scholarly journals Associated risk factors of underweight among under-five children in Ethiopia using multilevel ordinal logistic regression model

2021 ◽  
Vol 21 (1) ◽  
pp. 362-72
Author(s):  
Nigussie Adam Birhan ◽  
Denekew Bitew Belay
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Proportional Odds Model ◽  
Proportional Odds ◽  
Under Five ◽  
Single Level ◽  
Under Five Children ◽  
Under Nutrition ◽  
Partial Proportional Odds Model ◽  
Associated Risk Factors

Background: Malnutrition is associated with both under nutrition and over nutrition which causes the body to get improp- er amount of nutrients to maintain tissues and organ function. Under nutrition is the result of insufficient intake of food, poor utilization of nutrients due to illnesses, or a combination of these factors. The purpose of this study was to identify associated risk factors and assess the variation of underweight among under-five children of different regions in Ethiopia. Methods: Ethiopian Demography and Health Survey (EDHS-2016) weight-to-age data for under-five children is used. In order to achieve the objective of this study; descriptive, single level and multilevel ordinal logistic regression analysis were used. Results: From a total of 8935 children about 8.1% were severely underweight, 17.1% were moderately underweight and 74.8% were normal. The test of heterogeneity suggested that underweight varies among region and multilevel ordinal model fit data better than single level ordinal model. Conclusion: Educational level of mother, religion, birth order, type of birth, sex of child, mother body mass index, birth size of child, existence of diarrhea for last two weeks before survey, existence of fever for last two weeks before survey, duration of breast feeding, age child and wealth index had significant effect on underweight among under-five children in Ethiopia. The finding revealed that among the fitted multilevel partial proportional odds model, the random intercept model with fixed coefficients is appropriate to assess the risk factors of underweight among under-five children in Ethiopia. The findings of this study have important policy implications. The government should work closely with both the private sector and civil society to teach women to have sufficient knowledge, awareness and mechanisms of improving under-five under- weight for children’s wellbeing. Keywords: Underweight; Partial proportional odds model; Multilevel partial proportional odds model; under-five children.

scholarly journals Determinants of Undernutrition among Children under Five Years of Age in Ethiopia

2020 ◽  
Author(s):  
Gashu Workneh Kassie ◽  
Demeke Lakew Workie
Keyword(s):  
Regression Models ◽  
Composite Index ◽  
Wealth Index ◽  
Proportional Odds Model ◽  
Proportional Odds ◽  
Anthropometric Indices ◽  
Under Five ◽  
Anthropometric Indicators ◽  
Under Nutrition ◽  
Partial Proportional Odds Model

Abstract Background: Ethiopia is one of the developing countries where child under-nutrition is prevalent. Prior studies employed three anthropometric indicators for identifying factors of children’s under-nutrition. This study aimed at identifying the factors of child under-nutrition using a single composite index of anthropometric indicators. Methods: Data from Ethiopia’s Demographic and Health Survey (EDHS) 2016 was the base for studying under-nutrition in a sample of 9494 children below 59 months. A single composite index of under-nutrition was created from three anthropometric indices through principal component analysis recoded into an ordinal outcome. In line with Child Growth Standards (WHO, 2006), the three anthropometric indices involve z-score of height-for-age (stunting), weight-for-height (wasting) and weight-for-age (underweight). To identify significant determinants of under-nutrition, partial proportional odds model was fitted and its relative performance compared with some other ordinal regression models. Results and conclusion: In the Brant test of proportional odds model, the null hypothesis that the model parameters were equal across categories was rejected. Compared to ordinal regression models that do not involve parallel regression assumption, and Akaike information criterion, partial proportional odds model showed an improved fit. The fitted partial proportional odds model indicated that age and sex of the child, maternal education, region, source of drinking water, number of under five children, mother’s body mass index, wealth index, anaemic status, multiple birth, fever, mother’s age at birth, and husband’s education significantly associated with child under-nutrition. It is argued that interventions focus on improving household wealth index, food security, educating mothers and their spouses, improving maternal nutritional status, and increasing mothers’ health care access. Keywords: Stunting; underweight; wasting; partial proportional odds model

Prevalence of anaemia and it's associated risk factors among under five children at Mukinge Missions Hospital in Kasempa District: Retrospective Study (Preprint)

2019 ◽  
Author(s):  
Lloyd Sampa
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Mean Corpuscular Volume ◽  
Sub Saharan Africa ◽  
Corpuscular Volume ◽  
Under Five ◽  
Under Five Children ◽  
Mission Hospital ◽  
Associated Risk Factors ◽  
Prevalence Of Anemia

BACKGROUND Anemia is a worldwide major problem known to affect people throughout the world. It has an adverse effect on both the social and economic development. The worldwide prevalence of anemia is 9% in developed nations. The global estimate indicates that 293.1 million of children under five years, approximately 43%, are anaemic worldwide and 28.5% of these children are found in sub Saharan Africa. In Zambia specifically Kasempa, no documented studies on prevalence have been done. Despite iron supplementation being given to pregnant women and the availability of blood transfusion. The burden of the disease remains high as determined by high mortality and morbidity. This study aims at determining the prevalence of anemia and the associated risk factors among under-five children at Mukinge Mission Hospital in Kasempa District. Knowledge of prevalence and the associated risk factors of anaemia will enhance early detection and timely management. OBJECTIVE 1.To determine the hemoglobin status of anaemia by its severity among anaemic under-five children admitted at Mukinge Mission Hospital. 2.To assess the association of anaemia with Malaria among under-five children admitted at Mukinge Mission Hospital. METHODS This was a retrospective study review of under-five children that were diagnosed and managed of Anemia at Mukinge Missions Hospital, over the period of period of 2015, 2017 and 2018. .Data of the variables of interest was extracted and analyzed using SPSS. RESULTS A sample population of 52 children was included in our study. The majority of the children were females 28 (53.8 %) and 24 (46.2 %) were Males. It was found that moderate and severe anaemia was 17.3% and 82.7 % respectively. Additionally, Majority of the anaemic children (75%) had Normocytic anaemia. The Pearson Chi square test revealed no statistical relationship between the variables; Malaria (p=0.58), Age (P=0.82), Gender (P=0.91). CONCLUSIONS According to our study, 39 (75%) had normal mean corpuscular volume which could suggest chronic diseases and sickle cell anemia. 11 (21.2%) had a low mean corpuscular volume indicating Microcytic anemia which could suggest diseases such as iron deficiency and thalassemia among many other causes. However, we were unable to determine the specific cause of anemia.

scholarly journals Tracking Progress in Anthropometric Failure Among Under-five Children in Ethiopia: A Geospatial and Multilevel Analysis.

2020 ◽  
Author(s):  
Binyam Tariku Seboka ◽  
Samuel Hailegebreal ◽  
Delelegn Emwodew Yehualashet ◽  
Abel Desalegn Demeke
Keyword(s):  
Logistic Regression ◽  
Associated Factors ◽  
Composite Index ◽  
Temporal Distribution ◽  
Health Concern ◽  
Multilevel Logistic Regression ◽  
Statistical Tool ◽  
Under Five ◽  
Under Five Children ◽  
Under Nutrition

Abstract Background Under-nutrition is a major public health concern among under-five children in many developing countries. This work evaluated the overall prevalence of under-nutrition by using a composite index of anthropometric failure (CIAF), which helps in the detection of children with multiple anthropometric failures. Additionally, this study provides a Spatio-temporal distribution and associated factors of childhood anthropometric failures across time.Methods Secondary data was obtained from the Ethiopian Demographic and Health Survey for the survey 2005, 2011, and 2016 years. Data included 23,864 samples of children between the ages of 0-59 months, which is a nationally representative sample in Ethiopia. Analytical methods used in this paper include multivariate multilevel logistic regression to identify associated factors and Getis-Ord spatial statistical tool to identify high and low hotspots areas of anthropometric failures. ResultThe prevalence obtained with CIAF in 2005, 2011, and 2016 was, 53.5%, 51%, and 46.2% of children were suffering from under-nutrition respectively. The spatial analysis revealed areas that are at a higher risk of anthropometric failures consistently were found in northern parts of the country, largely in the Amhara, Tigray, and Afar regions. Multilevel logistic regression analysis showed that the risk of anthropometric failure was higher among older children, had low birth weight, had a mother with low BMI, was in a rural area, had mothers and fathers without formal education. Conclusion In addition to identifying wasted, stunted, and overweight children, CIAF also identified children with multiple conditions, which are generally neglected in most nutritional surveys. As revealed by this composite index, the prevalence of anthropometric failure remains considerably high and its spatial distribution also significantly varied across the regions in the country. The identified socio-demographic characteristics and districts at an increased likelihood of anthropometric failure can inform localized intervention and prevention strategies to improve the nutritional status and healthcare of children in Ethiopia.

scholarly journals Tracking progress in anthropometric failure among under-five children in Ethiopia: a geospatial and multilevel analysis

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Binyam Tariku Seboka ◽  
Samuel Hailegebreal ◽  
Delelegn Emwodew Yehualashet ◽  
Abel Desalegn Demeke
Keyword(s):  
Logistic Regression ◽  
Formal Education ◽  
Composite Index ◽  
Temporal Distribution ◽  
Secondary Data ◽  
Health Concern ◽  
Multilevel Logistic Regression ◽  
Under Five ◽  
Under Five Children ◽  
Under Nutrition

Abstract Background Undernutrition is a major public health concern among under-five children in many developing countries. This work evaluated the overall prevalence of under-nutrition by using a composite index of anthropometric failure (CIAF), which helps in the detection of children with multiple anthropometric failures. This research also includes the Spatio-temporal distribution of childhood anthropometric failures across time. Methods Secondary data was obtained from the Ethiopian Demographic and Health Survey for the survey 2005, 2011, and 2016 years. Data included 23,864 samples of children between the ages of 0–59 months, which is a nationally representative sample in Ethiopia. Other than descriptive statistics, the multivariate multilevel logistic regression was used to identify associated factors, and Getis-Ord spatial statistical tools were employed to identify high and low hotspots areas of anthropometric failures. Result The prevalence obtained with CIAF in 2005, 2011, and 2016 was, 53.5 %, 51 %, and 46.2 % of children were suffering from under-nutrition respectively. The spatial analysis revealed areas that are at a higher risk of anthropometric failures consistently were found in northern parts of the country, largely in the Amhara, Tigray, and Afar regions. Multilevel logistic regression analysis showed that the risk of anthropometric failure was higher among older children, had low birth weight, had a mother with low BMI, was in a rural area, had mothers and fathers without formal education. Conclusions In addition to identifying wasted, stunted, and underweight children, CIAF also identified children with multiple conditions, which are often overlooked in nutritional surveys. As revealed by this composite index, the prevalence of anthropometric failure remains considerably high and its spatial distribution also significantly varied across the regions in the country. The established socio-demographic characteristics and districts with a higher risk of anthropometric failure can be used to develop localized intervention and prevention strategies to improve Ethiopian children’s nutritional status and healthcare.

scholarly journals PREVALENCE OF ACUTE DIARRHEAL DISEASES AND ASSOCIATED RISK FACTORS AMONG UNDER FIVE CHILDREN IN AN URBAN SLUM OF MUMBAI

2021 ◽  
Vol 9 (10) ◽  
pp. 690-694
Author(s):  
Swapnil Bele ◽  
◽  
S.R. Suryawanshi ◽  
Shailesh Palve ◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Urban Slum ◽  
Cross Sectional Study ◽  
Hand Washing ◽  
Family Type ◽  
Cross Sectional ◽  
Under Five ◽  
Under Five Children ◽  
Child Deaths ◽  
Associated Risk Factors

Introduction: Diarrhoea is one of the single most common causes of death among children under age five worldwide. Diarrheal disorders in childhood account for a large proportion (18%) of childhood deaths, with an estimated 1.5 million deaths per year globally, making it the second most common cause of child deaths worldwide1.So the study was undertaken in order to study the prevalence and associated risk factors causing diarrhoea in urban slum of Metropolitan city. Methods- A cross sectional study was done from January 2012 to December 2012 in Cheetah Camp area. Toal 478 under five children were selected and the parent/guardian of the child was interviewed using pre-designed, semi-structured and pre-tested questionnaires. Results and Conclusion-The prevalence of diarrhoea in children under 5 years during past 2 weeks was 17.8%. Diarrheal episodes in the past 2 weeks was significantly associated with education of mother, socioeconomic status of family, type of family, source of water supply, housefly nuisance in home, child hand-washing before meals, mother hand-washing before meals and immunization status.

scholarly journals Comparison of Antimicrobial Resistant Neisseria gonorrhea to Ceftriaxone and Ciprofloxacin using Partial Proportional Odds Model for patients seen at the University Teaching Hospital in Lusaka, Zambia

2019 ◽  
Author(s):  
PRISCILLA KAPOMBE ◽  
LUNGOWE SITALI ◽  
PATRICK MUSONDA
Keyword(s):  
Risk Factors ◽  
Teaching Hospital ◽  
Susceptibility Testing ◽  
Proportional Odds Model ◽  
University Teaching ◽  
Proportional Odds ◽  
Neisseria Gonorrhea ◽  
Partial Proportional Odds Model ◽  
The University ◽  
Ethical Clearance

Abstract Background Neisseria gonorrhea, the causative agent of Gonorrhea, has developed antibiotic resistance to the “last-line” Cephalosporin’s, Quinolones and Macrolides which is cause for concern. In Zambia, despite recommendations of discontinued use, Ciprofloxacin is used for treatment. The lack of an active surveillance system, appropriate and structured data management and analysis tools magnifies the problem because resistance patterns cannot be monitored. The study aimed to ascertain effectiveness of Ciprofloxacin a Quinolone in comparison with Ceftriaxone a Cephalosporin, in treatment of Gonorrhea using Susceptibility testing; and to identify possible risk factors associated with resistance. Methods Study design was parallel non-inferior quasi experimental study. Patients at the University Teaching Hospital with discharge and Gonorrhea symptoms who gave consent, were recruited. Fishers Exact Test for associations was used. Data was analyzed using Ordinal logistic regression as the Susceptibility was at 3 levels; Susceptible, Intermediate or Resistant with an assumed Ordinal nature. Proportionality assumption was checked, and when violated Partial Proportional Odds Model was used instead. Results A total of 104 isolates were obtained. The overall proportion of patients who had Susceptible, Intermediate and Resistant results were: 49 (47.1%), 55 (52.9%) and 0 (0) for Ceftriaxone and 70 (68.0%), 10 (9.7%) and 22 (22.3%) for Ciprofloxacin respectively. Adjusted estimates in partial Proportional Odds model showed that, Males were 4.1 (95% CI; 1.8, 9.4, p-value=0.001) times more likely to have Intermediate or Susceptible results compared to Resistance than females, or they were more likely to have Susceptible compared to Resistance or Intermediate result compared to females. Ciprofloxacin was 70% less likely than Ceftriaxone of having susceptible or intermediate results compared to resistance and this could be as high as 90% and as high as 40% p-values <0.001). Conclusion Level of Ciprofloxacin resistance detected from the Susceptibility testing, shows it is not an effective treatment for Gonorrhea. Ceftriaxone remains a satisfactory option for first-line treatment of Gonorrhea at UTH. Risk factors identified to be associated with resistance in this study were being female and use of Ciprofloxacin. Ethical Clearance Ethical clearance was obtained from University of Zambia Biomedical Ethics Research Committee (UNZABREC Ref # 033-06-17).

scholarly journals Socio-demographic, environmental and behavioural factors of the prevalence of diarrhea among children age under-five years in Rural Ethiopia: A Cross-Sectional Study

2019 ◽  
Author(s):  
Melkamu Molla Ferede
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Birth Order ◽  
Multivariable Logistic Regression Analysis ◽  
Cross Sectional ◽  
Older Mothers ◽  
Under Five ◽  
Under Five Children ◽  
Rural Ethiopia ◽  
Behavioural Risk Factors

Abstract Background : Diarrhea is one of the major contributors to deaths for under age five children in Ethiopia. Studies conducted in different countries showed that rural children are highly affected by diarrhea than urban children. Thus, the purpose of this study was to identify the socio-demographic, environmental and behavioural risk factors of the prevalence of diarrhea among children age under five years in Rural Ethiopia. Methods: Data for the study was drawn from the 2016 Ethiopia Demographic and Health Survey. A total of 8,041 under-five children were included in the study. Bivariate and multivariable binary logistic regression were employed for the analysis of the data to assess the relationships between the prevalence of diarrhea and socio-demographic, environmental and behavioural risk factors among under five children. Data was analyzed using SPSS version 23. Results : The multivariable logistic regression analysis revealed that younger mothers’ children and child’s age 6-11 months (AOR: 3.5; 95% CI: 2.58-4.87), 12-23 months (AOR: 3.1; 95% CI: 2.33-4.04) and 24-35 months (AOR: 1.7; 95% CI: 1.26-2.34) were significantly associated with diarrhea. The two week prevalence of diarrhea was also significantly associated with male children (AOR: 1.3; 95% CI: 1.05-1.58), Children in rural Afar and Gambela regions, households who shared toilet facilities with other households (AOR: 1.4; 95% CI: 1.09-1.77), higher birth order number and households with 3 or more under-five children interacted with older mothers (AOR: 4.7; 95% CI: 1.64-13.45). Conclusion: The prevalence of diarrhea among under-five children was strongly associated with younger mothers, child’s age between 6-35 months, male children, children in rural part of Afar and Gambela regions, children with higher birth order numbers, those who shared toilet facility with other households and households with 3 or more number of under-five children interacted with older mothers/primary caregivers. Thus, in order to reduce childhood diarrhea, I suggest that child’s health care programs and other efforts in Ethiopia should give special attention to those categories of children who had highly affected by diarrhea.

scholarly journals Determinants of Under-nutrition among Children under Five Years of Age in Ethiopia

2020 ◽  
Author(s):  
Gashu Workneh Kassie ◽  
Demeke Lakew Workie
Keyword(s):  
Body Mass Index ◽  
Regression Models ◽  
Composite Index ◽  
Wealth Index ◽  
Proportional Odds Model ◽  
Nutrition Status ◽  
Proportional Odds ◽  
Anthropometric Indices ◽  
Under Nutrition ◽  
Partial Proportional Odds Model

Abstract Background: Ethiopia is one of the developing countries where child under-nutrition is prevalent. Prior studies employed three anthropometric indicators for identifying factors of children’s under-nutrition. This study aimed at identifying factors of child under-nutrition using a single composite index of anthropometric indicator. Methods: Data from Ethiopia’s Demographic and Health Survey 2016 was the base for studying under-nutrition in a sample of 9494 children below 59 months. A single composite index of under-nutrition was created from three anthropometric indices through principal component analysis recoded into an ordinal outcome. In line with WHO 2006 Child Growth Standards, the three anthropometric indices involve z-score of height-for-age (stunting), weight-for-height (wasting) and weight-for-age (underweight). To identify significant determinants of under-nutrition , partial proportional odds model was fitted and its relative performance compared with some other ordinal regression models. Results: The single composite index of anthropometric indicators showed that 49.0% (19.8% moderately and 29.2% severely) of sampled children were undernourished. In the Brant-test of proportional odds model, the null hypothesis that the model parameters equal across categories was rejected. Compared to ordinal regression models that do not involve parallel regression assumption, and Akaike information criterion, partial proportional odds model showed an improved fit. A child with mother of body mass index less than 18.5 kg, from poorest family, a husband without education and male to be in a severe under-nutrition status was 1.4, 1.8 1.2 and 1.2 times more likely to be in worse under-nutrition status compared to its reference group respectively. Conclusion: The authors conclude that the fitted partial proportional odds model indicated that age and sex of the child, maternal education, region, source of drinking water, number of under five children, mother’s body mass index, wealth index, anemic status, multiple birth, fever before two months of survey, mother’s age at first birth, and husband’s education were significantly associated with child under-nutrition. Thus, it is argued that interventions focus on improving household wealth index, food security, educating mothers and their spouses, improving maternal nutritional status, and increasing mothers’ health care access.

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