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ABSTRACT: Introduction: Micronutrient malnutrition remains a huge public health problem, with the main issues lying with the lack of diet diversity, either lack or less of animal products, sparse amount of fruits and vegetables. Fruits are a very good source of vitamins and minerals to help in the growth and development of the child. There are a lot of implementation hurdles at the ground level. Hence there is a need for further exploration of the role of fruits and dietary diversity on the growth and development of the children. Methodology: The study is an interventional study, conducted over 3 months. There was a systematic random sampling performed. A total of 60 participants, were taken out of which 30 were given the intervention. The assessment was conducted through anthropometry and semi-structured questionnaire. Results: When asked about their reluctance to include fruits in their diet, 58.3% did not prioritise it in their daily diet, while the rest found it expensive to buy it. There was a significant difference in the height and MUAC between the groups and that had no influence on the intervention. There was a slight increase in height over the three months in the interventional groups. Conclusion: Malnutrition is not a single-factor disease but happens because of many factors which include, education, income, environment and nutritional awareness among mothers and families. Fruits are a major component in the diet and have to be included by the family for the children to improve their basic anthropometry and also more functions. [ABSTRACT FROM AUTHOR]

Introduction: Micronutrient malnutrition remains a huge public health problem, with the main issues lying with the lack of diet diversity, either lack or less of animal products, sparse amount of fruits and vegetables. Fruits are a very good source of vitamins and minerals to help in the growth and development of the child. There are a lot of implementation hurdles at the ground level. Hence there is a need for further exploration of the role of fruits and dietary diversity on the growth and development of the children. Methodology: The study is an interventional study, conducted over 3 months. There was a systematic random sampling performed. A total of 60 participants, were taken out of which 30 were given the intervention. The assessment was conducted through anthropometry and semi-structured questionnaire. Results: When asked about their reluctance to include fruits in their diet, 58.3% did not prioritise it in their daily diet, while the rest found it expensive to buy it. There was a significant difference in the height and MUAC between the groups and that had no influence on the intervention. There was a slight increase in height over the three months in the interventional groups. Conclusion: Malnutrition is not a single-factor disease but happens because of many factors which include, education, income, environment and nutritional awareness among mothers and families. Fruits are a major component in the diet and have to be included by the family for the children to improve their basic anthropometry and also more functions.

Context: Smartphones have revolutionized, and become an integral part of a child’s life. The child’s interaction with these modern devices needs to be assessed because it could have an enormous effect on their behavior, sleep habits, and psychological addiction. Aims: The aim of this study is to determine the pattern of exposure to smartphone, and the association between the exposure and behavioral, functional changes among under-five children in rural Puducherry. Settings and Design: This community-based cross-sectional study was done in the field practice area of a private medical college in Puducherry. A multistage sampling technique was used to select 340 eligible participants. Subjects and Methods: A semi-structured questionnaire was used to assess the pattern of exposure and physical, social, and behavioral changes among study participants. Statistical Analysis Used: The data were analyzed using SPSS software, and P < 0.05 was considered statistically significant. Results: Among 340 children, more than half of participants 180 (52.9%) were female. Interestingly, around half of the study participants’ parents 181 (53.2%) accepted that their children were exposed to smartphone for entertainment purposes, and around one-tenth 35 (10.3%) of the participants viewed screen for more than the recommended screen time for age. Increased smartphone exposure was statistically associated with behavioral and functional changes. Conclusions: Measures must be undertaken to prevent deleterious behavioral and functional changes in under-five children due to excessive smartphone usage. Health education sessions and social behavioral change communication should be planned for the parents to protect the budding generation from the negative effects of smartphone usage.

BackgroundWasting, stunting, and underweight in children are complex health challenges shaped by a combination of immediate, underlying, and systemic factors. Even though copious data demonstrates that the causation routes for stunting and wasting are similar, little is known about the correlations between the diseases in low- and middle-income nations.ObjectiveThe objective of this study is to evaluate the factors that concurrently affect wasting, stunting, and underweight in

Context: Smartphones have revolutionized, and become an integral part of a child's life. The child's interaction with these modern devices needs to be assessed because it could have an enormous effect on their behavior, sleep habits, and psychological addiction. Aims: The aim of this study is to determine the pattern of exposure to smartphone, and the association between the exposure and behavioral, functional changes among under-five children in rural Puducherry. Settings and Design: This community-based cross-sectional study was done in the field practice area of a private medical college in Puducherry. A multistage sampling technique was used to select 340 eligible participants. Subjects and Methods: A semi-structured questionnaire was used to assess the pattern of exposure and physical, social, and behavioral changes among study participants. Statistical Analysis Used: The data were analyzed using SPSS software, and P < 0.05 was considered statistically significant. Results: Among 340 children, more than half of participants 180 (52.9%) were female. Interestingly, around half of the study participants' parents 181 (53.2%) accepted that their children were exposed to smartphone for entertainment purposes, and around one-tenth 35 (10.3%) of the participants viewed screen for more than the recommended screen time for age. Increased smartphone exposure was statistically associated with behavioral and functional changes. Conclusions: Measures must be undertaken to prevent deleterious behavioral and functional changes in under-five children due to excessive smartphone usage. Health education sessions and social behavioral change communication should be planned for the parents to protect the budding generation from the negative effects of smartphone usage. [ABSTRACT FROM AUTHOR]

BackgroundAcute respiratory infection is an infectious illness caused by acute viral or bacterial infection. According to a 2018 WHO report, exposures to indoor and ambient air environmental pollution were contributing factors to a higher risk of respiratory problems following 7 million deaths of children under five globally. Housing conditions such as wall material, roof type, kitchen location, sanitation condition, and cooking fuel type are household-level predictors of acute respiratory disease among children under five years of age.MethodThis research used EDHS-2016 secondary data, which are nationally representative. The data collection period was from January 18, 2016, to June 27, 2016. Among the 16,650 total surveys, 10,006 households that had children below 5 years of age. The outcome variable for this study was acute respiratory infection symptoms. Analyses were performed using STATA Version 17.1. The data were weighted before performing analysis to reinstate the representativeness of the sample. In the bivariable analysis, a p value

Background: Children are the most important assets to any country; their physical, mental, and emotional developments are crucial for future as they become citizens. Mothers' knowledge on nutrition for kids plays a vital role in the health of the children. Regular interventions as counseling or discussions with the mothers will be an effective tool to counter under nutrition, malnutrition, and also micronutrient deficiencies. Our objective was to assess the effectiveness of nutritional awareness in child diet among the mothers of under five in anganwadis in Mysuru with pre- and post-awareness. Materials and Methods: It is a quasi-experimental study for a duration of 3 months. The sample size was 35, with convenient sampling, and the data were collected using a semi-structured, validated questionnaire from mothers whose children are enrolled in anganwadis. The data were analyzed using mean, Chi-square/ Fischer test using SPSS version 22. Results: The mean score before and after awareness was 6.26 ± 0.701, and the post score was 6.83 ± 0.618. There was a significant association between birth order of the child enrolled and the post-awareness grades. There was also a statistical significance between mean scores of pre- and post-awareness. Conclusion: We can conclude from the above study that regular and objectified communication with the mothers is an effective strategy for the improvement of their awareness regarding child nutrition. [ABSTRACT FROM AUTHOR]

Background: Undernutrition in under-five children still remains a major public health problem. Most of the under-five deaths are due to undernutrition, putting the child at more risk of catching common infections. The contributing factors for undernutrition may differ from one region to another. Aim: The aim of this study was to study undernutrition in rural under-fives. Settings and Design: A cross-sectional study was carried out. The study included 307 under-five children from a rural area of western Maharashtra. Information was collected on pretested semi-structured questionnaire after taking informed consent. The anthropological measurements were taken by standard methods. The statistical tests were performed and 5% level significance was taken for analysis. Statistical Analysis Used: Data were analyzed using software: WHO Anthro3.2.2, SPSS 26, and Epi Info v7.2.4.0. Results: More than half of the under-five children (56.3%) were found to be undernourished. The prevalence of underweight, stunting, and wasting was found to be 33.5%, 35.5%, and 12.4%, respectively. Logistic regression performed showed prelacteal feed, colostrum, BPL cardholder status, and per capita income to be significantly associated with undernutrition. Conclusions: Undernutrition still persists to be a major public health concern in rural areas. Most of the determinants of undernutrition are modifiable. The preventive and remedial measures should be an ongoing process to combat this problem.

Background: Undernutrition in under-five children still remains a major public health problem. Most of the under-five deaths are due to undernutrition, putting the child at more risk of catching common infections. The contributing factors for undernutrition may differ from one region to another. Aim: The aim of this study was to study undernutrition in rural under-fives. Settings and Design: A cross-sectional study was carried out. The study included 307 under-five children from a rural area of western Maharashtra. Information was collected on pretested semi-structured questionnaire after taking informed consent. The anthropological measurements were taken by standard methods. The statistical tests were performed and 5% level significance was taken for analysis. Statistical Analysis Used: Data were analyzed using software: WHO Anthro3.2.2, SPSS 26, and Epi Info v7.2.4.0. Results: More than half of the under-five children (56.3%) were found to be undernourished. The prevalence of underweight, stunting, and wasting was found to be 33.5%, 35.5%, and 12.4%, respectively. Logistic regression performed showed prelacteal feed, colostrum, BPL cardholder status, and per capita income to be significantly associated with undernutrition. Conclusions: Undernutrition still persists to be a major public health concern in rural areas. Most of the determinants of undernutrition are modifiable. The preventive and remedial measures should be an ongoing process to combat this problem. [ABSTRACT FROM AUTHOR]

This is a cross-sectional descriptive study conducted in the River Nile State, Sudan; known with increasing morbidity of Measles. The objective is assess Measles vaccination and possibly other factors leading to abnormal high level of cases. A community-based cross-sectional, descriptive study using a questionnaire was designed to collect data, a sample of 183 was collected, vaccination cards were viewed to obtain information about vaccination status directors of Epidemiology and Immunization departments in the state was interviewed to collect data regarding Measles vaccination coverage and cases reports. The study clarified that, according to the state reports Measles vaccination coverage in children under five years old was 92% of the targeted population. While only 73.8% of the study group was vaccinated by the routine immunization system, the availability of measles vaccination service at the centers was 98.4%.78.7% of vaccination services were provided by static centers. Barriers discovered were suboptimal access to measles immunization represented in distant health center 19.7% (more than 5 km), on foot access to center 44.3%, rejection of vaccination from mothers7%). study recommended increasing the number of static and sub-centers, activating the health education programs to raise awareness, using simple attractive message to educate the public about the disease, and the importance of vaccination and encouraging mothers to vaccinate their children. [ABSTRACT FROM AUTHOR]

Abstract Background Malaria is widespread in Ethiopia and has been a major cause of illness and death in that country. Therefore, Ethiopia has been exerting enormous efforts towards eliminating malaria by 2030. In the context of comprehensive malaria control, the malaria vaccine is used for the prevention of Plasmodium falciparum malaria in children living in regions with moderate- to-high malaria transmission. Methods A community-based cross-sectional study was conducted among caregivers of children under the age of five throughout the months of September 2021. A structured interviewer-administered questionnaire was designed for data collection, and binary logistic regression analysis was used. The final result of the association was determined based on an adjusted odds ratio (AOR) at a 95% confidence interval (CI) level, and p

Abstract Background The trio of commonest illnesses and causes mortality among children under five (Malaria, Pneumonia and Diarrhea) are easily treatable through timely exposure to cost effective interventions at the community level. Patent and proprietary medicine vendors (PPMVs) are a leading source of care for illnesses among under-five children in Nigeria. This study was designed to explore child health services offering, particularly commodity stocking patterns and case management knowledge for common childhood illnesses among PPMVs in Ebonyi and Kaduna States. Methods A descriptive cross-sectional study was conducted among PPMVs in four local government areas across Ebonyi and Kaduna States. Data was collected using semi-structured interviewer-administered questionnaires. Information was obtained on medicine and supplies, knowledge of common childhood illnesses management and referral practices. Results A total of 374 PPMVs were interviewed; the mean age was 33.7 ± 9.8 years. Among the 132 health trained respondents, 59.0% offer treatment services for sick children while 83.5% of the non-health trained respondents offer the same service. At least, 88.0% of the respondents keep stock ACTs, Amoxycilin DT, ORS and Zinc. About 38.5% reported stock-out of ACTs in the month preceding the study, 55.1% reported stock out lasting only 0 to 6 days. Only 83 (22.2%) of respondents knew the correct diagnosis of fast breathing among children aged 2 to less than 12 months old. Education and health training background were associated with a good knowledge of common childhood illnesses management (X2 = 44.88, p

Background: Anemia is a major global public health public health problem in the early stages of childhood, particularly in developing countries. In Africa, anemia causes higher morbidity and mortality among children less than five years old, especially in Ethiopia. Objective: This study aimed to assess the prevalence of anemia and its associated factors among children under five years old attending Bule Hora General Hospital, West Guji Zone, southern Ethiopia. Methods: A hospital-based quantitative cross-sectional study was conducted at Bule Hora General Hospital, Southern Ethiopia from October to November 2020. A convenience sampling technique was used to include 375 under five children enrolled in the study. The pretested structure questionnaire was used to collect socioeconomic and demographic characteristics of study individuals after taking appropriate written informed consent. Then, a venous blood sample was collected from each child and analyzed for hemoglobin determination using a Cell-DYN 1800 machine. Binary logistic regression models were used to identify associated factors of anemia. A P value ≤ 0.05 was considered statistically significant. Results: The overall prevalence of anemia among under five children was 13.2% (50) [95% CI=5.2– 21.2%] of them anemic children, 11.1% (1) had mild anemia, and 33.3% (3) had moderate anemia and 55.6% (5) had severe anemia. In this study, anemia was significantly associated with recent intestinal protozoan infection [AOR=2.13, 95% CI=1.35– 9.270], malaria infection [AOR=5.42, 95% CI=0.307– 11.034] and soil-transmitted helminths infection [AOR=6.09, 95% CI=2.047– 27.54]. Conclusion: Anemia among under five children in this study was found to be a mild public health problem. It could be managed by preventing malaria infection, intestinal protozoa and soil-transmitted helminthic infection. [ABSTRACT FROM AUTHOR]

Background: Malaria is widespread in Ethiopia and has been a major cause of illness and death in that country. Therefore, Ethiopia has been exerting enormous efforts towards eliminating malaria by 2030. In the context of comprehensive malaria control, the malaria vaccine is used for the prevention of Plasmodium falciparum malaria in children living in regions with moderate- to-high malaria transmission. Methods: A community-based cross-sectional study was conducted among caregivers of children under the age of five throughout the months of September 2021. A structured interviewer-administered questionnaire was designed for data collection, and binary logistic regression analysis was used. The final result of the association was determined based on an adjusted odds ratio (AOR) at a 95% confidence interval (CI) level, and p < 0.05 indicated statistical significance. Results: A total of 406 caregivers of children under the age of 5 were interviewed. Overall, 131 (32.3%) respondents were willing to vaccinate their children. Marital status (AOR = 1.243; 95% CI 1.021–3.897), knowledge (AOR = 3.120; 95% CI 1.689–5.027), and previous experience with childhood vaccination (AOR = 2.673; 95% CI 1.759–4.101) were found to be significantly associated with willingness to accept a malaria vaccine for their children, at p < 0.05. Conclusions and recommendations: The willingness to accept a malaria vaccine for children among caregivers of children under the age of five was low in the study area. Thus, health education and communication are crucial for alleviating poor knowledge about malaria vaccines. [ABSTRACT FROM AUTHOR]

Underweight is the most dependable growth indicator for overall child growth. Tanzania has the highest rate of underweight children in East Africa, with 1.27 million children under the age of five suffering from the condition. This study aimed to determine factors that influence underweight in Tanzanian children aged 0–23 months. We used data from the Tanzania Demographic and Health Survey (TDHS) 2015–2016 to conduct secondary analysis on a sample of 4,327 children aged 0–23 months. Descriptive and inferential statistics such as frequency, chi‐square, binary, and multivariate logistic regression were performed using the Statistical Package of Social Science (SPSS version 25). Statistical significance was defined as a p‐value of less than 0.05. Multivariate analysis found risk factors for underweight children were as follows: child's gender, age, birth weight, mothers' BMI, level of education, and type of toilet facility used by the households. Females had a significantly lower risk of being underweight (AOR = 0.62, 95% CI = 0.48–0.81, p <.05) compared with male children. The odds of being underweight increase with low birth weight (AOR = 2.92, 95% CI = 1.92–4.43, p <.05), low mother's BMI (AOR = 2.48, 95% CI = 1.34–4.58, p <.05), and low educational level (AOR = 1.78, 95% CI = 1.23–2.58, p <.05). Nutrition interventions such as growth monitoring, nutrition counseling, and nutrition education for parents/caregivers are critical to ensuring proper weight gain for all children under 2 years of age. [ABSTRACT FROM AUTHOR]

Introduction: There is a growing body of evidence against using World Health Organization (WHO) charts for developing nations. Our objectives were: 1) To compare nutritional status of -0.5 (clinically significant), whereas on WHO charts all wealth classes had WHZ

Objectives: A study was undertaken to assess the prevalence of undernutrition and associated factors among children under five in two drought-prone areas in Ethiopia. Study design and setting: Through a cross-sectional, mixed-methods approach, data were analysed using multistage random sampling methods. Study subjects and outcome measures: Data were collected on socioeconomic factors, demographic characteristics and anthropometric measurements from 350 households. Height-for-age (HAZ), weight-for-height (WHZ) and weight-for-age (WAZ) z-scores of 304 children, aged 0–60 months, were calculated using the WHO Anthro software. Children with z-scores of less than −2 standard deviations (SDs) for HAZ, WHZ and WAZ were classified as stunted, wasted and underweight respectively. Descriptive statistics, t-tests, correlation and regression analyses were used to assess the relationships between independent variables and stunting and underweight. Results: Prevalence of stunting, wasting and underweight were 49.4%, 13.7% and 37.1% respectively. Among independent variables tested, agroecology was significantly associated with stunting (p = 0.012) and underweight (p

Vaccination coverage in India has improved from 44% to 62%, an increase of 19% over a span of 10 y (2006–2016), the inequity continues among the vulnerable people belonging to tribal groups and migrant population. In order to leave no one behind strategy, their vaccination coverage, reasons for low coverage were analyzed from available literary sources through this review article. A systematic search for relevant articles was conducted and articles published in various journals over the past 5 y were included. The vaccine coverage among the vulnerable population ranged from 31% to 89% from various studies. It was found that parents’ education status, income of the family and lack of awareness of the schedule were the most important reasons for vaccine hesitancy. Introduction of cash assistance integrated into other national program, digitalizing vaccination cards, involvement of local healers are few strategies suggested in this article.

Children mortality rates describe the health services’ quality as indicators of each countries’ welfare, particularly in Indonesia. Several factors were determined as the main contributors of mortality, such as neonatal factors, maternal, environment and health services. The important of this research is to give recommendation to the government of Indonesia to propose some policies in handling of the increasing children mortality and modifying underlying disease as contributor mortality among children in Indonesia. The design of this study is cross sectional. The data was taken from World Health Organization Maternal Child Epidemiology Estimation from 2000 to 2017. There were three main categories : neonatal mortality rate (NND), post neonatal mortality rate (PND) and under five mortality rate (UFIVE). The leading causes of mortality were searched according to those categories and followed by descriptive analysis by line graphs. According to the data that had been found, there was declining on NND (102.700 to 60.986), PND (138.553 to 63.471), UFIVE (241.253 to 124.457). The children mortality tend to decline at the range of 17 years, meanwhile the highest mortality among the three of groups are : premature birth in neonates, ARI in post neonates and premature birth in under five children. In conclusion, the trend of three parameters of children mortality declined within 17 years. On several cases, there were outbreak of injury on 2004 and fluctuation of measles incident among infant and under five children. Premature birth and ARI have the highest prevalence among children in Indonesia.

Abstract Background Stunting, which describes a small height for one’s age, is an indicator of chronic malnutrition. It develops mainly as a result of prolonged food deprivation or a chronic disease or illness. Unintended pregnancies and unplanned births are among the psychological factors that negatively affect the nutritional status of children. Therefore, this study aimed to determine the effects of unintended pregnancies and other family and child characteristics on the nutritional status of children under 5 years old. Methods A community-based unmatched case-control study was conducted among 302 children (151 cases and 151 controls) 6–59 months old in Wonago town, Gedeo Zone, Southern Ethiopia. The cases were stunted children and the controls were non-stunted children in the study area. The cases were randomly selected from among the stunted children, and the controls were randomly selected from among the non-stunted children. The descriptive characteristics of the respondents were compared using the chi-squared test, and a multivariable logistic regression was used to assess the effects of an unintended pregnancy on stunting, after controlling for the other variables, with a p value of 0.05. Results The result revealed that unintended pregnancy is found to be among predictors of stunting where children from unintended pregnancy were about three times more likely to be stunted [AOR: 2.62, CI: (1.26, 5.45)]. The other predictors identified in this study were educational status of the father, wealth index of the household and daily meal frequency. From the finding, children from illiterate fathers [AOR: 3.43, CI: (1.04, 11.29)], children from poorer household economic status [AOR: 2.32, CI: (1.20, 4.49)] and children whom their daily meal frequency is below the recommended number of feeding [AOR: 4.50, CI: (1.31, 15.49)] were found to be more stunted. Conclusions Based on the results of this study, the children born from unintended pregnancies exhibited a significantly higher risk of stunting. Therefore, preventing unintended pregnancy could play a great role in decreasing the risk of stunting in children.

Mid-upper arm circumference (MUAC) is simple to use and inexpensive in Ethiopia; both MUAC and target weight are employed, although the time to cure for MUAC is not indicated. The present study is aimed to determine cure time of MUAC for children in outpatient therapeutic program. A prospective cohort study was conducted among 414 severe acute malnourished under-five children admitted to selected health twenty-two posts from 1 February to 30 July 2021, in Oromia, Ethiopia. Data were coded, entered to Ep-data version 4.2 software, and transferred to SPSS for windows version 25 software for analysis. The Multivariate Cox Proportional Hazards model was used to fit independent determinants of time to cure. All tests were two-sided and statistical implications at P-values < 0⋅05. In the present study, the minimum week for a cure was 4 weeks, the maximum was 16 weeks and the overall time to cure severe acute malnutrition as measured by MUAC is judged to be 10 at 95 % CI (9⋅65–10⋅35). Families with six or more members are 2⋅16 times more at risk, children from homes with the lowest wealth index are at 1⋅4 times more risk, and children from food insecure families were 2⋅61 times more likely to require long-term treatment for MUAC. In the present study, the time to cure severe acute malnutrition by MUAC is determined as 10 weeks. Moreover, family size, low wealth index, and household food insecurity were risks to delay in cure time MUAC.

Background: Diarrhea remains the main cause of morbidity and mortality in children under 5 years old, accounting for nearly-two million deaths per year globally. Mothers play a significant role in prevention and management of diarrhea related diseases. Aim: The study aimed at assessing the knowledge and practice of mothers on home management of diarrhea in under five children at Ruli health centre in Gakenke district, Rwanda. Methodology: A quantitative non-experimental descriptive cross-sectional design was conducted from April to May 2019. Using simple random sampling, a sample of 160 mothers were selected. Data was collected using a structured interview schedule. Descriptive statistics were used to describe demographics, knowledge, and practice of mothers. Inferential statistics of chi squared, and correlational coefficient (r) were used in identification of significant associations and relationships between demographic factors, mother’s knowledge, and practices. Results: Poor knowledge and practices were found in 55.6 % and 52.5 % of mothers, respectively. The diarrhea treatment methods utilized included: using sweetened tea, fruits, drinks, or coffee (76 %), homemade fluids (48.1 %), breast milk, rice drained or clean water and porridge (45 %). Additionally, 31.9 % did not even wash utensils or foods and fruits. Knowledge was significantly associated with both age (p = 0.035); and wealth status (p = 0.033) whilst practice with age (p = 0.002) and a child’s caretaker (p = 0.040). There was a strong significant positive linear correlation between practice and knowledge (r = 0.755; p = 0.0001). Conclusion: The mother’s knowledge and practice regarding home management of diarrhea was poor. There is need to implement health policy and intensify effective health education approach on home management of diarrhea among mothers with children under 5 years old.

Background: Acute respiratory infection is an infectious illness caused by acute viral or bacterial infection. According to a 2018 WHO report, exposures to indoor and ambient air environmental pollution were contributing factors to a higher risk of respiratory problems following 7 million deaths of children under five globally. Housing conditions such as wall material, roof type, kitchen location, sanitation condition, and cooking fuel type are household-level predictors of acute respiratory disease among children under five years of age., Method: This research used EDHS-2016 secondary data, which are nationally representative. The data collection period was from January 18, 2016, to June 27, 2016. Among the 16,650 total surveys, 10,006 households that had children below 5 years of age. The outcome variable for this study was acute respiratory infection symptoms. Analyses were performed using STATA Version 17.1. The data were weighted before performing analysis to reinstate the representativeness of the sample. In the bivariable analysis, a p value <0.2 was used to screen for multivariable. Multicollinearity was checked using the variance inflation factor. Then, a multilevel multivariable regression model was used in this study for the analysis of acute respiratory infection symptoms and possible predictor variables. Variables with a p value <0.05 in multivariable regression analysis were considered statistically significant predictors., Results: Most (95.00%) households commonly used solid fuel for cooking, and household main construction materials: 81.44 and 91.03% of floors and walls of households were constructed with unprocessed natural materials, respectively. The prevalence of acute respiratory infection symptoms among children under five years of age was 7.955% (7.397, 8.551%). The findings indicated that acute respiratory infection symptoms among children under five years of age were significantly linked with the age of the children, diarrhea status, residence, region, fuel type, stool disposal, wall material, and floor material., Conclusion: Interventions should target modifiable factors such as proper stool disposal of the youngest child, informing the health effects of poor housing conditions such as improving wall and floor construction material to reduce acute respiratory infection symptoms among children under five years of age., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Azanaw, Weldegebriel and Malede.)

Abstract Background Stunting is an indicator of the devastating result of malnutrition in early childhood. The effects of childhood stunting are irreparable physical and cognitive harm. It is an issue of the great public health importance throughout Sub-Saharan African countries including Ethiopia. Therefore, identification of the risk factors of child stunting from recent data is very important for timely intervention. Methods The 2016 Ethiopian Demographic and Health Survey data were used for this study. A generalized linear mixed model which is an extension of the general linear model was employed to identify socioeconomic, demographic, environmental and health related risk factors for stunted under-five children. Results The result shows that the age and sex of the child, preceding birth interval, mother’s body mass index, household wealth index, mother’s education level, breastfeeding period, type of toilet facility, use of internet and source of drinking water were the major determinants of stunting of under-five children in Ethiopia. Conclusion The study indicated that children from undernourished mothers, who are not breastfeeding, from poor households, households that have no toilet facilities, who are male, older age (between 12 to 59 months), who have illiterate mother and short birth spacing were associated with stunting problems. Therefore, family planning education and policy is required for the country to improve on under-five age stunting problems.

Background: Underweight is a key indicator of malnutrition in children and results in long term effects such as abnormalities in physical and mental health, behavioural problems, and low educational achievement. Objective: Using the conceptual framework for child malnutrition by the United Nations Children's Fund, we examined the predictors of underweight in children under five years in Ghana. Methods: This cross-sectional study made use of data from the 2014 Ghana Demographic and Health Survey. A total of 2720 children were included in the analysis. Descriptive and inferential statistics comprising frequency, percentage, chi-square, and binary logistic regression were used in analysing the data. Results: The prevalence of underweight was 11%. Age, wealth status, mother’s education, region, ethnicity, household toilet facility, the source of drinking water, the incidence of diarrhoea, and subscription to health insurance significantly predicted underweight in the children. The risk of being underweight was higher in females than males (OR=1.04, 95% CI=0.81–1.34). This was, however, not statistically significant. The probability of being underweight also declined significantly with mother’s level of education. Conclusion: Our findings underscore the need for the Ghana Health Service and other health sector stakeholders to apportion interventions with a focus on improving complementary feeding, poverty alleviation, and health status of children. Funding: No funding was received for the study Keywords: malnutrition, underweight, predictors, children, under five, Ghana

Introduction: There is a growing body of evidence against using World Health Organization (WHO) charts for developing nations. Our objectives were: 1) To compare nutritional status of <5-year-old Indian children using WHO charts and synthetic Indian charts (SC) 2019. 2) To study nutritional status across wealth index categories. 3) To study nutritional status of predominantly breast-fed infants <6 months of age using both charts. Materials and Methods: Data from 4th National Family Health Survey (n ~ 236117, 0-59-month-old children) were used for assessing nutritional status using the WHO charts and SC. Z-scores were calculated for length/height, weight, and weight-for-height (WAZ) using both charts. Children were classified into degrees of malnutrition using appropriate cutoffs. Results: Stunting, wasting, and underweight were significantly higher using WHO charts. The prevalence of stunting (height for age) and wasting (WHZ) changed from high to medium and critical to poor when the reference changed from WHO to SC. All Z-scores showed an improving trend with increasing wealth index. On SC, almost all WHZ (wasting) from the richest to poorer were >-0.5 (clinically significant), whereas on WHO charts all wealth classes had WHZ <-0.5. For children under the age of 6 months, WHZ from richest to poorest was between -0.97 and -0.89 by WHO and 0.27 and 0.38 by SC. Conclusions: Use of Indian synthetic growth charts for growth monitoring of under-five children may be more appropriate; infants under 6 months and children from well off families performed well on these charts. [ABSTRACT FROM AUTHOR]

Multimorbidity of malaria, anemia, and malnutrition (MAMM) is a condition in which an individual has two or more of these health conditions, and is becoming an emergent public health concern in sub-Saharan African countries. The independent associations of a child's demographic variables and household socioeconomic (HSE) disparities with a child's health outcomes have been established in the literature. However, the effects of the intersection of these factors on MAMM, while accounting for other covariates, have not been studied. Therefore, this study aimed to determine how children's sex, age, and household socioeconomic status interact to explain the variations in MAMM among children aged 6-59 months in Nigeria. Data from the 2018 Nigeria Demographic and Health Survey and the 2018 National Human Development Report (NHDR) were used. This study included weighted samples of 10,184 children aged 6-59 months in Nigeria. A three-level multilevel mixed effect ordinal logistic regression model was used, such that individual characteristics at level 1 were nested in communities at level 2 and nested in states at level 3. Subsequently, predictive probability charts and average adjusted probability tables were used to interpret the intersectional effects. Five models were created in this scenario. Model 1 is the interaction between the child's sex and household wealth status; model 2 is the interaction between the child's sex and age; model 3 is the interaction between the child's age and household wealth status; model 4 has the three two-way interactions of the child's sex, age, and household wealth status; and model 5 includes model 4 and the three-way interactions between a child's sex, age, and household wealth quintiles; while accounting for other covariates in each of the models. The prevalence of children with a 'none of the three diseases' outcome was 17.3% (1767/10,184), while 34.4% (3499/10,184) had 'only one of the diseases', and 48.3% (4918/10,184) had 'two or more' MAMMs. However, in the multivariate analyses, model 3 was the best fit compared with other models, so the two-way interaction effects of a child's age and household wealth status are significant predictors in the model. Children aged 36-47 months living in the poorest households had a probability of 0.11, 0.18, and 0.32 of existing with MAMM above the probability of children of the same age who live in the middle class, more prosperous, and richest households, respectively, while all other covariates were held constant. Thus, the variation in the prevalence of MAMM in children of different ages differs depending on the household wealth quintile. In other words, in older children, the variations in MAMM become more evident between the richer and the poorer household quintiles. Therefore, it is recommended that policies that are geared toward economic redistribution will help bridge the disparities observed in the prevalence of multiple diseases among children aged 6-59 months in Nigeria.

Current recommendations within integrated community case management (iCCM) programmes advise community health workers (CHWs) to refer cases of chest indrawing pneumonia to health facilities for treatment, but many children die due to delays or non-compliance with referral advice. Recent revision of World Health Organization (WHO) pneumonia guidelines and integrated management of childhood illness chart booklet recommend oral amoxicillin for treatment of lower chest indrawing (LCI) pneumonia on an outpatient basis. However, these guidelines did not recommend its use by CHWs as part of iCCM, due to insufficient evidence regarding safety. We present a protocol for a one-arm safety intervention study aimed at increasing access to treatment of pneumonia by training CHWs, locally referred to as Community Oriented Resource Persons (CORPs) in Nigeria. The primary objective was to assess if CORPs could safely and appropriately manage LCI pneumonia in 2–59 month old children, and refer children with danger signs. The primary outcomes were the proportion of children 2–59 months with LCI pneumonia who were managed appropriately by CORPs and the clinical treatment failure within 6 days of LCI pneumonia. Secondary outcomes included proportion of children with LCI followed up by CORPs on day 3; caregiver adherence to treatment for chest indrawing, acceptability and satisfaction of both CORP and caregivers on the mode of treatment, including caregiver adherence to treatment; and clinical relapse of pneumonia between day 7 to 14 among children whose signs of pneumonia disappeared by day 6. Approximately 308 children 2–59 months of age with LCI pneumonia would be needed for this safety intervention study.

Introduction: Nearly half of all deaths in children under 5 are attributable to under nutrition; under nutrition increases morbidity and delays recovery. Objective: To investigate age and gender variations in height and weight, levels of stunting, underweight and wasting among children under 5 years in Surat city. Methodology: Levels of stunting, underweight and wasting among 970 children of urban Surat from 20 Anganwadi centers were assessed. Z-scores were used to assess the prevalence of malnutrition following the WHO Guidelines. Results: Results revealed that as age increased, the mean weight and height also increased. However, even the prevalence of malnutrition increased. Older children met lower percentages of the standards than younger children. The overall (age and sex combined) rates of stunting, underweight and wasting were 39.27%, 38.14% and 20.41%, respectively. The rates of underweight and wasting were significantly higher among boys (underweight = 38.73 %, wasting = 22.31 %) compared with girls (underweight = 37.57%, wasting = 18.78 %). Conclusion: The nutritional status of the subjects of the present study is not satisfactory, there is a scope for improvement in the form of enhanced supplementary nutrition. Therefore, it is imperative that the ICDS authorities consider its enhancement.

Background: Rotavirus diarrhea is often referred as “winter diarrheal disease” as it causes nearly 50% of the pediatric hospitalizations during winter season. This study was done with the objective of bringing out the epidemiological nexus of rotavirus cases with different seasonal parameters like maximum, minimum temperature, humidity, and average rainfall.Methods: This prospective observational study was conducted in a tertiary care teaching hospital of Eastern India from February 2016 to December 2018. Data on daily maximum and minimum temperature, relative humidity, and rainfall were collected.Result: Of 964 children admitted, 768 stool samples were collected for rotavirus assay. A total of 222 children (29%) were positive. The maximum, minimum temperature, average rainfall, and average humidity of 83.4 mm, 79.2%, 28.1, and 21.9, respectively, were significantly associated with positive rotaviral cases.Conclusions: The incidence of rotavirus positivity cases was found to be inversely associated with average temperature, humidity, and rainfall. The knowledge about the seasonal pattern in a particular geographical area would help in the reallocation of hospital services (staff and bed) to tackle the epidemic or emergency situations resulting from clustering of cases.

Abstract Background More than one in every ten (14%) of under-five child deaths is associated with diarrheal morbidity in Ethiopia. Although Ethiopia has implemented different health interventions like its immunization program, childhood diarrhea morbidity, on which literature is limited, continues as a public health problem. Hence, the aim of this study was to assess the prevalence of diarrheal morbidity and associated factors among under-five children in Bahir Dar, northwest Ethiopia. Method A community based cross-sectional study was carried out from March 05 to April 03/2015 in Bahir Dar in which 553 mother-child pairs participated. A structured questionnaire was adapted from the World Health Organization (WHO) and the Ethiopian Demography and Health Survey (EDHS) to collect the data. Bivariate and multivariate logistic regression analyses were carried out to identify the independent predictors of diarrheal morbidity. Result The overall prevalence of diarrheal morbidity was 9.4% [95% Confidence Interval (CI): 4.8, 14.0%]. No receipt of Rotavirus vaccine dose 2 [AOR = 3.96, 95%CI; 2.13, 7.33], non-exclusive breastfeeding [AOR = 2.69, 95%CI; 1.39, 5.19], unavailability of solid waste disposal system [AOR = 2.62, 95%CI; 1.19, 5.77], employed and private business occupational status of mothers [AOR = 2.10, 95%CI; 1.02, 4.31)], and less than Ethiopia Birr (ETB) 600 household monthly income [AOR = 2.10, 95% CI; 1.2, 7.2] were independently associated with diarrheal morbidity. Conclusion In Bahir Dar, one in every ten of the under-five children surveyed suffered from diarrheal morbidity. Thus, implementing effective rotavirus vaccination programs, encouraging exclusive breastfeeding and emphasizing appropriate solid waste management would reduce childhood diarrheal morbidity in the region. In addition, the finding suggests that improved child care mechanisms, especially for mothers working outside the home, and efforts to increase household income should be intensified to reduce incidence of diarrhea.

Objectives: A study was undertaken to assess the prevalence of undernutrition and associated factors among children under five in two drought-prone areas in Ethiopia. Study design and setting: Through a cross-sectional, mixed-methods approach, data were analysed using multistage random sampling methods. Study subjects and outcome measures: Data were collected on socioeconomic factors, demographic characteristics and anthropometric measurements from 350 households. Height-for-age (HAZ), weight-for-height (WHZ) and weight-for-age (WAZ) z-scores of 304 children, aged 0–60 months, were calculated using the WHO Anthro software. Children with z-scores of less than −2 standard deviations (SDs) for HAZ, WHZ and WAZ were classified as stunted, wasted and underweight respectively. Descriptive statistics, t-tests, correlation and regression analyses were used to assess the relationships between independent variables and stunting and underweight. Results: Prevalence of stunting, wasting and underweight were 49.4%, 13.7% and 37.1% respectively. Among independent variables tested, agroecology was significantly associated with stunting (p = 0.012) and underweight (p < 0.001), while livestock holding was significantly correlated with stunting (p = 0.008) and underweight (p = 0.012). Access to irrigation was also significantly associated with stunting (p = 0.028) and underweight (p = 0.016). However, the prevalence of stunting, wasting and underweight was not significantly associated with household size, landholdings or frequency of sickness. Conclusions: The prevalence of undernutrition within the study areas was higher than the national average for Ethiopia. Lowland areas exhibited the highest rates of undernutrition; consequently, interventions that include the enhancement of livestock holdings and access to irrigation should include agroecological factors in an effort to reduce childhood undernutrition. [ABSTRACT FROM AUTHOR]

Background: Stunting, which describes a small height for one's age, is an indicator of chronic malnutrition. It develops mainly as a result of prolonged food deprivation or a chronic disease or illness. Unintended pregnancies and unplanned births are among the psychological factors that negatively affect the nutritional status of children. Therefore, this study aimed to determine the effects of unintended pregnancies and other family and child characteristics on the nutritional status of children under 5 years old.Methods: A community-based unmatched case-control study was conducted among 302 children (151 cases and 151 controls) 6-59 months old in Wonago town, Gedeo Zone, Southern Ethiopia. The cases were stunted children and the controls were non-stunted children in the study area. The cases were randomly selected from among the stunted children, and the controls were randomly selected from among the non-stunted children. The descriptive characteristics of the respondents were compared using the chi-squared test, and a multivariable logistic regression was used to assess the effects of an unintended pregnancy on stunting, after controlling for the other variables, with a p value of 0.05.Results: The result revealed that unintended pregnancy is found to be among predictors of stunting where children from unintended pregnancy were about three times more likely to be stunted [AOR: 2.62, CI: (1.26, 5.45)]. The other predictors identified in this study were educational status of the father, wealth index of the household and daily meal frequency. From the finding, children from illiterate fathers [AOR: 3.43, CI: (1.04, 11.29)], children from poorer household economic status [AOR: 2.32, CI: (1.20, 4.49)] and children whom their daily meal frequency is below the recommended number of feeding [AOR: 4.50, CI: (1.31, 15.49)] were found to be more stunted.Conclusions: Based on the results of this study, the children born from unintended pregnancies exhibited a significantly higher risk of stunting. Therefore, preventing unintended pregnancy could play a great role in decreasing the risk of stunting in children. [ABSTRACT FROM AUTHOR]

Current recommendations within integrated community case management (iCCM) programmes advise community health workers (CHWs) to refer cases of chest indrawing pneumonia to health facilities for treatment, but many children die due to delays or non-compliance with referral advice. Recent revision of World Health Organization (WHO) pneumonia guidelines and integrated management of childhood illness chart booklet recommend oral amoxicillin for treatment of lower chest indrawing (LCI) pneumonia on an outpatient basis. However, these guidelines did not recommend its use by CHWs as part of iCCM, due to insufficient evidence regarding safety. We present a protocol for a one-arm safety intervention study aimed at increasing access to treatment of pneumonia by training CHWs, locally referred to as Community Oriented Resource Persons (CORPs) in Nigeria. The primary objective was to assess if CORPs could safely and appropriately manage LCI pneumonia in 2–59 month old children, and refer children with danger signs. The primary outcomes were the proportion of children 2–59 months with LCI pneumonia who were managed appropriately by CORPs and the clinical treatment failure within 6 days of LCI pneumonia. Secondary outcomes included proportion of children with LCI followed up by CORPs on day 3; caregiver adherence to treatment for chest indrawing, acceptability and satisfaction of both CORP and caregivers on the mode of treatment, including caregiver adherence to treatment; and clinical relapse of pneumonia between day 7 to 14 among children whose signs of pneumonia disappeared by day 6. Approximately 308 children 2–59 months of age with LCI pneumonia would be needed for this safety intervention study. [ABSTRACT FROM AUTHOR]

Background: Nutritional status of children who are less than 5 years old is of significant regard as the beginning years of life are important for best development. Childhood malnutrition occurs due to several reasons, but spacing of birth is frequently unnoted even if it is accompanied with stunting which reflect chronic malnutrition. Aims: To assess the nutritional status of children less than 5 years old, and its relationship with birth interval, and associated factors. Materials and Methods: It was a cross sectional study was carried on children of 0-5 years age groups of both sexes. Data was collected using predesigned and pretested questionnaire, face to face interview with the mothers and anthropometric measurements of children were performed. Results: Most of undernourished children were with birth space less than 24 months. The frequency of stunting and wasting was the highest among children with birth interval less than 24 months, it was (14.5%) and (6.8%) respectively as compared to those with birth interval 24-59 months were frequency of stunting and wasting was found to be the lowest, it was (11.2%) and (2.2%) respectively. Conclusion: This paper draws attention to significant linkages between birth spacing and child nutritional status. Most of undernourished children were with birth space less than 24 months. [ABSTRACT FROM AUTHOR]

Abstract Background Diarrhoea is a main cause of morbidity and mortality in children under 5 responsible for approximately four billion cases and 1.1 million deaths annually. In developing countries, it causes two million deaths each year. The major causative organism responsible is Rotavirus which is responsible for one-third of hospitalizations with approximately 40% mortality. Results The prevalence of Rotavirus infection was 26.4% (73/277). The predominant strain of Rotavirus found was G1 21/73 (53.8%), followed by G8 9/73 (23.1%), G12 5/73 (12.8%), G9 3/73(7.7%) and G4 1/73 (2.6%). All serotypes identified were in children who had completed Rotavirus vaccination except for one who had G8 in whom the vaccine was introduced after they had completed immunizations. Conclusion The overall prevalence of rotavirus has reduced from 33.2% in 2009 to 26.4% in 2016. We have found G1 to be the predominant serotype as well as other circulating serotypes namely G4, G8, G9 and G12. Despite a reduction in prevalence, there is a need for further rotavirus surveillance in the region.

Background: Stunting is an indicator of the devastating result of malnutrition in early childhood. The effects of childhood stunting are irreparable physical and cognitive harm. It is an issue of the great public health importance throughout Sub-Saharan African countries including Ethiopia. Therefore, identification of the risk factors of child stunting from recent data is very important for timely intervention.Methods: The 2016 Ethiopian Demographic and Health Survey data were used for this study. A generalized linear mixed model which is an extension of the general linear model was employed to identify socioeconomic, demographic, environmental and health related risk factors for stunted under-five children.Results: The result shows that the age and sex of the child, preceding birth interval, mother's body mass index, household wealth index, mother's education level, breastfeeding period, type of toilet facility, use of internet and source of drinking water were the major determinants of stunting of under-five children in Ethiopia.Conclusion: The study indicated that children from undernourished mothers, who are not breastfeeding, from poor households, households that have no toilet facilities, who are male, older age (between 12 to 59 months), who have illiterate mother and short birth spacing were associated with stunting problems. Therefore, family planning education and policy is required for the country to improve on under-five age stunting problems. [ABSTRACT FROM AUTHOR]

Background: Underweight is a key indicator of malnutrition in children and results in long term effects such as abnormalities in physical and mental health, behavioural problems, and low educational achievement. Objective: Using the conceptual framework for child malnutrition by the United Nations Children's Fund, we examined the predictors of underweight in children under five years in Ghana. Methods: This cross-sectional study made use of data from the 2014 Ghana Demographic and Health Survey. A total of 2720 children were included in the analysis. Descriptive and inferential statistics comprising frequency, percentage, chi-square, and binary logistic regression were used in analysing the data. Results: The prevalence of underweight was 11%. Age, wealth status, mother's education, region, ethnicity, household toilet facility, the source of drinking water, the incidence of diarrhoea, and subscription to health insurance significantly predicted underweight in the children. The risk of being underweight was higher in females than males (OR=1.04, 95% CI=0.81-1.34). This was, however, not statistically significant. The probability of being underweight also declined significantly with mother's level of education. Conclusion: Our findings underscore the need for the Ghana Health Service and other health sector stakeholders to apportion interventions with a focus on improving complementary feeding, poverty alleviation, and health status of children. [ABSTRACT FROM AUTHOR]

Background: Under five morbidity constitutes serious public health challenge with attendant deleterious sequelae on children globally, especially in sub-Saharan Africa and other least developed countries. This is further aggravated by inadequate research data on the state of health of under five children especially in rural areas. This study was done to describe the pattern of morbidity among under five children presenting at a rural secondary health care facility in Etinan Local Government Area of Akwa Ibom State, Southern Nigeria. Method: This was a descriptive retrospective study involving 494 children aged 0-59 months who presented at the general out patient and emergency units of Qua Iboe Church Leprosy Hospital (QICLH) Ekpene Obom, Etinan Local Government Area, Akwa Ibom State, between June 2014 to June, 2017. The case records of the under five children who presented at the period of the study both at the out patient and the wards were collated and entered into a spread sheet. The age, sex, diagnoses, causes and outcome of admission were extracted from the records. Results: The mean age of the children was 21.63 ( ±15.34) months. Results obtained showed that 259 (52.43%) of the children were male while 235 (47.57%) were female, giving a male to female ratio of 1.1:1. Out of 526 morbidities presented, 262 (49.81%) were malaria, 133 (25.29%) were acute respiratory infections (ARI’s), 37(7.03%) were skin infections, 23(4.37%) were diarrhoea while haemoglobinopathy was the least presentation of only one case (0.19%). There were 74 cases of admission, giving an admission rate of 14.17%. Complicated malaria was the commonest cause of admission while 89.19% of those admitted were successfully treated and discharged. Conclusion: Most of the morbidities that presented in the facility during the period of the study were preventable through improved socioeconomic condition, health education and immunization. The need therefore to improve the socioeconomic conditions of the populace especially those aspects that affect the wellbeing of under five children and strict adherence to immunization programme as a panacea for reduction of morbidity among the under five children in rural areas is recommended.

Background Pneumonia has been one of the serious problems for children under five in Indonesia. Imbalanced interactions among host factors, agents, and environments influence incidence of pneumonia. Objective To determine the risks of the host related to the incidence of pneumonia in children aged 3-59 months in Pediatrics Department, Dr. Soetomo General Hospital during 2011-2012. Methods This was a case control study on medical records of patients with respiratory infections in Pediatrics Department, Dr. Soetomo General Hospital. We grouped patients with pneumonia as the case group and patients with other respiratory infections as the control group. The data were statistically processed to calculate odds ratios and P values. Results There were 326 subjects reviewed, 163 in the case group and 163 in the control group. Host factors that increased the risk of pneumonia were: low birth weight (OR=3.10; 95%CI 1.34 to 6.86), inadequate exclusive breastfeeding (OR=1.7; 95%CI 1.09 to 2.64), malnutrition (OR=3.44; 95%CI 2.12 to 5.58) and incomplete immunization in a certain period of age (OR=2.70; 95%CI 1.72 to 4.24). Existed comorbidity was unrelated to the incidence of pneumonia (OR=1.53; 95%CI 0.86 to 2.71). Conclusion Low birth weight, inadequate exclusive breastfeeding, malnutrition, and incomplete immunization in a certain period of age increase the risk of pneumonia.

Background: Hydrocephalus among children is an important medical problem in view of its neurological sequelae in the growing child. This situation is compounded by the acute shortage of neurosurgeons in third world countries like Nigeria; hence, the need for its early detection and proper management. Objective: Evaluation of the ultrasound (US) appearances in children under 5 years of age presenting with clinical signs of raised intracranial pressure suggestive of hydrocephalus. Patients and Methods: A retrospective review of transfontanelle US scans done in 64 children (39 boys and 25 girls) attending the Department of Radiology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria over a period of 2 years was carried out. The patients had a mean age of 5.0 ± 4.6 months (range: 1–60 months) at the time of their US examination. Some of the clinical indications for US scan included: Congenital hydrocephalus, encephalocele, meningomyelocele, and meningitis. All scans were performed through the anterior fontanelle using SIUI Apogee 800 PLUS scanner with a curvilinear probe using multi-frequency transducer of 2–5 MHz. Results: Fifty-two patients (81.3%) had hydrocephalus of congenital origin. Eleven cases (17.2%) had postmeningitic hydrocephalus while only 1 case (1.6%) was posthemorrhagic. Twenty-five patients (48.0%) of the congenital cases were due to cerebral aqueduct stenosis. Eleven (21.2%) of the congenital cases were from obstruction at the exit foramina of Luschka and Magendie resulting in the communicating type of hydrocephalus. Conclusion: Hydrocephalus is a known cause of neurological morbidity among infants in developing countries. Majority of the cases are congenital in origin and most commonly due to cerebral aqueduct stenosis. Transfontanelle US is cheap, affordable, nonhazardous, and more accessible than other imaging modalities. It should serve as the first-line investigation of infants with suspected hydrocephalus for early detection and monitoring of progression to determine those cases that would require shunt operation.

Introduction The under-five age group is crucial because the health profile of this age group will have a huge effect on the future development of the nation. Early infancy is marked by several distinct developmental characteristics. Progress in each domain of childhood development is used to track a child's development. Objectives The objectives of the present study were to assess and compare the growth of under-five children of employed and unemployed mothers in the Etawah District of Uttar Pradesh, India. Material and methods A community-based cross-sectional survey was carried out in Etawah district's urban and rural areas between January 2021 and June 2022. A total of 200 mothers with children under the age of five were recruited using the purposive sampling method. To gather pertinent information, a semi-structured, pre-tested, interviewer-administered questionnaire was used. Results In the present study on the comparison of the growth of children among employed and unemployed mothers, it shows that 48 children (50.5%) with a weight between 10.5 and 15 kg were of employed mothers, while 52 children weighing less than 10.5kg were of unemployed mothers (p<0.001). Forty-four children (57.1%) with a chest circumference of more than 48 cm were of employed mothers, while 26 children (78.8%) with a chest circumference of less than 45 cm were of unemployed mothers (p = 0.001). Conclusion The present study indicates that statistically significant differences were found in age-appropriate gain in weight and chest circumference, which was higher among the children of employed mothers in comparison to children of unemployed mothers. There was no statistically significant difference in age-appropriate gain in height, head circumference, or mid-upper arm circumference among the children of employed mothers and unemployed mothers., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Kumar et al.)

Background: According to the World Health Organization, Vitamin A deficiency can cause immune system depression in about 130 million preschool children and 7 million pregnant women mostly in developing countries and cause mortality risk up to 20%-30%. Objectives: We aimed to evaluate the knowledge, attitude, and practice of parents in Benghazi regarding the Vitamin A campaign. Subjects and Methods: A cross-sectional descriptive study of 1390 parents attending maternal and child health clinics and pediatric clinics at six main polyclinics, in Benghazi in April and May 2018. Results: Most of the parents were younger than 40 years (71%). Mothers constitute 68% of the study population and 52% of the children were male. Half of the parents had higher education. Only 40% of the parents were having good knowledge about the benefits and food sources of Vitamin A. The coverage rate of Vitamin A supplementation among under-five children in the study was 66%. The main reason for not giving their children Vitamin A supplementation in this study was the lack of awareness of the campaign during the previous year. However, 88% of the interviewed parents had a positive attitude of regiving Vitamin A to their children in the next campaign. Conclusions: The overall knowledge level of Vitamin A among the parents was relatively low; hence, more efforts are needed to promote awareness about Vitamin A supplementation. [ABSTRACT FROM AUTHOR]

Introduction: 1-5 years old children are most vulnerable and high risk group. According to national family health survey 3 (NFHS-3) 48% of under-five children are chronically malnourished. Nutrition of pre-school children is of paramount importance because it is the foundation for life time health. Objective: To study the associated socio-demographic factors affecting the growth status. Methods: A Cross- sectional Community based descriptive study was conducted involving 530 under-five children in urban slums of Davangere City. Data was collected using a pre-designed & pre-tested questionnaire & anthropometric measurements. Results: The prevalence of underweight (49.3%), stunting (76.8%) and wasting (27.5%) was highest in 12-24 month. The prevalence of underweight is 34.5% in males and 23% in females. Stunting and wasting was seen in 50.3% and 21.4% male children. Conclusions: Socio-demographic factors like age, sex, parent’s literacy status had an impact on better growth status of children. Lower socio-economic condition, higher birth order, lower birth interval were found to have adverse effect on growth status of children.

Objective: To determine the factors associated with retaining the vaccination card among care takers of 12-59 months old children in Karachi, Pakistan. Methods: This was an analytical cross-sectional study in Karachi. Households were randomly selected throughout a multistage cluster sampling technique. Data was collected for 504 children of 12- 59 months of age. Questionnaire was administered to caretakers to gather information regarding the children’s vaccination status, socio-demographic characteristics and reviewing their vaccination cards. Statistical analysis was done by SPSS 19 using logistic regression. Results: Among 462 vaccinated children, caretakers of 33% provided vaccination cards. Odds of card retention decrease if the caretaker has a large household i.e., >5 people sharing one room (AOR 0.277, 95% CI: 0.096, 0.797) and if the child is of four to five years of age (AOR 0.544, 95% CI: 0.305, 0.970). Gender of the child, and the caretaker’s education and access to electronic media were not significant predictors of vaccination card retention in our study. Conclusion: Our study showed that vaccination card retention for children 12-59 months of age was low (33%) in Karachi. There is a need to educate caretakers of young children regarding the importance of keeping vaccination card and to disseminate this information through healthcare providers. Improving vaccination card retention is one of the key measures which will help towards accurately estimating coverage and to inform health policy decisions.

Background: Diarrhoea is a main cause of morbidity and mortality in children under 5 responsible for approximately four billion cases and 1.1 million deaths annually. In developing countries, it causes two million deaths each year. The major causative organism responsible is Rotavirus which is responsible for one-third of hospitalizations with approximately 40% mortality. Results: The prevalence of Rotavirus infection was 26.4% (73/277). The predominant strain of Rotavirus found was G1 21/73 (53.8%), followed by G8 9/73 (23.1%), G12 5/73 (12.8%), G9 3/73(7.7%) and G4 1/73 (2.6%). All serotypes identified were in children who had completed Rotavirus vaccination except for one who had G8 in whom the vaccine was introduced after they had completed immunizations. Conclusion: The overall prevalence of rotavirus has reduced from 33.2% in 2009 to 26.4% in 2016. We have found G1 to be the predominant serotype as well as other circulating serotypes namely G4, G8, G9 and G12. Despite a reduction in prevalence, there is a need for further rotavirus surveillance in the region. [ABSTRACT FROM AUTHOR]

Background: Infections affecting the middle ear are a common childhood occurrence. Some cases may present with ear discharge through a tympanic membrane perforation which may heal spontaneously. However, up to 5% or more cases of those affected have persistent ear discharge. A number of barriers contribute towards delayed presentation at health facilities for treatment of ear infections. We conducted a study to evaluate parents' and caregivers' knowledge and care seeking practices for ear infections in children under five in Gasabo district in Kigali, Rwanda. Methods: Parents/guardians (n = 810) were interviewed using a structured questionnaire to elicit their knowledge of ear infections in children under five and their attitude to seeking care for their children. Results: The mean age of the respondents was 31.27 years (SD = 7.88, range 17-83). Considering an average of knowledge parameters which included causes, symptoms, prevention, treatment and consequences of ear infections, we found that 76.6% (622) of respondents were knowledgeable about ear infections. We defined a positive practice as seeking medical treatment (community health workers or health facility) and this was found in 89.1% (722) respondents. Correlating knowledge with choice of seeking treatment, respondents were 33% less likely to practice medical pluralism (OR = 0.33, CI 0.11-0.97, P = 0.043) if they were familiar with infections. Moreover, urban dweller were 1.7 times more likely to know ear infections compared to rural dwellers (OR = 1.70, CI 1.22-2.38, P = 0.002). Conclusion: The majority of respondents had good knowledge and positive attitudes and practices about ear infection. However, medical pluralism was common. There is need to improve the community's awareness and access to primary health care facilities for the care of ear infections especially in rural areas of Rwanda. [ABSTRACT FROM AUTHOR]

Background: Child undernutrition is internationally recognized as an important public health indicator for monitoring nutritional status and health in populations. Prevalence of under nutrition is very high in India; especially in urban slums. Objective: To estimate the prevalence and factors affecting undernutrition among under five years children using WHO growth standards. Materials and Methods: Community-based cross sectional study was done during November-2008 to December-2009 in urban field practice area of Medical College Pune, India. All the under five years children (336) were enumerated by house-to-house survey. Parents were informed about the objectives of the study and their written consent was obtained. Anthropometric measurements of the children who were available during the study period were carried out as per WHO guidelines. Various indices of nutritional status were expressed in standard deviation units (z scores) from the reference median. The children were examined for nutritional deficiencies and other morbidities. Epi-Info 2002 and Primer of Bio-statistics software package was used for statistical analysis. Results: Total 336 children were enumerated by house-to-house visit. Only 319 children were available during the study, out of which 208 (65.2%) were undernourished. Undernutrition was significantly (P < 0.001) higher among boys than among girls. It was maximum in 49-60 months age group. The higher the level of the mother′s education, the lower was the level of child weight for age (P = 0.003). The overall prevalence of morbidities was 43.4%. Conclusion: Malnutrition continues to be a public health problem in children particularly in marginalized groups.