scholarly journals Geographic variation and risk factors for teenage pregnancy in Uganda

2020 ◽  
Vol 20 (4) ◽  
pp. 1898-907
Author(s):  
Joseph Byonanebye ◽  
Ruta Brazauskas ◽  
Nazarius Tumwesigye ◽  
Staci Young ◽  
Thomas May ◽  
...  
Keyword(s):  
Risk Factors ◽  
Teenage Pregnancy ◽  
Sub Saharan Africa ◽  
Health Issue ◽  
Bivariate Analysis ◽  
Demographic And Health Surveys ◽  
Wealth Status ◽  
Pregnancy Risk ◽  
Global Health Issue ◽  
Sub Saharan

Background: Teenage pregnancy is a global health issue with high rates in sub-Saharan Africa. In Uganda, teenage pregnan- cy is a public and community health issue. Objectives: This study hypothesized that there would be regional variations in rates, risk factors and trends of teenage pregnancy in Uganda. Methods: Data were analyzed from the Uganda Demographic and Health Surveys (UDHS) in 2006 and 2011. The outcome of interest was current pregnancy for females 15 to 19 years of age at the time of the survey. Bivariate analysis was per- formed for each year to examine the rate and trends of pregnancy by various demographic characteristics. Logistic regres- sion was conducted to assess the association between teenage pregnancy and sociodemographic variables. Results: Uganda’s rate of teenage pregnancy increased from 7.3/1000 in 2006 to 8.1/1000 in 2011. The East Central region consistently had the highest rates than other regions. In 2006, teenage pregnancy was significantly associated with being mar- ried, living with a partner or separated, as compared to those who were single. Marital and wealth status were also significant predictors of teenage pregnancy based on the 2011 survey. Conclusion: The rate of teenage pregnancy in Uganda is high and the trend demonstrated regional variation. Future inter- ventions could focus on regions with high poverty and low education. Keywords: Teenage pregnancy; risk factors; Uganda demographic; health survey.

scholarly journals Impact of Orphanhood on Underweight Prevalence in Sub-Saharan Africa

2008 ◽  
Vol 29 (1) ◽  
pp. 32-42 ◽  
Author(s):  
Jonathan Rivers ◽  
John Mason ◽  
Eva Silvestre ◽  
Stuart Gillespie ◽  
Mary Mahy ◽  
...  
Keyword(s):  
Household Wealth ◽  
Household Structure ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Wealth Status ◽  
Orphan Status ◽  
Confounding Variables ◽  
Multiple Indicator ◽  
Sub Saharan ◽  
Child Nutritional Status

Background In Africa, approximately 25 million people live with HIV/AIDS and 12 million children are orphaned. Although evidence indicates that orphans risk losing opportunities for adequate education, health care, and future employment, the immediate effects of orphanhood on child nutritional status remain poorly understood. Objective This paper assesses the nutritional impact of orphanhood, with particular emphasis on taking account of various factors potentially confounding or masking these impacts. Methods Child anthropometry and orphan status were examined in 23 Multiple Indicator Cluster Surveys and Demographic and Health Surveys throughout sub-Saharan Africa, which were subsequently merged into larger, region-specific datasets (East, West, and Southern Africa). To compare orphans and nonorphans, linear regression and probit models were developed, taking account of orphan status and type, presence of a surviving parent in the household, household structure, child age and sex, urban versus rural residence, and current wealth status. Results Few differences emerged between orphans and nonorphans in controlled and uncontrolled comparisons, regardless of orphan type, presence of surviving parent, or household structure. Age differentials did confound nutritional comparisons, although in the counterintuitive direction, with orphans (who were 8 months older on average) becoming less malnourished when age differences were taken into account. Wealth did appear to be associated with orphanhood status, although it did not significantly confound nutritional comparisons. Conclusions Orphans were not consistently more malnourished than nonorphans, even when potential confounding variables were examined. Since household wealth status is likely to change after becoming affected by HIV, ruling out wealth as a potential confounder would require more detailed, prospective studies.

SPOUSAL AGREEMENT ON PREFERRED WAITING TIME TO NEXT BIRTH IN SUB-SAHARAN AFRICA

2011 ◽  
Vol 43 (4) ◽  
pp. 385-400 ◽  
Author(s):  
TESFAYI GEBRESELASSIE ◽  
VINOD MISHRA
Keyword(s):  
Socioeconomic Factors ◽  
Waiting Time ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Wealth Status ◽  
Number Of Children ◽  
Spousal Communication ◽  
Sub Saharan ◽  
Living Children ◽  
Social Demographic

SummaryThis study investigates how various social, demographic and economic factors affect spousal agreement on preferred waiting time to next birth. Data for matched cohabiting couples from ten Demographic and Health Surveys in sub-Saharan Africa (Benin, Burkina Faso, Ghana, Guinea, Mali, Ethiopia, Kenya, Mozambique, Zambia and Zimbabwe), conducted between 2003 and 2006, were analysed to compare reported waiting time to next birth by the husband and the wife. Couples where the reported waiting time to next birth was the same for both partners (difference is 0 months) were defined as having agreement on waiting time to next birth. In sub-Saharan Africa, spousal agreement on waiting time to next birth was found to be associated with wanting the next child sooner. When the spouses disagree on waiting time to next birth, the wives want to wait longer than their husbands in most cases. Additionally, the study found that demographic factors are the primary determinants of spousal agreement on waiting time to next birth, not socioeconomic factors. The strongest predictors of spousal agreement on waiting time to next birth were number of living children, difference between the number of ideal and living children and wife's age. Couples with fewer children, a younger wife and those with a difference of five or more children between ideal and living number of children were more likely to agree on waiting time to next birth. Effects of socioeconomic factors, such as education and wealth status, on spousal agreement on waiting time to next birth were generally weak and inconsistent. The findings highlight some of the challenges in developing programmes to promote spousal communication and birth spacing and underscore the need for programmes to be gender-sensitive.

scholarly journals Risk factors for prelacteal feeding in sub-Saharan Africa: a multilevel analysis of population data from twenty-two countries

2017 ◽  
Vol 20 (11) ◽  
pp. 1953-1962 ◽  
Author(s):  
Anselm S Berde ◽  
Hilal Ozcebe
Keyword(s):  
Risk Factors ◽  
Breast Feeding ◽  
Health Surveys ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Prelacteal Feeding ◽  
Birth Rank ◽  
Sub Saharan ◽  
Ssa Countries ◽  
Prelacteal Feeds

AbstractObjectiveTo examine the risk factors of prelacteal feeding (PLF) among mothers in sub-Saharan Africa (SSA).DesignWe pooled data from Demographic and Health Surveys in twenty-two SSA countries. The key outcome variable was PLF. A multilevel logistic regression model was used to explore factors associated with PLF.SettingDemographic and Health Surveys in twenty-two SSA countries.SubjectsMother–baby pairs (n 95348).ResultsPrevalence of PLF in SSA was 32·2 %. Plain water (22·1 %), milk other than breast milk (5·0 %) and sugar or glucose water (4·1 %) were the predominant prelacteal feeds. In the multivariable analysis, mothers who had caesarean section delivery had 2·25 times the odds of giving prelacteal feeds compared with mothers who had spontaneous vaginal delivery (adjusted OR=2·25; 95 % CI 2·06, 2·46). Other factors that were significantly associated with increased likelihood of PLF were mother’s lower educational status, first birth rank, fourth or above birth rank with preceding birth interval less than or equal to 24 months, lower number of antenatal care visits, home delivery, multiple birth, male infant, as well as having an average or small sized baby at birth. Mothers aged 20–34 years were less likely to give prelacteal feeds compared with mothers aged ≤19 years. Belonging to the second, middle or fourth wealth quintile was associated with lower likelihood of PLF compared with the highest quintile.ConclusionsTo achieve optimal breast-feeding, there is a need to discourage breast-feeding practices such as PLF. Breast-feeding promotion programmes should target the at-risk sub-population groups discovered in our study.

scholarly journals Profiling Household Double and Triple Burden of Malnutrition in sub-Saharan Africa: Prevalence and Influencing Household Factors

2021 ◽  
pp. 1-32
Author(s):  
Aaron K. Christian ◽  
Fidelia A. A. Dake
Keyword(s):  
Household Head ◽  
Household Wealth ◽  
Overweight And Obesity ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Health Concern ◽  
Demographic And Health Surveys ◽  
Wealth Status ◽  
Women And Children ◽  
Sub Saharan

Abstract Objective: Undernutrition and anaemia - the commonest micronutrient deficiency, continue to remain prevalent and persistent in sub-Saharan Africa (SSA) alongside a rising prevalence of overweight and obesity. However, there has been little research on the co-existence of all three conditions in the same household in recent years. This study examines the co-existence and correlates of the different conditions of household burden of malnutrition in the same household across SSA. Setting: The study involved twenty-three countries across SSA who conducted demographic and health surveys between 2008 and 2017. Participants: The analytical sample includes 145,020 households with valid data on the nutritional status of women and children pairs (i.e. women of reproductive age; 15-49 years and children under-five years). Design: Logistic regression analyses were used to determine household correlates of household burden of malnutrition. Results: Anaemia was the most common form of household burden of malnutrition, affecting about 7 out of 10 households. Double and Triple burden of malnutrition though less common, was also found to be present in 8 and 5 percent of the households respectively. The age of the household head, location of the household, access to improved toilet facilities and household wealth status were found to be associated with various conditions of household burden of malnutrition. Conclusions: The findings of this study reveal that, both double and triple burden of malnutrition is of public health concern in SSA, thus nutrition and health interventions in SSA must not be skewed towards addressing undernutrition only, but also address overweight/obesity and anaemia.

scholarly journals Risk factors associated with the coexistence of stunting, underweight, and wasting in children under 5 from 31 sub-Saharan African countries

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e052267
Author(s):  
Iddrisu Amadu ◽  
Abdul-Aziz Seidu ◽  
Eric Duku ◽  
James Boadu Frimpong ◽  
John Elvis Hagan Jnr. ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multinomial Logistic Regression ◽  
National Level ◽  
Three Dimensions ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
Factors Associated ◽  
Z Scores ◽  
Sub Saharan

ObjectiveThis study investigated the risk factors associated with the coexistence of stunting, underweight, and wasting among children under age 5 in sub-Saharan Africa (SSA).DesignData of 127, 487 under-5 children from 31 countries in SSA were pooled from the Demographic and Health Surveys collected between 2010 and 2019. We examined the risk of coexistence of stunting, underweight, and wasting using multinomial logistic regression models. The results were presented using relative risk ratios (RRR) with corresponding confidence intervals (CIs).SettingThirty-one sub-Saharan African countries.ParticipantsChildren under age 5.Outcome measuresThe outcome variables were three child anthropometrics: stunting (height-for-age z-scores); underweight (weight-for-age z-scores) and wasting (weight-for-height z-scores).ResultsThe prevalence of coexistence of stunting, underweight, and wasting varied across countries, with the highest (12.14%) and lowest (0.58%) prevalences of coexistence of stunting, underweight and wasting in Benin and Gambia respectively. The risk of coexistence of the three indicators of undernutrition was higher among children aged 1 year (RRR=3.714; 95% CI 3.319 to 4.156) compared with those aged 0. The risk of coexistence of the three dimensions was lower among female children (RRR=0.468 95% CI 0.420 to 0.51), but higher for those with small size at birth (RRR=3.818; CI 3.383 to 4.308), those whose mothers had no education (RRR=3.291; 95% CI 1.961 to 5.522), not working (RRR=1.195; 95% CI 1.086 to 1.314), had no antenatal visits during pregnancy (RRR=1.364; 95% CI 1.20 to 1.541), children delivered at home (RRR=1.372; CI 1.232 to 1.529), those from poor households (RRR=1.408; 95% CI 1.235 to 1.605), those whose mothers had no access to media (RRR=1.255; 95% CI 1.144 to 1.377) and living in households with an unimproved toilet facility (RRR=1.158; 95% CI 1.032 to 1.300).ConclusionsFindings suggest the urgent need for consideration of the coexistence of stunting, wasting and underweight among under-5 children in policy design and programming of interventions to eradicate child malnutrition in SSA. In the short-term, national-level policies and interventions need to be well tailored considering the compositional characteristics.

scholarly journals Predictors of lost to follow up from antiretroviral therapy among adults in sub-Saharan Africa: a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Hafte Kahsay Kebede ◽  
Lillian Mwanri ◽  
Paul Ward ◽  
Hailay Abrha Gesesew
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Care Services ◽  
Validity Assessment ◽  
Sub Saharan ◽  
Lost To Follow Up

Abstract Background It is known that ‘drop out’ from human immunodeficiency virus (HIV) treatment, the so called lost-to-follow-up (LTFU) occurs to persons enrolled in HIV care services. However, in sub-Saharan Africa (SSA), the risk factors for the LTFU are not well understood. Methods We performed a systematic review and meta-analysis of risk factors for LTFU among adults living with HIV in SSA. A systematic search of literature using identified keywords and index terms was conducted across five databases: MEDLINE, PubMed, CINAHL, Scopus, and Web of Science. We included quantitative studies published in English from 2002 to 2019. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for methodological validity assessment and data extraction. Mantel Haenszel method using Revman-5 software was used for meta-analysis. We demonstrated the meta-analytic measure of association using pooled odds ratio (OR), 95% confidence interval (CI) and heterogeneity using I2 tests. Results Thirty studies met the search criteria and were included in the meta-analysis. Predictors of LTFU were: demographic factors including being: (i) a male (OR = 1.2, 95% CI 1.1–1.3, I2 = 59%), (ii) between 15 and 35 years old (OR = 1.3, 95% CI 1.1–1.3, I2 = 0%), (iii) unmarried (OR = 1.2, 95% CI 1.2–1.3, I2 = 21%), (iv) a rural dweller (OR = 2.01, 95% CI 1.5–2.7, I2 = 40%), (v) unemployed (OR = 1.2, 95% CI 1.04–1.4, I2 = 58%); (vi) diagnosed with behavioral factors including illegal drug use(OR = 13.5, 95% CI 7.2–25.5, I2 = 60%), alcohol drinking (OR = 2.9, 95% CI 1.9–4.4, I2 = 39%), and tobacco smoking (OR = 2.6, 95% CI 1.6–4.3, I2 = 74%); and clinical diagnosis of mental illness (OR = 3.4, 95% CI 2.2–5.2, I2 = 1%), bed ridden or ambulatory functional status (OR = 2.2, 95% CI 1.5–3.1, I2 = 74%), low CD4 count in the last visit (OR = 1.4, 95% CI 1.1–1.9, I2 = 75%), tuberculosis co-infection (OR = 1.2, 95% CI 1.02–1.4, I2 = 66%) and a history of opportunistic infections (OR = 2.5, 95% CI 1.7–2.8, I2 = 75%). Conclusions The current review identifies demographic, behavioral and clinical factors to be determinants of LTFU. We recommend strengthening of HIV care services in SSA targeting the aforementioned group of patients. Trial registration Protocol: the PROSPERO Registration Number is CRD42018114418

scholarly journals Decomposing the rural–urban gap in factors associated with childhood immunisation in sub-Saharan Africa: evidence from surveys in 23 countries

2021 ◽  
Vol 6 (1) ◽  
pp. e003773
Author(s):  
Edward Kwabena Ameyaw ◽  
Yusuf Olushola Kareem ◽  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Sanni Yaya
Keyword(s):  
Decomposition Analysis ◽  
Household Wealth ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Childhood Immunisation ◽  
Urban Settings ◽  
Factors Associated ◽  
Rural And Urban ◽  
Full Immunisation ◽  
Sub Saharan

BackgroundAbout 31 million children in sub-Saharan Africa (SSA) suffer from immunisation preventable diseases yearly and more than half a million children die because of lack of access to immunisation. Immunisation coverage has stagnated at 72% in SSA over the past 6 years. Due to evidence that full immunisation of children may be determined by place of residence, this study aimed at investigating the rural–urban differential in full childhood immunisation in SSA.MethodsThe data used for this study consisted of 26 241 children pooled from 23 Demographic and Health Surveys conducted between 2010 and 2018 in SSA. We performed a Poisson regression analysis with robust Standard Errors (SEs) to determine the factors associated with full immunisation status for rural and urban children. Likewise, a multivariate decomposition analysis for non-linear response model was used to examine the contribution of the covariates to the observed rural and urban differential in full childhood immunisation. All analyses were performed using Stata software V.15.0 and associations with a p<0.05 were considered statistically significant.ResultsMore than half of children in urban settings were fully immunised (52.8%) while 59.3% of rural residents were not fully immunised. In all, 76.5% of rural–urban variation in full immunisation was attributable to differences in child and maternal characteristics. Household wealth was an important component contributing to the rural–urban gap. Specifically, richest wealth status substantially accounted for immunisation disparity (35.7%). First and sixth birth orders contributed 7.3% and 14.9%, respectively, towards the disparity while 7.9% of the disparity was attributable to distance to health facility.ConclusionThis study has emphasised the rural–urban disparity in childhood immunisation, with children in the urban settings more likely to complete immunisation. Subregional, national and community-level interventions to obviate this disparity should target children in rural settings, those from poor households and women who have difficulties in accessing healthcare facilities due to distance.

scholarly journals Inflammatory bowel disease in sub-Saharan Africa: a protocol of a prospective registry with a nested case–control study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e039456
Author(s):  
Leolin Katsidzira ◽  
Wisdom F Mudombi ◽  
Rudo Makunike-Mutasa ◽  
Bahtiyar Yilmaz ◽  
Annika Blank ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Case Control Study ◽  
Alpha Diversity ◽  
Case Control ◽  
Sub Saharan Africa ◽  
Inflammatory Bowel ◽  
Sub Saharan ◽  
Nested Case Control ◽  
Control Study

IntroductionThe epidemiology of inflammatory bowel disease (IBD) in sub-Saharan Africa is poorly documented. We have started a registry to determine the burden, phenotype, risk factors, disease course and outcomes of IBD in Zimbabwe.Methods and analysisA prospective observational registry with a nested case–control study has been established at a tertiary hospital in Harare, Zimbabwe. The registry is recruiting confirmed IBD cases from the hospital, and other facilities throughout Zimbabwe. Demographic and clinical data are obtained at baseline, 6 months and annually. Two age and sex-matched non-IBD controls per case are recruited—a sibling or second-degree relative, and a randomly selected individual from the same neighbourhood. Cases and controls are interviewed for potential risk factors of IBD, and dietary intake using a food frequency questionnaire. Stool is collected for 16S rRNA-based microbiota profiling, and along with germline DNA from peripheral blood, is being biobanked. The estimated sample size is 86 cases and 172 controls, and the overall registry is anticipated to run for at least 5 years. Descriptive statistics will be used to describe the demographic and phenotypic characteristics of IBD, and incidence and prevalence will be estimated for Harare. Risk factors for IBD will be analysed using conditional logistic regression. For microbial analysis, alpha diversity and beta diversity will be compared between cases and controls, and between IBD phenotypes. Mann-Whitney U tests for alpha diversity and Adonis (Permutational Multivariate Analysis of Variance) for beta diversity will be computed.Ethics and disseminationEthical approval has been obtained from the Parirenyatwa Hospital’s and University of Zimbabwe’s research ethics committee and the Medical Research Council of Zimbabwe. Findings will be discussed with patients, and the Zimbabwean Ministry of Health. Results will be presented at scientific meetings, published in peer reviewed journals, and on social media.Trial registration numberNCT04178408.

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