Large Family Size Research Articles

Delays in health care seeking for diarrheal disease and associated factors among caregivers of under five children in health centers of northwest Ethiopia: a mixed-method study

BackgroundApproximately 70% of child deaths due to diarrhea are caused by a lack of timely healthcare. However, there was little evidence of factors associated with delays in seeking health care for patients with diarrheal diseases in the study area. Therefore, this study aimed to investigate delays in seeking healthcare for children with diarrhea and identify associated factors among caregivers in health centers of Northwest Ethiopia.Method and materialsAn institution-based mixed study method was conducted from May to June 2022. Quantitative data were collected from 374 participants who were selected by systematic random sampling using a structured interviewer-administered questionnaire and chart review. The data were analyzed using the Statistical Package for Social Science software version 25. Bivariable and multivariable logistic regression models were used to identify associated factors. Variables with a p- value < 0.05 in the multivariable analysis were considered to be significantly associated. Qualitative data were collected from participants in waiting area after receiving treatments via in-depth interviews and analyzed using open-source software. The qualitative data were transcribed, translated, coded, thematized, and interpreted accordingly.ResultsIn this study, 53.48% of patients experienced delays in seeking healthcare for diarrhea. A large family size (adjusted odds ratio (AOR) = 2.64, 95% CI: 1.26–5.4), poor knowledge about diarrhea danger signs (AOR = 3.25, 95% CI: 1.6–6.6), difficulty paying for treatment (AOR = 2.95, 95% CI: 1.6–5.3), not visiting health facilities as the first response to diarrhea (AOR = 3.94, 95% CI: 1.96–7.9), only diarrhea (AOR = 2.39, 95% CI: 1.01–5.63), and no information about early healthcare seeking (AOR = 4.88, 95% CI: 1.91–12.43) were identified; moreover, from the qualitative findings, mothers’ perceptions of the illness were mild, poor service provision, and economic problems were determinants of delay. Awareness, barriers, compliance, and perception emerged as themes.ConclusionThe prevalence of delays in seeking healthcare for children with diarrhea was high. This poses a negative health risk to the lives of children and their caregivers. A large family size, poor knowledge about diarrhea danger signs, difficulty paying for treatment, and many others were factors associated with delayed health care seeking. Hence, the government and other concerned stakeholders should give due emphasis to tackling the identified causes of delay in seeking health care for children under five years of age with diarrhea by diverting community focus toward timely care seeking and disease prevention.

Mass drug administration coverage evaluation for lymphatic filariasis in selected endemic districts of Jharkhand, India.

This study aimed to evaluate mass drug administration (MDA) coverage for lymphatic filariasis (LF) in selected endemic districts of Jharkhand, India, and to identify household-level determinants of drug consumption. A cross-sectional coverage evaluation survey was conducted in the Deoghar, Giridih and Godda districts of Jharkhand in 2023 within 6 wk of the completion of the MDA campaign. The survey included 9039 individuals from 1680 households across 56 randomly selected clusters (three urban, eight tribal and 45 rural). Approximately 78.5% of households reported that at least one member consumed MDA drugs, with 54.5% reaching 'complete epidemiological drug coverage'. Factors positively associated with achieving 'complete epidemiological drug coverage' included higher education levels (adjusted OR [AOR] 1.02), awareness of LF (AOR 2.32), prior communication about MDA (AOR 1.38) and previous MDA participation (AOR 4.42). By contrast, larger family sizes were associated with a lower likelihood of achieving complete coverage (AOR 0.78). Adverse events were experienced by 14.9% of participants, primarily when MDA drugs were consumed on an empty stomach. Key reasons for non-compliance included perceived absence of disease (25.5%), fear of side effects (22.4%) and absence during the campaign (20.9%). MDA coverage was suboptimal, with only one-half of households achieving 'complete epidemiological drug coverage'. Enhancing MDA coverage and compliance requires intensified Information, Education, and Communication efforts, especially among marginalized communities, both during campaigns and all year round.

Health-seeking behaviors during an outbreak of acute conjunctivitis in Central India.

To report the health-seeking behaviors of individuals with acute viral conjunctivitis during an outbreak. A cross-sectional survey was carried out in the Raipur district of Chhattisgarh after an outbreak of acute conjunctivitis in July-August 2023. The treatment choices were pharmacies (51.4%), ophthalmologists (21.1%), quacks (non-qualified doctors) (6.8%), general practitioners (1.6%), home remedies (5.2%), and no treatment (13.9%). Treatment preferences were influenced by place of residence (P < 0.001), occupation (P = 0.002), socioeconomic category (P < 0.001), and highest level of education of male (P < 0.001) and female (P < 0.001) members within the household. The overall expenditure was higher when patients sought treatment from quacks (INR 427.27 ± 202.21), followed by ophthalmologists (INR 374.57 ± 251.31) and pharmacies (INR 201.39 ± 102.65) (P < 0.001). Individuals aged 21-40 years (odds ratio [OR]: 0.24, 95% CI: 0.05-1.03, P = 0.055) and those from villages (OR: 0.16, 95% CI: 0.07-0.32, P < 0.001) were less likely to use prophylaxis. Individuals from families with high level of education of male members (OR: 2.70, 95% CI: 1.08-7.20, P = 0.039) or large family sizes (OR: 6.27, 95% CI: 2.42-19.09, P = 0.039) were more likely to use prophylaxis. The use of separate items of daily use reduced the risk of spread of conjunctivitis (OR: 0.24; 95% CI: 0.06-0.35, P = 0.035). Several insights into health-seeking behaviors among individuals with conjunctivitis during an outbreak were identified in this study, which can aid public health interventions during future outbreaks.

The Impact of Health Education on Hemoglobin A1C in Diabetic Patients at the Family Medicine Department of King Fahad Armed Forces Hospital in Jeddah.

Diabetes mellitus (DM) is a long-term condition associated with severe complications. Individuals with diabetes must make numerous self-management decisions and participate in diverse care activities. Diabetes self-management education and support assist patients in making these decisions and performing these activities, enhancing their health outcomes. The study aims to assess the effects of health education on median hemoglobin A1c (HbA1C) levels, the development of diabetic complications, and the number of hospital admissions in patients with uncontrolled type 2 DM. This prospective quasi-experimental study, conducted at King Fahad Armed Forces Hospital in Jeddah, Saudi Arabia, from September 2020 to September 2022, assessed the impact of a structured diabetic education program on uncontrolled type 2 DM patients. The study involved 100 patients with HbA1c >8%: 50 in the intervention group who received the program and 50 in the control group who did not. HbA1c levels were measured before and after the intervention. Data was collected securely, and an experienced biostatistician performed statistical analysis. The two groups found no significant differences in age, disease duration, HbA1c, medication type, insulin type, education level, employment, and clinical visits. However, the control group had significantly more females (40 (81.6%) vs. 32 (64%), p=0.049), and the intervention group had larger family sizes (43 (86%) with >4 members vs. 21 (42.9%), p<0.0001). The intervention group showed a significant decrease in HbA1c from baseline across all measurements post-educational program (p<0.0001), whereas the control group did not show significant changes. Economic status also differed significantly (p=0.024). No significant differences were found between groups in follow-up HbA1c measurements. The study demonstrates that the diabetic education program at King Fahad Armed Forces Hospital effectively lowered HbA1c levels in type 2 DM patients, confirming the program's role in enhancing glycemic control through structured self-management education and support.

Sociodemographic and maternal health-related factors associated with mortality among children under three in Bangladesh: an analysis of data from Bangladesh Demographic and Health Survey 2017-18

BackgroundChild mortality remains remarkably high in many low- and middle-income countries (LMICs), including Bangladesh. This study aimed to identify the sociodemographic and maternal health-related factors associated with under three (U3) child mortality in Bangladesh.MethodsWe extracted data of 5299 U3 children from Bangladesh Demographic and Health Survey (BDHS) 2017-18. We used descriptive statistics to summarize the data. The chi-square (χ2) test, simple and multiple Firth logistic regression were performed to test the associations between priori-defined factors and U3 mortality.ResultsIn Bangladesh, the U3 child mortality rate was 35 deaths per 1,000 live births, with a median age at death of less than one month. The adjusted model revealed that the odds of U3 child mortality were higher among children born to mothers aged between 30 and 39 years [adjusted odds ratio (AOR) = 2.01, 95% confidence interval (CI): 1.30–3.11; p-value (p) = 0.002], those who did not use any contraceptive [AOR = 2.57, 95% CI: 1.90–3.47; p < 0.001], with first pregnancy [AOR = 14.91, CI: 4.60–48.30; p < 0.001], had birth interval less than 24 months [AOR = 2.10, CI: 1.23–3.60; p = 0.007], children born to mothers who delivered vaginally [AOR = 3.18, 95% CI: 2.07–4.87; p < 0.001]. However, lower odds of mortality were observed among children of mothers with higher education levels [AOR = 0.50, 95% CI: 0.28–0.90; p = 0.021] and families with more than five members [AOR = 0.61, 95% CI: 0.45–0.83; p < 0.01]. In addition, religion, birth attendant during delivery, and the child’s birth order were significantly associated with U3 child mortality, whereas mortality did not vary significantly across the divisions.ConclusionsHigher odds of U3 child mortality were associated with mothers who did not use contraceptives, delivered vaginally, and were aged 30–39 years in Bangladesh. Conversely, higher maternal education and larger family size were associated with lower odds of U3 child mortality. The findings suggest that community-based family planning awareness programs focused on contraceptive use, as it prevents childbirth and is also a marker of health service usage.

Asymptomatic nasopharyngeal carriage of multidrug resistant bacteria among children at University of Gondar Hospital Northwest Ethiopia Revealing Hidden Health Risks

Gram-negative bacteria in the nasopharynx can eventually invade bacteria-limited sites and cause serious illnesses such as meningitis, otitis media, and pneumonia. However, data related to the carriage of these bacteria in children attending outpatient departments in the study area are limited. To assess nasopharyngeal carriage, antibiotic susceptibility patterns, and associated factors of gram-negative bacteria among children attending the outpatient department at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. A hospital-based cross-sectional study was conducted from September 1, 2023, to December 30, 2023. A total of 385 children aged 3 to 14 years were enrolled using a systematic random sampling technique. Sociodemographic and clinical data were collected using a semistructured questionnaire. A total of 385 nasopharyngeal samples were collected using a sterile specimen collection nasopharyngeal swab, transported using Amie’s transport medium, and subsequently inoculated on chocolate agar, blood agar, modified thayer martin agar, and MacConkey agar plates. Bacterial species were identified by colony morphology, Gram staining, and biochemical tests such as oxidase tests, satellitism tests, and carbohydrate utilization tests. An antibiotic susceptibility test was performed using the Kirby–Bauer and modified Kirby–Bauer methods on Mueller–Hinton agar plates. The data were entered into Epi-Data version 4.6.0.6 and exported to SPSS version 25 for analysis. The adjusted odds ratio at a 95% confidence interval with a P value of < 0.05 in the binary logistic regression model was considered to indicate statistical significance. The overall nasopharyngeal carriage of gram-negative bacteria was 146 (37.9%) (95% CI: 33.2–42.9). Among these, nonfastidious gram-negative bacteria represented 45 (11.7%), followed by M. catarrhalis 41 (10.6%), N. meningitidis 34 (8.8%), and H. influenzae 26 (6.8%). The isolates exhibited high resistance to tetracycline (85; 75.9%), trimethoprim-sulfamethoxazole (105; 71.9%), ampicillin (76; 67.9%), and amoxicillin/clavulanic acid (60; 69.8%) but high susceptibility to meropenem (122; 83.6%), gentamicin (73; 84.9%), and minocycline (87; 72.5%). There were 99 total multidrug-resistant strains (67.8%, 95% CI: 59.7–75.0). Male sex (AOR = 1.785, 95% CI: 1.102–2.892, P = 0.019), smoking (AOR = 2.675, 95% CI: 1.149–6.230, P = 0.022), and large family size (≥ 5) (AOR = 1.857, 95% CI: 1.140–3.023, P = 0.013) were risk factors for nasopharyngeal colonization. Increased nasopharyngeal colonization of multidrug-resistant gram-negative isolates was observed in this study. Gentamicin, minocycline, and meropenem were the most effective antibiotics for the tested isolates. Bacterial colonization increased with increasing family size, smoking status, and male sex. Therefore, a definitive diagnosis in the outpatient pediatric department should be based on culture and susceptibility test results.

Statistical Methods in Credit Risk Prediction: Analyzing Risk through Data Analytics

This study explores the factors influencing loan approval decisions by financial institutions using logistic regression analysis. By examining a dataset of loan applicants, we identify key predictors that significantly impact the likelihood of loan approval. The analysis reveals that higher income, larger family size, higher education levels, possession of a CD account, use of online banking, and having a credit card are positively associated with loan approval. Conversely, the presence of a securities account has a more complex relationship with loan approval likelihood. These findings suggest that financial institutions favor applicants with stable financial profiles and higher levels of financial engagement. Understanding these factors can help improve risk assessment models, ensuring more accurate and fair loan approval processes.

Family Size and Past Obstetric History of Married Women Aged 45 Years and Older in Erbil.

The family size plays an important role in fulfilling the primary needs of each family member and providing a quality life for them. This research studies the association of family size with various socioeconomic and demographic factors and the lifetime fertility patterns of previous decades. This cross-sectional study was conducted at the Maternity Teaching Hospital in Erbil, Kurdistan Region of Iraq (KRI). The data was collected from December 11, 2023, to April 15, 2024, after the ethics committee of the Kurdistan Higher Council for Medical Specialties approved the proposal. A convenience sample of 400 women aged 45-74 years who had completed their families were directly interviewed. The data was analyzed using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York, United States). The prevalence of large family size (seven members and above) was 78.5%. The lifetime fertility rate of the women was 6.78 live births per woman. Large family size is significantly (p < 0.001) associated with age <18 years at marriage, short birth spacing interval, and unplanned pregnancies. The majority (91.7%) of the participants were grand multipara. The Cesarean section (CS) rate was 7.3%, 60.2% of the births were delivered at home, and 46.6% of the live births were delivered with a preceding birth interval of less than two years. The majority (82.2%) of the pregnancies were unplanned. Large family size is highly prevalent among women who have completed their families in Erbil. Many demographic and socioeconomic factors are associated with large family sizes, such as rural residency, age <18 years at marriage, low socioeconomic status (SES), short birth spacing interval, and unplanned pregnancies.For a more desired family size, it is recommended that young females be empowered by encouraging their education and providing occupation opportunities. In addition to that, prohibiting early marriageand providing/strengthening premarital programs focusing on the importance of family planning including birth spacing and utilizing contraceptive methods properly play a great role.

Machine learning algorithms for prediction of measles one vaccination dropout among 12–23 months children in Ethiopia

IntroductionDespite the availability of a safe and effective measles vaccine in Ethiopia, the country has experienced recurrent and significant measles outbreaks, with a nearly fivefold increase in confirmed cases from...

The Interplay Between Livelihood Diversification, Gender Roles, and Food Security by Rural Women Farmers in Osun State Nigeria

This study investigated the interplay between livelihood diversification, gender roles and food security among rural women farmers in Osun state, Nigeria. A multi-stage sampling procedure was used to select 129 respondents for this study. Data were collected through an interview schedule and analyzed using inferential statistics (PPMC and linear regression). Results revealed that most women in the study area were informally educated, within productive age, and married with a relatively large family size, which necessitated livelihood diversification to ensure food security. The women diversified their livelihood with crop farming and trading as primary activities, although lack of access to agricultural inputs and credit facilities were key limiting factors to their efforts.Livelihood diversification significantly influenced food security among rural women. Therefore, the government and agricultural development agencies should train women in the study area to seize opportunities for livelihood diversification and facilitate access to agricultural inputs and credits.

Parental attitudes and perceptions towards the recruitment of children to clinical trials: a cross-sectional survey.

Clinical trials (CTs) in children are critical for understanding and treating childhood diseases. However, there trials require prior permission from parents. We evaluated parental attitudes and perceptions regarding the recruitment of their children in CTs. We used a cross-sectional survey questionnaire targeting parents of children admitted to the neonatal and pediatric departments in two tertiary hospitals in Qatar. The survey was administered by investigators and was composed of two domains to assess the knowledge and attitude of parents regarding children's enrollment in CTs, in addition to the participant's demographics domain. Of the 167 questionnaires offered to parents, we received a total of 138 responses, resulting in a response rate of 82.6%, with the majority being women (72%). Many parents (75%) expressed willingness to enroll their children in CTs. However, 66% opposed new experimental treatments for their child, while 41% agreed to new treatments if they had previously been used in the medical field. Logistic regression analysis revealed key predictors influencing parents' decisions to include their children in CTs, including having a newborn (aOR = 17.651, p < 0.001), families with five or more members (aOR = 3.293, p = 0.012), collecting blood samples (aOR = 8.602, p = 0.003), performing additional tests on collected samples (aOR = 4.115, p = 0.046), belief in helping others (aOR = 8.744, p = 0.002), and the option of home therapy (aOR = 7.090, p = 0.004). Many parents are open to enrolling their children in CTs, particularly when treatments have been previously used. Factors like having a newborn, large family size, blood collection, additional tests, and home therapy influence their decisions. Clear communication can enhance recruitment in pediatric trials.

Herders’ willingness to accept for grassland grazing ban in northwest China

Payment for Ecosystem Services (PES) has been widely acknowledged as an effective tool for mitigating grassland degradation and enhancing ecosystem services provision. However, critical factors such as herders’ willingness to accept (WTA) preferences and their compensation expectations, are often overlooked, leading to insufficient effectiveness of PES initiatives. This study focused on grassland ecological compensation policy (GECP), quantifying herders’ WTA compensation for grassland grazing bans. Through face-to-face surveys and employing the contingent valuation method, we estimated households’ WTA for participating in a grassland conservation program aimed at bolstering ecosystem service provision. Our findings indicate that herders required an average compensation of 237 CNY mu-1 yr-1 to engage in the grazing ban program. Notably, our study revealed that herders’ environmental awareness positively influenced their willingness to participation, whereas larger family sizes were negatively correlated with WTA. Additionally, herders in better health, with higher livestock incomes or categorized as semi-herders, tended to accept lower compensation levels. These insights are crucial for improving the effectiveness of GECP and provide valuable reference points for similar analyses in economically disadvantaged and ecologically fragile regions.

Association Between Socio-Demographic Characteristics and Household Food Waste Behaviors Among University Students in Italy: The UniFoodWaste Study

Food waste is a growing environmental, economic, and social challenge worldwide. This study aimed to assess the association between various socio-demographic characteristics and household food waste behaviors among university students in Italy. A cross-sectional study was conducted using a validated, online, anonymous, and voluntary-based questionnaire distributed among university students in Milan, Italy. Linear regression analyses were performed to explore the association between socio-demographic factors and anti-household food waste behaviors (preventive practice, abilities scores, and parental guidance). A total of 2779 students participated in the survey. Students residing outside Lombardy exhibited higher preventive practice scores (β = 0.11, p = 0.030). Regular smoking was negatively associated with preventive practice (β = −0.22, p &lt; 0.001) and abilities scores (β = −0.11, p = 0.009). Cohabitation with a partner positively impacted abilities scores (β = 0.23, p = 0.007). Larger family sizes and students in scientific fields showed higher scores for parents’ guidance (β = 0.18, p &lt; 0.001). Frequent use of food delivery apps correlated with lower scores across all categories, while anti-food waste apps had a positive effect. Socio-demographic factors significantly influence food waste behaviors among university students. Tailored public health policies and educational programs addressing these factors could effectively reduce food waste.

Discourses of Poverty: The Narratives of the Poor in Samar

The study aimed at exploring, through the view of the future for themselves and their children, the perceptions of the poor about the temporal dimensions of poverty. The study adopted a discursive perspective, to illustrate the hopes, dreams and expectations of the poor regarding their future and, ultimately, how they view their status and how the LGU officials would address the different faces and current status of poverty in their respective locality. The researchers used Critical Discourse Analysis (CDA). The following are the themes obtained from the responses of the participants: limited knowledge and lower health status, lack of ambition and motivation to improve the situation, inadequate basic needs like food due to large family size, and poverty are transmitted to the next generation. Eradicating poverty is a challenge that sees no means of receding. LGUs do whatever they can to improve people’s lives. Despite those programs and initiatives of the local government units, there are still municipalities in Samar that are experiencing poverty. The poorest of the poor in Samar suffer from a lack of jobs in rural areas, low motivation to pursue education, and limited resources for large families. This has led to a widening gap between the haves and have-nots. Add to that frequent natural disasters being experienced in Samar at least fifteen typhoons in a year which takes away what little the poor have. The fundamental solution for reducing poverty is to tackle poverty and to pursue equity in income, and education, provide more livelihood programs or interventions, and social participation. Community projects that focus on the restoration and development of social networks and social cohesion and the improvement of the social, communication, and coping skills of the deprived, should be encouraged.

Predictors of adolescent childbearing among Ethiopian women with spatial effect adjustment

BackgroundChildbearing under the age of 20 is referred to as teenage childbearing. Compared to high-income countries, it is significantly higher in low-income countries. Adolescent childbearing is influenced by a number of variables, including economic, demographic, and social factors, and these vary geographically. Thus, this study aimed to determine the predictors of adolescent childbearing among Ethiopian women with spatial effect adjustment.MethodsA total weighted sample of 4712 women aged 15 to 49 were included. The data were obtained from the 2019 Ethiopia Demographic and Health Survey. A generalized Geoadditive model which accounts for spatial effect and the non-linear effect of continuous variables was adopted to determine the associated factors of adolescent childbearing among Ethiopian women.ResultsThe spatial pattern of adolescent childbearing was non-random in Ethiopia with Moran’s index statistics 1.731999 (P-value < 0.001). Based on the evidence of spatial variation in a model, the highest risk of adolescent childbearing was observed in Jijiga, Shinilie, Welwel and Walder, Afar (Zone1 and Zone 5), Assosa, Metekel, and Gambela (Zone1). We also noted that women not intending to use a contraceptive method, Muslim religion, living in a rural area, and large household family size were significantly associated with a high risk of adolescent childbearing. Furthermore, our model results also confirmed that higher educational levels, older household age, and good economic status significantly reduced the risk of adolescent childbearing.ConclusionsThis study revealed that adolescent childbearing distribution was significantly clustered in the Eastern and Southwestern parts of Ethiopia. Intervention programs aimed at the prevention of early marriage and raising awareness of sexual activity are essential to reducing adolescent childbearing.

Ready-to-use therapeutic food as a promising therapy for the prevention and cure of undernutrition in pre-school children: A review

The nutritional status of pre-school children is a reflection of health of children in the world and forms the basis for the development of success-oriented interventional programs. This study indicates the prevalence of under-nutrition in under five children in the world, Africa and Nigeria. It also showed the prevalence of under-nutrition in the six geopolitical regions in Nigeria, with the Northern regions reported to have the highest burden of under-nutrition compared to the other regions due to several factors such as inadequate breast feeding, lack of access to healthcare, lack of clean water, armed conflict, inadequate dietary intake, inappropriate feeding, foetal growth restriction, inadequate sanitation, lack of parental education, large family size, incomplete vaccination, poverty and low socio-economic status and desire to have more children. Several nutritional interventions have been put in place to prevent and cure under-nutrition in pre-school children, which include Promotion of exclusive breastfeeding, Micronutrient supplementation, Food fortification, Nutrition education, Complimentary feeding, and Cash transfer programs, Ready-to-use therapeutics foods (RUTF), Nutritional rehabilitation centers, Parenteral nutrition, and Nutritional counseling and education. However, RUTF has been reported to have an effective intervention in the prevention and treatment of severe acute malnutrition (SAM) in pre-school children. It is an energy dense, shelf stable and ready to eat food which composed of peanut butter, sugar, full fat milk and mineral-vitamin premix. Other plant-based ingredients such as chickpea, soybean, sesame, maize, oats, sorghum and sunflower oil have also, been used in the production of RUTF and reported to be effective for complete recovery of SAM children.

Predictors of Overweight/Obesity Among Preschool Children in Arba Minch City, Southern Ethiopia: Does Consumption of Sweet Food Predispose to Overweight/Obesity?

Childhood overweight/obesity is a serious public health problem in the world today specially low-and-middle income countries like Ethiopia. This study aimed to assess the prevalence of overweight/obesity and associated factors among preschool children. A community-based cross-sectional study was conducted among preschool children aged 3-5years in Arba Minch city from April to June 2022. A multistage sampling method was used to select 577 study participants. Data were collected using a structured and pretested questionnaire. A binary logistic regression model was used for analysis. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to assess the strength of the association. The combined prevalence of overweight/obesity was 23.9% (95% CI: 20.5, 27.6). Age of 36-47months, family size < five, watching TV/video for ≥2h, and consuming sweet foods, were factors associated with being overweight/obese among preschool children. Overweight/obesity was predicted by consuming sweet foods, long time TV/video watching, and large family size in the study area. Special attention should be given to child feeding practices and reducing sedentary lifestyles.

Multilevel and geographically weighted regression analysis of factors associated with full immunization among children aged 12–23 months in Ethiopia

Immunization is the process of building immunity or resistance to an infectious disease, typically through administering a vaccine. It is one of the most effective strategies for lowering child morbidity and death. It protects against more than 20 potentially fatal diseases, increasing longevity and health. Despite progress, Ethiopia failed to meet its vaccination coverage target. The magnitude of full immunization is different across areas. Therefore, conducting geographically weighted regression to identify the local factors and multilevel analysis to investigate and identify factors associated with full immunization coverage among children aged 12–23 months is necessary. The study was conducted using the 2019 Ethiopian Mini Demographic Health Survey dataset. A sample of 1028 weighted children aged 12–23 months were included in the analysis. Descriptive statistics were used to describe variables. For the spatial analysis, Arc-GIS version 10.8 statistical software was used. Spatial regression (geographically weighted regression) was done to identify factors associated with the proportion of full immunization, and model comparison was based on adjusted R2 and Akaike Information Criteria (AICc). Multilevel mixed-effect binary logistic regression models were fitted to identify factors associated with full immunization. The fitted models were compared based on log-likelihood, deviance, median odds ratio, and Proportional Change in Variance. Finally, statistically significant factors were reported using an adjusted odd ratio (AOR) with a 95% Confidence Interval for fixed effect. All variables with a p-value less than 0.05 in the final model were considered statistically significant factors. In Ethiopia, the overall full immunization coverage among children aged 12–23 months was 40.58%, with spatial variation across regions in Ethiopia. The significant spatial distribution of full immunization coverage among children aged 12–23 months was detected in northern Tigray, Addis Ababa, central Oromia, and southeastern Amhara regions. The proportion of rural residents,the proportion of women aged 35–44 years, the proportion of women who had ANC 4 and above andthe proportion of women who had PNC were local factors associated with the proportion of full immunization among children aged 12–23 months. Rural residence [AOR 0.27 (95% CI 0.10, 0.70)], family size 4 and above[AOR 0.41 (95% CI 0.17, 0.96)], never breastfeed [AOR 0.026(95% CI 0.003, 0.21)], 1–3 times ANC visit [AOR 0.45 (95% CI 0.23, 0.86)], being from Oromia region [AOR 0.23 (95% CI 0.05, 0.97)], Eastern pastoralist region [AOR 0.09 (95% CI 0.023, 0.35)], age 35–44 years [(AOR 6 (95% CI 1.57, 22.9)], and PNC [AOR 2.40 (95% CI 1.24, 4.8)] were significant factors associated with fully immunization in multilevel mixed effect analysis. Full immunization coverage in Ethiopia is below the global target with significant geographical variation. The high proportion of rural residents, the high proportion of women who had ANC 4 and above, mothers who had a high proportion of PNC, and the high proportion women age 35-44 years were local geographical factors for the proportion of full immunization among children age 12–23 months in Ethiopia. Women who had PNC, ANC visits four or more times, and increased maternal age were positively associated, whereas larger family size, no breastfeeding, rural residence, and being from Oromia and eastern pastoralist region were negatively associated with full immunization. Strengthening maternal and child health services, focusing on rural areas and low-coverage regions, is essential to increase immunization coverage in Ethiopia.

Determinants of breakfast skipping among pregnant women from South Ethiopia Gamo Zone: a case-control study.

Skipping breakfast during pregnancy presents several challenges and potential health risks for both the mother and her baby. Breakfast plays a crucial role in providing essential nutrients and energy after an overnight fast. Skipping breakfast during pregnancy creates an unhealthy environment for the fetus. Thus, this study aimed to identify the determinants of breakfast skipping among pregnant women. An unmatched, community-based case-control study was conducted among 116 randomly selected cases (breakfast skippers) and 232 neighboring controls (regular breakfast consumers). Data was collected using pre-tested interviewer-administered structured questionnaire. Binary logistic regression analysis was employed to determine predictors of breakfast skipping using STATA version 16. The odds of non-formal education (AOR = 3.92; 95% CI: 1.75, 8.78), low socioeconomic status (AOR = 2.93; 95% CI: 1.12, 7.68), poor dietary knowledge (AOR = 2.89; 95% CI: 1.29, 6.47), and experiencing morning sickness (AOR = 2.57; 95% CI: 1.13, 5.84) were higher among cases than controls. The odds of breakfast skipping were higher for every increase in family size (AOR = 1.65; 95% CI: 1.25, 2.18), but decrease with every unit increase in mid-upper arm circumference (AOR = 0.58; 95% CI: 0.46, 0.72) and weekly frequency of drinking coffee leaf tea beverage (AOR = 0.84; 95% CI: 0.78, 0.89). Findings of this study showed that poor economic status, lack of formal education, poor dietary knowledge, having morning sickness, having large family size, maternal nutritional status, and frequent consumption of coffee leaf tea beverage were significantly associated with breakfast skipping among pregnant women. Thus, efforts should focus on improving dietary awareness during pregnancy, strengthening dietary counseling during antenatal care, enhancing access to contraceptive services, and ensuring timely management of morning sickness.

Wasting and its associated factors among under-two years children in Ethiopia: a systematic review and meta-analysis

IntroductionGlobally, about 45 million under-five children have suffered from wasting where Asian and African countries have the major share of these wasted children. Despite wasting is affected all types of populations, the long and short term effect is more severe and sensitive in under-two aged children. Hence, this review was intended to assess pooled prevalence and associated factors of wasting among under-two children in Ethiopia.MethodsThe search was done using electronic data bases (Hinari, PubMed, Google scholar, Scopus) and research repositories from June 19–22/2023. The review included articles published between January 2013 and December 2023.The study included Cross-sectional/case control studies which report the prevalence and associated factors of wasting in under-two aged children. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) quality assessment checklists for observational studies. The presence of heterogeneity between included studies was evaluated using Cochrane Q-test and the I2 statistics. Publication bias was checked through graphical and statistical test. Associated factors were estimated by random effect model using DerSimonian-Laird model weight.ResultsThe pooled prevalence of wasting among under-two children was 10.91% (95% CI: 8.97–12.85; I2 = 86.36%). Absence of maternal antenatal follow up (OR; 3.23: 95%CI: 1.20–5.26), no exclusive breast feeding until six months (OR; 5.30; 95%CI: 1.17–9.43), current illness of the child (OR; 2.58: 95%CI: 1.78–3.37), large family size (OR; 12.38; 95%CI: 1.37–26.13) and low wealth status of the households (OR; 3.91; 95%CI: 1. 54-8.36) were significant factors of wasting among under-two children.ConclusionsThis study disclosed that the pooled prevalence of wasting among under- two children were high in Ethiopia. Absence of maternal antenatal follow up, no exclusive breast feeding, low wealth status of the households, large family size and current illness of the child were significant factors of wasting. Strictly adherence of maternal antenatal follow up, counsel the parents to feed only breast milk until six months, limit the number of family size to the level of the household income and early treatment of the sick child were recommended. Furthermore, scale up the wealth status and living standard of the family can address the agenda of reducing and eradicating all forms of malnutrition. This review registered at PROSPERO with registration number CRD42023414914 (https://www.crd.york.ac.uk/prospero/#myprospero).