Quality of Care for Children Under Five with Malaria Using IMCI Approach at Public Health Centre: Literature Review

Integrated Management of Childhood Illness is one of the strategies in health care services for infants and children under five at primary health care facilities. Children with fever in high malaria endemic areas must have a blood test done to check whether the children have malaria or not. IMCI is one of the interventions recommended by WHO to screen and also ensure that children receive proper initial treatment at first-level health facilities. This article aims to discuss the quality of care for children under five with malaria using IMCI approach. This is a systematic review by searching 4 databases including Scopus, Web of Science, SAGE and Proquest. Health care services for children under five with an integrated management of childhood illness are intended to provide immediate and appropriate treatment. The guideline for treating children under five with malaria using IMCI approach is very helpful for nurses both in assessing, classifying, treating/curing and making decisions for pre-referral measures for severe cases. Several factors to support quality of care are trained officers, supervision and procurement of essential medicines, RDT and malaria microscopy. Enforcement of the right diagnosis will improve the quality of life of children and prevent death in children under five. Keywords: IMCI, Malaria, Children under five

WASH Practices and Its Association With Disease and Nutritional Status of Under Five Children: Evidence From Rural Bangladesh

This study aimed to assess knowledge and practice of caregivers and its relationship to the disease and nutritional status of children under five years of age in rural areas of Sylhet, Bangladesh. A total of 110 households having 6 to 59 months aged children was selected by simple random method from ten rural communities of three Upazila of Sylhet during September 2019 to February 2020. Descriptive statistics were used to assess the WASH knowledge & practice and multivariate chi-square analyses were performed to assess associations among diseases & nutritional status with WASH following a structured questionnaire. The study found a significant association of WASH with childhood disease and nutritional status, and 65% of children were found to be in a diseased state and 35% of children were found to be in a disease-free state within the last six months. The findings sketched that mother with poor wash knowledge and practice was at greater risk for disease outbreaks, disease frequency and duration. The highest incidence of diarrhea was 17% in children aged 12 to 23 months. Significant effect of WASH was also found in children nutrition status, that was reflected in the ratio of stunted, underweight and wasted children. Integrated convergent work focusing on the provision of clean water within the household, stop open defecation, promotion of hand washing, behavior change and poverty alleviation is needed to improve the situation. Health, nutrition and livelihood programs should be uninterrupted, and mothers or caregivers should be encouraged to participate in these programs.

Assessment of the Behavioural Effects of Cartoon Viewing among Parents of Under-Five Children

Background of the Study: Cartoons are the most popular entertainment for the Children. Mostly children begin watching cartoons on television at the early age of six months, and by the age of two or three children become enthusiastic viewers. Objectives: The main objective of the study is to assess the behavioral effects of cartoon viewing among the parents of under-five children. Methodology: Descriptive study design was used to conduct the study in selected tertiary care hospital. As per the inclusion criteria 50 samples were selected by using non probability purposive sampling technique. Self structured questionnaire was used to collect data and the behavioral effects of cartoon viewing among the parents of under-five children. Results: The study findings revealed that, among 50 samples 32% of the Children had mild effects on behaviour, 66% had moderate effects on behaviour and 2% of the Children had sever effects on behaviour. The mean and standard deviation score of the study was 54.72+0.8571. There was a significant association between the behavioral effects of cartoon viewing and the age of the Children (χ2 = 7.6364 , P<0.05). Conclusion: The study concluded that, 32% of the children had mild effects on behaviour, 66% had moderate effects on behavior and 2% of the children had sever effects on behaviour. Keywords: Cartoons, behavioral effects, under five children, parents.

Adapting and validating the log quadratic model to derive under-five age- and cause-specific mortality (U5ACSM): a preliminary analysis

Background The mortality pattern from birth to age five is known to vary by underlying cause of mortality, which has been documented in multiple instances. Many countries without high functioning vital registration systems could benefit from estimates of age- and cause-specific mortality to inform health programming, however, to date the causes of under-five death have only been described for broad age categories such as for neonates (0–27 days), infants (0–11 months), and children age 12–59 months. Methods We adapt the log quadratic model to mortality patterns for children under five to all-cause child mortality and then to age- and cause-specific mortality (U5ACSM). We apply these methods to empirical sample registration system mortality data in China from 1996 to 2015. Based on these empirical data, we simulate probabilities of mortality in the case when the true relationships between age and mortality by cause are known. Results We estimate U5ACSM within 0.1–0.7 deaths per 1000 livebirths in hold out strata for life tables constructed from the China sample registration system, representing considerable improvement compared to an error of 1.2 per 1000 livebirths using a standard approach. This improved prediction error for U5ACSM is consistently demonstrated for all-cause as well as pneumonia- and injury-specific mortality. We also consistently identified cause-specific mortality patterns in simulated mortality scenarios. Conclusion The log quadratic model is a significant improvement over the standard approach for deriving U5ACSM based on both simulation and empirical results.

Prevalence and Determinants of Under-Nutrition Among Under-Five Children in Afar Region, Ethiopia: Evidence From 2016 Ethiopian Demographic and Health Survey

Background: Undernutrition is one of the major public health concerns among infants and young children in the country. Childhood under-nutrition is widespread in low and middle-income countries. This study was initiated to assess the prevalence of under-nutrition and its associated factors among under-five children in Afar Region, Ethiopia. Methods: The data for this study were extracted from the Ethiopian Demographic and Health Survey (EDHS) 2016. The information collected from 937 children born 5 years before the survey was considered in the analysis. A multivariable binary logistic regression analysis was used at a 5% level of significance to determine the individual- and community-level factors associated with childhood malnutrition.Results: The prevalence of stunting, underweight and wasting in Afar region were 41.1%, 36.2% and 17.7%, respectively. About 26.7% of children in Afar region were both stunting and underweight, 12.7% were both underweight and wasting, 7.6% were both stunting and wasting and only 7.0% of children had all the three under-nutrition conditions. Among the factors considered in this study, age of a child in months, anemia level, mothers’ BMI, household wealth index, size of child at birth, number of living children and place of residence were significantly associated with stunting, underweight and wasting in Afar Region. Conclusions: The prevalence of all stunting, underweight and wasting was relatively high. Undernutrition is one of the major public health concerns among children in Afar Region. The effect of these factors should be considered to develop strategies to reduce under-nutrition in the study area. Thus, intervention should be focused on improving the under-nutrition determinants of the children to improve the child's nutritional status and reduce child morbidity and mortality.

Spatial disparities and associated factors of Under-five diarrhea disease in Ilubabor Zone, Oromia Regional State, Ethiopia

Diarrhea is commonly a sign of an infection in the intestinal tract that is caused by different bacteria, virus and parasitic entities. It is one of the leading causes of child mortality worldwide, especially in sub-Saharan Africa countries including Ethiopia. The main objective of this study was to identify spatial disparities and associated factors of under- five diarrhea disease in Ilubabor zone, Oromia regional state, Ethiopia. The study has been conducted in Ilu Aba Bor zone of entire districts and the data is basically both primary and secondary which were obtained from each woreda health office of Ilu Aba Bor zone and corresponding mother or care givers of sampled child. Spatial disparities of under-five diarrhea were identified using global and local measures of spatial autocorrelation. Geo-additive regression model was used to identify the spatial disparities and associated factors of under-five diarrheal disease. The value of global and local measures of spatial autocorrelation shows that under-five diarrheal disease varies according to geographical location and shows significant positive spatial autocorrelation. The results of Geo-additive regression model showed that statistically significant relationship between under-five diarrhea disease and independent variables .There is evidence of significant under-five diarrheal disease clustering in Ilu Aba Bor zone, southwest Ethiopia. Model based data analysis showed that there is significant relationship between Under-five diarrhea and covariates (mother’s age, mother’s education, source of drinking water, quality of toilet facility, DPT 3 vaccination, Polio 3 vaccination and household wealth index.).

Characteristics of severely malnourished under-five children immunized with Bacillus Calmette-Guérin following Expanded Programme on Immunization schedule and their outcomes during hospitalization at an urban diarrheal treatment centre, Bangladesh

Background Bacillus Calmette-Guérin (BCG) vaccination has recently been found to have beneficial effects among children infected other than Mycobacterium tuberculosis. Due to the paucity of data on the outcomes of children who had successful BCG vaccination following Expanded Programme on Immunization (EPI) schedule, we aimed to investigate the characteristics of such children and their outcomes who were hospitalized for severe malnutrition. Methods A prospective observational study was conducted to determine the viral etiology of pneumonia in severely malnourished children those were admitted to the Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) between April 2015 and December 2017, constituted the study population. Using a case-control design for the analysis, children having BCG vaccination prior hospital admission were treated as cases (n = 611) and those without vaccination, constituted as controls (n = 83). Bi-variate analysis was conducted using socio-demographic, clinical, laboratory, and treatment characteristics on admission and outcomes during hospitalization. Finally, log-linear binomial regression analysis was done to identify independent impact of BCG vaccination. Results The cases more often presented with older age, have had lower proportion of maternal illiteracy, higher rate of breastfeeding, severe wasting and lower rate of hypoglycemia, compared to the controls. The cases were also found to have lower risk of severe sepsis and deaths, compared to the controls (for all, p<0.05). However, in log-linear binomial regression analysis, after adjusting for potential confounders, BCG vaccination following EPI schedule (RR:0.54; 95%CI = 0.33–0.89; p = 0.015) and breastfeeding (RR:0.53; 95%CI = 0.35–0.81; p = 0.003) were found to be protective for the development of severe sepsis. Conclusion BCG vaccination and breastfeeding were found to be protective for the development of severe sepsis in hospitalized severely malnourished under-five children which underscores the importance of continuation of BCG vaccination at birth and breastfeeding up to two years of age.

Caregivers’ Satisfaction toward Under-Five Health Care Services Provided at Primary Health Care Centers in Al Karkh, Baghdad, 2020

Background: Satisfied caregivers are more likely to return for further care and to recommend the primary health care center services to others. Satisfied caregivers usually are compliant with the medical provider advice and the recommended treatment plan. Compliance will eventually lead to better health outcomes. Method: A cross-sectional study with an analytic element was conducted during the period from the beginning of July to the end of September 2020. A convenient sample was collected from six primary health care centers in Al-Karkh side of Baghdad city where caregivers who attend those centers with their children for under-five health care services were interviewed using a structured questionnaire.Objective: To measure the caregivers’ satisfaction toward under-five health care services at primary health care centers in Baghdad Al-Karkh and their association with certain socio-demographic characteristics. Results: A total of 500 caregivers were interviewed during the study period, the overall satisfaction was (64%). Caregivers were satisfied with primary health care centers cleanliness (77.8%), while they were highly dissatisfied with the communication with the nurses (78.8%), with the waiting time for a routine visit (74.6%), with nurses’ antiseptic methods (59.2%), and with the availability and adequacy of their children’s vaccines (65.4%). Conclusions: The level of satisfaction of caregivers with under-five health care services provided at primary health care centers was relatively low. The study revealed that the less educated and older caregivers showed a significant higher level of satisfaction.

Trends and Determinants of Underweight among Children under Five Years in Ethiopia: Further Analysis with Ethiopian Demographic and Health Survey 2005–2016—Multivariate Decomposition Analysis

Background. Underweight is one of the paramount major worldwide health problems, and it traces a big number of populations from infancy to old age. This study aimed to analyze the trends and predictors of change in underweight among children under five years in Ethiopia. Method. The data for this study were accessed from three Ethiopian Demographic and Health Survey data sets 2005, 2011, and 2016. The trend was examined separately for the periods 2005–2011, 2005–2016, and 2011–2016. Multivariate decomposition analysis of change in underweight was employed to answer the major research question of this study. The technique employed the output from the logistic regression model to parcel out the observed difference in underweight into components, and STATA 14 was utilized for data management and analysis. Result. Perceiving the overall trend, the rate of underweight was decreased from 38% in 2005 to 24% in 2016. The decomposition analysis results revealed that, about 12.60% of declines in underweight have been explained by the difference in population characteristics or endowments (E) over the study period. The size of the child at birth, husband’s education, women’s education, and household wealth index contributed significantly to the compositional decline in underweight. Conclusion. The magnitude of underweight among children under five years indicates a remarkable decline over the last ten years in Ethiopia. In this study, two-twelfth of the overall decrease in underweight among children under five years over the decade was due to the difference in characteristics between 2005 and 2016. Continuing to educate the population and boost the population’s economy is needed on the government side in Ethiopia.