjusted model, children whose mothers had a maximum of three ANC visits were 56% less likely to have complete vaccination, compared with those who had at least four ANC visits (adjusted OR (aOR)=0.44, 95% CI 0.42 to 0.46). Children whose mothers were assisted by traditional birth attendant/other (aOR=0.43, 95% CI 0.41 to 0.56) had lower odds of complete vaccination. The odds of complete vaccination were lower among children whose mothers did not attend PNC clinics (aOR=0.26, 95% CI 0.24 to 0.29) as against those whose mothers attended.ConclusionThe study found significant variations in complete childhood vaccination across countries in sub-Saharan Africa. Maternal healthcare utilisation (ANC visits, skilled birth delivery, PNC attendance) had significant association with complete childhood vaccination. These findings suggest that programmes, interventions and strategies aimed at improving vaccination should incorporate interventions that can enhance maternal healthcare utilisation. Such interventions can include education and sensitisation, reducing cost of maternal healthcare and encouraging male involvement in maternal healthcare service utilisation.

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