The level of wasting and associated factors among children aged 6-59 months in sub-Saharan African countries: multilevel ordinal logistic regression analysis.

Background: Despite various interventions to combat child malnutrition in sub-Saharan Africa, wasting remains a critical public health concern for children aged 6-59 months. Wasting is a significant predictor of child survival and development, with a heightened risk of mortality among children. However, there is a lack of recent comprehensive data on the prevalence, severity level, and factors contributing to wasting in this age group. Objective: To identify the severity levels of wasting and its individual and community-level factors contributing to wasting among children aged 6-59 months in Sub-Saharan African countries. Methods: This research utilized Demographic and Health Survey data from 34 Sub-Saharan African countries, spanning the period from 2007 to 2022. The study included a weighted sample of 180,317 6-59-month-old children. We employed a multilevel proportional odds model to identify factors predicting the severity of wasting. Adjusted odds ratios and 95% confidence intervals were reported to demonstrate significant relationships (p < 0.05) in the final model. Results: In Sub-Saharan Africa, 7.09% of children aged 6-59 months experience wasting (95% CI: 6.97, 7.20%). Among these children, the prevalence of moderate wasting is 4.97% (95% CI: 4.90, 5.10%), while severe wasting affects 2.12% (95% CI: 2.0, 2.20%). Factors such as term/post-term babies, wealth, frequency of feeding, improved toilet facilities, water sources, employed and educated mothers, rural residence, high community maternal education, and community media exposure are strongly associated with a lower chance of experiencing severe form of wasting. Conversely, birth order, family size, breastfeeding, diarrhea, cough, and fever, high community poverty, female household heads, and all Sub-Saharan Africa regions are linked to higher levels of wasting. Conclusion: The study findings underscore the persistent challenge of wasting among Sub-Saharan Africa's children, with 7.09% affected, of which 4.97% experience moderate wasting and 2.12% severe wasting. The identified predictors of wasting highlight the complex interplay of socio-economic, environmental, and health-related determinants. To address this issue improve access to healthcare and nutrition services, enhance sanitation infrastructure, promote women's empowerment, and implement community-based education programs. Additionally, prioritize early detection through routine screening and strengthen health systems' capacity to provide timely interventions.

Individual-and community-level factors associated with anemia among children aged 6-23 months in sub-Saharan Africa: evidence from 32 sub-Saharan African countries.

BACKGROUND: Anemia among children aged 6-23 months is a major public health problem worldwide specifically in sub-Saharan Africa (SSA). Anemia during the childhood period causes significant short-and long-term health consequences. However, there is a paucity of evidence on Anemia among children aged 6-23 months in SSA. Therefore, this study examined the individual- and community-level factors associated with anemia among children aged 6-23 months in sub-Saharan Africa. METHODS: A secondary data analysis was done based on the most recent Demographic and Health Survey (DHS) of 32 sub-Saharan African countries. A total weighted sample of 51,044 children aged 6-23 months was included for analysis. We have used a multilevel proportional odds model to identify predictors of severity levels of anemia. Variables with p < 0.2 in the bivariable analysis were considered for the multivariable analysis. In the multivariable multilevel proportional odds model, the Adjusted Odds Ratio (AOR) with the 95% Confidence Interval (CI) was reported to declare the statistical significance and strength of the association. RESULTS: In this study, about 76.6% (95% CI: 76.2%, 76.9%) of children aged 6-23 months in sub-Saharan Africa were anemic. In the multivariable multilevel proportional odds model, being female, being aged 18-23 months, higher level of maternal education, being larger size at birth, belonging to a wealthier household, getting four ANC visits and above, advanced maternal age, and belonging to a community with high maternal education were significantly associated with lower odds of higher levels of anemia. On the other hand, being twin birth, being smaller size at birth, being of a higher order of birth, having fever in the last two weeks, and distance to a health facility were significantly associated with higher odds of higher levels of anemia. CONCLUSION: The study found that more than three-fourths of children aged 6-23 months in sub-Saharan Africa were anemic. This finding proved that the severity levels of anemia among children in sub-Saharan Africa remain a serious public health concern. Therefore, to curve this problem enhancing maternal education, promoting maternal health service utilization, and improving health care access is crucial. In addition, health care providers better give special emphasis to twin births, higher-order birth, and those belonging to poor households to reduce the incidence of anemia among children aged 6-23 months in SSA.

Early initial video-electro-encephalography combined with variant location predict prognosis of KCNQ2-related disorder.

BACKGROUND: The clinical features of KCNQ2-related disorders range from benign familial neonatal seizures 1 to early infantile epileptic encephalopathy 7. The genotype-phenotypic association is difficult to establish. OBJECTIVE: To explore potential factors in neonatal period that can predict the prognosis of neonates with KCNQ2-related disorder. METHODS: Infants with KCNQ2-related disorder were retrospectively enrolled in our study in Children's Hospital of Fudan University in China from Jan 2015 to Mar 2020. All infants were older than age of 12 months at time of follow-up, and assessed by Bayley Scales of Infant and Toddler Development-Third Edition (BSID-III) or Wechsler preschool and primary scale of intelligence-fourth edition (WPPSI-IV), then divided into three groups based on scores of BSID-III or WPPSI-IV: normal group, mild impairment group, encephalopathy group. We collected demographic variables, clinical characteristics, neuroimaging data. Considered variables include gender, gestational age, birth weight, age of the initial seizures, early interictal VEEG, variant location, delivery type. Variables predicting prognosis were identified using multivariate ordinal logistic regression analysis. RESULTS: A total of 52 infants were selected in this study. Early interictal video-electro-encephalography (VEEG) (ß = 2.77, 1.20 to 4.34, P = 0.001), and variant location (ß = 2.77, 0.03 to 5.5, P = 0.048) were independent risk factors for prognosis. The worse the early interictal VEEG, the worse the prognosis. Patients with variants located in the pore-lining domain or S4 segment are more likely to have a poor prognosis. CONCLUSIONS: The integration of early initial VEEG and variant location can predict prognosis. An individual whose KCNQ2 variant located in voltage sensor, the pore domain, with worse early initial VEEG background, often had an adverse outcome.

[Factors Related to Salt-Reduction Cognizance and Salt Intake in Women Aged 40-59 Years: Characteristics of Guardians of Medical University Students].

OBJECTIVES: In our previous study in which we aimed to clarify the factors related to salt intake in women aged 40-59 years, salt intake was found to be not related to salt-reduction cognizance. The aim of this research was to clarify factors related to salt intake in those who were cognizant of the importance of reducing their salt intake. METHODS: Two hundred and forty-seven female guardians (effective rate, 32.2%) in a medical university, aged 40-59 years old, participated in this study. The participants were divided into three groups according to their salt-reduction cognizance. RESULTS: There was no significant difference in salt intake between the three groups who were salt-reduction cognizant. Intakes of potassium (mg/1,000 kcal), vegetables, and fruits were higher in those who were cognizant of the importance of reducing their salt intake. The frequencies of consuming stewed foods, miso soup, and vinegared and marinated dishes were also higher. Those who were salt-reduction cognizant were knowledgeable about salt consumption, had experienced making low-salt dishes, used low-sodium seasoning, and made light-tasting dishes by regulating ingredients when cooking. However, when it came to eating, there was no difference in the percentage of those who left most of the broth when eating noodle soups and the frequency with which they added seasoning in terms of salt-reduction cognizance. CONCLUSION: Salt-reduction cognizant women aged 40-59 years made conscious efforts to use less salt at the time of cooking, but made no efforts when eating, even though they were cognizant of the importance of reducing their salt intake.

Does hospital ownership influence hand hygiene compliance?

The issue as to whether hospital ownership has an impact on the quality of care has long been a serious concern. Hand hygiene (HH) compliance is regarded as an important indicator of the quality of care in the control of hospital-acquired infections. However, little information is available on whether hospital ownership influences HH compliance. In this study, of 229 hospitals selected from Hubei province in China, 152 were public and 77 were private hospitals. A total of 23 652 healthcare workers (HCWs) were surveyed, using a convenience sampling. HH compliance, the WHO's "My Five Moments for hand hygiene" (5MHH), among HCWs, together with the factors of hospital ownership, training frequency, bed occupancy rates, etc. were collected. Univariate analysis and ordinal logistic regression analysis were used to analyze factors affecting HH compliance. Overall, HH compliance rates were 67% and 79% for public and private hospitals, respectively. The HH compliance rates of HCWs and 5MHH were between 55% and 95%, and influenced by hospital ownership (P<0.05), excluding compliance rate at the moment after body fluid exposure, and other influence factors included training frequency and bed occupancy rate (P<0.05). HH compliance is better in private than in public hospitals. Hospital ownership is a significant factor affecting HH compliance, in addition to training frequency and bed occupancy rate.

Does Hospital Ownership Influence Hand Hygiene Compliance? / 华中科技大学学报（医学）（英德文版）

The issue as to whether hospital ownership has an impact on the quality of care has long been a serious concern.Hand hygiene (HH) compliance is regarded as an important indicator of the quality of care in the control of hospital-acquired infections.However,little information is available on whether hospital ownership influences HH compliance.In this study,of 229 hospitals selected from Hubei province in China,152 were public and 77 were private hospitals.A total of 23 652 healthcare workers (HCWs) were surveyed,using a convenience sampling.HH compliance,the WHO's "My Five Moments for hand hygiene" (5MHH),among HCWs,together with the factors of hospital ownership,training frequency,bed occupancy rates,etc.were collected.Univariate analysis and ordinal logistic regression analysis were used to analyze factors affecting HH compliance.Overall,HH compliance rates were 67％ and 79％ for public and private hospitals,respectively.The HH compliance rates of HCWs and 5MHH were between 55％ and 95％,and influenced by hospital ownership (P＜0.05),excluding compliance rate at the moment after body fluid exposure,and other influence factors included training frequency and bed occupancy rate (P＜0.05).HH compliance is better in private than in public hospitals.Hospital ownership is a significant factor affecting HH compliance,in addition to training frequency and bed occupancy rate.

Analysis of the compliance and the related influence factors in the follow-up process of surveillance for Creutzfeldt-Jakob disease in China.

Creutzfeldt-Jakob disease (CJD) is a kind of rare, rapidly progressive fatal central nervous system disorders. In China, the surveillance for CJD has started since 2006. As one of the major issues in CJD surveillance, the follow-up process via telephone plays important role in CJD diagnosis and surveillance. Although the follow-up process was conducted by the experiential staffs from CJD surveillance center in China CDC, it is frequently encountered that some interviewed family members do not cooperate well during follow-up. To screen the possible factors influence on the compliances of the interviewees during CJD follow-up, 11 independent variables from patient aspect and 4 variables from interviewee aspect were selected and a questionnaire was prepared. Based on 199 suspected sporadic CJD cases reported to CJD surveillance center in 2013, a telephone-inquiring was conducted and the degree of compliances of the interviewees were given as good, fair or poor. After screened with univariate analysis and evaluated ordinal logistic regression analysis, several indictors, such as the patient gender, CJD diagnosis, numbers of clinical symptoms, continual medical treatment after diagnosis, medical treatment mode, as well as the relationship with the patient and CJD knowledge of the interviewees, showed influence on the compliance in CJD follow-up process significantly. The data here provide for the first time the factors related with the compliances of the interviewed family members of the suspected CJD patients during follow-up process, which supplies useful clue for us to improve CJD follow-up process and increase the capacity of CJD surveillance.