Dissertations / Theses: 'Children under five years'

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Al, Hosani H. A. "Mortality in infants and children under five years in Abu Dhabi Emirate." Thesis, University of Aberdeen, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.592058.

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A two stage survey was carried out in order, a) to investigate trends and differentials in infant mortality in Abu Dhabi Emirate from 1980 to 1996 and b) to investigate the influence of risk factors on the problem of mortality under five years. The first stage reviewed infant mortality by sex, ethnicity, locality and cause of death. Data about the births and deaths of children were obtained from the Departments of Preventive Medicine in the three Health Regions of Abu Dhabi, Al Ain and the Western Region; 4523 infant deaths were coded according to the 9^th revision of the International Classification of Diseases. The underlying causes of death were grouped into six main categories, namely: infections; congenital anomalies; conditions originating in the perinatal period; ill-defined conditions; accidents and miscellaneous. The rates for infant, perinatal, neonatal and postneonatal mortalities decreased substantially during the study period. The values for these mortality rates (per 1000 live births or total births in the case of the perinatal mortality rate) or 21.55, 20.43, 13.42 and 8.13 respectively in 1980 contrasted with their values of 9.15, 12.12, 5.51 and 3.64 in 1996. By contrast, the stillbirth rate showed the least change, declining from 8.4 in 1980 to a minimum of 7.79 per 1000 total births in 1996. The ratio of postneonatal to neonatal mortality rates remained broadly constant during the study period. In 1996, the under-5 mortality per 1000 live births was 13.1 in Abu Dhabi Emirate. Accidents formed the leading cause of death in the 1-5 year old children in the whole population from 1980 to 1996. A multiple regression technique was used to evaluate the independent effect of the variables (sex, nationality and region) upon the infant mortality rate. The rate of decline of the infant mortality rate appeared to be changing during the study period, which made the models containing the square of the year more fitting to the data points.

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Kukeba, Margaret. "Ethnography of household cultural feeding practices of children under five years in rural northern Ghana." Thesis, University of Manchester, 2017. https://www.research.manchester.ac.uk/portal/en/theses/ethnography-of-household-cultural-feeding-practices-of-children-under-five-years-in-rural-northern-ghana(cac6d660-1ac9-447d-9fc3-1970fdb56df0).html.

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Background: Appropriate child feeding prevents nutrient deficiencies, diseases, and deaths in children. However, only 13.3% of children aged 6-23 months in Ghana receive the minimum acceptable diet. Thus, undernutrition remains high in rural northern Ghana, especially among under-fives. This is showing no improvement despite economic development and implementation of globally recommended nutrition & feeding interventions. There is limited context specific evidence about child feeding in rural northern Ghana. Aim: To examine how culture might impact upon the feeding of children under five years of age in rural northern Ghana. Methods: A qualitative ethnographic study was completed between October 2014 and May 2015. Data were collected in a rural Ghanaian community via participant observation and sixty-one ethnographic interviews with mothers, fathers, and grandparents in 15 households, and spiritual leaders are known as "diviners". Themes were developed through inductive analysis of field notes and verbatim transcribed interviews using a framework approach. Results: The content of a child's diet and the pattern of feeding were found to be influenced by the community's notion of food, taboos, and beliefs which originated in a traditional African religion. Shared household responsibility for feeding children and the gendered and age related hierarchy of household decision making also influenced child feeding. Discussion: This study has shown multifaceted taken-for-granted social and cultural influences on child feeding. Whilst mothers are the main recipients of the official public health nutrition and child feeding advice, the communal structures, living arrangements and social interactions support, enhance, and reinforce the community inclined practices that limit mothers' independent decision making. Conclusion: To effect community change and promote uptake of public health nutrition recommendations, a community wide nutrition intervention approach may be more beneficial than the current approach which targets mothers. Furthermore, community and cultural influences must be understood and considered by health professionals if such interventions are to succeed.

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Jorosi-Tshiamo, Wananani B. "DIETARY INTAKE OF CHILDREN AGED 1 YEAR TO 5 YEARS AND THEIR ANTHROPOMETRIC MEASURES IN KWENENG DISTRICT-BOTSWANA." Case Western Reserve University School of Graduate Studies / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=case1346223185.

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Maphalala, Gugu Petunia. "Epidemiology of rotatirus diarrhoea in children under five years years of age from selected healthcare facilities in Swaziland." Thesis, University of Limpopo (Medunsa Campus), 2013. http://hdl.handle.net/10386/1154.

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Thesis (MSc (Medical science in medical virology)) -- University of Limpopo
Background: It has been established that rotaviruses are the main cause of acute gastroenteritis in children worldwide, resulting in more than 453 000 deaths, with a high mortality still occurring in African countries and Asia. In Swaziland, diarrheal diseases are a common cause of morbidity and mortality among children <5 years of age. Approximately 10% of hospitalised Swazi children die due to diarrhoea every year. Through financial assistance from the World Health Organization (WHO), many African countries have conducted a lot of rotavirus disease studies. In Swaziland, the epidemiology of rotavirus infection is unknown due to lack of data. Thus, the study’s aim was to examine the epidemiology and characterize rotavirus strains in children <5 years of age, hospitalised and attending the outpatient departments of public and private healthcare facilities in Swaziland. Materials and methods: A total of 745 diarrheal stool specimens were collected from children <5 years of age from April 2009 to December 2010. Group A rotavirus antigen was detected using a commercially available enzyme immunoassay (EIA) kit (ProSpectTM, Oxoid Ltd, UK). Polyacrylamide gel electrophoresis (PAGE) was used to determine the electrophoretic pattern of rotavirus strains. The P and G genotypes were established by reverse transcription polymerase chain reaction (RT-PCR) and multiplex hemi-nested PCR amplification of the VP4 and VP7 genes respectively, using type-specific primers. Sequencing was performed on 35 specimens to confirm the circulating genotypes. The phylogenetic tree and similarity distances between genotypes were constructed using the neighbour joining method and the Kimura two-parameter model package in the MEGA version 5.05 software program. Results: Group A rotavirus was detected at 13.3% in 2009 (based on samples collected from April to December) and 23.4% in 2010 (based on one year collection) from children <5 years of age hospitalized and attending outpatient departments. The rotavirus infection was more frequently detected in the age group 0-11 months (22.2%). Gender did not play a major role in rotavirus infection, because both male (20.8%) and female (18.8%) children were equally affected. Of the children that were admitted in the hospital, 33.3% were affected by rotavirus infection compared to those attending the outpatient departments (13.5%). The rotavirus infection was observed during the cooler, drier months of the year. The three most predominant G and P genotypes detected were G2P[4] (30.4%), followed by G1P[8] (15.5%) and G9P[8] (8.8%). A significant number of uncommon rotavirus strains (32.4%), mixed infections (8.8%) and nontypeables (4.1%) were also detected. The circulating genotypes detected were classified into lineages and sub-lineages defined by phylogenetic analysis of nucleotide sequences. The Swaziland strains were found clustering with known African and global strains from the GenBank. Conclusion: The findings of this study reveal that group A rotaviruses are the etiological agents of severe diarrhoea in children under 5 years in Swaziland. The diversity of rotavirus strains that were detected highlights the importance of introducing the rotavirus vaccine in the country. The currently licensed vaccines may confer protection against the circulating strains detected in this study. Data on the burden of rotavirus disease in Swaziland will be used to convince the Ministry of Health and policy makers in the country to advocate for the introduction of the rotavirus vaccine. This is the first data on the epidemiology and characterization of rotavirus strains in Swaziland; therefore there is a need for continuing with the surveillance of rotavirus in the existing sentinel sites to determine the impact of rotavirus infection over time. It is also essential to continuously monitor the rotavirus strains circulating among Swazi children.

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Taye, Mami Dorothy. "Pain assessment of children under five years in a primary health care setting / Mami Dorothy Taye." Thesis, North-West University, 2012. http://hdl.handle.net/10394/9844.

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Pain is a very common problem experienced by the general population and children in particular. It goes beyond personal suffering and affects all dimensions of the quality of life and general functioning of both adults and children, be it the physiological, psychological or financial aspects. Children may suffer from pain that may either be chronic or acute, depending on the diagnosis. Assessment of pain in children is equally important as that of adults, except that they lack the verbal fluency and cognitive development to communicate their pain. Children’s experience of pain is similar to that of adults. Pain assessment is a key aspect in the nursing management of children and delivery of care within the Primary Health Care (PHC) setting. Effective pain assessment is thus reliant on comprehensive assessment of the child and his or her pain. The aim of this research was to explore and describe practices and perceptions of professional nurses working in a PHC facility regarding pain assessment of children under five years in the Mangaung Metropolitan Municipality and to formulate recommendations for professional nurses in PHC facilities to facilitate pain assessment in PHC settings. A qualitative study design was used and data was collected with the use of focus groups. A purposive sampling was conducted to select participants who represent the target population. The sample used for the study included all the professional nurses working in PHC facilities registered with the South African Nursing Council and that have at least one year of experience. The practical training of the researcher to conduct an interview was done prior to the actual research. A pilot focus group was conducted and the interview schedule was finalised. Semi-structured focus groups were used to obtain data from the participants. The researcher conducted 6 focus group interviews attended by 32 professional nurses. Data was collected until data saturation was achieved. Trustworthiness was ensured in accordance with the principles of credibility, transferability, dependability and confirmability. Data was captured on a digital voice recorder and transcribed verbatim. Field notes were taken during each focus group. Data analysis was done by means of content analysis by the researcher and an independent co-coder. After consensus and saturation, three major themes emerged. Each theme was identified and divided into sub-themes and was consequently discussed together with the relevant data obtained from literature. The findings indicated that professional nurses perceive the assessment of pain in children under five years as a challenge. The combination of signs and symptoms to make decisions with pain assessment was identified as an area of concern. The participants further p erceived the history provided by the parent as important in the process of pain assessment. The conclusions drawn are that the professional nurses acknowledge that they don’t take sufficient notice of pain in children under five, which means that children with pain are neglected. Professional nurses maintain that there is a need for sufficient pain assessment and the need for guidelines and tools to assess pain in children under five, especially in the PHC setting. These professional nurses support the availability of guidelines to assist them to conduct effective and comprehensive pain assessment. The research report concluded with the researcher’s recommendations for nursing education, nursing research and nursing practice with specific formulation of guidelines for the facilitation of professional nurses to truly render effective and comprehensive pain assessment in PHC settings.
Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.

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Makala, Lukuni. "The influence of maternal HIV status on mortality in children under the age of five years." Master's thesis, University of Cape Town, 2020. http://hdl.handle.net/11427/32538.

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Child mortality can be used to measure the level of social development as well as the health status of children (Hill 1991). By world regions, sub-Saharan Africa maintains the highest rates of under-five mortality. Current under-five mortality is estimated at 76 deaths per 1,000 live births (Hug, Sharrow, Zhong et al. 2018). In Zambia, under-five mortality reached a peak of 197 in 1996 and is currently estimated at 60 (Hug, Sharrow, Zhong et al. 2018). On the world health agenda, reducing child mortality has been made a priority, especially for low income countries that remain the most affected. Among the targets of the Sustainable Development Goals (SDGs) is reduction of neonatal mortality to at least 12 deaths per 1,000 live births and under-five mortality to 25 deaths by 2030 (United Nations 2015). HIV/AIDS is one of the leading causes of mortality in Zambia and has contributed to the slow decline of under-five mortality (Garenne and Gakusi 2006). Children under the age of five years get infected with HIV mainly through vertical transmission (Fishel, Ren, Barrère et al. 2014). In the absence of treatment, vertical transmission of HIV is high and can range between 15 and 45 per cent, reducing below 5 per cent with effective interventions (Barral, Oliveira, Lobato et al. 2014). Despite vertical transmission being the main pathway through which children get infected with HIV, little research has been done to determine the significance of maternal HIV status on under-five mortality in Zambia. The aim of the study was, therefore, to determine the extent to which mortality of children with HIV-positive mothers differs from that of children with HIV-negative mothers. The Zambia Demographic and Health Survey (ZDHS) data for 2007 and 2014 which contain HIV serotesting data were used. Survival analysis using Poisson regression was used to model the influence of maternal HIV status taking into account confounding factors. The results of the study indicate that maternal HIV status was significantly associated with child mortality in both survey periods but by 2013/14 the influence of maternal HIV status had reduced and was insignificant for children born within one year of the 2013/14 survey. The reduction in the risk of dying between the inter-survey period may be as a result of increased coverage of prevention of mother-to-child transmission (PMTCT) and antiretroviral therapy (ART) services over the years. In order to reach universal coverage, there is need for increased provision of PMTCT and ART treatments and support for HIV strategies such as the 90 90 90 target.

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van, Aswegen Tanya. "Factors associated with morbidity and mortality in children under-five years admitted with severe acute malnutrition to a regional paediatric hospital in Kwazulu-Natal." University of the Western Cape, 2018. http://hdl.handle.net/11394/6741.

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Magister Public Health - MPH
Background: Malnutrition is a complex condition profoundly impacting child mortality and morbidity, especially in sub-Saharan Africa. Severe acute malnutrition is of growing concern locally where unacceptable mortality rates persist, despite reasonable standards of clinical care. Aim: To determine factors associated with morbidity and mortality in children under-five years admitted with severe acute malnutrition to a regional paediatric hospital in KwaZulu-Natal. Methodology: This was a quantitative study. A retrospective observational study design was used. Medical records of all children with severe acute malnutrition, under the age of five years, admitted between April 2015 and December 2016 to the regional paediatric hospital in KwaZulu-Natal were included. Data was obtained from medical records and admission books. A trained research assistant was used to extract and record data with a piloted data extraction tool. Data was entered and cleaned using Microsoft Excel and analysed using SPSS (v 20) and STATA (v 14). Descriptive summary statistics were used to describe the characteristics of the study population and bivariate analysis using t-tests and Chi-square tests to determine significance. Kaplan Meier and Multivariate Cox regression was used to assess the association of variables with morbidity and mortality. Results: Of the 276 eligible case records included in the study, 54% were male and 90% of all cases were younger than 2 years. Even though associations did not reach significance, teenage pregnancy and unemployment was high amongst the caregivers of the study population. Most of the malnourished children admitted (74%) presented with multiple comorbidities. Diarrhoea (43%), HIV- infection (30%) and respiratory tract infections (30%) were the top three comorbidities found, followed by tuberculosis (27%). The overall mortality rate was 8.7%. Survival probability was significantly reduced in children with pneumonia and those who presented with hypoglycaemia, dehydration, dermatosis, severe pallor, altered consciousness or shock on admission (p < 0.05). There was a significantly increased risk of death in males (HR = 0.174, 95%CI = 0.05 - 0.665), and in those who presented with dehydration (HR = 4.1, 95%CI = 1.25 - 13.59), evidence of lethargy or coma (HR = 4.2, 95%CI = 1.04 - 17.12) or multiple clinical signs (HR = 4.4, 95% CI =2.56 - 7.59) on admission (p < 0.05). The comorbidities HIV-infection (HR = 9.9, 95%CI = 1.39 - 70.68) and pneumonia (HR = 3.4, 95%CI = 1.56 - 7.43) showed a significantly increased mortality risk (p < 0.05). Conclusion: This study supports the body of evidence that despite reasonable standards of hospital care, it is difficult to obtain the target for severe acute malnutrition mortality (< 5%), likely due to the presence of contextually specific factors. Local interventions at hospital, primary health care and community level is needed, as well as further research to facilitate comprehensive policy-making.

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Aheto, Justice Moses Kwaku. "Modelling malnutrition among under-five-year-old children in Ghana." Thesis, Lancaster University, 2016. http://eprints.lancs.ac.uk/82143/.

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Childhood malnutrition is a real-life and a chronic problem and one of the global major public health challenges, especially in developing countries like Ghana. Several attempts from governmental and non-governmental organizations to address the problem have fallen below expectation. It is recognised that the existing studies and nutrition intervention strategies are inadequate and hence not working to expectation. This thesis examines childhood malnutrition in Ghana using appropriate and advanced statistical methods to help improve the understanding of childhood nutrition and to better inform targeted public health nutrition interventions in the country. In this thesis, we provided solutions to five main problems: (1) investigated the major risk factors for malnutrition; (2) investigated household level variations in nutritional outcomes of children; (3) explored, modelled and illustrated spatial variations in the risk of childhood malnutrition over Ghana; (4) explored, modelled, forecasted and illustrated spatio-temporal variations in the risk of childhood malnutrition over Ghana; (5) jointly modelled weight-for-age Z-score (WAZ) and height-for-age Z-score (HAZ) to improve accuracy and reliability in estimates. To answer the first and the second problems, multilevel models were considered. The results showed strong residual household-level variations in under-fives nutritional outcomes and that child’s age, type of birth, child’s experience of diarrhoeal episodes, size of child at birth and months of breast feeding, mother’s education, current age, BMI and national health insurance status, household toilet facility ownership and wealth status were predictive of under-fives nutrition. To answer the third problem, spatial models were employed. The study found substantial spatial variation in the predicted risk of under-fives malnutrition over Ghana and also showed that Normalised Difference Vegetation Index (a marker for vegetation cover), elevation and rural/urban residence status were predictive of under-fives nutritional outcomes. The study considered spatio-temporal models to answer the fourth problem. The results showed substantial spatio-temporal variation in the risk of under-fives chronic malnutrition over Ghana. Our forecasted map of chronic malnutrition showed substantial spatial variation with children from parts of Northern and Western regions being at the highest risk of malnutrition compared to children from other regions of the country. In our forecast maps, the effect of increasing the level of maternal education was shown to reduce the prevalence of malnutrition throughout Ghana. To answer the fifth problem, multivariate response multilevel models were considered. The study found that the residual household effects for WAZ and HAZ are very strongly correlated and that the correlation was stronger for the residual household effects than the residual child effects. This also suggests that after adjusting for risk factors in our model, it is the same as-yet unidentified factors at household level that influence both WAZ and HAZ. The results also showed that there was more accuracy and reliability in estimates from the multivariate response multilevel model over separate multilevel models and showed that the effect of some important risk factors differed substantially across WAZ and HAZ. The findings from this thesis are intended to help policymakers responsible for the health and nutrition of children to design efficient public health policies and targeted nutrition interventions amidst scarce public health resources available in Ghana to better understand, target and to reduce childhood malnutrition prevalence closer to the level expected in a healthy, well-fed population of children under-fives.

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Linjewile-Marealle, Navoneiwa. "Oral health and nutritional status of the children under five years, Queen Elizabeth II Hospital, Maseru, Lesotho." Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_1437_1190193126.

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The aim of this study was to compare the oral health status between well and malnourished children under five years old attending Mother and Child Health clinic in Queen Elizabeth II Hospital in Maseru, Lesotho.

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Attique, Amer Boonyong Keiwkarnka. "Utilization of immunization services among mothers with children under five years of age in abbottabad district, Pakistan /." Abstract, 1999. http://mulinet3.li.mahidol.ac.th/thesis/2542/42E-AmerAttique.pdf.

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Del, Valle Mendoza Juana Mercedes, Oré Veronica Casabona, Helasvuo Veronica Petrozzi, Tapia Angela Cornejo, Pablo Weilg, Maria J. Pons, Mora Erico Cieza, Mayra Jorge Bazán, Pacherres Hernan Cornejo, and Joaquin Ruiz. "Bordetella pertussis diagnosis in children under five years of age in the Regional Hospital of Cajamarca, Northern Peru." The Journal of Infection in Developing Countries (JIDC), 2015. http://hdl.handle.net/10757/605267.

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Introduction: Bordetella pertussis is an important human pathogen that causes whooping cough (pertussis), an endemic illness responsible of significant morbidity and mortality, especially in infants and children. Worldwide, there are an estimated of 16 million cases of pertussis, resulting in about 195,000 child deaths per year. In Peru, pertussis is a major health problem that has been on the increase despite immunization efforts. The objective of this study was to determine the prevalence of B. pertussis among children under five years of age suspected to have whopping cough in Cajamarca, Peru. Methodology: Children diagnosed with whooping cough admitted to the Hospital Regional de Cajamarca from August 2010 to July 2013 were included. Nasopharyngeal samples were obtained for B. pertussis culture and polymerase chain reaction (PCR) detection. Results: In 133 children, the pertussis toxin and IS481 gene were detected in 38.35% (51/133) of the cases by PCR, while only 9.02% (12/133) of the Bordetella cultures were positive. The most frequent symptoms in patients with positive B. pertussis were paroxysm of coughing 68.63% (35/51), cyanosis 56.86% (29/51), respiratory distress 43.14% (22/51), and fever 39.22% (20/51). Pneumonia and acute bronchial obstructive syndrome were present in 17.65% (9/51) and 13.72% (7/51) of the cases, respectively. Conclusions: B. pertussis is responsible for an important proportion of whooping cough in hospitalized children in Cajamarca. Epidemiologic surveillance programs for B. pertussis are essential in Peru, especially in children who could most benefit from the vaccine.

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Siswanto, Eddy Bhuiyan Shafi Ullah. "Knowledge and perception of pneumonia disease among mothers of children under five years attending Nakhon Pathom General Hospital, Thailand /." Abstract, 2007. http://mulinet3.li.mahidol.ac.th/thesis/2550/cd399/4937989.pdf.

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Carter, Yvonne Helen. "The aetiology and prevention of accidents to pre-school children : an evaluation of accidents to children under five years old in North Staffordshire." Thesis, Imperial College London, 1993. http://hdl.handle.net/10044/1/7464.

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Senzilet, Linda Debra. "The impact of Ontario's child restraint legislation on the incidence, severity and patterns of injury in children under five years." Thesis, University of Ottawa (Canada), 1992. http://hdl.handle.net/10393/7698.

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In 1983, the Ontario government introduced legislation which mandated the restraint of all child passengers under 50 pounds in restraint systems appropriate to their weight. The efficacy of such restraint systems has been proven, and standards for their manufacture have been set by the government of Canada. The objectives of this study were to determine whether Ontario's child restraint legislation has resulted in significant and sustained reductions in the incidence and severity of injury, as well as changes in the anatomical patterns of fatal and non-fatal injury. Data sources included the Hospital Medical Records Institute (HMRI) and Transport Canada's Traffic Accident Information Data Bank (TRAID). The study used the interrupted time-series design and autoregressive integrated moving average (ARIMA) modelling to analyze a variety of rates and indicators calculated for children under 5, as well as for a control group of adults 20-44 years old. The study period encompassed five pre-law years and five post-law years, extending from 1979 to 1988. Results suggested that there were no significant changes in either the incidence, severity or anatomical patterns of injury in children covered by the legislation. Two possible explanations for the apparent lack of an intervention effect are that either the pre- to post-legislation increase in (proper) usage rates was not large enough, or that any positive effects of the law were too gradual to be detected. These conclusions are supported by evidence that there was a relatively high usage of child restraints prior to the legislation, and that rates of proper wearing of restraints did not exceed 50% in the years following implementation. Child restraint laws cannot achieve their objectives without a higher level of sustained compliance. Several means of achieving this objective are presently being implemented by the so-called "95 by 95" program, i.e., the National Occupant Restraint Program that is operating in all provinces, and whose stated goal is a 95% wearing rate of restraints in all age groups by the year 1995. (Abstract shortened by UMI.)

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hussein, hanaa. "Prevalence of Diarrhea and assoicated risk factors in children under five years of age in Northern Nigeria : A secondary data analysis of Nigeria and Demographic and Health Survey 2013." Thesis, Uppsala universitet, Internationell mödra- och barnhälsovård (IMCH), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-323559.

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He, Hui Sirikul Isaranurug. "Risk factors of pneumonia among children under five years of age at Queen Sirikit National Institute of Child Health, Bangkok, Thailand /." Abstract, 2000. http://mulinet3.li.mahidol.ac.th/thesis/2543/43E-HeHui.pdf.

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Angkham, Ounavong Santhat Sermsri. "Self-medication of antibiotics in mild URI among mothers with children under five years old, in Naxaithong district, Vientiane, Lao PDR /." Abstract, 2003. http://mulinet3.li.mahidol.ac.th/thesis/2546/4537458.pdf.

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Adji, Seno Charnchudhi Chanyasanha. "Factors related to mother's behavior in order to give ORS to children under five years old at Kuma Health Center, Indonesia /." Abstract, 2005. http://mulinet3.li.mahidol.ac.th/thesis/2548/cd375/4737944.pdf.

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Adhiambo, Oreje Joy Susan. "Assessment of prescribing patterns and availability of anti-malarial drugs to children under five years of age in a rural district in Kenya." University of Western Cape, 2013. http://hdl.handle.net/11394/3927.

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Magister Public Health - MPH
Aim: The aim of this study was to assess the prescribing practices and availability of antimalarial drugs to children under five years of age in primary health care facilities in Bondo district.

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Kamaranzi, Bakunda Kaakaabaale. "Factors associated with late presentation of children under five and pregnant women with malaria for treatment at health units in Bungokho Health Sub District." Thesis, University of the Western Cape, 2010. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_9025_1363357146.

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Background: Malaria is the leading cause of death of Uganda&rsquo
s children under 5 years of age and the number-one cause of illness in adults in Uganda. The success of malaria treatment strategies is closely linked to the behavior of patients and caretakers of young children. In the case of malaria this includes accessing appropriate treatment for
suspected malaria in time. In Bungokho Sub County, in spite of the efforts by district health workers and the Ministry of Health to implement the malaria control, prevention and treatment strategies, pregnant women and caretakers of children under 5 years of age continue to present late for treatment in the health units resulting in possible avoidable
death or disability. Aim and objectives: The aim of this study was to explore the factors that lead to late presentation of children and pregnant women with malaria for treatment at health units. This was done by exploring the perceptions of caregivers of children under five years and pregnant women on the community&rsquo
s knowledge and understanding of the
symptoms and treatment of malaria
and describing perceptions of caregivers and pregnant women on health care provision at the health units and alternative treatment for malaria. Methods :The study was conducted in Bungokho Health sub-district, in Mbale district, Eastern Uganda over a two month period in 2009. It was a descriptive exploratory study using qualitative research methods. Four focus groups were carried out, two with caregivers of children under 5 years and two with pregnant women, with each focus group consisting of eight participants. Two caregivers and two pregnant women were identified from the focus groups for further indepth interviews. Four in-depth interviews were conducted with health unit staff from Bungokho HCVI. Notes were taken and observations made during the focus groups and interviews. The proceedings were audio-taped and recordings used to expand and clarify notes. Thematic content analysis was used to analyze the data and identify recurrent themes from the focus group discussions and
interviews of the reasons for late presentation for malaria treatment. Results: All caregivers were women, a significant majority of whom were peasants who had not gone beyond the primary education. Caregivers were aware of the general symptoms of malaria but associated more serious or dangerous symptoms with other causes including
witchcraft. Pregnant women, on the other hand, seemed to have sound knowledge of both the general and dangerous symptoms of malaria and were likely to attend the health
units timeously for reatment. Religious beliefs and practices, particularly belief in the healing ability of prayers prevented early reporting of malaria cases to health units leading
to late presentation. Alternative treatment of malaria from traditional herbalists was also sought by the communities particularly when the intensity of malaria was at its peak during the rainy season. Poverty in the community seemed to play a big role in shaping community preference for treatment sources, as well as early presentation to the health
units. It was found that the anticipated cost of laboratory tests and sundries at the health units deterred caregivers from taking children under five to health units. There was therefore a strong reliance (and preference for) community medicine distributor&rsquo
s (CMDs) because of free services and easy access. Lack of support from spouses (in particular husbands) coupled with the rude behavior of health workers towards caregivers and pregnant women discouraged visits to health units. The long waiting time and intermittent drug stock-outs also created a negative perception of service at the health units. Conclusions and recommendations: There is need for further sensitization of communities on the need to seek prompt treatment for children under five years of age at the health units (that is, within 24 hours of the onset of fever). Training and supervision of CMDs should be strengthened to ensure consistent supply of drugs, correct dosage of anti-malarial medication and improvements in the referrals to the health units. In order to improve
service delivery at the health units, there is need to review and strengthen human resource management of the health units, including staffing requirements and management
practices, such as support and supervision, patient care standards and client feedback mechanisms. It is also important that there are adequate stocks of anti-malarial drugs
and laboratory supplies at health units.

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Kalyango, Joan N., Elizeus Rutebemberwa, Charles Karamagi, Edison Mworozi, Sarah Ssali, Tobias Alfven, and Stefan Peterson. "High Adherence to Antimalarials and Antibiotics under Integrated Community Case Management of Illness in Children Less than Five Years in Eastern Uganda." Uppsala universitet, Internationell mödra- och barnhälsovård (IMCH), 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-197719.

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Background Development of resistance to first line antimalarials led to recommendation of artemisinin based combination therapies (ACTs). High adherence to ACTs provided by community health workers (CHWs) gave reassurance that community based interventions did not increase the risk of drug resistance. Integrated community case management of illnesses (ICCM) is now recommended through which children will access both antibiotics and antimalarials from CHWs. Increased number of medicines has been shown to lower adherence. Objective To compare adherence to antimalarials alone versus antimalarials combined with antibiotics under ICCM in children less than five years. Methods A cohort study was nested within a cluster randomized trial that had CHWs treating children less than five years with antimalarials and antibiotics (intervention areas) and CHWs treating children with antimalarials only (control areas). Children were consecutively sampled from the CHWs' registers in the control areas (667 children); and intervention areas (323 taking antimalarials only and 266 taking antimalarials plus antibiotics). The sampled children were visited at home on day one and four of treatment seeking. Adherence was assessed using self reports and pill counts. Results Adherence in the intervention arm to antimalarials alone and antimalarials plus antibiotics arm was similar (mean 99% in both groups) but higher than adherence in the control arm (antimalarials only) (mean 96%). Forgetfulness (38%) was the most cited reason for non-adherence. At adjusted analysis: absence of fever (OR = 3.3, 95%CI = 1.6–6.9), seeking care after two or more days (OR = 2.2, 95%CI = 1.3–3.7), not understanding instructions given (OR = 24.5, 95%CI = 2.7–224.5), vomiting (OR = 2.6, 95%CI = 1.2–5.5), and caregivers' perception that the child's illness was not severe (OR = 2.0, 95%CI = 1.1–3.8) were associated with non-adherence. Conclusions Addition of antibiotics to antimalarials did not lower adherence. However, caregivers should be adequately counseled to understand the dosing regimens; continue with medicines even when the child seems to improve; and re-administer doses that have been vomited.

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O'Brien, Kathryn. "The prevalence of urinary tract infection (UTI) in children under five years old presenting with an acute illness in UK general practice." Thesis, Cardiff University, 2013. http://orca.cf.ac.uk/47309/.

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Urinary tract infections (UTI) in young children have been associated with serious long-term complications such as renal scarring, hypertension and renal failure. The presenting symptoms of UTI in children are non-specific. If UTI is not suspected, a urine sample is not obtained, and without this, UTI cannot be diagnosed. There is evidence that the diagnosis is often missed. Most published studies have not systematically sampled urine, and those that have are largely based in US emergency departments and only include highly selected groups of children. The true prevalence of UTI in acutely ill children presenting in UK general practice is therefore unknown. My thesis consists of a literature review discussing the association of childhood UTI with long-term complications, the challenges of diagnosis and the evidence that UTIs are being missed; a systematic review of papers reporting UTI prevalence in children which highlights the need for a study in UK general practice; a pilot study to determine the feasibility of recruiting children and obtaining urine samples in UK general practice; and a prospective cohort study to determine the point prevalence of UTI in 597 presenting children, determine the predictive value of presenting symptoms, signs and risk factors, and describe the clinical outcomes for children with UTI. I found that the prevalence of UTI was 5.9% (95% confidence interval: 4.3-8.0%). This may be sufficiently high to justify increased urine sampling in general practice. A multi-variable logistic regression model identified younger age range, pain on passing urine (dysuria) and urinary frequency as being associated with UTI. I propose a urine sampling strategy for GPs assessing acutely ill children and compare this to suspicion-led sampling and current guidelines. In my discussion I discuss the limitations, generalisability and implications of these findings.

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Nurhaeni, Nani. "Assessment of the feasibility of modifying risk factors for acute respiratory infection in children under five years of age in West Java, Indonesia /." St. John's, NF : [s.n.], 2001.

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Langi, Grace Kerly Lony Nate Hongkrailert. "Knowledge and perception of mothers about nutritional status of children under five years of age in Bahu Health Center, Manado city, North Sulawesi province, Indonesia /." Abstract, 2008. http://mulinet3.li.mahidol.ac.th/thesis/2551/cd415/5037990.pdf.

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Rossouw, Esmari. "The molecular epidemiology and diversity of gastroenteritis viruses in HIV-infected, -exposed and -unexposed children under the age of five years in Pretoria, South Africa." Diss., University of Pretoria, 2020. http://hdl.handle.net/2263/75468.

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Viruses are common causes of both endemic and epidemic gastroenteritis, infecting millions of people per year, with norovirus, rotavirus and adenovirus-F as the main causative agents, and sapovirus and astrovirus as contributing viruses. These viruses are highly infectious and most severe in the very young, old, or individuals who are immunocompromised. The viral infection usually causes self-limited gastroenteritis, although chronic infection has been observed in highly immunocompromised patients. African and South-East Asian regions are disproportionally affected by diarrhoeal disease. These regions (especially South Africa) are also more severely affected by human immunodeficiency virus (HIV) infections. It has been suggested that immunocompromised individuals may form part of a reservoir for novel virus variants and recombinants. It should be taken into account that not every person is equally susceptible to infection after pathogen exposure and that not all infected persons develop clinical symptoms (Ramani and Giri, 2019). One host genetic factor that can influence susceptibility to enteric infection is the expression of histo-blood group antigens (HBGAs). Histo-blood group antigens are a major group of complex carbohydrates and are determinants of both human and animal ABO blood groups and the Lewis blood group systems, which are distributed in abundance on the mucosal epithelia of the gastrointestinal tract. Histo-blood group antigens have been proven to influence susceptibility to rotavirus and norovirus infections. Saliva, blood and stool specimens (n=205) have previously been collected from children (≤ 5 years of age) hospitalised with gastroenteritis at Kalafong Provincial Tertiary Hospital from June 2016 to December 2017. Follow up stool specimens were then collected six weeks after enrolment when possible. A descriptive questionnaire was completed by each child’s guardian, giving information on age, residential area, HIV status etc. of the participating child. The stool specimens were screened for six gastroenteritis causing viruses (norovirus GI and –GII, rotavirus, sapovirus, astrovirus and adenovirus) by multiplex PCR. Forty-seven percent (96/205) of specimens tested positive for at least one gastroenteritis causing virus. Rotavirus predominated (46/205), followed by norovirus (32/205), adenovirus (15/205), sapovirus (9/205) and astrovirus (3/205). A total of 27/32 norovirus (GI.3, GII.2, GII.3, GII.4, GII.7, GII.12 and GII.21), 44/46 rotavirus (G1P[8], G2P[4], G2P[6], G3P[4], G3P[8], G8P[4], G8P[6], G9P[6] and G9P[8]) and 8/9 sapovirus (GI.1, GI.2, GII.1, GII.4 and GII.8) strains have been genotyped, of which norovirus GII.4 and rotavirus G3P[4] predominated. A total of 46/205 children submitted a follow up stool specimen to be tested. Of the 46 children, 9 tested positive for norovirus infection with initial stool specimen testing. Follow up screening resulted in 13/46 (28%) specimens testing positive for either norovirus GI or GII, with all patients presenting as asymptomatic. After genotyping it was observed that only one of the follow up specimens were identical to the original sequence genotyped, indicating prolonged shedding. FUT2 genotyping of 205/205 children showed a 71%:29% ratio between secretors and non-secretors. Eighty percent (77/96) of the virus-infected children were secretors whereas only 20% (19/96) were non-secretors. Rotavirus (p<0.01) and norovirus GII.4 (p<0.05) specifically were found to be more prevalent in secretors. In this study, no statistical significance was observed in terms of severity of and susceptibility to gastroenteritis viruses between HIV-infected, HIV-exposed uninfected or HIV-uninfected individuals. Histo-blood group phenotyping has resulted in various combinations, with Le(b) being the most prevalent antigen found. Next generation sequencing was unsuccessful. In future, fresh specimens should be considered for testing, with more funding and time for optimisation of this process and to give adequate results. In summary, gastroenteritis is still a leading cause of childhood morbidity and mortality, with all advancements in understanding the disease helping to decrease the impact of it. This study again reinforced the importance of these viruses, as they are circulating in such high abundance. It also reinforced the concept that susceptibility to noro- and rotavirus infection is affected by the secretor status of a person. This could in future help with better understanding the viral infection mechanisms and in turn help with vaccine development and treatment
Dissertation (MSc (Medical Virology))--University of Pretoria, 2020.
Reese Mushrooms
Discovery grant
PRF
Medical Virology
Msc
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Lan, Nguyen Thi Ngoc Phitaya Charupoonphol. "Self-care of mothers with children under five years of age on acute respiratory infection in Thanhdong commune of binhminh district, vinh long province, Vietnam /." Abstract, 1999. http://mulinet3.li.mahidol.ac.th/thesis/2542/42E-NguyenThiNgocLan.pdf.

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Vilella, Nebot Maria Eugènia. "The effect of a nutrition-specific intervention on nutritional status in moderate acute malnourished children under five years of age in a rural area of Mozambique." Doctoral thesis, Universitat Rovira i Virgili, 2017. http://hdl.handle.net/10803/442982.

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Segons l’ Organització Mundial de la Salut (OMS) al 2015 aproximadament 156 milions de nens patien malnutrició crònica, 49.8 milions malnutrició aguda i 95.5 milions malnutrició global. A Moçambic (2011) es va veure que el 43.1% dels nens patien malnutrició crònica, 6.1% malnutrició aguda i 15.6% malnutrició global. Segons les Nacions Unides Internacionals a l’ajuda als nens amb emergència (UNICEF), al 2015, un total de 50 milions de nens estaven vivint amb desnutrició aguda, d’aquests 34 tenien desnutrició aguda moderada (DAM). Existeixen diferents programes per adreçar DAM però no hi ha consens sobre quines són les millor estratègies per prevenir i tractar els nens amb DAM. El nostre objectiu va ser avaluar l’efecte d’una intervenció amb suplements locals juntament amb un programa d’educació intensiu a les mares sobre l’estat nutricional dels nens amb malnutrició aguda moderada a una zona rural de Moçambic. De l’Abril del 2009 al Juliol del 2010 es va dur a terme un estudi transversal. Un qüestionari estructurat es va administrar al cap de la família. Al Març 2010, el Centre de Recolzament Nutricional d’Ibo (CANI) es va crear amb una intervenció específica de nutrició per millorar l’estat nutricional dels nens amb DAM. Al Juliol del 2011 es a fer l’avaluació de la intervenció a Ibo. Van ser identificades i entrevistades 3313 persones a Ibo. Les prevalences de malnutrició aguda, malnutrició crònica i malnutrició global eren 13.4%, 49.8% i un 22.7% respectivament. La intervenció va tenir una eficiència d’un 60.2%. La mitjana del guany de pes (Desviació Standard, SD) va ser 2.3 (1.7) g/kg/dia i 0.69 (0.50) mm/dia pel perímetre braquial. Tots els tipus de desnutrició vam disminuir al 2011 comparant amb el 2009, especialment per malnutrició crònica. La duració de la lactància, la lactància exclusiva I el biberó va augmentar significativament del 2009 al 2011. La freqüència dels nens consumint ≥3 menjades/dia va incrementar significativament al 2011. A més a mes, un augment significatiu es va notar amb els horts familiars i la diversificació en la dieta. Una intervenció concreta de nutrició amb un programa d’educació nutricional intensiu amb suplements locals és una intervenció viable per els nens amb MAM en una zona rural de Moçambic.
Según la Organización Mundial de la Salud (OMS) en el 2015 aproximadamente 156 millones de niños padecían malnutrición crónica, 49.8 millones malnutrición aguda y 95.5 millones malnutrición global. En Mozambique (2011) el 43.1% de los niños padecían malnutrición crónica, 6.1% malnutrición aguda y el 15.6% malnutrición global. Según las Naciones Unidas Internacionales para la ayuda de los niños en emergencia (UNICEF), en el 2015 un total de 50 millones de niños estaban viviendo con desnutrición aguda, de estos 34 tenían desnutrición aguda moderada (DAM). Existen diferentes programas para enderezar la DAM pero no hay consenso sobre cuáles son las mejores estrategias para prevenir y tratar los niños con DAM. Nuestro objetivo fue evaluar el efecto de una intervención con suplementos locales juntamente con un programa de educación intensivo a las madres sobre el estado nutricional de los niños con malnutrición aguda moderada en una zona rural de Mozambique. De Abril del 2009 a Julio del 2010 se llevó a cabo un estudio transversal. Un cuestionario estructurado se administró al responsable de familia. En Marzo del 2010, el Centro de Apoyo Nutricional de Ibo (CANI) se creó con una intervención nutricional específica para mejorar el estado nutricional de los niños con DAM. En Julio del 2011 se hizo la evaluación de la intervención en Ibo. Se identificaron y entrevistaron 3313 personas en Ibo. Las prevalencias de malnutrición aguda, malnutrición crónica y malnutrición global fueron 13.4%, 49.8% y un 22.7% respectivamente. La intervención tuvo una eficiencia de un 60.2%. La media de ganancia de peso (Desviación Standard, SD) fue un 2.3 (1.7) g/kg/día y un 0.69 (0.50) mm/día del perímetro braquial. Todos los tipos de desnutrición disminuyeron en el 2011 comparando con el 2009, especialmente por malnutrición crónica. La duración de la lactancia, la lactancia exclusiva y el biberón aumentó significativamente del 2009 al 2011. La frecuencia de los niños consumiendo ≥3 comidas/día incrementó significativamente en el 2011. Además, se notó un aumento significativo en los huertos familiares y la diversificación en la dieta. Una intervención específica de nutrición con un programa de educación nutricional intensivo con suplementos locales es una intervención viable para los niños con DAM en una zona rural de Mozambique.
Child malnutrition is still a public health challenge. Malnutrition contributes to more than one-third of all deaths of children under five, especially in Africa. According to World Health Organization in 2015 approximately 156 million children were stunted, 49.8 million were wasted and 95.5 million were underweight. In Mozambique (2011), was counted that 43.1% of the children was stunted, 6.1% wasted and 15.6% underweight. According to United Nations International Children’s Emergency Fund (UNICEF), in 2015, a total of 50 million children were living with acute malnutrition, from those 34 had moderate acute malnutrition (MAM). It exists many programmes to address MAM but there is no consensus in which are the best strategies to prevent and treat the MAM children. The aim was to evaluate the effect of a local-based supplementary intervention combined with a maternal intensive educational programme on the nutritional status in moderate acute malnourished children in a rural area of Mozambique. From April 2009 to July 2010 a cross-sectional study was conducted. A structured questionnaire was administrated to the head of the family. In March 2010, the Centro de Apoio Nutritional do Ibo (CANI) was created with a nutrition-specific intervention to improve nutritional status in MAM children. In July 2011, the evaluation of the nutrition-specific intervention was done in Ibo. 3313 people on Ibo were identified and interviewed. The prevalences of wasting, stunting and underweight were 13.4%, 49.8% and 22.7% respectively. The intervention was 60.2% effective. The mean (SD) gain was 2.3 (1.7) g/kg/day for weight and 0.69 (0.50) mm/day for mid-upper arm circumference (MUAC). The overall types of malnutrition decrease in 2011 comparing to 2009, especially for stunting. The duration of breastfeeding, exclusive breastfeeding and bottle-feeding increased significantly from 2009 to 2011. The frequency of children having ≥3 meals/day increased significantly in 2011. Furthermore, a significant increase was noticed in owning a home gardening and diet diversification. A specific-nutrition intervention with an intensive nutritional educational programme with a local supplement is a feasible intervention for MAM children in a rural area of Mozambique.

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Musgrave, Jacqueline Mary. "How do practitioners create inclusive environments in day care settings for children under the age of five years with chronic health conditions? : an exploratory case study." Thesis, University of Sheffield, 2014. http://etheses.whiterose.ac.uk/6174/.

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The concept of inclusion within the English education system is often taken for granted. There are a number of factors that can impact on inclusive practice and this demands careful exploration. Chronic health conditions (CHCs), such as anaphylaxis, asthma, diabetes, epilepsy and eczema, pose particular challenges to inclusion for practitioners who teach, educate and care for children under the age of five years in day care settings. These conditions can have a significant effect on children’s health, especially in the minority world. However, there is a paucity of research about how the symptoms affect children’s early education. This mixed-methods study collected quantitative data by sending a postal survey to 60 settings in order to find out how many children are affected by these conditions in day care settings. Four of the surveyed settings went on to participate in the qualitative aspect of the study. Qualitative data were also collected from parents of children with CHCs and the study included observations of a child in his early childhood setting over the course of a year. The findings revealed that 11% of children attending the settings in this study had been diagnosed with one or more CHCs and that CHCs had a profound effect on children and their parents. Parents reported that knowledge of the specific conditions is important for practitioners to have in order to create inclusive relationships with them. Practitioners in this study demonstrated a collaborative approach to leadership when creating inclusive environments. However, the findings revealed tensions for practitioners regarding the inclusion of all children in the curriculum. The findings suggest that achieving inclusion may therefore be problematic for some children. However, the communication skills, knowledge of CHCs and willingness of practitioners were vital to the inclusion of children with CHCs in their early education.

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Karkuki, Osguei Nushin. "The relationship between socio-economic variation and nutritional status of under five year old Nepalese children and their mothers." Thesis, University of Cambridge, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.648724.

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Gathitu, Eunice. "DETERMINANTS OF UTILISATION OF INSECTICIDE TREATED NETS FOR MALARIA PREVENTION AMONG CHILDREN UNDER FIVE YEARS OF AGE IN KENYA: A SECONDARY ANALYSIS OF KENYA DEMOGRAPHIC HEALTH SURVEY DATA, 2014." Thesis, Uppsala universitet, Institutionen för kvinnors och barns hälsa, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-302880.

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ABSTRACT Background The use of Insecticide Treated Nets (ITNs) is one of the main strategies of Roll Back Malaria programme aimed to reduce malaria burden in Sub Saharan Africa. Aim The study aimed to assess the determinants of ITN utilisation among under five children in Kenya. Method This was a secondary analysis of Kenya Demographic Health Survey (2014) data, which was a cross sectional descriptive survey. Data was analysed from three regions in Kenya which were Nyanza, Western and Coast. The study population was under five children who were residents in the surveyed households. Multivariable analyses was used to establish the determinants of ITN utilisation among under five children in Kenya. Results The prevalence of ITN utilisation among under five children was 63% which was below RBM targets of 80% for ITN coverage and utilisation. The factors that were significantly associated with ITN utilisation included: child’s age, respondent’s age, education level, religion, access to radio, wealth index, house hold size and number of under five children in the house hold. These factors were significant at 95% confidence interval. Conclusion The low prevalence of ITN utilisation identified in this study should be addressed through redistribution of ITNs to households with no nets and with untreated nets. This should be accompanied by behaviour change and communication messages to ensure effective utilisation of ITNs. Social inequalities and poverty should be addressed since they are related to the determinants of ITN utilisation.

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Vu, Thi Lan. "Determinants of utilization of insecticide-treated nets for malaria prevention among children under five years of age in Ghana: A secondary analysis of the National Malaria Indicator Survey Data 2016." Thesis, Uppsala universitet, Institutionen för kvinnors och barns hälsa, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-397980.

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Background: Insecticide-treated nets (ITNs) are one of the most effective prevention measures against malaria. Malaria is highly endemic in Ghana. The country implemented mass distribution campaigns of ITNs to cover 80% to 95% of the population but the rate of ITNs use among children under 5 years was 52%, which was lower than the universal coverage target of 100%. Objective: The objective of this study was to identify the socio-demographic factors associated with ITNs utilization among children under 5 years in Ghana. Methods: This was a secondary analysis from cross-sectional data of 3,029 children under five years obtained from Ghana Malaria Indicator Survey 2016. Logistic regression analysis was done to identify the determinants of ITNs utilization among children under 5 years in Ghana. Results: Size of the household, number of children ≤5 years old in the household, household wealth index, education level of mother, knowledge of mother on the protection of mosquito nets, place of residence, and region of residence were found to be significantly associated with ITNs utilization in children under 5 years. Conclusion: More interventions are needed to promote the use of ITNs to protect children against malaria. Interventions should focus on households with more than 7 members, households with more than 3 childrens ≤5 years, and on promoting girl’s education.

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Coetzer, Dorothea. "Visual perception and motor function of children with birth-weights under 1250grams and their full term normal birth weight peers at five to six years of age : a Cape Town study." Master's thesis, University of Cape Town, 1996. http://hdl.handle.net/11427/27001.

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This study aimed to assess and compare the visual perceptual, visual motor integration and motor abilities of infants weighing less than 1250 grams at birth and a matched group of normal full birth weight controls at the age of five to six years. The group of infants with birth weights below 1250 grams were born during the period July 1988 to June 1989 at Groote Schuur Hospital (GSH), Cape Town or in midwife obstetric units in the Peninsula Maternal and Neonatal Service (PMNS) and referred to the neonatal intensive care unit at GSH. The very low birth weight (VLBW) infants were assessed at 1 and 2 years of age in 1989 & 1990. The present study was part of a broader study that included the examination of developmental outcome of these infants, using the Griffith's Mental Development Scale (Griffith's). The study recognised the complex interaction of biological and environmental factors and their influence on development and attempted to describe the confounds that may have influenced outcomes. The VLBW children were shorter in stature than their full birth weight counterparts. They were also significantly lighter and had smaller head circumferences. Psychometric evaluation with the Griffith's showed the VLBW children to fall predominantly in the normal range, though their performances were significantly inferior to that of the full-term children. The greatest differences between the groups were in scores for the subscales performance and practical reasoning of the Griffith's. Visual perception, visual motor integration, fine motor skill and gross motor function were all significantly poorer in the VLBW children. There was no correlation within the VLBW group between the test results and birth weight, gestational age, growth status, neonatal hospital stay or social status.

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Madondo, Andrew. "Socio-demographic characteristics of caregivers and the clinical profile of undernourished under five year old children admitted in Nyangabgwe Referral Hospital, Botswana." Thesis, University of Limpopo (Medunsa Campus), 2012. http://hdl.handle.net/10386/668.

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Thesis (MPH) -- University of Limpopo, 2012.
Background: Despite Botswana being a middle income country undernutrition among children younger than five years of age continues to affect different parts of the country. Undernutrition can be attributed to a number of reasons which vary from region to region. There is little information on the socio-demographic characteristics of caregivers and the clinical profile of undernourished children in Francistown and surrounding villages. Purpose: To determine the socio-demographic characteristics of caregivers and the clinical profile of undernourished children admitted at Nyangabgwe Referral Hospital, Francistown, Botswana. Method: Data were collected from 113 caregiver-child pairs using a researcher administered questionnaire targeting caregivers and the child's hospital card and the child's anthropometric measurements were taken. Data were analysed using the WHO Anthro 2006 software and Stata 10. Descriptive statistics were derived and Chi -square tests were done at 5% level of significance to determine any associations. Results: The majority of the caregivers were single mothers (80%) younger than 30 years of age. Oedematous malnutrition was found in 50% of the children and was more common in males at 55%. The reasons given by caregivers as to why their children had been admitted did not relate to the child's nutritional state. The child's gender was associated with stunting (X2 = 4.0638, P = 0.044) at 5% level of significance. Looking at any associations between caregiver characteristics and the child's clinical profile only marital status was associated with child presenting with cough (X2 = 4.0947, P = 0.045) at 5% level of significance. There was no association between the caregiver characteristics and the severity of any of the three types of undernutrition (wasting, stunting and underweight). Conclusion: This study showed that the majority of caregivers were younger than 30 years of age and single. The child's gender was associated with stunting which may need more research on. Almost 50% of the children had oedematous malnutrition. Public health interventions should focus on providing caregivers with health education on the early signs of undernutrition so as to facilitate timely interventions and prevent severe cases of undernutrition.

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Andreasson, Maria, and Nina Berglund. "How nurses at a state health clinic in Namibia work to reduce diarrheal diseases among children under five years of age. : - How do they work preventive and what obstacles are they facing? -." Thesis, Högskolan Väst, Avd för vårdvetenskap på grundnivå, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-5225.

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Background: Diarrheal diseases are one of the leading causes in the world that leads to mortality for children under the age of five. A very common factor for an undeveloped country’s lower class is that the access to clean water, sanitation, education and the right nutrition for children are lacking. Part of the nurse profession is to prevent and to make sure that the message is being received by the client in order to reduce sickness. Aim: The aim of this study is to find out how nurses at a state health clinic work preventive to reduce diarrheal diseases among children under five years of age and what obstacles nurses are facing in their daily work when giving preventive advice. Method: The method used is qualitative research. In depth interviews were conducted with six nurses that lasted 30-45 min. Result: To prevent diarrheal diseases the nurses at the state clinic are using a national guideline and they give health education. The obstacles they face in their daily work are communication difficulties due to many different ethnical groups and different languages in the country, poverty and sanitation. Many mothers are working or are infected by HIV and do not want to breastfeed. Conclusions: More research should focus on how to give health education to people in society and the connection between nursing education and practice. Preventive work is a relatively cheap way to reduce suffering and make a whole population healthier. Keywords: Communication, Hygiene, Namibia, Nursing, Preventive work Acknowledgements: We would like to express our sincere gratitude to Sida that gave us a scholarship so we were able to make a minor field study in Namibia.

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Caicedo, Ceron Margarita. "The Availability and the Use of Basic Services in Relation to the Nutritional Status, Acute Diarrhetic Diseases and Acute Respiratory Infections in Children Under five Years of Age in Three Rural Communities of the Imbabura Province during the 1998-1999 Period." BYU ScholarsArchive, 2000. https://scholarsarchive.byu.edu/etd/5339.

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To a large degree, the political and economic conditions of third world countries influence poverty levels, especially in rural areas. This poverty affects the availability of basic services, such as potable water, refuse elimination, housing, and sewage systems. As a consequence of these deficiencies, more diseases are transmitted through the water and environment. These diseases include acute diarrhea and acute respiratory infections in children younger than five years of age. Consequently, it is important to have available water and sewage elimination to control these diseases among children and the general population.

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Chikhungu, Lana. "Modelling under-nutrition in under-five children in Malawi." Thesis, University of Southampton, 2013. https://eprints.soton.ac.uk/354348/.

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Despite numerous Government efforts to tackle the problem of child under-nutrition in Malawi, the levels of child under-nutrition remain high with stunting estimated at 47% and underweight at 12.7% . This thesis investigates whether the levels and patterns of stunting and underweight in Malawi have changed between the years 2000 and 2010 and if so how. It studies how feeding patterns and child immunisation affects child’s nutritional status in Malawi and analyses the different pathways through which household and community level socio-economic factors affect a child’s nutritional status in Malawi. The Malawi Demographic and Health Survey (MDHS) data sets of 2000, 2004 and 2010 are used in the study of levels and patterns of child under-nutrition in Malawi whilst the 2004 MDHS is used to investigate how feeding patterns and child immunisation affect a child’s nutritionals status in Malawi. The 2004 Malawi Integrated Household Survey data is merged with the 2004 Community level to analyse the pathways through which household and community level socio-economic factors affect child nutritional status in Malawi. Results of this study show that children from communities that have a daily market are less likely to be stunted compared to children from communities without a daily market. Children from communities that trace their descendants through their father have a lower likelihood of stunting compared to children from communities that trace their descendants through the mother due to being of relatively higher economic status. The levels of stunting and underweight have gone down significantly from 54.1% and 21.4% respectively in the year 2000 to 47.1% and 12.7% respectively in 2010. However, the percentage of children that are stunted but not affected with other under-nutrition problems has hardly changed, estimated at 37.2% in 2000 and 36.2% in 2010. Although generally female children are less likely to be stunted and less likely to be underweight, female children are more likely to be underweight as they get older. Contrary to what one would expect, children are more likely to be stunted during harvest time compared to the hunger season. Most of the children are fed food from the local grain, whilst in fact children aged between 7 to 36 months who consume food from animal sources are less likely to be undernourished. Children whose mothers are in possession of a child health card1 are less likely to be underweight. The Malawi Government should therefore intensify its efforts of encouraging mothers to attend under-five clinics, feed children that are undergoing weaning food from animal sources and should invest more in programmes that boost socio-economic status such as education and entrepreneurship skills.

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Ahmed, Fayyaz Shaikh Teera Ramasoota. "Factors affecting nutritional status of five years old children in Islamabad, Pakistan /." Abstract, 2007. http://mulinet3.li.mahidol.ac.th/thesis/2550/cd399/4937997.pdf.

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Mikhala, Paul L. "Understanding the determinants of under five mortality in Kenya." Thesis, University of Southampton, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.327252.

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La, Charité Darlene. "Kiparsky's level-ordered lexical hypothesis and morphological development in children five to thirteen years." Thesis, University of Ottawa (Canada), 1987. http://hdl.handle.net/10393/5294.

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Clements, Andrea D. "Use of the CPRS-48 With Children Under 3 Years of Age." Digital Commons @ East Tennessee State University, 2000. https://dc.etsu.edu/etsu-works/7311.

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Sineke, Tembeka. "Measuring PMTCT effectivenss through HIV free survival in children under 2 years." Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/19907.

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Background: The prevalence of HIV was greater than 30% in the Free State province in South Africa and PMTCT services were widely available at the time the guidelines recommended nevirapine in labour and to the child postpartum. Aim: The aim was to determine the effectiveness of the PMTCT program in the Free State by measuring HIV transmission and HIV-free survival in children less than two years of age. Variables associated with HIV transmission and HIV-free survival including PMTCT uptake by mother, demographic characteristics, type of delivery and breastfeeding status were investigated. Methods: This was a secondary analysis of data collected from a cross sectional community household survey, using multistage cluster sampling. The population was all women who had given birth to a child in the two years prior to the study in the catchment area of three sub-districts that were randomly selected in Free State. All mothers were anonymously tested for HIV and if infected the child was also tested. Trained field workers interviewed mothers, identified children who had died and collected data on variables that could be related to transmission and survival. Logistic regression was used to determine risk factors.

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Waichungo, Charity Muringo. "A storytelling curriculum for character development for children ages three years to five years for the Goldia and Robert Naylor Children's Center." Theological Research Exchange Network (TREN), 2003. http://www.tren.com.

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43

Liias, Nejla. "The possession versus use of mosquito nets for children under five in Kenya." CONNECT TO ELECTRONIC THESIS, 2007. http://dspace.wrlc.org/handle/1961/4139.

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Ricci, Alison. "Unintentional ingestions of prescription and over the counter medications in children five years of age and younger." The University of Arizona, 2011. http://hdl.handle.net/10150/623571.

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Class of 2011 Abstract
OBJECTIVES: Accidental ingestions of medications in children under five years old are an increasing problem faced by parents and caregivers. This study will determine which medications are most commonly ingested and which cause more harmful side effects. METHODS: A descriptive, retrospective study was performed by obtaining data from electronic patient charts from the Arizona Poison and Drug Information Center (APDIC). Subjects were selected if they were younger than five years old and had ingested a medication during 2009. Age and gender were analyzed by calculating percentages and means and comparing them using an independent t-test. Adverse effects of medications were compared using a Chi Square test. RESULTS: A total of 4,373 cases met inclusion criteria for analysis, including 2,019 females and 2,354 males. The average age of patients was 2.2 years. Of 3,275 cases (74.4%) involving OTC medications, 119 patients (3.6%) developed minor effects and 20 patients (0.6%) developed moderate effects. Of 1,129 children (25.6%) ingesting prescription medications, 78 patients (6.9%) developed minor effects, 35 patients (3.1%) developed moderate effects and 1 patient (0.1%) developed a major effect (p=0.003). CONCLUSION: Males were more likely to have unintentional ingestions than females. The incidence of OTC ingestions was higher than prescription ingestions. Toddlers tended to have more ingestions than infants or older children. Unintentional prescription medication ingestions resulted in significantly more adverse effects than unintentional OTC ingestions.

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Hekkala, A. (Anne). "Ketoacidosis at diagnosis of type 1 diabetes in children under 15 years of age." Doctoral thesis, Oulun yliopisto, 2016. http://urn.fi/urn:isbn:9789526212579.

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Abstract The aim of this work was to evaluate the frequency of diabetic ketoacidosis (DKA) in children <15 years of age at the time of diagnosis of type 1 diabetes (T1D) at Oulu University Hospital over a period of 33 years (1982−2014) and throughout Finland in 2002−2005. The aim was to assess the effect of certain host characteristics (age at diagnosis, family history of T1D, T1D-associated HLA risk genotypes and participation in T1D prediction and prevention trials) on the frequency on DKA. A further aim was to assess temporal changes in the frequency of DKA. The overall frequency of diabetic ketoacidosis at the diagnosis of T1D in children <15 years was low both at Oulu University Hospital and over the whole country. A decrease in the frequency of DKA was observed at the university hospital during the years 1982−2001, but it then seemed to stabilize at just under 20.0%. The frequency in the whole of Finland during the period 2002−2005 was similar, i.e. 19.4%. The frequency of DKA at diagnosis in very young children (<2 years of age) at Oulu University Hospital decreased markedly during the period in question, being 50.0% in 1982−1991, 39.1% in 1992−2001 and 17.1% in 2002−2014 (p=0.021), and a similar decrease was seen in children <5 years (32.1% in 1982−1991, 17.7% in 1992−2001 and 13.0% in 2002−2014, p=0.007). The children aged 10−14.9 years at diagnosis, however, had an increased risk of DKA over the whole period studied here, and more attention should definitely be paid to this group in the future to reduce its DKA frequency. In the analysis of the data based on all children in Finland diagnosed with T1D in 2002−2005 the risk of DKA at diagnosis was lower in those with a first-degree relative affected by T1D. The children carrying a higher HLA-conferred risk of T1D had DKA less frequently at the manifestation of the disease. Prospective studies based on screening for HLA-DQB1-associated genetic susceptibility to T1D from cord blood and subsequent regular clinical, immunological and metabolic follow-up have been going on in Oulu University Hospital since 1995, and the children taking part have been found to have a reduced frequency of DKA (5%) at diagnosis. Genetic screening without follow-up did not prevent DKA at disease presentation
Tiivistelmä Väitöstyön tarkoituksena oli tutkia diabeettisen ketoasidoosin (DKA) esiintymistä alle 15–vuotiailla lapsilla tyypin 1 diabeteksen toteamisvaiheessa Oulun yliopistollisessa sairaalassa vuosina 1982–2014 ja koko Suomessa vuosina 2002–2005. Tavoitteena oli selvittää tiettyjen lapsen erityispiirteiden (ikä diagnoosihetkellä, perheen diabeteshistoria, diabetekseen liittyvien HLA riskigenotyyppien esiintyminen ja osallistuminen prospektiivisiin tyypin 1 diabeteksen seurantatutkimuksiin) vaikutusta ketoasidoosin esiintymiseen. Lisäksi tärkeänä tavoitteena oli tutkia mahdollisia ajallisia muutoksia ketoasidoosin esiintymisessä. Kaikkiaan ketoasidoosin esiintyminen oli matala alle 15–vuotiailla lapsilla tyypin 1 diabeteksen diagnoosihetkellä Oulun yliopistollisessa sairaalassa tutkimusjakson aikana. Ketoasidoosin esiintymisessä nähtiin vähenemistä kahden ensimmäisen 10–vuotisjakson aikana (1982–1991 ja 1992–2001), minkä jälkeen sen esiintyminen vakiintui alle 20 %:n tasolle. Koko Suomessa ketoasidoosin kokonaisesiintyvyys vuosina 2002–2005 oli 19,4 % mikä vastasi Oulun yliopistollisessa sairaalassa havaittua esiintyvyyttä. Pienillä, alle 2–vuotiailla lapsilla ketoasidoosin esiintyminen diabeteksen toteamisvaiheessa väheni huomattavasti tutkimusjakson aikana Oulun yliopistollisessa sairaalassa ollen 50,0 % 1982–2001, 39,1 % 1992–2001 ja 17,1 % 2002–2014 (p=0,021). Samanlainen laskeva suunta havaittiin tuona ajanjaksona myös alle 5–vuotiailla lapsilla (32,1 % 1982–1991, 17,7 % 1992–2001 ja 13,0 % 2002–2014, p=0,007). Sen sijaan ketoasidoosiriski pysyi huomattavan korkeana yli 10–vuotiailla lapsilla koko tutkimusjakson ajan. Tulevaisuudessa on tärkeä kiinnittää erityishuomio tähän ikäluokkaan ketoasidoosin vähentämiseksi. Analysoitaessa kaikkia Suomessa 2002–2005 tyypin 1 diabetekseen sairastuneita lapsia, havaittiin lapsilla, joilla oli ensimmäisen asteen tyypin 1 diabetesta sairastava sukulainen (vanhemmat, sisarukset), ketoasidoosiriski matalammaksi. Lisäksi niillä lapsilla, joilla oli korkeaan sairastumisriskiin liittyvä HLA–genotyyppi, oli ketoasidoosin esiintyminen vähäisempää tyypin 1 diabeteksen diagnoosihetkellä. Prospektiivinen tyypin 1 diabeteksen kehittymistä selvittävä seurantatutkimus aloitettiin Oulussa 1995. Tutkimuksessa lapsen napaverinäytteestä analysoidaan perinnöllinen diabetesalttius ja riskiryhmiä seurataan säännöllisesti. Seurantatutkimukseen osallistuneiden lasten ketoasidoosiriski diabeteksen diagnoosihetkellä oli vähentynyt taudin toteamishetkellä (5,0 %). Pelkkä geneettiseen seulontatutkimukseen osallistuminen ei kuitenkaan suojannut lasta ketoasidoosilta

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McCartney, Damon Andrew. "Development of the AnimalSeek method to evaluate the localisation ability of children under five." Thesis, University of Nottingham, 2013. http://eprints.nottingham.ac.uk/13147/.

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This thesis describes the development of a novel game-like method, the AnimalSeek method, which can be used, along with motion tracking technology, to measure localisation ability of a child under five years of age. For the game-like task to be successful, a high number of responses (in particular correct head turn responses) was required. Previous studies, although not all looking at localisation ability, have used many different techniques to obtain the maximum number of responses from a child. The children were engaged inside a custom-built environment inside an anechoic chamber. Three large video screens onto which backgrounds and animated characters were projected and manipulated and used to engage the child in the game-like task. Behind the video screens were loudspeakers from which the auditory stimulus where presented. A correct response to the auditory stimulus i.e. a head, hand or eye movement towards the target speaker was rewarded with a animated character presented on the screens (incorrect responses were presented with a static character). The location of the reward in relation to the auditory stimulus was a point of interest and was investigated to see how it affected the number of responses. The method shows it was possible to engage the child with the visual environment and obtain responses, however, the results showed generally fewer head turn responses than expected, especially in the younger age groups. Motion tracking technology was used to measure the localisation ability of the children, as well as measuring the responses, the motion tracking data was used and programs developed which could automatically classify the responses the children made to the sounds. The thesis has shown that it is possible to devise a new method which can be used to engage the child in the task and extract and classify their responses to auditory stimuli in order to measure their localisation ability.

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Piniel, Abigail. "Factors contributing to severe acute malnutrition among the under five children in Francistown-Botswana." Thesis, University of the Western Cape, 2016. http://hdl.handle.net/11394/5253.

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Magister Artium (Child and Family Studies) - MA(CFS)
Introduction: Malnutrition is the immediate result of inadequate dietary intake, the presence of disease or the interaction between these two factors. It is a complicated problem, an outcome of several etiologies. SAM is one of the leading causes of morbidity and mortality among children under the age of five in developing countries. Although studies in Botswana show some improvement in child malnutrition since the 1980s, severe acute malnutrition still remains a cause for concern in many parts of the country. There is little information on undernourishment situation of children under the age of five years in the urban areas of the country. Aim: The purpose of this study was to determine the risk factors to severe acute malnutrition among children under the age of five years in Francistown, Botswana. The UNICEF conceptual framework was used as a guide in assessing and analysing the causes of the nutrition problem in children and assisted in the identification of appropriate solutions. Methods: The study was conducted on cases who had been admitted and referred at any time between March and July 2015. A quantitative research methodology was used to conduct the study. A case-control study design was utilised. Random selection of cases and controls was done on a ratio of 1:2 case per control. Cases included children under the age of five years admitted to Nyangabgwe Referral Hospital and those referred to the Nutritional Rehabilitation Centre within the hospital in Francistown-Botswana with a diagnosis of severe acute malnutrition. Controls were children of the same age, gender and attending the same Child welfare clinic as the case and with good nutritional status. Data was collected through face-to-face standardised interviews with care-givers. Results: Data collection was done using a combination of a review of records (child welfare clinic registers, and child welfare clinic cards) and structured questionnaires. 52 cases and 104 controls were selected with the primary or secondary care-giver as the respondent. (N=156). Data was collected using a self-developed structured questionnaire and the review of documents. Of all the cases 36.5% (n=19) were diagnosed with MAM, 46.2% (n=24) with SAM, 1.9% (n=1) with moderate PEM and 7.7% (n=4) each for PEM and Severe PEM. All the cases had presented with clinical signs and symptoms of severe acute malnutrition and/or the weight-for-height Z-score of ≤ -3 SD. Following placement of the data in regression models, the factors that were found to be significantly associated with child malnutrition were low birth weight (AOR = 0.437; 95% CI = 0.155-1.231) , exclusive breastfeeding (AOR = 2.741; 95% CI = 0.955-7.866), child illness (AOR = 0.383; 95% CI = 0.137-1.075), growth chart status (AOR =7.680; 95% CI = 1.631-36.157), level of care-giver’s education (AOR = 0.953; 95% CI = 0.277-3.280), breadwinner's work status (AOR = 1.579; 95% CI = 0.293-8.511), mother’s HIV status (AOR = 0.777; 95% CI = 0.279-2.165), alcohol consumption (AOR = 0.127; 95% CI = 0.044-0.369), household having more than one child under the age of five (AOR = 0.244; 95% CI = 0.087-0.682), household food availability (AOR = 0.823; 95% CI = 0.058-11.712), living in a brick type of house (AOR = 13.649; 95% CI = 3.736-49.858), owning a tap (AOR = 1.269; 95% CI = 0.277-5.809) and refuse removed by the relevant authority (AOR= 2.095; 95% CI = 0.353-12.445) were all statistically significantly associated with severe acute malnutrition (p < 0.05). Therefore, all these variables were included in the binary stepwise regression where living in a mud house type was the most significant factor and not being breastfed for at least three months was the least significant. Conclusion: The findings of this study suggested that immediate determinants to SAM were; child born with a low birth weight, appetite and child illness. Underlying contributing factors were; the child not exclusively breastfed for at least three months, growth chart not up to date, care-givers education level, employment status, alcohol consumption, household food availability, type of housing, owning a tap and number of children under the age of five year. Therefore, increasing household food security and strengthening educational interventions for women could contribute to a reduction in the prevalence of SAM in Francistown, Botswana.

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Jroundi, Imane. "Epidemiology and aetiology of severe respiratory infections among children under five, admitted to the children hospital of Rabat, Morocco." Doctoral thesis, Universitat de Barcelona, 2015. http://hdl.handle.net/10803/396205.

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Pneumonia is one of the major public health problems threats to child survival in large parts of the world. The burden of this disease in terms of morbidity and mortality remains unacceptably high with almost one million children dying every year as a result of pneumonia episode. Over 90% of these pneumonia-associated deaths in young children occur in developing countries and are mainly secondary to bacterial infections. The availability of effective vaccines against bacterial pneumonia, coupled with adequate and efficacious antibiotic treatments, should be sufficient to reduce this burden. In Morocco, a middle income country of North Africa, Pneumonia is the first cause of death of children under five of age. However, few data is available regarding its etiology and epidemiology. The first article of this thesis attempts to comprehensively review what was the available knowledge regarding pediatric pneumonia in Morocco, prior to the initiation of this project. Indeed, scarcity of data often hinders the implementation of measures to prevent and better manage these infections. This review confirms the alarming lack of recent data regarding pediatric pneumonia one of the major killers of children in Morocco. The second article of this thesis is a general overview on the epidemiology, etiology and the clinical presentation of acute respiratory infections in Moroccan children under the age of five years. Through our study, we were able to show a high prevalence of viral infections, with wheezing as the major clinical symptomatology. These findings are similar to what can be found in wealthy countries and markedly differ from the high bacterial burden that can be found in poorer settings, although overall case fatality rates remained unacceptably high in our setting. As a result of afore mentioned high case fatality rates in our series, we decided to investigate the specific risk factors upon admission for a bad prognosis during hospitalization. The results of this analysis are presented in the third article of this thesis. The article concluded that the early identification of factors associated with a poor prognosis could improve management strategies and the survival likelihood of Moroccan children with severe pneumonia. In the fourth article of this thesis, we chose to focus on two highly prevalent and potentially hazardous viruses causing acute respiratory infections in our setting, namely respiratory syncytial virus (RSV) and Human metapneumovirus (hMPV). In this analysis, we compared the epidemiological, clinical and laboratory features of these two infections, and concluded that despite the clinical presentation of those two pathogens was almost indistinguishable, hMPV tented to be highly more severe and significantly associated to a poor outcome. An early recognition of these viruses and good management of the cases is important to guarantee a better outcome. The fifth article of this thesis specifically addresses the use of antibiotics to treat acute respiratory infections in Morocco. By analyzing data on pre-admission antibiotics use, and intra-hospital antibiotics utilization, we discuss whether such valuable drugs are used rationally in the country. This analysis also reflects on whether antibiotic usage may have had or not an impact on antimicrobial resistance rates. The last article of this thesis examines data on the distribution of serotypes among streptococcus pneumoniae isolates from the nasopharynx of healthy children and compares it to those isolated among admitted children with clinical severe pneumonia. These data will be used as a baseline to help assessing the impact of the pneumococcal vaccine and to monitor any potential serotype replacement phenomena. Altogether, this thesis tries to offer a comprehensive snapshot of the situation of pediatric pneumonia in Morocco.
A pesar de los esfuerzos hechos para reducir la carga de mortalidad causada por las infecciones respiratorias agudas, estas enfermedades se mantienen como uno de los principales peligros para la salud infantil en amplias zonas del mundo. Las medidas de control existentes son claramente insuficientes a la hora de reducir globalmente el impacto de infecciones tan comunes en la infancia. De hecho, la carga de estas enfermedades en términos de morbilidad y mortalidad persiste inaceptablemente alta con, anualmente, cerca de un millón de muertes anuales, lo que es lo mismo, una muerte cada 34 segundos. Las infecciones respiratorias agudas, siendo la neumonía su forma más paradigmática, son responsables del 15% de las muertes de niños menores de 5 años en el mundo. Más del 90% de estas infecciones respiratorias agudas se producen en los países en vías de desarrollo, fundamentalmente asociadas a neumonías bacterianas. Mientras que la enfermedad clínica puede afectar a cualquier grupo de edad, la mortalidad por neumonía se ve esencialmente circunscrita a los niños menores de cinco años en los países pobres. La disponibilidad de vacunas efectivas contra las neumonías bacterianas, sumada al uso adecuado de los tratamientos antibióticos, debería ser suficiente para reducir esta carga. Sin embargo, la identificación y tratamiento precoz de los episodios clínicos y al acceso a los centros de salud parecen constituirse como barreras infranqueables en la mayoría de los países pobres. Adicionalmente, la malnutrición y el bajo nivel socio económico imperante en muchos de estos entornos dónde las neumonías son un mayor problema, contribuyen desfavorablemente al mal pronóstico de estas infecciones. El conocimiento de los determinantes locales específicos de la enfermedad respiratoria aguda pediátrica en esos entornos ayudaría a entender o mejor por qué todavía estamos muy lejos de controlar adecuadamente estas infecciones, y profundizar sobre las razones por las cuales siguen causando un impacto tan importante en la salud del niño.

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Onghena, Matthias. "Study of the possible migration risks of food contact materials for children under 3 years." Doctoral thesis, Universitat Jaume I, 2016. http://hdl.handle.net/10803/400866.

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El Bisfenol-A (BPA) se ha usado durante muchos años como monómero en polímeros de policarbonato (PC) (botellas de agua y comida para niños-biberones) y en resinas tipo epoxi (botes de comida preparada), a partir de los cuales puede liberarse este compuesto a la comida y al agua, lo que constituye la principal fuente de exposición a BPA de los seres humanos. Como consecuencia de sus propiedades como disruptor endocrino, se prohibió su uso en la producción de polímeros para materiales en contacto con comida para niños menores de 3 años (European Commission, Regulation No. 10/2011). Recientemente, el Superior Health Council of Belgium expresó su preocupación por los posibles riesgos asociados a las alternativas usadas para fabricación de PC (No. 8697, 11.03.2010). Los productos alternativos al PC para fabricación de materiales en contacto con alimentos (food contact materials (FCMs)) para niños, tales como polipropileno (PP), polietersulfona (PES), poliamida (PA), Tritan™ o silicona, han aparecido en el mercado en los últimos años. La migración de BPA a partir de PC ha sido ampliamente estudiada. Sin embargo, la naturaleza y las cantidades de sustancias liberadas de los materiales poliméricos usados como alternativa al PC son mucho menos conocidas. Por ello, el principal objetivo de esta Tesis ha sido la identificación y cuantificación de los compuestos mayoritarios y de mayor toxicidad que pueden migrar desde los biberones en el marco de un proyecto del gobierno belga (ALTPOLYCARB) en el que han participado varias Universidades de Bélgica.
Bisphenol-A (BPA) has been used for many years as a monomer for polycarbonate (PC) polymers (water and infant feeding bottles) and epoxy resins (canned food packaging) from which it can be released into the food, the major exposure source of BPA to humans. Since BPA has endocrine disrupting properties, its use was prohibited for the production of polymers for food contact materials for children younger than 3 years old (European Commission, regulation No. 10/2011). Furthermore, in a recent opinion, the Superior Health Council of Belgium expressed its concern regarding the possible risks associated with the used alternatives to PC (No. 8697, 11.03.2010). Consequently, alternatives to PC food contact materials (FCMs) for infants, such as polypropylene (PP), polyethersulphone (PES), polyamide (PA), Tritan™ or silicone baby bottles, have appeared on the market. Migration of BPA from PC has already been extensively studied. Unfortunately, the nature and amounts of substances migrating from the polymeric alternatives other than PC is much less known. The principal aim of this PhD was the identification and quantification of the major and most toxic compounds migrating from baby bottles, in the frame of a Belgian governmental project (ALTPOLYCARB) involving several Belgian universities.

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Wohlford, Christine A. "Identifying Risk Factors Associated with Early Childhood Caries in Children Under Three Years of Age." The Ohio State University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=osu1274823503.

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Dissertations / Theses on the topic 'Children under five years'

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