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BMC Pediatr ; 20(1): 62, 2020 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-32041562


BACKGROUND: The Infant Mortality Rate (IMR) in Sub-Saharan Africa (SSA) remains the highest relatively to the rest of the world. In the past decade, the policy on reducing infant mortality in SSA was reinforced and both infant mortality and parental death decreased critically for some countries of SSA. The analysis of risk to death or attracting chronic disease may be done for helping medical practitioners and decision makers and for better preventing the infant mortality. METHODS: This study uses popular statistical methods of re-sampling and one selected model of multiple events analysis for measuring the survival outcomes for the infants born in 2016 at Kigali University Teaching Hospital (KUTH) in Rwanda, a country of SSA, amidst maternal and child's socio-economic and clinical covariates. Dataset comprises the newborns with correct information on the covariates of interest. The Bootstrap Marginal Risk Set Model (BMRSM) and Jackknife Marginal Risk Set Model (JMRSM) for the available maternal and child's socio-economic and clinical covariates were conducted and then compared to the outcome with Marginal Risk Set Model (MRSM). That was for measuring stability of the MRSM. RESULTS: The 2117 newborns had the correct information on all the covariates, 82 babies died along the study time, 69 stillborn babies were observed while 1966 were censored. Both BMRSM JMRSM and MRSM displayed the close results for significant covariates. The BMRSM displayed in some instance, relatively higher standard errors for non-significant covariates and this emphasized their insignificance in MRSM. The models revealed that female babies survive better than male babies. The risk is higher for babies whose parents are under 20 years old parents as compared to other parents' age groups, the risk decreases as the APGAR increases, is lower for underweight babies than babies with normal weight and overweight and is lower for babies with normal circumference of head as compared to those with relatively small head. CONCLUSION: The results of JMRSM were closer to MRSM than that of BMRSM. Newborns of mothers aged less than 20 years were at relatively higher risk of dying than those who their mothers were aged 20 years and above. Being abnormal in weight and head increased the risk of infant mortality. Avoidance of teenage pregnancy and provision of clinical care including an adequate dietary intake during pregnancy would reduce the IMR in Kigali.

Afr Health Sci ; 19(2): 1897-1909, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31656473


Background: One of the public health problems in developing countries is child malnutrition. An important factor for children's well-being is good nutrition. Therefore, the malnutrition status of children under the age of five is an important outcome measure for children's health. This study uses the proportional odds model to identify risk factors associated with child malnutrition in Ethiopia using the 2016 Ethiopian Demographic and Health Survey data. Methods: This study uses the 2016 Ethiopian Demographic and Health Survey results. Based on weight-for-height anthropometric index (Z-score) child nutrition status is categorized into four levels namely- underweight, normal, overweight and obese. Since this leads to an ordinal variable for nutrition status, an ordinal logistic regression (OLR)proportional odds model (POM) is an obvious choice for analysis. Results: The findings and comparison of results using the cumulative logit model with and without complex survey design are presented. The study results revealed that to produce the appropriate estimates and standard errors for data that were obtained from complex survey design, model fitting based on taking the survey sampling design into account is better. It has also been found that for children under the age of five, weight of a child at birth, mother's age, mother's Body Mass Index (BMI), marital status of mother and region (Affar, Dire Dawa, Gambela, Harari and Somali) were influential variables significantly associated with underfive children's nutritional status in Ethiopia. Conclusion: This child's age of a child, sex, weight of child at birth, mother's BMI and region of residence were significant determinants of malnutrition of children under five years in Ethiopia. The effect of these determinants can be used to develop strategies for reducing child malnutrition in Ethiopia. Moreover, these findings show that OLR proportional odds model is appropriate assessing thedeterminants of malnutrition for ordinal nutritional status of underfive children in Ethiopia.

Transtornos da Nutrição Infantil/epidemiologia , Desnutrição/epidemiologia , Estado Nutricional , Antropometria , Índice de Massa Corporal , Peso Corporal , Criança , Transtornos da Nutrição Infantil/diagnóstico , Pré-Escolar , Etiópia/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Desnutrição/etiologia , Obesidade/epidemiologia , Prevalência , Características de Residência , Fatores Socioeconômicos , Magreza/epidemiologia