Open defecation: risk factors for adverse outcomes in Indonesia

The increasing number of Indonesian population has caused serious issue of open defecation. Indonesia ranks the second large of open defecation prevalence in the world, after India. Human’s excrement was disposed in trench, drain, terrace, grassland, backwoods, forest, river, lake or other open spaces, thus, contaminates the water system. Open defecation can lead to the increasing risk of transmission of water-boene diseases of child morbidity in Indonesia. This study aimed at exploring different socio-economic and demographic factors of Indonesians who practice open defecation. Data were obtained from 49,627 female respondents of the 2017 Indonesia Demographic and Health Survey. The data were examined utilizing descriptive and logistic regression. The results reveal that the practice of open defecation is significantly influenced by place of residence, household’s wealth quintile, and household’s water supply. The findings suggest the needs for toilet construction and water supply sustainability in public area as well as in poor neighbourhood to eliminate open defecation in the country.

Vaccinating children against COVID-19: commentary and mathematical modelling

With the recent licensure of mRNA vaccines against COVID-19 in the 5-11 year old age group, the public health impact of a childhood immunization campaign is of interest. Using a mathematical epidemiological model, we project that childhood vaccination carries minimal risk and yields modest public health benefits. These include large relative reductions in child morbidity and mortality, although the absolute reduction is small because these events are rare. Furthermore, the model predicts altruistic absolute reductions in adult cases, hospitalizations, and mortality. However, vaccinating children to benefit adults should be considered from an ethical as well as a public health perspective. From a global health perspective, an additional ethical consideration is the justice of giving priority to children in high-income settings at low risk of severe disease while vaccines have not been made available to vulnerable adults in low-income settings.

Faktor Risiko Kejadian Diare pada Anak Usia 6-24 bulan di Kota Jambi

Diarrhea is a major cause of child morbidity and mortality in developing countries, including Indonesia. This study aimed to determine the risk factors for diarrhea in children aged 6-24 months. This study used a case-control design with 48 cases and 48 controls. Cases were children aged 6-24 months who had experienced diarrhea with the ICD code A.09 recorded in the register book from October 2019 to March 2020. The control samples were children aged 6-24 months who did not suffer from diarrhea with age (range ±3 months), gender, and domiciled in the same village as the case. Samples were taken using the total sampling method. Data collection used interview and direct observation techniques in July 2020. Data analysis was carried out univariate and bivariate using the chi-square test. The results of the study showed the relationship between exclusive breastfeeding (p= 0.000 OR=4.8 95% CI: 2.04-11.53), use of milk bottles (p=0.000 OR=6.3 95%CI 2.5-15.7), and CTPS habits (p = 0.000 OR = 4.8 95% CI 2.0-11.5) with the incidence of diarrhea in children. Family latrines (p=0.168 OR=4.3 95%CI 0.4-39.7), and drinking water sources (p=1,000 OR=1.0 95%CI 0.1-16.4) were not factors diarrhea risk. Health workers should educate the importance of the habit of washing hands with soap and washing bottles. Parents should give exclusive breastfeeding, clean regularly, and pay attention to how to store milk bottles before use.

Prevalence and patterns of adverse events following immunisation among children less than 24 months attending immunisation clinics in Kano, Nigeria

Adverse Events Following Immunisation (AEFI) contribute to child morbidity and mortality as they often lead to low uptake of vaccines with consequent persistence of vaccine-preventable diseases. It is essential to assess the prevalence of AEFIs in northern Nigeria, where misconceptions about immunisation exist. This study assessed the prevalence and pattern of AEFI among children less than 24 months after attending immunisation clinics in Kano, Nigeria. Using a mixed-methods design, adapted intervieweradministered questionnaires were assigned to a cross-section of 384 mother-baby pairs who presented to the immunisation clinics of selected primary healthcare centres (PHCs) within metropolitan Kano. This was followed by six sessions of focus group discussion with a sub-sample of the mothers. Logistic regression and the framework approach were used to analyse the data. The prevalence of AEFI was (43.5%, n=164), and most cases (72.4%, n=273) were mild. Fever was the most common type of AEFI reported (66.5%, n=109) and was higher among infants less than three months (44.5%, n=73). Age of the index child was the only significant predictor of AEFI (OR:0.18, 95% CI: 0.10-0.35). Our study shows that AEFI was common among children less than 24 months old in Kano. We recommend sensitisation and health education of caregivers using valuable communication strategies and sufficient training of immunisation service providers on professional ways to deliver these vaccines safely.

Assessment of Risk Factors and Prevalence of under Nutrition Using Composite Index of Anthropometric Failure (CIAF) among under 5 Children in a Tertiary Care Center

Background: Under nutrition is a major health problem in the developing countries especially India. It has a significant impact to child morbidity and mortality. Objective: To assess the risk factor and prevalence of under nutrition among children under 5 years of age, using conventional indices and the Composite Index of Anthropometric Failure (CIAF), and then comparing their estimated results. Materials and Methods: This cross-sectional study was carried out in the pediatrics department (outpatient and inpatient) from January 2021 to March 2021 using sample size of 300. Attendants of Toddler’s were interviewed with semi structured proforma and height and weight of toddler were measured by measuring tape and weighing machine respectively. Informed consent was obtained. MS excel was used for data analysis after compilation. Results: CIAF identified 96% of childrens to have under nutrition. By using conventional indices it was seen that 62.8% of the children were underweight, 50% were stunted and 44.4% were wasted. Conclusion: CIAF gives a better estimate of under nutrition than currently used conventional indices; and identifies more children with multiple anthropometric failures.

A Bivariate Analysis of the Spatial Distributions of Stunting and Wasting Among Children Under-Five in Nigeria

Stunting and wasting are major malnutrition issues among children under five years of age and have continued to remain unacceptably high in Nigeria leading to high rates of child morbidity and mortality. Evidence-based strategies are required by government and non-governmental agencies to mitigate the suffering of these children, and this could be realised when the association between the determinants and the geographical distributions are fully understood. Using data from four waves of the Nigerian Demographic and Health Survey, we employed a distributional bivariate probit model to examine the geographical distributions of the levels and linear association between acute and chronic malnutrition in Nigeria after accounting for possible observed determinants. Bayesian inference was based on Markov chain Monte Carlo simulation. The findings reveal substantial spatial variations in stunting and wasting among under-five children in Nigeria, indicating a north–south divide. The findings show negative linear association between the two malnutrition indicators among children in some northern fringe states but positive for Akwa Ibom, Ebonyi and Anambra. The correlation also peaks around age 20 months indicating that during the first 2 years of life, the children have an increasing likelihood of suffering from stunting and wasting.

Diet therapy for toxic and mucous-bloody diarrhea

Advances in nutrition and childcare over the past decades have resulted in declines in child morbidity and overall mortality. Despite this, we still have to deal with acute gastrointestinal diseases and higher infant mortality especially often.

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.

FAKTOR RISIKO STUNTING PADA ANAK BALITA DI KABUPATEN LAMPUNG TENGAH

<em>Stunting is stunted growth in children due to malnutrition. It can affect children's cognitive and physical development, increase the risk of infection, and significantly contribute to child morbidity and mortality. This study aims to analyze the risk factors for stunting in children under five (13-59 months). The study used a case-control design to compare previous exposure to stunting and normal children under five. Measurements and interviews were conducted with 120 children under five and their mothers. The SPSS (24.0) was used for the Chi-square and Odds Ratio (alpha = 5%) test. The study found the risk factors for stunting under five, poor income (OR = 4.75; 95% CI 2.18-10.33), not getting exclusive breastfeeding (OR = 5.29; 95% CI 2.39-11.68) ), there is no access to clean water (OR = 3.00; 95% CI 1.42–6.32), and healthy latrines (OR = 3.73; 95% CI 1.75-7.94). Increasing the nutritional status of pre-pregnant and pregnant women and access to clean water and healthy latrines to prevent infection is an urgent need to be implemented immediately.</em><p> </p>