Dataset Information

Determinants of growth measurements in rural Cambodian infants: a cross-sectional study.

ABSTRACT:

Background

Inappropriate feeding and hygiene practices and poor environment are associated with malnutrition. We aimed to investigate the contributions of feeding, hygiene practices and recent illness to the nutritional status of rural Cambodian infants and any sex-specific differences.

Methods

In a cross-sectional study, nested within an ongoing birth cohort, trained fieldworkers conducted anthropometry and collected information from the main caregiver during home visits. Multivariable linear regression was used to investigate associations with nutritional status as length-for-age z-scores (LAZ) and weight-for-length z-scores (WLZ).

Results

A total of 156 children, 87 (55.8%) male, ages 0-11 months were enrolled. The prevalence of acute malnutrition (WLZ <-2) in males and females was 2.3% (2/87) and 5.8% (4/69), respectively, and 23.0% (20/87) of males and 14.5% (10/69) of females were stunted (LAZ <-2). WLZ but not LAZ decreased with age. WLZ was independently negatively associated with increasing age (?-coefficient -0.14 [95% confidence interval {CI} -0.20 to -0.08], p<0.001), and regular use of feeding bottles (?-coefficient -0.46 [95% CI -0.83 to -0.10], p=0.014), and positively with handwashing with soap (?-coefficient 0.40 [95% CI 0.05 to 0.75), p=0.027).

Conclusions

The prevalence of acute malnutrition was low, but stunting was prevalent without evidence of a sex difference. Non-linear growth faltering was associated with increasing age and hygiene/feeding practices.

SUBMITTER: Miyazaki A

PROVIDER: S-EPMC7807240 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Determinants of growth measurements in rural Cambodian infants: a cross-sectional study.

Miyazaki Asuka A Matsui Mitsuaki M Tung Rathavy R Taing Bunsreng B White Laura V LV Iwamoto Azusa A Cox Sharon E SE

International health 20210101 1

<h4>Background</h4>Inappropriate feeding and hygiene practices and poor environment are associated with malnutrition. We aimed to investigate the contributions of feeding, hygiene practices and recent illness to the nutritional status of rural Cambodian infants and any sex-specific differences.<h4>Methods</h4>In a cross-sectional study, nested within an ongoing birth cohort, trained fieldworkers conducted anthropometry and collected information from the main caregiver during home visits. Multiva ...[more]

PMID: 32379305

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Project description:Introduction:Practicing exclusive breastfeeding (EBF) in an infant's first six months of life is recommended by the World Health Organization because of its proven effectiveness as a method to support the infant's short- and long-term physical and cognitive development. However, many countries, including Cambodia, face contextually driven challenges in meeting this optimum standard of breastfeeding. The recent declining EBF rate in Cambodia is a concerning indicator of the impact of these challenges. Methods:We used existing data from the 2014 Cambodian Demographic and Health Survey (CDHS) to analyze 717 Cambodian mother-infant pairs. CDHS 2014 used a two-stage stratified cluster sampling approach to select samples. A multivariable logistic regression analysis was used to assess determinants of EBF, taking into account the sampling weight in the analysis. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated, and significance level was considered at p value < 0.05. Results:Our findings indicate that among mothers with infants under six months, EBF was more likely if they resided rurally (AOR = 2.28; 95% CI 1.23-4.23) and if they delivered at a public hospital (AOR = 2.64; 95% CI 1.28-5.47). On the other hand, mothers of middle wealth index practiced EBF less than mothers of low wealth index (AOR = 0.58; 95% CI 0.34-0.99). And as expected, our analysis confirmed that the older the infants grew, the less likely they were to be exclusively breastfed than those younger than one month old (2-3 months: AOR = 0.49; 95% CI 0.26-0.92; 4-5 months: AOR = 0.25; 95% CI 0.15-0.43). Conclusion:The findings emphasize the need to address these determinants adequately by appropriate interventions to halt the declining trend of EBF practice. We recommend a multifaceted approach to improve EBF rates in Cambodia. Advocacy around EBF at public hospitals should continue, and private hospital staff should receive training to provide EBF counselling and support to mothers.

Project description:BackgroundThe incidence of inappropriate admissions in China has become the shackle of its' service supply system. This research aims to assess the level of children's inappropriate admissions to county hospitals in rural China and identify the characteristics and determinants of children's inappropriate admissions.MethodsA retrospective review was conducted on data of children aged 0-14?years. A total of 771 children medical records in four county hospitals was collected by stratified random sampling in Midwestern China and was evaluated through the Rural Appropriateness Evaluation Protocol. A questionnaire survey was conducted among doctors whose names were shown in medical records. Chi-square test was used to analyse the characteristics of inappropriate admissions, and a binary logistic regression model was used to examine the determinants of inappropriate admissions.ResultsInappropriate admissions indicate that patients who could have been treated as outpatients received services as inpatients. The average rate for inappropriate admissions of children in county hospitals was 61.35%. The highest rate of inappropriate admissions was found among children aged 1-5?years (68.42%). Inappropriate admissions mostly occurred in children with respiratory diseases (72.45%), circulatory diseases (72.22%) and certain infectious diseases and parasitic diseases (70.37%). Binary logistic regression analysis showed that county, normal health status, treating department, disease, the length of hospital stay and the doctor's self-evaluation on the understanding about the degree of the patient's feelings were determinants for children's inappropriate admissions.ConclusionsCounty hospitals have a high rate of inappropriate admissions of children. The relationship of children's inappropriate admissions to age distribution and the insurance compensation is affected by disease and hospitalisation expenses, respectively. The determinants of children's inappropriate admissions are directly related to the weak level of primary care services in the health service system, the initial requirements requested by children's admission decision makers and the interests among medical institutions and doctors.

Project description:Background: Mothers and their newborns are vulnerable to threats to their health and survival during the postnatal period. Full postnatal care (PNC) uptake decreases maternal deaths and is also essential for first 1,000 days of newborn's life, but PNC usage is usually inadequate in rural areas. Little is known about the full PNC utilization among rural Myanmar women. This study, therefore, aimed to study the situation of the utilization of full PNC and examine its determinants. Methods: This community-based cross-sectional study was conducted in selected villages of the Magway Region, Myanmar. A total of 500 married women who had children aged under 2 years were selected using multistage cluster sampling and interviewed with semi-structured questionnaires. The determinants of full PNC usage were identified by generalized estimating equation (GEE) under a logistic regression framework. Results: Among 500 rural women, around a quarter (25.20%; 95% confidence interval (CI), 21.58-29.21%) utilized full PNC. Multivariable analysis revealed that factors associated with full PNC usage included mothers attaining educational level of secondary or higher (adjusted odds ratio (AOR), 2.16; 95% CI, 1.18-3.94), belonging to higher income level (AOR, 2.02; 95% CI, 1.11-3.68), having male involvement (AOR, 2.19; 95% CI, 1.02-4.69), being of low birth order (i.e. the first birth) (AOR, 3.26; 95% CI, 1.80-5.91), and having awareness of postnatal danger signs (AOR, 2.10; 95% CI, 1.15-3.83). Moreover, the presence of misconceptions on postnatal practice was identified as a strong barrier to adequate PNC usage (AOR, 0.12; 95% CI, 0.04-0.36). Conclusion: Most of the rural women practiced inadequate PNC in Myanmar. Maternal healthcare services at rural areas should be intensively promoted, particularly among women who had high birth order (greater number of births). Health education regarding perinatal misconceptions and danger signs, and benefits of full PNC services usage should be emphasized and urgently extended.

Project description:BackgroundProper utilization of skilled care services in neonatal illnesses is crucial to reduce neonatal morbidity and mortality. The study aimed to evaluate the level and factors associated with seeking care from skilled healthcare service providers for reported neonatal illnesses in rural Matlab, Bangladesh.MethodsThis community based cross-sectional study was based on data from a randomly selected sample comprised of 2223 women who delivered live-born babies in 2014. Data were collected from June to October 2015 through a structured questionnaire. We used a multivariable logistic regression model and presented the results by adjusted odds ratios (AOR) with 95% confidence intervals (CI).ResultsOf the neonates, 1361 (61.2%) suffered from at least one complication, and among these, 479 (35.2%) sought care from skilled healthcare service providers. In the multivariable logistic regression analysis, the participants' husbands' educational level, number of antenatal care visits, and place of childbirth were significantly associated with seeking skilled care for reported neonatal illnesses. The care-seeking from skilled healthcare service providers for neonatal illness was more than two times higher (AOR = 2.26, 95% CI = 1.51-3.39) in the group in which the participants' husband had attended school for more than 10 years as compared to the group in which they had attended school for less than six years. The AORs of seeking skilled care were 1.93 (95% CI = 1.42-2.62) and 2.26 (95% CI = 1.51-3.39) with the mothers receiving two to three and four or more antenatal care services, respectively, compared to the mothers with no or one antenatal care visit. Women who gave birth at a health facility were three times (AOR = 3.24, 95% CI = 2.50-4.19) more likely to seek skilled care for sick neonates compared to those who gave birth at home.ConclusionThe utilization of skilled care for neonatal sicknesses was low in this rural setting in Bangladesh. The participants' husbands' higher school attendance, increased number of ANC visits, and facility delivery were positively associated with care-seeking from skilled healthcare providers for neonatal illness. The husbands with low school attendance should be targeted for intervention, and continue efforts to increase ANC coverage and facility delivery to improve neonatal health in this country's rural area.

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Project description:OBJECTIVE:Zambia is among the world's top 10 countries with higher fertility rate (5.5 births/woman); unmet family planning need for births spacing (14%) and limiting births (7%). Women in rural Zambia (24%) are reported to have unmet need for family planning than those in urban areas (17%). This study was conducted to ascertain factors associated with modern contraceptive use among rural Zambian women. DESIGN:Cross-sectional study. SETTING:Rural Zambia. PARTICIPANTS:Secondary data of 4903 married or cohabiting rural women (15-49 years) after filtering out the pregnant, urban based and unmarried women from 2013 to 2014 Zambian Demographic and Health Survey (ZDHS) were analysed using SPSS V.22. Multiple logistic regression, Pearson's ?2 and descriptive statistics were performed to examine factors associated with modern contraceptive use. RESULTS:Factors that were positively associated with contraceptive use were respondent's education (secondary adjusted ORs (AOR?=?1.61, p?0.002); higher (AOR?=?2.39, p?0.050)), wealth index (middle class, (AOR?=?1.35, p?0.005); rich (AOR?=?2.04, p?0.001) and richest (AOR?=?1.95, p?0.034)), high parity (1-2 (AOR?=?5.31, p?0.001); 3-4 (AOR?=?7.06, p?0.001); 5+ (AOR?=?8.02, p?0.001)), men older than women by <10 years (AOR?=?1.50, p?0.026) and women sensitised about family planning at health facility (AOR?=?1.73, p?0.001). However, old age (40-49 years (AOR?=?0.49, p?0.001)), other religions (Protestants, African traditionalists and Muslims) (AOR?=?0.77, p?0.007), ever had pregnancy miscarried, aborted or stillbirth (AOR?=?0.78, p?0.026) and women without knowledge of number of children husband desires (AOR?=?0.71, p?0.001) were negatively associated with contraceptive use. CONCLUSION:Modern contraceptive use in rural Zambia among currently married women of reproductive age group is relatively low (43%). We recommend that appropriate interventions are instituted to increase contraceptive access and use especially among uneducated older rural Zambian women.

Dataset Information

Determinants of growth measurements in rural Cambodian infants: a cross-sectional study.

Background

Methods

Results

Conclusions

Publications

Determinants of growth measurements in rural Cambodian infants: a cross-sectional study.

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