Trends in the Prevalence and Associated Contributing Factors of Stunting in Children Under Five Years of Age. Secondary Data Analysis of 2005, 2010 and 2014-2015 Rwanda Demographic and Health Surveys

Background Stunting affects more than 161 million children under five years of age worldwide. Rwanda has a high prevalence of stunted children under five years of age (~38%) according to the 2014-2015 Rwanda Demographic and Health Survey. Objectives The aim of this study is to compare the prevalence rates of stunting in Rwanda using the Rwanda Demographic and Health Survey data of 2005, 2010 and 2014-2015. Methods The three Rwanda Demographic and Health Survey cross-sectional studies into consideration were conducted in 2005, 2010 and in 2014-2015. Stunting prevalence rates from those surveys were compared using Pearson's chi-squared tests and Marascuilo procedure using STATA (StataCorp. 2013. Stata Statistical Software: Release 13. College Station, TX: StataCorp LP.). Results The Pearson's chi-squared tests and Marascuilo procedure used in this research confirmed a significant difference between the reported three RDHS stunting prevalence rates. The trends in the stunting prevalence rates among children under five years of age showed a decrease of 13% in stunting prevalence rate, falling from 51%in 2005 to 38%in 2014-15. Conclusion A statistical analysis based on2005, 2010 and 2014-15 RDHS surveys datasets confirmed that there is a statistically significant reduction in stunting prevalence rates  over that decade(from 51% in 2005 to 38%in 2014-2015). The main persistent associated factors with stunting were the age, sex, size at birth, residence place of the child, and the mother’s educational level and household wealth index. Keywords: Stunting; children under five years; demographic and health survey; nutrition; Rwand

Factors associated with childhood diarrhea in Rwanda: a secondary data analysis of the Rwanda demographic and health survey 2014-15

Background: Diarrheal diseases remain an important cause of morbidity among children, particularly in children under five years old, in low- and middle-income countries where it causes nearly 1.7 billion cases every year.Methods: We used a quantitative cross-sectional design. This study aimed to explore the determinants of child diarrhea among under five-year children in Rwanda. A deep analysis of the 2014- 2015 Rwanda Demographic and Health Survey (RDHS), with multivariate logistic regression, using stata13 was performed. The 2014-2015 Survey was the fifth standard national survey, implemented by the National Institute of Statistics of Rwanda (NISR) in a period of six months from November 2014 to April 2015.Results: A sample of 2841 children under five years old were included. Chi-square test and logistic regression were performed. A significance level of 0.05 at 95% CI was considered. Child age and wealth index showed a strong association with diarrhea. Children in the age groups of 6-11, 12-23, 24-35 months were at higher risk of diarrhea than children aged 48-59 months, OR: 5.0 [3.1-8.2], P-value: 0.001; OR: 7.6, CI [4.7-12.2], P-value: 0.001; OR:3.8 [2.3-6.2], P-value: 0.001 respectively. Moreover, children from poorest and poorer families were twice more at risk of diarrhea than children from richest families. OR: 2, CI [1.3-2.9], P-value: 0.001.Conclusion: The study concluded that low wealth index, and child age less than 35 months were important risks for under-five child diarrhea.Keywords: determinants, under five years children, diarrhe

Prevalence of Periodontitis and Associated Factors among Pregnant Women: A cross sectional survey in Southern Province, Rwanda

Background The literature has shown the relationship between maternal periodontitis and complications associated with pregnancy. Thus, prevalence estimates and risk factor identification for periodontitis during pregnancy in Rwanda are paramount. Aim The aim of the current study was to determine the prevalence of periodontitis and identify related risk factors among pregnant women in Rwanda. Methods A cross sectional study was conducted to determine the prevalence of periodontal diseases in a convenience sample of 400 pregnant women in the Southern Province of Rwanda. A logistic regression analysis using a hierarchical approach was performed to assess the risk factors for periodontal disease. Socio demographic factors were put in the regression model first followed by a second step for other potential factors. Results The overall prevalence of periodontitis was 60.5%. Multivariable logistic regression showed that age OR=2.48 (95% CI. 1.18-5.22), education level OR=82.15 (95% CI. 8.21-822.11), socio economic status OR=2.28 (95% CI. 1.49-6.62), employment status OR=7.3 (95% CI. 1.38-38.74, and tobacco use OR=6.89 (95% CI. 1.78-60.65) were significantly associated with periodontitis. Conclusion Periodontitis appears to be a common problem among pregnant women in Rwanda. Risk factor screening could help identify pregnant women at higher risk of periodontal disease. Rwanda J Med Health Sci 2021;4(1):131-15

Impact of Maternal Periodontitis on Preterm Birth and Low Birth Weight in Babies: Results of a Scoping Review

Background Periodontitis has been documented as public health concern but its association with preterm and low birth weight remains uncertain, thus the objective of this scoping review is to summarize the most recent published evidence related to the impact of periodontitis on preterm birth and low birth weight in order to improve public awareness and to inform policies for oral health during pregnancy. Methods Hinari, PubMed, and Google Scholar were searched to acquire the published literature. The retrieved studies included cross-sectional, case control studies and randomized controlled trials with available full text published in English from 2008 to 2019. Results After combining the key words, 333 articles were identified with only 133 eligible articles published from 2008 to 2019. After reviewing the available 50 full text articles, duplicates were removed and 15 studies fully met the inclusion criteria. There were 13 articles that supported the association between maternal periodontitis and preterm low birth weight while 2 found no evidence to support the association. Conclusion The results of this scoping review contribute to an increasing body of evidence to support the hypothesis that maternal periodontal disease may be a risk factor for preterm delivery and low birth weight. Rwanda J Med Health Sci 2020;3(3):372-38

Prevalence and risk factors of intestinal parasites among children under two years of age in a rural area of Rutsiro district, Rwanda – a cross-sectional study

Introduction: this study aimed to assess the prevalence and associated risk factors of intestinal parasite infections among children less than two years of age in Rutsiro, Rwanda. Methods: a cross-sectional parasitological survey was conducted in Rutsiro in June 2016. Fresh stool samples were collected from 353 children and examined using microscopy to detect parasite. A questionnaire was administered to collect data on hygiene, sanitation, socio-demographic and economic characteristics. Results: approximately one in two children (44.8%) were found to be infected with at least one intestinal parasite. Ascaris (28.5%) was the most prevalent infection followed by Entamoeba histolytica (25.95%) and Giardia lamblia (19.6%). Infection with more than one pathogen was noted e.g. presence of Ascaris and yeasts (8.9%), and amoeba with Trichocephale (4.4%), respectively. Children from non-farming families were less likely to be at risk of intestinal parasite infections (AOR = 0.41, p = 0.028) compared to children from farming families. Children from households with access to treated drinking water were less likely to contract intestinal parasite infections (AOR = 0.44, p = 0.021) compared with those who used untreated water. Children from families with improved sources of water were twice as likely to be diagnosed with intestinal parasitoses compared to those who did not. We postulate that the majority of families (50.1%) who have access to improved water sources do not treat water before consumption. Conclusion: the high prevalence of intestinal parasitoses in children warrants strict control measures for improved sanitation, while treatment of drinking water should be considered

Sexual Violence against Children in Rwanda: Prevalence and Associated Factors

Background Information and data on the burden and factors associated with violence against children are critical in designing and implementing preventive strategies and interventions. This study aimed to examine patterns of the prevalence of sexual violence (SV) against children in Rwanda and investigate associated factors to contribute to the knowledge about violence against children in Rwanda. Methods A sample of 1,110 children aged 13-17 years from a cross-sectional national survey done in Rwanda in 2015 was analysed. Weighted descriptive statistics were applied to describe the prevalence of SV against children, and weighted logistic regression allowed us to investigate factors associated with it. Results Over eight percent (8.4%) of all children, including about three percent (2.8%) of male children and around five percent (5.6%) of female children, reported having experienced SV within the last twelve months. Being a female child, having a romantic partner, and not attending school were some factors associated with SV against children in Rwanda. Conclusion Female children reported more SV than male children. Factors associated with sexual violence pertained to the child’s characteristics, family or household background characteristics, and community relations. The study findings call for an urgent need to prevent SV against children through awareness raising about it amongst children and the general public. Rwanda J Med Health Sci 2022;5(3):302-31

Allaitement maternel en milieu urbain et en milieu rural au Rwanda (état actuel de la question)

Doctorat en Sciences de la santé publiqueinfo:eu-repo/semantics/nonPublishe

Allaitement maternel en milieu urbain et en milieu rural au Rwanda (état actuel de la question)

Doctorat en Sciences de la santé publiqueinfo:eu-repo/semantics/nonPublishe

Les Determinants Du Desir De Grossesse Chez Les Femmes Seropositives Sous Traitement Antiretroviral Dans Le District De Rwamagana

The study aims at analyzing the determinants of desire for pregnancy among HIV positive women receiving anti-retroviral treatment in order to contribute to the reduction of HIV transmission from mother to child. Its specific objectives are to determine the proportion of pregnancies among HIV positive women, evaluate the attitude of health personnel regarding the messages to provide on HIV positive women under anti-retroviral treatment in terms of desire of pregnancy and to identify factors determining the desire to have children after being subjected to antiretroviral therapy. This is a cross-sectional study. It was conducted among 260 women infected with HIV on ARVs and tracked in health facilities, having VCT / PMTCT and ARVs services. The main results are: 26.9% of women became pregnant after having been informed of their HIV status to HIV positive and 38.5% of HIV positive women receiving antiretroviral treatment want to have children in the future. The majority of women (82.7%) know the importance of using contraceptive methods whereas women who know the importance of using ARVs during pregnancy and childbirth for reducing the risk of transmission from mother to child are 76.9%. The factors determining the desire of pregnancy among women with HIV positive are: Confidence attributed to anti-retrovirals, parity that means that women who have not had children have a desire for motherhood twice higher than women who had at least one child, and the contraceptive methods unused among women with HIV positive to reduce the risk of transmission from mother to child. We recommend strengthening the integration of the activities of reproductive health and Family Planning in the services of fighting HIV / AIDS such as PMTCT, VCT and treatment of HIV-positive patients.L’étude vise à analyser les déterminants du désir de grossesse chez les femmes séropositives sous traitement anti-retroviral, afin de contribuer à la réduction de la transmission du virus de la mère à l’enfant. Elle a pour objectifs spécifiques de déterminer la proportion des grossesses chez les femmes à sérologie VIH positive, d’évaluer l’attitude du personnel de santé à l’égard des messages à donner aux femmes séropositives sous ARVs en ce qui concerne le désir de la grossesse, et relever les facteurs déterminant le désir d’avoir des enfants après la mise ne route d’un traitement par antirétroviraux . Il s’agit d’une étude descriptive transversale. Elle a été conduite auprès de 260 femmes infectées par le VIH sous ARVs et suivies dans les FOSA, ayant les services de VCT/PMTCT et des ARVs. L’étude montre que 26,9% des femmes ont été enceintes après avoir été informées de leur statut sérologique positif pour le VIH et que 38,5% des femmes séropositives sous traitement anti-rétroviral désirent avoir des enfants dans le futur. La majorité des femmes (82,7%) reconnaissent l’importance de l’utilisation des contraceptifs alors que le pourcentage des femmes qui connaissent l’importance d’utiliser les ARVs pendant la grossesse et l’accouchement pour réduire le risque de transmission de la mère à l’enfant est de 76,9%. Les facteurs déterminant le désir de la grossesse parmi les femmes séropositives sont : La confiance attribuée aux anti-rétroviraux, la parité c’est-à-dire les femmes qui n’ont pas eu d’enfant ont un désir de maternité deux fois supérieur que les femmes qui ont eu au moins un enfant, et la non utilisation des méthodes contraceptives chez les femmes à sérologie VIH positives pour réduire le risque de transmission de la mère à l’enfant. Nous recommandons de renforcer l’intégration des activités de santé de la reproduction et de Planning familial dans les services de lutte contre le VIH/SIDA,à savoir le PTME, Conseils et dépistage volontaire du VIH, ainsi que la prise en charge des patients séropositifs

Knowledge, Attitudes And Practices Of Exclusive Breast-Feeding Of Infants Aged 0-6 Months By Urban Refugee Women In Kigali

This study aims at determining the knowledge, attitudes and practices of urban refugee women regarding the exclusive breastfeeding (EBF) in order to promote its practice among this group of population and increase the number of women who adhere to it for achieving a better development of their children. The specific objectives of the study are to determine the urban refugee women’s knowledge regarding EBF, to identify their source of information about EBF, to assess their attitudes towards EBF and to determine EBF practice rate among these women. This is a descriptive crosssectional study. It involves 90 urban refugee women who had children aged six months to two years during the period of the study. The study was conducted between January 2011 and mid-February of the same year. The main results are the following: 74.4% of the mothers have correct knowledge about the EBF, and the health facilities are reported to at 90 % their main source of the information 71.1% of the mothers have positive attitude towards EBF, but 34.4 % practised EBF up to 6 months. There is no significant correlation between the dependant and the independent variables (p > 0.05). The factors leading the mothers in the study to such low practice of EBF, which are not captured by this study, might be anchored in their cultural or traditional practices. For almost all of the mothers come from the same country: the Democratic Republic of the Congo; mainly from the East of the country. Therefore, as a recommendation, a qualitative research should diligently be conducted in order to dig up the reasons for these women’s failure in practising EBF to six months. In addition, the women’s sensitisation for EBF practice should continue and be enhanced.La présente étude vise à déterminer la connaissance, les attitudes et la pratique des femmes réfugiées en milieu urbain, en matière de l’allaitement maternel exclusif afin de promouvoir la pratique de cette méthode d’allaitement au sein de ce groupe de population et d’accroitre le nombre de femmes qui y adhèrent pour un développement meilleur de leurs enfants. Ainsi, l’étude a pour objectifs spécifiques de déterminer le niveau de connaissance, d’identifier la principale source d’information, d’évaluer les attitudes, et de déterminer le niveau de pratique de femmes refugiées en milieu urbain concernant l’allaitement maternel exclusif jusqu’à six mois à dater de la naissance du nourrisson. C’est une étude transversale à visée descriptive. Elle a été conduite auprès de 90 femmes réfugiées vivant à Kigali qui avaient des enfants âgés de six mois à deux ans pendant la période de l’étude, c’est-à-dire entre janvier 2011 et mi-février de la même année. Les principaux résultats de l’étude sont: 74.4 % de femmes réfugiées en milieu urbain ont une bonne connaissance concernant l’allaitement maternel exclusif, et les formations sanitaires constituent à 90% la principale source d’information. 71.1% de ces mères ont une attitude positive vis-à-vis de l’allaitement maternel exclusif, mais seules 34.4% d’entre elles ont exclusivement allaité leurs nourrissons jusqu’à six mois. En outre, aucune corrélation significative n’a été établie entre les variables dépendantes et les variables indépendantes (p > 0.05). Les facteurs contribuant à un tel faible taux d’allaitement maternel exclusif parmi les mères réfugiées en milieu urbain n’ont pas été identifiés par la présente étude, ils peuvent être cachés dans leurs pratiques culturelles ou traditionnelles, car presque la totalité de ces mères proviennent d’un seul pays: la République Démocratique du Congo; principalement de l’Est de ce pays. Ainsi, nous recommandons qu’une étude qualitative soit diligemment conduite auprès de cette population pour déceler les vraies causes de leur échec dans l’allaitement maternel exclusif jusqu’à six mois. En outre, nous recommandons que la sensibilisation de femmes refugiées en milieu urbain pour l’allaitement maternel exclusif continue et soit renforcée