Diarrhea Prevalence, Care, and Risk Factors Among Poor Children Under 5 Years of Age in Mesoamerica.
Ontology highlight
ABSTRACT:
SUBMITTER: Colombara DV
PROVIDER: S-EPMC4775889 | biostudies-literature | 2016 Mar
REPOSITORIES: biostudies-literature
Publications
Diarrhea Prevalence, Care, and Risk Factors Among Poor Children Under 5 Years of Age in Mesoamerica.
Colombara Danny V DV Hernández Bernardo B McNellan Claire R CR Desai Sima S SS Gagnier Marielle C MC Haakenstad Annie A Johanns Casey C Palmisano Erin B EB Ríos-Zertuche Diego D Schaefer Alexandra A Zúñiga-Brenes Paola P Zyznieuski Nicholas N Iriarte Emma E Mokdad Ali H AH
The American journal of tropical medicine and hygiene 20160119 3
Care practices and risk factors for diarrhea among impoverished communities across Mesoamerica are unknown. Using Salud Mesoamérica Initiative baseline data, collected 2011-2013, we assessed the prevalence of diarrhea, adherence to evidence-based treatment guidelines, and potential diarrhea correlates in poor and indigenous communities across Mesoamerica. This study surveyed 14,500 children under 5 years of age in poor areas of El Salvador, Guatemala, Mexico (Chiapas State), Nicaragua, and Panam ...[more]
Similar Datasets
Project description:BackgroundDiarrhea and acute respiratory infection (ARI) are major causes of child mortality. We aimed to identify risk factors associated with diarrhea and ARI among children under 2 years of age in rural northern Bangladesh.MethodWe collected information on diarrhea and ARI in the previous 14 days and the previous 6 months at 6, 12, 18 and 24 months of age as part of a longitudinal, cluster randomized effectiveness trial, the Rang-Din Nutrition Study which enrolled 4011 pregnant women at ≤20 gestational weeks. Women and their children were followed up until 2 years postpartum. Information on household socioeconomic status, type of toilet, garbage disposal system, food insecurity, number of under-five children in the household, type of family, maternal characteristics and child characteristics was collected at baseline and/or at 6, 12, 18 and 24 months postpartum. Data on newborn health and feeding behaviors were collected within 72 h of delivery. Associations between potential risk factors and morbidity prevalence outcomes were assessed using logistic regression controlling for potential confounders.ResultsOut of 3664 live born children, we collected information from ~ 3350 children at 6, 12, 18 and 24 months of age. Diarrhea in the previous 14 days, and in the previous 6 months, was associated with maternal depression score and food insecurity; diarrhea in the previous 6 months was also associated with family type (nuclear vs. joint). ARI in the previous 14 days was associated with maternal depression score, type of toilet and garbage disposal, household food insecurity and sex. Cough or nasal discharge in the past 6 months was associated with maternal depression score, type of toilet and garbage disposal, household food insecurity, sex and perceived overall physical condition of the infant after birth.ConclusionMaternal depression and food insecurity appear to be important risk factors for diarrhea and respiratory infection among children under 2 years of age in this setting. These findings suggest that policies and programs that include strategies to address maternal mental health and household food insecurity may contribute to improved child health.Trial registrationThe trial was registered with the US National Institutes of Health at ClinicalTrials.gov, # NCT01715038 , with registration completed October 26, 2012.
| S-EPMC6815354 | biostudies-literature
Project description:BackgroundWorldwide, diarrhea is the second most common cause of death and morbidity among under -five years' children. In sub-saran Africa, access to water, sanitation, and hygiene are very scanty and the burden of diarrhea diseases is countless relative to the rest of the world. Prior studies conducted in East Africa vary in design, sample size, and other data collection tools. Through those studies, it is hard to make regional comparisons. Combining datasets that are studied on similar people and having common variable identified enhances statistical power due to the large sample size, advance the ability to compare outcomes, and create the opportunity to develop new indicators. Hence, this study aimed to assess the prevalence and associated factors of diarrhea among under five years' children using the most recent national representative Demographic and Health Surveys from 12 East African countries. The information generated from this pooled datasets will give good insight into the sub-regional prevalence of diarrhea.MethodsThis study utilized secondary data from 12 East African countries' most recent demographic health survey. Variables were extracted and appended together to assess the pooled prevalence of diarrhea and associated factors. A total of 90,263 under-five years of age children were encompassed in this study. STATA version was used to cross-tabulate and fit the models. To account for the hierarchical nature of the demographic health survey, multilevel logistic regression was calibrated. BIC, AIC, deviance, and LLR were used as Model comparison parameters. Variables with a p-value of <0.2 were considered for multivariable analysis. Adjusted odds ratio with 95% CI and p-value <0.05 were used to declare statistical significances of factors.ResultsThe pooled prevalence of diarrhea in under five years children was 14.28% [95%CI; 14.06%, 14.51%]. Being child whose mother age is 15-24 years [AOR = 1.41, 95% CI; 1.33, 1.49], 25-34 years[AOR = 1.17, 95%CI; 1.10, 1.23], being 7-12 months child [AOR = 3.10, 95%CI; 2.86, 3.35], being 12-24 months child [AOR = 2.56, 95%CI; 2.38, 3.75], being 25-59 months child [AOR = 0.88, 95%CI; 0.82, 0.95], being child from poor household [AOR = 1.16, 95%CI; 1.09, 1.23], delayed breast feeding initiation (initiated after an hour of birth) [AOR = 1.15, 95%CI; 1.10, 1.20], and being a child from community with low educational status [AOR = 1.10, 95%CI; 1.03, 1.18] were factors associated with diarrheal diseases.ConclusionThe pooled prevalence of diarrhea among under five years of children in East African countries is high. Maternal age, child's age, wealth status of the household, the timing of breast feeding initiation, sex of the child, community level of educational status, working status of the mother, and the number of under five children were factors that were associated with diarrheal diseases. Scaling up of maternal and child health services by government and other concerned bodies should consider those economically marginalized communities. Additionally, awareness should be created for those uneducated mothers concerning the nature of childhood diarrhea.
| S-EPMC9009646 | biostudies-literature
Project description:BACKGROUND: Diarrheal diseases are an important cause of mortality and morbidity globally in children under 5 years of age. OBJECTIVE: To find the prevalence and risk factors of diarrhea among children under 5 years. MATERIALS AND METHODS: A population-based analytical cross-sectional study was conducted in the urban slums of Bankura, West Bengal on the prevalence of diarrhea and feeding practices, nutrition, and immunization among 152 children under 5 years (69 males and 83 females). RESULTS: Overall prevalence of diarrhea was 22.36%; 21.73% males and 22.89% females were affected with diarrhea. There were 57.69% diarrhea cases in children of 7-12 months age group, followed by 25.71% in those of 13-24 months age group; with increasing age, the prevalence of diarrhea gradually decreased. Diarrhea was noted to be 20.33% in exclusively breastfed children and 31.57% in children who were breastfed for less than 6 months. In bottle-fed children, the frequency of diarrhea was 26.08%. The prevalence of diarrhea was 21.83% in completely immunized children and 30% in partially immunized children. Risk of diarrhea was 19.80% in normal participants and 27.45% in undernourished children. CONCLUSION: The present study identified a high prevalence of diarrhea in children under the age of 5 years. Findings of the study also revealed the demographic features, feeding practices, immunization practices, and nutritional status as risk factors of diarrhea, which can be tackled by effective education of the community.
| S-EPMC4338445 | biostudies-other
Project description:Despite growing evidence that infants and very young children can be infected with schistosomes, the epidemiological features and risk factors are not well described in this age group. We aimed to assess the prevalence of S. mansoni infection in children under two years of age from a population with a known high burden of infection in school-aged children and adults and thus inform the need for interventions in this potentially vulnerable age group. In a cross-sectional study in Mbita Sub-county, along the east coast of Lake Victoria, Western Kenya, we enrolled 361 children aged 6-23 months. The prevalence of S. mansoni infection was detected using the Kato-Katz stool examination and a point-of-care test for urinary circulating cathodic antigen (POC-CCA) (Rapid Medical Diagnostics, Pretoria, South Africa). Three-hundred and five (305) children had complete data of whom 276 (90.5%, 95%CI: 86.6-93.5) children were positive for S. mansoni by the POC-CCA test, while 11 (3.6%, 95%CI: 1.8-6.4) were positive by the Kato-Katz method. All Kato-Katz positive cases were also positive by the POC-CCA test. In multivariable analysis, only geographical area, Rusinga West (AOR = 7.1, 95%CI: 1.4-35.2, P = 0.02), was associated with S. mansoni infection using Kato-Katz test. Independent associations for POC-CCA positivity included age, (12-17 months vs 6-11 months; AOR = 7.8, 95%CI: 1.8-32.6, P = 0.002) and breastfeeding in the previous 24 hours (AOR = 3.4, 95%CI: 1.3-9.0, P = 0.009). We found a potentially very high prevalence of S. mansoni infection among children under two years of age based on POC-CCA test results in Mbita Sub-county, Kenya, which if confirmed strongly supports the need to include infants in public health strategies providing universal prophylactic treatment in high burden settings. Further research is required to determine the accuracy of diagnostic tools to detect light infection among very young children and possible long-term health impacts.
| S-EPMC7447014 | biostudies-literature
Project description:BackgroundDiarrheal disease remains a significant cause of child mortality, particularly in regions with limited access to healthcare and sanitation. Inappropriate practices, including unjustified medication prescriptions, pose challenges in the management of acute diarrhea (AD), especially in low- and middle-income countries.ObjectiveThis study analyzed antibiotic prescription patterns and assessed compliance with Integrated Management of Childhood Illness (IMCI) guidelines in children under 5 with AD in the Ministry of Public Health (MOPH) Ambulatory Care Centers of Quito city, Ecuador.MethodsA cross-sectional design was used, collecting electronic health records (EHR) of patients diagnosed with AD from 21 health facilities in District 17D03. A probabilistic and stratified sampling approach was applied. Patient characteristics, prescriber characteristics, treatments, and compliance of IMCI guideline recommendations were evaluated. A stepwise logistic regression analysis examined the association between antibiotic prescription and patient and physician characteristics.ResultsA total of 359 children under 5 years of age were included, with 58.77% being girls. 85.24% of the cases of AD were attributed to gastroenteritis and colitis of infectious and unspecified origin. Amebiasis and other protozoal intestinal diseases accounted for 13.37% and 1.11% of the cases, respectively. The completion rates of recording various IMCI parameters varied; parameters such as duration of diarrhea, presence of blood in stool, and evidence of sunken eyes had high completion rates (100%, 100%, and 87.47%, respectively), while parameters like state of consciousness, presence of thirst, and type of diarrhea had low completion rates (0.28%, 0.28%, and 0.84%, respectively). None of the cases had all parameters fully recorded. Antimicrobials were prescribed in 38.72% of the cases. Children aged 3 to 5 years had higher odds of receiving antimicrobial prescription for AD (aOR: 4.42, 95% CI 2.13-9.18, P < .0001) compared to those under 1 year, after adjusting for the number of loose stools per day, gender, and age of the health professional.ConclusionVariations in IMCI guideline compliance were observed, with no cases fully adhering to the guidelines. Antimicrobial prescription rates were notably high, especially among older children. Further research and specialized interventions are necessary to gain comprehensive insight into the factors underlying non-compliance with the IMCI guidelines.
| S-EPMC10467298 | biostudies-literature
Project description:Background: Anemia is a severe public health problem affecting more than half of children under five years of age in low-, middle- and high-income countries. We aimed to determine the prevalence and factors associated with anemia among children under five years of age in northern Tanzania. Methods: This was a community-based cross-sectional study conducted in Rombo district, Kilimanjaro region, northern Tanzania in April 2016. Multistage sampling technique was used to select a total of 602 consenting mothers and their children aged 6-59 months and interviewed using a questionnaire. Data were analyzed using Stata version 15.1. We used generalized linear models (binomial family and logit link function) with robust variance estimator to determine factors associated with anemia. Results: Prevalence of anemia was 37.9%, and it was significantly higher among children aged 6-23 months (48.3%) compared to those aged 24-59 months (28.5%). There were no significant differences in anemia prevalence by sex of the child. Adjusted for other factors, children aged 6-23 months had over two times higher odds of being anemic (OR=2.44, 95% CI 1.71, 3.49, p<0.001) compared to those aged 24-59 months. No significant association was found between maternal and nutritional characteristics with anemia among children in this study. Conclusion: Prevalence of anemia was lower than the national and regional prevalence but it still constitutes a significant public health problem, especially among children aged 6-23 months. Interventions such as iron supplementation, food fortification and dietary diversification and management of childhood illnesses in this setting should be targeted towards mothers and children less than two years.
| S-EPMC9936566 | biostudies-literature
Project description:We report the clinical findings, epidemiology, and risk factors for moderate-to-severe diarrhea (MSD) associated with Aeromonas species in children 0-59 months of age, from the Global Enteric Multicenter Study, conducted at three sites in south Asia and four sites in sub-Saharan Africa. Children with MSD were enrolled along with controls matched for age, gender, and neighborhood. Pooled, age-stratified conditional logistic regression models were applied to evaluate the association of Aeromonas infection controlling for coinfecting pathogens and sociodemographic variables. A pooled, age-stratified, multivariate logistic regression analysis was done to identify risk factors associated with Aeromonas positivity in MSD cases. A total of 12,110 cases and 17,291 matched controls were enrolled over a period of 48 months. Aeromonas was identified as a significant pathogen in 736 cases of MSD in Pakistan and Bangladesh (22.2%). Aeromonas remained a significant pathogen even after adjustment for the presence of other pathogens and sociodemographic factors. Odds ratio (OR) for Aeromonas were higher in the presence of Shigella (matched OR: 6.2, 95% confidence interval [CI]: 1.9-20.2). Cases of Aeromonas were likely to present with dysentery, particularly in the 0-11 months (OR: 1.4, 95% CI 1.0-2.0) and 12-23 months (OR: 1.8, 95% CI: 1.3-2.5) age group. The odds of Aeromonas increased with increasing degree of stunting, being highest for severe stunting (OR: 10.1, 95% CI: 3.6-28.9). Aeromonas is a significant pathogen for MSD in Pakistan and Bangladesh. Presence of dysentery and co-occurrence with other pathogens, notably Shigella spp. are significant features of Aeromonas-associated diarrhea.
| S-EPMC5062620 | biostudies-literature
Project description:Diarrhea is the leading infectious cause of childhood morbidity and mortality. Among bacterial agents, diarrheagenic Escherichia coli (DEC) is the major causal agent of childhood diarrhea in developing countries, particularly in children under the age of 5 years. Here, we performed a hospital-based prospective study to explore the pathotype distribution, epidemiological characteristics and antibiotic resistance patterns of DEC from <?5-year-old diarrheal children.Between August 2015 and September 2016, 684 stool samples were collected from children (<?5 years old) with acute diarrhea. All samples were cultured and identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) and biochemical tests. PCR was used for subtyping, and enteropathogenic E. coli (EPEC) isolates were identified simultaneously with serology. Furthermore, antimicrobial sensitivity tests and sequencing of antibiotic resistance-related genes were conducted.DEC strains were identified in 7.9% of the 684 stool samples. Among them, the most commonly detected pathotype was EPEC (50.0% of DEC), of which 77.8% were classified as atypical EPEC (aEPEC). Age and seasonal distribution revealed that DEC tended to infect younger children and to occur in summer/autumn periods. Multidrug-resistant DEC isolates were 66.7%; resistance rates to ampicillin, co-trimoxazole, cefazolin, cefuroxime, cefotaxime, and ciprofloxacin were ??50%. Among 5 carbapenem-resistant DEC, 60.0% were positive for carbapenemase genes (2 blaNDM-1 and 1 blaKPC-2). Among 30 cephalosporin-resistant DEC, 93.3% were positive for extended-spectrum ?-lactamase (ESBL) genes, with blaTEM-1 and blaCTX-M-55 being the most common types. However, no gyrA or gyrB genes were detected in 16 quinolone-resistant isolates. Notably, aEPEC, which has not received much attention before, also exhibited high rates of drug resistance (81.0%, 66.7%, and 14.3% for ampicillin, co-trimoxazole , and carbapenem resistance, respectively).EPEC was the most frequent DEC pathotype in acute diarrheal children, with aEPEC emerging as a dominant diarrheal agent in central China. Most DEC strains were multidrug-resistant, making even ciprofloxacin unsuitable for empiric treatment against DEC infection. Among carbapenem-resistant DEC strains, those harboring blaNDM-1 and blaKPC-2 were the main causal agents. blaTEM-1 and blaCTX-M-55 were the major genetic determinants associated with high levels of cephalosporin resistance.
| S-EPMC5796495 | biostudies-literature
Project description:BackgroundAnemia during childhood adversely affects mental, physical and social development of the children. This study is aimed to assess the prevalence of anemia and its associated factors among children less than five years of age in Guguftu, South Wollo, Northeast Ethiopia.MethodA cross-sectional health facility based study was conducted among 404 children aged 6 to 59 months. Systematic random sampling technique was used to include the participants. Pretested and structured questionnaires were used to collect socioeconomic and demographic characteristics of the family and child. Data on nutritional status, capillary blood and stool samples were collected from each child. Multivariate logistic regression was used to calculate adjusted odds ratios and the corresponding 95% confidence intervals.ResultThe overall prevalence of anemia was 41.1% (95% CI;36.6% - 45.8%). Of the anemic under five children, 112 (67.5%) had mild anemia, 52(31.3%) had moderate anemia, and 2(1.2%) had severe anemia. Children who were in the age group of 6-11(AOR = 4.52; 95% CI: 1.67-12.34) and 12-23 (AOR = 2.79; 95% CI: 1.04-7.51) months, living in an urban (AOR = 1.83; 95% CI: 1.05-3.18), with no formal education mothers (AOR = 7.05; 95% CI: 2.93-17.01) and primary education mothers (AOR = 3.26; 95% CI: 1.29-8.24), with a family monthly income of <750 ETB(AOR = 5.19; 95% CI: 1.24-21.75) and 750-1500 ETB(AOR = 5.89; 95% CI: 1.45-23.98), with early (<6 months) introduction of complementary foods (AOR = 3.53; 95% CI: 1.23-10.18), Underweight (AOR = 2.11; 95% CI: 1.21-3.69) were more likely to become anemic.ConclusionThis study has revealed that the prevalence of anemia in children less than five years is high and a severe public health problem in the study area. Therefore, the policymakers should make a strategy that can reduce poverty and increase the awareness of women on breastfeeding, nutrition, and other associated factors to reduce anemia.
| S-EPMC6611584 | biostudies-literature
Project description:BackgroundDiarrhea is a leading cause of morbidity and mortality among under-five children in Bangladesh. Hospitalization for diarrhea can pose a significant burden on households and health systems. The aim of this study was to estimate the cost of illness due to diarrhea from the healthcare facility, caregiver, and societal perspectives in Bangladesh.MethodA cross-sectional study with an ingredient-based costing approach was conducted in 48 healthcare facilities in Bangladesh. In total, 899 caregivers of under-five children with diarrhea were interviewed face-to-face between August 2017 and May 2018, followed up over phone after 7-14 days of discharge, to capture all expenses and time costs related to the entire episode of diarrhea.ResultsThe average cost per episode for caregivers was US$62, with $29 direct and $34 indirect costs. From the societal perspective, average cost per episode of diarrhea was $71. In 2018, an estimated $79 million of economic costs were incurred for treating diarrhea in Bangladesh. Using 10% of income as threshold, over 46% of interviewed households faced catastrophic expenditure from diarrheal disease.ConclusionThe economic costs incurred by caregivers for treating per-episode of diarrhea was around 4% of the annual national gross domestic product per-capita. Investment in vaccination can help to reduce the prevalence of diarrheal diseases and avert this public health burden.
| S-EPMC8208894 | biostudies-literature