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Article ; Online: Trend and determinants of home delivery in Gambia, evidence from 2013 and 2020 Gambia Demographic and Health Survey

Solomon Gedlu Nigatu

PLoS ONE, Vol 18, Iss 12, p e

A multivariate decomposition analysis.

2023 Volume 0295219

Abstract: Background Home delivery is defined as is an even of pregnant women getting giving birth in a woman her home or other homes without an unskilled health professional assistance. It is continuing as public health problem since its responsible for death of ... ...

Abstract	Background Home delivery is defined as is an even of pregnant women getting giving birth in a woman her home or other homes without an unskilled health professional assistance. It is continuing as public health problem since its responsible for death of women and newborn. In Gambia there is a high maternal mortality rate, which may be related to home delivery. Therefore, this study aimed to assess the trend of home delivery and identify predictors using Gambia Demographic and Health Survey (GDHS) 2013 and 2019-2020 data sets. Methods A Cross-Section survey was conducted based on GDHS 2013 and 2019-2020 among reproductive age group women. A total of 8607 women participated in this study. A bivariate decomposition model was fitted, and variables that had a p-value > 0.25 were dropped. Finally, variables that got a p-value of < 0.05 with 95% confidence interval (CI) in the multivariate decomposition analysis were considered as statistical significance variables in the overall decomposition. Results There has been a dramatic decrement in maternal home delivery in Gambia. It was 36.18% (95% CI:34.78, 37.58) in 2013 GDHS and 14.39% (95% CI:13.31,15.47) in 2019-2020 GDHS. This reduction is real because there was a change in the characteristics effect of the population and the coefficient effect some variables in the home delivery. Changes in characteristics effect of husband education, women education, rural residents, more than three antenatal cares follow up, and no problem reaching health facilities played a significant role in the reduction of home delivery. Being urban resident and women who had occupation were variables that had a positive effect on coefficient effect change. Conclusion In this study, the home delivery rate had steeply declined in the Gambia during the study period of the two surveys. Just above nine-tenths decrement in home delivery rate resulted because there was a change in the characteristics effect of the study participants. Enhancing more citizens to attend high school and above, ...
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Trend and determinants of home delivery in Gambia, evidence from 2013 and 2020 Gambia Demographic and Health Survey

Solomon Gedlu Nigatu

PLoS ONE, Vol 18, Iss

A multivariate decomposition analysis

2023 Volume 12

Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Spatial distribution of stillbirth and associated factors in Ethiopia

Solomon Gedlu Nigatu

BMJ Open, Vol 10, Iss

a spatial and multilevel analysis

2020 Volume 10

Abstract: Objective Although the rate of stillbirth has decreased globally, it remains unacceptably high in developing countries. Today, only 10 countries share the burden of more than 65% of the global rate of stillbirth and these include Ethiopia. Ethiopia ranks ...

Abstract	Objective Although the rate of stillbirth has decreased globally, it remains unacceptably high in developing countries. Today, only 10 countries share the burden of more than 65% of the global rate of stillbirth and these include Ethiopia. Ethiopia ranks seventh in terms of high rate of stillbirths. Exploring the spatial distribution of stillbirth is critical to developing successful interventions and monitoring public health programmes. However, there is no study on the spatial distribution and the associated factors of stillbirth in Ethiopia. Therefore, this study aimed to explore the spatial distribution and the associated factors of stillbirth.Methods Secondary data analysis was conducted based on the 2016 Ethiopian Demographic and Health Survey data. A total weighted sample of 11 375 women were included in the analysis. The Bernoulli model was fitted using SaTScan V.9.6 to identify hotspot areas and ArcGIS V.10.6 to explore the spatial distribution of stillbirth. For associated factors, a multilevel binary logistic regression model was fitted using STATA V.14 software. Variables with a p value of less than 0.2 were considered for the multivariable multilevel analysis. In the multivariable multilevel analysis, adjusted OR (AOR) with 95% CI was reported to reveal significantly associated factors of stillbirth.Results The spatial analysis showed that stillbirth has significant spatial variation across the country. The SaTScan analysis identified significant primary clusters of stillbirth in the Northeast Somali region (log likelihood ratio (LLR)=13.4, p<0.001) and secondary clusters in the border area of Oromia and Amhara regions (LLR=8.8, p<0.05). In the multilevel analysis, rural residence (AOR=4.83, 95% CI 1.44 to 16.19), primary education (AOR=0.39, 95% CI 0.20 to 0.74), no antenatal care (ANC) visit (AOR=2.77, 95% CI 1.70 to 4.51), caesarean delivery (AOR=5.07, 95% CI 1.65 to 15.58), birth interval <24 months (AOR=1.95, 95% CI 1.20 to 3.10) and height <150 cm (AOR=2.73, 95% CI 1.45 to 4.97) ...
Keywords	Medicine ; R
Subject code	910
Language	English
Publishing date	2020-10-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The magnitude and determinants of delayed initiation of antenatal care among pregnant women in Gambia; evidence from Gambia demographic and health survey data

Solomon Gedlu Nigatu / Tilahun Yemanu Birhan

BMC Public Health, Vol 23, Iss 1, Pp 1-

2023 Volume 10

Abstract: Abstract Background Despite gains throughout the 20th century, maternal health remains a major public health concern. Despite global efforts to enhance access to maternal and child healthcare services, women in low- and middle-income countries still have ...

Abstract	Abstract Background Despite gains throughout the 20th century, maternal health remains a major public health concern. Despite global efforts to enhance access to maternal and child healthcare services, women in low- and middle-income countries still have a high risk of dying during pregnancy and after birth. This study aimed to determine the magnitude and determinants of late antenatal care initiation among reproductive age women in Gambia. Method Secondary data analysis was conducted using the 2019-20 Gambian demographic and health survey data. All reproductive age women who gave birth in the five years preceding the survey and who had an antenatal care visit for the last child were included in this study. The total weighted sample size analyzed was 5310. Due to the hierarchical nature of demographic and health survey data, a multi-level logistic regression model was performed to identify the individual and community level factors associated with delayed first antenatal care initiation. Result In this study, the prevalence of delayed initiation of initial antenatal care was 56% ranged from 56 to 59%. Women with age 25–34 [Adjusted Odds Ratio = 0.77; 95% CI 0.67–0.89], 35–49 [Adjusted Odds Ratio = 0.77; 95% CI 0.65–0.90] and women reside in urban area [Adjusted Odds Ratio = 0.59; 95% CI 0.47–0.75] respectively had lower odds of delayed first antenatal care initiation. While women with unplanned pregnancy [Adjusted Odds Ratio = 1.60; 95% CI 1.37–1.84], no health insurance [Adjusted Odds Ratio = 1.78; 95% CI 1.14–2.76] and previous history of cesarean delivery [Adjusted Odds Ratio = 1.50; 95% CI 1.10–2.07] had higher odds of delayed initiation of antenatal care. Conclusion Despite the established advantages of early antenatal care initiation, this study revealed that late antenatal care initiation is still common in Gambia. Unplanned pregnancy, residence, health insurance, history of caesarian delivery, and age were significantly associated with delayed first antenatal care presentation. Therefore, focusing extra ...
Keywords	Antenatal care ; Pregnant women ; Late initiation and Gambia ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2023-03-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Trachoma prevention practice and associated factors among mothers having children aged under nine years in Andabet district, northwest Ethiopia, 2022

Zufan Alamrie Asmare / Natnael Lakachew Assefa / Dagmawi Abebe / Solomon Gedlu Nigatu / Yezinash Addis Alimaw

PLoS Neglected Tropical Diseases, Vol 17, Iss 6, p e

A multi-level analysis.

2023 Volume 0011433

Abstract: Background The world health organization (WHO) adopted the Surgery, Antibiotic, facial cleanliness, and environmental improvement (SAFE) strategy for the prevention of trachoma, and different prevention strategies have been employed in Andabet district. ... ...

Abstract	Background The world health organization (WHO) adopted the Surgery, Antibiotic, facial cleanliness, and environmental improvement (SAFE) strategy for the prevention of trachoma, and different prevention strategies have been employed in Andabet district. Trachoma still has a high prevalence despite these efforts. So, it is imperative to assess ground trachoma prevention practice (TPP) since there are insufficient studies in the study area. Objective To determine the magnitude and factors associated with TPP among mothers having children aged under nine years in Andabet district, Northwest Ethiopia. Method A community-based cross-sectional study involving 624 participants was conducted June 1-30, 2022. Systematic random sampling was carried out to select study participants. Multi-level binary logistic regression analysis was used to identify factors associated with poor TPP. Descriptive and summary statistics were performed and variables with p-value < 0.05 in the best-fitted model were declared to be significantly associated with poor TPP. Results In this study, the proportion of poor TPP was found to be 50.16% (95%CI = 46.23, 54.08). In the multi-variable multi-level logistic regression; having no formal education (AOR = 2.95; 95%CI: 1.41,6.15) and primary education (AOR = 2.33; 95%CI:1.04, 5.24), being a farmer (AOR = 3.02; 95%CI:1.73,5.28), and merchant (AOR = 2.63; 95%CI:1.20, 5.75), time taken to water point >30 minutes (AOR = 4.60,95CI:1.30,16.26) and didn't receive health education about trachoma (AOR = 2.36;95CI:1.16,4.79) were significantly associated with poor TPP. Conclusion The proportion of poor TPP was high relative to other studies. Level of education, occupation, time taken to the water point, and health education were significantly associated with poor TPP. Therefore, taking special attention to these high-risk groups could decrease the poor TPP.
Keywords	Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Prevalence and determinants of scabies among school-age children in Central Armachiho district, Northwest, Ethiopia

Bisrat Misganaw / Solomon Gedlu Nigatu / Gebremedhin Necho Gebrie / Anteneh Ayelign Kibret

PLoS ONE, Vol 17, Iss

2022 Volume 6

Abstract: Background Scabies is a major global public health issue that might affect people from all socioeconomic levels. Globally, scabies affects more than 200 million people at any time. It remains one of the commonest skin diseases seen in developing ... ...

Abstract	Background Scabies is a major global public health issue that might affect people from all socioeconomic levels. Globally, scabies affects more than 200 million people at any time. It remains one of the commonest skin diseases seen in developing countries including Ethiopia. Therefore, this study aimed to assess the prevalence and determinants of scabies among school-age children in Central Armachiho district, Northwest Ethiopia. Methods A community-based cross-sectional study was conducted from August to September 2020. A multi-stage sampling technique was used to select 850 study populations. Data was checked for its completeness, coded, and entered by using EPI-INFO version 7 and exported to the SPSS version 20 for analysis. A Binary logistic regression model was fitted to identify the determinants of scabies. Crude odds ratio (COR) and adjusted odds ratio (AOR) with 95% CI were used as measurements for the associations. P-values <0.005 were considered significant. Result Prevalence of scabies among the 850 participants studied was 10.82% (95% CI: 8.7–12.9). Contact history with confirmed scabies patient (AOR = 5.28,95% CI: 2.96–9.44), child not attending school (AOR = 3.08, 95% CI;1.45–6.54), rarely changing clothes (AOR = 2.43,95% CI: 1.27–4.62), sleeping on the floor (AOR = 4.11, 95% CI:1.95–8.67), bed sharing; (AOR = 3.38, 95% CI:2.86–6.15), rarely washing cloth: (AOR = 5.08,95% CI:2.75–9.36), living with internally displaced people; (AOR,95% CI: 3.47 (1.30–9.24) and using only water to wash hands; (AOR = 3.18,95% CI:1.74–5.80) had a statistically significant association with scabies infestation among school-age children. Conclusion The current study found nearly one out of ten school-age children had scabies. Not attended school, contact history with confirmed scabies patient, not washing cloth, infrequent changing clothes, bedding sharing, sleeping on the floor, living with internally displaced people, and only using water for handwashing practice were the independent predictors for the occurrence of ...
Keywords	Medicine ; R ; Science ; Q
Subject code	370
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Caregiver burden and its associated factors among primary caregivers of stroke survivors at Amhara regional state tertiary hospitals

Gebremariam Bekele / Melisew Mekie Yitayal / Yihalem Belete / Yisak Girma / Tesfa Kassa / Yohannes Awoke Assefa / Solomon Gedlu Nigatu / Getachew Azeze Eriku

Frontiers in Stroke, Vol

a multicenter study

2023 Volume 2

Abstract: BackgroundCaregivers of stroke survivors play a crucial role in post-stroke functional recovery and the prevention of complications. Although the situation is incredibly stressful and intimidating and the caregiver burden is high, there is little ... ...

Abstract	BackgroundCaregivers of stroke survivors play a crucial role in post-stroke functional recovery and the prevention of complications. Although the situation is incredibly stressful and intimidating and the caregiver burden is high, there is little evidence in the local Ethiopian context of the extent of the burden among caregivers of stroke survivors. Therefore, the aim of this study was to assess the level of caregiver burden and its associated factors among primary caregivers of stroke survivors in Ethiopia.MethodsA cross-sectional study was conducted in Amhara regional state tertiary hospitals from April to June 2022. A standardized questionnaire was used to record factors associated with caregiver burden, including sociodemographic, clinical, and care situation factors. The Zarit caregiver burden interview (short form) was used to assess the level of caregiver burden. A systematic random sampling method was employed to select the study participants. Multinomial logistic regression was employed to identify the potential factors associated with the level of caregiver burden.ResultsThe overall prevalence burden among primary caregivers of stroke survivors was 67%. 61.1% had a mild to moderate burden, while 5.9% had a severe burden. In multivariable multinomial logistic regression analysis, sex, household income, duration of care, and duration of caregiving hours per day were factors significantly associated with the level of burden among caregivers of stroke survivors.ConclusionsBeing female, having a low household income, caring for more than 3 months, and caring for more than 6 h per day were factors significantly associated with the burdens of the primary caregivers of stroke survivors. It is better: health care providers must recognize and screen for burdens and provide special attention.
Keywords	caregiver burden ; caregiver strain ; primary caregivers ; informal caregivers ; stroke survivors ; Ethiopia ; Medicine ; R
Subject code	150
Language	English
Publishing date	2023-09-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000–17

Kirsten E Wiens / Paulina A Lindstedt / Brigette F Blacker / Kimberly B Johnson / Mathew M Baumann / Lauren E Schaeffer / Hedayat Abbastabar, Sr / Foad Abd-Allah / Ahmed Abdelalim / Ibrahim Abdollahpour / Kedir Hussein Abegaz / Ayenew Negesse Abejie / Lucas Guimarães Abreu / Michael R M Abrigo / Ahmed Abualhasan / Manfred Mario Kokou Accrombessi / Dilaram Acharya / Maryam Adabi / Abdu A Adamu /

Oladimeji M Adebayo / Rufus Adesoji Adedoyin, Sr / Victor Adekanmbi / Olatunji O Adetokunboh, Sr / Beyene Meressa Adhena / Mohsen Afarideh / Sohail Ahmad / Keivan Ahmadi / Anwar E Ahmed / Muktar Beshir Ahmed / Rushdia Ahmed / Temesgen Yihunie Akalu / Fares Alahdab / Ziyad Al-Aly / Noore Alam, Sr / Samiah Alam / Genet Melak Alamene / Turki M Alanzi / Jacqueline Elizabeth Alcalde-Rabanal / Beriwan Abdulqadir Ali / Mehran Alijanzadeh / Vahid Alipour / Syed Mohamed Aljunid / Ali Almasi, Sr / Amir Almasi-Hashiani / Hesham M Al-Mekhlafi / Khalid A Altirkawi / Nelson Alvis-Guzman / Nelson J Alvis-Zakzuk / Saeed Amini, Sr / Arianna Maever L Amit, Sr / Catalina Liliana Andrei, Sr / Mina Anjomshoa / Amir Anoushiravani, Sr / Fereshteh Ansari / Carl Abelardo T Antonio / Benny Antony / Ernoiz Antriyandarti / Jalal Arabloo / Hany Mohamed Amin Aref, Sr / Olatunde Aremu / Bahram Armoon / Amit Arora, Sr / Krishna K Aryal / Afsaneh Arzani / Mehran Asadi-Aliabadi / Hagos Tasew Atalay / Seyyed Shamsadin Athari, Sr / Seyyede Masoume Athari / Sachin R Atre / Marcel Ausloos / Nefsu Awoke / Beatriz Paulina Ayala Quintanilla / Getinet Ayano / Martin Amogre Ayanore, Sr / Yared Asmare Aynalem IV / Samad Azari / Peter S Azzopardi / Ebrahim Babaee / Tesleem Kayode Babalola / Alaa Badawi, Sr / Mohan Bairwa / Shankar M Bakkannavar / Senthilkumar Balakrishnan / Ayele Geleto Bali / Maciej Banach, Sr / Joseph Adel Mattar Banoub, Sr / Aleksandra Barac / Till Winfried Bärnighausen / Huda Basaleem / Sanjay Basu / Vo Dinh Bay / Mohsen Bayati / Estifanos Baye / Neeraj Bedi / Mahya Mahya Beheshti Beheshti / Masoud Behzadifar / Meysam Behzadifar / Bayu Begashaw Bekele / Yaschilal Muche Belayneh / Michellr L Bell, Sr / Derrick A Bennett, Sr / Dessalegn Ajema Berbada / Robert S Bernstein / Anusha Ganapati Bhat, Sr / Krittika Bhattacharyya, Sr / Suraj Bhattarai / Soumyadeep Bhaumik / Zulfiqar A Bhutta / Ali Bijani / Boris Bikbov / Binyam Minuye Birihane IV / Raaj Kishore Biswas / Somayeh Bohlouli / Hunduma Amensisa Amensisa Bojia I / Soufiane Boufous / Oliver J Brady / Nicola Luigi Bragazzi / Andrey Nikolaevich Briko / Nikolay Ivanovich Briko / Gabrielle B Britton / Sharath Burugina Nagaraja, Sr / Reinhard Busse, Sr / Zahid A Butt / Luis LA Alberto Cámera, Sr / Ismael R Campos-Nonato, Sr / Jorge Cano / Josip Car / Rosario Cárdenas / Felix Carvalho, Sr / Carlos A Castañeda-Orjuela, Sr / Franz Castro / Wagaye Fentahun Chanie, Sr / Pranab Chatterjee / Vijay Kumar Chattu / Tesfaye Yitna Yitna Chichiabellu, Jr / Ken Lee Chin, Sr / Devasahayam J Christopher / Dinh-Toi Chu / Natalie Maria Cormier / Vera Marisa Costa / Carlos Culquichicon / Matiwos Soboka Daba / Giovanni Damiani, Sr / Lalit Dandona / Rakhi Dandona / Anh Kim Dang / Aso Mohammad Darwesh / Amira Hamed Darwish / Ahmad Daryani, Sr / Jai K Das / Rajat Das Gupta / Aditya Prasad Dash / Gail Davey / Claudio Alberto Dávila-Cervantes / Adrian C Davis, Sr / Dragos Virgil Davitoiu / Fernando Pio De la Hoz / Asmamaw Bizuneh Demis / Dereje Bayissa Demissie / Getu Debalkie Demissie / Gebre Teklemariam Demoz, Sr / Edgar Denova-Gutiérrez, Sr / Kebede Deribe, Sr / Assefa Desalew / Aniruddha Deshpande / Samath Dhamminda Dharmaratne / Preeti Dhillon / Meghnath Dhimal / Govinda Prasad Dhungana / Daniel Diaz, Sr / Isaac Oluwafemi Dipeolu / Shirin Djalalinia / Kerrie E Doyle / Eleonora Dubljanin / Bereket Duko / Andre Rodrigues Duraes / Mohammad Ebrahimi Kalan / Hisham Atan Edinur, Sr / Andem Effiong, Sr / Aziz Eftekhari / Nevine El Nahas / Iman El Sayed / Maysaa El Sayed Zaki / Maha El Tantawi / Teshome Bekele Elema I / Hala Rashad Elhabashy, Sr / Shaimaa I El-Jaafary / Hajer Elkout / Aisha Elsharkawy / Iqbal RF Elyazar / Aklilu Endalamaw / Daniel Adane Endalew, Sr / Sharareh Eskandarieh / Alireza Esteghamati / Sadaf Esteghamati, Sr / Arash Etemadi / Oluchi Ezekannagha / Mohammad Fareed / Roghiyeh Faridnia / Farshad Farzadfar / Mehdi Fazlzadeh / Valery L Feigin, Sr / Seyed-Mohammad Fereshtehnejad / Eduarda Fernandes / Irina Filip / Florian Fischer / Nataliya A Foigt / Morenike Oluwatoyin Folayan, Sr / Masoud Foroutan / Richard Charles Franklin / Takeshi Fukumoto / Mohamed M Gad / Reta Tsegaye Gayesa / Teshome Gebre, Sr / Ketema Bizuwork Gebremedhin / Gebreamlak Gebremedhn Gebremeskel, Sr / Hailay Abrha Gesesew / Kebede Embaye Gezae / Keyghobad Ghadiri, Sr / Ahmad Ghashghaee / Pramesh Raj Ghimire, Sr / Paramjit Singh Gill, Sr / Tiffany K Gill / Themba G G Ginindza / Nelson G M Gomes / Sameer Vali Gopalani / Alessandra C Goulart / Bárbara Niegia Garcia Goulart / Ayman Grada / Mohammed Ibrahim Mohialdeen Gubari / Harish Chander Gugnani, Sr / Davide Guido / Rafael Alves Guimarães / Yuming Guo, Sr / Rajeev Gupta / Nima Hafezi-Nejad / Dessalegn H Haile, Sr / Gessessew Bugssa Hailu / Arvin Haj-Mirzaian / Arya Haj-Mirzaian / Randah R Hamadeh / Samer Hamidi / Demelash Woldeyohannes Handiso / Hamidreza Haririan, Sr / Ninuk Hariyani / Ahmed I Hasaballah / Md Mehedi Hasan / Edris Hasanpoor / Amir Hasanzadeh / Hadi Hassankhani / Hamid Yimam Hassen / Mohamed I Hegazy / Behzad Heibati / Behnam Heidari / Delia Hendrie, Sr / Nathaniel J Henry / Claudiu Herteliu / Fatemeh Heydarpour / Hagos Degefa de Hidru I / Thomas R Hird / Chi Linh Hoang / Enayatollah Homaie Rad / Praveen Hoogar / Mohammad Hoseini / Naznin Hossain / Mostafa Hosseini / Mehdi Hosseinzadeh / Mowafa Househ / Mohamed Hsairi, Sr / Guoqing Hu / Mohammedaman Mama Hussen / Segun Emmanuel Ibitoye / Ehimario U Igumbor, Sr / Olayinka Stephen Ilesanmi / Milena D Ilic / Mohammad Hasan Imani-Nasab / Usman Iqbal / Seyed Sina Naghibi Irvani / Sheikh Mohammed Shariful Islam / Chinwe Juliana Iwu / Neda Izadi, Sr / Anelisa Jaca / Nader Jahanmehr / Mihajlo Jakovljevic / Amir Jalali / Achala Upendra Jayatilleke / Ravi Prakash Jha / Vivekanand Jha / John S Ji, Sr / Jost B Jonas / Jacek Jerzy Jozwiak / Ali Kabir / Zubair Kabir, Sr / Amaha Kahsay / Hamed Kalani / Tanuj Kanchan / Behzad Karami Matin / André Karch / Mohd Anisul Karim / Hamidreza Karimi-Sari / Surendra Karki / Amir Kasaeian / Gebremicheal Gebreslassie Kasahun / Yawukal chane Kasahun / Habtamu Kebebe Kasaye / Gebrehiwot G Kassa / Getachew Mullu Kassa / Gbenga A Kayode / Ali Kazemi Karyani / Mihiretu M Kebede / Peter Njenga Keiyoro / Abraham Getachew Kelbore, Sr / Andre Pascal Kengne, Sr / Daniel Bekele Ketema / Yousef Saleh Khader / Morteza Abdullatif Khafaie / Nauman Khalid / Rovshan Khalilov / Ejaz Ahmad Khan, Sr / Junaid Khan / Md Nuruzzaman Khan I / Muhammad Shahzeb Khan / Khaled Khatab, Sr / Amir M Khater / Mona M Khater / Maryam Khayamzadeh / Mohammad Khazaei / Salman Khazaei / Mohammad Hossein Khosravi / Jagdish Khubchandani / Ali Kiadaliri / Yun Jin Kim / Ruth W Kimokoti / Adnan Kisa / Sezer Kisa / Niranjan Kissoon, Sr / Shivakumar KM Marulasiddaiah M KMShivakumar, Sr / Sonali Kochhar / Tufa Kolola, Sr / Hamidreza Komaki / Soewarta Kosen / Parvaiz A Koul / Ai Koyanagi / Moritz U G Kraemer / Kewal Krishan / Nuworza Kugbey / G Anil Kumar / Manasi Kumar, Sr / Pushpendra Kumar / Vivek Kumar / Dian Kusuma / Carlo La Vecchia / Ben Lacey / Sheetal D Lad / Dharmesh Kumar Lal / Felix Lam / Faris Hasan Lami, Sr / Prabhat Lamichhane / Van Charles Lansingh / Savita Lasrado / Avula Laxmaiah / Paul H Lee, Sr / Kate E LeGrand / Mostafa Leili / Tsegaye Lolaso Lenjebo / Cheru Tesema Leshargie, Sr / Aubrey J Levine / Shanshan Li, Sr / Shai Linn / Shiwei Liu / Simin Liu / Rakesh Lodha / Joshua Longbottom / Jaifred Christian F Lopez / Hassan Magdy Abd El Razek / Muhammed Magdy Abd El Razek / D R Mahadeshwara Prasad / Phetole Walter Mahasha, Sr / Narayan B Mahotra / Azeem Majeed / Reza Malekzadeh, Sr / Deborah Carvalho Malta / Abdullah A Mamun, Sr / Navid Manafi, Sr / Ana Laura Manda / Narendar Dawani Dawanu Manohar / Mohammad Ali Mansournia / Chabila Christopher Mapoma / Joemer C Maravilla / Gabriel Martinez, Sr / Santi Martini / Francisco Rogerlândio Martins-Melo / Anthony Masaka / Benjamin Ballard Massenburg / Manu Raj Mathur / Benjamin K Mayala / Mohsen Mazidi / Colm McAlinden / Birhanu Geta Meharie / Man Mohan Mehndiratta, Sr / Kala M Mehta / Tefera C Chane Mekonnen / Gebrekiros Gebremichael Meles / Peter T N Memiah / Ziad A Memish, Sr / Walter Mendoza / Ritesh G Menezes / Seid Tiku Mereta / Tuomo J Meretoja, Sr / Tomislav Mestrovic / Bartosz Miazgowski / Kebadnew Mulatu Mihretie, Sr / Ted R Miller / GK Mini / Erkin M Mirrakhimov / Babak Moazen / Bahram Mohajer / Amjad Mohamadi-Bolbanabad / Dara K Mohammad / Karzan Abdulmuhsin Mohammad / Yousef Mohammad / Naser Mohammad Gholi Mezerji / Roghayeh Mohammadibakhsh / Noushin Mohammadifard / Jemal Abdu Mohammed, Sr / Shafiu Mohammed / Farnam Mohebi / Ali H Mokdad / Mariam Molokhia / Lorenzo Monasta / Yoshan Moodley, Sr / Catrin E Moore, Sr / Ghobad Moradi / Masoud Moradi / Mohammad Moradi-Joo / Maziar Moradi-Lakeh / Paula Moraga / Linda Morales / Ilais Moreno Velásquez / Abbas Mosapour / Simin Mouodi / Seyyed Meysam Mousavi / Miliva Mozaffor I / Kindie Fentahun Muchie, Sr / Getahun Fentaw 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The Lancet Global Health, Vol 8, Iss 8, Pp e1038-e

2020 Volume 1060

Abstract: Summary: Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 ... ...

Abstract	Summary: Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods: We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000–17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2·5th and 97·5th percentiles of those 250 draws. Findings: While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62·6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000–7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910–68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation: To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. Funding: Bill & Melinda Gates Foundation.
Keywords	Public aspects of medicine ; RA1-1270
Subject code	310
Language	English
Publishing date	2020-08-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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