Under-five children\'s diarrhea is a significant public health threat and the World Health Organization (WHO) reported it as the second leading cause of children\'s death worldwide. In this study area, little is known about the spatiotemporal distribution of under-5 diarrhea incidence. This study was therefore, conducted among all districts in the Central Gondar zone to assess the spatial, temporal, and spatiotemporal variation in diarrhea incidence among under-five children in the Central Gondar zone. The data for children under 5 years of age with diarrhea was obtained from Central Gondar Zone Health Department diarrhea reports from January 2019 to December 2022. All districts were included and geo-coded. The spatial data were created in ArcGIS 10.8.1. Global and local spatial autocorrelation were used to detect hot spots and cold spots. The Poisson model was generated by applying the Kulldorff method in SaTScan™9.6 to analyse the the purely temporal, spatial, and space-time clusters. The study revealed spatial variation of under-5 diarrhea where Gondar City, Gondar Zuria, East Dembia, and Lay Armacho districts were the high-rate spatial clusters during the study period. A year search window for temporal scan statistic identified 01 January 2020-30 December 2021 as risk periods across all districts. Spatiotemporal scan statistics detected high-rate clusters at Gondar City, Gondar Zuria, East Dembia, Lay Armacho, and Alefa between 2019 and 2022. In conclusion, there has been a spatial, temporal, and spatiotemporal variability of under-5 children\'s diarrhea in the Central Gondar Zone. Interventional and preventive strategies should be developed and given priority to the areas that has been detected as a hotspot in this study to reduce the mortality and morbidity of under 5 children.

Community-facility linkage interventions are gaining popularity as a way to improve community health in low-income settings. Their aim is to create/strengthen a relationship between community members and local healthcare providers. Representatives from both groups can address health issues together, overcome trust problems, potentially leading to participants\' empowerment to be responsible for their own health. This can be achieved via different approaches. We conducted a systematic literature review to explore how this type of intervention has been implemented in rural and low or lower-middle-income countries, its various features and how/if it has helped to improve child health in these settings. Publications from three electronic databases (Web of Science, PubMed and Embase) up to 03 February 2022 were screened, with 14 papers meeting the inclusion criteria (rural setting in low/lower-middle-income countries, presence of a community-facility linkage component, outcomes of interest related to under-5 children\'s health, peer-reviewed articles containing original data written in English). We used Rosato\'s integrated conceptual framework for community participation to assess the transformative and community-empowering capacities of the interventions, and realist principles to synthesize the outcomes. The results of this analysis highlight which conditions can lead to the success of this type of intervention: active inclusion of hard-to-reach groups, involvement of community members in implementation\'s decisions, activities tailored to the actual needs of interventions\' contexts and usage of mixed methods for a comprehensive evaluation. These lessons informed the design of a community-facility linkage intervention and offer a framework to inform the development of monitoring and evaluation plans for future implementations.

UNASSIGNED: Appropriate health-seeking behaviour could help in reducing child mortality and morbidity. Information on social factors of mortality and health-seeking behaviours of caregivers of under-5 children from slums of Indian cities is minimal in literature.
UNASSIGNED: We estimated the prevalence of health-seeking behaviour for morbidity ofunder-5 children and its determinants in urban slums in Chennai city, India.
UNASSIGNED: A cross-sectional study was conducted using a mixed-method design among primary caregivers of under-5 children living in Chennai slums, India. Two-stage cluster sampling was adopted to select 40 slums. A total of 233 primary caregivers were interviewed. Nine focus group discussions and 18 in-depth interviews were conducted among the primary caregivers. Prevalence of inappropriate health-seeking behaviour was estimated, and determinants were identified by multivariate binary logistic regression analysis. Thematic analysis was done on qualitative data.
UNASSIGNED: We interviewed 233 primary caregivers. The weighted prevalence of inappropriate health-seeking behaviour for under-five children in urban slums of Chennai was 53.9% (95% CI: 46.9 - 60.8). Primary caregivers educated above secondary school were more likely (AOR of 2.3, 95% CI: 1.3-4.1) to follow inappropriate health-seeking behaviour compared to those educated below. Similarly, caregivers who were unaware of young child feeding practices (AOR of 3.6, 95% CI: 1.9-6.5) and early care-seeking and health practices (AOR of 2.5, 95% CI: 1.3-4.9) were more likely to engage in inappropriate health-seeking behaviour compared to those who were aware and we found that illness symptoms influenced health-seeking behaviour and that early disease detection might prevent severe illness.
UNASSIGNED: Health-seeking behaviour was found to be suboptimal among under-5 children in Chennai\'s urban slums. We suggest policymakers improve interventions on early care-seeking of common childhood illnesses in the urban health programme.

Food insecurity is a leading cause of childhood morbidity and mortality. This study assessed the prevalence of household food insecurity and its associated factors among under-5 children in Ibadan, Nigeria.
This was a cross-sectional household survey of 1,027 under-5 children and their caregivers in urban and rural slums in Ibadan. We used an electronic interviewer-administered, semi-structured questionnaire adapted from the Nigeria Demographic Health Survey and Household Food Insecurity Access Scale was used to report sociodemo-economic characteristics, food insecurity, and anthropometric measurement. The household food insecurity scale consisted of nine questions graded from 0 (Never) to 3 (Often) computed to determine the presence of food insecurity. Nutrition indices were computed, and the results were classified according to World Health Organization 2006 cut-off points. Chi-square tests were used to assess associations between food insecurity and the independent variables. Binary logistic regression analyses were conducted to identify the predictors of food insecurity (α = 0.05).
The mean ages of the caregivers and under-5 children were 31.7 ± 7.47 years and 34.49 ± 15.8 months respectively. Overall, 530 (51.7%) children were females, and 765 (74.5%) had normal weight for height. In all, 195 (19.0%) households had food insecurity, while 832 (81.0%) households had food security (Chi-square = 103.364, p = < 0.001). Under-5 children living in urban slums were seven times more likely to experience household food insecurity compared to those in rural slums (AOR = 6.859, 95%CI = 4.524-10.509, p = < 0.001).
Household food insecurity was more prevalent in urban slums. Strengthening of the school health program would help identify children with nutritional deficits, and improve the overall health status of children living in slum communities.

UNASSIGNED: To evaluate the changes in the global burden of foreign body aspiration (FBA) among children under 5 years old at regional, age, sex, and socio-demographic index (SDI) levels between 1990 and 2019.
UNASSIGNED: Data on FBA was derived from the Global Burden of Disease (GBD) Study 2019 database on pulmonary aspiration and foreign body in airway. The means and 95% uncertainty intervals (UIs) were calculated for incidence, and disability-adjusted life-years (DALYs). The temporal trends were represented by estimated annual percentage change (EAPC) using Joinpoint regression.
UNASSIGNED: Globally, FBA caused 109.6 (95% UI: 69.5, 175.7) per 100,000 incidence and 317.9 (95% UI: 270.7, 372.4) per 100,000 DALYs under 5 years old in 2019. Many European countries (such as Italy, Netherlands, Iceland, etc.) showed a high incidence rate, but did not cause a large disease burden (DALYs all less than 200 per 100,000). Compared to 1990, although a decrease in both incidence and DALYs occurred in 2019, the Joinpoint regression showed an increasing trend in incidence rate from 2014 to 2019 [APC: both (2.10), female (2.25), male (1.98), P < 0.05)], especially China, Netherlands, and Malta. Despite the lower incidence rate in early neonatal group and middle SDI areas, they instead resulted in higher DALYs than other age groups and areas.
UNASSIGNED: Although declines occurred in incidence and DALYs of FBA among children under 5 years of age from 1990 to 2014, an upward trend began to emerge from 2014 to 2019. The incidence and DALY rates were correlated with age and SDI. Increased efforts are needed to improve the necessary monitoring and reporting systems, hazard assessment, and public education activities.

This current work describes how the nutritionists and dietitians in Nigeria to tackle the nutritional deficiencies among the under-5 children in Nigeria due to poor food preparation by the parents and caregivers as well as how the food is chosen for these children. Studies have shown that the resultant effects of poor food preparation and the skewness of food choices on particularly the more vulnerable group of under-5s are malnutrition. According to the State of the World\'s Children, published by the United Nations International Children\'s Emergency Fund, the prevalence of child malnutrition in Sub-Saharan Africa, including Nigeria, is particularly high. Thus, it is high time for the nutritionists and dietitians in Nigeria to step up their advocacy, community sensitization, and awareness campaigns on appropriate diet and approach to food issues, especially on how food is prepared by most Nigerian parents and caregivers, and also work on their decision-making process governing the food choices they make for their children.

UNASSIGNED: Insecticide-treated nets (ITNs) are widely used tools that have been proven effective in preventing and controlling malaria. However, usage varies among households and can greatly affect the benefits of ITNs. Thus, this study aimed to assess the household utilization of insecticide-treated nets and its associated factors for under-5 children.
UNASSIGNED: A cross-sectional study was conducted in March-April 2020 in the East Mesekan district. A total of 591 households with under-5 children were chosen by using a systematic random sampling approach for the interviews. The data was collected using a pretested questionnaire. Epi-Data version 3.1 was used to enter data and SPSS version 21 for analysis. A P-value of .05 was considered statistically significant.
UNASSIGNED: In this study, 58.2% (95% CI: [54.1%-62.2%]) of household participants used ITN for children under 5 years of age while sleeping the night before the survey. The study participants\' overall knowledge and practice of malaria prevention were 27.1% and 23.9%, respectively. Having a family size of less than 5 (AOR = 0.60, 95% CI: [0.37-0.98]) and complaints of skin irritation (AOR = 0.43, 95% CI: [0.29-0.63]) significantly decreased ITN utilization. However, having 1 ITN (AOR = 2.15, 95% CI: [1.15-4.02]) or 2 ITNs (AOR = 2.58, 95% CI: [1.51-4.39]), as well as low (AOR = 2.07, 95% CI: [1.33-3.20]) and medium (AOR = 1.83, 95% CI: [1.11-3.02]) knowledge of ITN importance, increased ITN utilization significantly.
UNASSIGNED: The households\' use of ITNs for children under the age of 5 was inadequate. It was significantly associated with having a family size of less than 5, complaints of skin irritation, owning 1 or 2 ITNs, and having low and medium knowledge of its importance. It is recommended that continuous and progressive health awareness about the consistent use of ITN for malaria prevention in the study area be promoted.

OBJECTIVE: Rwanda reported a stunting rate of 33% in 2020, decreasing from 38% in 2015; however, stunting remains an issue. Globally, child deaths from malnutrition stand at 45%. The best options for the early detection and treatment of stunting should be made a community policy priority, and health services remain an issue. Hence, this research aimed to develop a model for predicting stunting in Rwandan children.
METHODS: The Rwanda Demographic and Health Survey 2019-2020 was used as secondary data. Stratified 10-fold cross-validation was used, and different machine learning classifiers were trained to predict stunting status. The prediction models were compared using different metrics, and the best model was chosen.
RESULTS: The best model was developed with the gradient boosting classifier algorithm, with a training accuracy of 80.49% based on the performance indicators of several models. Based on a confusion matrix, the test accuracy, sensitivity, specificity, and F1 were calculated, yielding the model\'s ability to classify stunting cases correctly at 79.33%, identify stunted children accurately at 72.51%, and categorize non-stunted children correctly at 94.49%, with an area under the curve of 0.89. The model found that the mother\'s height, television, the child\'s age, province, mother\'s education, birth weight, and childbirth size were the most important predictors of stunting status.
CONCLUSIONS: Therefore, machine-learning techniques may be used in Rwanda to construct an accurate model that can detect the early stages of stunting and offer the best predictive attributes to help prevent and control stunting in under five Rwandan children.

UNASSIGNED: Percentile curves are often used to assess variances in children\'s growth pattern. This study is aimed at explaining effect of the respondents\' sociodemographic characteristics on under-5 children\'s birth weight and identifying most suitable models, out of 11 statistical models reviewed, for estimating children\'s growth in terms of height and weight of a given birth-weight category and obtain estimated growth curves.
UNASSIGNED: The study used National Family Health Survey (NFHS)-4 data from four Eastern States of India, consisting of 54,075 under-5 children. Estimated growth curves were obtained, using best-fit models.
UNASSIGNED: Birth weight was found to be associated with children\'s age, gender, birth order, body mass index, mother\'s education, living place and wealth index. Two models - Cubic Model and Power Model - showed best fit to the height and weight measurements. We obtained estimated growth curves of boys and girls for a given birth-weight category.
UNASSIGNED: All socio-demographic factors studied, except respondent\'s occupation, were associated with children\'s birth weight. Cubic and Power Models were most suitable for assessing growth in terms of height and weight of boys and girls, belonging to a given birth-weight category.

Mothers are understandably concerned about protecting the well-being of their offspring in every way possible, including providing oral dietary supplements (DSs). Up to now, there has been limited data on maternal knowledge and attitudes toward concomitant maternal-child DSs practices in Lebanon. This study evaluated the maternal knowledge and attitudes toward DSs and documented the DS-related practices in mothers and their under-5 children with their correlates. This cross-sectional study involved a representative stratified cluster random sample of 511 mother-child dyads (mothers: mean age ± SD = 30.25 ± 4.98 years; children: mean age ± SD = 18.7 ± 15.5 months, girls: 55.0%). A self-administered questionnaire was used to meet study aims. Most mothers lack awareness and hold unfavorable attitudes regarding DS use. Among all mothers, 47% were DS users, with the majority using vitamin D (82%). Almost 64% of mothers provide DSs for their children, with a predominant use of multivitamin drops (61.0%). \"To keep the child healthy\" was the reported reason by 60.0% of mothers to provide DSs for their children. Physicians were the primary information source about DSs for most mothers (64.0%). The usage of DSs among mothers was influenced by their pregnancy status, child\'s age, number of children per household, and their awareness and attitudes towards DSs. DS usage among children was correlated with maternal DS use and their mothers\' attitudes towards DSs. DS usage among Lebanese mother-child dyads is common. Mothers should be the focus of education sessions regarding DS use.