Acute malnutrition and its determinants of preschool children in Bangladesh: gender differentiation.

BACKGROUND: Children acute malnutrition (AM) is a global public health concern, especially in low and middle income countries. AM is associated with multiple physiological vulnerabilities, including immune dysfunction, enteric barrier disruption, gut microbiome dysbiosis, and essential nutrient deficits. This study aimed to determine the prevalence of AM and its associated factors among preschool children in Rajshahi district, Bangladesh. METHODS: This cross-sectional study was conducted from October to December, 2016. Children acute malnutrition was assessed using mid-upper arm circumference. Multiple binary logistic regression analyses were employed to determine the associated factors after adjusting the effect of independent factors of children AM. RESULT: The prevalence of AM amongst preschool children was 8.7%, among them 2.2 and 6.5% were severe acute malnutrition and moderate acute malnutrition, respectively. Z-proportional test demonstrated that the difference in AM between girls (11.6) and boys (5.9%) was significant (p < 0.05). Children AM was associated with being: (i) children aged 6-23 months (aOR = 2.29, 95% CI: 1.20-4.37; p < 0.05), (ii) early childbearing mothers' (age < 20 years) children (aOR = 3.06, 95% CI: 1.08-8.66; p < 0.05), (iii) children living in poor family (aOR = 3.08, 95% CI: 1.11-8.12; p < 0.05), (iv) children living in unhygienic latrine households (aOR = 2.81, 95% CI: 1.52-5.09; p < 0.01), (v) Hindu or other religion children (aOR = 0.42, 95% CI: 0.19-0.92; p < 0.05). CONCLUSION: The prevalence of AM was high among these preschool children. Some modifiable factors were associated with AM of preschool children. Interventions addressing social mobilization and food security could be an effective way to prevent acute malnutrition among children in Bangladesh.

Household-level risk factors for influenza among young children in Dhaka, Bangladesh: a case-control study.

OBJECTIVES: To identify household-level factors associated with influenza among young children in a crowded community in Dhaka, Bangladesh. METHODS: We conducted a case-control study using existing active surveillance for respiratory illness. Cases were children aged 12-59 months with laboratory-confirmed influenza. Controls were children frequency-matched by age group with no respiratory illness in the prior 6 months. We interviewed caregivers and observed household handwashing behaviour. Soap consumption was estimated by summing weight differences of three bars of soap sequentially left in each household. We measured concentrations of airborne particulate matter <2.5 µg in diameter (PM2.5) in a subset of households. We used logistic regression to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI). RESULTS: We enrolled 145 cases and 341 controls between March 2009 and April 2010. Case and control household members were observed to wash hands with similar frequency during a 5-h period (mean, 0.64 events vs. 0.63, P = 0.87), and similar daily soap consumption per capita (mean 2.92 grams vs. 2.93, P = 0.92). Case households were more likely than controls to have crowded (≥4 persons) sleeping areas (aOR = 1.67, CI: 1.06-2.63) and cross-ventilated cooking spaces (aOR = 1.75, CI: 1.16-2.63). Case and control households had similar median 24-h geometric mean PM2.5 concentrations in the cooking (69.2 vs. 69.6 µg/m(3), P = 0.45) and sleeping (65.4 vs. 67.4 µg/m(3), P = 0.19) spaces. CONCLUSIONS: Handwashing with soap was practiced infrequently and was not associated with paediatric influenza in this community. Interventions aimed at crowded households may reduce influenza incidence in young children.

Household air quality risk factors associated with childhood pneumonia in urban Dhaka, Bangladesh.

To inform interventions to reduce the high burden of pneumonia in urban settings such as Kamalapur, Bangladesh, we evaluated household air quality risk factors for radiographically confirmed pneumonia in children. In 2009-2010, we recruited children < 5 years of age with pneumonia and controls from a population-based surveillance for respiratory and febrile illnesses. Piped natural gas was used by 85% of 331 case and 91% of 663 control households. Crowding, a tin roof in the living space, low socioeconomic status, and male sex of the child were risk factors for pneumonia. The living space in case households was 28% less likely than in control households to be cross-ventilated. Particulate matter concentrations were not significantly associated with pneumonia. With increasing urbanization and supply of improved cooking fuels to urban areas, the high burden of respiratory illnesses in urban populations such as Kamalapur may be reduced by decreasing crowding and improving ventilation in living spaces.