Socio-demographic and economic inequity in the use of insecticide-treated bed nets during pregnancy: a survey-based case study of four sub-Saharan African countries with a high burden of malaria.

Despite global investments in malaria eradication and mitigation efforts, including the dissemination of ITNs to vulnerable communities, the goal of widespread malaria control among pregnant women has yet to be realized in many African countries. One of the explanations forwarded for this is related to the adoption and regular use of ITNs by pregnant women. Based on the available DHS and MIS data from four malaria high burden African countries- according to WHO malaria report 2020- inequality was measured by applying both relative and absolute summary measures for the four dimensions of inequality: economic status, education, place of residence and region. By considering the number of subgroups in each variable, simple and complex summary measures were used.ITN utilization by pregnant women showed an increasing trend over time in all the four countries. There was also significant inequality (variability) in the ITN utilization among population groups. DRC, Mozambique and Uganda showed noticeable inequality that favors the richest population, whereas in Nigeria the inequality was observed among both the rich and the poor during different survey yearsIn conclusion, in all the four countries, there were significant regional variations or differences in ITN use among pregnant mothers across all dimensions of inequality in the survey years. Tailored cost-effective interventions could be considered to improve ITN utilization among pregnant women.

Magnitude and distribution of vitamin A deficiency in Ethiopia.

BACKGROUND: Several surveys conducted over a period of 40 years have shown that vitamin A deficiency is a serious public health problem in Ethiopia. To address the problem effectively, up-to-date, comprehensive information on the magnitude and distribution of vitamin A deficiency is needed. OBJECTIVE: A national vitamin A survey was conducted to assess the national and regional prevalence rates of vitamin A deficiency in Ethiopia. METHODS: The survey employed a multistage, cluster-sampling approach and a cross-sectional study design. A total of 23,148 children aged 6 to 71 months and their respective mothers were examined for clinical signs and symptoms, and blood samples were collected from 1200 systematically selected children for serum retinol analysis. RESULTS: The findings indicated national prevalence rates of 1.7% for Bitot's spots among children. 0.8% for night-blindness among children, and 1.8% for night-blindness among mothers. Nationally, 37.7% of children (95% CI, 35.6% to 39.9%) had deficient serum retinol levels, 50.7% had been sick in the previous 15 days, and 22.6% had received vitamin A supplements in the previous 6 months. The prevalence of clinical vitamin A deficiency was significantly (p < .05) higher among children who were male, older, or rural residents. CONCLUSIONS: The study confirmed that vitamin A deficiency is a serious public health problem in Ethiopia. Intensification of the ongoing vitamin A supplementation program, postpartum vitamin A supplementation for mothers, intensifying efforts to improve the health status of preschool age children, and promotion of production and consumption of fruits and vegetables are recommended.

Demographic and health-related risk factors of subclinical vitamin A deficiency in Ethiopia.

The study was conducted to determine the demographic and health-related risk factors of subclinical vitamin A deficiency in Ethiopia. Blood samples were collected from 996 children in 210 clusters across the nation for analysis of serum retinol. Interviews were conducted with the respective mothers of the 996 children on presumed risk factors of vitamin A deficiency. A higher subclinical vitamin A deficiency was associated with: not receiving vitamin A supplement over the year, having been ill during the two weeks preceding the survey, no or incomplete vaccination, belonging to a mother with high parity, and low levels of awareness of vitamin A. Moreover, being from Muslim household was strongly associated with higher levels of subclinical vitamin A deficiency. Among the risk factors identified, low levels of vaccination, high parity, and low levels of maternal awareness of vitamin A contributed to higher risks of vitamin A deficiency among Muslim children. The findings underscore the need for creation of strengthened awareness of family planning and importance of vitamin A, promotion of vaccination and child health, intensification of vitamin A supplementation, and in-depth investigation on factors contributing to increased vulnerability of Muslim children.