Academic literature on the topic 'Malnutrition in children – Botswana – Kweneng District'

ObjectivesMillions of children die every year from serious childhood illnesses. Most deaths are avertable with access to quality care. Saving Children’s Lives (SCL) includes an abbreviated high-intensity training (SCL-aHIT) for providers who treat serious childhood illnesses. The objective of this study was to examine the impact of SCL-aHIT on knowledge acquisition and retention of providers.Setting76 participating centres who provide primary and secondary care in Kweneng District, Botswana.ParticipantsDoctors and nurses expected by the District Health Management Team to provide initial care to seriously ill children, completed SCL-aHIT between January 2014 and December 2016, submitted demographic data, course characteristics and at least one knowledge assessment.MethodsRetrospective, cohort study. Planned and actual primary outcome was adjusted acquisition (change in total knowledge score immediately after training) and retention (change in score at 1, 3 and 6 months), secondary outcomes were pneumonia and dehydration subscores. Descriptive statistics and linear mixed models with random intercept and slope were conducted. Relevant institutional review boards approved this study.Results211 providers had data for analysis. Cohort was 91% nurses, 61% clinic/health postbased and 45% pretrained in Integrated Management of Childhood Illness (IMCI). A strong effect of SCL-aHIT was seen with knowledge acquisition (+24.56±1.94, p<0.0001), and loss of retention was observed (−1.60±0.67/month, p=0.018). IMCI training demonstrated no significant effect on acquisition (+3.58±2.84, p=0.211 or retention (+0.20±0.91/month, p=0.824) of knowledge. On average, nurses scored lower than physicians (−19.39±3.30, p<0.0001). Lost to follow-up had a significant impact on knowledge retention (−3.03±0.88/month, p=0.0007).ConclusionsaHIT for care of the seriously ill child significantly increased provider knowledge and loss of knowledge occurred over time. IMCI training did not significantly impact overall knowledge acquisition nor retention, while professional status impacted overall score and lost to follow-up impacted retention.

The purpose of this study was to identify and determine the risk factors for malnutrition among children under the age of 5 years in Kweneng West District of Botswana. A case control study was conducted. The cases consisted of 37 underweight children under the age of 5 (n=37), and the controls consisted of 76 children less than 5 years of age (n=76) recruited concurrently among the under-five children attending Letlhakeng Child Welfare Clinic on a monthly basis. The controls were of good nutritional status. Data collection was done using a combination of a review of records (child welfare clinic registers, and child welfare clinic cards) and structured questionnaires. Following placement of the data in regression models, the factors that were found to be significantly associated with child malnutrition were small number of daily meals taken by the child (Adjusted OR=19.04, 95% CI 3.24-112.13), lack of knowledge of methods of prevention of child malnutrition by the parent (Adjusted OR=4.71, 95% CI 1.41-15.82), parent’s unemployment (Adjusted OR=50.3, 95% CI 4.86-52.1), low birth weight (Adjusted OR=12.34, 95% CI 2.76-55.02), inadequate Vitamin A supplementation (Adjusted OR=13.27, 95% CI 1.94-90.46), child illness (OR=20.95, 95% CI 7.55-58.10), and child raised by a guardian (Adjusted OR=5.67, 95% CI 1.30-24.73). The findings from this study suggest that Socio-economic factors such as unemployment, a lack of knowledge about recommended infant and child feeding practices, the child raised by a guardian, and health-related factors such as low birth weight, inadequate Vitamin A supplementation, and child illness are predictors of malnutrition in under five. Therefore, increasing household food security and reinforcing educational interventions could contribute to a reduction in the prevalence of child malnutrition in the district
Health Studies
M.A. (Public Health)

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg in partial fulfilment of the requirements for the degree of Master of Public Health in the field of Health Systems and Policy. Johannesburg / RSA, 2015
Purpose: Screening of young children exposed to tuberculosis (TB) in a household setting is widely recommended, but rarely implemented in some endemic countries. The aim of this study was to screen household under five children who have been exposed to smear-positive pulmonary tuberculosis (PTB) of adult cases; to explore and describe the initial follow-up of these children by the Kweneng district health care system; and to determine clinical outcomes (occurrence of TB disease and latent tuberculosis infection) among those children. Methods and procedures: In a nested case-control type study design, under 5 years child contacts of 200 randomly selected adult smear positive pulmonary TB patients, were enrolled and evaluated for TB infection and disease. Risk factors were compared between those with TB and those without TB. Data was collected during the study period (December 2005 through November 2006) through face-to-face interviews using a pre-designed data collection tool. Child contacts were then investigated at their respective nearest health facility using Tuberculin Skin Test (TST), clinical examination, and chest x-ray (CXR). Finally child contacts were diagnosed as follow: No TB, Latent Tuberculosis Infection (LTBI), or TB disease. We defined LTBI as having a TST ≥10 mm at 48–72 hours. Major results: A total of 497 child contacts were recruited, of which 278 (55.9% [95%CI: 51.4% - 60.3%]) and 219 (44.1% [95%CI: 39.7% - 48.6%]) were respectively girls and boys both in age group: 0-24 months: 51 (10.3% [95% CI: 7.8% - 13.4%]) and 25-59 months: 446 (89.7% [95% CI: 86.6% - 92.2%]). Among all children 19 (3.8% [95% CI: 2.4% - 6.0%]) were found not vaccinated. The duration of exposure to TB case ranged from 1 to 4 months; and the social proximity of child contact to TB case was as follow: 185 (37.2% [95%CI: 33.0% - 41.7%]) were first degree relatives, 304 (61.2% [95%CI:56.7% - 65.4%]) distant relatives, and 8 (1.6% [95%CI: 0.8% - 3.3%]) child contacts were not related to the cases. The respondent dissatisfaction rate about TB screening (follow-up) by the health care system was 163 (81.50%). Of 497 child contacts, 104 (20.9% [95%CI: 17.5% - 24.8%]) were initially screened for TB at the time the TB index cases were diagnosed. 163 (81.5% [95%CI: 75.4% - 86.6%]) respondents were dissatisfied about the initial follow-up and screening of child contacts by the health care system. Among all 497 child contacts evaluated at the time of this study, LTBI prevalence rate was 35.0% [95%CI: 30.8% - 39.4%], and the prevalence of TB disease was 3.4% [95% CI: 2.1% - 5.5%]. Under five children who had been screened initially were less likely to have TB infection or disease identified during the evaluation by this study, than those who had not been screened (OR=0.296, X2 = 20.202, p < 0.001) by Kweneng health care system. Main Conclusions: This is the first comprehensive household TB contact tracing in under five children exposed to smear positive TB from adult cases in the rural Botswana. The study found that health care services in Kweneng were not adequately implementing TB contact tracing of household under five children. When children were followed up during this study, we documented a high prevalence rate of TB infection and disease among child contacts who had not been followed up and screened for TB by the health system. This not only suggests that under five child living in the same household with an adult TB case in rural Botswana is at high risk of LTBI and active TB disease; but it also evidently supports the benefice and importance of household contact tracing in enhancing case finding and prevention of tuberculosis disease (Triasih, 2015). Recommendations: A scale-up of targeted household contacts tracing for under five children followed by appropriate management can enhance early case detection and lower the risk of TB transmission among under five children. A targeted tuberculosis contact tracing with an emphasis on younger children should be made a priority by the Botswana National TB Programme (BNTP). The policy needs to clarify who is responsible and accountable for TB contact tracing services. The gap between guidelines and practice, and the human resource capacity should be addressed. An improved training of TB care providers on guidelines in Kweneng district will be important in strengthening TB contact tracing. Key words: Contact tracing, household, tuberculosis, latent tuberculosis infection, index case, child contact, under five child, follow-up, preventive therapy, TST, CXR.

Thesis (MPH.) -- University of Limpopo, 2019
Background: School children are mostly affected by diarrhoeal and respiratory infections and these are related to lack of proper hand washing. For children to be able to practice proper hand washing, they must have the knowledge and necessary resources to practice hand washing. The study’s purpose was therefore to establish the knowledge and practice of hand washing among primary school children. Purpose: The study’s aim was to assess the knowledge and practices of hand washing among primary school children in Kweneng Central Sub-District. Methods: A quantitative approach using a self-administered structured questionnaire to collect data regarding knowledge and practices on hand washing among primary school children was used. An observation checklist was also used to assess the practice of hand washing among primary school children. A stratified random sampling method was used to come up with a sample size of 330. SPSS 24.0 version was used to analyse the data. Results: The study revealed that the majority of primary school children had knowledge on hand washing but lacked proper hand washing practices. The results also showed that hand washing knowledge and practice among primary school children had no association with their age and gender. However, there was association between washing hands after going to the toilet and gender as well as the availability of bucket/basin to wash hands and gender. Conclusion: Children spend much of their day time at school; therefore schools are the right institutions to impart hand washing information and emphasise the importance of hand washing to the children. The availability of facilities such as clean water and soap are paramount to the facilitation of hand washing among primary school children and as such should be adequately provided in schools. Keywords: Hand washing, knowledge, practice, children, primary school.