Caregiver Supervision Practices and Risk of Childhood Unintentional Injury Mortality in Bangladesh.
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ABSTRACT:
SUBMITTER: Khatlani K
PROVIDER: S-EPMC5451966 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundUnintentional injuries are an important cause of death in India. However, no reliable nationally representative estimates of unintentional injury deaths are available. Thus, we examined unintentional injury deaths in a nationally representative mortality survey.MethodsTrained field staff interviewed a living relative of those who had died during 2001-03. The verbal autopsy reports were sent to two of the 130 trained physicians, who independently assigned an ICD-10 code to each death. Discrepancies were resolved through reconciliation and adjudication. Proportionate cause specific mortality was used to produce national unintentional injury mortality estimates based on United Nations population and death estimates.ResultsIn 2005, unintentional injury caused 648,000 deaths (7% of all deaths; 58/100,000 population). Unintentional injury mortality rates were higher among males than females, and in rural versus urban areas. Road traffic injuries (185,000 deaths; 29% of all unintentional injury deaths), falls (160,000 deaths, 25%) and drowning (73,000 deaths, 11%) were the three leading causes of unintentional injury mortality, with fire-related injury causing 5% of these deaths. The highest unintentional mortality rates were in those aged 70 years or older (410/100,000).ConclusionsThese direct estimates of unintentional injury deaths in India (0.6 million) are lower than WHO indirect estimates (0.8 million), but double the estimates which rely on police reports (0.3 million). Importantly, they revise upward the mortality due to falls, particularly in the elderly, and revise downward mortality due to fires. Ongoing monitoring of injury mortality will enable development of evidence based injury prevention programs.
| S-EPMC3532420 | biostudies-literature
Project description:We compared rates of unintentional injury (UI) deaths (total and by injury category) among Alaska Native (AN) people to rates of U.S. White (USW) and Alaska White (AKW) populations during 2006-2015. The mortality data for AN and AKW populations were obtained from Alaska Bureau of Vital Statistics and USW mortality data were obtained from WISQARS, the Center for Disease Control and Prevention online injury data program. AN and AKW rates were age-adjusted to the U.S. 2000 Standard Population and rate ratios (RR) were calculated. AN people had higher age-adjusted total UI mortality than the USW (RR = 2.6) and AKW (RR = 2.3) populations. Poisoning was the leading cause of UI death among AN people (35.9 per 100,000), more than twice that of USW (RR = 2.9) and AKW (RR = 2.5). Even greater disparities were found between AN people and USW for: natural environment (RR = 20.7), transport-other land (RR = 12.4), and drowning/submersion (RR = 9.1). Rates of AN UI were markedly higher than rates for either USW or AKW. Identifying all the ways in which alcohol/drugs contribute to UI deaths would aid in prevention efforts. All transportation deaths should be integrated into one fatality rate to provide more consistent comparisons between groups.
| S-EPMC5774398 | biostudies-literature
Project description:BackgroundChild and neonatal mortality is a serious problem in Bangladesh. The main objective of this study was to determine the most significant socio-economic factors (covariates) between the years 2011 and 2014 that influences on neonatal and child mortality and to further suggest the plausible policy proposals.MethodsWe modeled the neonatal and child mortality as categorical dependent variable (alive vs death of the child) while 16 covariates are used as independent variables using χ2 statistic and multiple logistic regression (MLR) based on maximum likelihood estimate.FindingsUsing the MLR, for neonatal mortality, diarrhea showed the highest positive coefficient (β = 1.130; P < 0.010) leading to most significant covariate for both 2011 and 2014. The corresponding odds ratios were: 0.323 for both the years. The second most significant covariate in 2011 was birth order between 2-6 years (β = 0.744; P < 0.001), while father's education was negative correlation (β = -0.910; P < 0.050). In general, 10 covariates in 2011 and 5 covariates in 2014 were significant, so there was an improvement in socio-economic conditions for neonatal mortality. For child mortality, birth order between 2-6 years and 7 and above years showed the highest positive coefficients (β = 1.042; P < 0.010) and (β = 1.285; P < 0.050) for 2011. The corresponding odds ratios were: 2.835 and 3.614, respectively. Father's education showed the highest coefficient (β = 0.770; P < 0.050) indicating the significant covariate for 2014 and the corresponding odds ratio was 2.160. In general, 6 covariates in 2011 and 4 covariates in 2014 were also significant, so there was also an improvement in socio-economic conditions for child mortality. This study allows policy makers to make appropriate decisions to reduce neonatal and child mortality in Bangladesh.ConclusionsIn 2014, mother's age and father's education were also still significant covariates for child mortality. This study allows policy makers to make appropriate decisions to reduce neonatal and child mortality in Bangladesh.
| S-EPMC5928324 | biostudies-literature
Project description:BackgroundThe child nutritional status of a country is a potential indicator of socioeconomic development. Child malnutrition is still the leading cause of severe health and welfare problems across Bangladesh. The most prevalent form of child malnutrition, stunting, is a serious public health issue in many low and middle-income countries. This study aimed to investigate the heterogeneous effect of some child, maternal, household, and health-related predictors, along with the quantiles of the conditional distribution of Z-score for height-for-age (HAZ) of under five children in Bangladesh.Methods and materialsIn this study, a sample of 8,321 children under five years of age was studied from BDHS-2017-18. The chi-square test was mainly used to identify the significant predictors of the HAZ score and sequential quantile regression was used to estimate the heterogeneous effect of the significant predictors at different quantiles of the conditional HAZ distribution.ResultsThe findings revealed that female children were significantly shorter than their male counterparts except at the 75th quantile. It was also discovered that children aged 7-47 months were disadvantaged, but children aged 48-59 months were advantaged in terms of height over children aged 6 months or younger. Moreover, children with a higher birth order had significantly lower HAZ scores than 1st birth order children. In addition, home delivery, the duration of breastfeeding, and the BCG vaccine and vitamin A received status were found to have varied significant negative associations with the HAZ score. As well, seven or fewer antenatal care visits was negatively associated with the HAZ score, but more than seven antenatal care visits was positively associated with the HAZ score. Additionally, children who lived in urban areas and whose mothers were over 18 years and either normal weight or overweight had a significant height advantage. Furthermore, parental secondary or higher education had a significant positive but varied effect across the conditional HAZ distribution, except for the mother's education, at the 50th quantile. Children from wealthier families were also around 0.30 standard deviations (SD) taller than those from the poorest families. Religion also had a significant relationship with the conditional HAZ distribution in favor of non-Muslim children.ConclusionsTo enhance children's nutritional levels, intervention measures should be designed considering the estimated heterogeneous effect of the risk factors. This would accelerate the progress towards achieving the targets of Sustainable Development Goals (SDGs) related to child and maternal health in Bangladesh by 2030.
| S-EPMC9879476 | biostudies-literature
Project description:BackgroundTo examine trends in unintentional falls mortality from 2006 to 2016 in China by location (urban/rural), sex, age group and mechanism.MethodsMortality data were retrieved from the National Disease Surveillance Points system (DSPs) of China, a nationally representative data source. Percent change in mortality between 2006 and 2016 was calculated as "mortality rate ratio - 1" based on a negative binomial regression model.ResultsThe crude unintentional falls mortality was 9.55 per 100 000 population in 2016. From 2006 to 2016, the age-adjusted unintentional falls mortality increased by 5% (95% confidence interval (CI) = 1%-9%), rising from 7.65 to 8.03 per 100 000 population. Males, rural residents and older age groups consistently had higher falls mortality rates than females, urban residents and younger age groups. Falls on the same level from slipping, tripping and stumbling (W01) was the most common mechanisms of falls mortality, accounting for 29% of total mortality.ConclusionsUnintentional falls continued to be a major cause of death in China from 2006 to 2016. Empirically-supported interventions should be implemented to reduce unintentional falls mortality.
| S-EPMC6445498 | biostudies-literature
Project description:BackgroundDespite improvements in many health indicators, maternal mortality has plateaued in Bangladesh. Achieving the global target of reductions in maternal mortality and the associated Sustainable Development Goals will not be possible without actions to prevent deaths due to preeclampsia/eclampsia. Here we examined the levels, trends, specific causes, timing, place, and care-seeking behaviours of women who died due to these two causes.MethodsWe used nationally representative Bangladesh Maternal Mortality and Health Care Surveys (BMMSs) conducted in 2001, 2010, and 2016 to examine levels and trends of deaths due to preeclampsia/eclampsia. We based the analysis of specific causes, timing, and place of preeclampsia/eclampsia deaths, and care seeking before the deaths on 41 such deaths captured in the 2016 survey. We also used BMMS 2016 survey verbal autopsy (VA) questionnaire to highlight stories that put faces to the numbers.ResultsThe preeclampsia/eclampsia-specific mortality ratio decreased from 77 per 100 000 live births in the 2001 BMMS to 40 per 100 000 live births in the 2010 BMMS, yet halted in the 2016 BMMS at 46 per 100 000 live births. Although preeclampsia/eclampsia accounted for around one-fifth of all maternal deaths in the 2010 BMMS, in the 2016 BMMS, the percentage contribution reached the 2001 BMMS level of 24%. An analysis of the VA questionnaire's open section showed that almost all such death cases left their homes to seek care; however, most had to visit more than one facility before they died, indicating an unprepared health system.ConclusionsA cluster of preeclampsia/eclampsia-specific mortality observed during the first trimester, during delivery, and within 48 hours of birth indicates a need for preconception health check-ups and strengthened facility readiness. Awareness of maternal complications, proper care seeking, and healthy reproductive practices, like family planning to space and limit pregnancy through client-supportive counselling, may be beneficial. Improving regular and emergency maternal services readiness is also essential.
| S-EPMC10344461 | biostudies-literature
Project description:Scientific malpractice is not just due to researchers having bad intentions, but also due to a lack of education concerning research integrity practices. Besides the importance of institutionalised trainings on research integrity, research supervisors play an important role in translating what doctoral students learn during research integrity formal sessions. Supervision practices and role modelling influence directly and indirectly supervisees’ attitudes and behaviour toward responsible research. Research supervisors can not be left alone in this effort. Research institutions are responsible for supporting supervisors in being more aware of their RI function, and in supporting responsible supervision practices to have a positive cascading effect on supervisees’ research practices. We interviewed 22 European research supervisors to investigate how they perceive their role as research integrity trainers and their real-life supervision practices. Moreover, we investigated their points of view concerning the role of research institutions in supporting supervision practices. Although there are different commonalities in supervisors’ perception of their research integrity-related role, differences are emphasised depending on the supervisors’ characteristics such as academic domain, seniority, working country and gender. In addition, supervisors’ way of mentoring depend also on supervisees’ learning curve. Overall, all supervisors agreed on institutions playing an important role in support their supervision effort and practices. This study aims to be a starting point for better understanding research integrity supervision practices and the role of institutions in supporting them. Moreover, it puts the basis to further investigate differences in supervision practices depending on supervisors’ characteristics. Supplementary Information The online version contains supplementary material available at 10.1007/s10805-022-09468-y.
| S-EPMC9772598 | biostudies-literature
Project description:OBJECTIVE:Using estimates from the Global Burden of Disease (GBD) study, we examined differences in unintentional occupational injury mortality rates from 1990 to 2016 between high-income countries (HICs) and low- and middle-income countries (LMICs). METHODS:Unintentional occupational injury mortality rates were obtained through the GBD online visualization tool. We quantified mortality changes over time for common external causes of injury for ages 15?49 years and 50?69 years separately in HICs and LMICs using negative binomial regression models. RESULTS:In 2016, there were 24,396 and 303,999 unintentional occupational injury deaths among individuals aged 15 to 69 years in HICs and LMICs, respectively, corresponding to 3.1 and 7.0 per 100,000 people. Between 1990 and 2016, unintentional occupational injury mortality for people aged 15?69 years dropped 46% (from 5.7 to 3.1 per 100,000 people) in HICs and 42% in LMICs (from 13.2 to 7.0 per 100,000 people). Sustained and large disparities existed between HICs and LMICs for both sexes and both age groups during 1990?2016 (mortality rate ratio: 2.2?2.4). All unintentional occupational injury causes of death displayed significant reduction with one exception (ages 15?49 years in HICs). Country-specific analysis revealed large variations in unintentional occupational injury mortality and changes in occupational injury mortality between 1990 and 2016. CONCLUSIONS:Despite substantial decreases in mortality between 1990 and 2016 for both HICs and LMICs, a large disparity continues to exist between HICs and LMICs. Multifaceted efforts are needed to reduce the disparity.
| S-EPMC6210857 | biostudies-other
Project description:To design effective national diarrhea control programs, including oral rehydration solution (ORS) and therapeutic zinc supplementation, information is needed on local perceptions of illness, external care seeking behaviors, and home treatment practices.A cross-sectional, community-based household survey was conducted in the Orodara Health District, Burkina Faso. Caregivers of 10,490 children <27 months were interviewed to assess child diarrhea prevalence and related care practices. Characteristics of households, caregivers, children, and reported illnesses were compared for those caregivers who did or did not recognize the presence of diarrhea, as defined according to clinical criteria (? 3 liquid or semi-liquid stools/day). Multiple logistic regression models were used to examine factors associated with illness recognition and treatment.Clinically defined diarrhea was present in 7.6% (95% CI: 7.1-8.1%) of children during the 24 hours preceding the survey but recognized by only 55% of caregivers. Over half (55%) of the caregivers of 1,067 children with a clinically defined diarrhea episode in the past 14 days sought care outside the home; 78% of those seeking care attended a public sector clinic. Care was sought and treatment provided more frequently for children with fever, vomiting, anorexia, longer illness duration, and those living closer to the health center; and care was sought more frequently for male children. 80% of children with recent diarrhea received some form of treatment; only 24% received ORS, whereas 14% received antibiotics. Zinc was not yet available in the study area.Caregivers frequently fail to recognize children's diarrhea, especially among younger infants and when illness signs are less severe. Treatment practices do not correspond with international recommendations in most cases, even when caregivers consult with formal health services. Child caregivers need additional assistance to recognize diarrhea correctly, and both caregivers and health care providers need updated training on current diarrhea treatment recommendations.
| S-EPMC3302832 | biostudies-literature
Project description:BackgroundVariation in healthcare delivery is increasingly recognized as an important metric of healthcare quality. Directly observed therapy (DOT) has been the standard of care for tuberculosis (TB) treatment supervision for decades based on World Health Organization (WHO) guidelines. However, variation in implementation of DOT and associated TB treatment supervision practices remains poorly defined.MethodsWe collected individual patient data from TB treatment registers at 18 TB treatment units in Uganda including District Health Centers, District Hospitals, and Regional Referral Hospitals. We also administered a survey and did observations of TB treatment supervision practices by health workers at each site. We describe variation in TB treatment outcomes and TB treatment supervision practices.ResultsOf 2767 patients treated for TB across the 18 clinical sites between January 1 and December 31, 2017, 1740 (62.9%) were men, most were of working age (median 35 years, interquartile range [IQR] 27 - 46), 2546 (92.0%) had a new TB diagnosis, and nearly half (45.9%, n = 1283) were HIV positive. The pooled treatment success proportion was 69.4% (95% confidence interval [CI] 67.8 - 71.1) but there was substantial variation across sites (range 42.6 - 87.6%, I-squared 92.7%, p < 0.001). The survey and observation of TB treatment practices revealed that the majority of sites practice community-based DOT (66.7%, n = 12) and request a family member, who receives no additional training or supervision, to serve as a treatment supporter (77.8%, n = 14). At TB medication refill visits, all sites screen for side effects and most assess adherence via self-report (83.3%, n = 15). Only 7 (38.9%) sites followed-up patients who missed appointments using either phone calls (22.2%, n = 4/7) or community health workers (16.7%, n = 3/7). All 18 sites counseled patients at treatment initiation, but none provided additional counseling at refill visits other than addressing poor adherence or missed appointments.ConclusionThere was substantial variation in implementation of DOT, including observation and documentation of daily dosing, training and supervision of treatment supporters, and follow-up for missed clinic visits. Identifying best practices and reducing uncontrolled variation in the delivery of TB treatment is critical to improving treatment outcomes.
| S-EPMC7648165 | biostudies-literature