Children In Myanmar Research Articles

Hygiene practice and diarrhea prevalence among underfive children in Myanmar: a cross-sectional study

BackgroundOver 1.7 billion instances of diarrheal illness in children are reported worldwide yearly. Diarrhea was a major cause of death in children, accounting for 9% of all global under-five child deaths in 2021. The objective of this study was to identify the association between hygiene practices and childhood diarrhea among under-five children in Myanmar.MethodThis cross-sectional study was conducted in 16 townships from 8 states and regions of Myanmar. 1207 children between the ages of 6 and 59 months were recruited by multistage random sampling. Data were collected with a preformed questionnaire after participants provided consent. Multiple logistic regressions were administered to determine the factors associated with childhood diarrhea.ResultThis study found that 86 (7.13%) under-five children experienced diarrhea disease. This study identified that children receiving limited hygiene services were 2.85 times (AOR = 2.85, 95% CI: 1.31 to 6.21; p value 0.01) and children without hygiene services were 2.63 times (AOR = 2.63, 95% CI: 1.42 to 4.89; p value 0.01) more likely to have diarrhea disease than those with basic hygiene services. Other factors associated with diarrhea included: fathers who washed their hands less than four steps (AOR = 2.20, 95% CI: 1.29 to 3.74; p value 0.01), families taking more than 15 min to collect water (AOR = 1.77, 95% CI: 1.06 to 2.97; p value 0.03), families sharing toilet usage (AOR = 2.00, 95% CI: 1.15 to 3.48; p value 0.01), mother’s inadequate and problematic hygiene promotion health literacy (AOR = 2.20, 95% CI: 1.24 to 3.90; p value 0.01), houses made of bamboo or lacking floors (AOR = 2.31, 95% CI: 1.38 to 3.89; p value 0.01), families with three or more children (AOR = 1.68, 95% CI: 1.01 to 2.79; p value 0.05) and breastmilk being the primary food after 6 months of age (AOR = 2.07, 95% CI: 1.09 to 3.93; p value 0.03).ConclusionsEnsuring access to basic hygiene services, getting water at home 24 h per day, seven days per week, using private toilets, promoting hygiene health literacy, improving house flooring, family planning and introducing a variety of foods after age 6 months could significantly prevent diarrhea among under-five children in Myanmar. This study underscores the critical role of handwashing facilities in reducing the diarrhea incidence in children.

Development of a bioelectrical impedance analysis-based prediction equation for body composition of rural children aged 4-8 years in Myanmar.

Background: Reliable and accurate estimates of body composition are essential when studying the various health correlates of disease. Bioelectrical impedance analysis (BIA) is an affordable and feasible body composition assessment technique for clinical and field settings. Total body water (TBW) and hence fat-free mass is estimated by predictive regression algorithms using anthropometric measurements plus the resistance index. Aim: The study aimed to develop a BIA prediction equation for TBW in children in Myanmar using the deuterium dilution technique as the reference method. Methods: The study design was cross-sectional in a school setting with convenience sampling of participants. One hundred and two healthy children (57 boys and 45 girls) with aged 4 and 8 years participated; randomly divided into the prediction group (29 boys and 22 girls) and cross-validation group (28 boys and 23 girls). Whole-body impedance, anthropometric and TBW (by D2O dilution) measurements. The prediction equation was cross-validated using a split-group design and compared to published equations for contemporaneous populations. Results: TBW could be predicted by the following equation. TBW = 0.4597 * Weight (kg) + 0.1564 * Impedance index + 0.6075 (R2 = 0.891, P < 0.0001) with a correlation coefficient of 0.942 and limits of agreement of 0.98 kg TBW on cross-validation. Conclusions: This equation can be used to predict body composition in young (aged 4-8 years) children in Myanmar but because the age range of the participants in the present study was relatively narrow, more research in different age groups is required to establish its broader applicability.

Unsafe child feces disposal and childhood wasting among under five children in Myanmar

Background: Wasting is a major public health problem among under five children in developing countries, including Myanmar. The distribution of wasting and its associated factors are not well known in Myanmar. Objectives: This study aimed to examine the wasting prevalence and identify the association between child feces disposal and wasting among under-five children in Myanmar. Methods: A cross-sectional study was conducted on 1,207 under five children in Myanmar from September to December 2022. This study employed a multistage random sampling method with structured questionnaires and anthropometric measures. The World Health Organization's (WHO) definition and growth standards were used to determine the wasting. Multivariable logistic regression was performed to identify the association. An adjusted odds ratio with a 95% confidence interval and a p-value &lt;0.05 was used to define statistical significance. Results: The prevalence of childhood wasting among under five children in Myanmar was 11.10% (95% CI: 9.45 to 13.00). This study revealed that children from unsafe child feces disposing families were 94 % more likely to be wasted (AOR=1.94, 95% CI: 1.22 to 3.09; p-value 0.005). Other covariates to childhood wasting were water shortage (AOR=2.17, 95% CI: 1.13 to 4.16; p-value 0.02), less than four handwashing steps of mother (AOR=3.20, 95% CI: 1.93 to 5.32; p-value &lt;0.001), located in hilly region (AOR=2.27, 95% CI: 1.53 to 3.37; p-value &lt;0.001), boys (AOR=2.80, 95% CI: 1.86 to 4.23; p-value &lt;0.001), birth interval less than 3 years (AOR=1.84, 95% CI: 1.10 to 3.11; p-value 0.02), and eating more than 4 times per day (AOR=3.19, 95% CI: 1.93 to 5.27; p-value &lt;0.001). Conclusion: This study showed a high prevalence of wasting among under five children in Myanmar. Improving the safe child feces disposal practices of mothers would be a critical intervention to reduce under five children's wasting.

Examining the Factors Affecting Reading Readiness of Kindergarten Students

Reading is one of the core literacy skills of every individual and early reading for children has a great impact on future learning pathways and the success of school life. The purpose of this study was to investigate the reading readiness of kindergarten students in Myanmar and examine factors affecting reading readiness. A quantitative survey method was used in this study with a total of 222 kindergarten students from seven schools in Yangon and Rakhine selected using the multistage cluster sampling method. The Myanmar Reading Assessment Test (Cronbach’s alpha of 0.925) for kindergarten was used to administer the reading readiness skills of the students. In addition, demographic factors related to students and parents’ involvement in their children’s learning were collected using a self-administered questionnaire. The statistical analysis methods used were descriptive statistics, percentiles, t test, and Analysis of Variance (ANOVA). According to the results, there were five reader groups: below basic (25.7%), basic (6.8%), satisfactory (11.3%), proficient (16.7%), and advanced (39.6%) levels. The results of the statistical analysis concluded that no preschool experiences, lower socioeconomic status, the region in which they live, and unsupportive parents were the main factors affecting reading readiness. Among these factors, preschool experience is the only solution that can be tackled to improve reading readiness than other factors. However, most children in Myanmar cannot yet access preschool programmes adequately. Therefore, the government, NGOs, INGOs, CSOs, CBOs, and other organisations should ensure that every child has the opportunity to attend preschool regardless of geographical barriers.

Safely managed sanitation practice and childhood stunting among under five years old children in Myanmar.

In 2020, 149 million children under the age of five were estimated to be stunted globally. Around half of deaths among children under 5 years of age are related to under-nutrition. Objective of this study is to determine the association between safely managed sanitation and childhood stunting among under-five years old children in Myanmar. This cross-sectional analytical study was conducted in 16 townships across three regions and five states in Myanmar. Multiple logistic regressions analysis was performed to determine the associations. This study found that 327 (27.09%) under-five children were stunted among a total of 1207 children in Myanmar. Children with unsafely managed sanitation were 2.88 times more likely to be stunting compared with children who access to safely managed sanitation services (AOR = 2.88, 95% CI: 2.16 to 3.85; p-value <0.01). Other associated factors for childhood stunting were needs 1-15 minutes for water collection (AOR = 2.07, 95% CI: 1.46 to 2.94; p-value <0.01), 15-60 minutes for water collection times (AOR = 1.55, 95% CI: 1.08 to 2.23; p-value 0.02), improper waste water disposal (AOR = 1.99, 95% CI: 1.47 to 2.70; p-value <0.01), boys children (AOR = 4.49, 95% CI: 3.30 to 6.12; p-value <0.01), did not take vitamin A supplements(AOR = 1.64, 95% CI: 1.22 to 2.20; p-value <0.01), mothers height shorter than 153.4cm (AOR = 1.94, 95% CI: 1.45 to 2.58; p-value <0.01), and the lower minimal diet diversity (AOR = 1.47, 95% CI: 1.08 to 2.01; p-value 0.02). More access to safely managed sanitation facilities, technical sharing for proper waste water disposal, promoting household water supply system, health promotion for children's diet eating pattern, and regular support for Vitamin A supplementation are critical to reduce childhood stunting among children under the age of five in Myanmar.

Maternal Factors in Relation to Early Childhood Caries Among Preschool Children in Myanmar.

A cross-sectional study was conducted among 3- to 5-year-old preschool children in Yangon City in 2016-2017 to investigate the association between their caries experience and maternal factors. Children's oral examination and questionnaire surveys to their mothers were conducted. Children's caries prevalence was 82.9% with mean dmft of 6.4 ± 4.9. Mean oral health knowledge score of their mothers was 8.5 ± 2.8. Mother's educational level and oral health knowledge were significant predictors of childhood caries. Third- or later-born children were twice more likely to have dental caries than first-born children (P = .022). Mother's regular dental check-up resulted in significantly lower odds ratios for caries development in her child. Children's caries experience was high and mother's oral health knowledge regarding the importance of primary teeth was unsatisfactory. It is, therefore, necessary to improve awareness and attentiveness for prevention of childhood caries among parents and guardians in Myanmar.

Factors associated with syndemic anemia and stunting among children in Myanmar: A cross-sectional study from a positive deviance approach

BackgroundAnemia and stunting in children are detrimental to the prospects of a normal, healthy upbringing. Having similar risk factors and serious consequences, the syndemic aspect of these two ailments is mostly underrated, and positive deviant (PD) factors that ensure non-anemic status in stunted children have not been studied to date. MethodsThis study aimed to identify PD factors that have potential to prevent syndemic anemia among stunted children aged 6–59 months in Myanmar. This was a cross-sectional secondary analysis of the Myanmar Demographic and Health Survey (DHS) data conducted in 2016, applying the PD concept, where children who were stunted without anemia were considered as PDs. ResultsAmong 1248 stunted children, those who had the syndemic condition were compared with their PD peers in terms of maternal characteristics as well as socioeconomic and health-related factors. Multivariable logistic regression analyses were used to identify the determinants of syndemic state. The results showed that three out of every five stunted children were anemic. The syndemic risk was decreased among children of maternal age groups 20–34 years and 35–44 years: [aOR] = 0.19, 95% CI = 0.05–0.69; p = 0.012, and aOR = 0.19, 95% CI = 0.05–0.75; p = 0.018, respectively. Moderately stunted children (aOR = 0.53, 95% CI = 0.34–0.81; p = 0.004) and children who were not currently breastfed (aOR = 1.56, 95% CI = 1.01–2.41; p = 0.044) were less likely to develop the syndemic condition. ConclusionMaternal age, stunting severity, breastfeeding duration, and maternal anemic status are strong predictors in determining hemoglobin concentrations among stunted children. This study suggests that nutritional interventions targeting PD factors could represent syndemic action in improving child health.

Factors Predicting Chronic Malnutrition Among Young Children in Myanmar

Chronic malnutrition (i.e., stunting) is one of the significant health problems among children under five years old in Myanmar. The government has been trying to accelerate the reduction of malnutrition by collaborating and coordinating with other government and non-government organizations. However, the prevalence of chronic malnutrition remains high. This study examines the factors that could predict chronic malnutrition among young children using the Myanmar Demographic and Health Survey 2015–2016. Data record forms were used to collect the required information from the original data source. Descriptive statistics, the chi-square test, and logistic regression analysis were applied to analyze the data analysis and to determine the predictive power of independent variables. It was found that breastfeeding, birth weight, and family wealth index were significant predictors of childhood stunting. This study recommends emphasizing low-birth-weight infants to prevent chronic malnutrition and promote breastfeeding for all infants and children in Myanmar. Furthermore, policymakers should try poverty reduction and establish healthcare services that are easily accessible to the public, especially to the poor. Based on the findings of this study, more efforts to set up readily available public health services providing care for pregnant women and promoting breastfeeding would be some better precautions against chronic malnutrition for every child, particularly from developing countries.

Risk factors for stunting of under-five children in Myanmar

Background: This study aimed to identify risk factors and assess their significance concerning childhood stunting in Myanmar. Methods: This study was conducted through the analysis of a secondary dataset based on the 2015-2016 Myanmar Demographic and Health Survey (MDHS 2015-2016), a program funded by the United States Agency for International Development (USAID). Among the 5239 under-five children who participated in the Myanmar DHS 2015-2016 survey, 4172 children with complete anthropometric measurements were included in this study. This was a cross-sectional study, and Chi-squared analysis was applied to determine the association of each risk factor with stunting. In addition, logistic regression was used for multivariate analysis of all risk factors combined. Results: Out of 4172 children who participated in the study, 1146 (27.5%) were stunted. Type of place of residence, household wealth index, and maternal education level have a significant effect on stunting of under-five children with (χ2=52.79, df=1, p=0.000), (χ2=82.03, df=2, p=0.000) and (χ2=72.31, df=3, p=0.000) respectively. When applied to multivariate logistic regression analysis, all three factors remained significant predictors of stunting in under-five children. Conclusions: Individual- and community-level factors determining the stunting of under-five children in Myanmar were explored. Government support programs for the occupation and income of the household heads and household members, as well as education programs targeting women in both the short term and long term, may help improve the condition.

A Prepandemic Nutrition-Sensitive Social Protection Program Has Sustained Benefits for Food Security and Diet Diversity in Myanmar during a Severe Economic Crisis

BackgroundOne-third of preschool children in Myanmar were stunted in 2015–2016, and three-quarters of children 6–23 mo had inadequate diet diversity. In response, a large-scale nutrition-sensitive social protection program was implemented over 2016–2019. In 2020, however, Myanmar’s economy was hit hard by the COVID-19 pandemic and harder still by a military takeover in 2021. ObjectiveThe objective of this study was to examine whether former beneficiaries of this program experienced better food security, food consumption, and diet diversity outcomes in the wake of major economic shocks. MethodsIn a previous cluster-randomized controlled trial conducted over 2016–2019, pregnant women and their children aged <2 y were randomly assigned to either: 1) CASH; 2) CASH + social and behavioral change communication (SBCC); or 3) a control group. Subsamples of these former participants were then resurveyed 10 times from June 2020 to December 2021 during Myanmar’s protracted economic crisis. Randomized treatment exposure was used in a regression analysis to test for postprogram impacts on Food Insecurity Experience Scale indicators, household food consumption, and maternal and child diet diversity. We also examined the impacts on household income as a secondary outcome and potential impact pathway. ResultsBoth intervention arms reported lower food insecurity, more frequent consumption of nutritious foods, and more diverse maternal and child diets compared with households in the control group. However, the improved dietary outcomes were larger for mothers and children exposed to CASH+SBCC compared with CASH, as was their monthly household income. ConclusionsThe findings suggest that a program combining cash transfers with nutrition-related education can yield sustained benefits 1–2 y after the program was completed. This strengthens the evidence to support the expansion and scale-up of nutrition-sensitive social welfare programs to redress chronic malnutrition and enhance nutritional resilience in the face of a severe economic crisis.

Humanitarian Food Assistance and Nutrition Outcomes among Refugees: A Historical Perspective

Background: Humanitarian interventions are done after a significant disruption of people’s daily life which in turn affect their food security and nutrition needs. Food assistance has become a key element of humanitarian aid to conflict-affected populations. Hunger and undernutrition can significantly worsen during situations of prolonged conflicts and where institutional capacities are weak. Humanitarian food aid provided in the form of food or non-food items for people affected by famine, drought, or natural disaster is intended to feed, shelter, and provide legal protection. Malnutrition in children is related to insufficient food intake, poor food quality, and severe or repeated infectious diseases. Therefore, humanitarian food assistance is given to ensure sufficient, safe, and nutritious food is consumed to prevent malnutrition and prevent death.&#x0D; Objectives: This paper seeks to understand the following specific objectives; to explore the evolution of humanitarian food assistance or food aid; to gain an understanding of the contemporary views on humanitarian food assistance; to explore the comparative views on humanitarian food assistance, and to find out the implications of shifting from Food Aid to Food Assistance.&#x0D; Study Design/Method: Secondary data collection method was used and both published and official documents were reviewed based on the objectives of this paper, and relevant information was picked. The review provides evidence on the benefits as well as gaps related to humanitarian food assistance interventions and their relationship with the nutrition status of children below the age of five years.&#x0D; Results: Food in-kind directly impacts positively on the nutrition status of households and influences the coping mechanisms of the affected populations. In Mali, a study found food transfers exert a protective effect on food-insecure populations in conflict situations and increased micro-nutrient availability. Another study found improvement in nutrition status among children in Myanmar, Kenya, Niger, and South Sudan. While global acute malnutrition (GAM) in Myanmar declined from 6.6% to 2.6% and from 7.5% to 4.7%, in Niger, GAM rates declined from 21.3% to 13.6%, and 11.4% to 7.3% in Kenya and South Sudan, a decline of 6% GAM. Also, a study on the “impact of cash transfers on food consumption in humanitarian settings found cash transfer” is an appropriate and effective modality in humanitarian settings for meeting the needs of vulnerable populations.&#x0D; Conclusion: The strategic shift from food aid to food assistance has the potential to enhance effectiveness in addressing hunger because there is increased use of non-food aid in operational modalities and other initiatives to enhance local production and purchase, and the use of vouchers and cash transfers in humanitarian response.

Mother's Dietary Diversity and Underweight among Under-five Rural Children in Three Major Agro-climatic Zones, Myanmar.

Children's growth is essential to nutritional status and population health. In 2015, 18.9% of under-five children in Myanmar were underweight, and only 25% of 6-23-month-old children had the minimum dietary diversity (MDD). We conducted this study to assess the association between mother's dietary diversity score (DDS) and underweight among under-five children. This study analyzed data from the "Livelihood and Food Security Survey," a cross-sectional study conducted in 2016 in rural areas in Chin State, Magway, and Ayeyarwady regions. It included 2029 under-five children and used underweight as an outcome variable. We calculated DDSs for mothers of under-five children using the MDD-women methodology. The prevalence of underweight and MDD were estimated. A multivariable binary logistic regression analysis estimated odds ratios and 95% confidence intervals (CIs). The overall prevalence of underweight was 26.3% (95% CI: 23.4, 29.3), and that of the mother with a MDD score was 29.2% (95% CI: 26.0, 32.8). Multivariable binary logistic regression analysis showed that the prevalence of underweight in children was higher if maternal MDD was not met (adjusted odds ratio = 1.41; 95% CI: 1.05, 1.89). The children's age, types of toilets, and region were independent predictors of being underweight. Underweight among under-five children and diverse food consumption among their mothers are critical public health challenges in rural Myanmar that require urgent action. Nutrition education for rural communities should focus on feeding children with locally available diverse foods.

The use of corporal punishment against children in Myanmar: An analysis of data from the 2015–2016 Myanmar Demographic and Health Survey

BackgroundThe corporal punishment of children is a significant public health concern; corporal punishment also violates children's rights and may have negative impacts on children's long-term health. ObjectiveThis study investigates the prevalence of corporal punishment of children in Myanmar and associated factors. Participant and settingThis study is a secondary data analysis of the 2015–2016 Myanmar Demographic and Health Survey (MDHS). The study targeted 13,235 (weighted) children between 2 and 14 years old. MethodsCorporal punishment of children by caregivers was assessed using six questions that utilized UNICEF's child disciplinary module. Multiple logistic regression analyses were carried out to identify associated factors. ResultsNearly half of the children in the study (44.5 %; 95 % confidence interval (CI): 42.60, 46.50) were found to have been subjected to corporal punishment, and the most common form of corporal punishment was “spanking, hitting, or slapping the child on the bottom with a bare hand” (29.1 %; 95 % CI: 27.53, 30.80). Multivariable analyses revealed that a child's sex, age, education level, location of residence, and number of family members; the primary caregiver's sex and attitude toward corporal punishment; and the family's socio-economic status were all factors significantly associated with corporal punishment. The prevalence of corporal punishment of children in Myanmar was high, and many significant predictors were identified. ConclusionThe implementation of child protection policies and the promotion of nonviolent parenting methods should be conducted immediately to community members. Community education should particularly focus on uneducated caregivers and families with low socioeconomic status.

Clinical manifestations and outcome of viral acute lower respiratory infection in hospitalised children in Myanmar

BackgroundAcute lower respiratory infection (ALRI) remains the leading cause of death in children worldwide, and viruses have been the major cause of ALRI. In Myanmar, ALRI is associated with high morbidity and mortality in children, and detailed information on ALRI is currently lacking.MethodsThis prospective study investigated the viral aetiologies, clinical manifestations, and outcomes of ALRI in hospitalised children aged 1 month to 12 years at the Yankin Children Hospital, Yangon, Myanmar from May 2017 to April 2019. The sample size was set to 300 patients for each year. Two nasopharyngeal swabs were obtained for the patients with suspected viral ALRI; one for rapid tests for influenza and respiratory syncytial virus (RSV), and the other for real-time PCR for the 16 ALRI-causing viruses. Pneumococcal colonization rates were also investigated using real-time PCR. Clinical information was extracted from the medical records, and enrolled patients were categorised by age and severity for comparison.ResultsAmong the 5463 patients admitted with a diagnosis of ALRI, 570 (10.4%) were enrolled in this study. The median age of the patients was 8 months (interquartile range, 4–15 months). The most common symptoms were cough (93%) and difficulty in breathing (73%), while the most common signs of ALRI were tachypnoea (78%) and chest indrawing (67%). A total of 16 viruses were detected in 502 of 570 patients’ samples (88%), with RSV B (36%) and rhinovirus (28%) being the most commonly detected. Multiple viruses were detected in 221 of 570 samples (37%) collected from 570 patients. Severe ALRI was diagnosed in 107 of 570 patients (19%), and RSV B and human rhinovirus were commonly detected. The mortality rate was 5%; influenza virus A (29%) and RSV B (21%) were commonly detected, and stunting and lack of immunization were frequently observed in such cases. Additionally, 45% (259/570) of the patients had pneumococcal colonization.ConclusionsViral ALRI in hospitalised children with a median of 8 months has significant morbidity and mortality rates in Myanmar. RSV and rhinovirus were the most commonly detected from nasopharyngeal swabs, while influenza virus and RSV were the most frequently associated with fatal cases.

Soft Violence: Wicked Hurdles Driving Systemic Discrimination Against Rohingya Children in Myanmar?

Soft Violence: Wicked Hurdles Driving Systemic Discrimination Against Rohingya Children in Myanmar?

Clonal Diversity and Molecular Characteristics of Methicillin-Susceptible and -Resistant Staphylococcus aureus from Pediatric Patients in Myanmar.

The spread of multidrug-resistant and virulent Staphylococcus aureus among children is a public health concern, but the actual conditions in Myanmar have not been characterized. In this study, a total of 244 clinical isolates of S. aureus collected from pediatric patients in Yangon Children's Hospital during a 1-year period were analyzed for their drug resistance and genetic features. Methicillin-resistant S. aureus (MRSA) accounted for 19.7% of isolates associated with staphylococcal cassette chromosome mec (SCCmec) type III, IV, or V. Panton-Valentine leukocidin (PVL) genes were detected in 61.5% of all isolates, with a significantly higher prevalence in methicillin-susceptible S. aureus (MSSA; 67.9%) than in MRSA (35.4%) isolates. Sequence type (ST) 239/SCCmec-III was the most common MRSA clone lacking PVL genes, while PVL-positive MRSA belonged to mostly ST361/SCCmec-V and ST772/SCCmec-V. Among MSSA isolates, ST121, ST2990, ST88, and ST1930 were dominant, harboring mostly PVL genes. ST239 MRSA isolates exhibited the highest resistance rates to antimicrobials, and quinolone resistance was found in the dominant MRSA clones (ST239, ST361, and ST772) and some MSSA lineages. The present study revealed the prevalence and clonal diversity of MRSA/MSSA in children in Myanmar in relation to drug resistance and virulence determinants.

Parental migration and care for left‐behind children in Myanmar's Dry Zone

AbstractMyanmar's population has been on the move at an unprecedented level since 2011. Given the country's lack of data infrastructure, little is known about how parental migration affects children in Myanmar's migration‐source areas. Based on the 2017 Dry Zone Migration Impact Survey, this study examines the extent to which parental migration is associated with the frequency of care provision for left‐behind children and the likelihood that their care needs are adequately met. Results suggest that the negative impacts of parental migration were limited to a small proportion of children whose mothers migrated (regardless of their father's migration). These children received significantly less frequent care and experienced a lower likelihood of having adequate support for daily necessities. Yet, the statistically significant negative associations between maternal migration and children's met needs for emotional and financial support were not found. On the contrary, children with migrant fathers and non‐migrant mothers enjoyed significantly more frequent care than other children. Looking ahead, Myanmar's rising trends in migration, population aging, and female labor force participation can pose new challenges in care provision for left‐behind children. Thus, continual monitoring of migration impacts and changing societal contexts is critical for formulating policies to manage risks associated with migration in developing countries.

Effectiveness of the SA 14-14-2 Live-Attenuated Japanese Encephalitis Vaccine in Myanmar.

Myanmar is an endemic country for the Japanese encephalitis virus (JEV), and the SA-14-14-2 live-attenuated JEV vaccine was first introduced as a catch-up vaccination campaign in 2017. To determine the effectiveness of vaccination by means of neutralizing antibody titers against JEV, a cross-sectional descriptive study was conducted among five to 15-year-old monastic school children in Mandalay, Myanmar. A total of 198 students who had received vaccines were recruited, and single-time investigation of anti-JEV IgG and neutralizing antibodies against wild-type JEV were determined using anti-JEV IgG ELISA and plaque reduction neutralization tests (PRNT50). All students 100% (198/198) showed positive results on the anti-JEV IgG ELISA, and 87% (172/198) of the students had neutralizing antibodies against JEV six months after immunization. The geometric mean titers of both IgG antibodies and neutralizing antibodies increased with the participants’ age groups, and statistically significant differences in anti-JEV IgG titers were noted across age groups. In this study, we could not investigate the persistence of neutralizing antibodies as only single-time blood collection was done. This study, which is the first report of JEV vaccination among children in Myanmar, showed similar neutralizing antibody production rates among vaccinated individuals as did studies in other countries.

Dual Burden of Malnutrition among Primary School Children in Myanmar

Background: The distribution of childhood nutritional diseases is shifting from a predominance of under nutrition to a dual burden of under-and over nutrition in low and middle income countries. Rapid economic development and urbanization lead to an increase in overweight and obesity and diet-related chronic diseases. The co-existence of under-and over nutrition is double burden and this is a public health challenge for community. Objective: To find out the nutritional status of primary school children. Method: The study was school based descriptive study and conducted during November 2014 to February 2015 in basic primary schools, basic middle schools and basic high schools in urban and rural area of Yangon, Mandalay, Taungyi and Mawlamyaing. A total of (2937) Grade IV and Grade V students were measured for weight, height and 592 students were measured for haemoglobin by standard equipment and standard procedure. Results: The overall prevalences of stunting, wasting, overweight, obesity and anaemia were 8.8%, 15%, 4.6% and 3.1% and 36.1% respectively. The prevalences of stunting, over weight and obesity were more prevalent in boys and wasting and anaemia were more prevalent in girls. The result showed that the stunting was more prevalent in rural than in urban (7.5% in urban and 12.0% in rural). The prevalences of overweight and obesity were higher in urban than rural area (overweight 5.3% in urban and 2.8% in rural, obesity 3.8% in urban and 0.9% in rural). Children residing in urban area had higher anthropometric parameter than rural children. Conclusion: The present study observed the coexistence of obesity, overweight and undernourishment (wasting and stunting) among Myanmar School children.The findings highlighted the need for continued health promotion efforts to improve nutritional status of primary school children.

Soil-transmitted helminthiasis among school-aged children in Myanmar: the result of 14 years after the implementation of deworming

Background: Soil-transmitted helminth (STH) infections were the most common infections among school-aged children (SAC) in Myanmar. The routine school-based mass drug administration (MDA) with twice a year frequency has started in 2005.Methods: This cross-sectional study aimed to determine the prevalence and intensity of STH infection among SAC as the follow-up study after 14 years of MDA. In August 2019, 1000 school-aged children attending Grades 4 and 5 from four geographical regions across the country were enrolled using a multi-stage sample random sampling. The anthropometry and hemoglobin concentration was measured, and stool specimens were detected parasite eggs using the Kato Katz technique.Results: The intensity of infection was classified according to WHO criteria. Infection prevalence was 17% for any STH infections, 10.4% for A. lumbricoides, 17% for T. trichiura, and 2% for the hookworm. All STH infections were virtually not detected in the hilly region. The highest prevalence of A. lumbricoides and T. trichiura infection were seen in the coastal region. The hookworm was seen only in the plain region. The underweight prevalence was 9% and anemia prevalence was 38% while there were huge differences across regions. The finding showed that STH infections continued to be endemic among SAC throughout the country except for the hilly region after 14 years of MDA.Conclusions: The regular deworming program should be reduced to once a year frequency in Myanmar. Triple-dose regimens should be considered to eliminate the whipworms. The burden of anemia among SAC should also be addressed in cooperation with MDA.