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488 reports · page 48 of 49

Peer-reviewed articleCrossref1 Jan 2025

Routine Childhood Immunisation Coverage and Dropout Rates at a Tertiary Hospital in South-South Nigeria: A Four-Year Retrospective Review (2022–2025)

Background: Routine childhood immunisation is central to child survival in Nigeria, yet coverage and completion vary across settings and over time. Facility-level evidence is needed to assess programme performance during disruption and recovery. Objectives: This study reviewed routine childhood immunisation coverage and dropout rates at the University of Port Harcourt Teaching Hospital (UPTH), a tertiary hospital in South-South Nigeria, from 2022 to 2025, identified vaccines with consistently high uptake, and assessed schedule completion between Penta1-Penta3 and BCG-measles. Methods: A retrospective descriptive analysis was conducted using routine immunisation registers from the Family Health Clinic, UPTH. All children aged 0-23 months vaccinated between January 2022 and December 2025 were included. Administrative coverage rates were calculated for each antigen, and monthly dropout rates were estimated for Penta1-Penta3 and BCG-measles. Results: A total of 37,685 immunisation visit records were reviewed. Male children accounted for 17,570 (46.6%) visit records, while female children accounted for 20,115 (53.4%). Administrative coverage estimates were generally high but varied over time, with a decline in 2023, an increase in 2024, and a subsequent reduction in 2025. Vaccines administered at birth and at 6 weeks of age, including BCG, OPV0, HBV0, Penta1, and PCV1, consistently had the highest uptake. In contrast, vaccines administered later in infancy, including rotavirus vaccine, inactivated polio vaccine (IPV), measles vaccine, yellow fever vaccine, and meningococcal A conjugate vaccine (MenA), showed greater variability. Penta1–Penta3 dropout rates were slightly above the recommended threshold in 2022, improved in 2023, and increased in 2024, while BCG–measles dropout rates remained high and fluctuated throughout the study period. Conclusion: Facility administrative immunisation coverage estimates at UPTH remained generally high, although completion across the schedule was inconsistent, particularly for rotavirus, inactivated polio, measles, yellow fever, and meningococcal A conjugate vaccines. Strengthening follow-up systems and defaulter-tracking may improve completion rates.

Peer-reviewed articleOpenAlex8 Sept 2026

Attitude and Practice of Effective Weaning Techniques Among Breastfeeding Mothers Attending General Hospital Koko, Kebbi State, Nigeria

Effective complementary feeding is essential for infant growth, development, and prevention of malnutrition. This study assessed the attitude and practice of effective weaning techniques and identified factors influencing these practices among breastfeeding mothers attending the antenatal clinic at General Hospital Koko, Koko/Besse Local Government Area, Kebbi State, Nigeria. A descriptive cross-sectional design was adopted. The target population comprised 90 eligible breastfeeding mothers with children aged 6–24 months, from which a sample of 73 respondents was obtained using Taro Yamane’s formula. A self-structured 25-item questionnaire covering demographic characteristics, attitude, practice, and influencing factors was used for data collection. The instrument was subjected to face and content validity and test-retest reliability, yielding a reliability coefficient of 0.81. Data were analyzed using descriptive statistics with SPSS version 25. All 73 questionnaires were retrieved. Respondents demonstrated a generally positive attitude toward effective weaning techniques, with a grand mean of 3.0. They also reported positive weaning practices, with a grand mean of 3.0, particularly in hygienic preparation of foods, hand hygiene, introduction of complementary foods at six months, and avoidance of harmful foods. Financial status was the most strongly identified influencing factor (mean = 3.3), followed by lack of knowledge and health workers’ advice (mean = 3.0 each). The study concludes that although mothers demonstrated favourable attitudes and reported appropriate practices, economic constraints, knowledge gaps, family influence, and other contextual factors may affect effective weaning. Strengthening nutrition education and counselling through antenatal and community-based services is recommended.

Almustapha Lawal Ahmad, Danjuma Aishatu, Sani Gaddafi Wasagu et al.

SurvivalNGRead at source

OtherOpenAlex8 Sept 2026

Zero-Dose and Dropout Children in Nigeria: A Comparative Machine Learning Analysis of Childhood Immunization Cascade Failure Using the 2023–24 Nigeria Demographic and Health Survey

Abstract Background There are two distinct failure points in childhood immunization: children who receive no immunization (“zero-dose”); and children who start but do not complete the immunization series (“dropout”). Two failure points to address are possible: ‘zero-dose’, where children receive no first doses; and ‘dropout’, where children begin but do not complete the immunization series. These are plausibly different failure points that require different interventions. Nigeria has the largest number of children with zero doses in absolute numbers in the world. The newly released Nigeria Demographic and Health Survey (NDHS) 2023–24 is used to describe failure cases and to compare the performance of machine learning techniques with standard regression in predicting them. Methods We analyzed 4,937 children aged 12-23 months (the age range covered by the WHO/UNICEF children’s recode) in the NDHS. Survey-weighted logistic regression was used to model ZDS and dropout (Penta1 received vs. Penta3 not received) and to compare them with the WHO/UNICEF national coverage estimates (WUENIC). With the same held-out test data, each of three additional algorithms - elastic net, random forest, and XGBoost - was compared to logistic regression, and sampling weights were added to each. Geographic clustering, after adjusting for individual-level effects, was quantified using a mixed-effects model with a state-level random intercept. Results Zero-dose prevalence was 37.3% (implied Penta1 coverage 62.7%), compared with the WUENIC national estimate of 71% Penta1 coverage; incomplete series coverage was at 9.1% (14.5% of Penta1 recipients), and full vaccination coverage was at 53.6%, which is lower than the administratively weighted global coverage estimates (67% Penta3). The associations of zero-dose status were strong and independent for maternal education, facility delivery, attending ANC, and household wealth, whereas these factors were surprisingly weak, albeit statistically significant for Maternal education and Facility delivery, and not significant for the other factors in the dropout group. After full adjustment, religious affiliation (among Muslims) remained an independent predictor of zero dose, even though clustering by state was adjusted for. Survey-weighted logistic regression performed best for both outcomes (zero-dose AUC=0.825; dropout AUC=0.613), whereas XGBoost performed worst for both. Only 4.7% of the residual variation in dropout could be accounted for by state of residence, but 11.2% could be accounted for by zero-dose status. Conclusions Zero-dose status as well as dropout are characterized by very different predictor profiles and are, therefore, separate policy problems and should not be treated as a single “coverage gap”. There was no improvement in prediction performance in terms of algorithmic complexity compared to a correctly specified logistic regression for either outcome.

Eloghosa Aisosa Nosa-Ihaza, Michael Chiebuka Ogidi, Stephen Okello Odeke et al.

SurvivalNGRead at source

Peer-reviewed articleOpenAlex8 Sept 2026

Correlation of Nutritional Status and Blood Pressure of Apparently Healthy Primary School Pupils Aged 6–12 years in Zaria Local Government Area of Kaduna State

Anthropometric indices have become practical tools for evaluating the nutritional status of populations. Understanding the nutritional status of children has far-reaching implications for promoting the health of future generations. The necessity for routine blood pressure screening in children was debated in the past, the main argument against it being that essential hypertension is an adult disease and there was no evidence that screening apparently healthy children for hypertension is rewarding. Its value as a screening tool for hypertension in adults has long been documented. This study has been designed to assess the relationship between nutritional status and blood pressure among apparently healthy primary school pupils aged 6–12 years in Zaria Local Government Area, Kaduna State. The study was conducted on 219 pupils randomly selected from public and private schools using a table of random numbers. Blood pressure was measured after 5 minutes of rest in the sitting position with an aneroid sphygmomanometer and a cuff suitable to the pupil’s arm circumference according to WHO standard procedures. Nutritional and growth status were determined using z-score for BMI-for-age and height-for-age (HA). Pearson correlation was used to determine the correlation coefficients between anthropometric indices and blood pressure parameters. Study findings revealed a z-score of < -3 in 4.34% (n=5) of boys and 1.92% (n=2) of girls as severe wasting while severe stunting was recorded to be 2.61% (n=3) in boys and 1.92% (n=2) in girls. Significant differences (P ≤ 0.05) were not observed between severe thinness or stunting between boys and girls P ≤ 0.05 level of significant. Pearson correlation revealed a positive correlation between weight and Systolic BPs, Diastolic BPs and mean arterial pressures of the subjects ( r =0.77, 0.61, and 0.74 respectively). The study found out that severe malnutrition exists among the pupils, as significant percentages of the school children were thin and stunted. Blood pressure increased with age and was higher among pupils from private schools than among those from public schools.

Ubangida Suleiman, Olumuyiwa Adeyemi Owolabi, Abbas Olagunju et al.

SurvivalNGRead at source

Peer-reviewed articleOpenAlex11 Sept 2026

Beyond Conflict Presence: Cumulative Armed Insecurity and Childhood Stunting in Nigeria

Background: Stunting remains a major public health challenge in Nigeria, affecting 40% of children according to the Nigeria Demographic and Health Survey (NDHS, 2024) amid persistent insecurity orchestrated by Boko Haram/ISWAP insurgency, farmer-herder conflicts, and banditry. However, much of the existing studies treat conflict exposure as a binary condition, overlooking important differences in event frequency and fatality intensity and their potentially distinct implications for child growth and development. Aims: We aimed to assess whether cumulative conflict exposure, captured by event frequency and fatality intensity, better explains childhood stunting in Nigeria than measures of conflict presence alone. Methods: This cross-sectional analysis used the 2024 NDHS dataset (children under 59 months = 9,410), ACLED events (2009-2025 = 73,147), and UCDP GED (1990-2025 = 8,255) as data sources. Conflict events were geocoded to NDHS clusters using 5 km, 10 km, and 50 km buffers. The frequency and intensity of conflict exposure were estimated separately and jointly using weighted cluster-robust logistic regression. Model performance for cumulative exposure versus binary presence/absence exposure was assessed using AIC, BIC, and McFadden's pseudo-R². Results: Weighted prevalence of stunting was 39.1%, with the highest rate observed in the North-West at 52.4% and the lowest in the South-South at 17.9% (p < .001). Conflict experience also differed significantly across geopolitical zones based on both ACLED and UCDP GED indicators (p < .001). The adjusted result showed a significant negative correlation between higher frequency of ACLED events and stunting (AOR = 0.85, 95% CI: 0.76–0.97, p = .012). Overall, the findings indicate that the relationship between armed insecurity and stunting varies by the frequency, intensity, and cumulative nature of conflict exposure. Conclusions: Insecurity involving conflict was correlated with childhood stunting, although this was context-specific, depending on how conflict was captured and what data were utilised. Frequency was a better indicator than fatality, and cumulative metrics were not superior to non-cumulative indicators of conflict. Based on this study’s results, we recommend that nutrition interventions focus on regions experiencing the highest levels of insecurity and childhood stunting.

Tersoo Solomon Shaminja, Merlyn Barkhuizen

SurvivalProtectionNGRead at source

Peer-reviewed articleOpenAlex12 Sept 2026

Maternal Education, Religious Affiliation, and Child Undernutrition in Mion District, Ghana: Evidence of a Public Health Emergency

This study addresses this evidence gap by investigating maternal determinants of child nutritional status in a predominantly rural district where no prior published study had examined these relationships. A community-based analytical cross-sectional study was conducted among 340 mother-child pairs. Systematic random sampling was employed at Child Welfare Clinics across five sub-districts of Mion District. Associations between maternal factors and nutritional outcomes were assessed via bivariate chi-square and Fisher's exact tests at p < 0.05. Prevalence of stunting (22.4%), wasting (15.8%), and underweight (18.3%) significantly exceeded national averages of 18.4%, 5.3%, and 10.4% respectively. Notably, wasting exceeded the WHO emergency threshold of 15%, indicating a critical public health situation. Significant associations were identified between household income and wasting (p = 0.03), maternal religious affiliation and underweight (p = 0.006), and maternal educational level and stunting (p < 0.001). Stunting prevalence unexpectedly increased with maternal education, likely attributable to small sample sizes in higher education tiers and uncontrolled confounding. Maternal age, marital status, and occupation were not significantly associated with any nutritional outcome. Undernutrition in Mion District has reached WHO-defined emergency levels, necessitating an immediate scale-up of Community-based Management of Acute Malnutrition (CMAM) services. Interventions must be culturally tailored, engaging religious and community leaders to address nutritional disparities linked to religious affiliation, while integrating social protection programmes, including targeted cash transfers, to mitigate the impact of low household income on acute malnutrition.

Noble Tiire, Augustina Attiah, Seidu Abdul Hanan

SurvivalGHRead at source

Peer-reviewed articleOpenAlex17 Sept 2026

Early Body Mass Index z ‐Score Change and Resolution of Severe Malnutrition in Children With Sickle Cell Anemia in a Low‐Income Setting: A Prospective Single‐Arm Extension Study

BACKGROUND: Children with sickle cell anemia (SCA) in low-income settings are at risk of severe malnutrition, but optimal nutritional management has not been established. We evaluated an intensified ready-to-use therapeutic food (RUTF) regimen in children with persistent severe malnutrition after initial treatment and assessed whether early change in body mass index z-score (BMIZ) was prognostic of later resolution of severe malnutrition. PROCEDURE: Children aged 5-12 years with SCA and BMIZ less than -3.0 after 12 weeks of supplemental RUTF received higher intensity, weight-based RUTF plus hydroxyurea through Week 24. We examined whether the change in BMIZ from baseline to Week 4 was associated with the resolution of severe malnutrition (BMIZ ≥-3.0) by Week 12 or, among extension participants, by Week 24. RESULTS: Of 108 children, 66 (61%) entered the extension. During Weeks 12-24, 11 of 66 (17%) achieved resolution, increasing the cumulative proportion with BMIZ ≥-3.0 from 39% (42/108) at Week 12 to 49% (53/108) by Week 24. Greater improvement in BMIZ from baseline to Week 4 was associated with higher odds of resolution by Week 12 or, among extension participants, by Week 24 (OR 12.38; p < 0.001), whereas older age was associated with lower odds of resolution (OR 0.72; p = 0.006). Among extension participants, higher Week-12 BMIZ was associated with higher odds of Week-24 resolution (OR 14.44; p = 0.039). CONCLUSIONS: In children with SCA and severe malnutrition, early BMIZ improvement in this small, single-arm extension was associated with later resolution of severe malnutrition, and may help risk-stratify children who need earlier reassessment or alternative management, a prognostic signal that warrants prospective testing rather than an immediate change in practice.

Safiya Gambo, Shehu Umar Abdullahi, Hassan Adam Murtala et al.

SurvivalPre/postNGRead at source

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Routine Childhood Immunisation Coverage and Dropout Rates at a Tertiary Hospital in South-South Nigeria: A Four-Year Retrospective Review (2022–2025)

Gender Issues in Nigerian Newspapers Coverage of Maternal and Child Healthcare Issues

Attitude and Practice of Effective Weaning Techniques Among Breastfeeding Mothers Attending General Hospital Koko, Kebbi State, Nigeria

Zero-Dose and Dropout Children in Nigeria: A Comparative Machine Learning Analysis of Childhood Immunization Cascade Failure Using the 2023–24 Nigeria Demographic and Health Survey

Correlation of Nutritional Status and Blood Pressure of Apparently Healthy Primary School Pupils Aged 6–12 years in Zaria Local Government Area of Kaduna State

Beyond Conflict Presence: Cumulative Armed Insecurity and Childhood Stunting in Nigeria

Maternal Education, Religious Affiliation, and Child Undernutrition in Mion District, Ghana: Evidence of a Public Health Emergency

Determinants of Maternal Malnutrition and Child Health in Balanga LGA, Gombe State, Nigeria: A Qualitative Study

Ethnic Diversity and Child Health: New Insights From Ghana

Early Body Mass Index z ‐Score Change and Resolution of Severe Malnutrition in Children With Sickle Cell Anemia in a Low‐Income Setting: A Prospective Single‐Arm Extension Study

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