Country characteristics and acute diarrhea in children from developing nations: A multilevel study

a multilevel study

Resultado de la investigación: Contribución a RevistaArtículo

11 Citas (Scopus)

Resumen

BACKGROUND: Each year 2.5 billion cases of diarrheal disease are reported in children under five years, and over 1,000 die. Country characteristics could play a role on this situation. We explored associations between country characteristics and diarrheal disease in children under 5 years of age, adjusting by child, mother and household attributes in developing countries.

METHODS: This study included 348,706 children from 40 nations. We conducted a multilevel analysis of data from the Demographic and Health Surveys and the World Bank.

RESULTS: The prevalence of acute diarrhea was 14 %. Country inequalities (OR = 1.335; 95 % CI 1.117-1.663) and country's low income (OR = 1.488; 95 % CI 1.024-2.163) were associated with diarrhea, and these country characteristics changed the associations of well-known determinants of diarrhea. Specifically, living in poor countries strengthens the association of poor household wealth and mother's lack of education with the disease. Other factors associated with diarrhea were female sex of the child (OR = 0.922; 95 % CI 0.900-0.944), age of the child (OR = 0.978; 95 % CI 0.978-0.979), immunization status (OR = 0.821; 95 % CI 0.799-0.843), normal birthweight (OR = 0.879; 95 % CI 0.834-0.926), maternal age (OR = 0.987; 95 % CI 0.985-0.989), lack of maternal education (OR = 1.416; 95 % CI 1.283-1.564), working status of the mother (OR = 1.136; 95 % CI 1.106-1.167), planned pregnancy (OR = 0.774; 95 % CI 0.753-0.795), a nuclear family structure (OR = 0.949; 95 % CI 0.923-0.975), and household wealth (OR = 0.948; 95 % CI 0.921-0.977).

CONCLUSIONS: Inequalities and lack of resources at the country level in developing countries -but not health expenditure- were associated with acute diarrhea, independently of child, family and household features. The broad environment considerably modifies well-known social determinants of acute diarrhea and public health campaigns designed to target diarrhea should consider macro characteristics of the country.

Idioma originalEnglish (US)
Páginas (desde-hasta)811
PublicaciónBMC Public Health
Volumen15
DOI
EstadoPublished - ago 21 2015
Publicado de forma externa

Huella dactilar

Developing Countries
Diarrhea
Mothers
Education
Multilevel Analysis
United Nations
Maternal Age
Family Planning Services
Health Expenditures
Health Promotion
Nuclear Family
Immunization
Public Health
Demography

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@article{9fe22a4121a54f239700ce6027aa86e7,
title = "Country characteristics and acute diarrhea in children from developing nations: A multilevel study: a multilevel study",
abstract = "BACKGROUND: Each year 2.5 billion cases of diarrheal disease are reported in children under five years, and over 1,000 die. Country characteristics could play a role on this situation. We explored associations between country characteristics and diarrheal disease in children under 5 years of age, adjusting by child, mother and household attributes in developing countries.METHODS: This study included 348,706 children from 40 nations. We conducted a multilevel analysis of data from the Demographic and Health Surveys and the World Bank.RESULTS: The prevalence of acute diarrhea was 14 {\%}. Country inequalities (OR = 1.335; 95 {\%} CI 1.117-1.663) and country's low income (OR = 1.488; 95 {\%} CI 1.024-2.163) were associated with diarrhea, and these country characteristics changed the associations of well-known determinants of diarrhea. Specifically, living in poor countries strengthens the association of poor household wealth and mother's lack of education with the disease. Other factors associated with diarrhea were female sex of the child (OR = 0.922; 95 {\%} CI 0.900-0.944), age of the child (OR = 0.978; 95 {\%} CI 0.978-0.979), immunization status (OR = 0.821; 95 {\%} CI 0.799-0.843), normal birthweight (OR = 0.879; 95 {\%} CI 0.834-0.926), maternal age (OR = 0.987; 95 {\%} CI 0.985-0.989), lack of maternal education (OR = 1.416; 95 {\%} CI 1.283-1.564), working status of the mother (OR = 1.136; 95 {\%} CI 1.106-1.167), planned pregnancy (OR = 0.774; 95 {\%} CI 0.753-0.795), a nuclear family structure (OR = 0.949; 95 {\%} CI 0.923-0.975), and household wealth (OR = 0.948; 95 {\%} CI 0.921-0.977).CONCLUSIONS: Inequalities and lack of resources at the country level in developing countries -but not health expenditure- were associated with acute diarrhea, independently of child, family and household features. The broad environment considerably modifies well-known social determinants of acute diarrhea and public health campaigns designed to target diarrhea should consider macro characteristics of the country.",
author = "Pinz{\'o}n-Rond{\'o}n, {{\'A}ngela Mar{\'i}a} and Carol Z{\'a}rate-Ardila and Alfonso Hoyos-Mart{\'i}nez and Ruiz-Sternberg, {{\'A}ngela Mar{\'i}a} and Alberto V{\'e}lez-van-Meerbeke",
year = "2015",
month = "8",
day = "21",
doi = "10.1186/s12889-015-2120-8",
language = "English (US)",
volume = "15",
pages = "811",
journal = "BMC Public Health",
issn = "1471-2458",
publisher = "BioMed Central",

}

Country characteristics and acute diarrhea in children from developing nations: A multilevel study : a multilevel study. / Pinzón-Rondón, Ángela María; Zárate-Ardila, Carol; Hoyos-Martínez, Alfonso; Ruiz-Sternberg, Ángela María; Vélez-van-Meerbeke, Alberto.

En: BMC Public Health, Vol. 15, 21.08.2015, p. 811.

Resultado de la investigación: Contribución a RevistaArtículo

TY - JOUR

T1 - Country characteristics and acute diarrhea in children from developing nations: A multilevel study

T2 - a multilevel study

AU - Pinzón-Rondón, Ángela María

AU - Zárate-Ardila, Carol

AU - Hoyos-Martínez, Alfonso

AU - Ruiz-Sternberg, Ángela María

AU - Vélez-van-Meerbeke, Alberto

PY - 2015/8/21

Y1 - 2015/8/21

N2 - BACKGROUND: Each year 2.5 billion cases of diarrheal disease are reported in children under five years, and over 1,000 die. Country characteristics could play a role on this situation. We explored associations between country characteristics and diarrheal disease in children under 5 years of age, adjusting by child, mother and household attributes in developing countries.METHODS: This study included 348,706 children from 40 nations. We conducted a multilevel analysis of data from the Demographic and Health Surveys and the World Bank.RESULTS: The prevalence of acute diarrhea was 14 %. Country inequalities (OR = 1.335; 95 % CI 1.117-1.663) and country's low income (OR = 1.488; 95 % CI 1.024-2.163) were associated with diarrhea, and these country characteristics changed the associations of well-known determinants of diarrhea. Specifically, living in poor countries strengthens the association of poor household wealth and mother's lack of education with the disease. Other factors associated with diarrhea were female sex of the child (OR = 0.922; 95 % CI 0.900-0.944), age of the child (OR = 0.978; 95 % CI 0.978-0.979), immunization status (OR = 0.821; 95 % CI 0.799-0.843), normal birthweight (OR = 0.879; 95 % CI 0.834-0.926), maternal age (OR = 0.987; 95 % CI 0.985-0.989), lack of maternal education (OR = 1.416; 95 % CI 1.283-1.564), working status of the mother (OR = 1.136; 95 % CI 1.106-1.167), planned pregnancy (OR = 0.774; 95 % CI 0.753-0.795), a nuclear family structure (OR = 0.949; 95 % CI 0.923-0.975), and household wealth (OR = 0.948; 95 % CI 0.921-0.977).CONCLUSIONS: Inequalities and lack of resources at the country level in developing countries -but not health expenditure- were associated with acute diarrhea, independently of child, family and household features. The broad environment considerably modifies well-known social determinants of acute diarrhea and public health campaigns designed to target diarrhea should consider macro characteristics of the country.

AB - BACKGROUND: Each year 2.5 billion cases of diarrheal disease are reported in children under five years, and over 1,000 die. Country characteristics could play a role on this situation. We explored associations between country characteristics and diarrheal disease in children under 5 years of age, adjusting by child, mother and household attributes in developing countries.METHODS: This study included 348,706 children from 40 nations. We conducted a multilevel analysis of data from the Demographic and Health Surveys and the World Bank.RESULTS: The prevalence of acute diarrhea was 14 %. Country inequalities (OR = 1.335; 95 % CI 1.117-1.663) and country's low income (OR = 1.488; 95 % CI 1.024-2.163) were associated with diarrhea, and these country characteristics changed the associations of well-known determinants of diarrhea. Specifically, living in poor countries strengthens the association of poor household wealth and mother's lack of education with the disease. Other factors associated with diarrhea were female sex of the child (OR = 0.922; 95 % CI 0.900-0.944), age of the child (OR = 0.978; 95 % CI 0.978-0.979), immunization status (OR = 0.821; 95 % CI 0.799-0.843), normal birthweight (OR = 0.879; 95 % CI 0.834-0.926), maternal age (OR = 0.987; 95 % CI 0.985-0.989), lack of maternal education (OR = 1.416; 95 % CI 1.283-1.564), working status of the mother (OR = 1.136; 95 % CI 1.106-1.167), planned pregnancy (OR = 0.774; 95 % CI 0.753-0.795), a nuclear family structure (OR = 0.949; 95 % CI 0.923-0.975), and household wealth (OR = 0.948; 95 % CI 0.921-0.977).CONCLUSIONS: Inequalities and lack of resources at the country level in developing countries -but not health expenditure- were associated with acute diarrhea, independently of child, family and household features. The broad environment considerably modifies well-known social determinants of acute diarrhea and public health campaigns designed to target diarrhea should consider macro characteristics of the country.

U2 - 10.1186/s12889-015-2120-8

DO - 10.1186/s12889-015-2120-8

M3 - Article

VL - 15

SP - 811

JO - BMC Public Health

JF - BMC Public Health

SN - 1471-2458

ER -