Prevalence and determinants of stunting among preschool and school-going children in the flood-affected areas of Pakistan

Stunting is a significant public health problem in low- and middle-income countries. This study assessed the prevalence of stunting and associated risk factors of stunting among preschool and school-going children in flood-affected areas of Pakistan. A cross-sectional study was conducted by visiting 656 households through multi-stage sampling. Respondent’s anthropometric measurements, socio-demographic information and sanitation facilities were explored. A logistic regression model was used to determine determinants of stunting, controlling for all possible confounders. The overall prevalence of stunting in children was 40.5%, among children 36.1% boys and 46.3% of girls were stunted. The prevalence of stunting in under-five children was 50.7%. Female children (OR=1.35, 95% CI:0.94-2.0), children aged 13-24 months (OR=6.5, 95% CI: 3.0-13.9), mothers aged 15-24 years (OR=4.4, 95% CI: 2.6-7.2), joint family (OR=2.1, 95% CI: 1.4-3.0) did not have access to improved drinking water (OR=3.3, 95% CI: 1.9-5.9), and the toilet facility (OR=2.8, 95% CI, 1.9-4.3), while the children from district Nowshera (OR=1.7, 95% CI: 0.9-3.2) were significantly (P<0.05) associated in univariate analysis. The regression model revealed that child age, maternal age, family type, quality of water, and toilet facility, were the significant (P<0.05) factors contributing to child stunting in the flood-hit areas. Identification of key factors might be helpful for policymakers in designing comprehensive community-based programs for the reduction of stunting in flood-affected areas. In disasters such as flood, the detrimental consequences of the stunting problem could be even more on children. Evidence-based education and care must be provided to the families in the flood-affected regions to reduce the stunting problem. The determinants of stunting should be targeted by making comprehensive policies regarding proper nutrition, livelihood, clean water, and sanitation facilities in flood-hit regions.

Infrastructure evaluation of anganwadi centres in Kalaburagi city: a cross sectional study

Background: ICDS scheme represents one of the largest programmes, which is a symbol of India’s commitment to its children, providing pre-school education on one hand and breaking the today vicious cycle of malnutrition, morbidity, reduced learning capacity and mortality on the other hand.Methods: The present study was taken up to assess the infrastructure and services of anganwadi centers. Community based cross sectional observational study was conducted by involving 92 anganwadi centers in Kalaburagi city.Results: Out of 92 AWCs studied, 52 (56.5%) were belonged to Government set up whereas 40 i.e.; 43.5% were on rental basis. Safe drinking water was available in 81 i.e.; 88% of AWCs, toilet facility was available in 34 i.e.; 37% of AWCs. Adequate outdoor space was available in 54 i.e.; 58.7% of AWCs. Adequate indoor space was available in 72 i.e.; 78.3% of AWCs. Adequate kitchen space was available in 65 i.e.; 70.7% of AWCs. Adequate food storage facility was available in 70 i.e.; 76.1% of AWCs and in 22 i.e.; 23.9% it was not adequate. In 30 i.e.; 32.6% of AWCs, source of fuel use was LPG.Conclusions: Safe drinking water was available in majority of AWCs. Almost one third of anganwadi have inadequate space. Majority of anganwadi have maintained sufficient number of registers. Outdoor and indoor game kits and equipment’s were available at majority of AWCs.

On Prevention of Diarrheal Disease: Assessing the Factors of Effective Handwashing Facilities in Bangladesh

People in Bangladesh usually do not utilize handwashing facilities properly, which makes it challenging to implement hygiene practices of handwashing to reduce diarrhea and other health risks. Against this backdrop, this research attempts to assess the factors associated with Effective Handwashing Facilities (EHFs) in Bangladesh utilizing the Multiple Indicator Cluster Survey 2019. This study utilizes descriptive statistics techniques and also bivariate and multivariable logistic regression methods by representing odd ratios to identify the relationship between associated factors and EHF in Bangladesh. The descriptive statistics show that about 74.22% of the households in Bangladesh have EHFs. Gender, education, ethnicity, male-head households, household wealth status, source of water, sanitation status, sharing toilet facility are identified as the potential determinants of EHF. As a result, we recommend that all levels of society in Bangladesh have continuous access to handwashing equipment and facilities to reduce hygiene-related illnesses especially diarrheal disease.

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

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.

Helicobacter pylori Seromarkers in a University Students Population in Central Nigeria

Infection due to Helicobacter pylori is a public health challenge worldwide as over 3 billion persons are infected with the bacterium globally. There is a serious need to update the knowledge on the epidemiology of this bacterial pathogen and its probable risks factors to generate intervention programs that will reduce the morbidity and mortality of infected individuals. This chapter evaluated the seromarkers of H. pylori infection and its predisposing factors among students of Nasarawa State University, Keffi, Central Nigeria. This study was done between June through August 2019; blood and stool specimens were collected from 400 students of the institution. Before the commencement of the study, ethical clearance and informed consent were retrieved and a structured questionnaire was administered to each participant. Specimens were screened for H. pylori antigen and antibody using rapid test kits (CTK Biotech, Inc., San Diego, USA and Biotest Biotech, China). Information obtained were analyzed using SSP version 2.80. P values <0.05 were reflected statistically significant. Out of the 400 students tested, 166 (41.5%) and 128 (32.0%) showed positive for anti-H. pylori IgG and Ag markers respectively. The antibody seromarker was higher in female while the H. pylori antigen was higher in males. Those students aged 21–30 years old reported the highest prevalence of the seromarkers while those of more than 41 years old had the least prevalence. Location, type of toilet facility and place of residence were statistical associated between H. pylori antigen (P < 0.05). There was a statistically significant association between anti-H. pylori IgG and the sources of water of the students (P < 0.05). This is the first public report that has successfully reported the prevalence of these seromarkers among students of a tertiary institution in Nasarawa state. The overall outcomes of this study stressed the need for student-based intervention programs to stem the transmission of this infection in Nasarawa State, Nigeria.

Household Food Insecurity and Unavailability of Toilet Facility Contribute to Adverse Health Outcomes of Under-five Children in Bangladesh: A Cross-sectional Study

BackgroundDespite recent progress in rural economic development and food production, the prevalence of household food insecurity (FI) and use of unimproved toilet facilities are widespread in Bangladesh. Limited studies have sought to understand the relationship of household FI and sanitation, separately and in combination, with child morbidity. This paper aimed to assess the effect of FI and unimproved toilet facility of households on adverse health outcomes of children less than five years of age in Bangladesh.MethodsWe used data from a cross-sectional survey that was conducted as part of an evaluation of the Maternal, Infant and Young Child Nutrition (MIYCN) Program in Bangladesh. The study population included children aged 6-59 months and their caregivers, identified using a two-stage cluster-sampling procedure. Child morbidity status was the outcome variable, and household FI status and type of toilet used were considered the main exposure variables in this study. We performed logistic regression, calculated adjusted odds ratios (AOR) to assess the association of child morbidity with household FI and unimproved toilet facility after adjusting for potential confounders. ResultsA total of 1,728 households were eligible for this analysis. About 23% of the households were food-insecure, and a large number of households had improved toilet facilities (93.4%). In the multivariable logistic regression model, we found that children in food-insecure households with unimproved toilet facility had 5.88 (AOR: 5.88; 95% CI 2.52, 13.70) times more chance, of being morbid compared to the children of food-secure households with improved toilet facility. A similar association of FI and toilet facilities with each of the morbidity components was observed, including diarrhea (AOR:3.6; 95% CI 1.79, 7.89), fever (AOR:3.47; 95% CI 1.72, 6.99), difficult or fast breathing with cough (AOR:3.88; 95% CI 1.99, 7.59), and difficult or fast breathing with blocked or running nose (AOR:1.29; 95% CI 0.56, 2.95).ConclusionsOur study shows that household FI and unimproved toilet facility jointly have more deteriorative effects on child morbidity than either of these conditions alone. Therefore, it is important to consider these two critical factors while designing a public health intervention for reducing morbidity among under-five children.

Trends in the Prevalence of Overweight and Obesity and Associated Socioeconomic and Household Environmental Factors among Women in Nepal: Findings from the Nepal Demographic and Health Surveys

This study aimed to examine the trends in the prevalence of overweight and obesity and to determine the associated socioeconomic and household environmental factors among women in Nepal. Using nationally representative data from the 1996, 2001, 2006, 2011, and 2016 cross-sectional Nepal Demographic and Health Surveys (NDHSs) (n = 33,507), the prevalence of overweight–obesity (body mass index (BMI) ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2) among women aged 15–49 years were examined. From the latest NDHS 2016, non-pregnant women with recorded anthropometric measurements (n = 6165) were included in the final analyses. Multivariate logistic regression models were used to determine the socioeconomic and household environmental factors associated with BMI ≥ 25 and BMI ≥ 30. Between 1996 and 2016, the prevalence of overweight–obesity increased from 1.8% to 19.7%, while the prevalence of obesity increased from 0.2% to 4.1%. Age, marital status, wealth index, province of residence, type of cooking fuel, and household possessions—refrigerator and bicycle were significantly associated with having overweight–obesity and obesity. Similarly, educational status, religion, type of toilet facility, and household possessions—television and mobile phone were significantly associated with having overweight–obesity. Given the alarming increase in the prevalence of overweight and obesity among Nepalese women, there is an urgent need for interventions addressing these critical socioeconomic and household environmental factors.

Knowledge and practice of environmental sanitation and personal hygiene by traders. A case study of Tamale Central Market

Tamale is one of the rapidly growing cities in Ghana which is faced with numerous sanitation and hygiene problems. Markets generate large volumes of wastes due to their functions. Poor waste management in markets poses a threat to public health. This study sought to assess traders’ knowledge and practice of environmental sanitation and personal hygiene. It also sought to identify the environmental sanitation challenges in the market. Questionnaire surveys, interviews, and personal observations were employed for data collection. The traders demonstrated fair knowledge on environmental sanitation but most did not practice recommended sanitation practices. Moreover, both males (50.1%) and females (49.9%) demonstrated good knowledge of personal hygiene and practiced it. The study identified poor drainage systems, lack of potable water, inadequate waste bins, littering, pilling of wastes, poor wastewater handling as major environmental challenges in the market. The findings of this study underline the need for bolstering up environmental education and hygiene promotion activities in public places like markets. It is also recommended that the toilet facility within the market get replace or renovated. The need for sanitation equipment and tools like waste bins should be met by the Metropolitan Assembly, as well as supports from NGOs and other bodies.

Conceptual Behaviour Underpinning the Occurrence of Nonfaecal Matter in Faecal Sludge in Some Urban Communities, Ghana

Faecal sludge (FS) management is pertinent to the achievement of sustainable development goal 6.2 around the world; yet it is constrained by urbanisation challenges, waste management complexities, and defective attitudes. These deny communities of the plausible supply of resources from FS. This paper assesses the perception underpinning the occurrence of nonfaecal matter in FS in Ghana. Primary data were obtained from 400 respondents in four communities in Brong Ahafo and Greater Accra Regions of Ghana, using a structured questionnaire. Data were analysed by using STATA software version 15. Chi-square test and multiple logistic regression were conducted on all independent variables and statistical significance was accepted at p < 0.05 . The study identified the following as the most perceived frequently disposed nonfaecal matter into FS: sanitary pads and diapers (38.5%), fabrics/rags (23.2%), toilet rolls (20.8%), razor/shaving sticks (10.3%), and others (7.2%). Gender, state of toilet facility (roof or unroofed), presence of container for collecting other types of waste in the toilet room, and state of container in toilet room either covered or uncovered were the factors found to be significantly associated with the disposal of solid waste (SW) into FS at 95% confidence level. The fear of exposing used sanitary materials for rituals, the use of fabric as an alternative to toilet rolls, and the desire to conceal aborted pregnancies from the public were some of the reasons alluded to the disposal acts. Education and awareness campaigns on proper SW disposal practices, appropriate use of toilet facilities, and the resource potentials of FS were found to be the best way forward to discourage indiscriminate disposal of SW into FS.

Determinate of diarrhea among under-five children in Northwest Ethiopia

This study aimed to assess the determinants of diarrhea among children under-five in Jabitehnan district, Northwest Ethiopia. A community-based cross-sectional study was done using a cluster sampling technique. The study was done in the Jabitehnan district from April to July 2019. The study was done among women who had children under five during the survey who settled in Jabitehnan district. The main outcome measure was the occurrence of diarrhea. A binary logistic regression was used to identify factors associated with diarrhea. The prevalence of diarrhea was found to be 19.8%. The child lived with whose non-biological mothers were 32.44 times more likely to be exposed to diarrhea compared to the child who lived with whose biological mothers. The odds of being diarrheal for a child whose mother does not wash her hand after latrine was 7.91 times higher than its counterpart. A child whose mother pregnant was 5.66 times higher risk of developing diarrhea than whose mother do not pregnant. The likelihood of diarrhea for children drinking unprotected water were14.1times higher than its counterpart. The magnitude of reported diarrhea was high. Child age, residence, drinking water, pregnant mother, toilet facility, washing hand after latrine, and child live with whom were the main determinates of diarrhea. Addressing these factors will help to prevent future morbidity and mortality of children and will assist in alleviating hygiene and refining their quality of life. Moreover, a trend-based sampling design might be considered for a better understanding.