scholarly journals Systematic Review and Meta-Analysis on the Aetiology of Bacterial Pneumonia in Children in Sub-Saharan Africa

2021 ◽  
Author(s):  
Chukwuemeka Onwuchekwa ◽  
Bassey Edem ◽  
Victor Williams ◽  
Ibiloye Olajuwon ◽  
Musa Jallow ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bacterial Pneumonia ◽  
Pathogenic Bacteria ◽  
Case Series ◽  
Sub Saharan Africa ◽  
Children Under Five ◽  
Under Five ◽  
Microbiological Methods ◽  
Vaccine Type ◽  
Sub Saharan

Abstract BackgroundBefore the introduction of vaccination to protect children from pneumonia, Streptococcus pneumoniae and Haemophilus influenzae type B (HiB) were the most frequent aetiological agents causing bacterial pneumonia in children under five years old. However, under the influence of these vaccines, the aetiology of childhood pneumonia appears to be changing and non-vaccine-type S. pneumoniae, non-typeable H. influenzae, and Staphylococcus aureus are becoming more relevant. MethodsWe conducted a systematic review aimed at identifying the common causes of bacterial pneumonia in children in sub-Saharan Africa. We searched PubMed, Web of Science and African Index Medicus and included primary studies conducted since January 2010 that reported on the bacterial causes of pneumonia in children under five from sub-Saharan Africa. We extracted data items (about the study setting, pneumonia diagnosis, sampling, microbiological methods, and etiological agents) as well as study quality indicators.ResultsEleven studies (published in twelve records), involving 5362 pneumonia cases, were included in our review: nine were case-control studies and two were case series. S. pneumoniae was the most common bacteria identified from blood cultures in children with pneumonia (8%, 95% CI: 4 – 14%), and H. influenzae was the second most common (3%, 95% CI: 1 - 17%). Common isolates from nasopharyngeal swabs were S. pneumoniae (66%), Moraxella catarrhalis (62%), and H. influenzae (44%) were commonly identified in the nasopharynx of children Conclusion S. pneumoniae and H. influenzae remain relevant causes of bacterial pneumonia in children in sub-Saharan Africa. Our review also highlights the ubiquitous occurrence of several potentially pathogenic bacteria in the nasopharynx of children under five group and makes the case for continued research aimed at understanding how nasopharyngeal colonization results in pneumonia.

scholarly journals A Systematic Review of the Incremental Costs of Implementing a New Vaccine in the Expanded Program of Immunization in Sub-Saharan Africa

2019 ◽  
Vol 4 (2) ◽  
pp. 238146831989454
Author(s):  
Joe Brew ◽  
Christophe Sauboin
Keyword(s):  
Systematic Review ◽  
Data Collection ◽  
Interquartile Range ◽  
Sub Saharan Africa ◽  
World Health ◽  
African Countries ◽  
Vaccine Type ◽  
Sub Saharan ◽  
Health Organization ◽  
The Cost

Background. The World Health Organization is planning a pilot introduction of a new malaria vaccine in three sub-Saharan African countries. To inform considerations about including a new vaccine in the vaccination program of those and other countries, estimates from the scientific literature of the incremental costs of doing so are important. Methods. A systematic review of scientific studies reporting the costs of recent vaccine programs in sub-Saharan countries was performed. The focus was to obtain from each study an estimate of the cost per dose of vaccine administered excluding the acquisition cost of the vaccine and wastage. Studies published between 2000 and 2018 and indexed on PubMed could be included and results were standardized to 2015 US dollars (US$). Results. After successive screening of 2119 titles, and 941 abstracts, 58 studies with 80 data points (combinations of country, vaccine type, and vaccination approach–routine v. campaign) were retained. Most studies used the so-called ingredients approach as costing method combining field data collection with documented unit prices per cost item. The categorization of cost items and the extent of detailed reporting varied widely. Across the studies, the mean and median cost per dose administered was US$1.68 and US$0.88 with an interquartile range of US$0.54 to US$2.31. Routine vaccination was more costly than campaigns, with mean cost per dose of US$1.99 and US$0.88, respectively. Conclusion. Across the studies, there was huge variation in the cost per dose delivered, between and within countries, even in studies using consistent data collection tools and analysis methods, and including many health facilities. For planning purposes, the interquartile range of US$0.54 to US$2.31 may be a sufficiently precise estimate.

scholarly journals A Scoping Review of the Risk Factors Associated with Anaemia among Children Under Five Years in Sub-Saharan African Countries

2020 ◽  
Vol 17 (23) ◽  
pp. 8829
Author(s):  
Phillips Edomwonyi Obasohan ◽  
Stephen J. Walters ◽  
Richard Jacques ◽  
Khaled Khatab
Keyword(s):  
Risk Factors ◽  
Scoping Review ◽  
Household Wealth ◽  
Sub Saharan Africa ◽  
Cochrane Library ◽  
Children Under Five ◽  
Contextual Risk ◽  
Under Five ◽  
Factors Associated ◽  
Sub Saharan

Background/Purpose: Globally, anaemia is a severe public health condition affecting over 24% of the world’s population. Children under five years old and pregnant women are the most vulnerable to this disease. This scoping review aimed to evaluate studies that used classical statistical regression methods on nationally representative health survey data to identify the individual socioeconomic, demographic and contextual risk factors associated with developing anaemia among children under five years of age in sub-Saharan Africa (SSA). Methods/Design: The reporting pattern followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. The following databases were searched: MEDLINE, EMBASE (OVID platform), Web of Science, PUBMED, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Scopus, Cochrane library, African Journal of online (AJOL), Google Scholar and Measure DHS. Results: The review identified 20 relevant studies and the risk factors for anaemia were classified as child-related, parental/household-related and community- or area-related factors. The risk factors for anaemia identified included age, birth order, sex, comorbidities (such as fever, diarrhoea and acute respiratory infection), malnutrition or stunting, maternal education, maternal age, mother’s anaemia status, household wealth and place of residence. Conclusion: The outcome of this review is of significant value for health policy and planners to enable them to make informed decision that will correct any imbalances in anaemia across socioeconomic, demographic and contextual characteristics, with the view of making efficient distributions of health interventions.

scholarly journals Assessing and decomposing inequality of opportunity in access to child health and nutrition in sub-Saharan Africa: evidence from three countries with low human development index

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Yacobou Sanoussi ◽  
Bright Opoku Ahinkorah ◽  
Aduragbemi Banke-Thomas ◽  
Sanni Yaya
Keyword(s):  
Sub Saharan Africa ◽  
Inequality Of Opportunity ◽  
Access To Health Services ◽  
Children Under Five ◽  
Under Five ◽  
Guinea Bissau ◽  
Health And Nutrition ◽  
Access To Health ◽  
Sub Saharan ◽  
Favorable Group

Abstract Background Inequality of opportunity in health and nutrition is a major public health issue in the developing regions. This study analyzed the patterns and extent of inequality of opportunity in health and nutrition among children under-five across three countries sub-Saharan Africa with low Human development index (HDI). Methods We used data from the Multiple Indicator Cluster Survey of the Democratic Republic of Congo (20,792 households, 21,756 women aged 15 to 49 and 21,456 children under five), Guinea Bissau (6601 households, 10,234 women aged 15–49 and 7573 children under five) and Mali (11,830 households, 18,409 women in 15–49 years and 16,468 children under five) to compute the human opportunity index (HOI) and the dissimilarity index (D-index). Secondly, the Shapley decomposition method was used to estimate the relative contribution of circumstances that are beyond the control of children under-five and affecting their development outcomes in later life stages. Results The study revealed that children belonging to the most favorable group had higher access rates for immunization (93.64%) and water and sanitation facilities (73.59%) in Guinea Bissau. In Congo DR, the access rate was high for immunization (93.9%) for children in the most favorable group. In Mali, access rates stood at 6.56% for children in the most favorable group. In Guinea Bissau, the inequality of opportunity was important in access to health services before and after delivery (43.85%). In Congo DR, the inequality of opportunity was only high for the immunization composite indicator (83.79%) while in Mali, inequality of opportunity was higher for access to health services before and after delivery (41.67%). Conclusion The results show that there are efforts in some places to promote access to health and nutrition services in order to make access equal without distinction linked to the socio-economic and demographic characteristics in which the children live. However, the inequalities of opportunity observed between the children of the most favorable group and those of the least favorable group, remain in general at significant levels and call on government of these countries to implement policies taking them into account.

scholarly journals Caregivers' Knowledge, Attitude and Practice Regarding Diarrhoea in Children under Five Years Old in Sub-Saharan Africa: An Integrative Narrative Review

2021 ◽  
pp. 1-27
Author(s):  
Margaret Wekem Kukeba ◽  
Salifu Lukman ◽  
Rosina Darcha ◽  
Abdul-Razak Doat
Keyword(s):  
English Language ◽  
Narrative Review ◽  
International Standards ◽  
Sub Saharan Africa ◽  
Children Under Five ◽  
Under Five ◽  
Attitude And Practice ◽  
Prevention And Treatment ◽  
Sub Saharan ◽  
Knowledge Attitude And Practice

Background: Diarrhoeal diseases constitute a significant burden on the health and growth of children the world over. Globally, diarrhoeal conditions remain the second leading cause of death among children under 5. Knowledge, attitudes and practice of caregivers are at the heart of diarrhoeal disease prevention and proper management. Objective: This review aimed to assess caregivers' knowledge, attitude, and practice regarding diarrhoea in children under five years old in sub-Saharan Africa, as discussed in the literature. Design: Integrative narrative review Data Sources: The review saw an extensive search on two electronic databases. Search results were screened using inclusion and exclusion criteria. At the end of the screening, 37 studies were included in the review. Review Methods: Inclusion criteria: Only studies whose focus was on caregivers’ knowledge, attitude and practice relating to diarrhoea in children under five were included. Also, only publications reported in the English Language were considered, and publications must have been between 2010-2020. Additionally, the methodological quality of studies was assessed using the Down & Black (1998) checklist for quality evaluation in a systematic review. Results: In this review, it emerged that studies in Sub-Saharan Africa indicate that caregivers display poor overall knowledge about diarrhoea. Also, the attitudes of caregivers towards diarrhoea prevention and treatment was low in many studies. On care practices, prevention practices, and management/treatment practices, including ORS and Zinc usage, were mainly reported to be quiet. Conclusions: The review concluded that there are poor levels of knowledge, attitude and practice of managing diarrhoea among caregivers of children under five (5) years of age in sub-Saharan Africa. The researchers recommended continuous health education to address knowledge gaps of mothers about diarrhoea, its prevention and treatment according to international standards.

scholarly journals Maternal age at first childbirth and under-five morbidity in sub-Saharan Africa: analysis of cross-sectional data of 32 countries

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Bright Opoku Ahinkorah
Keyword(s):  
Maternal Age ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Outcome Variable ◽  
Demographic And Health Surveys ◽  
Odds Ratios ◽  
Cross Sectional ◽  
Children Under Five ◽  
Under Five ◽  
Sub Saharan

Abstract Background The prevalence of childhood morbidity remains high in low-and middle-income countries, including sub-Saharan Africa (SSA). In this study, the association between maternal age at first childbirth and under-five morbidity in SSA was examined. Methods This was a cross-sectional study involving nationally-representative data from the most recent Demographic and Health Surveys conducted in 32 countries in SSA from 2010 to 2019. A sample size of 311,603 mothers of children under-five was considered. The outcome variable for this study was under-five morbidity. This variable was derived from the experience of fever, cough, and diarrhoea among children under-five. Both multilevel and binary logistic regression models were used to test the hypothesis that adolescent childbirth is associated with under-five morbidity. The results were presented as crude odds ratios (cORs) and adjusted odds ratios (aORs), with 95 % confidence intervals (CIs). Results Children born to mothers whose first childbirth occurred at < 20 years were 16 % times more likely to suffer from under-five morbidity, compared to those whose mothers’ first childbirth occurred at age ≥ 20 years [cOR = 1.16; CI = 1.13–1.19], and this persisted but with reduced odds after controlling for covariates [aOR = 1.10; CI = 1.07–1.12]. At the country level, children born to mothers whose first childbirth occurred at < 20 years were more likely to suffer from under-five morbidity, compared to those whose mothers’ first childbirth occurred at age ≥ 20 years in Angola, Burundi, Congo DR, Guinea, Kenya, and Uganda. Conclusions In this study, an association between adolescent childbirth and morbidity in children under five in SSA has been established. The study concludes that under-five morbidity is higher among children born to mothers whose first childbirth occurred before 20 years compared to those whose mothers’ first childbirth occurred at 20 years and above. The findings indicate that in order to reduce under-five morbidity, there is the need to deal with adolescent childbearing through cultural and social change, coupled with engagement of adolescents and stakeholders in adolescent sexual and reproductive health programmes.

scholarly journals A Scoping Review of Selected Studies on Predictor Variables Associated with the Malaria Status among Children under Five Years in Sub-Saharan Africa

2021 ◽  
Vol 18 (4) ◽  
pp. 2119
Author(s):  
Phillips Edomwonyi Obasohan ◽  
Stephen J. Walters ◽  
Richard Jacques ◽  
Khaled Khatab
Keyword(s):  
Scoping Review ◽  
Household Wealth ◽  
Sub Saharan Africa ◽  
World Health ◽  
Bed Net ◽  
Children Under Five ◽  
Under Five ◽  
The World ◽  
Sub Saharan ◽  
Effective Distribution

Background/Purpose: In recent times, Sub-Saharan Africa (SSA) had been rated by the World Health Organization (WHO) as the most malaria-endemic region in the world. Evidence synthesis of the factors associated with malaria among children aged under-five in SSA is urgently needed. This would help to inform decisions that policymakers and executors in the region need to make for the effective distribution of scarce palliative resources to curb the spread of the illness. This scoping review is aimed at identifying studies that have used multivariate classical regression analysis to determine the predictors associated with malaria among children under five years old in SSA. Methods/Design: The search terms followed population, intervention, comparator, outcome, timing, setting (PICOTS), and were used in searching through the following databases: PubMed, MEDLINE, Web of Science, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Scopus, and Measure DHS. The databases were searched for published articles from January 1990 to December 2020. Results: Among the 1154 studies identified, only thirteen (13) studies met the study’s inclusion criteria. Narrative syntheses were performed on the selected papers to synchronize the various predictors identified. Factors ranging from child-related (age, birth order and use of a bed net), parental/household-related (maternal age and education status, household wealth index) and community-related variables (community wealth status, free bed net distribution) were some of the identified significant predictors. Conclusions: It is timely to have a synthesis of predictors that influence the malaria status of children under-five in SSA. The outcome of the review will increase the knowledge of the epidemiology of morbidity that will form the basis for designing efficient and cost-effective distribution of palliatives and control of malaria in SSA.

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