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Introduction: Although diarrheal diseases are highly preventable, they remain one of the leading causes of mortality and morbidity in the pediatric population in developing countries. Knowledge of etiological agents is essential to implement public health programs. Viral infections are the most common cause of acute infectious diarrhea among children. There is a paucity of information regarding viral enteropathogens responsible for diarrhea in India, as many hospitals do not routinely carry out diagnostic tests for viral detection. Aim and Objectives: To estimate the prevalence of viral enteropathogens in children under five years of age presenting with acute diarrhea using real-time multiplex polymerase chain reaction (PCR) and its correlation with clinico-demographic features. Methodology: A cross-sectional study was carried out in a tertiary care center in Maharashtra from January 2016 to June 2019. Our study included 300 children who were under five years old with acute diarrhea. Standard protocols were advocated for the collection and transportation of stool samples. All samples were subjected to real-time multiplex PCR (Light cycler 480 Roche) using Fast Track Diagnostic kits for viral gastroenteritis. Data analysis was done using descriptive and analytical methods. Results: In our study, 57% of samples were positive for viral enteropathogens. Rotavirus (32%) was the most common isolate, followed by Norovirus Genogroup II (GII) (17%). The majority of pathogens were isolated from children less than 2 years of age. Conclusion: There is a need to test stool specimens of clinically confirmed diarrheal patients for enteric virus. This will avoid blind antibiotic treatment.

Abstract Background The state of a child’s nutrition is a critical indicator of their overall health and wellbeing. Public health still faces challenges from undernutrition, especially in developing nations across the globe. In Rwanda, around 33% of children aged under five years suffer from chronic undernutrition. Many factors, such as poverty, illiteracy, poor WASH practices, improper child feeding practices, and insufficient healthcare, are the leading causes of undernutrition. The study aims to assess infant and young child feeding practices, WASH, food security, and their association with the nutritional status of children under five years in Rwanda’s Western and Southern provinces. Methods A community-based cross-sectional study design was applied to study factors affecting the nutritional status of children under five years in 439 households in the Karongi, Nyabihu, and Nyamagabe districts of Rwanda. The study assessed anemia, stunting, underweight, and wasting indicators, and collected data was analyzed using SPSS version 25. Results The study findings indicate that among the children surveyed, 29.2% (128) were identified as stunted, 5.9% (26) were underweight, 2.3% (10) suffered from wasting, and 20.9% (31) had anemia. Factors associated with these conditions included larger household size [AOR = 2.108; 95% CI (1.016–4.371)], positively associated with stunting. Additionally, children from households where the head was above 60 years old were more likely to exhibit stunting [AOR = 4.809; 95% CI (1.513, 15.283)]. Furthermore, a high household dietary diversity score was positively linked to being underweight [AOR = 6.061; 95% CI (1.535,23.942)]. Conclusion Household characteristics like size, dietary diversity, and the age of the household head affect children’s nutritional status. Improving these conditions would enhance children’s nutritional status.

Introduction: Although diarrheal diseases are highly preventable, they remain one of the leading causes of mortality and morbidity in the pediatric population in developing countries. Knowledge of etiological agents is essential to implement public health programs. Viral infections are the most common cause of acute infectious diarrhea among children. There is a paucity of information regarding viral enteropathogens responsible for diarrhea in India, as many hospitals do not routinely carry out diagnostic tests for viral detection. Aim and Objectives: To estimate the prevalence of viral enteropathogens in children under five years of age presenting with acute diarrhea using real-time multiplex polymerase chain reaction (PCR) and its correlation with clinico-demographic features. Methodology: A cross-sectional study was carried out in a tertiary care center in Maharashtra from January 2016 to June 2019. Our study included 300 children who were under five years old with acute diarrhea. Standard protocols were advocated for the collection and transportation of stool samples. All samples were subjected to real-time multiplex PCR (Light cycler 480 Roche) using Fast Track Diagnostic kits for viral gastroenteritis. Data analysis was done using descriptive and analytical methods. Results: In our study, 57% of samples were positive for viral enteropathogens. Rotavirus (32%) was the most common isolate, followed by Norovirus Genogroup II (GII) (17%). The majority of pathogens were isolated from children less than 2 years of age. Conclusion: There is a need to test stool specimens of clinically confirmed diarrheal patients for enteric virus. This will avoid blind antibiotic treatment. [ABSTRACT FROM AUTHOR]

Background: Acute respiratory infection (ARI) causes high morbidity and mortality rates among children. As parents are the main caregivers for these children, it is essential to assess and strengthen their knowledge, attitudes, and practices (KAPs) toward ARI. Purpose: To assess KAPs toward ARI among Jordanian and Syrian parents with children under five years, and KAPs relationships with the parental sociodemographic variables. Methods: A cross-sectional design was conducted using a sample of 204 parents (124 Jordanians and 80 Syrians). The data was collected at community associations in Irbid city in the northern part of Jordan, between December 2021 and February 2022. A self-reporting questionnaire was used to measure parents’ KAPs toward ARI in children under five years. Results: The results revealed that 48% of the fathers and 61% of the mothers were educated to college level. The total score of knowledge was 10 out of 18 (SD =2.75), while that of attitudes was 8 out of 12 (SD = 1.97), and that of practices was 4 out of 5 (SD = 0.89). Spearman correlation indicated that mother’s education and father’s education were positively correlated with the knowledge, attitude, and practice scores. Pearson correlation indicated that family income was positively correlated with the attitude and practice scores. Independent sample t-test indicated that Jordanian parents reported significantly higher attitude and practice scores than Syrian parents (p ≤ 0.05). Conclusion: Overall, Jordanian and Syrian parents’ knowledge about ARI in Irbid city is insufficient and mainly correlated with their level of education. Implications for Nursing: The study highlights the need for health education in primary health care centers, public places, and community organizations. Health education should target parents with low socioeconomic status and Syrian refugee parents. [ABSTRACT FROM AUTHOR]

Abstract Background Multidimensional factors such as socioeconomic or environmental factors influence malnutrition. Several studies have strongly linked malnutrition to poverty. Some international studies point to the worse nutritional status of urban slum children than rural children. Limited data is available regarding the nutritional status of slum children in Karachi. This study aimed to determine characteristics of malnourished children in an urban squatter settlement in Karachi, Pakistan. Methods A case- control study was carried out at the primary healthcare center of a squatter settlement in Karachi, Pakistan. All children under five years of age visiting the primary healthcare center were recruited consecutively. Cases were defined as children with z scores < -2 SD of WHO reference measurements of WFA, HFA, WFH and OFC. The controls were similar in terms of age group but had z scores between − 2SD and + 2SD. A self- structured risk factor questionnaire that included information about sociodemographic, economic and environmental factors as well as child- related characteristics was researcher administered via face-to-face interviews with the mothers of children. Univariate and multivariate logistic regression analyses were conducted. Crude and adjusted odds ratios were calculated with 95% confidence interval. Results A total of 280 participants including 140 cases and 140 controls participated in the study. A larger proportion of the sample originated from individuals with low household income. After adjusting for the confounders, childhood malnutrition was significantly associated with a low education level of father (aOR 4.86, 95% CI 2.23–10.60), a monthly income less than 25,000 PKR (89 USD) per month (aOR 7.13, 95% CI 1.67–30.54), pour pit latrine type of toilet (aOR 4.41, 95% CI 2.67–7.3), less than six months of exclusive breast feeding (aOR 3.578, CI 1.58–8.08), inappropriate weaning age (aOR 3.71, 95% CI 1.53-9). Conclusion Malnutrition in children under five years of age in the community is associated with low family income, low paternal education, poor toilet facilities, lack of exclusive breastfeeding and inappropriate weaning age. The implementation of poverty reduction programs, sanitation provision at affordable rates, community-based breast feeding and weaning education intervention are urgently required to efficiently improve children’s nutritional status.

Background: Although Namibia has made strides in improving the policy enabling environment, eradication of malnutrition is still elusive. Objective: This review was aimed at determining the extent to which food and nutrition-related policies in Namibia address malnutrition. Methods: This study used a qualitative approach by retrospectively analysing policy frameworks that address malnutrition in Namibia from 1991 to 2022. The analysis employed the policy triangle framework to elucidate the contextual factors, content, actors and process involved in the policy development. Moreover, a comparative analysis of Namibian policies and those of other southern African countries was undertaken. Results: The review showed that there is a considerable degree of coherence in policy goals and strategies to address malnutrition despite parallel coordination structures. Policy process involved limited consultations with local communities which might have jeopardised the formulation of community problem-tailored interventions, ownership and participation in policy implementation. There is a strong political commitment to the eradication of malnutrition in Namibia. The Office of the Prime Minister played a leading role in policy development. Influential actors such as the UN agencies elevated the nutrition agenda. Further, the Namibian policy framework was generally similar to those of other southern African countries. Conclusions: The review showed that Namibia has relevant and comprehensive policies to address malnutrition, however, contextual factors indicated high levels of malnutrition still exist in the communities. Further research is needed to understand the barriers and enablers to optimal nutrition for children under five years in Namibia. [ABSTRACT FROM AUTHOR]

Background: Acute respiratory infection (ARI) causes high morbidity and mortality rates among children under five years. As parents are the main caregivers for these children, it is important to assess their knowledge, attitudes, and practices (KAPs) toward managing ARI. Objectives: The objectives of this study were to assess KAPs toward ARI among Jordanian and Syrian parents with children under five years, and to examine the relationship between KAPs toward ARI and parental sociodemographic variables. Method: A cross-sectional design was conducted using a sample of 204 parents (124 Jordanians and 80 Syrians). The data were collected at community associations in Irbid city between December 2021 and February 2022 through a self-reporting questionnaire. Results: The results revealed that the total score of knowledge toward ARI was 10.14 (SD = 2.75) out of 18, the score of attitudes was 8.09 (SD = 1.97) out of 12, while the score of practice was 4.04 (SD = .89) out of 5. Father’s education and mother’s education were positively correlated with the knowledge scores. Family income, father’s education, and mother’s education were positively correlated with the attitude and practice scores. Finally, Jordanian parents reported significantly higher attitude and practice scores than Syrian parents (p ≤ .05). Conclusions and Nursing Implications: The study highlights the need for health education that should target parents with low socioeconomic status in general and Syrian refugee parents in particular. Primary health care centers, hospitals, public places, and community organizations are the best places to conduct health education.

Background. Anemia is a public health issue that affects both industrialized and developing nations. Childhood anemia has severe consequences, including reduced growth, poor motor and cognitive development, and increased death and morbidity. Objective. This study aims to determine sociodemographic factors associated with the severity of anemia among under-five children in Kut City. Methods. A cross-sectional study with a convenience sample (non-probability) was conducted among 264 children admitted to hospitals in Kut City, from September 1st, 2022, to March 1st, 2023. Data were collected via questionnaires, and descriptive and inferential statistics were used to evaluate the data. Results. The total number of children participating in the study was 264, with 39.0% having mild anemia and 60.0% having moderate anemia, according to the World Health Organization classification of anemia. The results showed that the children most at risk of developing anemia were within 4 years of age and had a lower mean hemoglobin level than the rest of the age groups of the children participating in the study, compared to the mean+standard deviation (SD) (9.46+0.99). Boys are more affected than girls, and those who reside in rural areas have lower hemoglobin (HB) percentages with a mean+SD of (9.21+0.93). Unemployed mothers who read and write had the lowest HB percentage. In contrast, parents with primary education and government jobs have the lowest percentage of HB. Children of married mothers are more affected by anemia. Families with high overcrowding showed the lowest rate of HB. They experienced low socioeconomic status as a result. The degree of anemia was significantly correlated with the child’s age, residence, mother’s educational level, father’s job, and socioeconomic position. Conclusion. This study concludes a significant association between the severity of anemia and sociodemographic factors, both unmodifiable (age) and modifiable (residence, mothers’ education, fathers’ jobs, and economic and social status). Children with modifiable risk factors need to have their anemia risk constantly evaluated. [ABSTRACT FROM AUTHOR]

Background: The prevalence of anemia is a global public health concern, affecting both developed and developing countries. The effects of childhood anemia are devastating, ranging from stunted growth and impaired cognitive and motor development to an increased risk of mortality. Objectives: The study aims to determine the mother and child medical history associated with hemoglobin levels among under-five children in Kut City. Methodology: A cross-sectional study with a convenience sample (non-probability) was conducted among 264 children admitted to hospitals in Kut City. From September 1st, 2022, to March 1st, 2023. Data were collected via questionnaires, and descriptive and inferential statistics were used to evaluate the data. Results: The total number of children participating in the study was 264, with 39.0% having mild anemia and 60.0% having moderate anemia, according to the WHO classification of anemia. The results showed that the children most at risk of developing anemia were born to mothers with prenatal medical problems. As well as the period of admission of the child to the hospital. Children who were partially immunized showed the lowest mean of hemoglobin. In contrast, children with a History of acute blood loss showed the lowest mean of hemoglobin. The degree of anemia was significantly associated with a long duration admission in pediatric word or neonatal care unit Conclusion: According to the study, the most critical factors facing anemia were high significant with partially immunized and a history of blood loss. [ABSTRACT FROM AUTHOR]

Introduction: The objectives were to determine the prevalence, Socio-demographic, and environmental factors influencing the prevalence of malaria among children under five years attending the pediatric ward at Hoima Regional Referral Hospital, Hoima district. Methodology: The study was a descriptive cross-sectional study of 100 respondents, selected by simple random sampling technique, data was selected using self-administered questionnaires and the researcher assisted in interpreting for the illiterates. Findings: The prevalence of malaria among children under five years was (92/100) 92%. Most 92(92%) had ever suffered from malaria, half 50(50%) of the respondents reported the death of children under five years due to malaria, majority 90(90%) reported that malaria was commonest in a rural setting, 90(90%) slept under insecticide-treated nets, all 100(100%) obtained their insecticide-treated nets freely from health centers, majority 80(80%) controlled mosquito population in their area by slashing, all 100(100%) reported that mother’s education influenced malaria prevalence, all 100(100%) reported that malaria was commonest in the wet season, most 99(99%) reported more malaria prevalence in areas(warm) near the equator, most 40(40%) reported more mosquito bites in the grass thatched lastly more than half 76(76%) reported that malaria was more in low land. Conclusion: The study found that the prevalence of malaria is very high among children under five years attending pediatric wards in HRRH. This was influenced by being in a rural setting, low level of mother’s education, being peasants, wet season, being near the equator, humidity, and sleeping in grass-thatched houses. Poor control of the mosquito population, and not sleeping in well-ventilated houses with mosquito traps were the other factors Recommendations: The government in conjunction with the administration and health workers of HRRH should carry out regular and comprehensive health education programs and campaigns regarding malaria. Supporting and providing easy access to health centers and prompt management of those affected.

Adequate nutrition during infancy and early childhood is essential to ensure children's growth, health, and development to their full potential. Geographical area may influence dietary intake and, hence, the population's nutritional status. This study aimed to assess dietary intake among children aged 6–59 months in the lowland and highland areas in the Kilosa District, Morogoro. A cross-sectional study involved 200 randomly selected households from the lowland and 141 in the highland areas. Socio-demographic characteristics, feeding practices, and 24-h dietary recall information were collected using a pre-tested questionnaire. In assessing dietary intake, a single day 24-h dietary recall was used where a mother/care giver was asked to recall foods and beverages fed to the child in the 24 h prior to the interview. Mean daily nutrient intake (calorie, vitamin A, iron, calcium and zinc) were estimated using NutriSurvey version 2007 with food database from Tanzania Food composition table. Furthermore, Dietary Diversity Score was done by grouping the mentioned foods into the seven main food groups which are grains, roots and tubers; legumes and nuts; Vitamin A rich fruits and vegetables; other fruits and vegetable; dairy products; and flesh foods and eggs. For each food group consumed, a score of one was assigned and a zero score for the non-consumed group. Inadequate intakes of vitamin A, calcium, and iron were observed more in younger children of age 6–12 months, where none of them met the RDA in both areas. There was a significant difference only in fat intake in children aged 12–36 months between the lowland and highland areas. Children who reside in the lowland area had a significantly more diversified diet. Nutrition education with promotion of home gardening and keeping small animals is necessary to ensure household food availability which subsequently will facilitate dietary diversification.

Background. Anemia is a public health issue that affects both industrialized and developing nations. Childhood anemia has severe consequences, including reduced growth, poor motor and cognitive development, and increased death and morbidity. Objective. This study aims to determine sociodemographic factors associated with the severity of anemia among under-five children in Kut City. Methods. A cross-sectional study with a convenience sample (non-probability) was conducted among 264 children admitted to hospitals in Kut City, from September 1st, 2022, to March 1st, 2023. Data were collected via questionnaires, and descriptive and inferential statistics were used to evaluate the data. Results. The total number of children participating in the study was 264, with 39.0% having mild anemia and 60.0% having moderate anemia, according to the World Health Organization classification of anemia. The results showed that the children most at risk of developing anemia were within 4 years of age and had a lower mean hemoglobin level than the rest of the age groups of the children participating in the study, compared to the mean+standard deviation (SD) (9.46+0.99). Boys are more affected than girls, and those who reside in rural areas have lower hemoglobin (HB) percentages with a mean+SD of (9.21+0.93). Unemployed mothers who read and write had the lowest HB percentage. In contrast, parents with primary education and government jobs have the lowest percentage of HB. Children of married mothers are more affected by anemia. Families with high overcrowding showed the lowest rate of HB. They experienced low socioeconomic status as a result. The degree of anemia was significantly correlated with the child’s age, residence, mother’s educational level, father’s job, and socioeconomic position. Conclusion. This study concludes a significant association between the severity of anemia and sociodemographic factors, both unmodifiable (age) and modifiable (residence, mothers’ education, fathers’ jobs, and economic and social status). Children with modifiable risk factors need to have their anemia risk constantly evaluated.

Abstract Background Health insurance enrolment provides financial access to health care and reduces the risk of catastrophic healthcare expenditure. Therefore, the objective of this study was to assess the prevalence and correlates of health insurance enrolment among Ghanaian children under five years. Methods We analysed secondary data from the 2017/18 Ghana Multiple Indicator Cluster Survey. The survey was a nationally representative weighted sample comprising 8,874 children under five years and employed Computer Assisted Personal Interviewing to collect data from the participants. In addition, Chi-square and Logistic Regression analyses were conducted to determine factors associated with health insurance enrolment. Results The results showed that a majority (58.4%) of the participants were insured. Health insurance enrollment was associated with child age, maternal educational status, wealth index, place of residence and geographical region (p

Indonesia is among the five countries with the highest burden of stunting. Food insecurity reflecting the availability of food in the household is one of the indirect causes of undernutrition. This study examines the relationship between food insecurity and stunting in Indonesia. We used data from the 2021 Indonesian Nutrition Status Survey (SSGI) with a sample size of 82,777 under-five children selected using multistage random sampling. The relationship between food insecurity and stunting was calculated using cox regression to obtain crude and adjusted prevalence ratios (PR) considering strata and weights. Children from households with moderate food insecurity had a (PR unadj) 1.24 (1,18 – 1,31) times higher risk of stunting, and the risk rose in households with severe food insecurity (PR unadj) 1.39 (1,27 – 1,53). Subgroup analysis based on regional categories showed that the association between food insecurity and stunting was only significant in rural areas. Children in rural regions who experienced moderate food insecurity had a 1.09 (95% CI 1.02-1.16) times greater risk of stunting and an increased risk of 1.15 times (95% CI 1.03 – 1.28) in households with severe food insecurity. Interventions are needed to prevent stunting by improving household food security, particularly in rural areas. Further research is needed with better study designs to prove a causal relationship between food insecurity and stunting.

Food insecurity is a continuing challenge for many households in South Africa. This challenge poses serious immediate and long-term health and development risks for children. Despite the intensive literature on household food insecurity, there is limited literature on the household food security status in South African informal settlements. Thus, the household food security status and dynamics in informal settlements are not clearly defined. Hence, this study assessed the food security status of households living with children under 60 months in the informal settlements of the Inanda area, eThekwini Municipality. This study employed a cross-sectional quantitative research approach. A non-probability sampling method was used, which used convenience sampling supplemented by a non-discriminative snowball sampling to obtain a sample size of 160 households with children under the age of five. Data was collected through face-to-face interviews, where questionnaires were administered to household child caregivers. Ethical considerations such as informed consent, anonymity, confidentiality, permission from authorities, and cultural considerations were obeyed in this study. The HFIAS and HDDS tools were used to estimate the household food security status. Data were coded and analysed in SPSS version 25 software. This study revealed that higher proportions of the surveyed informal households living with children under 60 months were food insecure. The HFIAS analysis showed that approximately 34, 31, and 28% were severely, mildly, and moderately food insecure, respectively. In contrast, a small (approximately 8%) proportion of the surveyed informal households was estimated to be food secure. The HDDS analysis revealed that most (approximately 77%) of the surveyed informal households had low dietary diversity (deemed food insecure). Cereal, roots, and fatty foods were the main dietary components in the informal settlements of Inanda. It is paramount to improve the food security status of informal households living with children under 60 months through an integrated approach. This study suggests government and private stakeholders' engagement in developing policies and programs directed at informal households living with children under 60 months to alleviate food insecurity. [ABSTRACT FROM AUTHOR]

Majene Regency has the second highest prevalence of stunting in West Sulawesi by having the highest number of cases found in the village of Rangas. Due to these reasons, it is necessary to research the determinants of stunting, so the studies are expected to provide input to the Majene district government in conducting interventions related to stunting. A case-control study design was used. The subjects were the children aged 12-59 months who lived in the Rangas Village which the children under five years diagnosed stunting based on measurements from the Nutrition Executors (NE) of the Public Health Center. Meanwhile, the controls were children under five years who had not been diagnosed stunting based on measurements from the Nutrition Executors (NE) of the Public Health Center. The samples were 72 respondents with a ratio of 1:1, and the under-five children's mothers as the research respondents. Purposive sampling was used. The stunting data was obtained from the health office, while the identity of the respondents, the characteristics of the mothers, and the characteristics of the children under five years were carried out directly by interview using a questionnaire and strengthened by Mother and Child Health (MCH) Book. Data analysis used the chi-Square test and multiple logistic regression tests. Multivariate analysis results showed that the incidence of stunting was influenced by several factors, including parity (OR=30.40; 95%CI: 3.86-239.43), Maternal Mid-Upper Arm Circumference (MUAC) history < 23.5 cm during pregnancy (OR=2.41; 95%CI: 1.04-5.56) and not exclusive breastfeeding (OR=3.21; 95%CI: 1.29-7.94). The conclusion of this study is parity, a history of maternal MUAC during pregnancy, and not exclusive breastfeeding are risk factors for stunting in children under five years in Banggai District. Therefore, it is necessary to improvement of health promotion strategy for pregnant women by maximizing the first 1000 days of life and campaign two healthy children needs to be maximized.

Pneumonia is still a major health problem in the world, with high morbidity and mortality rates among children under 5 years old, especially in developing countries. In Indonesia, especially Bali, nutritional problem is one of the infection risk factors in children, thus, it is necessary to know the correlation between nutritional status and severity of pneumonia among children under 5 years old at Wangaya District Hospital. This study was based on secondary data. The subjects of this study were paediatric patients diagnosed with pneumonia aged 2 months to 5 years who were treated in Kaswari Room of Wangaya District Hospital from July to December 2019, and were selected by consecutive sampling. The total subjects were 41children with male subjects were more than female (58.5% versus 41.5%). The subjects were mostly in the age groups of 2-10 and 11-20 months old (29.3%); 73.2% of the subjects had good nutrition status, and 73.2% of the cases were non-severe pneumonia. Bivariate analysis between nutritional status and severity of pneumonia obtained p=0.015 and PR of 3.27 (95% CI:1.247-8.590). This study concluded that there was association between nutritional status and severity of pneumonia among children under 5 years old attending Wangaya District Hospital.

Pneumonia is an acute respiratory infection that majorly causes the death of children in the world, especially in developing countries. Malnourished is a risk factor for pneumonia in children under five years. This study aims to determine the association between nutritional status and pneumonia severity in children under five years in the Universitas Kristen Indonesia General Hospital. The design of this study was an analytical cross-sectional. The data was collected from December 2016 - to January 2017 in central to the medical record of UKI General Hospital. The subject was all infants hospitalized with pneumonia from 2013 to 2015. The indicator used for nutritional status was based on weight for height according to WHO 2007 chart. Pneumonia was found most in 13 - 24 months (36,6%). Thirteen of 82 children with normal nutritional status and 24/82 children with undernutrition had severe pneumonia (p = 0,025). Undernutrition status was significantly associated with the severity of pneumonia. [ABSTRACT FROM AUTHOR]

Stunting becomes one of the prior nutritional problems in Bangka Belitung Islands Province, especially West Bangka Regency with a high stunting rate. Feeding habit in children will continuously influence nutrition fulfillment that will directly affect the incidence of stunting. This study aimed at identifying the correlation between feeding habit (beliefs, feeding practices, and children’s eating behavior and the incidence of stunting in children under five years in West Bangka Regency. This was a quantitative study with across-sectional approach. The total sample was 186 respondents taken using a consecutive sampling technique. The instruments for data collection were height measuring instrument, height-for-age graphic according to WHO 2006 to see the z-score and the under-five children’s characteristics questionnaire, a questionnaire of food beliefs, feeding practices questionnaire (CFQ), and child eating behaviour (CEBQ). The analysis in this study used a Chi-Square test. The result showed that there was a significant correlation between child eating behavior and the incidence of stunting in children under five in West Bangka Regency with a p-valueof 0.001 (p

Background: Pneumonia is an ongoing public health problem in Indonesia, ranking as the second most prevalent disease in South Tangerang. Purpose: This study aimed to examine the physical housing environment characteristics in relation to pneumonia occurrence rates among children under-five years of age in South Tangerang City. Method: This research was carried out as a quantitative study with a case-control study design. The population consisted of children under five who were diagnosed with pneumonia at Public Health Center (PHC) of Pamulang and PHC of Ciputat Timur between January 2017 and March 2018. The data were analyzed using the chi-square statistical test. Results: The following characteristics of the housing environment were shown to be associated with pneumonia are bad routines of opening windows (p = 0.00; OR = 11; 95% CI = 2.59–46.78), location of the kitchen is in similar area with other rooms (p = 0.04; OR = 4.03; 95% CI = 1.20–13.53), unqualified humidity in the house (p = 0.05; OR = 3.86; 95% CI = 1.18–12.60), unqualified light intensity in the house (p = 0.01; OR = 9.04; 95% CI = 1.74–46.89), unqualified ventilation area (p = 0.02; OR = 4.50; 95% CI = 1.38–14.82), and unqualified occupancy (p = 0.03; OR = 4.84; 95% CI = 1.29–18.26). Conclusion: The community needs to maintain the physical environment in their houses, such as by opening the windows in the morning so that light comes in and the house does not get damp.

Objective: To determine the proportion of HBV surface antigen (anti-HBs) antibody positive children under five years of age born to HBsAg-negative mothers and to analyze the possible related factors following implementation of a hepatitis B vaccination program for infants in Indonesia 22 years ago. Methods: Blood samples were taken from children under five years of age born to HBsAg-negative mothers who have completed primary vaccination series. Anti-HBs antibodies were determined by using rapid test. Data of age, gender, nutritional status, vaccination timing or vaccination compliance, and booster vaccination were collected from vaccination card. Results: Ninety children were enrolled, consisting of 47 females and 43 males with a mean age of 2.3 years. Twenty two (24.4%) children received booster vaccine between 18 and 24 months and 55 (61.1%) were anti-HBs positive. Among factors of age, gender, nutritional status, compliance to vaccination and booster vaccine, only administration of booster vaccine was significantly associated with anti-HBs status (OR 5.45, 95% CI 1.45, 20.52). Children who received booster vaccine at age of 18-24 months were 5.45 times more likely to be anti-HBs positive than that of children who did not receive booster vaccine. Conclusions: Booster vaccine rate is low among children under 5 years of age but is associated with anti-HBs positivity. Booster vaccination may be required to improve anti-HBs seropositivity.

Background: Health insurance enrolment provides financial access to health care and reduces the risk of catastrophic healthcare expenditure. Therefore, the objective of this study was to assess the prevalence and correlates of health insurance enrolment among Ghanaian children under five years.Methods: We analysed secondary data from the 2017/18 Ghana Multiple Indicator Cluster Survey. The survey was a nationally representative weighted sample comprising 8,874 children under five years and employed Computer Assisted Personal Interviewing to collect data from the participants. In addition, Chi-square and Logistic Regression analyses were conducted to determine factors associated with health insurance enrolment.Results: The results showed that a majority (58.4%) of the participants were insured. Health insurance enrollment was associated with child age, maternal educational status, wealth index, place of residence and geographical region (p < 0.05). Children born to mothers with higher educational status (AOR = 2.14; 95% CI: 1.39-3.30) and mothers in the richest wealth quintile (AOR = 2.82; 95% CI: 2.00-3.98) had a higher likelihood of being insured compared with their counterparts. Also, children residing in rural areas (AOR = 0.75; 95% CI: 0.61-0.91) were less likely to be insured than children in urban areas.Conclusion: This study revealed that more than half of the participants were insured. Health insurance enrolment was influenced by the child's age, mother's educational status, wealth index, residence, ethnicity and geographical region. Therefore, interventions aimed at increasing health insurance coverage among children should focus on children from low socio-economic backgrounds. Stakeholders can leverage these findings to help improve health insurance coverage among Ghanaian children under five years. [ABSTRACT FROM AUTHOR]

Abstract Background Prompt and effective malaria diagnosis and treatment is a cornerstone of malaria control. Case management guidelines recommend confirmatory testing of suspected malaria cases, then prescription of specific drugs for uncomplicated malaria and for severe malaria. This study aims to describe case management practices for children aged 1–59 months seeking treatment with current or recent fever from public and private, rural and urban health providers in Mali. Methods Data were collected at sites in Sikasso Region and Bamako. Health workers recorded key information from the consultation including malaria diagnostic testing and result, their final diagnosis, and all drugs prescribed. Children with signs of severe diseases were ineligible. Consultations were not independently observed. Appropriate case management was defined as both 1) tested for malaria using rapid diagnostic test or microscopy, and 2) receiving artemisinin combination therapy (ACT) and no other antimalarials if test-positive, or receiving no antimalarials if test-negative. Results Of 1602 participating children, 23.7% were appropriately managed, ranging from 5.3% at public rural facilities to 48.4% at community health worker sites. The most common reason for ‘inappropriate’ management was lack of malaria diagnostic testing (50.4% of children). Among children with confirmed malaria, 50.8% received a non-ACT antimalarial (commonly artesunate injection or artemether), either alone or in combination with ACT. Of 215 test-negative children, 44.2% received an antimalarial drug, most commonly ACT. Prescription of multiple drugs was common: 21.7% of all children received more than one type of antimalarial, while 51.9% received an antibiotic and antimalarial. Inappropriate case management increased in children with increasing axillary temperatures and those seeking care over weekends. Conclusions Multiple limitations in management of febrile children under five were identified, including inconsistent use of confirmatory testing and apparent use of severe malaria drugs for uncomplicated malaria. While we cannot confirm the reasons for these shortcomings, there is a need to address the high use of non-ACT antimalarials in this context; to minimize potential for drug resistance, reduce unnecessary expense, and preserve life-saving treatment for severe malaria cases. These findings highlight the challenge of managing febrile illness in young children in a high transmission setting.

Abstract Background Adherence to Antiretroviral Therapy (ART) is required to achieve HIV viral load suppression. However, children under 5 years in Jinja, Uganda, had been shown to have low HIV suppression rates. This study aimed to determine the level of ART non-adherence among these children and the associated factors. Methods Data for the cross-sectional study was collected from April to July 2019, from caregivers of 206 children under 5 years living with HIV who were attending health facilities in Jinja and had been on ART for at least 3 months. Non-adherence was measured using a Visual Analog Scale that assessed both dosing and timing non-adherence, and by determining the Proportion of Days Covered by the medication. A questionnaire administered to the caregivers was used to collect the data, together with medical record review. A child was only considered adherent if they had adherence greater than 95% on all the measures. The data was analysed using Modified Poisson Regression, taking a p-value less than 0.05 as statistically significant. Results Of the 206 children, 73.8% were older than 2 years, and 52.9% were female. Likewise, the majority of caregivers were female (93.7%). Using the combined adherence measure, 57.3% of the children were categorised as non-adherent. School/day-care attendance, Prevalence Ratio (PR) = 1.25 (p = 0.042), the caregiver having higher than a primary school education, PR = 0.72 (p = 0.044) and satisfaction with the quality of service at the health facility, PR = 0.97 (p

Food insecurity is a continuing challenge for many households in South Africa. This challenge poses serious immediate and long-term health and development risks for children. Despite the intensive literature on household food insecurity, there is limited literature on the household food security status in South African informal settlements. Thus, the household food security status and dynamics in informal settlements are not clearly defined. Hence, this study assessed the food security status of households living with children under 60 months in the informal settlements of the Inanda area, eThekwini Municipality. This study employed a cross-sectional quantitative research approach. A non-probability sampling method was used, which used convenience sampling supplemented by a non-discriminative snowball sampling to obtain a sample size of 160 households with children under the age of five. Data was collected through face-to-face interviews, where questionnaires were administered to household child caregivers. Ethical considerations such as informed consent, anonymity, confidentiality, permission from authorities, and cultural considerations were obeyed in this study. The HFIAS and HDDS tools were used to estimate the household food security status. Data were coded and analysed in SPSS version 25 software. This study revealed that higher proportions of the surveyed informal households living with children under 60 months were food insecure. The HFIAS analysis showed that approximately 34, 31, and 28% were severely, mildly, and moderately food insecure, respectively. In contrast, a small (approximately 8%) proportion of the surveyed informal households was estimated to be food secure. The HDDS analysis revealed that most (approximately 77%) of the surveyed informal households had low dietary diversity (deemed food insecure). Cereal, roots, and fatty foods were the main dietary components in the informal settlements of Inanda. It is paramount to improve the food security status of informal households living with children under 60 months through an integrated approach. This study suggests government and private stakeholders’ engagement in developing policies and programs directed at informal households living with children under 60 months to alleviate food insecurity.

Background: In T1DM children with decreased serum 25-hydroxy-vitamin D (25OHD) levels and decreased insulin sensitivity, there is also a substantially greater insulin requirement. Objectives: The purpose of this study was to detect Children with Type1 Diabetes Mellitus under Five Years toward Vitamin-D Deficiency, and to find the significant relationship between Vitamin-D Deficiency and demographic data (BMI and Feeding) of Children. Materials and Method: A descriptive analytic study design was carried out to Detect of Vitamin-D Deficiency in Children Under Five Years with Type 1 Diabetes Mellitus at Diabetes and Endocrinology Center in Al- Nasiriya City. The study had started from October 6th, 2019 to December 17th, 2020. Non randomize (purposive) study of (104) child under five years that suffering from type 1 diabetes mellitus at Diabetes and Endocrinology Center in Al- Nasiriya City. The tool of the research were questionnaire and blood sample taken for test of vitamin D. The questionnaire which has been developed and Two pieces consist of the research questionnaire. The first component contains the demographic features of participants, the second part includes level of vitamin D and its effected factors domain. Results: The distribution of Study Sample according to their Classification of vitamin D level which of 31.7% of 104 children was Severe Deficiency, 48.1% of them was Mild- moderate Deficiency, and 20.2% of them was Optimal. A significant differentiation between the vitamin D level and study group at P≤0.05 level of one sample t test. Conclusion: The present study concluded that the incidence of vitamin D deficiency is high among children under five years with type 1 diabetes, and the largest number of them suffer from mild to moderate deficiency. In addition, the child has more risk factors that effect on vitamin D level such as (Time of Sun light exposure, Duration of sunlight in the week, Period of Sun light exposure, Multivitamin intake and Vitamin D Supplement). [ABSTRACT FROM AUTHOR]

Diarrheal disease is the second leading cause of under‑five mortality, about two billion cases of diarrheal disease are registered annually worldwide, and 1.9 million children under the age of five die each year from diarrhea. A descriptive study was conducted to assessing the self-efficacy among mother′s for preventing diarrhea in children under 5 years and find out the association between self-efficacy of mother′s for preventing diarrhea with her selected demographic variables. The study started from the period of 19th September 2020 to 15th March the 2021. Convenience sample of 200 mothers of children under five years was selected. The data were described statistically and analyzed through the use of descriptive and inferential statistical analysis procedures. Results revealed that mothers self-efficacy evaluated moderate level in the prevention of diarrhea in their children represented (64.3%), with respect to the relation of there is non significant differentiation at P>0.05 among mother’s responding regarding studied domains and their (SDCv.) except between occupation variable level of education variable and socio-economic status since significant relationships are accounted at P<0.01. The study concludes there is non significant differentiation among mother’s responding regarding studied domains and child (SDCv.) except between method of breastfeeding in the first six months, at any age the mother began to give her child extra food has the child previously suffered diarrhea since significant relationships and recommended that community based diarrhea prevention programs” need to adopt the mothers self-efficacy scale to assess mothers ‘perceived risks in order to implement specific interventions that will boost and sustain Diarrhea prevention strategies at the health household levels. [ABSTRACT FROM AUTHOR]

Abstract Background Artemisinin-based combination therapy (ACT), used to treat uncomplicated malaria cases, is one of the main strategies of malaria control and elimination. One of the main objectives of the Benin National Malaria Control Program’s (NMCP) strategic plan is to ensure that at least 80% of uncomplicated malaria is treated with ACT within 24 h. Therefore, it was of great interest to measure whether the country case management of fever amongst children under five, adhered to the NMCP’s strategic plan and look into the barriers to the use of ACT. Methods A cross-sectional survey based on a cluster and multi-stage sampling was conducted in two rural health districts in Benin. We recruited 768 and 594 children under five years were included in the northern and in the southern respectively. Data was collected on the general use of ACT and on the correct use of ACT that adheres to the NMCP’s strategy, as well as the barriers that prevent the proper management of fever amongst children. To assess the certain predictors of ACT usage, logistic regression was used, while taking into account the cluster random effect. Results Among febrile children aged 6 to 59 months, 20.7% in the south and 33.9% in north received ACT. The correct use of ACT, was very low, 5.8% and in southern and 8.6% northern areas. Caregivers who received information on ACT were 3.13 time more likely in the south and 2.98 time more likely in the north to give ACT to their feverish child, PPR = 3.13[1.72–4.15] and PPR = 2.98 [2.72–3.11] respectively. Chloroquine and quinine, other malaria treatments not recommended by NMCP, were still being used in both areas: 12.3 and 3.3% in the south and 11.4 and 3.0% in the north. Conclusion In Benin, the use and the correct use of ACT for febrile children remains low. The study also showed that having received information about the use of ACT is positively associated with the use of ACT. This point highlights the fact that efforts may not have been sufficiently integrated with social communication, which should be based on the behavioural determinants of populations.

Background: Prompt and effective malaria diagnosis and treatment is a cornerstone of malaria control. Case management guidelines recommend confirmatory testing of suspected malaria cases, then prescription of specific drugs for uncomplicated malaria and for severe malaria. This study aims to describe case management practices for children aged 1-59 months seeking treatment with current or recent fever from public and private, rural and urban health providers in Mali.Methods: Data were collected at sites in Sikasso Region and Bamako. Health workers recorded key information from the consultation including malaria diagnostic testing and result, their final diagnosis, and all drugs prescribed. Children with signs of severe diseases were ineligible. Consultations were not independently observed. Appropriate case management was defined as both 1) tested for malaria using rapid diagnostic test or microscopy, and 2) receiving artemisinin combination therapy (ACT) and no other antimalarials if test-positive, or receiving no antimalarials if test-negative.Results: Of 1602 participating children, 23.7% were appropriately managed, ranging from 5.3% at public rural facilities to 48.4% at community health worker sites. The most common reason for 'inappropriate' management was lack of malaria diagnostic testing (50.4% of children). Among children with confirmed malaria, 50.8% received a non-ACT antimalarial (commonly artesunate injection or artemether), either alone or in combination with ACT. Of 215 test-negative children, 44.2% received an antimalarial drug, most commonly ACT. Prescription of multiple drugs was common: 21.7% of all children received more than one type of antimalarial, while 51.9% received an antibiotic and antimalarial. Inappropriate case management increased in children with increasing axillary temperatures and those seeking care over weekends.Conclusions: Multiple limitations in management of febrile children under five were identified, including inconsistent use of confirmatory testing and apparent use of severe malaria drugs for uncomplicated malaria. While we cannot confirm the reasons for these shortcomings, there is a need to address the high use of non-ACT antimalarials in this context; to minimize potential for drug resistance, reduce unnecessary expense, and preserve life-saving treatment for severe malaria cases. These findings highlight the challenge of managing febrile illness in young children in a high transmission setting. [ABSTRACT FROM AUTHOR]

• 25% of children with community-acquired pneumonia are given antibiotics at home. • Children with CAP in Tanzania are often delayed in seeking appropriate treatment. • In 27.5% of the cases, children with viral CAP unnecessarily received antibiotics. • Nasopharyngeal carriage of bacteria in children is linked to referral to higher level of care. To describe the treatment of community-acquired pneumonia (CAP) in children under five years in Tanzania. Between January and December 2017, children aged 2–59 months with chest radiography-confirmed CAP were enrolled. The parents were interviewed to collect information on the patients and home-based medication. Clinical information was derived from the patient files. Nasopharyngeal swab and blood samples were collected for isolation of the causative pathogens. Swab samples were analysed by quantitative PCR whereas blood samples were tested using BacT/Alert 3D. Overall, 109 children with CAP were included in this analysis. Provision of care to most children was delayed (median = 4.6 days). A quarter (26.6%) were given unprescribed/leftover antibiotics at home. Only one child had positive bacterial culture. Referrals were associated with nasopharyngeal carriage of Streptococcus pneumoniae (p = 0.003) and Haemophilus influenzae (p = 0.004). Of all admitted children, more than a quarter (n = 29) did not need to be hospitalised and inappropriately received injectable instead of oral antibiotics. We found high rates of home treatment, particularly with antibiotics. Appropriate health care was delayed for most children because of home treatment. Efforts are needed at the community level to improve awareness of antimicrobial resistance. [ABSTRACT FROM AUTHOR]

Background: Under-five mortality is a health indicator in population health and the health sciences. Force of death is a more accurate measure of mortality than others, which indicates the situation of mortality when time tends to zero. The purpose of this research is to construct a simulation for l x (the number of people living at exact age x) for under-five mortality in Bangladesh as a whole, and separately for rural and urban areas, and then estimating the mortality rate in regard to these matched models. Methods: Secondary data were collected from Bangladesh Demographic and Health Survey 2007. A polynomial model was selected to match the l x values. To prove the accuracy of the model, the rule of cross-validity was applied. Results: It has been shown that fourth degree polynomial models can be adjusted to l x values ​​with explanation of more than 94% variation. It was noted that the mortality rate shows a rapidly decreasing pattern for people aged 0-20 months, a monotonically increasing pattern for those aged 20-53.5 months and then it begins to decrease. It is found that the mortality rate in rural areas is higher than in urban areas of all ages. Conclusions: It has been shown that the mortality rate in rural areas is higher than for urban areas of all ages, except for those aged 53.5 months. The health situation should therefore be improved to reduce mortality in rural Bangladesh.

• Neurologic complications in children under five years of age with SCD are common. • Diagnosis of neurologic complications is difficult in young children with SCD. • Silent cerebral infarct and cognitive impairment are the most common neurologic complications. • Detection of overt stroke in very young children is challenging. Sickle Cell Disease (SCD) is one of the most common genetic diseases in the world affecting every organ. The major challenge in the medical care of children with SCD is preventing end-organ dysfunction, particularly the brain. Major neurologic complications in children less than five years with SCD include, but are not limited to, Silent cerebral infarct, cerebral sinus thrombosis, epilepsy, reversible encephalopathy syndrome, and ischemic and hemorrhagic stroke. Recurrent headaches and migraine are not rare in children under five years with SCD. This review will focus on the neurologic complications and the description of the modifiable risk factors in children less than 5 years of age with emphasis on differences between high and low resource settings. Neurologic complications of children under 5 years of age and the modifiable risk factors. The PUBMED database was searched using medical subject headings (MeSH) and keywords for articles regarding neurologic complications in children under 5 years of age. Neurologic complications in children under five years of age with SCD may be more frequent than currently reported, among which Silent cerebral infarct and cognitive impairment are the most common. [ABSTRACT FROM AUTHOR]

Introduction: streptococcus pneumonia is a leading cause of bacterial pneumonia, meningitis and sepsis in children, and pneumococcal carriage is an important source of horizontal spread of these pathogens within the community. Methods: a questionnaire was addressed to parents for the collection of sociodemographic and medical information. Nasopharyngeal swabbing was processed using a molecular method. We used logistic regression models to examine independent associations between pneumococcal carriage and potential risk factors. All associations with a p-value of < 0.25 in the bivariate regression analyses were subsequently entered in the multivariate regression model. Results: a total of 637 children aged 1 to 59 months admitted for acute respiratory infection were included. The rate of respiratory virus carriage was 76%, whereas that of bacteria was 47% and that of bacteria-virus co-colonization was 42%. A bivariate analysis showed that carriage was not related to gender, father's or mother's education level, father's occupation, type of housing or lighting, or passive exposure to cigarette smoking in the house. It was also not linked to complete vaccination with PCV-13 or PPSV-23 and antibiotic treatment prior to hospitalization. A multivariate analysis showed that carriage was related to age greater than 3 months, maternal occupation, house flooring type, and co-colonization of another bacterium and virus. Conclusion: these results can be helpful to understand the dynamics of pneumococcal nasopharyngeal colonization; they confirm the interest of vaccinating infants before the age of 3 months with appropriate vaccine to prevent spread nasopharyngeal colonization and pneumococcal diseases in children. [ABSTRACT FROM AUTHOR]

Pneumonia is the first globally infectious disease causing death in children under five years of age in which the discovery of cases has increased in Indonesia in recent years. Immunization is a major preventive effort against the disease and is administered through the DPT, Hib, measles, PCV, and rotavirus vaccines. The aim of this study was to understand the correlation between complete basic immunization administration, parental characteristics, and the characteristics of children under five years with the incidence of pneumonia among children in this age group in Depok, Indonesia. The study used a cross-sectional design. There were 104 samples chosen by consecutive sampling. The study was conducted at the public health center in Depok between April and June of 2018. The data collection used questionnaires, parental characteristics, characteristics of children under five years, and complete basic immunization data for the children, which was arranged by the researchers. The questionnaire was tested for validity and reliability. The results of the study showed that complete basic immunization (p: 0.000, α: 0.05), age (p: 0.002, α: 0.05), and nutritional status (p: 0.043, α: 0.05) had a significant correlation with the incidence of pneumonia in children under five years. Health education about the importance of complete basic immunization and balanced nutrition needs to be given to parents who have under-five years of age. [ABSTRACT FROM AUTHOR]

Abstract Background Undernutrition remains the major public health concern in Ethiopia and continues as the underlying cause of child mortality. However, there is a scarcity of information on the magnitude and determinant factors of undernutrition. Therefore, this study aimed to assess the prevalence of undernutrition and associated factors among children aged 6–59 months in East Belesa District, northwest Ethiopia. Methods A community-based cross-sectional study was conducted from April to May, 2014. A multistage stratified sampling technique was used to select 633 study participants. A structured interviewer-administered questionnaire was used to collect data. In order to identify factors associated with undernutrition (stunting and wasting) a multivariate logistic regression analysis was employed. The Adjusted Odds Ratio (AOR) with a 95 % Confidence Interval (CI) was computed to show the strength of the association. In the multivariate analysis, variables with a p-value of

Background and Objectives: Damages caused by accidents are accounted as a major cause of death for children under 5 years old. To design preventive programs, health education theories could be employed. This study aimed to determine the effect of educational intervention based on health belief model on the damage caused by accidents in children less than 5 years in 1392 in Qorveh city. Methods: The present randomized field trial study was conducted on 120 mothers with children less than 5 years who were supported by four different health centers. These centers were randomly divided into two groups of intervention and control. The effect of intervention was investigated using a standardized questionnaire including 85 items of health belief model structures. The questionnaires were completed using interviews by trained interviewers. Statistical analysis was done using SPSS 19.0, independent and two-tailed samples t-test. Results: We found that there were positive and significant differences in terms of knowledge, intensity, perceived barriers and self-efficacy between two groups after intervention (P

Background: Indonesia is on the fifth in world population for children with small stature. It could affect to their future, so growth disorders should be detected as early as possible. The influence of growth disorders is inseparable from the socioeconomic condition of the family. This study aims to analyze the influence of socioeconomic based on education, occupation and family income towards small stature children under five years old in Jatinangor. Methods: This was a study of analytic cross sectional with multi-stage proportionate consecutive sampling. 110 samples of children under five years of age (12–59months) from 12 villages (6087 children) in Jatinangor sub district were taken on October and November 2012. Their height was measured using a microtoise based on WHO Growth Chart and the socioeconomic status was measured using questionnaire completed by their mother Results: There were 32 children (29,1%) with small stature. The relationship between maternal education with short stature (p=0.310), father’s education with small stature (p=0.368), mother’s occupation with small stature (p=0.774), father’s occupation with small stature (p=0.524) and family income with small stature (p=0.890) after it was examined using chi-squre test were not significant (p>0.05). Conclusion: In Jatinangor, there are still many children with small stature under five years old and the socioeconomic factors do not have any relationship with this condition.

Background: Early marriage is a marriage at <21 years old. One of the districts in South Kalimantan Province with the percentage of early marriage are above the percentage of Regency was East Martapura District (23.39%). Early marriage leads to lack of mental readiness and cognitive mothers so that mothers are not optimal in carrying out their role and impact on their child growth. Material and Methods: This research was an observational analytic research with cross- sectional approach with 205 toddlers as a sample. Primary data was collected by conducting interviews to fill out questionnaires, weight and height measurement, and using Pre- screening Developmental Questionnaire (PDQ) to measured child development. Result: There was significant influence between family income (p=0.018), mothers education (p=0,032), feeding practices (p= 0,000), hygiene practices (p=0,000), health care practices (p=0,000), and early stimulation (p=0.009) with nutritional and development status of children under five years. Conclusion: There was influenced between family income, mother's education, feeding practice, hygiene practices, health care practices, and early stimulation with the nutritional and development status of children under five years old It is necessary to improve the delivery of health information especially in relation to feeding practices, child hygiene practices, child health care practices and the provision of proper early stimulation to optimize child growth. [ABSTRACT FROM AUTHOR]

Background: Artemisinin-based combination therapy (ACT), used to treat uncomplicated malaria cases, is one of the main strategies of malaria control and elimination. One of the main objectives of the Benin National Malaria Control Program's (NMCP) strategic plan is to ensure that at least 80% of uncomplicated malaria is treated with ACT within 24 h. Therefore, it was of great interest to measure whether the country case management of fever amongst children under five, adhered to the NMCP's strategic plan and look into the barriers to the use of ACT.Methods: A cross-sectional survey based on a cluster and multi-stage sampling was conducted in two rural health districts in Benin. We recruited 768 and 594 children under five years were included in the northern and in the southern respectively. Data was collected on the general use of ACT and on the correct use of ACT that adheres to the NMCP's strategy, as well as the barriers that prevent the proper management of fever amongst children. To assess the certain predictors of ACT usage, logistic regression was used, while taking into account the cluster random effect.Results: Among febrile children aged 6 to 59 months, 20.7% in the south and 33.9% in north received ACT. The correct use of ACT, was very low, 5.8% and in southern and 8.6% northern areas. Caregivers who received information on ACT were 3.13 time more likely in the south and 2.98 time more likely in the north to give ACT to their feverish child, PPR = 3.13[1.72-4.15] and PPR = 2.98 [2.72-3.11] respectively. Chloroquine and quinine, other malaria treatments not recommended by NMCP, were still being used in both areas: 12.3 and 3.3% in the south and 11.4 and 3.0% in the north.Conclusion: In Benin, the use and the correct use of ACT for febrile children remains low. The study also showed that having received information about the use of ACT is positively associated with the use of ACT. This point highlights the fact that efforts may not have been sufficiently integrated with social communication, which should be based on the behavioural determinants of populations. [ABSTRACT FROM AUTHOR]

Pneumonia is the major cause of mortality in children under five years. A total of 751 children aged 1–59 months admitted for acute respiratory infection were included in this study. Pneumococcal serum IgG antibody was determined by ELISA. Carriage of Streptococcus pneumoniae was determined by molecular analyses of nasopharyngeal swabbings, and the rapid urinary diagnostic test Binax NOW ® Sp was used for detection of pneumococcal antigen in urine. A total of 224 (29.8%) children had vaccination record books, and among them, 186 (83%) were vaccinated with the 23-Valent Pneumococcal Polysaccharide Vaccine (PPSV-23), 7 (3%) were vaccinated with the 13-Valent Pneumococcal Conjugate Vaccine (PCV-13), and 31 (14%) had not been vaccinated. IgG levels against pneumococcal polysaccharide were ≥1.3 μg/mL in most of the children (99.4%). The carriage rate of S. pneumoniae was 39%, and the Binax NOW ® Sp test was positive in 26% of children. There was no significant variation between the means of IgG concentrations against pneumococcal polysaccharides as related to vaccination status, age and nasopharyngeal carriage of S. pneumoniae . However, there was a weak positive correlation between age and level of IgG (r = 0.08; p = 0.021), and there was a significant variation (p = 0.038) of the IgG level according to presence of S. pneumoniae antigen in urine. The presence of S. pneumoniae antigen in urine is significantly (p ≤ 0.01) higher in children with nasopharyngeal carriage of S. pneumoniae (40%) than non-carriers (20%). This study shows that S. pneumoniae has high circulation in children under the age of five years either through infection or carriage. [ABSTRACT FROM AUTHOR]

Background: Undernutrition remains the major public health concern in Ethiopia and continues as the underlying cause of child mortality. However, there is a scarcity of information on the magnitude and determinant factors of undernutrition. Therefore, this study aimed to assess the prevalence of undernutrition and associated factors among children aged 6-59 months in East Belesa District, northwest Ethiopia.Methods: A community-based cross-sectional study was conducted from April to May, 2014. A multistage stratified sampling technique was used to select 633 study participants. A structured interviewer-administered questionnaire was used to collect data. In order to identify factors associated with undernutrition (stunting and wasting) a multivariate logistic regression analysis was employed. The Adjusted Odds Ratio (AOR) with a 95 % Confidence Interval (CI) was computed to show the strength of the association. In the multivariate analysis, variables with a p-value of <0.05 were considered as statistically significant.Results: In this study, about 57.7 and 16 % of the children were stunted and wasted, respectively. The odds of stunting were higher in children born to mothers who gave their first birth before 15 years of age (AOR = 2.4; 95 % CI: 1.19, 5.09) and gave prelacteal feeding to their child (AOR = 1.83; 95 % CI: 1.28, 2.61). However, lower odds of stunting were observed among children aged 36-47 months (AOR = 0.41; 95 % CI: 0.22, 0.78) and had higher family monthly income, Et. Br. 750-1000, (AOR = 0.61; 95 % CI: 0.39, 0.92). Moreover, the odds of wasting were higher among children who received butter as prelacteal food (AOR = 2.32; 95 % CI:1.82, 5.31).Conclusion: Child undernutrition is a critical public health problem in the study area. Advanced age of children (36-47 months) and higher family monthly income were inversely associated with stunting. However, higher odds of stunting were observed among children whose mothers delivered their first child before 15 years of age, and gave their children prelacteal feeding. Thus, delaying the first pregnancy and reducing prelacteal feeding is of a paramount significance in reducing the burden of undernutrition. [ABSTRACT FROM AUTHOR]