scholarly journals Point-of-use water chlorination among urban and rural households with under-five-year children: a comparative study in Kersa Health and Demographic Surveillance Site, Eastern Ethiopia

2018 ◽  
Vol 8 (3) ◽  
pp. 468-480 ◽  
Author(s):  
Abraham Geremew ◽  
Bezatu Mengistie ◽  
Esayas Alemayehu ◽  
Daniele Susan Lantagne ◽  
Jonathan Mellor ◽  
...  

Abstract Point-of-use water chlorination is one of the most effective means to prevent diarrhea in under-five children although challenges remain in its adoption and effective use. In Ethiopia, evidence of point-of-use water chlorination among households with under-five children in rural and urban settings that is verified with water testing is scarce. A comparative cross-sectional study was conducted among urban and rural households with under-five child in Kersa Health and Demographic Surveillance Site, Eastern Ethiopia from June to August, 2016. Data were collected from a caregiver of systematically selected households and analyzed using multivariable logistic regression. A total of 1,912 households were included in the analysis with a 96.5% response rate. In rural areas, 4.6% of caregivers were reportedly chlorinating water at point-of-use and 1.2% were confirmed with free residual chlorine. In urban areas, 17.1% of caregivers were reportedly chlorinating water and 6.6% were confirmed to have free residual chlorine. In two settings, caregivers' point-of-use water chlorination was associated with chlorine taste and water quality perception. Inaccessibility to treatment products in rural areas and use of bottled water in urban areas were among the reasons to discontinue point-of-use water chlorination. Behavior changing interventions with proper distribution and marketing is needed for sustainable point-of-use chlorination.

2008 ◽  
Vol 40 (1) ◽  
pp. 83-96 ◽  
Author(s):  
M. MAZHARUL ISLAM ◽  
KAZI MD ABUL KALAM AZAD

SummaryThis paper analyses the levels and trends of childhood mortality in urban Bangladesh, and examines whether children’s survival chances are poorer among the urban migrants and urban poor. It also examines the determinants of child survival in urban Bangladesh. Data come from the 1999–2000 Bangladesh Demographic and Health Survey. The results indicate that, although the indices of infant and child mortality are consistently better in urban areas, the urban–rural differentials in childhood mortality have diminished in recent years. The study identifies two distinct child morality regimes in urban Bangladesh: one for urban natives and one for rural–urban migrants. Under-five mortality is higher among children born to urban migrants compared with children born to life-long urban natives (102 and 62 per 1000 live births, respectively). The migrant–native mortality differentials more-or-less correspond with the differences in socioeconomic status. Like childhood mortality rates, rural–urban migrants seem to be moderately disadvantaged by economic status compared with their urban native counterparts. Within the urban areas, the child survival status is even worse among the migrant poor than among the average urban poor, especially recent migrants. This poor–non-poor differential in childhood mortality is higher in urban areas than in rural areas. The study findings indicate that rapid growth of the urban population in recent years due to rural-to-urban migration, coupled with higher risk of mortality among migrant’s children, may be considered as one of the major explanations for slower decline in under-five mortality in urban Bangladesh, thus diminishing urban–rural differentials in childhood mortality in Bangladesh. The study demonstrates that housing conditions and access to safe drinking water and hygienic toilet facilities are the most critical determinants of child survival in urban areas, even after controlling for migration status. The findings of the study may have important policy implications for urban planning, highlighting the need to target migrant groups and the urban poor within urban areas in the provision of health care services.


2021 ◽  
Author(s):  
Addisu Assefa ◽  
Ararsa Girma ◽  
Helmut Kloos

Abstract Background: Tuberculosis remains a major global health problem and ranks along with the human immunodeficiency virus (HIV) as a leading cause of mortality worldwide. The aim of this study was to investigate the treatment outcome of tuberculosis, and factors associated with treatment outcome of tuberculosis in TB patients enrolled in Arsi-Robe Hospital, Oromia regional state, South eastern Ethiopia between January 2013 to December 2017. Methods: An Institutional-based retrospective study was conducted in Arsi-Robe Hospital from 2013 to 2017 in study patients who had all forms of TB in DOTS clinic. The predictors of treatment outcomes were analyzed through bivariate and multivariable logistic regression analysis and a P-value < 0.05 were considered statistically significant. Results: Out of the 257 registered TB patients, most of them were males (57.9%), from rural areas (62.6%) and in age of 15-24 category (39.3%). PTB-, PTB+ and EPTB were recorded in 48.2%, 32% and 19.8% of the patients, respectively. Among all cases, 8.6% had TB-HIV co-infection. Among all TB cases, 84.0% had successful treatment outcome. TB patients from urban areas (AOR: 3.34, 95% CI: 1.33­8.38, P = 0.01), with failure treatment (AOR: 6.66, 95% CI = 1.12- 39.57; P = 0.037) and HIV positive (AOR: 4.92, 95% CI = 1.38-17.51; P = 0.014) had higher odd of unsuccessful treatment outcome of tuberculosis. However, TB patients with PTB+ (AOR: 0.1470, 95% CI = 0.031-0.687; P = 0.015) and EPTB (AOR: 0.194, 95% CI = 0.054-0.688; P = 0.011) had significantly lesser odd of unsuccessful treatment outcome. Conclusions: Being urban resident, treatment failure and HIV positive considerably challenge the treatment outcome of tuberculosis, but being PTB+ and EPTB were associated with higher treatment success rate of TB. Continuous follow-up of patients with unsuccessful treatment outcome of tuberculosis with strengthened implementation of the DOTs strategies are suggested. Trial Registered: retrospectively registered


2021 ◽  
Vol 14 (23) ◽  
pp. 34-49
Author(s):  
Chellai Fatih

Abstract Under-five-child mortality remains a major challenge for governments in the Arab world to achieve Sustainable Development Goals. Thus, further studies are needed to analyze the determinants of child mortality. The Multiple Indicators Cluster Surveys (MICS) datasets of six Arab countries (Algeria, Egypt, Iraq, Mauritania, Sudan, and Tunisia) have been used, which are consisting of 249.000 children nested within 54.644 mothers. The study was designed in a women-parity-covered one to six birth order. Binary multivariable logistic models were used to estimate the risk ratios of death by adjusting for child sex, birth outcome (twin vs. singleton), mother’s education level, maternal age, previous birth interval, place of residence (rural vs. urban), and the family wealth index. The findings revealed that the under-five child mortality rates were 87, 70,66,35,36, and 21 per 1000 live births in Sudan, Mauritania, Egypt, Iraq, Algeria, and Tunisia, respectively). First-born infants in these six countries have a higher risk of mortality during their five years of life. Second, third-and fourth-born infants were at a decreased risk of death compared to first-born infants in all countries; in contrast, fifth-and-sixth-born infants were at an increased risk in all countries except Sudan and Mauritania. Twin children have a higher risk of death than singletons in all countries and across all birth orders. Children of mothers with higher educational levels living in urban areas are at lower risk of death than their peers across all birth orders. Regarding policy implications, decision-makers can target three main axes: first, enhancing women’s educational levels; second, increasing birth intervals (birth spacing policies); and third, improving living standards and healthcare strategies, especially in rural areas to improve child and mother health.


PLoS ONE ◽  
2020 ◽  
Vol 15 (9) ◽  
pp. e0235818
Author(s):  
Awoke Keleb ◽  
Tadesse Sisay ◽  
Kassahun Alemu ◽  
Ayechew Ademas ◽  
Mistir Lingerew ◽  
...  

2021 ◽  
Vol 14 ◽  
pp. 117863882110470
Author(s):  
Quraish Sserwanja ◽  
Kassim Kamara ◽  
Linet M Mutisya ◽  
Milton W Musaba ◽  
Shirin Ziaei

Background: Undernutrition accounts for at least 50% of the annual global under-five mortality burden. Although disparities in the childhood stunting between urban and rural areas in Sierra Leone have been documented, information on factors associated with these differences is lacking. We aimed to determine rural-urban correlates of stunting among children under the age of 5 in Sierra Leone. Methods: We analyzed data from 2019 Sierra Leone demographic and health survey (SLDHS) focusing on under-five children. We conducted multivariable logistic regression to examine rural-urban factors associated with childhood stunting. Results: Prevalence of stunting was 31.6% (95% CI 29.8-33.2) in rural areas and 24.0% (95% CI 21.6-26.1) in urban areas. Within the rural areas, children of stunted mothers (aOR = 2.37; 95% CI 1.07-5.24, P < .05), younger mothers aged 15 to 19 years (aOR = 2.08; 95% CI 1.17-3.69, P < .05), uneducated mothers (aOR = 1.87; 95% CI 1.28-2.71, P < .01), as well as older children (24-59 months) (aOR = 1.83; 95% CI 1.48-2.27, P < .001), and boys (aOR = 1.37; 95% CI 1.12-1.66, P < .01) were more likely to be stunted compared to those of non-stunted, older, post-primary education mothers and those who were less than 24 months and girls respectively. While urban children whose fathers had lower education (aOR = 1.94; 95% CI 1.10-3.42, P < .05), whose mothers were more parous (para 2-4) (aOR = 1.74; 95% CI 1.03-2.95, P < .05), and boys (aOR = 1.48; 95% CI 1.06-2.08, P < .05) were more likely to be stunted compared to their counterparts with fathers that had tertiary education, mothers of low parity and girls, respectively. Conclusions: Stunting is more prevalent in the rural areas compared to the urban areas. Sex of the child was the only significant factor in both rural and urban areas. Our study findings suggest that programs designed to reduce stunting should aim for integrated yet context specific interventions in rural and urban areas.


2019 ◽  
Author(s):  
Veneranda M. Bwana ◽  
Edgar Simulundu ◽  
Leonard E.G. Mboera ◽  
Sayoki G. Mfinanga ◽  
Charles Michelo

AbstractBackgroundThere are evidences of the association between socio-economic factors and HIV prevalence in Sub-Saharan Africa. However, there is dearth of information on such relationship in Tanzania. Here, we present data on the relationship between household’s socio-economic factors and HIV prevalence among under five-year children in Muheza district, Tanzania.MethodsWe conducted a facility-based study from June 2015 to June 2016 in which we enrolled under five-year children born to HIV positive mothers. Information on HIV status of the child and socio-demographic characteristic of the head of the household was collected using a structured questionnaire. Data analysis was done using STATA version 13.0.ResultsA total of 576 mothers/guardians were interviewed each with respective HIV exposed under five-year child. Children who belonged to a head of household with at least a high education level (AOR= 0.4, 95% CI 0.2-0.8) and living in a relatively wealthy household (AOR = 0.5, 95% CI 0.2-0.9) was associated with reduced odds of HIV infection among children. Univariate analysis revealed that the odds of HIV infection was three-fold (COR = 2.9, 95% CI 1.2-7.0) higher among children living in rural than in urban areas. The heads of household living in rural areas (AOR=0.3 95% CI 0.1-0.9) had low education level compared to those living in urban areas.ConclusionChildren who belong to the head of households with high educational level, high household wealth were associated with reduced likelihood of HIV infection in Tanzania. Children living in rural areas had increased likelihood of acquiring HIV infection. These findings stress the need to focus on improving education status of the population and economically disadvantaged populations as a strategy for HIV prevention and control measures.


2019 ◽  
Vol 29 (6) ◽  
pp. 686-701 ◽  
Author(s):  
Abraham Geremew ◽  
Bezatu Mengistie ◽  
Jonathan Mellor ◽  
Daniele Susan Lantagne ◽  
Esayas Alemayehu ◽  
...  

2018 ◽  
Vol 28 (3) ◽  
pp. 201-210
Author(s):  
Sri Poedji Hastoety ◽  
Nunik Kusuma Wardhani ◽  
Sihadi Sihadi ◽  
Kencana Sari ◽  
Dwi Siska Kumala Putri ◽  
...  

AbstractMalnutrition has a role not only to increase morbidity and mortality, but also to psychosocial aspects and intellectual development. Three criteria for malnutrition are: underweight, stunting and wasting, reflecting both past and present growth failures. Growth failure in children under five that occur simultaneously is strongly influenced by the socio-economic conditions of the family. This analysis discusses how disparities in malnourished children in Indonesia are seen from the socioeconomic dimensions of the household. The analysis was done by using Riskesdas 2013 data that was processed by using the HEAT (Health Equity Assessment Toolkit) program issued by WHO 2016. From the analysis, the prevalence of underweight, stunting and wasting simultaneously CIAF (Composite Index of Anthropometric Failure) was 2.5%. The lower the economy the higher the prevalence of underfive children experiencing CIAF, under-fives with CIAF mostly live in rural areas compared to CIAF children under five living in urban areas. There are still 15 provinces that have a CIAF prevalence higher than the national figure. CIAF toddlers are more prevalent in mothers with lower level education compared to mothers who have a fairly good level of education. CIAF toddlers occur more common at age over 36 months from the age under 36 months. The provincial dimension gives the highest disparity compared to other dimensions. Abstrak Kurang gizi mempunyai peran tidak hanya terhadap bertambahnya angka kesakitan dan kematian, tetapi juga terganggunya aspek psikososial dan perkembangan intelektual. Tiga kriteria kurang gizi yaitu underweight (berat kurang), stunting (pendek), dan wasting (kurus), mencerminkan kegagalan pertumbuhan baik di masa lalu maupun dimasa kini. Kegagalan pertumbuhan pada balita yang terjadi bersamaan sangat dipengaruhi oleh kondisi sosial ekonomi keluarga. Analisis ini membahas bagaimana disparitas pada anak kurang gizi di Indonesia dilihat dari dimensi sosial ekonomi rumah tangga. Analisis dilakukan dengan menggunakan data Riset Kesehatan Dasar (Riskesdas) 2013 yang diolah dengan menggunakan program Health Equity Assessment Toolkit (HEAT) yang dikeluarkan oleh WHO 2016. Dari analisis yang dilakukan prevalensi balita yang mengalami underweight, stunting, dan wasting secara bersamaan Composite Index of Anthropometric Failure (CIAF) (sebesar 2,5%. Semakin rendah status ekonomi rumah tangga semakin tinggi prevalensi balita mengalami CIAF. Balita dengan CIAF lebih banyak tinggal di perdesaan dibandingkan dengan balita CIAF yang tinggal di perkotaan. Masih ada 15 provinsi yang memiliki prevalensi balita CIAF lebih tinggi dari angka nasional. Balita CIAF lebih banyak terjadi pada ibu dengan tingkat pendidikan rendah dibandingkan dengan ibu yang mempunyai tingkat pendidikan cukup baik. Balita CIAF lebih banyak terjadi pada usia diatas 36 bulan dari pada usia dibawah 36 bulan. Dimensi provinsi memberikan perbedaan disparitas yang paling tinggi dibandingkan dengan dimensi lainnya.


Author(s):  
Younes MOHAMMADI ◽  
Manoochehr KARAMI ◽  
Nasrin DERAKHSHANZADEH

Background: To estimate under-five mortality rate (U5MR), as one of the sustainable development goals, in rural and urban areas of Iran from 1990 to 2015. Methods: We used the data collected through two censuses and one Demographic and Health Surveys (DHS). We analyzed the Summary Birth History (SBH) data via 2 approaches including Maternal Age Cohort (MAC) and Maternal Age Period (MAP) methods, and then, Gaussian Process Regression (GPR) was used to combine the three trends and with 95% uncertainty. Finally, Ratio of U5MR in rural to urban was calculated. Results: At the national level and in urban areas, U5MR in 1990, 2000, 2010, and 2015 was 66, 34, 18, and 13 per 1000 live births, respectively. Corresponding values in rural areas in 1990, 2000, 2010, and 2015 was 129, 64, 31, and 21 per 1000 live births, respectively. Accordingly, the ratio of U5MR in rural to urban at the national level was 1.93, 1.86, 1.72 and 1.63 in the same years. At the sub-national level, U5MR in urban areas ranged from 11.2 per 1000 live births in Isfahan to 18.2 per 1000 live births in Hormuzagn. U5MR in rural areas ranged from 14.1 per 1000 live births in Isfahan to 29.5 per 1000 live births in Sistan and Baluchistan Conclusion: There is still a gap between rural and urban areas, although it has decreased during the 25 years of the study. To alleviate this gap, health system authorities are advised to plan appropriate actions using multisectoral capacities


2021 ◽  
Author(s):  
Gountante Kombate ◽  
Wakpaouyare Gmakouba ◽  
Susana Scott ◽  
Komi Ameko Azianu ◽  
Didier Koumavi Ekouevi ◽  
...  

Abstract Background: Malaria remains one of the main causes of morbidity and death among children less than 5. In Togo, despite intensification of malaria control interventions, persistence in malaria prevalence was observed and appears to vary from one region to another within the country. The aim of this study is to explore further regional heterogeneities in malaria prevalence and to determine associated risk factors.Methods: Data from the cross-sectional survey of the nationally representative 2017 Togo malaria indicator survey was used. Children aged 6–59 months in the selected households were tested for malaria using the rapid diagnostic test (RDT) and the microscopy. Univariate and multivariate logistic regression analysis were preformed using Generalized Linear Models.Results: A total of 3271 children under five (2441 in rural areas and 830 in urban areas was enrolled. Overall 26% of children tested positive for malaria, as confirmed by microscopy, ranging from 5.3% in the Lomé Commune region to 43.6% in the Plateaux region. In multivariate analysis, factors associated with malaria prevalence were living in the Plateaux region (aOR=4.24, 95%CI [2.38-7.65]), and the Maritime region (aOR=2.02, 95%CI [1.13-3.66], compared to Lomé Commune region); age 24 to 35 months (aOR=1.46, 95%CI [1.13-1.88) and age 36 to 59 months (aOR=2.5, 95%CI [2.04-3.09]) ], Compared to those age 6-23 months; households within the richest wealth quintile (a.OR=0.22, 95%CI [0.11-0.41], compared to poorest) and residence in rural areas (aOR=2.02, 95%CI [1.32-3.13], compared to resident in urban). Conclusion: Interventions that targeted use of combined prevention measures, adapted to older children living in rural areas and particularly in the regions of high malaria prevalence, could result in better malaria control in Togo.


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