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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

Malnutrition has adverse impacts on under-five children with pneumonia. The purpose of this study was to address the prevalence and impact of malnutrition on under-five years children with pneumonia, admitted to a tertiary large children hospital in Upper Egypt. This study is a prospective case-control study. All under-five children diagnosed with pneumonia who were admitted to Assiut University Children's Hospital (AUCH) from January 1st to December 31st, 2021, were enrolled. Based on their nutritional assessment, the studied participants were classified into 2 groups: (1): Children with pneumonia and with nutritional deficiency considered as cases, and (2): Children with pneumonia and without nutritional deficiency considered as controls. Three hundred-fifty cases and 154 control subjects were enrolled, respectively. 93.4%, 31.1%, and 61.7% of the cases had underweight, stunting, and wasting, respectively. Among those cases, there were significant differences between survivors and non-survivors with regard to some clinicodemographic factors, laboratory parameters, and anthropometric parameters. Lack of compulsory vaccination, presence of sepsis, and blood transfusion (OR 2.874, 95% CI 0.048 – 2.988, p = 0.004, 2.627, 0.040 – 2.677, p = 0.009, and 4.108, 0.134 – 3.381, p < 0.001, respectively) were significant independent predictors for mortality among malnourished children with pneumonia. Conclusion: Malnutrition has a high prevalence in under-five children with pneumonia in our locality. It has adverse effects on the outcomes and in-hospital mortality of those children. Lack of compulsory vaccination, presence of sepsis, and blood transfusion were significant independent predictors of mortality in malnourished children with pneumonia. Larger multicenter studies are warranted. What is Known: • Malnutrition has adverse impacts on under-five children with pneumonia. • Malnutrition could be a reason for in-hospital mortality among under-five children with pneumonia. What is New: • Malnutrition has a high prevalence in under-five children with pneumonia in Upper Egypt, with its adverse effects on the outcomes and mortality of those children. • Lack of vaccination, presence of sepsis, and blood transfusion are significant independent predictors of mortality in malnourished children with pneumonia in Upper Egypt. [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]

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

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

The objective of this study was to estimate the magnitude of acute respiratory infection (ARI) among children younger than 5 years (under-five children) and its association with biomass fuel use for domestic purposes and other behavioural and housing characteristics in Ethiopia. Systematic review and meta-analysis. PubMed, Google Scholar, MEDLINE and the Cochrane Library were systematically searched (using the Preferred Items for Systematic Review and Meta-analysis guideline) for studies that reported an association between biomass fuel use for domestic purposes and ARI. Grey literature and other sources of unpublished information, which were subjected to the same extraction methods and quality appraisal as published studies, were also identified. A meta-analysis was performed to combine the quantitative measures from eligible individual studies into a summary estimate. Quality assessment was conducted using the modified Newcastle-Ottawa Scale quality assessment tool for cross-sectional and case-control studies. Funnel and Doi plots were used to detect potential publication bias. Statistical analyses were performed using Comprehensive Meta-Analysis and MetaXL, version 5.3, software. A total of 21 (18 cross-sectional and 3 case-control) eligible studies with their combined 30,013 participants were reviewed. The overall pooled prevalence of ARI among under-five children in households where biomass fuel was the main source of energy was estimated to be 22% (95% confidence interval [CI]: 17–29). In the subgroup analysis by area of residence, the highest prevalence was found in urban regions 26% (95% CI: 24–28). Based on the preceding 2 weeks before the interview, a significant association was found between biomass fuel use and ARI (odds ratio [OR] = 2.6, 95% CI: 2.05–3.30). In addition to biomass fuel use, being female (OR = 1.57, 95% CI: 1.06–2.33), absence of a window in the kitchen (OR = 2.89, 95% CI: 2.11–3.96), being carried on the back or in lap during cooking (OR = 2.76, 95% CI: 1.96–3.89) and non-separated kitchen from the main house (OR = 1.99, 95% CI: 1.49–2.68) were associated with ARI. Based on the results of this review, ARI among under-five children remains high. The present study also revealed that ARI is associated with biomass fuel use, child's gender, absence of a window in the kitchen, non-separated kitchen and carrying the child while cooking. Improved solid fuel stoves, advanced combustion designs, windows or chimneys, separating the kitchen from the main house are all measures required to reduce ARI in under-five children. The review has been registered with PROSPERO (registration number CRD42020181372). • Acute respiratory infection (ARI) among children younger than 5 years remains high in Ethiopia. • ARI is associated with biomass fuel use. • Improved solid fuel stoves are required to reduce ARI. [ABSTRACT FROM AUTHOR]

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]

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: Malnutrition not only reflects health of children but it also represents the socioeconomic, demographic and psychological features of the family. Objective: To determine Socio-demographic factors effecting Under nutrition in under five children of slum area, Medhar block Method: An Exploratory study conducted in urban slum from August 9th to October 31st 2017. 10 Anganwadi workers and helpers were interviewed about malnourished children in their areas. 94 mothers of were randomly selected and interviewed about their antenatal and perinatal care. Anthropometric examination of 64, 1-5 years children was done. Focus group discussion done among 22 mothers and details of diet given to children were discussed. Data collected were compiled, anthropometric data entered in excel and WHO anthro and association with other factors were analyzed using chi-square tests, and t test in SPSS 24. Result: Under nutrition seen in 30% of under five children. Stunting in 34% and wasting in 14% .Stunting associated with antenatal weight gain (P 0.02) and birth weight (P 0.04). Wasting associated with age of mother at pregnancy and birth weight. 16% of mothers delivered low birth weight babies and 17% of them stopped breast feeding before 1year.Nutrition provided to children were inadequate. Conclusion: Awareness on antenatal care, exclusive breast feeding, supplementary food and adequate nutritious diet for children needs to be strengthened. Health workers should be trained regarding communication and health education, so that they convey proper knowledge to mothers. [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.

Globally, PEM continues to be a major health burden in developing countries and the most important risk factor for illnesses and death especially among young children. The WHO estimates that about 60% of all deaths, occurring among children aged less than five years in developing countries, could be attributed to malnutrition. The Sub-Saharan African countries and the Indian sub-continent bear the main brunt of PEM in the world. On an average, the PEM associated mortality in Sub-Saharan Africa is between 25 to 35%. In Indian sub continent, almost half of the children under five years of age (48%) are chronically malnourished, 43% under five are underweight for their age and one out of five is wasted. PEM is also associated with a number of co-morbidities such as lower respiratory tract infections including tuberculosis, diarrhea, malaria and anemia. These co-morbidities may prolong the duration of hospital stay and death among affected children. Thus the improvement of nutrition therefore is the main pre requisite for the reduction of high infant and under five mortality rates, the assurance of physical, social and mental development of children as well as academic achievements. [ABSTRACT FROM AUTHOR]