Older Mothers Research Articles

Contextual determinants of generational continuation of female genital mutilation among women of reproductive age in nigeria: analysis of the 2018 demographic and health survey

BackgroundFemale genital mutilation (FGM) has negative health implications and has long been recognised as violating sexual rights. Despite the huge efforts expended on eradicating FGM, generational continuation of the practice, i.e. the act of mutilated women also mutilating their daughters, persists in Nigeria. This study investigated the individual, household, and community factors associated with generational continuation of FGM among women in Nigeria.MethodsThe study analysed data from the 2018 Nigeria Demographic and Health Survey (NDHS). A weighted sample of 3835 women with FGM history and who had given birth to female children was analysed. Models were estimated using mixed-effects multilevel logistic regression with Stata 16.0.ResultsThe results showed that 40.0% of women continued FGM for their daughters. Regional prevalence of FGM continuation ranged from 14.9% in the South-South (the lowest) to 64.3% in the North-West (the highest). Women aged 15–24 years (uaOR = 0.40; 95% CI:0.28–0.57) and rich (uaOR = 0.44; 95% CI:0.35–0.56) had the least likelihood of generational continuation of FGM. In communities with low proportions of women unexposed to the media, the likelihood of FGM continuation was significantly higher (uaOR = 1.85; 95% CI:1.35–2.53). Generational continuation of FGM was significantly lower in communities with moderate proportions of uneducated mothers (aOR = 0.6; 95% CI:0.42–0.86).ConclusionFGM continuation was high in Nigeria, and it was most common among older and poor mothers and in communities with large proportions of uneducated women and those unexposed to the media. Existing National Policy and Plan on FGM elimination should be strengthened to target these characteristics.

The Effect of Media Distractions on Women During Breastfeeding and Infant Care: A Descriptive Cross-Sectional Study.

Background: In modern world, the pervasive use of media technologies has seen a significant increase across various domains. The study aimed to assess the level of distraction among lactating women during feeding and infant care, along with exploring associated factors. Methods: This cross-sectional study included 120 lactating mothers who visited comprehensive health centers in Zanjan City in 2023. The inclusion criteria were lactating mothers older than 18 years, who were within 42 days postpartum. A multistage sampling method was used for participant selection. Data were gathered using a standard maternal distraction questionnaire and analyzed using descriptive statistics, independent t-tests, and analysis of variance (ANOVA) test with a confidence level of 95%. Results: The study found that smartphone use (69.7%) was the most common source of distraction for mothers during breastfeeding, while reading books (17.5%) was the least distracting. In addition, 85% of mothers watched television while caring for their babies (except during breastfeeding), and a significant percentage used landline phones (92.5%) and mobile phones (79.2%). It was noted that older mothers tended to be less distracted during feeding or baby care compared with young mothers. Furthermore, maternal attention during baby feeding increased with higher education levels and having more children (p < 0.05). Conclusion: The study concludes that young mothers with lower levels of education experience significantly high levels of distraction while caring for their babies or breastfeeding. Given the substantial availability of media products, interventions are needed to raise mothers' awareness about the importance of maintaining eye contact with their babies and implementing strategies for managing distractions.

Older mothers and their difficult adult children: a life course exploration

ABSTRACT Adult child to parent violence is a growing international social problem that needs to be better understood to develop clinical interventions. An exploratory study on the antecedents of early life adversity on adult child to parent violence/elder mistreatment was carried out using secondary analysis. Directed content analysis was used based on life course theory with a data set of older mothers all > 57 years old (J. R. Smith 2021, 2022). Measurement of instances of child abuse, domestic violence, and birth trauma among abused older mothers was conducted. All the older women had reported being negatively affected by their adult children’s problems and 56% reported being physically attacked. A case example is presented to illustrate how repeated incidents of abuse or neglect in early life might explain an older woman’s inability to take actions for her own safety.

Gastroschisis and omphalocele: Incidence and outcome

Gastroschisis and omphalocele are the most common congenital abdominal wall defects. The main purpose of this study was to investigate the incidence, other associated anomalies and the course of these diseases in Iceland. The study was retrospective. The population was all newborns who were admitted to the NICU of Children's Hospital Iceland due to gastroschisis or omphalocele in 1991-2020. Furthermore, all fetuses diagnosed prenatally or post mortem where the pregnancy ended in spontaneous or induced abortion, were included. During the study period, 54 infants were born with gastroschisis and five with omphalocele. The incidence of gastroschisis was 4.11 and omphalocele 0,38/10,000 births. There was no significant change in the incidence of the diseases during the study period. In addition, five fetuses were diagnosed with gastroschisis and 31 with omphalocele where the pregnancy was terminated. In addition to gastroschisis in the live born infants and fetuses the most common associated anomalies were in the gastrointestinal or urinary tract but in infants and fetuses with omphalocele anomalies of the cardiac, central nervous or skeletal systems were the most common. Sixteen fetuses diagnosed with omphalocele had trisomy 18. Mothers aged 16-20 were more likely to give birth to an infant with gastroschisis than older mothers (p< 0.001). Primary closure was successful in 86% of the infants. Those reached full feedings significantly earlier and were discharged earlier. Overall survival rate was 95%. Three children were still receiving parenteral nutrition at discharge due to short bowel syndrome. The incidence of gastroschisis in Iceland is in accordance with studies in other countries but but the incidence of omphalocele is lower, which can be partly explained by spontaneous or induced abortions. Other anomalies associated with omphalocele are more severe than those associated with gastroschisis. Primary closure was associated with more benign course. Children with gastroschisis may need prolonged parenteral nutrition due to shortening of their intestines.

Assessment of Neonatal Care Practices Among Mothers Attending Postnatal Clinic at Mukono General Hospital Mukono District

Uganda's neonatal mortality rate was 20/1000 live births, and the country aims to meet the Sustainable Development Goal of 12 deaths per 1000 live births, or less, by 2030. Countries have decreased newborn deaths,infections, and intensive care unit admissions using the evidenced-based 'Essential Newborn Care' guidelines established by the World Health Organization. To assess the neonatal care practices among mothers attending a postnatal clinic at Mukono General Hospital. Mukono District. A descriptive cross-sectional design was used to assess 385 postnatal mothers at the six-week vaccination services at Mukono General Hospital. Data collection was done using a valid questionnaire. Data analysis included descriptive and binary logistic regression. The majority (65.1%) had good ENC knowledge and practice, whereas a third (34.9%) had poor knowledge and practice. Significant gaps in ENC included timing of breastfeeding 33(17.2%), cord care 32(16.7%), and thermoregulation of small birth weight newborns 6(3.1%). Significant associations with ENC included maternal age (p=0.003), and ENC education postpartum (p=0.020). The overall knowledge and practice of ENC are encouraging in this population, particularly with ENC education given postpartum, and older mothers. However, major gaps included evidencebased cord care, thermoregulation, and breastfeeding, particularly among younger mothers. Keywords: Neonatal mortality rate, Newborns deaths, Breastfeeding, Postnatal Mothers, ENC.

Born with an advantage: early life and maternal effects on fitness in female ground squirrels.

Lifetime fitness and its determinants are an important topic in the study of behavioral ecology and life-history evolution. Early life conditions comprise some of these determinants, warranting further investigation into their impact. In some mammals, babies born lighter tend to have lower life expectancy than those born heavier, and some of these life-history traits are passed on to offspring, with lighter-born females giving birth to lighter offspring. We investigated how weight at weaning, the relative timing of birth in the season, maternal weight, and maternal age affected the longevity and lifetime reproductive success (LRS) of female Columbian ground squirrels (Urocitellus columbianus). We hypothesized that early life conditions such as offspring weight would not only have lifetime fitness consequences but also intergenerational effects. We found that weight at weaning had a significant impact on longevity, with heavier individuals living longer. The relative timing of an individual's birth did not have a significant association with either longevity or LRS. Individuals born to heavier mothers were found to have significantly higher LRS than those born to lighter mothers. Finally, maternal age was found to be significantly associated with their offspring's LRS, with older mothers having less successful offspring. Our results provide evidence that early life conditions do have lifelong fitness and sometimes intergenerational consequences for Columbian ground squirrels.

Cost of Care for Newborns With Neonatal Abstinence Syndrome in a State Medicaid Program

Neonatal abstinence syndrome (NAS) is a medical condition among neonates experiencing substance withdrawal due to the mother's substance use during pregnancy. While previous studies suggest that the overall incidence and annual costs of NAS are increasing, to date, the long-term costs have yet to be demonstrated in Medicaid populations. To examine the demographic differences and long-term costs of care for neonates diagnosed with vs not diagnosed with NAS. This cohort study used claims data from the Alabama Medicaid Agency for neonates born to Medicaid-eligible mothers between January 1, 2010, and December 31, 2020. Data were analyzed in June 2022. A diagnosis of NAS within 30 days of birth. Rate of NAS by demographic and birth characteristics, long-term costs attributable to NAS status and demographic and birth characteristics, and distribution of this expenditure over the enrollment period. A total of 346 259 neonates with Medicaid eligibility were born during the study period (mean [SD] gestational age, 38.4 [2.2] weeks; 50.5%, male), 4027 (1.2%) of whom had an NAS diagnosis within 30 days of birth. A larger percentage of neonates with an NAS diagnosis were male (52.7%) than in the group without NAS (50.5%). Neonates with NAS also weighed less at birth (mean difference, -212.0 g; 95% CI, -231.1 to -192.8 g) and had older mothers (mean difference, 3.4 years; 95% CI, 2.6-4.2 years). An NAS diagnosis had an estimated additional cost of $17 921 (95% CI, $14 830-$21 012) over the enrollment period, and this cost was not evenly distributed over that period. In this cohort study of neonates born into the Alabama Medicaid population, those with an NAS diagnosis had a different demographic profile and a higher cost to state Medicaid agencies than those without NAS. These findings warrant further effort to reduce the occurrence of NAS.

Adult children’s education and older parents’ cognitive health in India: examining the pathways of parents’ empowered status and active engagement

ABSTRACT The health and well-being of older parents, especially in low and middle-income countries (LMICs) like India, depend on adult children. As such, using the 2017–18 wave 1 of the Longitudinal Aging Study in India (LASI), we examined (1) the association between adult children’s education and older parents’ cognitive health in India; (2) the extent to which this association is mediated by (a) parents’ empowered status and (b) their active engagement; and (3) whether the associations between (1) and (2) vary for older men and women. Findings reveal that adult children’s education was, indeed, positively associated with older parents’ cognitive health, and this association was significantly stronger for older mothers. The educational attainment of adult daughters was found to have a relatively stronger association with the cognitive functioning of older parents, particularly their older mothers, compared to their male counterparts. We also found that parents of well-educated children were more empowered and mentally and physically engaged, both factors linked to better cognitive functioning. These findings highlight that educating even one child beyond the ‘compulsory’ secondary education proves consequential not just for the child but for parents in later life. Given the considerable generational disparities in educational attainment and the proportion of joint families in the country, older Indians may be particularly well-situated to reap the cognitive health dividends of educating the next generation.

Longitudinal tracking of diet quality from childhood to adolescence: The Interplay of individual and sociodemographic factors

This study aimed to examine diet tracking from childhood to adolescence, using 4 time-points, and the influence of socioeconomic and individual characteristics in this transition. The sample included 6893 children from the Portuguese birth cohort Generation XXI with complete information on Food Frequency Questionnaire in at least one of the considered follow-ups. A Healthy Eating Index (HEI), previously developed to assess adherence to WHO's dietary recommendations, was applied at all ages (4, 7, 10 and 13y). The intraclass correlation coefficient (ICC) was used to analyse the tracking of diet quality. Linear mixed-effect models were performed to estimate the association of the child's socioeconomic and individual characteristics with the HEI score and respective trajectories over time. The overall diet quality decreased from childhood (22.2 ± 3.6 at 4y) to adolescence (18.2 ± 3.9 at 13y), with moderate tracking (ICC = 0.53), showing that children who start a healthy diet earlier might have a better diet quality as time goes by. Children of older mothers (β = 0.079, 95%CI = 0.061–0.097) and with higher education (β = 0.203, 95%CI = 0.178–0.229) and a higher household monthly income (β = 0.024,95%CI = 0.007–0.041) had a higher diet quality over time. Besides family characteristics, the child's sedentary activities (β = −0.009, 95%CI = −0.014–-0.003) negatively influence diet quality throughout life. In contrast, being a girl (β = −0.094, 95%CI = −0.132–-0.056) and having higher sleep duration (β = 0.039, 95%CI = 0.015–0.064) are associated with a higher diet quality over time. The presence of dietary tracking from childhood to adolescence implies that promoting healthy eating habits during the first years of life is crucial for a healthier diet quality during late childhood and early adolescence, focusing on maternal and individual child characteristics.

Advanced Maternal Age: A Scoping Review about the Psychological Impact on Mothers, Infants, and Their Relationship.

The mean age at childbirth in Europe has gradually increased, and it is now around 29 years of age. It has been shown that older maternal age is associated with problems of fertility; in fact, with increasing age, the chance of conceiving diminishes, and fetal and obstetric complications grow. Research has focused particularly on the biological risks associated with late pregnancy, both for the child and the woman. Less space has been dedicated to the potential psychological and relational benefits of motherhood at an advanced age. The aim of this review was to summarize the existing literature on this issue. Qualitative and quantitative studies were sourced from Pubmed, Science Direct, PsycINFO, and SciELO. The selected works highlight that advanced maternal age can be associated with some advantages for both mothers and their offspring in terms of physical healthcare, parenting styles, and child developmental outcomes. Specifically, the review suggests that older mothers have greater emotional maturity and feel more prepared for motherhood; also, advanced maternal age appears to exert a protective influence on children's behavioral, social, and emotional functioning, compensating for the biological risks.

Barriers and enablers to exclusive breastfeeding by mothers in Polokwane, South Africa.

Exclusive breastfeeding (EBF) for six months, with the introduction of appropriate complementary feeding thereafter, and breastfeeding continuing for up to 2 years and beyond, is highly recommended. This could save the lives of up to 1.4 million children each year worldwide. Despite this, breastfeeding rates in South Africa remain sub-optimal, with the recommended target of 50% by the World Health Assembly (WHA) not being achieved. The study aimed to investigate the reasons influencing mothers' practice of exclusive breastfeeding in the Polokwane municipality of Limpopo province in South Africa. A cross-sectional health facility-based quantitative and descriptive survey was conducted using a validated-structured questionnaire administered to 146 mothers. The data was analyzed using STATA. Chi-square tests were used to determine the relationship between selected demographic variables and their reasons not to breastfeed exclusively. Although 94% of the mothers had initiated breastfeeding, at the time of data collection 8% had stopped. Of those who had stopped breastfeeding, 5% did so within one month of starting. Thirty- nine percent of mothers' breastfed exclusively, while 61% practiced mixed feeding. A positive association between exclusive breastfeeding practices and the age of the mother were observed, with older mothers more likely to breastfeed. The reasons mothers stopped breastfeeding were: the mother was ill (45%) or they returned to school or work (27%). Reasons for not breastfeeding were cited as: medical conditions, not enough milk, and infant refusal to breastfeed (33%). Mothers believe that HIV-positive women should breastfeed their infants (57%), and health workers were found to be the main source of HIV information to mothers (77%). Exclusive breastfeeding during the first six months was less practiced. Infant formula and solid foods were introduced at an early age, usually within the first month of breastfeeding. This study sheds light on factors influencing the early initiation of breastfeeding and the practice of EBF as practiced in Polokwane.

Cooking behavior among mothers of children aged 2-5 years old in Kendari, Southeast Sulawesi, Indonesia.

Cooking at home was associated with parental feeding practices. This study aimed to explore the interplay of components in cooking behavior of mothers with young children aged 2-5 years old in Kendari city of Southeast Sulawesi, Indonesia. This qualitative study involved 33 mothers from Kendari city, which was represented by each two sub-districts in coastal and mainland areas that were randomlyselected. Six focus group discussions (FGDs) were carried out using 20-item guide questions. The guide questions were developed following the Model of Goal-Directed Behavior (MGDB) theory approach exploring the components of cooking behavior i.e., skill, intention, desire, confidence, and attitude in cooking. Data analysis was performed in the field to assist decision on data saturation, followed by data analysis at desk through multilevel coding from the verbatim transcripts using NVivo R1 software. The data was analyzed thematically using pre-determined themes according to the MGDB theory. Emerging topics on enabling factors and constraints were captured to enhance our understanding of the complexity of cooking behavior. The mothers' mean age was about 30 years old with a comparable representation of younger and older mothers. Most mothers were housewives and accomplished secondary school level. The mothers' intention was shown as they frequently cooked at home and allocated time for cooking. The enabling factors included their knowledge about food and nutrition, food source availability, their confidence in cooking meals and following recipes, and their motivation to keep their children healthy representing some intrinsic factors. The main constraint was the lack of skill to make snacks. The other extrinsic barriers were dependence on mobile food sellers and the availability of food kiosks that facilitated children's snack preferences. The study obtained some insights that mothers had favorable cooking intention and desire, were supported with a confidence in some basic cooking skills. However, the existing constraints that encouraged the development of unfavorable children's snacking habit were beyond the mothers' control. A cookbook specifically for snack recipes that utilizes local ingredients may assist mother in preparing more healthier options for the children.

Intergenerational Food Insecurity, Underlying Factors, and Opportunities for Intervention in Momostenango, Guatemala.

Achieving sustainable food security in Guatemala, where nearly half the population is food insecure and 50% of children face chronic malnutrition, is challenging. This mixed-methods study aimed to identify the impacts of climate change on food production, community food security, and household food security. Twelve agricultural group leaders in six communities were interviewed using semi-structured guides. Key informant interview themes included subsistence agriculture, commercial production, challenges related to climate, capital, market, and capacity, as well as sustainable opportunities. Fifty-five mothers from 13 distinct communities around Momostenango were surveyed and interviewed. A significant finding is that 85% of households were food insecure, with 93% relying on agriculture. Food-secure families mostly worked on their own or leased land, whereas food-insecure ones combined farming with day labor. In times of food scarcity, strategies such as altering food consumption and reducing expenses were common. Severely food-insecure families were significantly more likely to reduce portion sizes (72%), whereas food-secure families typically resorted to less preferred foods. Overall, food insecurity was notably linked to larger families, older mothers with limited education, and reliance on agricultural day labor. Food insecurity is a long-term issue in rural areas, deeply rooted in structural socioeconomic constraints, and recurring across generations.

A Cross-Sectional Analysis of 2017-2022 National Immunization Survey: Sociodemographic Disparities Associated With Human Papillomavirus Vaccine Initiation and Completion Series Among US Adolescents.

The introduction of the Human Papillomavirus (HPV) vaccine has led to future decline in prevalence of HPV-causing cancers; however, disparities in early HPV vaccine uptake and coverage may contribute to persistent inequalities in HPV-related cancers in the United States. We assess the current trend of sociodemographic factors significantly associated with the initiation and Up To Date (UTD) HPV vaccine series among adolescents in the U.S. The retrospective National Immunization Survey-Teen data were analyzed for a cohort of adolescents aged 13-17 years who initiated HPV vaccine and completed the series from 2017 to 2022. A multivariable logistic regression estimated the correlation of sociodemographic variables to determine the odds of HPV vaccine initiation and completion as the outcomes. There were 3.2% and 5% surge in HPV vaccine initiation and UTD, respectively, with teens' mean age of 14.98 over the years. The unvaccinated dropped by 5.6%, and those not UTD declined by 4.6% in the HPV vaccine series during this period. The proportion of teens who initiated and completed the vaccine series were mostly older female teens, non-Hispanics, regularly insured with private coverage, raised by educated older mothers, above poverty status, and living in the South. The adjusted multivariable logistic regression shows the odds of initiating and completing increases over the years, and older teens are more likely to initiate the HPV vaccine and complete the vaccine series. However, boys with non-Medicaid coverage/uninsured in the South have lower odds to initiate and complete the vaccine. Improved HPV vaccine uptake and UTD were found in older females, insured with Medicaid, and from highly educated mothers in the Northeast. Findings underscore the importance of effective strategies to address current HPV vaccination disparities among identified teens with lower uptake and UTD that may reduce future burden of HPV-related cancers in the U.S.

Identification of Familial Infections Using Multilocus Microsatellite Typing in Tinea Corporis due to Microsporum canis.

Microsporum canis is a type of dermatophyte that causes zoonotic dermatophytosis in cats and dogs. We report three cases of tinea corporis due to M. canis from a single household with a domestic cat as a pet. The cases included a woman in her thirties (mother), a girl in her teens (older sister), and a girl in her teens (younger sister). Following sudden hair loss in the domestic cat, annular erythema with pruritus and scales appeared on the face, neck, and limbs of the older sister, younger sister, and mother, sequentially; they subsequently visited our hospital. Potassium hydroxide direct microscopy revealed filamentous fungi on all three women. In addition, short-haired colonies with a white to yellowish-white color and extending in a radial manner were found in cultures using a flat plate agar medium. A slide culture with the same medium indicated pointed spindle-shaped macroconidia with 7-8 septa. Therefore, the cases were diagnosed as tinea corporis due to M. canis. Genetic analysis of the cells of the cat and the mother, older sister, and younger sister using multilocus microsatellite typing (MLMT) indicated that all cases were classified into the same genotype, suggesting that the transmission route of these cases was familial. Here, we show that MLMT is useful in identifying the infection route in cases of tinea corporis due to M. canis.

Effect of family integrated care on stress in mothers of preterm infants: A multicenter cluster randomized controlled trial

BackgroundReducing mother-infant separation in early life is a key breakthrough in the care improvement model in the neonatal intensive care unit (NICU). Previously, we reported effect of family integrated care (FICare) on clinical outcomes of preterm infants. We further clarify effect of FICare on maternal stress. MethodsMothers of preterm infants at eleven NICUs were randomized to the FICare group and the control group. The primary outcome was the reduction in Parental Stress Scale: NICU (PSS:NICU) score from enrollment to discharge. ResultsTotal of 601 mothers (298 in FICare and 303 in control groups) enrolled. There was no significant difference in PSS:NICU score between the 2 groups at enrollment (P = 0.824), and the FICare group had lower scores at discharge (P < 0.001). PSS:NICU scores of both groups were significantly decreased at discharge compared to at enrollment (P < 0.001), and the reduction was greater in the FICare group (P < 0.001). After applying linear regressions to adjust for potential confounders, results remained unchanged (adjusted P < 0.001). PSS:NICU score reductions from enrollment to discharge were positively correlated with maternal age in the control group (ρ = 0.147, P = 0.011). LimitationsThis study was limited to post-hoc analyses and did not include follow-up to evaluate long-term effects. ConclusionsFICare is helpful for reducing maternal stress in preterm infants in the NICU. Older mothers tend to have limited improvements in stress after traditional nonparent care, which suggests that they may benefit more from the FICare model.

Prevalence of Malaria among Pregnant Women Attending Muhammad Abdullahi Wase Teaching Hospital Kano State, Nigeria

Malaria in pregnant women remains a major public health problem especially in sub-Saharan Africa. Approximately twenty five million pregnant women in sub-Saharan Africa live at risk of malaria. The study was carried out between July and August 2021, to determine the prevalence of malaria parasite among pregnant women attending Mohammad Abdullahi Wase Teaching Hospital Kano. Microscopic examinations of both thick and thin smears were made using Giemsa Stained solution. Out of one hundred and forty blood samples examined, 60(42.9%) were positive for plasmodium falciparum parasite infection. Age group 18-22 years recorded the highest prevalence rate of (17.90%) and the difference between the age group of the pregnant women was statistically significant (P&lt;0.05) .Primigravida women recorded highest infection rate (23.60%). However, those in first trimester recorded the highest prevalence of (25%) followed by those in the second trimester (13.57%). These results show that pregnant women are more predisposed to malaria infection as they are immunosuppressed especially at early stage and as a primigravida and as teenage mothers than multigravida and older mothers. The problem of P. falciparum in pregnant women can be prevented by the preventive package of intermittent preventive treatment (IPT) with sulfadoxine pyrimethamine (SP) at 2 doses given to the pregnant women during their antenatal clinical visits. During this study, the prevalence of malaria infection among pregnant women attending Muhammad Abdullahi Wase Teaching Hospital was notably higher. P. falciparum is the most common Plasmodium parasite in this region therefore, more special attention should be directed towards pregnant women who exhibit identified risk factors for malaria infection.

Appropriate feeding practices and associated factors during diarrheal disease among children aged 6 to 23 months in Sub-Saharan Africa: a multilevel analysis of the recent demographic and health survey

BackgroundDiarrhea is the second leading cause of morbidity and mortality for under-five children which cause about 525,000 deaths annually. Even though diarrheal diseases have decreased substantially at the global level, low-income countries are still faced with a huge number of diarrheal diseases. Thus, our aim was to assess the child feeding practices during diarrheal diseases and associated factors among children aged 6 to 23 months in Sub-Saharan African countries using the recent demographic and health survey.MethodsThe appended and most recent demographic and health survey (DHS) dataset of 19 Sub-Saharan African countries from 2015 to 2020 was used for data analysis. A total of 64,628 living children aged 6–23 months with diarrhea were used as a weighted sample. The determinants of appropriate feeding practice were determined using a multilevel mixed-effects logistic regression model. Significant factors associated with appropriate feeding practice in the multilevel mixed-effect logistic regression model were declared significant at p-values < 0.05. The adjusted odds ratio (AOR) and confidence interval (CI) were used to interpret the results.ResultThe overall prevalence of appropriate child feeding practice during diarrhea in this study was 6.24% (95% CI: 6.06, 6.43). Maternal age (15 to 19 years and 20 to 35 years) (AOR = 1.32, 95%CI: 1.12, 1.55 and AOR = 1.14, 95%CI: 1.03, 1.27), mothers education (primary and secondary level) (AOR = 1.23, 95%CI: 1.12, 1.35 and AOR = 1.28, 95%CI: 1.15, 1.43), having media exposure(AOR = 1.36, 95%CI: 1.26, 1.46), being married (AOR = 1.18, 95%CI: 1.01, 1.38), currently working (AOR = 1.08, 95%CI:1.00, 1.15), vaccinated for Rotavirus (AOR = 1.30, 95%CI:1.19, 1.43) and living in Central and eastern African countries (AOR = 1.82, 95%CI: 1.12, 2.97) and (AOR = 2.23, 95%CI: 1.37, 3.61) respectively were significantly associated with appropriate feeding practice.ConclusionThe prevalence of appropriate feeding practice during child diarrheal disease aged 6–23 months of age was strictly low which implies that child diarrhea and appropriate feeding practice is still a great issue in in Sub-Saharan African countries. Enhancing maternal education, strengthening media exposure and vaccination for rotavirus, and designing interventions that address the mother’s marital status, mother’s work status, and country category are recommended to enhance appropriate feeding practices. Furthermore, special consideration should be given to older mothers to increase appropriate feeding practices during diarrheal disease.

Association of Kawasaki disease with urbanization level and family characteristics in Taiwan: A nested case-control study using national-level data.

Kawasaki disease (KD) is an inflammatory vasculitis disorder of unknown etiology. It is a rare but fatal disease and the leading cause of acquired coronary heart disease in children under the age of 5 years. We examined the association of KD with the demographics of family members, parents' characteristics, and perinatal factors in Taiwanese children. This nested case-control study used data from Taiwan's Health and Welfare Data Science Center and initially included children born in Taiwan between January 1, 2006, and December 31, 2015 (n = 1,939,449); the children were observed for KD development before the age of 5 years (n = 7870). The control group consisted of children without KD who were matched with each KD case by sex and birth date at a ratio of 8:1. The odds ratio (ORs) of the aforementioned associations were estimated using conditional logistic regression. The risk of KD decreased in children with younger parents [<25 years; younger maternal age, OR = 0.72, 95% confidence interval (CI), 0.66-0.79; younger paternal age, OR = 0.68, 95% CI, 0.59-0.78], lower socioeconomic status, more than 2 siblings (OR = 0.80, 95% CI, 0.73-0.89), and siblings with a history of KD (OR = 4.39, 95% CI, 3.29-5.86). Children living in suburban (OR = 0.95, 95% CI, 0.90-1.00) and rural (OR = 0.81, 95%CI, 0.74-0.90) areas exhibited a lower risk of KD than children living in urban areas. In conclusion, a higher incidence rate of KD was observed in children aged <5 years who had an urban lifestyle, had siblings with KD, were born to older mothers, and belonged to high-income and smaller families. Parental allergic or autoimmune diseases were not associated with the risk of KD.

Determinants of severe acute malnutrition among under-five children in Ethiopia: analysis using data from the 2016 Ethiopia Demographic and Health Survey.

Malnutrition is a silent killer that is under-reported, under-addressed, and, as a result, emphasized. This study aimed to identify the determinants of severe acute malnutrition (SAM) among under-five children in Ethiopia. Cross-sectional data from the 2016 Ethiopian Demographic and Health Survey (EDHS) were used. A total of 6,170 under-five children were included in the current analysis. The data were cleaned and analyzed using STATA 14. An adjusted odds ratio (AOR) and their 95% confidence intervals (CIs) were calculated to determine the association between factors and outcomes. A p-value of less than 0.05 was considered significant in multivariable logistic regression. A multivariable logistic regression revealed that under-five children with the age of children in months 6-11 (AOR = 1.52, 95% CI: 1.25, 1.86), 12-23 (AOR = 1.98, 95% CI: 1.65, 2.37), and 24-59 months (AOR = 1.71, 95% CI: 1.40, 2.08), birth order between fourth and fifth (AOR = 1.24, 95% CI: 1.01, 1.54), having fever (AOR = 1.31, 95% CI: 1.09, 1.58), anemic children (AOR = 1.21, 95% CI: 1.07, 1.36), age of mothers in years 25-34 (AOR = 0.60, 95% CI: 0.51, 0.72) and 35-49 (AOR = 0.49, 95% CI: 0.39, 0.63), antenatal care (ANC) visits (AOR = 0.83, 95% CI: 0.71, 0.92), rural residence (AOR = 2.98, 95% CI: 2.54, 3.49), and solid fuels users (AOR = 2.46, 95% CI: 1.86, 3.26) were significant predictors. Older age of children, those with higher birth order, those having fever, anemic children, those living in rural areas, and solid fuel users were more likely to suffer from SAM, while older mothers and those having ANC visits had reduced SAM as significant predictors.