[Prevalence and determinants of continued breastfeeding beyond 6 months among Algerian women. Evidence for Multiple Indicators Cluster Surveys]. / Prévalence et déterminants de l'allaitement maternel poursuivi au-delà de 6 mois chez les femmes algériennes. Analyse à partir des données de l'enquête par grappes à indicateurs multiples.

Background and rationale: Breastfeeding is considered the best nutrition for infants and plays a significant role in a child's growth and development. In this regard, the World Health Organization (WHO) strongly recommends exclusive breastfeeding for the first 6 months of life, as well as continued breastfeeding when safe and appropriate complementary foods are introduced, up to 2 years of age or beyond. Nonetheless, breastfeeding practices remain sub-optimal in many parts of the world. In this respect, many children have shown not to be breastfed up to 6 months of age or are not breastfed during their first hours of life or are weaned too early. This allows for the use of infant formula, which can be life threatening due to poor hygiene, storage conditions or inappropriate foods. Likewise, breastfeeding rates in the Middle East and North Africa (MENA) region are lower than the global average. In Algeria, the breastfeeding rate up to 6 months of age is among the lowest in the world according to previous Multiple Indicators Cluster Surveys (MICS) reports. In addition, by the end of the sixth month, the percentage of children exclusively breastfed is less than 3% and only 23% of children receive breast milk at 22-23 months. The median duration of breast-feeding is 12 weeks. However, the socio-demographic factors associated with this sub-optimal breastfeeding practice are not explored in these reports, as studies and research conducted in this context using other data are few and mostly conducted in limited geographical areas. Materials and methods: This stands for a descriptive cross-sectional study of all children who were breastfed in the MICS database, carried out in 2019, 8 709 children, including 4 471 boys and 4 238 girls, registered in the database. To explore factors associated with the duration of breastfeeding, we only included weaned children to minimize bias related to children who were still breastfeeding. This allowed to analyze data from 3 761 children, including 1 930 boys (5.4%) and 1,831 girls (48.6%). Through using a logistic regression model, we could attain the assessment of the role of different socio-demographic, economic and geographical factors in the maintenance of breastfeeding beyond 6 months. Results: The prevalence of breastfeeding is 81.1%; the rate of exclusive breastfeeding of children aged 0-6 months is 28.7%. The factors associated with breastfeeding beyond six months are area of residence, mother's occupational status and wealth quintile. In fact, rural area appears to be a factor favoring the continuation of breastfeeding beyond six months, compared with urban area (OR = 1.29; CI [1.032-1.369]). Mothers living in the Eastern Highlands geographic region appear to be 1.56 times more likely to maintain breastfeeding for more than six months compared to those living in the Southern region (OR = 1.56; CI [1.123 - 1.677]). Children of non-working mothers are almost 1.5 times more likely to be breastfed after 6 months than those of working mothers (OR = 1.489; CI [1.107 - 1.947]). Parents belonging to the "richest" wealth quintiles appear to increase the chance of continued breastfeeding after 6 months with a 1.24-fold increase compared to those belonging to the "poorest" quintile (OR = 1.24; CI [1.086 - 1.812]). Factors such as the child's gender, maternal education level, and functional difficulties do not appear to be determining factors for the continuation of breastfeeding after six months. Discussion and conclusion: The prevalence and factors associated with the initiation and continuation of breastfeeding vary from one country to another. Notwithstanding the numerous studies to better comprehend mothers' breastfeeding behaviour and various initiatives for promotion thereof, many countries have low rates. In consequence, the downward trend in breastfeeding is directly linked to advances in the production and marketing of industrial milks, the lack of information and awareness among mothers and the lack of training of health professionals. In this respect, it is highly recommended to encourage behavioural changes, to improve communication about the duration of breastfeeding, to increase the use of postnatal counselling and training of paramedical staff according to the recommendations with support for mothers.This study is of great interest in developing countries like Algeria, in order to adopt preventive interventions, and to organise communication and pre- and post-natal counselling in the breastfeeding project. Clearly, this study should be enhanced with supplementary qualitative studies concerning the factors contributing to early discontinuation of breastfeeding.

Prevalence and socio-economic determinants of consanguineous marriages in Algeria according to Multiple Indicator Cluster Survey 2019 data (MICS6).

Consanguineous marriage is still a customary social phenomenon in Arab-Muslim communities. The aim of this study was to estimate the prevalence of consanguineous marriages in the Algerian population and to identify the socio-economic determinants associated with the practice of this form of union. This is a descriptive cross-sectional study included data for 21141 ever-married women aged 15-49 years, from the MICS6 Algeria (Multiple Indicator Cluster Survey database), conducted in 2019. Using a logistic regression model, we assessed the influence of socio-economic and geographical determinants on the practice of consanguineous marriages. The prevalence of consanguinity was 23.0% (95% CI: 22.4-23.6). According to multivariable binary logistic regression analysis, low level of education, early age at marriage (15-19; 20-30 years), rural area of residence, all geographical regions except the north-western territorial programming space, economic activity, and the lowest wealth index were the main determinants that assist in the prevalence of high rates of consanguineous marriages in Algeria. Considering these explanatory variables could help national health policy decision-makers to create and implement national preventive action plans that are intended alter behaviors attitudes toward preference of consanguineous marriages and, thus, reduce the burden of genetic disorders or congenital abnormalities associated with consanguinity.

Prevalence and risk factors of prehypertension and hypertension in Algeria.

BACKGROUND: Hypertension, also referred to as the silent killer, is known to be one of the most common chronic diseases in the world today. This study aimed to identify the prevalence and risk factors of prehypertension and hypertension among Algerian population. METHODS: This is a descriptive cross-sectional epidemiological study involving individuals aged 18 to 69 years old who were identified in the database of the national survey on non-communicable diseases (NCDs) risk factors conducted in Algeria between 2016 and 2017 using the World Health Organization's (WHO) STEPwise approach. Differences in prevalence between normotensives, prehypertensives and hypertensives were assessed using the chi-square test. We also looked at the role of numerous socio-demographic, economic, geographical, and behavioural factors in blood pressure status using a logistic regression model. RESULTS: The prevalence of prehypertension and hypertension was 36.2% (95% confidence interval: 35.2-37.5%) and 31.6% (95% CI: 30.5-32.7%) respectively. Prehypertension was shown to be substantially higher in males than in women, while hypertension was found to be higher in females compared to men. In addition, both sexes had a rise in the prevalence of blood pressure as they grew older. A according to multivariate logistic regression analysis, the main common risk factors for prehypertension and hypertension were ageing, obesity, and abdominal obesity. Moreover hypercholesterolemia, and marital status (separated/divorced) were correlated to hypertension. CONCLUSION: Prehypertension and hypertension are high and epidemic in Algeria. Therefore, the urgent quantification and monitoring of their risk factors becomes a necessity to plan appropriate preventive measures, in order to fight against NCDs in general.

Socio-demographic determinants of neonatal mortality in Algeria according to MICS4 data (2012-2013).

BACKGROUND: Neonatal mortality remains a public health problem in developing countries, including Algeria. Information on this indicator makes it possible to assess government efforts to improve the living conditions of target populations. OBJECTIVES: This study aims to identify some determinants associated with this mortality from data of multiple indicator cluster survey conducted in Algeria in 2012-2013 (mics 4). METHODS: A retrospective case-control study including 1047 cases and 1041 controls. From a logistic regression model, we appreciated the role of different factors, socio-demographic, economic and geographic (Mother's age, level of education, wealth index, area of residence) in newborn survival. RESULTS: The main factors associated with neonatal mortality were rural residence (p<0.01; OR= 1.3; CI 1.08-1.54), South geographical area (p<0.05; OR=1.5; CI 1.18-1.84), low education level of mother (p<0.01; OR= 2.10; CI 1.35- 3.29), early age of maternal procreation (p<0.001; OR=4.34; CI 2.19- 14.40), the birth rank "7 and over" (<0.01; OR = 1.57; CI 1.13 - 2.44) and the two lowest wealth indices (p <0.001; OR = 2; 1.45-2.62 and p <0.01; OR = 1.66; CI 1.23-2.26). CONCLUSION: In addition to the various reproductive health strategies already adopted by the authorities for health promotion and family planning, action should be taken to evaluate their implementation with sustained assistance for disadvantaged people and in risk areas.