Dataset Information

Ecological zone and symptoms of acute respiratory infection among children under five in Ghana: 1993-2014.

ABSTRACT: Since 1993, evidence suggest that a significant portion of Ghanaian under-five children have suffered from Acute Respiratory Infection (ARI). This study sought to examine the prevalence of ARI symptoms among under-fives across ecological zones as well as childhood and maternal factors associated with ARI between 1993 and 2014. We used data from Ghana Demographic and Health Surveys (1993-2014). The study sample included women of reproductive age who had under-five children experiencing a cough accompanied with short rapid breaths in the last two weeks preceding each of the surveys. Data were extracted and analysed using STATA version 14.2. Both bivariate and multivariate analyses were done to establish the association between the explanatory and outcome variable. Among Coastal dwellers, the prevalence of reported ARI increased from 18.7% in 1993 to 36.5% in 2014. Increment occurred between 1993 (45.2%) and 2014 (47.3%) within the Middle zone. Between 1993 and 2014, reported ARI reduced from 36.1% to 16.2% among Savanna dwellers. In addition to ecological zone, place of residence, and survey year were associated with symptoms of childhood ARIs. The multivariate results showed that children whose mothers lived in rural areas [AOR?=?1.54, CI?=?1.21-1.97] and those born in survey wave 1998 [AOR?=?1.59, CI?=?1.24-2.04] had higher odds of reporting symptoms of ARI. The study findings have demonstrated the need for public health education and sensitization on ARI to be more specific and target women with children under-five who live in the Middle zone compared to those who live in other ecological zones.

SUBMITTER: Seidu AA

PROVIDER: S-EPMC6558297 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Ecological zone and symptoms of acute respiratory infection among children under five in Ghana: 1993-2014.

Seidu Abdul-Aziz AA Ameyaw Edward Kwabena EK Ahinkorah Bright Opoku BO Baatiema Linus L Appiah Francis F

SSM - population health 20190603

Since 1993, evidence suggest that a significant portion of Ghanaian under-five children have suffered from Acute Respiratory Infection (ARI). This study sought to examine the prevalence of ARI symptoms among under-fives across ecological zones as well as childhood and maternal factors associated with ARI between 1993 and 2014. We used data from Ghana Demographic and Health Surveys (1993-2014). The study sample included women of reproductive age who had under-five children experiencing a cough ac ...[more]

PMID: 31206003

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Project description:Acute 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.We 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.We 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.Although 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.

Project description:BackgroundArtisanal mining creates enabling breeding ground for the vector of malaria parasites. There is paucity of data on the effects of artisanal mining on malaria. This study assessed burden of malaria and caregivers' health-seeking behaviour for children under five in artisanal mining communities in East Akim District in Ghana.MethodsA cross-sectional study involving caregivers and their children under five was conducted in three artisanal mining communities in the East Akim District in Ghana. Caregivers were interviewed using a structured questionnaire. Finger prick blood samples were collected and analysed for haemoglobin concentration using a rapid diagnostic test, and thick and thin blood smears were analysed to confirm the presence of malaria parasites.ResultsOf the 372 children under 5 years included in the study, 197 (53.1%) were male, with a mean age (± SD) of 23.0 ± 12.7 months. The proportion of children with malaria (Plasmodium falciparum and P. malariae) was 98.1% and 1.9%, respectively, whilst the proportion with anaemia (Hb < 11.0 g/dl) was 39.5% (n = 147). Almost all caregivers were female (98.9%), and 28.6% (n = 106) did not have access to any malaria control information. Caregivers associated malaria infection with mosquito bites (68.3%, n = 254) and poor sanitation (21.2%, n = 79). Malaria in children under five was significantly associated with anaemia (OR 11.07, 95% CI 6.59-18.68, n = 111/160, 69.4%; P < 0.0001), residing close to stagnant water (≤ 25 m) from an artisanal mining site (AOR 2.91, 95% CI 1.47-5.76, P = 0.002) and caregiver age younger than 30 years (OR 0.44, 95% CI 0.208-0.917, n = 162, 43.55%, P = 0.001).ConclusionsThere is a high burden of malaria and anaemia among children under five in artisanal mining communities of the East Akim District, and far higher than in non-artisanal mining sites. Interventions are needed to effectively regulate mining activities in these communities, and strengthen malaria control and health education campaigns to curtail the high malaria burden and improve health-seeking behaviour.

Project description:BackgroundPoor air quality of the household is likely to be the largest public health concern in resource-constrained countries. Exposure to household air pollution, poor working environment, and fuel type used at household level have been associated with respiratory symptoms. This study aimed to assess acute respiratory symptoms and its associated factors among mothers who have under five-years-old children in Gondar city, northwest Ethiopia.MethodA cross-sectional study was carried out from February 15, 2019 to June 20, 2019. Study participants were selected using simple random sampling, and data were collected via face-to-face interviews. Binary logistic regression analysis was used to test the association of explanatory and outcome variables. Variables with p < 0.05 were considered as significantly associated with the outcome variable.ResultsThe prevalence of respiratory symptoms among mothers of under-five years-old children in this study was 46.1%. Education (vocational training compared to cannot read and write) (adjusted odd ratio (AOR) = 0.26 at 95% confidence interval (CI): 0.08-0.82), working in dusty environment (AOR = 2.90 at 95% CI: 1.39-6.08), wood fire use (AOR = 0.37 at 95% CI: 0.16-0.85), living in mud- and wood-walled houses (AOR = 0.53 at CI: 0.32-0.89), recent house painting (AOR = 1.95 at 95% CI: 1.03-3.69), new carpet (AOR = 2.02 at 95% CI: 1.08-3.77), pesticide use (AOR = 1.71 at 95% CI: 1.03-2.84), damp stain (AOR = 2.45 at 95% CI: 1.04-5.75), spending longer time in house for 6 to 11 h (AOR = 2.59 at 95% CI: 1.53-4.37) and 11 to 15 h (AOR = 3.47 at 95% CI: 1.87-6.43), and living less than 100 m from unpaved roads/streets (AOR = 4.35 at 95% CI: 2.64-7.18) were significantly associated with respiratory symptoms among mothers of under-five years-old children.ConclusionRespiratory symptoms were common among mothers who have under five-years-old children. Air quality improvement, fuel selection, and residential planning will help to reduce respiratory symptoms.

Project description:BackgroundUnderstanding the burden and contextual risk factors is critical for developing appropriate interventions to control undernutrition.MethodsThis study used data from the 2014 Ghana Demographic and Health Survey to estimate the prevalence of underweight, stunting, and wasting. Single multiple logistic regressions were used to identify the factors associated with underweight, wasting and stunting. The study involved 2720 children aged 0-59 months old and mother pairs. All analyses were done in STATA/IC version 15.0. Statistical significance was set at p<0.05.ResultsThe prevalence of underweight, wasting and stunting were 10.4%, 5.3%, and 18.4% respectively. The age of the child was associated with underweight, wasting and stunting, whereas the sex was associated with wasting and stunting. Normal or overweight/obese maternal body mass index category, high woman's autonomy and middle-class wealth index were associated with a lower odds of undernutrition. The factors that were associated with a higher odds of child undernutrition included: low birth weight (<2.5 kg), minimum dietary diversity score (MDDS), a higher (≥4th) birth order number of child, primary educational level of husband/partner and domicile in the northern region of Ghana.ConclusionThere is still a high burden of child undernutrition in Ghana. The age, sex, birth weight, birth order and the MDDS of the child were the immediate factors associated with child undernutrition. The intermediate factors that were associated with child undernutrition were mainly maternal related factors and included maternal nutritional status and autonomy. Distal level factors which were associated with a higher odds of child undernutrition were the wealth index of the household, paternal educational status and region of residence. We recommend that interventions and policies for undernutrition should address socioeconomic inequalities at the community level while factoring in women empowerment programmes.

Project description:BackgroundThe study objective was to determine the carriage and serotype distribution of Streptococcus pneumoniae among children in Accra, Ghana, five years after the introduction of the pneumococcal conjugate vaccine (PCV-13) in 2012.MethodsNasopharyngeal swab samples were collected from 410 children below 5?years of age in Accra, Ghana, from September to December, 2016. Pneumococcal isolates were identified by optochin sensitivity and bile solubility. Serotyping was performed using the latex agglutination kit and Quellung reaction. The isolates were furthermore tested for antimicrobial susceptibility for different antimicrobials, including penicillin (PEN). Twelve isolates including seven non-typeable (NT) isolates were characterized using whole-genome sequencing analysis (WGS).ResultsThe overall carriage prevalence was found to be 54% (95% CI, 49-59%), and 20% (95% CI, 49-59%) of the children were carrying PCV-13 included serotypes, while 37% (95% CI, 33-42%) of the children were carrying non-PCV-13 serotypes. Based on the serotype distribution, 33% of all observed serotypes were included in PCV-13 while 66% were non-PCV-13 serotypes. The dominating non-PCV-13 serotypes were 23B, 16F, and 11A followed by PCV-13 serotypes 23F and 19F. The PCV-13 covers the majority of resistant isolates in Accra. A proportion of 22.3% of the isolates showed intermediate resistance to penicillin G, while only one isolate showed full resistance. Forty-five isolates (20.5%) were defined as multidrug-resistant (MDR) as they were intermediate/resistant to three or more classes of antimicrobials. Of the seven NT isolates characterized by WGS, four showed highest match to genotype 38, while the remaining three showed highest match to genotype 14. Four MDR serotype 19A isolates were found to be MLST 320.ConclusionPCV-13 introduced in Ghana did not eliminate PCV-13 covered serotypes, and the carriage rate of 54% in this study is similar to carriage studies from pre PCV-13 period. However, the penicillin non-susceptible isolates have been reduced from 45% of carriage isolates before PCV-13 introduction to 22.3% of the isolates in this study. Continuous monitoring of serotype distribution is important, and in addition, an evaluation of an alternative vaccination schedule from 3?+?0 to 2?+?1 will be important to consider.

Project description:BackgroundGlobally, millions of children aged below 5 years die every year and some of these deaths could have been prevented. Though a global problem, under-five mortality is also a major public health problem in Ghana with a rate of 60 deaths per 1000 live births. Identification of drivers of mortality among children aged below 5 years is an important problem that needs to be addressed because it could help inform health policy and intervention strategies aimed at achieving the United Nations SDG Goal 3 target 2. The aim of this study is to develop a predictive model and to identify determinants of under-five mortality.MethodThe 2014 Ghana Demographic and Health Survey data was used in this study. Analyses were conducted on 5884 children. The outcome variable is child survival status (alive or dead). Single level binary logistic and multilevel logistic regression models were employed to investigate determinants of under-five mortality. The fit of the model was checked using Variance Inflation Factor and Likelihood Ratio tests. The Receiver Operating Characteristic curve was used to assess the predictive ability of the models. A p-value< 0.05 was used to declare statistical significance.ResultsThe study observed 289 (4.91%) deaths among children aged below 5 years. The study produced a good predictive model and identified increase in number of total children ever born, number of births in last 5 years, and mothers who did not intend to use contraceptive as critical risk factors that increase the odds of under-five mortality. Also, children who were born multiple and residing in certain geographical regions of Ghana is associated with increased odds of under-five mortality. Maternal education and being a female child decreased the odds of under-five mortality. No significant unobserved household-level variations in under-five mortality were found. The spatial map revealed regional differences in crude under-five mortality rate in the country.ConclusionThis study identified critical risk factors for under-five mortality and strongly highlights the need for family planning, improvement in maternal education and addressing regional disparities in child health which could help inform health policy and intervention strategies aimed at improving child survival.

Project description:BackgroundStunting is one of the most important public health problems in Ethiopia. It remains a problem of greater magnitude particularly in rural and low-income areas. It reflects chronic nutritional deficiencies and illness that occur during the most critical periods for growth and development in early life. It needs proper intervention to save the future, unless it resulted in diminished cognitive and physical development for the rest of their lives. Therefore, this study aimed to assess the prevalence of stunting and associated factors among under-five children in West Guji Zone, Oromia, Ethiopia.MethodA community-based cross-sectional study was conducted among 767 under-five children who were included in this study by using a multistage sampling technique in 12 kebeles from 3 selected districts. Data were collected from a mother/caregiver of the child by using a structured pretested questionnaire. Standardized anthropometric measurements were used to measure length, weight, and height of a child. Data were entered into Epi Info software version 3.5.1 and exported to SPSS version 23 for analysis for descriptive and logistic regression models.ResultThe prevalence of stunting was 244 (31.8%) with 95% CI (28.6-35.2) among under-five-age children. The under-five children whose fathers had a polygamous marriage (AOR = 4.92, 95% CI: 3.46, 7.00), being female sex (AOR = 1.74, 95% CI: 1.23, 2.47), having below 4 meal frequencies (AOR = 2.95, 95% CI: 1.56, 5.58), not vaccinated (AOR = 1.75, 95% CI: 1.15, 2.67), and from poor households' wealth status (AOR = 3.03, 95% CI: 1.63, 5.63) and also from severely food insecure household (AOR = 2.92, 95% CI: 1.36, 6.24) were short for their age compared with their counterparts.ConclusionNearly one-third of the under-five children were stunted in the study area which needs intervention on child-feeding practice to avoid sex discrimination in the community. In addition to this health officials in collaboration with other sectors, it is needed to act together to improve enforcement of the law for polygamous marriage, the household's wealth status, and food security for the better health of a child and future.

Dataset Information

Ecological zone and symptoms of acute respiratory infection among children under five in Ghana: 1993-2014.

Publications

Ecological zone and symptoms of acute respiratory infection among children under five in Ghana: 1993-2014.

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