Dataset Information

Prevalence and factors associated with underweight children: a population-based subnational analysis from Pakistan.

ABSTRACT:

Objectives

This study aims to determine the prevalence of and factors associated with underweight children under the age of 5 in Punjab, Pakistan.

Design

We analysed cross-sectional household-level subnationally representative Multiple Indicator Cluster Survey.

Settings

Punjab province, Pakistan.

Participants

24 042 children under 5 years of age.

Data analysis

Multilevel multivariate logistic regression analysis.

Results

Prevalence of moderately and severely underweight children was found to be (33.3% and 11.3%, respectively). Multivariate multilevel logistic regression results show that as the child grows older the likelihood of the child being underweight increases significantly (eg, children between 12 and 23 months are one and half times more likely to be underweight, whereas children between the ages of 36 and 47 months are two and a half times more likely to be underweight). Gender was found to be another significant factor contributing to underweight prevalence among children under the age of 5. The likelihood of a girl child being underweight is more than that of a boy child being underweight (OR 0.92, 95% CI 0.8 to 1.0). Similarly, a child whose birth order is three or more is two times more likely to be underweight (OR 1.96, 95% CI 1.5 to 2.5) relative to a child of a lower birth order. Moreover, diarrhoea also significantly increases the likelihood of the child being underweight (OR 1.31, 95% CI 1.1 to 1.5). Child size is another determinant for underweight prevalence among children under 5, for example, a child with a size smaller than average at the time of birth is 2.7 times more likely to be moderately underweight than a child with an average or larger than average size at the time of birth.

Conclusion

Rigorous community-based interventions should be developed and executed throughout the province to improve this grave situation of underweight prevalence in Punjab. Mother's education should be uplifted by providing them formal education and providing awareness about the importance of proper nutrition for children.

SUBMITTER: Kumar R

PROVIDER: S-EPMC6678069 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Publications

Prevalence and factors associated with underweight children: a population-based subnational analysis from Pakistan.

Kumar Ramesh R Abbas Faisal F Mahmood Tahir T Somrongthong Ratana R

BMJ open 20190730 7

<h4>Objectives</h4>This study aims to determine the prevalence of and factors associated with underweight children under the age of 5 in Punjab, Pakistan.<h4>Design</h4>We analysed cross-sectional household-level subnationally representative Multiple Indicator Cluster Survey.<h4>Settings</h4>Punjab province, Pakistan.<h4>Participants</h4>24 042 children under 5 years of age.<h4>Data analysis</h4>Multilevel multivariate logistic regression analysis.<h4>Results</h4>Prevalence of moderately and sev ...[more]

PMID: 31366654

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Project description:BackgroundUnderweight prevalence continues to be major public health challenge worldwide, particularly in developing countries like Pakistan. This study is focused on socio-economic and demographic aspects of underweight prevalence among children under-five in Punjab.MethodsIn this study, several socioeconomic and demographic factors are considered using MICS-4 data-set. Only those variables which are usually described in the nutritional studies of children were picked. Covariates include: the age of children, sex of the children, age of mother, total number of children born to women, family wealth index quintile, source of drinking water, type of sanitation, place of residence, parents' education and occupation. All Categorical variables are effect coded. The child's age and the mother's age are assumed to be nonlinear, geographical region is spatial effect, while other variables are parametric in nature. Since, the response is binary, covariate comprises linear terms, nonlinear effects of continues covariates and geographic effects, so we have use Geo-additive models (based on Fully Bayesian approach) with binomial family under logit link. Statistical analysis is performed on Statistical package R using Bayes X and R2 Bayes X Libraries.ResultsUnderweight status of children was found to be positively associated with number of under-five children in household, total number of children ever born to women and age of mother when the child was born. Whereas, it negatively associated with place of residence, parent's education and family wealth index quintile. On the regional effect, the Southern Punjab has higher prevalence of underweight compared to Central and Northern Punjab.ConclusionSimilarity of our results with several other studies demonstrate that the Geo-additive models are an ideal substitute of other statistical models to analyze the underweight prevalence among children. Moreover, our findings suggest the Punjab Government, to introduce target-oriented programs such as poverty reduction and enhancement of education and health facilities for poor population and disadvantaged regions, especially Southern Punjab.

Project description:BackgroundCryptosporidium spp are important intestinal protozoan parasites that cause diarrhea in humans, domestic and wild animals. Its infection remains a main public health concern however, the epidemics in human being is still unclear, particularly in developing countries. There are several factors that may enhance the spreading of this parasite in human population especially in young children.MethodologyA questionnaire was designed to obtain the demographic and clinical data from the participants. A total of 425 stool samples were collected from suspected children (aged 3-10 years) in different hospitals and villages. The initial screening was performed with modified Ziehl Neelsen (mZN) staining technique followed by polymerase chain reaction (PCR). Several potential risk factors were also assessed through the obtained information from suspected individuals.ResultsOut of all 425 collected samples, 127 were observed positive by mZN with a prevalence of 29.88% (127/425). The 127 mZN positive samples together with 50 mZN negative samples were processed for molecular analysis through PCR assay. Among them, 71 out of 127 mZN positive samples and 4 out of 50 mZN negative samples were found positive by PCR. The molecular analysis showed that Cryptosporidium parvum was the main cause of infection in children. The results revealed that individuals exposed to diarrhea were more likely to be infected with Cryptosporidium infection while several environmental factors may also play a key role in spreading of this parasite.Conclusions/significance of the studyThe current high prevalence of Cryptosporidium infection may be due to the lack of awareness and routine based testing in identification of this parasite in District Buner. Further studies are required to determine the importance of Cryptosporidium infection in this area as well as across the country and to find out the possible risk factors that may be associated with the occurrence of this protozoan. There is, however, an urgent need for laboratory-based observational studies to develop a more dynamic estimate of the cryptosporidial disease burden in the region.

Dataset Information

Prevalence and factors associated with underweight children: a population-based subnational analysis from Pakistan.

Objectives

Design

Settings

Participants

Data analysis

Results

Conclusion

Publications

Prevalence and factors associated with underweight children: a population-based subnational analysis from Pakistan.

Similar Datasets

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