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International Journal of Research in Medical Science 2024; 6(1): 97-102 ISSN Print: 2664-8733 ISSN Online: 2664-8741 IJRMS 2024; 6(2): 97-102 www.medicalpaper.net Received: 04-11-2024 Accepted: 20-12-2024 Dr. Avijit Sharma Public Health Specialist, Assistant Director, Institute of Health Technology, Sylhet, Bangladesh Dr. Md. Alahi Khandaker Founder and Health Policy analyst, Bangladesh Center for Health Studies, Dhaka, Bangladesh Md. Rafiqul Islam Medical Technologist (EPI), In-charge, Vaccination Centre, Mugda Medical College Hospital, Dhaka, Bangladesh Shanta Saha Graduate Student, College of Health and Human Sciences Purdue University (West Lafayette Campus), USA. Association between the disease patterns of children and socio-demographic factors at tertiary Hospital, Dhaka Avijit Sharma, Md. Alahi Khandaker, Md. Rafiqul Islam and Shanta Saha DOI: https://doi.org/10.33545/26648733.2024.v6.i2b.79 Abstract Background: Socio-demographic determinants of child health in urban Bangladesh shed light on the problem of more extensive urbanization and inequality. Knowledge of these relationships is therefore paramount in the formulation of operation and intervention strategies within the health sector. Objective: This study was conducted to assess the relationship between the disease patterns of children attending Mugda Medical College Hospital, Dhaka, Bangladesh, and their socio-demographic characteristics. Methods: A cross-sectional study was done on patients attending the Pediatrics Outpatient Department from January to June 2024. Luckily, primary data regarding the socio-demographic characteristics and disease prevalence data among children were gathered through a purposive sample of 450 children, interviews, and medical records. Results: The findings demonstrate the relationship between socio-demographic characteristics and pediatric health in urban Bangladesh. The study population comprised 55% boys and 45% girls, with 60% from lower economic status. Maternal education levels were high, with 65% of mothers being higher secondary education. Disease patterns varied by age group: diarrhea (30%) was most common in neonates, while fever (40%) predominated in children aged 1-5 years. Nutritional issues persisted, with 10% low birth weight and 5% acute malnutrition. High rates of maternal counseling were observed across various health topics. Conclusion: The Study was able to identify the gaps in the understanding of pediatric healthcare and how these can help design better policies for the improvement of such healthcare delivery in urban areas with possible extension to other developing nations. Keywords: Pediatric outpatient, children, health, Socio-demographic. Corresponding Author: Dr. Md. Alahi Khandaker Founder and Health Policy analyst, Bangladesh Center for Health Studies, Dhaka, Bangladesh Email: dralahi@gmail.com Introduction Child health is essential in determining the health and wellbeing of a nation [1]. The young or children are very important to the present generation as well as the future of a nation. It is common for parents, grandparents, aunts, and uncles to be very motivated in giving all the possible support for the children in their families and that these children are healthy and should have all the chances they require for them to maximize their potential [2]. Therefore, identifying the association between socio-demographic characteristics and disease distribution in children in a country like Bangladesh that is experiencing urbanization and socioeconomic inequality is paramount for proper health care planning and service delivery [3]. This paper, based on a study done at Mugda Medical College Hospital in Dhaka, will seek to understand these relationships and what they mean for childhood health in urban Bangladesh. The wellbeing of children is determined by several factors, such as their economic status, education of parents, their standard of living, and their ability to afford medical care. These factors can, therefore, differ significantly within rapidly-developing urban areas such as Dhaka, resulting in a complex environment of health. It is crucial to identify these patterns to effectively intervene and develop policies based on the needs of a specific demographic group. However, within the period of the past decades, several commendable achievements have been scored by the country in child health, especially in the reduction of the infant and under-five mortality rates [4] . However, there are still barriers, especially in the emerging regions with high population ~ 97 ~ International Journal of Research in Medical Science https://www.medicalpaper.net growth, pollution, and socio-economic disparities that magnify diseases. Some of the diseases of major concern in this respect include pneumonia, acute diarrheal diseases, malnutrition, and neonatal conditions [5]. It is important to pay attention to the impact of maternal education and occupation on child health. Research has found a strong positive relationship between maternal education and better child health, probably because of enhanced health awareness, proper caregiving, and more effective use of health facilities. Likewise, the maternal occupation affects a child’s health through enhancing the family income, timing for child care, and the flow of health information to the family [6]. Undernutrition has not been completely eradicated in children; factors such as LBW, SAM, and MAM are still present in the community and pose their threats. Such nutrition issues may affect the well-being of children in terms of growth, development, and health for the rest of their lives. Furthermore, breaking down diseases by the age group— neonates, infants, and children up to five years—allows for the description of changes in health status as children develop. The details are useful in formulating interventions for the right age demographic and helpful in resource management in the healthcare system [7]. It is against this background that this study at Mugda Medical College Hospital presents an excellent opportunity to explore these factors. In contrast to the previous studies done in urban Bangladesh on children’s health issues, we hope that further understanding of the socio- demographic characteristics of patients and diseases related to these patients will help to better identify the problem of children’s health in urban Bangladesh. The insights derived from this knowledge can be used to direct focused efforts, allocate resources wisely, as well as bring about better quality of children’s healthcare [6]. The findings of the present study may have important implications for both clinical practice and public health initiatives. In fact, acknowledging special needs of certain populations and common diseases and conditions would help in designing better plans and approaches to the promotion of health, prevention of diseases, and delivery of care. In addition, examining the relationships between several diseases and the socio-demographic characteristics enables one to forecast the emerging tendencies in the healthcare system and adapt it to the changing demands [8]. Thus, while describing the findings of this study, it is the intention of the authors to present a clear and coherent understanding of the situation concerning pediatric health and its bearing on sociodemographic factors in the context of Mugda Medical College Hospital. This information would be useful for practitioners, policymakers, and academics who are interested in enhancing child health status in Bangladesh and other similar urban contexts in developing countries. Results Table 1 shows the distribution of respondent children by sex. Out of 450 children, 247 (55.0%) were boys, and 203 (45.0%) were girls, indicating a slightly higher proportion of male children in the study population. Table 1: Distribution of The Respondent Children by Sex (N=450) Sex Boy Girl Total N 247 203 450 % 55 45 100 Fig 1: Pie Chat Showed Distribution of the Respondent Children by Sex (N=450) Table 2 presents the distribution of respondents by socioeconomic status. The majority (60.0%) belonged to the lower economic status (LES), followed by 30.0% from middle economic status (MES), and 10.0% from upper economic status (UES). This distribution reflects the diverse economic background of patients attending the hospital, with a predominance of lower-income families. Table 2: Distribution of The Respondent by Socioeconomic status (N=450) Socioeconomic status LES MES UES Total Materials and Methods This cross-sectional study was conducted at the Pediatrics Outpatient Department (OPD) of Mugda Medical College Hospital, Dhaka, from January to June 2024. A sample size of 450 children was selected using a purposive sampling technique. Data were collected on various socio-demographic factors and disease patterns of children through structured interviews and medical record reviews. Ethical considerations were maintained throughout the study. N 270 135 45 450 % 60 30 10 100 Fig 2: Column Chat Showed Distribution of the Respondent Children by Socioeconomic status (N=450) As shown in Table 3, a significant majority (80.0%) of the respondents were from urban areas, while 20.0% were from rural areas. This urban predominance is expected given the hospital’s location in Dhaka city. ~ 98 ~ International Journal of Research in Medical Science https://www.medicalpaper.net Table 5: Distribution of The Respondent by Mother Occupation (N=450) Table 3: Distribution of The Respondent by Residence (N=450) Residence Urban Rural Total N 360 90 450 % 80 20 100 Occupation Housewife Service Holder Others Total N 315 113 22 450 % 70 25 5 100 Fig 3: Pie Chat Showed Distribution of the Respondent by Residence (N=450) Fig 5: Pie Chat Distribution of the respondent by mother occupation (N=450) Table 4 illustrates the educational background of the children’s mothers. A substantial proportion (65.0%) of mothers were HSC, followed by 15.0% with SSC, 10.0% with Basic literacy, and 10.0% with others educational qualifications. This high level of maternal education is noteworthy and may influence health-seeking behaviors and child care practices. Table 6 presents the age distribution of the children. The majority (60%) were in the children category (presumably 15 years), followed by 30% infants, and 10% neonates. This distribution allows for a comprehensive analysis of disease patterns across different pediatric age groups. Table 4: Distribution of the respondent by mother education (N=450) Mother Education HSC SSC Basic literacy Others Total N 292 68 45 45 450 Table 6: Distribution of the respondent by age category of child (N=450) % 65 15 10 10 100 Age Category of Child Neonate Infant Children Total N 45 135 270 450 % 10 30 60 100 Fig 4: Bar Chat Showed Distribution of the Respondent by Mother Education (N=450) Fig 6: Column Chat Distribution of the Respondent by Age Category of Child (N=450) Table 5 shows the occupational status of the mothers. The majority (70.0%) were housewives, while 25.0% were service holders, and 5.0% had others occupations. This distribution suggests that a significant proportion of mothers are primarily engaged in child-rearing and household activities. Table 7 provides insights into various health issues. Nutritional problems were observed, with 10.0% of children having low birth weight (LBW), 2.0% with severe acute malnutrition (SAM), and 3.0% with moderate acute malnutrition (MAM). Eye problems were also noted, with 5.0% having conjunctivitis and 2.0% with corneal ulcers. ~ 99 ~ International Journal of Research in Medical Science https://www.medicalpaper.net Table 9: Distribution of The Respondent by Infant (< 1 Year) (N=450) Table 7: Distribution of The Respondent by Disease Patterns (N=450) Disease Patterns Nutritional Statistics LBW SAM MAM Eye Problems Conjunctivitis Corneal Ulcer Counseling of Mothers IYCF EBF IDD IDA N % 45 9 14 10 2 3 23 9 5 2 360 405 360 315 80 90 80 70 Disease Cough and Cold Diarrhea Pneumonia Fever Others Total N 23 135 135 90 23 450 % 5 30 30 20 5 100 Table 10: Distribution of The Respondent by Children (1 – 5 Year) (N=450) Disease Fever Diarrhea The same table shows high rates of maternal counseling on various health topics: 80.0% received counseling on Infant and Young Child Feeding (IYCF), 90.0% on Exclusive Breastfeeding (EBF), 80.0% on Iodine Deficiency Disorders (IDD), and 70.0% on Iron Deficiency Anemia (IDA). These high rates of counseling indicate a strong focus on preventive care and health education. Pneumonia Skin Problems Others Diseases Total N 180 90 113 23 45 450 % 40 20 25 5 10 100 Fig 8: Bar Chat Distribution of the Respondent by Neonate, Infant, Children (N=450) Fig 7: Pie Chat Distribution of the Respondent by Disease Patterns (N=450) Tables 8, 9, and 10 present disease patterns for neonates, infants, and children aged 1-5 years, respectively. For neonates (Table 8), diarrhea was the most common issue (30%), followed by pneumonia and very severe diseases (20% each), and cough and cold (15%). Table 8: Distribution of The Respondent by Neonate (0 – 28 Days) (N=450) Disease Cough and Cold Pneumonia Very Severe Diseases Diarrhea Others Total N 68 90 90 135 68 450 % 15 20 20 30 15 100 Among infants (Table 9), diarrhea and pneumonia were equally prevalent (30% each), followed by fever (20%), and cough and cold (5%). For children aged 1-5 years (Table 10), fever was the most common complaint (40%), followed by pneumonia (25%), diarrhea (20%), and skin problems (5%). These age-specific disease patterns highlight the changing health needs as children grow, with implications for targeted interventions and resource allocation in pediatric healthcare. Discussion The study’s findings are informative regarding sociodemographic characteristics and disease patterns of children being treated at Mugda Medical College Hospital in Dhaka. The respondents were also more inclined towards boys, with 55% of the respondents being boys while 45% were girls, which shows a similarity to the general population density ratio in Bangladesh. [3] also found such a distribution in rural Bangladesh, which implies that this pattern is not unique to an urban environment. It is also necessary to mention that this minor male dominant could also be related to the gender bias in treatment seeking, if any, and has been established in most South Asian countries [9]. In terms of the socioeconomic status, 60% of the participants belong to the lower economic status (LES) that supports the study conducted by Rahman et al. (2018) [10] in Dhaka’s slum area. Thus, the fact that 62% of patients treated in LES are in public hospitals points to the importance of these institutions in supporting economically disadvantaged groups of the population. Thus, the fact that 10 percent of patients belong to UES hints at the hospital’s ability to attract patients from different economic backgrounds, probably because of its reputation or additional services. It is expected to have many urban residents (80%) due to the location of the hospital but is way above the national urban population percentage, which currently stands at about 37% [11]. This urban bias underlines the importance and capacity of urban health facilities to further extend into the fast- urbanizing region such as Dhaka. The education level of mothers in our study was relatively high, where 65% of the mothers were graduates. This is way above the national ~ 100 ~ International Journal of Research in Medical Science https://www.medicalpaper.net female literacy rate of 72.9%, according to UNESCO global data for 2020 [12]. This could be attributed to the fact that the study was conducted in urban areas or may be as a result of sampling bias, whereby educated families were dominated in the study. With regard to the independent variables, the high proportion of maternal counseling identified could be attributed to the elevated education level of the respondents. The concept of educative motherhood is related to the fact that mothers with higher education levels are more likely to consult and obtain health information [8]. The disease patterns evident in various age groups depict some of the following interesting characteristics: Among neonates, the most frequent concern was diarrhea (30%); the next common concerns were pneumonia and VSD. This corresponds with global trends of neonatal morbidities as highlighted by the WHO (2020) [13]. Nevertheless, the high level of reported diarrhea episodes requires enhancement regarding sanitation and hygienic facilities, especially within the context of urban Bangladesh. Infants and children of one to five years of age, respiratory infections such as pneumonia, and diarrheal diseases remain problematic. This is in concordance with the Nasreen et al. (2019) [14] study on under five morbidity patterns in Bangladesh. Nevertheless, the research revealed a greater number of children in the 1–5 year age group with fever—40 percent—and the cause of the condition remains ambiguous, and further research should be conducted. In the nutrition category, issues that were still present were 10% with low birth weight (LBW), and overall acute malnutrition was 5% (SAM and MAM). These values, however, are higher than the international figures according to UNICEF (2019) [15] but slightly lower if compared to the South Korean rates with which our study population shares similarities in terms of urban residence and high educational status of mothers. Maternal counseling regarding various health issues (IYCF, EBF, IDD, IDA) appears to be good and is in line with Bangladesh’s endeavor to provide education and preventive measures to enhance maternal and child health [7]. But even in regions with high counseling rates, nutritional problems still prevail, pointing to the insufficient effectiveness of such educational endeavors. Although these observations highlight the scenario only of Mugda Medical College Hospital, they are rich in terms of illuminating the situation of pediatric health in urban Bangladesh. They demonstrate how socio-demographic risk factors and health status are connected and stress the necessity of considering the context when determining how to intervene in the system of healthcare. Conclusion This study is an essential reference for understanding the current status of children’s health in urban Bangladesh due to the findings of sociodemographic characteristics and disease patterns among children at Mugda Medical College Hospital in Dhaka. The research findings therefore show that the public hospitals offer important services to different and needy groups, especially those with low income. On the positive side, high maternal education levels should translate into better health-seeking behaviors and receptiveness to counseling. This is a problem of disease specific to different ages that requires action to be taken in terms of diarrhea and respiratory infections. There are still nutritional issues affecting children, although some factors, such as living in urban areas and education, may enhance child nutritional status. High rates of maternal counseling suggest that prevention is a focal point, though issues concerning utilization of knowledge persist. Future studies should examine factors that hinder improvement of the above behaviors and disseminate the concept of urban health to the rural areas in Bangladesh for better child health. References 1. Bhandari B, Bak Y, Lee M, Chon S, Bhattachan M, Rimal P. Assessment of socio-demographic factors, mother and child health status, water, sanitation, and hygienic conditions existing in a hilly rural village of Nepal. Int J Environ Res Public Health. 2019;16(20):3965. DOI: 10.3390/ijerph16203965. 2. National Research Council (US), Institute of Medicine (US). Children’s health, the nation’s wealth: Assessing and improving child health. NIH.gov; National Academies Press (US); c2012. Available from: https://www.ncbi.nlm.nih.gov/books/NBK92210/ 3. Chowdhury MRK, Rahman MS, Billah B, Kabir R, Perera NKP, Kader M. The prevalence and sociodemographic risk factors of coexistence of stunting, wasting, and underweight among children under five years in Bangladesh: A cross-sectional study. BMC Nutr. 2022;8(1). doi: 10.1186/s40795-022-00584-x. 4. Kabir R, Farag M, Lim HJ, Geda N, Feng C. Sociodemographic and environmental risk factors associated with multiple under-five child loss among mothers in Bangladesh. BMC Pediatr. 2021, 21(1). DOI: 10.1186/s12887-021-03034-y. 5. Kehoe SH, Krishnaveni GV, Veena SR, Guntupalli AM, Margetts BM, Fall CHD. Diet patterns are associated with demographic factors and nutritional status in South Indian children. Matern Child Nutr. 2013;10(1):145–58. DOI: 10.1111/mcn.12046. 6. Somanii A. Influence of socio-demographic factors on the diarrheal disease management approaches taken by two distinct communities of Bangladesh. JABET. 2019. 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New York: UNICEF; 2019. How to Cite This Article Sharma A, Khandaker MA, Islam MR, Saha S. Association between the disease patterns of children and socio-demographic factors at tertiary Hospital, Dhaka. International Journal of Research in Medical Science 2024; 6(2): 97-102. Creative Commons (CC) License This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 4.0 International (CC BY-NC-SA 4.0) License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms ~ 102 ~