Under-five Years Research Articles

Harmful Traditional Practices Affecting the Under-Five Years Children and Associated Factors in Sokoto, State, Nigeria

Introduction Harmful traditional practices violate and negatively affect the physical, psychological well-being and right of women and children. Nigeria has the third highest absolute number of women and girls who have undergone Female Genital Mutilation (FGM) worldwide. Aims To assess the harmful traditional practices on the under-five years children and associated factors in Sokoto, State, Nigeria. Methods A community based cross sectional study that was conducted in Sokoto State, Nigeria on 320 mothers of under-five year children from 1st January-31st March 2021. The study participants were selected using multi stage sampling method, after proportionate allocation of sample size, systematic random sampling method was used to get the study participants. A structured questionnaire was used to collect information on harmful traditional practices from the mothers of the eligible children. Data was analysed using SPSS version 22. Results The mean age of the children was 22.5 ± 17.7 months, there were 199(62.2%) males and 121(37.8%) females, and male to female ratio was 1.6:1. Eighty (25.0%) of the under five-year children were circumcised by traditional healers, 189(59.1%) had traditional uvulectomy, 86(28.9%) had female genital mutilation, while 11(3.4%) had scarification marks. The respondent’s educational status (p = 0.008) and (p = 0.001) were factors associated with the practice of FGM and circumcision respectively. Conclusion Harmful traditional practices are still prevalent in Sokoto. Government at all levels should embark on awareness creation programs on the dangers of these harmful traditional practices through mass media, schools, traditional leaders and religious places. Child protection laws should be implemented to curtail these harmful practices.

Concordance of weight status between mothers and children: a secondary analysis of the Pakistan Demographic and health survey VII

BackgroundFamilial concordance of weight status is an emerging field of study that may guide the development of interventions that operate beyond the individual and within the family context. There is a dearth of published data for concordance of weight status within Pakistani households.MethodsWe assessed the associations between weight status of mothers and their children in a nationally representative sample of households in Pakistan using Demographic and Health Survey data from 2017–18. Our analysis included 3465 mother–child dyads, restricting to children under-five years of age with body mass index (BMI) information on their mothers. We used linear regression models to assess the associations between maternal BMI category (underweight, normal weight, overweight, obese) and child’s weight-for-height z-score (WHZ), accounting for socio-demographic characteristics of mothers and children. We assessed these relationships in all children under-five and also stratified by age of children (younger than 2 years and 2 to 5 years).ResultsIn all children under-five and in children 2 to 5 years, maternal BMI was positively associated with child’s WHZ. For all children under-five, children of normal weight, overweight, and obese women had WHZ scores that were 0.21 [95% CI (confidence interval): 0.04, 0.37], 0.43 [95% CI: 0.25, 0.62], and 0.51 [95% CI: 0.30, 0.71] units higher than children of underweight women, respectively. For children ages 2 to 5, children of normal weight, overweight, and obese women had WHZ scores that were 0.26 [95% CI: 0.08, 0.44), 0.50 [95% CI: 0.30, 0.71), and 0.61 [95% CI: 0.37, 0.84] units higher than children of underweight women, respectively. There was no association between maternal BMI and child WHZ for children under-two.ConclusionsThe findings indicate that the weight status of mother’s is positively associated with that of their children, particularly after age 2. These associations further strengthen the call for research regarding interventions and policies aimed at healthy weight promotion among mothers and their children collectively, rather than focusing on individuals in isolation.

Rotavirus A Infection Prevalence and Spatio-Temporal Genotype Shift among Under-Five Children in Amhara National Regional State, Ethiopia: A Multi-Center Cross-Sectional Study.

Background: Globally, rotavirus (RV) A (RVA) is the most common cause of severe and sometimes fatal diarrhea in young children. It is also the major cause of acute gastroenteritis among children in Ethiopia. Currently, the WHO has prequalified four RVA vaccines for universal childhood immunization. Ethiopia introduced the monovalent Rotarix vaccine into its national immunization program in 2013. Since then, only a few studies on the burden and genotype distribution of RVA infection post-vaccine introduction have been conducted (mostly at sentinel surveillance sites). Therefore, this study aimed to assess RVA prevalence and genotype distribution among children under five years in Ethiopia (February 2021-December 2022). Methods: This multi-center hospital-based cross-sectional study involved 537 diarrheic children under-five years old. Rotavirus A detection was conducted using a one-step reverse-transcriptase polymerase chain reaction (RT-PCR). Genotyping was conducted by Sanger sequencing of the VP7 (complete) and VP4 (partial) genes. Descriptive analysis and Pearson's chi-squared test were carried out using SPSS version 29. Phylogenetic analysis with 1000 bootstrap replicates was performed using MEGA version 11 software. Statistical significance was set at p < 0.05 for all analyses. Results: The prevalence of RVA infection among diarrheic children was 17.5%. The most prevalent G-types identified were G3 (37%), the previously uncommon G12 (28%), and G1 (20%). The predominant P-types were P[8] (51%), P[6] (29%), and P[4] (14%). The three major G/P combinations observed were G3P[8] (32.8%), G12P[6] (28.4%), and G1P[8] (19.4%). Phylogenetic analysis revealed clustering of Ethiopian strains with the globally reported strains. Many strains exhibited amino acid differences in the VP4 (VP8* domain) and VP7 proteins compared to vaccine strains, potentially affecting virus neutralization. Conclusions: Despite the high RVA vaccination rate, the prevalence of RVA infection remains significant among diarrheic children in Ethiopia. There is an observable shift in circulating RVA genotypes from G1 to G3, alongside the emergence of unusual G/P genotype combinations such as G9P[4]. Many of these circulating RVA strains have shown amino acid substitutions that may allow for neutralization escape. Therefore, further studies are warranted to comprehend the emergence of these unusual RVA strains and the diverse factors influencing the vaccine's diminished effectiveness in developing countries.

Exploring Machine Learning Algorithms to Predict Diarrhea Disease and Identify its Determinants among Under-Five Years Children in East Africa

BackgroundThe second most common cause of death for children under five is diarrhea. Early Predicting diarrhea disease and identify its determinants (factors) using an advanced machine learning model is the most effective way to save the lives of children. Hence, this study aimed to predict diarrheal diseases, identify their determinants, and generate some rules using machine learning models.MethodsThe study used secondary data from the 12 east African countries for DHS dataset analysis using Python. Machine learning techniques such as Random Forest, Decision Tree (DT), K-Nearest Neighbor, Logistic Regression (LR), wrapper feature selection and SHAP values are used for identify determinants.ResultThe final experimentation results indicated the random forest model performed the best to predict diarrhea disease with an accuracy of 86.5%, precision of 89%, F-measure of 86%, AUC curve of 92%, and recall of 82%. Important predictors’ identified age, countries, wealth status, mother’s educational status, mother’s age, source of drinking water, number of under-five children immunization status, media exposure, timing of breast feeding, mother’s working status, types of toilet, and twin status were associated with a higher predicted probability of diarrhea disease.ConclusionAccording to this study, child caregivers are fully aware of sanitation and feeding their children, and moms are educated, which can reduce child mortality by diarrhea in children in east Africa. This leads to a recommendation for policy direction to reduce infant mortality in East Africa.

The proportion and determinants of appropriate health seeking behavior for febrile illness among caregivers of children under-five years in Butula sub-county, Busia county, Kenya

Background Almost 10 million children under the age of five in Kenya, die due to fever-related diseases. In Busia, a county in Kenya, malaria accounts for 13% of all child fatalities under the age of five, a number higher than any other county. This study aimed to determine (a) proportion of appropriate health-seeking behavior and (b) determinants of health-seeking behaviors (HSBs) among their caregivers in Butula Sub-County, Busia County, as reported by the caregivers. Methods This cross-sectional mixed-method study included 271 caregivers, 11 community health volunteers, and health facility workers in Butula Sub-County. Systematic random sampling for participants and purposive sampling for key informants were used. A questionnaire collected the data that was analysed using frequency and percentages and logistic regression. Results 70.1% of caregivers reported seeking care for a child's fever within 24 hours. Individual factors that caregivers reported to influence appropriate health-seeking HSB were unemployment (adjusted odds ratio (aOR) = 0.49, 95% CI: 0.217 – 0.593, p = 0.018), self-medication preference (aOR = 0.14, 95% CI: 0.054 – 0.363, p &lt; 0.001), had atleast two children (aOR = 0.63, 95% CI: 0.425 – 0.937, p = 0.042), and confidence in identifying fever (aOR = 7.0, 95% CI: 2.200 – 22.439, p = 0.001). Health-system factors reported to influence HSBs were facility too far (aOR = 0.86, 95% CI: 0.526 – 0.914, p = 0.027), getting health education (aOR = 1.8, 95% CI: 1.201-4.122, p=0.015), and facility level (aOR = 4.4, 95% CI: 2.015 – 9.750, p &lt; 0.001). Qualitative findings found health system factors related to HSB as stockouts, facility distance, and staff workload. Conclusions Policy and practice efforts should focus on significant individual and health system determinants for HSBs among caregivers of children under five with febrile illness.

Campylobacter jejuni and Campylobacter coli infection, determinants and antimicrobial resistance patterns among under-five children with diarrhea in Amhara National Regional State, Northwest Ethiopia.

Children with under-five year age disproportionally affected with foodborne illness. Campylobacteriosis is the most common foodborne disease next to Norovirus infection. Macrolides are commonly prescribed as the first line of treatment for Campylobacter gastroenteritis, with fluoroquinolone and tetracycline as secondary options. However, resistance to these alternatives has been reported in various regions worldwide. To determine the prevalence, associated risk-factors and antimicrobial resistance of Campylobacter jejuni and C. coli among under-five children with diarrhea. Institution-based cross-sectional study was conducted from November, 2022 to April 2023. The study sites were selected using a random sampling technique, while the study subjects were included using a convenient sampling technique. The data were collected using a structured questionnaire. Stool samples were inoculated onto modified charcoal cefoperazone deoxycholate agar and incubated for 48 hours. The suspected colonies were analyzed using matrix-assisted laser desorption ionization-time of flight mass spectrometry to confirm the species. Antimicrobial susceptibility testing was performed using a disc diffusion technique. All potential covariates (independent variables) were analyzed one by one using bivariate logistic regression model to identify candidate variables with P value < 0.25. Multivariable logistic analysis was used to identify potential associated factors using the candidate variables. A p value ≤ 0.05 at a 95% confidence interval was statistically significant. Among the 428 samples, 7.0% (CI: 4.5-9.3) were confirmed Campylobacter species. The prevalence of C. jejuni and C. coli among under-five children was 5.1% (CI: 3.0-7.0) and 1.9% (CI: 0.7-3.3), respectively. C. jejuni (73.3%) was dominant over C. coli (26.7%). The resident, contact with domestic animals, and parents/guardians education level were significantly associated with campylobacteriosis among under-five children. One-third of the Campylobacter isolates (33.3%, 10/30) were resistant to ciprofloxacin and tetracycline whereas 10.0% (3/30) were resistant to erythromycin. Furthermore, 3.3% (1/30) of the Campylobacter were found to be multidrug-resistant. The prevalence of Campylobacter species was 7.0%. The resistance rate of Campylobacter species of ciprofloxacin and tetracycline-resistance strains was 33.3%. Peri-urban residence, contact with domestic animals, and low parental educational statuses were significantly associated factors with increased risk of Campylobacter infection. Continuous surveillance on antimicrobial resistance and health education of personal and environmental hygiene should be implemented in the community.

Determinants of High Blood Pressure in Relation to Early Feeding Practices among Children under-Five Years of Age in Egypt

Determinants of High Blood Pressure in Relation to Early Feeding Practices among Children under-Five Years of Age in Egypt

Impact of Infancy Conditions on Physical Growth of Children Under-five

Children under five years old is the age group most vulnerable to several health problems. It is important to evaluate the impact of infancy condition on their physical growth. This research aimed to examine the impact of infancy condition on the physical growth of children under-five years old. The unmatched case-control study was conducted in Puskesmas Griya Antapani areas, Bandung from May to July, 2023. A total of 112 children aged under 5 years were included in this study (56 cases and 56 control). The analysis used multivariate logistic regression to determine adjusted odds ratios (OR). The results showed that the variables associated with the children growth are infection or illness in infancy (OR is 0,138 95 percent CI 0,51 until 0,375), feeding patterns in infancy (OR is 11,000 95 percent CI 4,566 until 26,503), birth weight (OR is 0,170 95 percent CI 0,036 until 0,818) and economic status (OR is 0,062 95 percent CI 0,14 until 0,280). Multivariate logistic regression showed that economic status was the most dominant factor for children physical growth (OR is 6.701 95 percent CI 1,323 until 33,944). Education for families is needed in choosing food that is rich in nutrition and economical by utilizing alternative sources of protein, the amount of food, and the schedule of meals according to the needs of children according to their age.

Hepatic mitochondrial and peroxisomal alterations in acutely ill malnourished Malawian children: A postmortem cohort study

ObjectivesTo describe and compare liver mitochondrial and peroxisomal histopathology by nutritional status in children who died following hospitalization for acute illness in Malawi. MethodsLiver tissue was collected using Minimally Invasive Tissue Sampling from eleven children under-five years old who died during hospitalization and were either non-wasted (n = 4), severely wasted (n = 4) or had edematous malnutrition (n = 3). Histology was assessed on hematoxylin and eosin stained slides. Mitochondrial and peroxisomal ultrastructural features were characterized using electron microscopy (EM) and immunofluorescence (IF). ResultsHepatic steatosis was present in 50 % of non-wasted and severely wasted children and all children with edematous malnutrition. Edematous malnutrition was associated with 56 % and 45 % fewer mitochondria than severe wasting (p < 0.001) and no wasting (p = 0.006), respectively, and abnormal mitochondrial morphology compared to severe wasting (p = 0.002) and no wasting (p = 0.035). Peroxisomal abundance was reduced in edematous malnutrition compared to severe wasting (p = 0.005), but did not differ from no-wasting. ConclusionEdematous malnutrition is associated with reduced abundance and altered morphology of hepatic mitochondria and peroxisomes. Interventions targeting improvements in hepatic metabolic function may be beneficial in improving metabolism and reducing mortality in children with severe malnutrition, particularly in those with nutritional edema.

Malaria Prevalence and Associated Risk Factors among Children under Five Years Attending Kitwe Health Center IV in Ntungamo District

Malaria is an acute febrile illness with the following symptoms: fever, headache, and chills. Malaria is caused by Plasmodium species, which is spread by female anopheles mosquito bites. This study aimed to assess the malaria prevalence and associated risk factors among children under five years attending Kitwe Health Center IV in Ntungamo District. This study employed a descriptive cross-sectional study design, 50 caregivers of children attending the children’s ward of Kitwe Health Center IV were selected using simple random sampling techniques, and self-administered questionnaires were used to collect data collected data was analyzed using SPSS version 22.0, and presented as percentage and frequency in tables, figure, and charts. Of 50 participants, 14(28.0%) tested positive for malaria. However, the majority of the children 25(50.0%) were within the age bracket of 6-12 months 29(58.0%) were female 32(64.0%) came from rural settings 28(56.0%) had more than 4 children staying together in the same household, 33(66.0%) said they hadn’t sprayed their houses with insecticide, 30(60.0%) knew that malaria can be transmitted through a mosquito bite, 36(72.0%) said they are sleeping under a treated mosquito, 30(60.0%) of the participants said they have stagnant water near their residential houses. Only 23(46.0%) of the participants said they have bushes around their homes. Malaria prevalence among children under-five years remains high at 28.0% which is slightly lower than the national standard findings of 30.2%. Factors such as age, number of children in the same households, education status of the caregivers, and their average monthly income greatly predisposed these children to malaria however other risk factors such as not spraying the household with insecticides and having stagnant water around the home were majorly reported by the caregivers. Keywords: Malaria Prevalence, Associated Risk Factors, Children Under-Five years

Determinants of aggregate anthropometric failure among children under-five years in Ethiopia: Application of multilevel mixed-effects negative binomial regression modeling.

Undernutrition significantly contributes to failure to thrive in children under five, with those experiencing multiple forms of malnutrition facing the highest risks of morbidity and mortality. Conventional markers such as stunting, wasting, and underweight have received much attention but are insufficient to identify multiple types of malnutrition, prompting the development of the Composite Index of Anthropometric Failure (CIAF) and the Composite Index of Severe Anthropometric Failure (CISAF) as an aggregate indicators. This study aimed to identify factors associated with CIAF and CISAF among Ethiopian children aged 0-59 months using data from the 2019 Ethiopia Mini Demographic and Health Survey. The study included a weighted sample of 5,259 children and used multilevel mixed-effects negative binomial regression modeling to identify determinants of CIAF and CISAF. The result showed higher incidence-rate ratio (IRR) of CIAF in male children (adjusted IRR = 1.27; 95% CI = 1.13-1.42), children aged 12-24 months (aIRR = 2.01, 95%CI: 1.63-2.48), and 24-59 months (aIRR = 2.36, 95%CI: 1.91-2.92), those from households with multiple under-five children (aIRR = 1.16, 95%CI: 1.01-1.33), poorer households (aIRR = 1.48; 95%CI: 1.02-2.15), and those who lived in houses with an earthen floor (aIRR = 1.37, 95%CI: 1.03-1.82). Similarly, the factors positively associated with CISAF among children aged 0-59 months were male children (aIRR = 1.47, 95% CI = 1.21-1.79), age group 6-11 months (aIRR = 2.30, 95%CI: 1.40-3.78), age group 12-24 months (aIRR = 3.76, 95%CI: 2.40-5.88), age group 25-59 months (aIRR = 4.23, 95%CI: 2.79-6.39), children from households living with two and more under-five children (aIRR = 1.27, 95%CI:1.01-1.59), and children from poorer households (aIRR = 1.93, 95% CI = 1.02-3.67). Children were more likely to suffer from multiple anthropometric failures if they were: aged 6-23 months, aged 24-59 months, male sex, living in households with multiple under-five children, and living in households with poor environments. These findings underscore the need to employ a wide range of strategies to effectively intervene in multiple anthropometric failures in under-five children.

Knowledge and Attitude of Rural Mothers toward Vaccination of Children under Five Years in Duhok Province

Abstract Background: Healthcare provision strategies show that disease prevention is always better than treatment. It is undeniable that vaccines have been an essential part of preventive measures based on their success in controlling vaccine-preventable diseases in the developed world. Objectives: The purpose of the study is to assess rural mothers’ knowledge and attitudes toward vaccinations of under five children. Additionally, determine how their demographic characteristics interrelate to such knowledge and attitude. Materials and Methods: A cross-sectional study was established to research (500) rural mothers from November 2016 to November 2017, the sample for the current study was chosen using multi-stage sampling (cluster-simple random selection). Through a direct interview-based questionnaire, information on rural mothers was gathered, including information about their sociodemographic traits as well as information about their knowledge of and attitudes regarding the immunization of their children who are under five. Two approaches were adopted, descriptive and inferential statistics to analyze the acquired study-related data. Results: Nearly half the mothers (49%) had fair knowledge, and (46.2%) of them had a neutral attitude toward their under-five children’s vaccination. Conclusion: This study concluded that in Duhok Province rural mothers were at an equal distance from the extremities level related to mothers’ knowledge and attitude toward under-five years immunization.

Food Intake Practices in Quantity and Frequency Per Day for Children Under-Five Years Old in Uvinza District

The global malnutrition crisis, underscored by the FAO, affects 9.8% of the world's population, including over 350 million children. In Tanzania, regions grapple with stunting rates exceeding 40%. WHO links malnutrition to 45% of child fatalities under five in low- and middle-income countries. This study assessed daily food intake practices among children under five in Uvinza District, in Kigoma Region, Tanzania.

Pattern Of Breast Feeding, Weaning And Nutritional Status Of Under Five Children Of Working Mothers Of Bangladesh Armed Forces

Background: Adequate nutrition is essential in early childhood to ensure healthy growth, proper organ formation and function, a strong immune system, and neurological and cognitive development. The objective of the study is to assess the pattern of breast feeding, weaning and dietary behavior of under-five children of working mothers attended Child Welfare Centre (CWC), Malobika and Combined Military Hospital (CMH), Dhaka. Methods: This cross sectional study was conducted at CWC, Malobika and Combined Military Hospital, Dhaka over a period of six months from July 2017 to December 2017. All under-five years old sick children of employed mothers of Bangladesh Armed Forces attended CWC Malobika and CMH, Dhaka were included in the study and mothers were the respondents. Total 130 children were selected purposively for the study. Data were analyzed by using SPSS (statistical package for social sciences), version 25.0. The level of significance was set at 5% and p &lt; 0.05 was considered statistically significant. Results: Majority (92.3%) of the children was nutritionally normal in terms Mid Upper Arm Circumference (MUAC). Only 10(7.7%) children was malnourished; of them 6(4.6%) were severely malnourished and 4(3.1%) were moderately malnourished. In terms of Weight for Age Z score (WAZ) 3.1% were severe underweight and another 3.1% were moderate underweight. In terms of Height for Age Z score (HAZ), 5.4% were severely stunted and 6.2% were moderately stunted, while with respect to Weight for Height Z score (WHZ), 2.3% were severely wasted and 7.7% were moderately wasted. Conclusion: Nutritional status in children of working mothers of Armed Forces at Dhaka Garrison was high compared to the national figure. Bangladesh Armed Forces Med J Vol 56 No (1) June 2023, pp 35-41

Fidelity of implementation of national guidelines on malaria diagnosis for children under-five years in Rivers State, Nigeria

BackgroundMalaria is still a disease of global public health importance and children under-five years of age are the most vulnerable to the disease. Nigeria adopted the “test and treat” strategy in the national malaria guidelines as one of the ways to control malaria transmission. The level of adherence to the guidelines is an important indicator for the success or failure of the country’s roadmap to malaria elimination by 2030. This study aimed to assess the fidelity of implementation of the national guidelines on malaria diagnosis for children under-five years and examine its associated moderating factors in health care facilities in Rivers State, Nigeria.MethodsThis was a descriptive, cross-sectional study conducted in Port Harcourt metropolis. Data were collected from 147 public, formal private and informal private health care facilities. The study used a questionnaire developed based on Carroll’s Conceptual Framework for Implementation Fidelity. Frequency, mean and median scores for implementation fidelity and its associated factors were calculated. Associations between fidelity and the measured predictors were examined using Mann Whitney U test, Kruskal Wallis test, and multiple linear regression modelling using robust estimation of errors. Regression results are presented in adjusted coefficient (β) and 95% confidence intervals.ResultsThe median (IQR) score fidelity score for all participants was 65% (43.3, 85). Informal private facilities (proprietary patent medicine vendors) had the lowest fidelity scores (47%) compared to formal private (69%) and public health facilities (79%). Intervention complexity had a statistically significant inverse relationship to implementation fidelity (β = − 1.89 [− 3.42, − 0.34]). Increase in participant responsiveness (β = 8.57 [4.83, 12.32]) and the type of malaria test offered at the facility (e.g., RDT vs. no test, β = 16.90 [6.78, 27.03]; microscopy vs. no test, β = 21.88 [13.60, 30.16]) were positively associated with fidelity score.ConclusionsThis study showed that core elements of the “test and treat” strategy, such as testing all suspected cases with approved diagnostic methods before treatment, are still not fully implemented by health facilities. There is a need for strategies to increase fidelity, especially in the informal private health sector, for malaria elimination programme outcomes to be achieved.

Impact of the COVID-19 pandemic in childhood and adolescent cancer care in northern Tanzania: a cross-sectional study

IntroductionThe SARS-CoV-2 (COVID-19) pandemic has strained healthcare systems and presented unique challenges for children requiring cancer care, particularly in low- and middle-income countries. This study aimed to assess the impact of the COVID-19 pandemic on access to cancer care for children and adolescents in Northern Tanzania.MethodsIn this cross-sectional study, we assessed the demographic and clinical characteristics of 547 pediatric and adolescent cancer patients (ages 0–19 years old) between 2016 and 2022 using the population-based Kilimanjaro Cancer Registry (KCR). We categorized data into pre-COVID-19 (2016–2019) and COVID-19 (2020–2022) eras, and performed descriptive analyses of diagnostic, treatment, and demographic information. A secondary analysis was conducted on a subset of 167 patients with stage of diagnosis at presentation.ResultsOverall admissions nearly doubled during the pandemic (n = 190 versus 357). The variety of diagnoses attended at KCMC increased during the pandemic, with only five groups of diseases reported in 2016 to twelve groups of diseases in 2021. Most patients were diagnosed at a late stage (stage III or IV) across eras, with the proportion of under-five years old patients increasing late-diagnoses from 29.4% (before the pandemic), 52.8% (during the pandemic), when compared to the overall cohort. Around 95% of children in this age category reported late-stage diagnosis during the pandemic. Six out of the twelve cancer site groups also reported an increase in late-stage diagnosis. During the pandemic, the proportion of children receiving surgery increased from 15.8 to 30.8% (p < 0.001).ConclusionChildhood and adolescent cancer care changed in Northern Tanzania during the COVID-19 pandemic, with increased late-stage diagnoses presentations among younger patients and the increased use of surgical therapies in the context of a growing practice. Understanding the impact of the COVID-19 pandemic on pediatric and adolescent cancer care can help us better adapt healthcare systems and interventions to the emerging needs of children and adolescents with cancer in the midst of a health crisis.

Prevalence and risk factors associated with under-five years children diarrhea in Malawi: Application of survey logistic regression

BackgroundDiarrhea is a leading cause of illness and mortality among children under five, posing a significant public health challenge in Malawi. The current study assesses the prevalence and risk factors linked to diarrhea among under-five children in Malawi. MethodThe researcher used the Malawi Multiple Indicator Cluster Survey (MICS) 2019-20 as the dataset for this study. Due to the complex sampling design, survey logistic regression was used to accomplish the study objectives. The sample size was 15569 children who were aged under five. ResultsThe study found that the prevalence of diarrhea was 24.9%, with a higher percentage observed among children aged 12–23 months (38.5%) compared to other age groups. Additionally, children from the southern region had a higher prevalence of diarrhea at 27% compared to those from the northern region at 19.3%. Children from the poorest households also had a higher prevalence of diarrhea at 28.9% compared to those from the richest households at 22.6%. Furthermore, children with fever had a higher prevalence of diarrhea at 33.3% compared to those who did not have fever at 19.4%. ConclusionThe current study concluded that the prevalence of diarrhea was higher among children aged 12–23 months. Subsequently, policymakers should apply policies to reduce this high prevalence among this age group of children. In addition, the government needs special consideration in diarrhea control for children from the southern region because of the high prevalence of the disease compared to the other regions in Malawi. My study can help policymakers understand the scope and nature of the problem, which can notify the development of policies and programs intended to decrease the prevalence of risk factors and enhance child health outcomes.

Clinical profile of children with influenza like illness during pre-monsoon at coastal Karaikal, Puducherry, India.

Influenza infections in developing countries are under reported and WHO estimates that nearly 99% of influenza deaths worldwide occur in children under-five years of age in Asian and African countries. Consequently, this study aims to analyze the use of clinical profile and easily available laboratory parameters to aid identification of the possible viral etiology in the setting of pre-monsoon ILI. A cross-sectional study was carried out for three months among children with ILI attending fever clinic of a tertiary care hospital in Karaikal, South India. In the study population the prevalence of ILI was highest in the age group four to five years followed by school aged children. Adolescents were affected the least. Influenza B was most common virus causing ILI in this region, followed by covid-19 infection. Laboratory parameters depicted a significantly high ESR in COVID-19 infected ILI children. They also exhibited leucopenia and normal platelet counts. Clinical symptoms and laboratory parameters which are easily available and cheaper can be used in resource poor settings of healthcare to identify possible influenza and COVID-19 infected children amongst cases presenting with ILI.

Correlation study of climate variability, population density, altitude, and low birth-weight rates on the incidence of children pneumonia in Bogor Regency

Purpose: This study aims to analyze the correlation between climate variability (temperature, humidity, rainfall, sunshine duration, and wind speed), population density, altitude, and low birth weight (LBW) rate on the incidence of under-five years old children with pneumonia. Methods: This research uses a combination study design based on place and time (mixed design ecological study). Results: There was no significant relationship between climate variability and lag effect of 0-2 months with the number of under-five pneumonia cases in Bogor Regency in 2018-2022, as well as the altitude variable (p=0.0619). Meanwhile, the variables of population density (r-value = 0.439) and LBW rate (r-value = 0.338) showed a positive correlation with the number of under-five pneumonia cases in Bogor Regency. Conclusion: This research shows the incidence of pneumonia among under-fives in Bogor Regency is influenced by population density and LBW rates. Ensuring access to proper sanitation, a complete basic immunization program, adequate housing, and also personal protective measures are important to reduce the spread of pneumonia.

Co-existence of maternal overweight/obesity, child undernutrition, and anaemia among mother-child pairs in Ethiopia.

Ethiopia is currently known to be the most food-insecure country in sub-Saharan Africa, where childhood undernutrition remains endemic. While attention is increasingly being paid to childhood undernutrition in Ethiopia, a current surge of "triple burden of malnutrition" (TBM) has received less attention. The purpose of this study was to determine the prevalence of TBM and identify the associated factors in Ethiopia. Data were from the Ethiopian Demographic and Health Surveys (2005-2016) and a total of 20,994 mother-child pairs were examined in this study. The TBM was our primary outcome variable, which encompasses three types of nutritional problems-when a mother may be overweight/obese, while her child is stunted, wasted, or underweight plus has anaemia under the same roof. A multilevel logistic regression explored the individual- and community-level factors associated with TBM. Our study indicated that children under-five years of age were anaemic, stunted, wasted, and underweight [49.3% (95% CI: 48.7-49.9), 43.1% (95% CI: 42.4-43.7), 10.3% (95% CI: 9.9-10.7), and 27.6% (95% CI: 27.0-28.1)] respectively. The overall prevalence of TBM was 2.6% (95% CI: 2.39-2.83). Multilevel analyses revealed that TBM was more likely to occur among children aged 12-23 months (AOR: 2.54, 95% CI: 1.68-3.83), 24-35 months (AOR: 1.54, 95% CI: 1.03-2.29), children perceived by their mothers to be smaller than normal at birth (AOR: 1.94, 95% CI: 1.48-2.56), who experienced fever in the past 2 weeks (AOR: 1.58, 95% CI: 1.24-2.01), and lived in urban settings (AOR: 1.79, 95% CI: 1.13-2.86). Lower odds of TBM were reported among female children (AOR: 0.59, 95% CI: 0.47-0.72), and those who lived in rich households (AOR: 0.69: 95% CI: 0.49-0.98). TBM was found to be present in almost three percent of households in Ethiopia. Addressing the TBM through double-duty actions will be of critical importance in achieving malnutrition in all its forms in Ethiopia.