• WHAT'S NEW THIS WEDNESDAY ON WWW.CHILDSURVIVAL.NET:
  
  'Training of household heads on the utilization of LLITN significantly reduces the burden of malaria in under-five children.'
  
  Abstract below, full text is at http://www.malariajournal.com/content/pdf/1475-2875-11-8.pdf
  
  

Malar J. 2012 Jan 6;11(1):8. [Epub ahead of print]

• THE EFFECT OF HOUSEHOLD HEADS TRAINING ABOUT THE USE OF TREATED BED NETS ON THE BURDEN OF MALARIA AND ANAEMIA IN UNDER-FIVE CHILDREN: A CLUSTER RANDOMIZED TRIAL IN ETHIOPIA.

Deribew A, Birhanu Z, Sena L, Dejene T, Reda AA, Sudhakar M, Alemseged F, Tessema F, Zeynudin A, Biadgilign S, Deribe K.

Abstract

ABSTRACT:

BACKGROUND:

Long-lasting insecticide-treated bed nets (LLITN) have demonstrated a significant effect in reducing malaria-related morbidity and mortality. However, barriers on the utilization of LLITN have hampered the desired outcomes. The aim of this study was to assess the effect of community empowerment on the burden of malaria and anaemia in under-five children in Ethiopia.

METHODS:

A cluster randomized trial was done in 22 (11 intervention and 11 control) villages in south-west Ethiopia. The intervention consisted of tailored training of household heads about the proper use of LLITN and community network system. The burden of malaria and anaemia in under-five children was determined through mass blood investigation at baseline, six and 12 months of the project period. Cases of malaria and anaemia were treated based on the national protocol. The burden of malaria and anaemia between the intervention and control villages was compared using the complex logistic regression model by taking into account the clustering effect. Eight Focus group discussions were conducted to complement the quantitative findings. Result A total of 2,105 household heads received the intervention and the prevalence of malaria and anaemia was assessed among 2410, 2037 and 2612 under-five children at baseline, six and 12 months of the project period respectively. During the high transmission/epidemic season, children in the intervention arm were less likely to have malaria as compared to children in the control arm (OR = 0.42; 95%CI: 0.32, 0.57). Symptomatic malaria also steadily declined in the intervention villages compared to the control villages in the follow up periods. Children in the intervention arm were less likely to be anaemic compared to those in the control arm both at the high (OR = 0.84; 95%CI: 0.71, 0.99)) and low (OR = 0.73; 95%CI: 0.60, 0.89) transmission seasons.

CONCLUSION:

Training of household heads on the utilization of LLITN significantly reduces the burden of malaria in under-five children. The Ministry of Health of Ethiopia in collaboration with other partners should design similar strategies in high-risk areas to control malaria in Ethiopia. Trial registration The study is registered in Australian New Zealand Clinical Trials Registry (ACTR number: ACTRN12610000035022).

• CHILD DEVELOPMENT IN DEVELOPING COUNTRIES
  
  Published in The Lancet, September 23, 2011

Best viewed at http://www.thelancet.com/series/child-development-in-developing-countries-2

Executive summary

Four years after The Lancet published a first Series on early child development, the challenge of supporting 200 million children under five years to reach their developmental potential remains. A new Series of two papers and a Comment now documents progress worldwide. The Series aims to identify gaps in implementation and coverage of interventions, calculate the economic costs of missed investment in early learning programmes, and present new evidence on the causes and effects of developmental inequities in early childhood.

The first article looks at the evidence on risks and protective factors in early child development, and identifies new risks not previously described. The second looks at the effectiveness of early child development intervention programmes in low-income and middle-income countries, as well as the cost of not investing in early child development.

The authors conclude that early childhood is the most effective time to prevent inequalities before disparities widen, particularly for the poorest children. By investing in children in early childhood, there are lifetime consequences not only for individuals but for the wellbeing of societies. Rapid action must now follow to ensure that effective interventions are financed and integrated into programmes that aim to improve maternal and child health outcomes.

Series Comments

Early childhood development—global action is due

Anthony Lake

Full Text | PDF

Series Papers

Inequality in early childhood: risk and protective factors for early child development

Susan P Walker, Theodore D Wachs, Sally Grantham-McGregor, Maureen M Black, Charles A Nelson, Sandra L Huffman, Helen Baker-Henningham, Susan M Chang, Jena D Hamadani, Betsy Lozoff, Julie M Meeks Gardner, Christine A Powell, Atif Rahman, Linda Richter

Summary | Full Text | PDF

Strategies for reducing inequalities and improving developmental outcomes for young children in low-income and middle-income countries

Patrice L Engle, Lia C H Fernald, Harold Alderman, Jere Behrman, Chloe O'Gara, Aisha Yousafzai, Meena Cabral de Mello, Melissa Hidrobo, Nurper Ulkuer, Ilgi Ertem, Selim Iltus, and the Global Child Development Steering Group

Summary | Full Text | PDF

Child Development in Developing Countries

Published in The Lancet, September 23, 2011

Best viewed at http://www.thelancet.com/series/child-development-in-developing-countries-2

Executive summary

Four years after The Lancet published a first Series on early child development, the challenge of supporting 200 million children under five years to reach their developmental potential remains. A new Series of two papers and a Comment now documents progress worldwide. The Series aims to identify gaps in implementation and coverage of interventions, calculate the economic costs of missed investment in early learning programmes, and present new evidence on the causes and effects of developmental inequities in early childhood.

The first article looks at the evidence on risks and protective factors in early child development, and identifies new risks not previously described. The second looks at the effectiveness of early child development intervention programmes in low-income and middle-income countries, as well as the cost of not investing in early child development.

The authors conclude that early childhood is the most effective time to prevent inequalities before disparities widen, particularly for the poorest children. By investing in children in early childhood, there are lifetime consequences not only for individuals but for the wellbeing of societies. Rapid action must now follow to ensure that effective interventions are financed and integrated into programmes that aim to improve maternal and child health outcomes.

Series Comments

Early childhood development—global action is due

Anthony Lake

Full Text | PDF

Series Papers

Inequality in early childhood: risk and protective factors for early child development

Susan P Walker, Theodore D Wachs, Sally Grantham-McGregor, Maureen M Black, Charles A Nelson, Sandra L Huffman, Helen Baker-Henningham, Susan M Chang, Jena D Hamadani, Betsy Lozoff, Julie M Meeks Gardner, Christine A Powell, Atif Rahman, Linda Richter

Summary | Full Text | PDF

Strategies for reducing inequalities and improving developmental outcomes for young children in low-income and middle-income countries

Patrice L Engle, Lia C H Fernald, Harold Alderman, Jere Behrman, Chloe O'Gara, Aisha Yousafzai, Meena Cabral de Mello, Melissa Hidrobo, Nurper Ulkuer, Ilgi Ertem, Selim Iltus, and the Global Child Development Steering Group

Summary | Full Text | PDF

• RURAL-URBAN DIFFERENCES OF NEONATAL MORTALITY IN A POORLY DEVELOPED PROVINCE OF CHINA 

BMC Public Health. 2011 Jun 18;11:477.

Yi B, Wu L, Liu H, Fang W, Hu Y, Wang Y.

Source

Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Hangkong Road 13, Wuhan, 430030, China.

Abstract

BACKGROUND:

The influence of rural-urban disparities in children's health on neonatal death in disadvantaged areas of China is poorly understood. In this study of rural and urban populations in Gansu province, a disadvantaged province of China, we describe the characteristics and mortality of newborn infants and evaluated rural-urban differences of neonatal death.

METHODS:

We analyzed all neonatal deaths in the data from the Surveillance System of Child Death in Gansu Province, China from 2004 to 2009. We calculated all-cause neonatal mortality rates (NMR) and cause-specific death rates for infants born to rural or urban mothers during 2004-09. Rural-urban classifications were determined based on the residence registry system of China. Chi-square tests were used to compare differences of infant characteristics and cause-specific deaths by rural-urban maternal residence.

RESULTS:

Overall, NMR fell in both rural and urban populations during 2004-09. Average NMR for rural and urban populations was 17.8 and 7.5 per 1000 live births, respectively. For both rural and urban newborn infants, the four leading causes of death were birth asphyxia, preterm or low birth weight, congenital malformation, and pneumonia. Each cause-specific death rate was higher in rural infants than in urban infants. More rural than urban neonates died out of hospital or did not receive medical care before death.

CONCLUSIONS:

Neonatal mortality declined dramatically both in urban and rural groups in Gansu province during 2004-09. However, profound disparities persisted between rural and urban populations. Strategies that address inequalities of accessibility and quality of health care are necessary to improve neonatal health in rural settings in China.