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Social and Demographic Factors Associated with Morbidities in Young Children in Egypt: A Bayesian Geo-Additive
Khaled Khatab1, Oyelola Adegboye2, Taofeeq Ibn Mohammed3
1Centre of Health and Social Care Research, Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield S10 2BP, United Kingdom.
Insights
Childhood diseases like diarrhea, cough, and fever are a major concern in Egypt. Younger children and specific regions, particularly the Nile Delta and Upper Egypt, face higher risks, necessitating targeted health interventions.
Area of Science:
- Public Health
- Epidemiology
- Pediatrics
Background:
- Childhood mortality globally, particularly in developing nations, is a significant public health concern.
- Diarrhea, cough, and fever, along with their co-occurrence, are major contributors to childhood morbidity and mortality.
- Addressing these prevalent childhood illnesses requires understanding their risk factors and spatial distribution.
Purpose of the Study:
- To investigate the risk factors and spatial patterns of co-occurring diarrhea, cough, and fever in children under five in Egypt.
- To identify demographic and socio-economic determinants associated with these common childhood illnesses.
- To map the geographical distribution of these diseases to inform public health strategies.
Main Methods:
- Utilized data from the 2008 Egypt Demographic and Health Survey, encompassing 10,872 children under five.
- Employed a Bayesian multinomial model to analyze area-specific spatial effects and risk factors.
- Applied multivariate Bayesian geo-additive models to assess co-morbidity of fever, diarrhea, and cough.
Main Results:
- Children under 20 months exhibited a significantly higher likelihood of having all three diseases (OR: 6.8) compared to older children.
- Maternal age over 20 was associated with a slightly increased risk of isolated cough (OR: 1.2) and fever (OR: 1.2).
- Spatial analysis revealed a higher incidence of these co-morbidities in the North-eastern region of Egypt.
Conclusions:
- The study identified distinct geographical patterns in the prevalence of combined childhood morbidities across Egyptian governorates.
- High disease rates were observed in the Nile Delta, Upper Egypt, and south-eastern Egypt, indicating these areas require focused attention.
- Findings underscore the need for targeted public health interventions in high-prevalence regions to reduce childhood illness burden.
Background:
Globally, the burden of mortality in children, especially in poor developing countries, is alarming and has precipitated concern and calls for concerted efforts in combating such health problems. Examples of diseases that contribute to this burden of mortality include diarrhoea, cough, fever, and the overlap between these illnesses, causing childhood morbidity and mortality.
Methods:
To gain insight into these health issues, we employed the 2008 Demographic and Health Survey Data of Egypt, which recorded details from 10,872 children under five. This data focused on the demographic and socio-economic characteristics of household members. We applied a Bayesian multinomial model to assess the area-specific spatial effects and risk factors of co-morbidity of fever, diarrhoea and cough for children under the age of five.
Results:
The results showed that children under 20 months of age were more likely to have the three diseases (OR: 6.8; 95% CI: 4.6-10.2) than children between 20 and 40 months (OR: 2.14; 95% CI: 1.38-3.3). In multivariate Bayesian geo-additive models, the children of mothers who were over 20 years of age were more likely to have only cough (OR: 1.2; 95% CI: 0.9-1.5) and only fever (OR: 1.2; 95% CI: 0.91-1.51) compared with their counterparts. Spatial results showed that the North-eastern region of Egypt has a higher incidence than most of other regions.
Conclusions:
This study showed geographic patterns of Egyptian governorates in the combined prevalence of morbidity among Egyptian children. It is obvious that the Nile Delta, Upper Egypt, and south-eastern Egypt have high rates of diseases and are more affected. Therefore, more attention is needed in these areas.
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