Under-five Children In Nigeria Research Articles

Geostatistical patterns of comorbidity of diarrhea, acute respiratory infection, and stunting among under-five children in Nigeria

ABSTRACT Among children under five in Nigeria, in the year 2018, the prevalence of diarrhea was 13%, that of acute respiratory infections 3%, and that of stunting 37%. A shared-component model highlights geographic variations in the comorbidities of these diseases. The data are from the 2018 Nigeria Demographic and Health Survey. The majority of states in northern Nigeria presented clusters of higher risk for comorbidities of any pair of the three diseases. Compared with mothers with primary education or less, mothers with secondary education were 1.4 times less likely to have two or three of these diseases at the same time, and women with tertiary education 2.0 times less. Compared to childless women of the same age, mothers were 1.6 times less when aged 20–29, 1.9 times less when aged 30–39, and 2.0 times less when aged 40–49. Access to a protected water source reduced the risk by a factor of 1.3. Girls under age five were 1.2 times less likely than boys of that age to have two or three of these diseases at the same time. This factor was the same for breastfed children compared to those who were not breastfed.

Determinants of Nutritional Practices Among Mothers with Under-Five Children is Paramount in Curbing the High Rate of Morbidities and Mortalities among Under-Five Children

Nutritional outcomes among under-five children in Nigeria are among the worst globally. Therefore, this study investigated the determinants of nutritional practices among mothers with under-five children attending selected primary health centers in Abeokuta, Ogun state, Nigeria. The study adopted a quantitative cross-sectional descriptive survey research design. A A multi-stage sampling technique was used to select 419 mothers of under-five children attending primary health centres in Abeokuta, Ogun State. All the Research questions and hypothesis were formulated and were tested using the SPSS version 27 to compute descriptive and inferential statistics which were tested at a 5% level of confidence. The result indicated that mean age of respondents in this study was 28.48 ± 5.811years with participants between the ages of 27-35 (44.6%) were the highest. High level of knowledge regarding under-five nutrition was measured on a 21-points rating scale showed a mean score of 12.65±3.61. There was good level of nutritional practices which was measured on a 17-points rating scale showed a mean score of 11.06±2.26. There was a significant difference between level of education of mother and their nutritional practice (P=0.000), there is a significant correlation between respondents’ level of knowledge (r=0.256; p=0.000). In conclusion, the study established that there is good level of knowledge of under-five nutrition; there was poor support and good level of nutritional practice. The study recommended that continued training and re-training is very important for mothers of under-five children. There is also need for active involvement of the media in dissemination of nutritional benefits of under-five children.

Multivariate logistic regression analysis on the association between anthropometric indicators of under-five children in Nigeria: NDHS 2018

BackgroundChild malnutrition is a huge health problem having multifaceted consequences for child survival and long-term well-being. Although, several studies investigated stunting, underweight, and wasting in low- and middle-income countries, in Nigeria, the link between them received little attention. The aim of this study is, therefore, to assess the association between anthropometric indicators of under-five children such as stunting, underweight and wasting given that of other characteristics of children and households.MethodsThe data for this study was obtained from Nigerian Demographic and health survey (NDHS) in 2018. A total of 11,314 under-five children were involved. Multivariate logistic regression model was used to determine the association between stunting, underweight and wasting given that of the estimated effect of other determinants.ResultsFrom 11,314 under-five children the study considered 36.2, 21.4 and 6.7% of them suffered from stunting, underweight and wasting, respectively. About half (50.7%) of the children were male, 24.1% was obtained from North West region of Nigeria, and 37.8% of them were from households having unimproved drinking water. The pairwise dependency between stunting and underweight; underweight and wasting was measured using odds ratio (OR) of 15.796, and 16.750 respectively. The estimated odds of children from richest household to become stunted, underweight, and wasted was respectively 0.392, 0.540, 0.786 times that of the estimated odds of children from poorest households.ConclusionThe prevalence of under-five children with stunting, underweight and/or wasting in Nigeria was very high. The important determinants of stunting, underweight, and wasting for under five children were household wealth index, women body mass index, sex of the child, anemia, mothers’ age at first birth, and a diarrhea two weeks prior to the survey. Whereas, region, religion, multiple birth, women’s educational level significantly associated with both stunting and underweight. Both stunting and wasting significantly associated with underweight.

Mothers Education and Respiratory Infection in Under-Five Children in Nigeria

Respiratory infection is one of the major causes of child ill health and mortality not only in Nigeria, but in most developing countries of the world. This study therefore, investigated the causal relationship between mothers’ level of education and under-five age respiratory infection in Nigeria. Probit regression is used to analyse data from Nigeria Multiple indicator cluster survey 2017. Results from the bivariate regression indicated a significant negative relationship between mothers’ educational level and respiratory infection in under-five age children in Nigeria. Mothers’ educational level became insignificant after controlling for other important covariates which signifies an indirect relationship with child respiratory infection. This implies that mothers’ education influences child respiratory disorder through other variables like place of residence and immunization. Other variables found to influence child respiratory infection includes region of residence, age of child, immunization and ethnicity. On the other hand, sex of child and wealth index were not found to be significant determinants of child respiratory infection. Nigerian government should encourage girl child education through the provision of free quality education at least to secondary school level. Programs to target free diagnosis, treatment and prevention of respiratory infection especially among under-five children should be prioritized by the ministry of health. Health care providers should also intensify awareness to mothers on preventive measures of child respiratory infection especially during antenatal care programs.

Patterns of Self-medication Practices by Caregivers to Under-five Children in South-Western Nigeria

ABSTRACT Self-medication has generated a serious public health concern with its accompanied unhealthy practices. In Nigeria, the prevalence of self-medication is on the increase. Globally, the use of medicines for children is of serious concern as children are considered to be vulnerable group. Despite the full range of self-medication practices, not much is known about its extension to the most vulnerable of under-five children in Nigeria. This paper examined the patterns of self-medication practices among the caregivers to under-five children in south-western Nigeria. Two local government areas from Lagos and Osun states were selected for the study based on their cosmopolitanism and non-cosmopolitanism nature. Eighty-six caregivers to under-five children within the communities participated in the discussions. Purposive snowballing technique was used to select the participants in the study area with the aid of people of influence in the community for the FGDs. Twelve FGDs were conducted and stratified into younger caregivers and older caregivers. Data were collected with the aid of FGD guide for the caregivers of U-5 children and with the assistance of audio-tape recorder to obtain relevant information from those involved in the practice of self-medicating to their U-5 children. Data were analyzed based on thematic analysis. This was developed by the use of codes based on the identified variables from the fieldwork. Data were transcribed verbatim and classified into different themes. Analysis was done with the aid of Nvivo 11.0, a software designed for the analysis of qualitative data. The pattern of self-medication identified from this study included various combinations of herbal medicine, western medicine and faith-based medicaments. Also, the social factors associated with these patterns included, age of the caregivers, level of education, religion and relationship of the caregivers to their under-five children.

Inequities in child survival in Nigerian communities during the Sustainable Development Goal era: insights from analysis of 2016/2017 Multiple Indicator Cluster Survey

BackgroundChild survival is a major concern in Nigeria, as it contributes 13% of the global under-five mortalities. Although studies have examined the determinants of under-five mortality in Nigeria, the comparative roles of social determinants of health at the different stages of early childhood development have not been concurrently investigated. This study, therefore, aimed to identify the social determinants of age-specific childhood (0–59 months) mortalities, which are disaggregated into neonatal mortality (0–27 days), post-neonatal mortality (1–11 months) and child mortality (12–59 months), and estimate the within-and between-community variations of mortality among under-five children in Nigeria. This study provides evidence to guide stakeholders in planning for effective child survival strategies in the Nigerian communities during the Sustainable Development Goals era.MethodsUsing the 2016/2017 Nigeria Multiple Indicator Cluster Survey, we performed multilevel multinomial logistic regression analysis on data of a nationally representative sample of 29,786 (weighted = 30,960) live births delivered 5 years before the survey to 18,497 women aged 15–49 years and nested within 16,151 households and 2227 communities.ResultsDeterminants of under-five mortality differ across the neonatal, post-neonatal and toddler/pre-school stages in Nigeria. Unexpectedly, attendance of skilled health providers during delivery was associated with an increased neonatal mortality risk, although its effect disappeared during post-neonatal and toddler/pre-school stages. Also, our study found maternal-level factors such as maternal education, contraceptive use, maternal wealth index, parity, death of previous children, and quality of perinatal care accounted for high variation (39%) in childhood mortalities across the communities. The inclusion of other compositional and contextual factors had no significant additional effect on childhood mortality risks across the communities.ConclusionThis study reinforces the importance of maternal-level factors in reducing childhood mortality, independent of the child, household, and community-level characteristics in the Nigerian communities. To tackle childhood mortalities in the communities, government-led strategies should prioritize implementation of community-based and community-specific interventions aimed at improving socioeconomic conditions of women. Training and continuous mentoring with adequate supervision of skilled health workers must be ensured to improve the quality of perinatal care in Nigeria.

Correlates of Safe Disposal of Children’s Stool in Nigeria: Evidence from 2018 Demographic and Health Survey

Unsafe Stool disposal has been linked to high under-five morbidity and mortality in many low and middle-income countries. This paper focuses on examining the prevalence of safe disposal of stools in Nigeria and the factors affecting such behaviour. The most-recent Nigeria Demographic and Health Survey 2018 (NDHS) Child’s dataset was used for the analysis in this study. Sample size of 7,834 children under age five was analysed. Percentages and frequencies, chi-square test of association, and binary logistic regression were employed for the statistical analysis. Findings show that a little above half of the women respondents reported safe disposal of stool of their under-five children in the study area (53%). Specifically, the odds of having stool safely disposed increased by 133 percent for children whose household wealth index falls within the richer category (adjusted Odd Ratio (aOR): 2.33; p<0.001), reduced by 17 percent for children whose mothers are working (aOR: 0.83; p<0.05), increased for children whose mothers are residing only in North-East and North-West (p<0.001), increased by 19 percent for children whose mothers were exposed to media exposure to mass media (aOR: 1.19; p<0.05), reduced by 24 percent for women whose children are of first birth order (aOR: 0.76; p<0.05), reduced by 31 percent for women whose children are of small size at birth (aOR: 0.69; p<0.001), increased by 66 percent for women who reported that distance to facility was not a problem (aOR: 1.66; p<0.001), reduced by 19 percent for women who delivered their children at an health centre (aOR: 0.81; p<0.05), and increased by 114 percent for women who used improved toilet facility (aOR: 2.14; p<0.001). This study concludes that a combination of socioeconomic, maternal, child’s and environmental factors are the correlates of safe disposal of stool among women with under-five children in Nigeria. It should therefore be prioritised for interventions aimed at reducing high under-five morbidity and mortality in Nigeria.

Spatial prediction of childhood malnutrition across space in Nigeria based on point-referenced data: an SPDE approach

Malnutrition remains a leading cause of child mortality in Nigeria. The spatial analysis based on areal level approaches could, in reality, conceal variations at smaller units. Using point-referenced data from Nigeria Demographic and Health Survey, we quantify the prevalence of malnutrition among under-five children in Nigeria at 1.63 by 1.63km spatial resolution, and compute the exceedance probability maps for stunting, wasting and underweight at 20% threshold level using the stochastic partial differential equation approach with Bayesian inference based on integrated nested Laplace approximation. Results show divergence prevalence of the malnutrition indicators among children living in neighbouring locations and that the prevalence of stunting and underweight increase with age. The prevalence of stunting was uneven among children living in Kebbi, Zamfara, Sokoto, Kaduna, Kano, Katsina, Bauchi, Gombe and Taraba states with more concentrations in the northern fringes of some of the states. Except for few locations in about three states, the probability is more than 90% that the prevalence of stunting in all parts of the country exceeds 20% but this was not the case for wasting. The findings can assist in location-specific policy formulation and implementations.

Understanding factors influencing care seeking for sick children in Ebonyi and Kogi States, Nigeria

BackgroundNigeria has one of the highest child mortality rates in the world, with an estimated 750,000 deaths annually among children under age five. The majority of these deaths are due to pneumonia, malaria, or diarrhea. Many parents do not seek sick-child care from trained, biomedical providers, contributing to this high rate of mortality.MethodsThis qualitative study explores factors enabling or preventing parents from seeking care for sick under-five children in Nigeria’s Kogi and Ebonyi states, including gender-related roles and social norms. Interviews were conducted with parents of sick under-five children and service providers, and focus group discussions were held with community leaders to assess how care-seeking behavior was influenced by four modes from the Colvin et al. conceptual framework for household decision-making and pathways to care. These include (1) caregivers’ recognition and response to illness, (2) seeking advice and negotiating access within the family, (3) making use of community-based treatment options, and (4) accessing biomedical services.ResultsParents were found to have a general understanding of illness symptoms but did not always attribute illness to biomedical causes. Intra-household decision-making processes were shaped by gender dynamics between men and women, and were found to have great effects on decisions to seek care. Use of traditional medicine and self-treatment were found to be common first steps in treatment before turning to the biomedical care system. Once the decision to seek biomedical care was taken, the route of seeking care varied between seeking care at chemists and then continuing to health facilities or starting with a health facility and then accessing prescriptions from a chemist.ConclusionWe conclude that care-seeking decisions do not follow a linear process; that intra-household decision-making processes particularly among parents should not be underestimated in addressing sick-child care seeking; and that, given the role of mothers as primary caregivers, their knowledge in illness recognition and agency in care-seeking decision-making, and seeking biomedical care, is deserving of future study.

Repellency and larvicidal activities of Azadirachta indica seed oil on Anopheles gambiae in Nigeria

Despite the recent decline in the global prevalence of malaria, the disease continues to be one of the major causes of morbidity and mortality among pregnant women and under-five children in Nigeria. The adoption of an integrated approach to malaria control including the use of bio-insecticide will further reduce the burden of malaria. This study determined the repellency and bio-insecticidal effects of Azadirachta indica oil on Anopheles gambiae in Ibadan, Nigeria. The study was experimental in design. Oil was extracted from the ground seed kernel of Azadirachta indica plants using N-hexane as a solvent. Larvicidal tests were carried out on 600 third and fourth instar stages of Anopheles gambiae using an aliquot of extracted oil emulsified with a surfactant (Tween 80) at concentrations ranging from 100 to 500 ppm. Mortality was recorded every 24 h for five days. Repellency tests were carried out by exposing Guinea pigs that were previously treated with the oil mixed with paraffin at 10–40%v/v concentrations, to 70 adult female Anopheles gambiae in netted cages. Data were analysed using descriptive statistics and ANOVA. The oil yield accounted for 40.0% weight of the ground seed kernel. The larvicidal effect was significant across the concentration of the emulsified Azadirachta oil ranging from 91.6-100.0%, compared to the control experiment ranging from 5-15% (LC50 and LC90: -1666.86 ppm and -2880.94 ppm respectively). A 100.0% larval mortality of Anopheles gambiae was recorded within three days at 500 ppm. All the concentrations of the oil solution also caused 100% inhibition of pupae formation. The repellent effect of adult Anopheles was significant (p < 0.05) across the concentrations but with varying degrees of protection. The highest repellent effect was observed at 40.0% (v/v). The possibility of using Azadirachta indica as bio-insecticide against Anopheles gambiae was established in this study.

PIN49 ADDRESSING THE LOW IMMUNIZATION RATES IN UNDER FIVE CHILDREN IN NIGERIA: A DATA ANALYSIS AND POLICY IMPLICATIONS

The global health observatory data shows that under-five death rates are the highest in the WHO African region, with 74 deaths per 1000 live births. In fact, under-five children have a 15 times higher chance of dying when compared to their peers in high-income countries. Nigeria is among the countries with the lowest immunization coverage in the region, according to the WHO estimates. In 2018 70% of the population is not vaccinated, representing an approximated 3 million people. The purpose of this presentation is to identify the risk factors of incomplete immunization in under-five children in Nigeria. Nigeria Demographic and Health Survey (NDHS) datasets, made publicly available by USAID were used. A cross-sectional analysis of secondary data was performed using the 2018 data. A logistic regression was performed to identify the risk factors of incomplete immunization. We focused on vaccine coverage status for BCG, Pentavalent, Polio 3, and Measles. The data analysis was performed using SAS. The analysis included a total of 6154 children aged 12 to 13 months. About 55% did not receive full immunization. Was considered having a complete immunization, children who received one dose of BCG vaccine, four doses against polio, three doses of Pentavalent vaccine, and one vaccine dose against measles. Children who had mothers with no education were 12.2 [95% CI (5.4, 27.6)] times at higher odds of having incomplete immunizations compared to those who had mothers with higher education. Added to that, children living in wealthier families were 4 [95% CI (2.4, 6.7)] times at higher odds of having incomplete immunization compared to those living in wealthier families. Parental factors influenced the immunization status of children under five. Immunization campaigns and national programs in Nigeria should take into consideration non-individual factors and focus on household-related factors.

A health benefit and cost-effectiveness analysis of pneumococcal conjugate vaccination program in Nigeria

Background: Nigeria ranks third just behind India and China in the global disease burden of pneumococcal disease. The current sustainability approach for an affordable pneumococcal conjugate vaccine (PCV) for the national immunization program from 2014 till 2025 involves a cost sharing plan funded with a 75% financial support from GAVI and a subsidy from Pfizer pharmaceuticals. There is a strong need to generate evidence on the cost-effectiveness of the national PCV program in Nigeria from 2014-2025 and beyond 2025.Methods: The following parameters (demography, disease burden, health services utilization and costs, vaccination coverage, vaccine efficacy, and vaccination costs) were used in a static cohort model to estimate the total cost, health and economic benefit, and cost-effectiveness of the implementation of PCV vaccination program, compared with no PCV vaccination among under-five children in Nigeria from 2014-2025 and from 2026-2033. A sensitivity analysis was conducted to evaluate the robustness of the data used.Results: The national PCV vaccination program would have an approximated 31.4% and 30% reduction of the total burden of pneumococcal diseases over the period of 2014-2025 and 2026-2033 respectively. One-way sensitivity analysis reveals vaccine efficacy as most sensitive parameter followed by disease incidence rate and treatment cost. Removal and addition of DTP3 and 3+1 (measles vaccine) dose respectively resulted to a similar ICER from both.Conclusions: The estimated ICER suggests that the national PCV program in Nigeria will be cost-effective post 2025 era. In addition, it is recommended for policy-makers adoption considering the budget and equity impact of the intervention in Nigeria.

Impact of Socio-Demographic factors on survival of under-five children in Nigeria

A number of discussions on mortality or survival patterns of under-five children in Nigeria have been presented in the literature over years, most of which were characterized by descriptive analysis, in which facts were reported by percentages, ratio and measures of association to mention a few. In this study, binary logistic regression model was employed to model the survival status (dead or alive) of under-five children in Nigeria as a function of some socio-demographic variables. Results from this study revealed that ten socio-demographic variables among several others were significantly associated with the survivals of under-five children in Nigeria. Specifically, the results showed that children that were born in urban area, that were exclusively breastfed, that were among the first four children in the family, whose mothers have secondary education and post-secondary education have significant increased odds, to about 27%, 580%, 20%, 22% and 102% respectively, of surviving beyond age five than their counterparts in the reference categories of the above identified risk factors (odds ratio is 1.271(p &lt; 0.0001 for urban), 6.810 (p&lt;0.0001 for breastfeeding), 1.197 (p &lt; 0.0001 for birth order), 1.225 (p = 0.001 for secondary education) and 2.023 (p &lt; 0.0001 for higher education)). Results from this work indicated that more enlightenment program is required to stem the alarming increase in under-five mortality rate in Nigeria which currently stood at 112%. Data set from Nigerian Demographic and Health Surveys (NDHS) report for 2008 was employed in this study.

Impact of Socio-Demographic factors on survival of under-five children in Nigeria

A number of discussions on mortality or survival patterns of under-five children in Nigeria have been presented in the literature over years, most of which were characterized by descriptive analysis, in which facts were reported by percentages, ratio and measures of association to mention a few. In this study, binary logistic regression model was employed to model the survival status (dead or alive) of under-five children in Nigeria as a function of some socio-demographic variables. Results from this study revealed that ten socio-demographic variables among several others were significantly associated with the survivals of under-five children in Nigeria. Specifically, the results showed that children that were born in urban area, that were exclusively breastfed, that were among the first four children in the family, whose mothers have secondary education and post-secondary education have significant increased odds, to about 27%, 580%, 20%, 22% and 102% respectively, of surviving beyond age five than their counterparts in the reference categories of the above identified risk factors (odds ratio is 1.271(p &lt; 0.0001 for urban), 6.810 (p&lt;0.0001 for breastfeeding), 1.197 (p &lt; 0.0001 for birth order), 1.225 (p = 0.001 for secondary education) and 2.023 (p &lt; 0.0001 for higher education)). Results from this work indicated that more enlightenment program is required to stem the alarming increase in under-five mortality rate in Nigeria which currently stood at 112%. Data set from Nigerian Demographic and Health Surveys (NDHS) report for 2008 was employed in this study.

On the discriminatory and predictive accuracy of the\xa0RDT against the microscopy in the diagnosis of malaria among under-five children in Nigeria

BackgroundAccurate identification of malaria cases is crucial to the management of cases and the eventual success of malaria eradication agenda. This study is designed to evaluate the discriminatory and predictive accuracy of malaria rapid diagnostic tests (RDTs) in Nigeria.MethodsThe data obtained during the 2015 Nigeria Malaria Indicator Survey was used to quantify the discriminatory accuracy of the RDT against the microscopy through the analysis of its sensitivity, specificity, positive (LR+) and negative (LR−) likelihood ratio. The positive (PPV) and negative (NPV) predictive values, area under the receiver operating characteristic curve, and diagnostic odds ratio were used to assess the predictive accuracy of the RDTs using expert microscopy as a gold standard at p = 0.05. The McNemar paired test and the Kappa statistics were used to assess the level of agreement between the diagnostic tests.ResultsThere was a significant but not an excellent agreement between the results of the RDT and microscopy tests (p < 0.001). The overall sensitivity of the RDT was 87.6% (85.9–89.2%), specificity was 75.8% (74.4–77.1%), while the diagnostic accuracy stood at 79.0% (77.9–80.0%). The LR+, LR−, PPV and NPV were 3.6 (3.4–3.8) and 0.16 (0.14–0.19), 57.5% (56.1–58.9%) and 94.2% (93.5–94.9%), respectively. The sensitivity of RDT increased as the age of the children increased, from 85.7% among those aged 0–6 months to 86.1% in 7–23 month olds to 88.1% among those aged 24–59 months, but the reverse was the specificity. For children with severe anaemia, the sensitivity of the RDT was nearly 100% compared with a specificity of 39%. While the sensitivity and the PPV reduced with children’s level of anaemia, the higher the severity of anaemia, the lower the NPV, specificity, the diagnostic accuracy of the RDT. The odds of RDT being sensitive was about 50% [adjusted Odds Ratio (aOR) = 0.52 (95% CI 0.30–0.90)] lower among children aged 7–23 months compared with those aged 24–59 months while the odds of RDT being sensitive was 2 times [aOR = 2.15 (95% CI 1.67–2.77)] higher among those 7–23 months than among those aged 24–59 months.ConclusionsAlthough there was a significant agreement in the outcomes of RDT and microscopy tests, the discriminatory accuracy of RDT was weak. Also, the predictive accuracy, especially the PPV of the RDTS, were very low. These measures of accuracies differed across the age of the children, level of anaemia, recent experience of malaria and other characteristics. Without an accurate, efficient and reliable diagnosis of malaria, the goal of eliminating malaria and reduction of malaria-related deaths to zero by 2020 will only remain elusive.

Housing type and risk of malaria among under-five children in Nigeria: evidence from the malaria indicator survey

BackgroundMalaria remains one of the major causes of morbidity and mortality among under-five (U5) children in Nigeria. Though different environmental factors have been assessed to influence the distribution and transmission of malaria vectors, there is a dearth of information on how housing type may influence malaria transmission among U5 children in Nigeria. This study assessed the relationship between housing type and malaria prevalence among U5s in Nigeria.MethodsA cross-sectional analysis of the nationally representative 2015 Nigeria malaria indicator survey data was done. A representative sample of 8148 households in 329 clusters was selected for the survey. Children aged 6–59 months in the selected households were tested for anaemia and malaria using the rapid diagnostic test (RDT) and the microscopy. Data were analysed using descriptive statistics, Pearson Chi square (χ2) and logistic regression models at 5% level of significance.ResultsThe odds of malaria infection was significantly higher among older children aged 24–59 months (aOR = 4.8, CI 2.13–10.99, p < 0.001), and children who lived in houses built completely with unimproved materials (aOR = 1.4, CI 1.08–1.80, p = 0.01). Other predictors of malaria infection include living in a rural area (aOR = 1.5, CI 1.25–1.91, p = 0.01), ever slept under a long-lasting insecticide-treated net (aOR = 1.1, CI 0.26–4.79, p = 0.89) and in a room not sprayed with insecticide (aOR = 1.2, CI 0.64–2.31, p = 0.56). Children who were malaria positive showed a higher prevalence of severe anaemia on RDT (87.6%) and Microscopy (67.4%) than those who were not anaemic (RDT = 31.6%, Microscopy = 12.9%).ConclusionsNon-improved housing predicted malaria infection among U5s in Nigeria. Improved housing is a promising means to support a more integrated and sustainable approach to malaria prevention. Education of the Nigerian people on the role of improved housing on malaria protection and empowerment of the public to adopt improved housing as well as overall enlightenment on ways to prevent malaria infection can help to augment the current malaria control measures among U5 children.

Burden of Common Childhood Diseases in Relation to Improved Water, Sanitation, and Hygiene (WASH) among Nigerian Children.

Having access to improved water, sanitation, and hygiene (WASH) facilities constitute a key component of healthy living and quality of life. Prolonged exposure to insanitary living conditions can significantly enhance the burden of infectious diseases among children and affect nutritional status and growth. In this study we examined the prevalence of some common infectious diseases/disease symptoms of childhood among under-five children in Nigeria, and the association between the occurrence of these diseases with household’s access to WASH facilities. Types of diseases used as outcome variables included diarrheal, and acute respiratory infections (fever and cough). Access to WASH facilities were defined by WHO classification. The association between diarrhoea, fever and chronic cough with sanitation, and hygiene was analyzed by logistic regression techniques. Results showed that the prevalence of diarrhoea, fever and cough was respectively 10.5% (95% CI = 9.7–2.0), 13.4% (95% CI = 11.9–14.8), and 10.4% (95% CI = 9.2–11.5). In the regression analysis, children in the households that lacked all three types of facilities were found to have respectively 1.32 [AOR = 1.329, 95% CI = 1.046–1.947], 1.24 [AOR = 1.242, 95% CI = 1.050–1.468] and 1.43 [AOR = 1.432, 95% CI = 1.113–2.902] times higher odds of suffering from diarrhea, fever and cough. The study concludes that unimproved WASH conditions is an important contributor to ARIs and diarrheal morbidities among Nigerian children. In light of these findings, it is recommended that programs targeting to reduce childhood morbidity and mortality from common infectious diseases should leverage equitable provision of WASH interventions.

Improving Water, Sanitation and Hygiene Practices, and Housing Quality to Prevent Diarrhea among Under-Five Children in Nigeria.

Sub-Saharan Africa as a region accounts for the bulk of the global under-five mortality rate, to which diarrhea is major contributor. Millions of children die from diarrheal diseases each year and those who survive often do so facing suboptimal growth. Preventing the common pathways of transmission for diarrhea-causing pathogens, including improved water, sanitation, and hygiene (WASH) are regarded as the most cost-effective measures for tackling this life-threatening disease. This study aimed to quantitatively assess the quality of living arrangement and access to WASH, and their impact on diarrheal outcomes among under-five children in Nigeria. Methods: Data were collected from the 2013 Nigeria Demographic and Health survey (NDHS). Study participants included 28,596 mother-child pairs. Household construction material for wall, floor, and ceiling, access to electricity, and improved water and toilet, were included as the main explanatory variables. Data were analyzed using descriptive and multivariable regression methods. Results: The prevalence of diarrhea was 11.3% (95% CI = 10.2–12.6), with the rate being markedly higher in rural (67.3%) as compared to urban areas (32.7%). In the regression analysis, lacking access to improved toilet and water facilities were associated with 14% and 16% higher odds, respectively, of suffering from diarrhea as compared to those who had improved access. Conclusion: There is evidence of a weak, but statistically significant, relationship between the quality of living environment, including water and sanitation facilities, and diarrhea among under-five children in Nigeria. The study concludes that investing in living conditions and WASH may have potential benefits for child mortality prevention programs in the country.

Determinants of Diarrhea and Optimal Childcare among Under-Five Children in Nigeria: Insights from the 2013 Demographic and Health Survey

Background: Diarrhea in children is still a public health concern especially in developing countries. In under-five children, diarrhea often presents impairment in growth and development of children. In the present study, we assessed the prevalence of diarrhea and optimal childcare in under-five children in the Nigerian populace. Method: Cross-sectional data obtained from the 2013 Nigeria Demographic and Health Survey (NDHS) was used for the study. Reproductive women of age 15-49 years were interviewed about socio-demographic factors, and a range of childcare. Prevalence of diarrhea was determined. Logistic regression analysis was used to assess association of diarrhea prevalence, as well as optimal childcare across different socio-demographic factors of children. Results: The overall prevalence of diarrhea in under-five children in Nigeria was 10.3%. Prevalence was higher in children less than 2 years of age, 57%. Prevalence was also higher among children residing in rural areas and northern part of Nigeria. Other predictors of diarrhea in children included maternal education, source of drinking water, quality of toilet facility and household wealth. Concerning health practices, logistic regression analysis showed that place and region of residence, child's age, maternal education and household wealth were significant determinants of optimal childcare. Conclusion: With regards to the predominant rate of diarrhea in children less than 5 years old and the attenuated optimal childcare among them, there is a need to facilitated concerted efforts towards effective and efficient public health interventions.

Factors contributing to regional inequalities in acute respiratory infections symptoms among under-five children in Nigeria: a decomposition analysis

BackgroundAcute respiratory infections (ARI) are major causes of morbidity and mortality in many low-income countries. Although factors associated with ARI symptoms in children under 5 years of age have been identified; however, variation in their prevalence resulting from regional-specific proximate determinants has received little attention. Therefore, we aim to investigate the specific regional determinants of overall and wealth-related inequality in children having ARI in Nigeria over a decade.MethodsWe analyzed trends in development of ARI symptoms among children under 5 years of age in Nigeria using nationally representative cross sectional surveys carried out in 2003, 2008 and 2013. Overall- and household wealth index based- inequality in the distribution of prevalence of ARI symptoms were estimated by region using Gini index and Concentration Index, respectively. Multivariate logistic regressions for complex survey and decomposition analysis for both indexes were used to calculate percentual contribution.ResultsWe found a decreasing trend in development of ARI symptoms over the decade between regions. Children in South Western region had reduced likelihood of developing the symptoms. Concentration index (CI) for the prevalence of ARI symptoms over the years and across regions had negative values (all p < 0.05). Gini index (GI) varies from 0.21 in North East to 0.62 in South Western region. Furthermore, the mapping showed that the extent at which both inequalities contribute to ARI symptoms prevalence in each region is different. The four major sources of wealth-related inequalities were poor households, no maternal education, biomass cooking, and rural area.The major contributors to overall inequalities were having a child aged 6 to 23 months, having no maternal education, having no vaccination card, and having a high birth order/short birth interval.ConclusionsAlthough ARI prevalence decreased over the decade, it has remained unequally distributed between regions and over the time. The sources of those inequalities are context sensitive. Thus, in future health promotion initiatives, it is imperative to account for regional variations in the distribution of ARI.