scholarly journals Epidemiological profile, spatial distribution, and syphilis time series: a cross-sectional study in a Brazilian municipality

2021 ◽  
Vol 15 (10) ◽  
pp. 1462-1470
Author(s):  
Carolina Matteussi Lino ◽  
Maria da Luz Rosário de Sousa ◽  
Marília Jesus Batista
Keyword(s):  
Time Series ◽  
Spatial Distribution ◽  
Congenital Syphilis ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Incidence Rates ◽  
P Value ◽  
Cross Sectional ◽  
Definition Of ◽  
Epidemiological Profile

Introduction: Syphilis is an infectious disease of bacterial nature, acting on organs and/or systems. The increase in the number of cases worldwide has been of concern and the infection has been considered a public health problem. Given this scenario, this study evaluates the epidemiological profile, spatial distribution, and time series of the cases of acquired syphilis, syphilis in pregnant women, and congenital syphilis in a Brazilian municipality. Methodology: This is a cross-sectional and descriptive study with second data of the notified cases. For the definition of the population universe, an initial survey of syphilis cases notified in the municipality was carried out, from January 1, 2013 to December 31, 2017. Results: There was an increase in the notified cases and the detection/incidence rates of syphilis. The epidemiological profile was composed of men (76.7%), adults (24.8%), white (60.4%), with eight or more years of study (53.7%) in addition to pregnant adolescents (36.7%) and young adults (26.0%), with inadequate treatment and untreated partners. A concentration of cases was identified in the regions with the lowest monthly income and the time series showed an increasing trend (p-value < 0.001). Conclusions: Health actions should continue to improve access to diagnosis and to notification, focusing on treatment, cure and health education actions to control and prevent new cases.

Diagnostic and Therapeutic Knowledge and Practices in the Management of Congenital Syphilis by Pediatricians in Public Maternity Hospitals in Brazil

2017 ◽  
Vol 49 (2) ◽  
pp. 322-342 ◽  
Author(s):  
Raquel Rodrigues dos Santos ◽  
Roberta Pereira Niquini ◽  
Francisco Inácio Bastos ◽  
Rosa Maria Soares Madeira Domingues
Keyword(s):  
Congenital Syphilis ◽  
Cross Sectional Study ◽  
Case Definition ◽  
Educational Work ◽  
Correct Treatment ◽  
Cross Sectional ◽  
Treatment Protocols ◽  
Missed Opportunities ◽  
Maternity Hospitals ◽  
Definition Of

The study aimed to assess conformity with Brazil’s standard protocol for diagnostic and therapeutic practices in the management of congenital syphilis by pediatricians in public maternity hospitals. A cross-sectional study was conducted in 2015 with 41 pediatricians working in all the public maternity hospitals in Teresina, the capital of Piauí State, Northeast Brazil, through self-completed questionnaires. The study assessed the conformity of knowledge and practices according to the Brazilian Ministry of Health protocols. The study has made evident low access to training courses (54%) and insufficient knowledge of the case definition of congenital syphilis (42%) and rapid tests for syphilis (39%). Flaws were observed in the diagnostic workup and treatment of newborns. Requesting VDRL (88%) and correct treatment of neurosyphilis (88%) were the practices that showed the highest conformity with standard protocols. Low conformity with protocols leads to missed opportunities for identifying and adequately treating congenital syphilis. Based on the barriers identified in the study, better access to diagnostic and treatment protocols, improved recording on prenatal cards and hospital patient charts, availability of tests and medicines, and educational work with pregnant women should be urgently implemented, aiming to reverse the currently inadequate management of congenital syphilis and to curb its spread.

scholarly journals Assessment on awareness towards preventive measures of COVID-19 in Sheka, Southwestern Ethiopia: Community based cross-sectional Study

2021 ◽  
Author(s):  
Assaye Belay Gelaw ◽  
Solomon Abebaw Andargie
Keyword(s):  
Public Health Problem ◽  
Cross Sectional Study ◽  
P Value ◽  
Critical Element ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Southwestern Ethiopia ◽  
Prevention Methods ◽  
And Control

Abstract Background: The coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and it is the most important of public health problem worldwide. A critical element in tackling the COVID-19 crisis is personal behavioral change; however, there is a paucity of evidence about peoples’ awareness towards COVID-19 pandemic. Hence, the aim of this was to assess the community’s awareness status towards COVID-19 in Sheka, Southwestern Ethiopia.Methods: Community-based cross-sectional study was conducted 10th to 21th April 2020. Four hundred-nineteen individuals participated during the study. Both univariable and multivariable logistic regression analyses were used to identify significant factors of awareness status, and variables with p-value<0.05 indicated it significantly influences the awareness status of the individuals towards COVID-19.Results: According to the study’s results, nearly half (49.4 %) of the participants had awareness about COVID-19 pandemic. Factors such being female equal (AOR: 0.476, 95%CI: 0.293, 0.772),education being secondary and above(AOR:2.178,95%CI:1.323,3.586),and prevention methods being fully used (AOR,8.127,95%CI: 1.273, 51.871)were significantly influencing the awareness status of the community towards COVID-19 pandemic than their counterparts.Conclusion: The study showed that there is a low awareness status among people towards COVID-19.Hence, programs to improve awareness towards COVID-19 pandemic is essential to prevent and control the pandemic.

scholarly journals Hypertension is the underlying cause of death assessed at the autopsy of individuals

2019 ◽  
Vol 53 ◽  
Author(s):  
Juliana Chaves Coelho ◽  
Renata Eloah de Lucena Ferretti-Rebustini ◽  
Claudia Kimie Suemoto ◽  
Renata Elaine Paraizo Leite ◽  
Wilson Jacob-Filho ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Public Health Problem ◽  
Female Gender ◽  
Cross Sectional Study ◽  
Aging Brain ◽  
Cross Sectional ◽  
History Of ◽  
Underlying Cause Of Death ◽  
Definition Of ◽  
Brain Study

ABSTRACT Objective: To analyze hypertension and its relationship with the causes of death identified by the autopsy. Method: Cross-sectional study analyzed 356 participants belonging to the Brazilian Aging Brain Study Group, over 50 years of age, autopsied at the Sao Paulo Autopsy Service between 2004 to 2014. A clinical interview was conducted with the informant of the deceased. Hypertension was defined by reporting the disease and/or use of antihypertensive medication, by the informant of the deceased. Descriptive analyzes and bivariate and multivariable associations were performed. Results: The prevalence of hypertension was 66.2% and it was the second leading cause of death (25.6%) identified by autopsy, preceded by atherosclerosis (37.8%). The variables associated with hypertension were: female gender (OR=2.30 (1.34-3.90)); living with partner [OR=0.55 (0.32-0.92)]; Body Mass Index [OR=1.14 (1.08-1.22)] and history of diabetes [OR=2.39 (1.34-4.27)]. Conclusion: The prevalence of hypertension was high, and it was the second most common underlying cause of death. The gold standard for the definition of cause of death, the autopsy, shows important results, which confirmed the relevance of hypertension as a public health problem.

scholarly journals Magnitude and Associated Factors of Delayed Immunization Among Children Aged 11 -23 Months in Edagahamus town, Tigray, Ethiopia, 2018.

2019 ◽  
Author(s):  
Merhawit Gebremeskel Hagos ◽  
Teferi Gebru Gebremeskel ◽  
Selam Shushay Kassahun ◽  
Birhane Hailu Gebrezgi ◽  
Manay Kifle Woldegebriel
Keyword(s):  
Tertiary Education ◽  
Public Health Problem ◽  
Simple Random Sampling ◽  
Cross Sectional Study ◽  
P Value ◽  
Major Public Health Problem ◽  
Cross Sectional ◽  
Vaccine Preventable Diseases ◽  
Keywords Child ◽  
Disease Epidemics

Abstract Background: Delay in receiving immunization is a major public health problem that has been associated with vaccine-preventable disease epidemics. In Ethiopia, many children have not received the benefits of age-appropriate immunization; thus more than 90% of child deaths are largely due to preventable communicable diseases. Therefore, the aim of this study to assess the magnitude and factors associated with delayed immunization among 12 -23 months old children’s in Edagahamus Town, Tigray, Ethiopia, and 2018 G.C. Methods: A community-based Cross-Sectional study was carried out on July1-30, 2018. A simple random sampling method was used to select study participants. Information was collected using a structured, pre-tested questionnaire. Vaccination dates were obtained from children’s immunization cards and timeliness assessed based on the recommended age ranges. Data were entered and analyzed using SPSS version 20.0. Variable with P-value < 0.2 in bivariate was exported to multivariate. The strength of association was identified using the odds ratio with a 95 % confidence interval (CI) and the P-value of <0.05 in multivariate was taken statistically significant. Results: In this study, the overall magnitude of delayed immunization was 29.5% (95%CI 26.7-45). Private firm work of mothers (AOR=0.205 95% CI 0.068-0.617) and Mothers who attend tertiary education (AOR 0.169, 95% CI 0.032-0.882) and secondary education (AOR 0.269, 95% CI 0.114-0.636) had the protective effect of delayed immunization. But the sickness of the child (AOR= 11.8, 95% CI 6.16-22.65) was a risk for delayed immunization. Conclusions: From the study, it is concluded that the magnitude of delayed immunization for children aged 12-23 months is high (29.5%) in Edagahamus. Delayed immunizations of children were predicted by the Mother's occupation, education, and the mother considered the child was too ill to undertake vaccination when it was due. Keywords: Child immunization, Delay to be immunized, Vaccine-preventable diseases

scholarly journals Perfil epidemiológico da sífilis congênita

2019 ◽  
Vol 13 (3) ◽  
pp. 604
Author(s):  
Isadora Maria Delmiro Silva ◽  
Eliane Maria Medeiros Leal ◽  
Helder Freire Pacheco ◽  
José Gilmar de Souza Junior ◽  
Filipe Santana da Silva
Keyword(s):  
Congenital Syphilis ◽  
Cross Sectional Study ◽  
Health Profile ◽  
Sectional Study ◽  
Annual Incidence Rate ◽  
Cross Sectional ◽  
Live Births ◽  
El Sistema ◽  
Epidemiological Profile

RESUMOObjetivo: descrever o perfil epidemiológico dos casos de Sífilis Congênita (SC) notificados em um município nordestino. Método: trata-se de um estudo do tipo seccional, de caráter descritivo, de todos os casos de sífilis congênita notificados pelo Sistema de Informação de Agravos de Notificação (SINAN) e pelo Sistema de Informações sobre Nascidos Vivos (SINASC). Apresentam-se os resultados em forma de tabelas. Resultados: identificaram-se 57 casos, com taxa anual média de incidência de SC de 6,72 casos por mil nascidos vivos (NV), entre 2011-2015, variando de 11,20/1000 NV em 2012 a 3,77/1000 NV em 2015. Registrou-se no período uma diminuição de 7,4% nos casos, porém, ainda ultrapassando a meta do Ministério da Saúde de incidência menor ou igual a 1/1000 NV. Conclusão: aponta-se, pelo estudo, a necessidade de melhorias na qualidade da assistência pré-natal, pois, mesmo havendo a diminuição na incidência da SC, os indicadores mostram valores distantes da meta. Descritores: Sífilis Congênita; Nascimento Vivo; Nascimento; Gravidez; Perfil de Saúde; Vigilância; Epidemiologia.ABSTRACT Objective: to describe the epidemiological profile of Congenital Syphilis (CS) cases reported in a Northeastern municipality. Method: this is a cross-sectional study of all cases of congenital syphilis reported by the SINAN and the SINASC. The results are presented in the form of tables. Results: 57 cases were identified, with a mean annual incidence rate of SC of 6.72 cases per thousand live births (LB), between 2011-2015, ranging from 11.20 / 1000 LB in 2012 to 3.77 / 1000 LB in 2015. A reduction of 7.4% in cases was recorded in the period, however, still exceeding the target of the Ministry of Health of incidence less than or equal to 1/1000 LB. Conclusion: the study points to the need for improvements in the quality of prenatal care, since even though there is a decrease in the incidence of CS, the indicators show values that are distant from the goal. Descriptors: Congenital syphilis; Live Birth; Birth; Pregnancy; Health Profile; Surveillance; Epidemiology.RESUMENObjetivo: describir el perfil epidemiológico de los casos de Sífilis Congénita (SC) notificados en un municipio nordestino. Método: se trata de un estudio del tipo seccional, de carácter descriptivo, de todos los casos de sífilis congénita notificados por el Sistema de Información de Agravios de Notificación (SINAN) y por el Sistema de Información sobre Nacidos Vivos (SINASC). Se presentan los resultados en forma de tablas. Resultados: se identificaron 57 casos, con una tasa anual media de incidencia de SC de 6,72 casos por mil nacidos vivos (NV), entre 2011-2015, variando de 11,20 / 1000 NV en 2012 a 3,77 / 1000 NV en el año En el período se redujo un 7,4% en los casos, pero superando la meta del Ministerio de Salud de incidencia menor o igual a 1/1000 NV. Conclusión: se señala, por el estudio, la necesidad de mejoras en la calidad de la asistencia prenatal, pues, aun habiendo la disminución en la incidencia de la SC, los indicadores muestran valores distantes de la meta. Descriptores: Sífilis Congénita; Nacimiento Vivo; Nacimiento; Embarazo; Perfil de Salud; Vigilancia; Epidemiología.

scholarly journals Assessment on awareness towards preventive measures of COVID-19 in Sheka, Ethiopia: Community based cross-sectional Study

2021 ◽  
Author(s):  
Assaye Belay Gelaw ◽  
Solomon Abebaw Andargie
Keyword(s):  
Sex Education ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
P Value ◽  
Critical Element ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Southwestern Ethiopia ◽  
Prevention Methods

Abstract Background: The coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and it is the most important of public health problem worldwide. A critical element in tackling the COVID-19 crisis is personal behavioral change; however, there is a paucity of evidence about peoples’ awareness towards COVID-19 pandemic. Hence, this study was aimed to assess the people’s awareness status towards COVID-19 in Sheka, Southwestern Ethiopia.Methods: Community-based cross-sectional study was conducted between 10th to 21th April 2020. Four hundred-nineteen individuals participated during the study. Both univariable and multivariable logistic regression analyses were used to identify significant factors of awareness status, and variables with p-value<0.05 indicated it significantly influences the awareness status of the individuals towards COVID-19.Results: According to the study’s results, nearly half (49.4 %) of the participants had awareness about COVID-19 pandemic. Factors such as sex, education level, religion, symptom, and knowing prevention methods were significantly associated with awareness of individuals towards COVID-19 pandemic. Respondents who did know all prevention methods (AOR: 8.1, 95% CI: 1.3, 51.9) are more likely to aware of COVID-19 than their counterparts.Conclusion: The study showed that there is a low awareness status among people towards COVID-19.Hence, programs to improve awareness towards COVID-19 pandemic is is essential to prevent and control the pandemic.

scholarly journals COVID-19 in socially vulnerable quilombola populations in Salvaterra, Pará, Eastern Amazon, Brazil

2021 ◽  
Vol 15 (08) ◽  
pp. 1066-1073
Author(s):  
Nelson Veiga Gonçalves ◽  
João Simão De Melo Neto ◽  
Selma Kazumi da Trindade Noguchi ◽  
Andrey Silva Machado ◽  
Alcindo Da Silva Martins Junior ◽  
...  
Keyword(s):  
Spatial Distribution ◽  
Epidemiological Survey ◽  
Incidence Rates ◽  
National Registry ◽  
Disease Notification ◽  
Cross Sectional ◽  
Notification System ◽  
Family Farmers ◽  
Use Of Data ◽  
Epidemiological Profile

Introduction: COVID-19 is a severe respiratory syndrome caused by the SARS-CoV-2 virus. In Brazil the highest infection rates are associated with socially vulnerable populations. This study therefore sought to analyze the spatial distribution of the disease and its relation with geographic, socioeconomic and public health policy characteristics associated with quilombola communities in Salvaterra municipality, state of Pará, for the period of March to September, 2020. Methodology: This cross-sectional and ecological study used data from the Disease Notification System and the National Registry of Health Establishments of the Ministry of Health, the Income Transfer Registry of the Ministry of Citizenship and the 2010 census of the Brazilian Institute of Geography and Statistics. Statistical and spatial analysis of the data was done through percentages of cases and Flow and Kernel map techniques. Results: Seventy-five notified cases of COVID-19 distributed among 7 quilombola communities in the municipality were analyzed. The epidemiological profile followed a national trend, with a higher percentage of cases among persons who were female, adults with low schooling levels, working as family farmers and with an outcome ending in recovery. The spatial distribution of the disease was not homogenous and showed clusters of cases and high incidence rates, especially in communities close to the municipal seat or to highways. Conclusions: The use of data analysis techniques was satisfactory for providing an understanding of the socioeconomic production of the disease in the areas studied. Accordingly, the need for intensifying epidemiological survey actions in the quilombola communities of the municipality is emphasized.

scholarly journals Perfil epidemiológico da sífilis congênita em uma microrregião no interior do estado da Bahia (2007-2017)

2019 ◽  
Vol 18 (4) ◽  
pp. 198-229
Author(s):  
Kaic Trindade Almeida ◽  
Álisson Neves Santos ◽  
Ana Karla Araújo Nascimento Costa ◽  
Myllena Rodrigues dos Santos ◽  
Ana Maria Fernandes Menezes ◽  
...  
Keyword(s):  
Public Health ◽  
Prenatal Care ◽  
Quantitative Study ◽  
Health Problem ◽  
Congenital Syphilis ◽  
Public Health Problem ◽  
Cross Sectional ◽  
Notification System ◽  
El Sistema ◽  
Epidemiological Profile

Objective: To analyze the epidemiological profile of Congenital Syphilis in 18 municipalities in the state of Bahia between 2007 and 2017.Method: A descriptive, cross-sectional and quantitative study of the confirmed cases of Congenital Syphilis in the micro-region registered in the Aggravation and Notification Information System.Results: In the study period, 39 cases were confirmed, with 30.8% of the mothers being between 20 and 24 years of age, 59% were brown, 46.2% had incomplete primary education, 33.3% were housewives, 74.4% 94.9% underwent prenatal care, 53.8% were diagnosed at the time of delivery / curettage, 41% received inadequate treatment and 38.5% of the partners were not treated. With regard to newborns, 69.2% were diagnosed with 0 day of life, 74.4% with recent Congenital Syphilis and 46.2% asymptomatic.Conclusion: The data reveal a serious public health problem in the micro-region analyzed, also pointing out failures in the notification system, observed in the high ignored index in the studied variables. Objetivo: Analizar el perfil epidemiológico de Sífilis Congénita en 18 municipios en el interior del estado de Bahía entre 2007 y 2017.Método: Estudio descriptivo, transversal y cuantitativo de los casos confirmados de Sífilis Congénita en la microrregión registrados en el Sistema de Información de Agravios y Notificación.Resultados: En el período estudiado se confirmaron 39 casos, donde el 30,8% de las madres tiene entre 20 a 24 años, el 59% son pardas, el 46,2% tienen enseñanza fundamental incompleta, el 33,3% amas de casa, el 74,4% en el momento del parto / curetaje, el 41% recibió tratamiento inadecuado y el 38,5% de los socios no fueron tratados. Con respecto a los recién nacidos, el 69,2% fue diagnosticado con 0 días de vida, 74,4% con Sífilis Congénita reciente y 46,2% asintomáticos.Conclusión: Los datos revelan un serio problema de salud pública en la microrregión analizada apuntando también fallas en el sistema de notificación, observadas en el elevado índice de ignorados en las variables estudiadas. Objetivo: Analisar o perfil epidemiológico de Sífilis Congênita em 18 municípios no interior do estado da Bahia entre 2007 e 2017. Método: Estudo descritivo, transversal e quantitativo dos casos confirmados de Sífilis Congênita na microrregião registrados no Sistema de Informação de Agravos e Notificação. Resultados: No período estudado foram confirmados 39 casos, onde 30,8% das mães tem entre 20 a 24 anos, 59% são pardas, 46,2% possuem ensino fundamental incompleto, 33,3% donas de casa, 74,4% residentes na zona urbana, 94,9% realizou o pré-natal, 53,8% foram diagnosticadas no momento do parto/curetagem, 41% receberam tratamento inadequado e 38,5% dos parceiros não foram tratados. Com relação aos recém-nascidos, 69,2% foram diagnosticados com 0 dia de vida, 74,4% com Sífilis Congênita recente e 46,2% assintomáticos. Conclusão: Os dados revelam um sério problema de saúde pública na microrregião analisada apontando também falhas no sistema de notificação, observadas no elevado índice de ignorados nas variáveis estudadas.

scholarly journals Epidemiological Aspects of the Initial Evolution of COVID-19 in Microregion of Uberlândia, Minas Gerais (MG), Brazil

2021 ◽  
Vol 18 (10) ◽  
pp. 5245
Author(s):  
Deborah Araujo Policarpo ◽  
Eduarda Cristina Alves Lourenzatto ◽  
Talita Costa e Silva Brito ◽  
Daise Aparecida Rossi ◽  
Roberta Torres de Melo
Keyword(s):  
The Elderly ◽  
Cross Sectional Study ◽  
Incidence Rates ◽  
World Health ◽  
Global Public Health ◽  
Cross Sectional ◽  
Initial Evolution ◽  
Epidemiological Profile ◽  
Health Organization ◽  
Epidemiological Characteristics

COVID-19 is considered by the World Health Organization to be a global public health emergency, which presents regional divergences that affect the epidemiological profile of the disease and are associated with political, economic, social and behavioral aspects. We aimed to analyze the epidemiological characteristics of the disease in the microregion of Uberlândia, Brazil, in order to determine risk factors that contributed to progression of SARS-CoV-2 virus. A cross-sectional study was conducted about micro- and macro-determinants combined with the significance analysis of suspected and confirmed cases in 18 municipalities during the epidemiological weeks (EW) 9 to 26. There were 34,046 notifications, of which 4935 (14.49%) people were diagnosed with COVID-19. Of these, 282 (5.71%) required hospital care and 40 (0.81%) died. Age and presence of associated comorbidities were decisive in the variations of incidence and lethality rates. In general, young people were the most affected and the elderly people, the most exposed to the serious and lethal form (p < 0.0001). Comorbidities such as diabetes and cardiopathies increased 33.5 times the death risk. The dispersion of the virus was centrifugal, in the inter as well as in the intra-municipal level. The disorderly implementation of municipal decrees applied in a decentralized manner in the municipalities seems to have contributed for the incidence rates increasing in the EW 25 and 26.

scholarly journals Dietary diversity score and socio-economic factors of stunting among pre-school children in Rajshahi city, Bangladesh

2019 ◽  
Vol 26 ◽  
pp. 31-40
Author(s):  
K Yeasmin ◽  
L Bari ◽  
KMS Islam ◽  
T Yeasmin
Keyword(s):  
Developing Countries ◽  
School Children ◽  
Dietary Diversity ◽  
Public Health Problem ◽  
Population Data ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Dietary Diversity Score ◽  
Rajshahi City

In the developing countries, stunting has been the most tenacious public health problem and is the major cause of child mortality and global disease burden, where 80% of this burden is found in developing countries and would result in 22% loss of adult income. The aim of this study was to investigate prevalence and determinant factors associated with stunting among pre-school children in Rajshahi City, Bangladesh. A multi-stage cross sectional study was performed during the period March 2017 to September 2017. One thousand and nine (1009) pre-school children (36≤ Age ≤71 months) were considered as our study population. Data were collected by using a pretested and semi-structured questionnaire, which consisted of socio-economic characteristics, dietary and feeding pattern related information. Stunting of a child was determined using the WHO Multicenter Growth Reference Standard. Chi-square test and multiple logistic regressions were carried out to identify determinants of stunting. The odds ratio (OR) with a 95% confidence interval was calculated to assess the strength of the association, and p-value of <0.05 were considered as statistically significant. Boys (52%) with mean age 53.56 ± 10.405 months and girls (48%) with mean age 51.67 ± 10.934 months were participated. The prevalence of stunting among the preschool children in Rajshahi City was 39.7% (5.4% severe, 24.9% moderate and 9.4% mild stunted). The odds of being stunted were illiterate mother, lower food purchasing capabilities, poor dietary diversity score (95% CI: 1.640-3.052; p<0.001), experiencing pre-lacteal (95% CI: 1.616-2.789; p <0.001), prevalence of disease frequency (95% CI: 1.62-3.56; p<0.01), poor socio-economic class (95% CI: 2.83- 9.51; p<0.01). J. bio-sci. 26: 31-40, 2018

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