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Birhanu MT, Liga AD, Jabir YN. Practices of hygiene during complementary food feeding and associated factors among women with children aged 6-24 months in Dedo district, Southwest Ethiopia: A cross-sectional study. Health Sci Rep 2023; 6:e1771. [PMID: 38111740 PMCID: PMC10725999 DOI: 10.1002/hsr2.1771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 11/29/2023] [Accepted: 12/04/2023] [Indexed: 12/20/2023] Open
Abstract
Background and Aims Poor food handling practices contribute to food contamination, leading to food-borne illnesses and childhood diarrhea in developing countries like Ethiopia. This study examines hygienic complementary food feeding practices and associated characteristics among women with children ages 6-24 months in the Dedo District. Method A community-oriented cross-sectional study design was used in a multistage sampling strategy to gather information from 501 mothers of children between May 25 and July 10, 2022. There were absolute and relative frequencies assigned to each variable. Multiple logistic models have been used for factors that were 20% significant in univariate analysis. Odds ratios with corresponding 95% confidence intervals (CI) were produced to identify the important predictors. Results This study showed that mothers with a diploma (adjusted odds ratio [AOR]: 11.2; CI: 5.51-22.8), urban residency (AOR = 6.35; CI: 3.57-11.3), a positive attitude toward hygienic complementary food feeding (AOR = 2.23; CI: 1.19-4.20), good knowledge of complementary food feeding practices (AOR = 3.95; CI: 2.39-6.55), access to a hand washing facility close to the latrine (AOR = 2.60; CI: 1.55-4.36), and access to water close to their home (AOR = 2.42; CI: 1.27-4.59) were highly associated with good hygiene practices of mothers. Conclusion This study shows that mothers of children aged between 6 and 24 months have a very low overall prevalence of good hygienic complementary feeding practices. The concerned parties should therefore establish a healthcare educational program for mothers that emphasizes the importance of hand washing and informs them about the dangers of improper complementary feeding practices.
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Affiliation(s)
| | - Abebe D. Liga
- Department of Statistics, College of Natural and Computational SciencesWolkite UniversityWolkiteEthiopia
| | - Yasin N. Jabir
- Department of Statistics, College of Natural ScienceJimma UniversityJimmaEthiopia
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Kassaw A, Kassie YT, Kefale D, Azmeraw M, Arage G, Asferi WN, Munye T, Demis S, simegn A, Agimas MC, Zeleke S. Pooled prevalence and its determinants of stunting among children during their critical period in Ethiopia: A systematic review and meta-analysis. PLoS One 2023; 18:e0294689. [PMID: 38019780 PMCID: PMC10686443 DOI: 10.1371/journal.pone.0294689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 11/07/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Stunting is a major public health concern, particularly in low and middle-income countries. Globally, nearly 149 million under-five children are suffering from stunting. Despite it can occur in all age groups, the impact is more severe among children age less than 24 months as this period is critical time of very rapid growth and development. Therefore, this review aimed to determine the pooled prevalence and determinants of stunting among children during this critical period in Ethiopia. METHODS The literature search was conducted using international electronic data bases (pumed, Google scholar, CINHAL, Hinari, open Google) and the hand search of reference lists of eligible articles. The presence of heterogeneity between studies was evaluated using Cochrane Q-test and I2 test statistics and sensitivity analysis was also checked. Small study effect was checked through graphical and statistical test. Sub-group analysis was performed to handle heterogeneity. RESULTS This study included 14 studies with a total sample size of 8,056 children. The overall pooled estimate of stunting was 35.01(95% CI: 24.73-45.28, I2 = 98.98%) in the country with the highest prevalence in Amhara region. Increased Child's age (OR = 3.83; 95% CI: 2.47-5.18, I2 = 97.76%), no maternal education (OR = 2.90; 95%CI: 1.59-4.20, I2 = 89.73%), no maternal postnatal follow up (OR = 1.81; 95% CI:1.51-2.10) less than four food diversity of the child (OR = 2.24;95%CI; 1.94-2.55,I2 = 21.55%), low maternal body mass index, failure to colostrum and exclusive breast feeding, two and more under five children in the household and poor wealth index of the family were significant factors of stunting. CONCLUSION AND RECOMMENDATIONS The pooled prevalence of stunting among children during their critical time is high. Increased Child's age, no maternal education and no maternal postnatal follow up, less than four food diversity of the child, low maternal body mass index, failure to colostrum and exclusive breast feeding, two and more under five children in the household and poor wealth index of the family were determinants of stunting. Therefore, providing continuous maternal postnatal follow up, increase awareness of mothers on importance of colostrum and exclusive breast feeding, feeding of children the recommended variety of foods and at large to improve the wealth status of the households are crucial interventions to meet national and international targets of zero stunting in children less than 2 years.
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Affiliation(s)
- Amare Kassaw
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Yohannes Tesfahun Kassie
- Department of Emergency and Critical Care Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Demewoz Kefale
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Molla Azmeraw
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Getachew Arage
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Worku Necho Asferi
- Department of Maternal and Neonatal Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tigabu Munye
- Department of Adult Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Solomon Demis
- Department of Maternal and Neonatal Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Amare simegn
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Muluken Chanie Agimas
- Department of Epidemiology and Biostatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Shegaw Zeleke
- Department of Adult Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Sahiledengle B, Mwanri L, Blumenberg C, Agho KE. Gender-specific disaggregated analysis of childhood undernutrition in Ethiopia: evidence from 2000-2016 nationwide survey. BMC Public Health 2023; 23:2040. [PMID: 37853384 PMCID: PMC10585928 DOI: 10.1186/s12889-023-16907-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 10/05/2023] [Indexed: 10/20/2023] Open
Abstract
INTRODUCTION Childhood undernutrition has been investigated extensively in previous literature but gender inequality detailing the burden of undernutrition has not been adequately addressed in scientific papers, especially in Ethiopia, where undernutrition is known to be a public health problem of high significance, necessitating increased efforts to address it and reduce this inequality. This study was carried out to: (1) explore gender differences in the prevalence of stunting, wasting, and underweight, and (2) compare the factors associated with childhood undernutrition between boys and girls in Ethiopia. METHODS The study used a dataset of more than 33,564 children aged under 5 years (boys: 17,078 and girls: 16,486) who were included in the nationally representative Ethiopia Demographic and Health Survey (EDHS) from 2000 to 2016. The outcome variables were anthropometric indices: stunting (height-for-age < -2 standard deviations), wasting (weight-for-height < -2 standard deviations), and underweight (weight-for-age < -2 standard deviations). Gender-specific multilevel analyses were used to examine and compare the factors associated with child undernutrition. RESULTS The overall prevalence of stunting (49.1% for boys vs 45.3% for girls, p < 0.001), wasting (11.9% for boys vs 9.9% for girls, p < 0.001), and underweight (33.1% for boys vs 29.8% for girls, p < 0.001) higher among boys compared to girls. Boys significantly had higher odds of stunting (aOR: 1.31, 95%CI: 1.21-1.42), wasting (aOR: 1.35, 1.23-1.48), and underweight (aOR: 1.38, 95%CI: 1.26-1.50) than girls. The common factors associated with childhood undernutrition for male and female children were the child's age, perceived size of the child at birth, breastfeeding status, maternal stature, maternal education, toilet facility, wealth index, and place of residence. Boys who were perceived by their mothers to be average sized at birth and were born to uneducated mothers had a higher likelihood of experiencing wasting, in contrast to girls. Among boys, birth order (firstborn), household size (1-4), and place of residence (urban) were associated with lower odds of being underweight. Boys living in cities had lower odds of being stunted. While girls born to mothers with no education and worked in agriculture were at a higher odd of being stunted. CONCLUSION Our study revealed that boys were more likely to be malnourished than girls, regardless of their age category, and there were variations in the factors determining undernutrition among boys and girls. The differences in the burden of undernutrition were significant and alarming, positioning Ethiopia to be questioned whether it will meet the set Sustainable Development Goals (SDGs), including SDG 2 of zero hunger by 2030. These findings call for more effort to address malnutrition as a significant public health issue in Ethiopia, and to urgently recognise the need for enhanced interventions that address the gender gap in childhood undernutrition.
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Affiliation(s)
- Biniyam Sahiledengle
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia.
| | - Lillian Mwanri
- Research Centre for Public Health, Equity and Human Flourishing (PHEHF), Torrens University Australia, Adelaide Campus, SA, 5000, Australia
| | - Cauane Blumenberg
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Causale Consultoria, Pelotas, Brazil
| | - Kingsley Emwinyore Agho
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
- School of Medicine, Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Penrith, NSW, 2571, Australia
- Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
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Som SV, Wieringa FT, Campos Ponce M, Polman K, Dakurah P, Duncan D, Blomberg J, Rasphone S, Hoeven MVD. Association of both Water, Sanitation and Hygiene (WASH) and Infant and Young Child Feeding (IYCF) practices with childhood malnutrition in Lao PDR: a cross-sectional study of the 2017 Lao Social Indicator Survey II. BMJ Open 2023; 13:e073974. [PMID: 37832981 PMCID: PMC10582958 DOI: 10.1136/bmjopen-2023-073974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/11/2023] [Indexed: 10/15/2023] Open
Abstract
OBJECTIVE We assessed whether Water, Sanitation and Hygiene (WASH) and Infant and Young Child Feeding (IYCF), either alone or combined, were associated with malnutrition among Lao People's Democratic Republic (Lao PDR) children aged 6 to <24 months. DESIGN This is a secondary analysis of the 2017 Lao Social Indicator Survey II (LSIS II), which used multistage probability proportional to size sampling. Logistic regression analyses were conducted with OR and its corresponding 95% CI. SETTING The LSIS II was conducted a nationwide household-based survey covering all 18 provinces in Lao PDR. PARTICIPANTS We had a total of 3375 children (weighted sample 3345) and 357 households with data on drinking water. OUTCOME MEASURES The outcomes of this study were stunting and wasting. RESULTS The prevalence of stunting and wasting was 28.9% and 10.1%, respectively. Even though households with access to a basic or improved water source were high (82.5%), over 83% of drinking water was contaminated with Escherichia coli. Access to improved sanitation, basic hygiene and adequate IYCF gave a significant lower risk of becoming stunted. The combined effect of these practices on stunting was (adjusted OR (AOR)=0.54; 95% CI=0.41 to 0.73) greater than each practice alone (improved sanitation: AOR=0.75; 95% CI=0.61 to 0.93; basic hygiene: AOR=0.69; 95% CI=0.57 to 0.83; adequate IYCF: AOR=0.79; 95% CI=0.64 to 0.98). Access to improved sanitation and adequate IYCF was associated with a significant lower risk for being wasted, and again the combined effect of these practices was (AOR=0.64; 95% CI=0.44 to 0.92) greater than each practice alone (improved sanitation: AOR=0.68; 95% CI=0.49 to 0.93 and adequate IYCF: AOR=0.66; 95% CI=0.47 to 0.92). CONCLUSION Given the strong associations with both stunting and wasting, and the added benefits when combining WASH and IYCF, there is a need of multisectoral interventions to reduce early childhood malnutrition in Lao PDR.
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Affiliation(s)
- Somphos Vicheth Som
- Section of Infectious Diseases, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank T Wieringa
- UMR QualiSud, French National Research Institute for Sustainable Development, Montpellier, France
| | - Maiza Campos Ponce
- Section of Infectious Diseases, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Katja Polman
- Section of Infectious Diseases, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Prosper Dakurah
- United Nations Children's Emergency Fund Lao PDR, Vientiane, Lao People's Democratic Republic
| | - David Duncan
- United Nations Children's Emergency Fund Lao PDR, Vientiane, Lao People's Democratic Republic
| | - Janneke Blomberg
- United Nations Children's Emergency Fund Lao PDR, Vientiane, Lao People's Democratic Republic
| | - Sitthorot Rasphone
- The Ministry of Planning and Investment's National Economic Research Institute, Vientiane, Lao People's Democratic Republic
| | - Marinka van der Hoeven
- Section of Infectious Diseases, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Tekeba B, Tarekegn BT, Zegeye AF, Ayele AD. Stunting disparities and its associated factors among preschool children of employed and unemployed mothers in Gondar City: a comparative community-based cross-sectional study. Front Nutr 2023; 10:1172501. [PMID: 37743916 PMCID: PMC10512046 DOI: 10.3389/fnut.2023.1172501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 08/07/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction A stunted child refers to a child who is too short for his/her age, which is the most common cause of morbidity and mortality in children under five in developing countries. Stunting in preschool children is caused by a multitude of socioeconomic and child-related factors, including the employment status of women. This study aimed to compare the prevalence and factors associated with stunting of preschool children among employed and unemployed mothers in Gondar city, Northwest Ethiopia, in 2021. Methods From 30 February to 30 March 2021, a community-based comparative cross-sectional study was conducted among 770 preschool children of employed and unemployed mothers in Gondar city. A structured questionnaire-based interview with anthropometric measurements was used to collect data. A multi-stage sampling technique was used. Data were entered into EPI Info version 7.22 and transferred to Stata version 14 for further analysis. To identify factors associated with stunting, a binary logistic regression analysis was used. The presence of an association was declared based on a p-value of <0.05 and confidence intervals. Results A total of 770 preschool children participated in the study. The overall prevalence of stunting among preschool children was 39.7% (95% CI: 36.3-43.2). The prevalence was higher among preschool children of employed mothers (42.6%) (95% CI: 37.6-47.5) than among unemployed mothers (36.7%) (95% CI: 32.0-41.7). Maternal age [AOR = 2.8, 95% CI: 1.26-6.34] and wealth status [AOR = 0.32, 95% CI: 0.18-0.57] were significantly associated with stunting among unemployed mothers, while family size [AOR = 7.19, 95% CI: 2.95-17.5], number of children under the age of five [AOR = 1.92, 95% CI: 1.12-3.29], and having a home servant [AOR = 0.126, 95% CI: 0.06-0.26] were associated with stunting of preschool children among employed mothers. Conclusion Stunting is more common in preschool children of employed mothers than in those of unemployed mothers. As a result, interventions such as raising awareness among employed mothers to devote time and care to their children, as well as concerned bodies assisting women with preschool or under-five children, is required. The nutrition intervention should focus on encouraging dietary diversity to combat the existing nutrition-associated stunting in children. Similarly, further research on the difference between employed and unemployed mothers' child stunting status as well as an investigation of extra variables such as the number of hours worked by an employed mother is also recommended to upcoming researchers.
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Affiliation(s)
- Berhan Tekeba
- Department of Pediatrics and Child Health Nursing, University of Gondar, Gondar, Ethiopia
| | | | | | - Amare Demsie Ayele
- Department of Pediatrics and Child Health Nursing, University of Gondar, Gondar, Ethiopia
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Masilela LN, Modjadji P. Child Nutrition Outcomes and Maternal Nutrition-Related Knowledge in Rural Localities of Mbombela, South Africa. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1294. [PMID: 37628293 PMCID: PMC10453191 DOI: 10.3390/children10081294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/20/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023]
Abstract
Poor nutrition outcomes among children have become one of the major public health concerns in South Africa, attributed to poor feeding practices and maternal nutrition-related knowledge with conflicting data. In view of this, a cross-sectional study was conducted to determine the association of nutrition outcomes of children aged under two years with feeding practices and maternal nutrition-related knowledge in Mbombela, South Africa. Mothers' nutrition-related knowledge was estimated using an adapted structured questionnaire on colostrum, continued breastfeeding, diarrhea prevention and treatment using oral rehydration solution, immunization, and family planning, and scored as excellent (80-100), good (60-79), average (40-59), and fair (0-39). This was along with questions on socio-demographic factors and obstetric history, as well as anthropometric measurements. Child nutrition outcomes were estimated by WHO classification using z-scores for stunting (length-for-age (LAZ)), underweight (weight-for-age (WAZ)), and thinness (body mass index-for-age (BAZ)). Using STATA 17, 400 pairs of children (8 ± 6 months) and their mothers (29 ± 6 years) participated in the study and were living in a poor socio-economic status environment. Half of children were stunted (50%) and over half (54%) were obese, while mothers were underweight (39%) and overweight (34%). In addition to one third of mothers reporting obstetric complications, two thirds, initiated breastfeeding within one hour of delivery, 30% exclusively breastfed, 48% introduced early complementary feeding, and 70% practiced mixed feeding. Twenty-eight percent (28%) of mothers had fair nutrition-related knowledge, while 66% had average knowledge, 6% good knowledge, and none of the mothers had excellent knowledge. A chi-square test showed that mothers' nutrition-related knowledge was significantly associated with child stunting. The final hierarchical logistic regression showed significant associations of stunting with mothers' nutrition-related knowledge (average: AOR = 1.92, 95%CI: 1.12-3.29), child's age (6-11 months: AOR = 2.63, 95%CI: 1.53-4.53 and 12-23 months: AOR = 3.19, 95%CI: 1.41-7.25), and education (completing Grade 12: AOR = 0.36, 95%CI: 0.15-0.86). Contextual and intensified interventions on continued education for mothers to gain accurate information on nutrition-related knowledge and feeding practices could ultimately enhance child nutrition outcomes in poorer settings. Efforts should therefore be made to ensure that nutrition knowledge is appropriately provided based on the phases of child growth from 0 to 2 years, even beyond infancy into school age.
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Affiliation(s)
- Lucy Nomsa Masilela
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, 1 Molotlegi Street, Ga-Rankuwa, Pretoria 0208, South Africa
| | - Perpetua Modjadji
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, 1 Molotlegi Street, Ga-Rankuwa, Pretoria 0208, South Africa
- Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town 7505, South Africa
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Getu BD, Azanaw KA, Zimamu LY, Adal GM, Tibebu NS, Emiru TD, Atalell KA. Wasting and its associated factors among children aged from 6 to 59 months in Debre Tabor town, Amhara region of Ethiopia, 2019: a multicentre community-based cross-sectional study. BMJ Open 2023; 13:e071679. [PMID: 37407062 DOI: 10.1136/bmjopen-2023-071679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/07/2023] Open
Abstract
OBJECTIVES Wasting is acute malnutrition that has harmful short-term consequences for children and is determined by an inadequate diet. This study aimed to assess the prevalence and associated factors of wasting among children aged 6-59 months in Debre Tabor town, Ethiopia. DESIGN This study was a community-based cross-sectional. SETTING The study was conducted at Debre Tabor town, Ethiopia. PARTICIPANTS A total of 436 children aged 6-59 months participants were enrolled. OUTCOME MEASURES A weight-for-height z-score, which is below -2 SD of the WHO median standard curve, was used to measure wasting. Logistic regression analyses were done to see which independent variables have an association with the dependent variable and a p value of <0.05 was considered significant at the 95% CI. RESULTS The result revealed that wasting in children aged 6-59 months was 6.2%. Children in the age group of 6-11 months were 4.3 times more likely to have wasted than those in the age group of 24-59 months (adjusted OR (AOR): 4.3; 95% CI: 1.5 to 12.5). Similarly, parents who have poor wealth status in their family are 3.1 times more likely to have wasted children than those who have rich wealth status in their family (AOR: 3.1 (1.01 to 9.35)). Moreover, mothers who gave birth at the age group of 20-25 years were 4.3 times more likely to have wasted children than those who gave birth at an age group of greater than 30 years (AOR: 4.3 (4.3 (1.56 to 12.5)). CONCLUSION Wasting is still an important public health problem for children in the age group of 6-59 months. The age of the child, the wealth status of the family, and giving birth before 20 years of age were significantly associated with wasting. Therefore, the government of Ethiopia should pay further attention to the wealth status of the family; create awareness among the mothers regarding childhood undernutrition care, and design further nutritional intervention programmes.
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Affiliation(s)
- Bisrat Dessie Getu
- Department of Nursing, Debre Tabor Health Sciences College, Debre Tabor, Ethiopia
| | | | | | - Gashaw Mekete Adal
- Department of Nursing, Debre Tabor Health Sciences College, Debre Tabor, Ethiopia
| | - Nigusie Selomon Tibebu
- Department of Pediatrics and Child Health Nursing, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tigabu Desie Emiru
- Department of Pediatrics and Child Health Nursing, Debre Tabor University, Debre Tabor, Ethiopia
| | - Kendalem Asmare Atalell
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Zelalem H, Demilew YM, Dagne S, Dessie AM. Prevalence of under-nutrition and its associated factors among 6–23 months old children of employed and unemployed mothers in town kebeles of Dera district, northwest Ethiopia: a comparative cross-sectional study. BMC Nutr 2023; 9:59. [PMID: 36978152 PMCID: PMC10053462 DOI: 10.1186/s40795-023-00713-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
Abstract
Background
Child under-nutrition remains a widespread problem around the globe. Improving child nutrition and empowering women are two important and closely connected development goals. These two interconnected goals will affect one another through different mechanisms, and the net effect may not necessarily be positive. Yet, the impact of maternal employment, one method of empowering mothers, on children’s nutritional is not well studied in Ethiopia. Hence, this study is to compare the prevalence of under-nutrition and its associated factors among 6–23 months old children of employed and unemployed mothers in town kebeles of Dera district, Northwest Ethiopia, 2022.
Methods
A community-based comparative cross-sectional study design was conducted among 356 employed and 356 unemployed mothers having 6–23 months old children. A systematic random sampling technique was used to select study participants. Epi-data version 3.1 and SPSS version 25.0 statistical software were used for data entry and analysis, respectively. Both bi-variable and multivariable binary logistic regression was done to assess the association between independent and dependent variables. A p-value of less than 0.05 in a multivariable binary logistic regression was declared as the level of statistical significance.
Result
The prevalence of under-nutrition was 69.8% (95% CI: 65.0, 74.7) among children of unemployed mothers, compared to 27.4% (95% CI: 22.7, 32.2) among children of employed mothers. Under-nutrition among children of unemployed mothers was significantly associated with being a male child, age increase by one month, household food insecurity, lack of ANC follow-up, and not exclusively breastfed. Whereas, among children of employed mothers, being a male child, age increase by one month, being sick during the last two weeks prior to data collection, not immunized to their age, and low meal frequency were significantly associated with their under-nutrition.
Conclusion
The prevalence of under-nutrition among children of unemployed women is significantly higher than those children of employed women which consolidate the evidence that women’s employment status have a positive association with child nutrition. Different factors were also identified as significant predictors of child under-nutrition among these two groups (employed and unemployed women). Thus, multi-sectoral intervention approach together with agriculture and education offices should be strengthened.
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Olcina Simón MA, Soriano JM, Morales-Suarez-Varela M. Assessment of Malnutrition among Children Presenting in a Nutrition Center in Gimbichu, Ethiopia. CHILDREN 2023; 10:children10040627. [PMID: 37189876 DOI: 10.3390/children10040627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 03/19/2023] [Accepted: 03/25/2023] [Indexed: 03/30/2023]
Abstract
Nowadays, Ethiopia has several problems affecting children below 5 years of age, resulting in low life expectancies. Our group carried out a study to calculate the presence of malnutrition as wasting, stunting underweight, and BMI-for-age in children presenting in a nutrition center in a rural Ethiopian village in the Oromia region according to WHO guidelines. Our results demonstrated that they had moderate chronic malnutrition or stunting from 1 to 2 years of age, affecting their life, their parents, their community/household, and their country. In our viewpoint, the solution for this situation will require a global focus on several levels, including individual, family, community, and country, the last being with the help of new health policies focused on short-, medium-, and long-term strategies with multi- and interdisciplinary approaches.
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Zeleke AM, Bayeh GM, Azene ZN. Hygienic practice during complementary food preparation and associated factors among mothers of children aged 6-24 months in Debark town, northwest Ethiopia, 2021: An overlooked opportunity in the nutrition and health sectors. PLoS One 2022; 17:e0275730. [PMID: 36490237 PMCID: PMC9733846 DOI: 10.1371/journal.pone.0275730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 09/06/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Hygienic practices during complementary food preparation are suboptimal in developing countries, in Ethiopia in particular. Hygienic complementary food preparation is crucial to prevent childhood communicable diseases like diarrhea and associated malnutrition among children aged 6-24 months. However, in Ethiopia, there is a paucity of evidence on the practice of hygiene during complementary food preparation. Thus, this study is aimed to assess the hygienic practice of complementary food preparation and associated factors among women having children aged 6-24 months in Debark town, northwest Ethiopia. METHODS A community-based cross-sectional study was conducted among 423 mothers with 6-24 months of age children from December 1 to January 30, 2021. A simple random sampling technique was used to select the study participants. Data were collected using an interviewer-administered structured questionnaire. Epi-data version 4.6 and SPSS version 23 software were used for data entry and analysis, respectively. Binary logistic regressions (Bivariable and multivariable) were performed to identify statistically significant variables. Adjusted odds ratio with 95% CI was used to declare statistically significant variables on the basis of p-value < 0.05 in the multivariable logistic regression model. RESULTS The study revealed that 44.9% (95% CI (40.2, 49.4%)) of the mothers having children aged 6-24 months had good practice of complementary food preparation. Maternal age of 25-29 years[AOR:3.23, 95% CI: (1.555-9.031)], husband's attained secondary school and above (AOR:2.65, 95% CI (1.211-5.783)], using modern stove for cooking [AOR:3.33,95% CI (1.404-7.874)], having a separate kitchen[AOR: 8.59, 95%Cl: (2.084-35.376], and having a three bowl dishwashing system(AOR: 8.45, 95% CL: (4.444-16.053)) were significantly associated with good hygiene practice of complementary food preparation. CONCLUSIONS The findings have indicated that the majority of the mothers had poor hygienic practices of complementary food preparation. Mother's age, husband's educational status, type of stove used for cooking, having a separate kitchen, having a three bowl dishwashing system were factors that significantly influenced the hygiene practice of mothers during complementary food preparation. Therefore, training and counseling mothers and caregivers on complementary food processing and preparation is important and such endeavors which inform the development and implementation of complementary food hygiene interventions in urban communities are recommended.
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Affiliation(s)
- Agerie Mengistie Zeleke
- Department of Midwifery, School of Public Health, Teda Health Science College, Gondar, Ethiopia
| | - Gashaw Melkie Bayeh
- Department of Environmental Health, School of Public Health, Teda Health Science College, Gondar, Ethiopia
| | - Zelalem Nigussie Azene
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Determinants of undernutrition among young children in Ethiopia. Sci Rep 2022; 12:20945. [PMID: 36470914 PMCID: PMC9722653 DOI: 10.1038/s41598-022-25160-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 11/25/2022] [Indexed: 12/12/2022] Open
Abstract
Ethiopia is one of the countries in sub-Saharan Africa with the highest burden of childhood undernutrition. Despite the high burden of this scourge, little is known about the magnitude and contributing determinants to anthropometric failure among children aged 0-23 months, a period regarded as the best window of opportunity for interventions against undernutrition. This study examined factors associated with undernutrition (stunting, wasting, and underweight) among Ethiopian children aged 0-23 months. This study used a total weighted sample of 2146 children aged 0-23 months from the 2019 Ethiopian Mini Demographic and Health Survey. The data were cleaned and weighted using STATA version 14.0. Height-for-age (HFA), weight-for-height (WFH), and weight-for-age (WFA) z-scores < - 2 SD were calculated and classified as stunted, wasting, and underweight, respectively. Multilevel mixed-effects logistic regression models adjusted for cluster and survey weights were used. Adjusted odds ratio (AOR) and 95% confidence interval (CI) were estimated. Statistical significance was declared at p < 0.05. The overall weighted prevalence of stunting, wasting, and underweight respectively were 27.21% [95% CI (25.32-29.18)], 7.80% [95% CI (6.71-9.03)], and 16.44% [95% CI (14.90-18.09)] among children aged 0-23 months in Ethiopia. Female children were less likely to be associated with stunting [AOR: 0.68, 95% CI (0.54-0.86)], wasting [AOR: 0.70, 95% CI (0.51, 0.98)], and underweight [AOR: 0.64, 95% CI (0.49, 0.83)] than their male counterparts. Conversely, older children aged 12-17 months [AOR: 2.22, 95% CI (1.52, 3.23)] and 18-23 months [AOR: 4.16, 95% CI (2.75, 6.27)] were significantly at an increased odds of becoming stunted. Similarly, the likelihood of being underweight was higher in older age groups: 6-11 months [AOR: 1.74, 95% CI (1.15, 2.63)], 12-17 months [AOR: 2.13, 95% CI (1.40, 3.24)], and 18-23 months [AOR: 4.08, 95% CI (2.58, 6.44)] compared with the children younger than 6 months. Lower wealth quintile was one of the other significant determinants of stunting and underweight. The study's findings indicated that the most consistent significant risk factors for undernutrition among children aged 0-23 months are: male sex, older age groups and lower wealth quintile. These findings emphasize the importance of strengthening nutrition-specific and sensitive interventions that address the immediate and underlying drivers of childhood undernutrition in early life, as well as targeting low-income households with male children, in order for Ethiopia to meet the Sustainable Development Goals (SDGs) 1,2 and 3 by 2030.
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Is Infant and Young Child-feeding (IYCF) a potential double-duty strategy to prevent the double burden of malnutrition among children at the critical age? Evidence of association from urban slums in Pune, Maharashtra, India. PLoS One 2022; 17:e0278152. [PMID: 36455056 PMCID: PMC9714859 DOI: 10.1371/journal.pone.0278152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 11/10/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND This study characterized undernutrition among children (0-24 months) by age groups specified for Infant and Young Child-feeding (IYCF) and determined the association between child malnutrition and IYCF. METHODS This cross-sectional survey recruited mother-children dyads (N = 1443). WHO standards were used to assess nutritional status and IYCF indicators. Multivariate analyses were performed to assess the association between IYCF and nutritional indicators. RESULTS Stunting, underweight, wasting, overweight, and obesity were prevalent in 33.1%, 26%, 20.2%, 4.6%, and 2.9% of the children, respectively. Age-wise distribution of undernutrition identified severity of stunting and underweight at 10-24 months (median < -1.6 SD; < -1.2 SD; 25th percentile at -2.6 & -2.2 SD respectively) and wasting highest at 0-6 months (25th percentile close to -2SD). Boys manifested higher stunting (lower value -5.2 SD) and were more wasted (lower value -4.7 SD). IYCF prevalence recorded early initiation at 45.2%, exclusive breastfeeding at 23.1%, and prelacteal and bottle-feeding at 37.5 and 22.5% respectively. Child minimum diet diversity (MDD) ≥4 was not achieved by 84%. Minimum meal frequency and minimum acceptable diet were achieved by 75% and 14% respectively. Bottle-feeding increased the odds of wasting [AOR: 1.501 (95% CI: 1.062-2.121)], severe stunting [AOR: 1.595 (95% CI: 1.079-2.358)] and underweight [AOR: 1.519 (95% CI 1.102-2.094)]. Wasting according to BAZ scores was associated with delayed initiation of breastfeeding [AOR: 1.387 (95% CI: 1.018-1.889)] and bottle feeding [AOR: 1.538 (95% CI: 1.087-2.175)]. Delayed introduction of complementary feeding increased the odds of severe stunting [AOR: 2.189 (95% CI: 1.090-4.399)]. Formula feeding increased the odds of underweight [AOR: 1.738 (95% CI: 1.046-2.888)] and obesity [AOR: 4.664 (95% CI: 1.351-16.10)]. Prelacteal feeding increased the odds of severe forms of stunting and underweight by 56% and 79% respectively, and overweight by 96%. CONCLUSION Setting and age-specific interventions to improve age-appropriate child-feeding practices are vital to address the double burden of malnutrition in the critical age group.
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Sahiledengle B, Petrucka P, Kumie A, Mwanri L, Beressa G, Atlaw D, Tekalegn Y, Zenbaba D, Desta F, Agho KE. Association between water, sanitation and hygiene (WASH) and child undernutrition in Ethiopia: a hierarchical approach. BMC Public Health 2022; 22:1943. [PMID: 36261797 PMCID: PMC9583486 DOI: 10.1186/s12889-022-14309-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 09/20/2022] [Accepted: 10/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background Undernutrition is a significant public health challenge and one of the leading causes of child mortality in a wide range of developing countries, including Ethiopia. Poor access to water, sanitation, and hygiene (WASH) facilities commonly contributes to child growth failure. There is a paucity of information on the interrelationship between WASH and child undernutrition (stunting and wasting). This study aimed to assess the association between WASH and undernutrition among under-five-year-old children in Ethiopia. Methods A secondary data analysis was undertaken based on the Ethiopian Demographic and Health Surveys (EDHS) conducted from 2000 to 2016. A total of 33,763 recent live births extracted from the EDHS reports were included in the current analysis. Multilevel logistic regression models were used to investigate the association between WASH and child undernutrition. Relevant factors from EDHS data were identified after extensive literature review. Results The overall prevalences of stunting and wasting were 47.29% [95% CI: (46.75, 47.82%)] and 10.98% [95% CI: (10.65, 11.32%)], respectively. Children from households having unimproved toilet facilities [AOR: 1.20, 95% CI: (1.05,1.39)], practicing open defecation [AOR: 1.29, 95% CI: (1.11,1.51)], and living in households with dirt floors [AOR: 1.32, 95% CI: (1.12,1.57)] were associated with higher odds of being stunted. Children from households having unimproved drinking water sources were significantly less likely to be wasted [AOR: 0.85, 95% CI: (0.76,0.95)] and stunted [AOR: 0.91, 95% CI: (0.83, 0.99)]. We found no statistical differences between improved sanitation, safe disposal of a child’s stool, or improved household flooring and child wasting. Conclusion The present study confirms that the quality of access to sanitation and housing conditions affects child linear growth indicators. Besides, household sources of drinking water did not predict the occurrence of either wasting or stunting. Further longitudinal and interventional studies are needed to determine whether individual and joint access to WASH facilities was strongly associated with child stunting and wasting. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14309-z.
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Affiliation(s)
- Biniyam Sahiledengle
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia.
| | - Pammla Petrucka
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
| | - Abera Kumie
- School of Public Health, College of Health Science, Addis Ababa University, Ababa, Ethiopia
| | - Lillian Mwanri
- Torrens University Australia, Adelaide Campus, 5000, Adelaide, SA, Australia
| | - Girma Beressa
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Daniel Atlaw
- Department of Human Anatomy, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Yohannes Tekalegn
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Demisu Zenbaba
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Fikreab Desta
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Kingsley Emwinyore Agho
- School of Health Sciences, Western Sydney University, Locked Bag 1797, 2751, Penrith, NSW, Australia
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Raru TB, Ayana GM, Merga BT, Negash B, Deressa A, Birhanu A, Hassen FA, Roba KT. Magnitude of under-nutrition among under five children in Ethiopia based on 2019 Mini-Ethiopia Demographic and Health Survey: Generalized Linear Mixed Model (GLMM). BMC Nutr 2022; 8:113. [PMID: 36253811 PMCID: PMC9575191 DOI: 10.1186/s40795-022-00598-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 09/06/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Malnutrition is a major public health problem that is experienced by many developing countries, like Ethiopia. Though some studies were conducted to identify the magnitude and determinants of acute malnutrition among under-five children, there is a lack of evidence that is representative of all children in Ethiopia. Hence, this national-level data could be representative of all targets and provide us with updated information on the nation-wide magnitude of nutritional status among children under the age of five in Ethiopia. METHODS This study used data from the 2019 Mini-Ethiopia Demographic and Health Survey (EDHS). Children aged 0-59 months with anthropometry data were included. Data processing and analysis were performed using STATA 15 software. Cross-tabulations and summary statistics were done to describe the study population. Generalized Linear Mixed Models (GLMMs) were used to estimate the association between nutritional status and explanatory variables and were expressed as an odds ratio with a 95% confidence interval (CI). Model comparison was done based on Akaike and Bayesian information criteria (AIC and BIC). RESULTS The magnitude of stunting was 37.71% [95%CI: 36.35-39.08], while the magnitude of wasting was 7.14% [95%CI: 6.52-7.91]. Living in Tigray [AOR = 2.90, 95%CI: 2.05-4.11], Amhara [AOR = 1.98, 95%CI: 1.41-2.79], having a child aged 24-35 [AOR = 3.79, 95%CI: 3.07-4.68], and being a rural resident were all significantly associated with stunting. Being born in Tigray [AOR = 1.75, 95% CI: 1.02-3.01], being born into the richest family [AOR = 0.74, 95% CI: 0.27-0.80], and being born from mothers aged 25-29 [AOR = 0.73, 95% CI: 0.55-0.96] were all significantly associated with wasting. CONCLUSION The magnitude of stunting and wasting is relatively high in Ethiopia. Region, place of residence, and age of the child were significantly associated with stunting, and region, wealth index, and age of the child were significantly associated with wasting. This result provides a clue to give due consideration to under-five children to mitigate the risks of malnutrition through various techniques.
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Affiliation(s)
- Temam Beshir Raru
- School of Public Health, College of Health and Medical Sciences, Haramaya University, P.O. Box: 235, Harar, Ethiopia
| | - Galana Mamo Ayana
- School of Public Health, College of Health and Medical Sciences, Haramaya University, P.O. Box: 235, Harar, Ethiopia
| | - Bedasa Taye Merga
- School of Public Health, College of Health and Medical Sciences, Haramaya University, P.O. Box: 235, Harar, Ethiopia.
| | - Belay Negash
- School of Public Health, College of Health and Medical Sciences, Haramaya University, P.O. Box: 235, Harar, Ethiopia.
| | - Alemayehu Deressa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, P.O. Box: 235, Harar, Ethiopia
| | - Abdi Birhanu
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Fila Ahmed Hassen
- School of Public Health, College of Health and Medical Sciences, Haramaya University, P.O. Box: 235, Harar, Ethiopia
| | - Kedir Teji Roba
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Ahmed M, Zepre K, Lentero K, Gebremariam T, Jemal Z, Wondimu A, Bedewi J, Melis T, Gebremeskel A. The relationship between maternal employment and stunting among 6-59 months old children in Gurage Zone Southern Nation Nationality People's region, Ethiopia: A comparative cross-sectional study. Front Nutr 2022; 9:964124. [PMID: 36276826 PMCID: PMC9582235 DOI: 10.3389/fnut.2022.964124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/24/2022] [Indexed: 11/16/2022] Open
Abstract
Background Motivating proper nutrition during childhood is the basis for optimal health, learning, productivity, and social wellbeing throughout life. Stunting is among the major public health problems. According to the Ethiopian mini demographic and health survey, the prevalence of stunting among under five children was 37%. In addition, stunting has a trans-generational effect on a mother’s nutritional status. However, evidence on the causal contribution of maternal employment to stunting among under five children is not well understood in Ethiopia. This study aimed to compare the stunting status and associated factors among under five children of employed and unemployed mothers in the Gurage Zone, Southern Ethiopia, in 2021. A community-based comparative cross-sectional study was conducted among 671 (330 employed and 341 unemployed) randomly selected mother–child pairs in the Gurage Zone, Southern Ethiopia. A pretested semi-structured tool and validated anthropometric measurements were used to collect the data. The data were entered into Epi Data version 3.1 and exported to Statistical Package for Social Science (SPSS) version 23.0 for analysis. Frequency, percent, mean, median, and SD were computed and presented by using tables and figures. A bivariable and multivariable binary logistic regression analysis was conducted to assess the association between factors and outcome variables. Results In this study, a total of 671 mother–child pairs (330 (94.60%) employed and 341 (97.70%) unemployed) participated, with a total response rate of 96%. Among the total participants, about 70 (21.2%) [95% CI: (17.0, 25.5)] and 98 (28.8%) [95% CI: (23.0, 33.4)] of children of employed and unemployed mothers, respectively, were stunted. Mothers’ level of education, primary and secondary [AOR = 1.79, 95% CI: (0.8, 3.7), age between 25 and 29 years [AOR = 0.08, 95% CI: (0.006, 0.904)], monthly family income > 5,000 birr [AOR = 0.42, 95% CI: (0.00, 0.64)], and children aged between 6 and 23 months [AOR = 2.9; 95% CI: (1.48, 5.80)] were predictors of stunting among the children of employed mothers. Compared to the mothers who did not receive nutritional education [AOR = 2.5; 95% CI: (1.10, 5.60)], monthly family income of 2,000 ETB [AOR = 2.64; 95% CI: (1.34, 5.19)], sex of child (girl) [AOR = 2.3; 95% CI: (1.30, 3.80), and mothers educational status of read-and-write only [AOR = 2.9, 95% CI: (1.40, 5.80)] were predictors of stunting among the children of unemployed mothers. The nutrition intervention should focus on encouraging women’s education as it increases the probability of being employed, improving the income of families by using different income-generating strategies, and strengthening the existing essential nutrition counseling strategy. Likewise, further research work on the difference between employed and unemployed mothers on stunting status is also recommended to researchers.
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Affiliation(s)
- Mekiya Ahmed
- Maternal, Neonatal and Child Health and Nutrition Core Process, Gurage Zone Health Department, Wolkite, Ethiopia
| | - Kebebush Zepre
- Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia,*Correspondence: Kebebush Zepre, ;
| | - Kifle Lentero
- Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Tigist Gebremariam
- Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Zeyneba Jemal
- Maternal, Neonatal and Child Health and Nutrition Core Process, Gurage Zone Health Department, Wolkite, Ethiopia
| | - Asegedech Wondimu
- Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Jemal Bedewi
- Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Tamirat Melis
- Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Alazar Gebremeskel
- College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
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Gilano G, Hailegebreal S, Sako S, Seboka BT. Stunting and Associated Factors Among 6-23 Months Age Children in Ethiopia: Application of Generalized Linear Latent and Mixed Modeling. Ecol Food Nutr 2022; 61:608-623. [PMID: 35934984 DOI: 10.1080/03670244.2022.2109023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Low height/length-for-age (stunting) is a public health problem in Ethiopia. Efforts that have been made to evaluate factors affecting national and international strategies related to the problem are very limited and poorly achieved. The present study aimed to evaluate low length/height-for-age (stunting) and its associated factors among children 6 to 23 months of age in Ethiopia. We used cross-sectional data collected for 2019 EMDHS. We cleaned, processed, and analyzed in Stata v.15. Socio-demographic, socio-economic parameters, and nutritional (wasting, diet frequency, breast milk, and animal milk) factors were used in the analysis. We fitted Generalized Linear Latent and Mixed Model (GLLAMM) to examine the associations. We analyzed the data of 2,037 children aged 6-23 months and found stunting of 933.07(45.80%). Some factors such as home delivery [coef. = -4.58, 95% CI:-7.81,-1.34] and household size of ≥6 [coef. = -5.53, 95% CI:-10.36,-7.10] were positively associated. No current breastfeeding [coef. = 10.70, 95% CI: 2.16, 19.23] and still breastfeed [coef. = 10.68, 95% CI: 2.62, 18.74] were negatively associated with stunting. Stunting among 6-23 months aged children in Ethiopia is very high above all the national, regional, and international targets. Feeding practice, socio-economic, and psychosocial-support for mothers need revised commitment for pragmatic solution.
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Affiliation(s)
- Girma Gilano
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Samuel Hailegebreal
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Sewunet Sako
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Binyam Tariku Seboka
- Department of Health Informatics, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia
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Child undernutrition and associated factors among children 6-23 months old in largely food insecure areas of rural Ethiopia. J Nutr Sci 2022; 11:e63. [PMID: 35992573 PMCID: PMC9379930 DOI: 10.1017/jns.2022.61] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 06/01/2022] [Accepted: 07/12/2022] [Indexed: 12/14/2022] Open
Abstract
Child malnutrition is the leading public health problem in Sub-Saharan Africa, resulting in poor health and economic losses. Ethiopia has one of the highest child undernutrition rates in the world that occurs to multifaceted factors, including food insecurity. Thus, we performed a cross-sectional study to assess the prevalence and risk factors for child undernutrition in largely food insecure areas of Ethiopia. Data were collected from 354 mother-child pairs from the Siraro district. Both bivariate and multivariate logistic regression was used for statistical analysis. Variables with a P-value of <0⋅05 in multivariate analysis were used to detect statistical significance at a 95 % confidence level. About 67 % of households are food insecure. The prevalence of stunting wasting and underweight were 42⋅7, 9⋅9 and 27⋅7 %, respectively. Female gender, higher age of the child (12-23 months v. 6-11 months), living in a household with five or more siblings, not getting therapeutic zinc supplement at least once, inadequate diet diversity, lack of growth monitoring service, and maternal own income increases the likelihood of child undernutrition. It can be concluded that child undernutrition is a severe public health problem in the study area. Improving primary healthcare services related to zinc supplementation, growth monitoring and promotion, and improving infant and child feeding practices can be considered as a strategy to address the problem.
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Associated Factors of Wasting among Infants and Young Children (IYC) in Kuyu District, Northern Oromia, Ethiopia. BIOMED RESEARCH INTERNATIONAL 2022; 2022:9170322. [PMID: 35909485 PMCID: PMC9328999 DOI: 10.1155/2022/9170322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/20/2022] [Indexed: 11/28/2022]
Abstract
Wasting among infants and young children in underdeveloped countries including Ethiopia is one of the most serious public health issues. Therefore, this study was designed to assess the magnitude of wasting and the variables that associate with it among infants and young children in the Kuyu district of Northern Oromia, Ethiopia. A community-based cross-sectional study of 612 infants and young children aged 6-23 months was conducted. To select eligible infants and young children from each family in the Kuyu district, a multilevel sampling approach was used. The amount and determinants related to wasting were investigated using the Statistical Package for Social Sciences (SPSS) version 20.0. In the study area, 14.1% of infants and young children were found to be wasting. Maternal educational status (AOR = 1.8, 95% CI; 1.01, 4.32), diarrhoea (AOR = 2.3, 95% CI; 1.98, 4.56), exclusive breastfeeding (AOR = 2.46, 95% CI, 1.4, 4.58), antenatal care visits (AOR = 2.21; 95% CI, 1.32, 3.48), and wealth index (AOR = 1.66, 95% CI; 1.07, 4.47) were significantly associated with wasting. According to the findings of this study, mother educational status, the occurrence of diarrhoea, exclusive breastfeeding, antenatal care visits, and wealth index have an impact on infants and young children's wasting. Therefore, to lower the burden of wasting among infants and young children in the study, community-based schooling and nutritional interventions are urgently needed.
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Food Safety Practices and Stunting among School-Age Children—An Observational Study Finding from an Urban Slum of Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138044. [PMID: 35805701 PMCID: PMC9265275 DOI: 10.3390/ijerph19138044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/23/2022] [Accepted: 06/27/2022] [Indexed: 02/01/2023]
Abstract
Background: Food safety incorporates the handling, preparation, and storage of food materials in ways that prevent foodborne illness. We aimed to investigate the typical food safety practices in a Bangladeshi slum context and to explore if stunting among school-age children was associated with various components of food safety. Method: We analysed the MAL-ED birth cohort data from the Bangladesh site. A total of 265 healthy children were enrolled in the study; we could follow up and collect food safety-related data from 187 participants. Results: The average age of the children was 6.5 years (standard deviation or SD 0.04) and 49% of them were female. About 26% of the children were stunted. In our bivariate analysis, caregivers’ handwashing practice after using the toilet, treatment of drinking water, presence of insects/pests in the cooking area, and child’s eating ready-made/street food more than three times per day were significantly associated with stunting. After adjusting for pertinent factors, treatment of drinking water (adjusted odds ratio or AOR = 2.50, 95% confidence interval or CI: 1.03, 6.05), and child’s eating ready-made/street food more than three times/day (AOR = 2.34, 95%CI: 1.06, 5.15) remained significantly associated with stunting. Conclusions: Diverse aspects of food safety practices have a substantial association with stunting among school-age children living in an unhygienic slum environment in Dhaka, Bangladesh.
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Ekholuenetale M, Okonji OC, Nzoputam CI, Barrow A. Inequalities in the prevalence of stunting, anemia and exclusive breastfeeding among African children. BMC Pediatr 2022; 22:333. [PMID: 35681131 PMCID: PMC9178835 DOI: 10.1186/s12887-022-03395-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/01/2022] [Indexed: 11/21/2022] Open
Abstract
Background Childhood stunting and anemia are on the increase in many resource-constrained settings, without a counter increase in proper feeding practices such as exclusive breastfeeding. The objective of this study was to explore the prevalence of stunting, anemia and exclusive breastfeeding across African countries. Methods Demographic and Health Survey (DHS) data from 39 African countries was analyzed. Data from under 5 children were analyzed. Forest plot was used to determine inequalities in the prevalence of the outcome variables. Results The prevalence of stunting was highest in Burundi (56%), Madagascar (50%) and Niger (44%). In addition, Burkina Faso (88%), Mali (82%), Cote d’Ivoire and Guinea (75% each) and Niger (73%) had the highest prevalence of anemia. Furthermore, Burundi (83%), Rwanda (81%) and Zambia (70%) had the highest exclusive breastfeeding. We found statistical significant difference in the prevalence of stunting, anemia and exclusive breastfeeding (p < 0.001). Higher prevalence of stunting and anemia were estimated among the male, rural residents, those having mothers with low education and from poor household wealth. Conclusion Concerted efforts are required to improve childhood health, survival and proper feeding practice. Reduced stunting and anemia could be achieved through sustained socioeconomic improvement that is shared in equity and equality among the population. Interventions aimed at increasing food availability can also aid in the reduction of hunger, particularly in impoverished communities.
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Affiliation(s)
- Michael Ekholuenetale
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Chimezie Igwegbe Nzoputam
- Department of Public Health, Center of Excellence in Reproductive Health Innovation (CERHI), College of Medical Sciences, University of Benin, Benin City, Nigeria.,Department of Medical Biochemistry, School of Basic Medical Sciences, University of Benin, Benin, Nigeria
| | - Amadou Barrow
- Department of Public & Environmental Health, School of Medicine & Allied Health Sciences, University of The Gambia, Kanifing, The Gambia.
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Yuliantini E, Sukiyono K, Yuliarso MZ, Sulistyo B. Food Security and Stunting Incidences in the Coastal Areas of Indonesia. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Food insecurity is a condition determined by limited or uncertain access to nutritious food for active, healthy, disproportionate people or community of people who are not prepared to anticipate. Stunting in coastal areas such as Indonesia is still severe at 30.8%, higher than the global data at 22.2%. Stunting in sub-Saharan Africa is 34.5%, Ethiopia is 52.4%, and Congo is 40%. The World Health Organization has determined that nutritional problems in a country should be <20% since it leads to impaired growth, development, and degenerative diseases in later adulthood.
AIM: This study aimed to identify the risk factors of the determinant of food security and stunting in the Indonesian Coastal regions.
METHODS: This review was conducted by collecting literature from various publications or articles in English and Indonesian, using the online database of PubMed, ScienceDirect, ProQuest, and manual searching using Google Scholar in reputable journals since the 2000s regarding factors related to or influencing factors can determine food security and the occurrence of stunting in the Indonesian Coastal regions.
RESULTS: Several studies pointed out that one of the causes of stunting in children is the lack of good nutrition for an extended period and often not realized by the parents until their children reach over 2 years old and look stunted. Based on the results of the literature review, it shows that the risk factors for stunting in coastal areas of Indonesia include birth length at risk of 16.43 times, low maternal education at risk of 3.27 times, children living in villages at risk of 2.45 times, LBW at risk 4.5 times, no ANC at risk of 3.4 times, no immunization at risk of 6.38 times, and not exclusively breastfeed at risk of 4.0 times.
CONCLUSION: The results of this synthesis that consistently become risk factors for stunting in children in coastal areas are family socio-economic status (family income), mother’s education, low birth weight, premature birth, non-exclusive breastfeeding, length of birth, and macronutrient and micronutrient deficiencies. Those are given the complex risk factors for stunting.
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Ketema B, Bosha T, Feleke FW. Effect of maternal employment on child nutritional status in Bale Robe Town, Ethiopia: a comparative cross-sectional analysis. J Nutr Sci 2022; 11:e28. [PMID: 35573460 PMCID: PMC9066325 DOI: 10.1017/jns.2022.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 11/07/2022] Open
Abstract
Adequate nutrition is essential for early childhood to ensure healthy growth, proper organ formation, and function, a strong immune system, neurological and cognitive development. The main aim of the present study was to assess the effect of maternal employment on nutritional status among children aged 6-23 months in the town of Bale Robe, Ethiopia. A community-based comparative cross-sectional study was conducted on about 597 (293 unemployed and 304 employed) having children aged 6-23-month-old children sampled were employed with a multistage sampling technique. A face-to-face interview was conducted using a structured pretested questionnaire. Descriptive statistics, binary and multivariable logistic regression analyses were used for the statistical analysis. The magnitude of stunting (39.9 %), underweight (39⋅9 %) and wasting (22⋅2 %) was greater in 6-23-month-old children born to employed mothers than their counterparts in unemployed ones [stunted (31⋅3 %), underweight (24⋅0 %) and wasted (11⋅8 %)]. Being a girl [AOR 0⋅31; 95 % CI (0⋅17, 0⋅54)] in employed mothers and [AOR 0⋅29; 95 % CI (0⋅16, 0⋅51)] in unemployed people significantly protected stunting. This study demonstrated that the nutritional status of 6-23-month-old children is better among unemployed mothers than among employed mothers. Therefore, concerted efforts may decrease child undernutrition in a study area.
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Key Words
- Bale Robe
- EBF, Exclusive Breastfeeding
- Ethiopia
- HAZ, Height-for-Age Z-score
- Infant and young child
- MAD, Minimum Acceptable Diet
- MDD, Minimum Diet Diversity
- MMF, Minimum Meal Frequency
- MUAC, Mid-upper arm circumference
- MUACAZ, Mid-upper arm circumference-for-age Z-score
- PCA, Principal Component Analysis
- PI, Principal Investigator
- SPSS, Statistical Product and Service Solutions
- Stunting
- UNICEF, United Nations Children's Fund
- Underweight
- WAZ, Weight-for-Age Z-score
- WHO, World Health Organization
- WHZ, Weight-for-Height Z-Score
- Wasting
- sd, Standard Deviation
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Affiliation(s)
- Bezawit Ketema
- College of Agriculture, Hawassa University, P.O. Box 05, Hawassa, Ethiopia
| | - Tafese Bosha
- College of Agriculture, Hawassa University, P.O. Box 05, Hawassa, Ethiopia
| | - Fentaw Wassie Feleke
- College of Agriculture, Hawassa University, P.O. Box 05, Hawassa, Ethiopia
- College of Health Science, Woldia University, P.O. Box 400, Woldia, Ethiopia
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Anato A. Predictors of wasting among children under-five years in largely food insecure area of north Wollo, Ethiopia: a cross-sectional study. J Nutr Sci 2022; 11:e8. [PMID: 35291271 PMCID: PMC8889084 DOI: 10.1017/jns.2022.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/27/2021] [Accepted: 01/10/2022] [Indexed: 12/31/2022] Open
Abstract
Child undernutrition is widespread in low- and middle-income countries and is linked with weakened immunity and increased risks of morbidity and mortality. Ethiopia has made a marked reduction in stunting, but there has, however, been little progress in wasting reduction and limited evidence in food insecure areas may hamper the design of effective interventions. Therefore, the aim of the present study was to determine the contributing factors to persistent high prevalence of wasting among 6-59-month-old children. A community-based cross-sectional study was employed in February to March 2020, and included 384 mother-child pairs. Data were collected using a structured interviewer-administered questionnaire. Bivariate and multivariable logistic regression analyses were conducted. The overall prevalence of wasting was 12⋅8 % (95 % CI 9⋅1, 16⋅1); with 5⋅8 % severely wasted. Factors significantly associated with wasting were child age 6-23 (v. 24-59 months), delayed initiation of breast-feeding, diarrhoeal illness in the last 2 weeks, poor dietary diversity and low socioeconomic status. The present findings support that aligning poverty reduction interventions and healthcare services is important to accelerate wasting reduction more equitably and achieve the World Health Assembly's target and SDG goal #2 in the coming years. Improving accessibility and affordability of nutritious foods and early diagnosis and treatment of childhood morbidity are critical to address childhood wasting in the context of food insecure areas.
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Affiliation(s)
- Anchamo Anato
- Department of Human Nutrition, School of Nutrition, Food Science and Technology, Hawassa University, Hawassa, Ethiopia
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Tadele TT, Gebremedhin CC, Markos MU, Fitsum EL. Stunting and associated factors among 6-23 month old children in drought vulnerable kebeles of Demba Gofa district, southern Ethiopia. BMC Nutr 2022; 8:9. [PMID: 35078514 PMCID: PMC8790906 DOI: 10.1186/s40795-022-00501-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 01/06/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Stunting is impaired linear growth of children: they experience stunting in the first 1000 days after conception and is an indication of chronic malnutrition. Children under the age of two are regarded as the most vulnerable to malnutrition due to their rapid growth and greater exposure to infectious disease. OBJECTIVE To assess the magnitude and associated factors of stunting among 6 to 23-month-old children in drought-vulnerable kebeles of the Demba Gofa district, southern Ethiopia. METHODS A community-based cross-sectional study was conducted from February to March 2021. Systematic random sampling was used to select pairs of mothers/caregivers with children aged 6 to 23 months. A semistructured questionnaire and anthropometric measurement were used to collect the data. The data were checked coded and entered into Epi-data version 3.1 and exported to SPSS for Windows version 20.0 for analysis. Simple and multivariable linear regressions were conducted. The level of significance was declared at 95% CI and p-value < 0.05. RESULTS The magnitude of stunting in the study area was 79(21.82%). Household dietary diversity [β = 0.217, 95% CI, 0.093-0.342], early initiation of complementary feeding [β = 0.444, 95% CI, 0.344-0.543], frequency of breastfeeding within 24 h [β = 0.217, 95% CI, 0.179-0.263] and child eating animal source food [β = 0.351, 95% CI, 0.196-0.506] were positively significant predictors of child height/length-for-age (HAZ). CONCLUSION The extent of stunting in the study area is relatively lower than that in regional and national reports, but one out of five children were still stunted. Therefore, health education on infant and young child feeding practices should be provided to mothers to reduce the problem.
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Affiliation(s)
- Tuba Tringo Tadele
- College of Engineering and Agro-Processing Technology, Arbaminch University, Arba minch, Ethiopia
| | | | - Makiso Urugo Markos
- College of Agricultural Sciences, Wachemo University, P.O.BOX: 667, Hosaena, Ethiopia. .,College of Agriculture and Veterinary Medicine, Jimma University, P.O.BOX: 307, Jimma, Ethiopia.
| | - Endale Liben Fitsum
- College of Medicine and Health Sciences, Wachemo University, Hosaena, Ethiopia
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Hechera Y, Dona A. Prevalence of Undernutrition and Its Associated Factors Among Lactating Women in the Shebedino District, Sidama Regional State, Ethiopia. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221087883. [PMID: 35377250 PMCID: PMC8984848 DOI: 10.1177/00469580221087883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Ensuring the nutritional status of lactating women is crucial to
prevent maternal morbidity and mortality in poor countries like Ethiopia. Hence, this
study aimed to assess the prevalence of undernutrition and its associated factors among
lactating women in Shebedino district, Sidama Regional State, Ethiopia. Methods: A community-based cross-sectional study was conducted among
randomly selected 612 lactating women from February to March 2020. Data were collected by
using an interviewer-administered, structured, and pretested questionnaire. Also, physical
measurements (weight, height, and body mass index) were measured by using standardized and
calibrated instruments. Data entered into Epi data version 3.1 and exported to SPSS
version 23 for further analysis. Descriptive statistics, bivariable, and multivariable
logistic regression analysis were done. A P-value of ≤.05 was used to
consider the statistical significance. Result: The prevalence of undernutrition was 25.9% (95% CI: 22.5, 29.5).
Having polygamous husband (AOR = 3.47, 95% CI: 1.13, 10.68), belonged to households with
less than 5 members (AOR = 1.81, 95% CI: 1.16, 2.83), abortion history in the last
6 months (AOR = 3.09, 95% CI: 1.73, 5.51), poor household wealth status (AOR = 3.85, 95%
CI: 1.89, 7.81), and medium wealth status (AOR = 2.07, 95% CI: 1.06, 4.03) were factors
positively associated with undernutrition. Conclusion: Undernutrition among lactating women was high in the study area.
Attention should be given to the economic status of the women, family planning services,
abortion prevention, and habits of marrying more than 1 wife (polygamy).
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Affiliation(s)
- Yonas Hechera
- Sidama Regional State Health Bureau, Hawassa, Ethiopia
| | - Aregahegn Dona
- Department of Social and Population Health, Yirgalem Hospital Medical College, Yirgalem, Ethiopia
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Bekele T, Rawstorne P, Rahman B. Socioeconomic inequalities in child growth failure in Ethiopia: findings from the 2000 and 2016 Demographic and Health Surveys. BMJ Open 2021; 11:e051304. [PMID: 34907054 PMCID: PMC8672003 DOI: 10.1136/bmjopen-2021-051304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Socioeconomic inequalities in child growth failure (CGF) remain one of the main challenges in Ethiopia. This study examined socioeconomic inequalities in CGF and determinants that contributed to these inequalities in Ethiopia. METHODS The Ethiopia Demographic and Health Surveys 2000 and 2016 data were used in this study. A pooled unweighted sample of the two surveys yielded 21514 mother-child pairs (10873 in 2000 and 10641 in 2016). We assessed socioeconomic inequalities in CGF indicators using the concentration curve and concentration index (CI). We then decomposed the CI to identify percentage contribution of each determinant to inequalities. RESULTS Socioeconomic inequalities in CGF have increased in Ethiopia between 2000 and 2016. The CI increased from -0.072 and -0.139 for stunting, -0.088 and -0.131 for underweight and -0.015 and -0.050 for wasting between 2000 and 2016, respectively. Factors that mainly contributed to inequalities in stunting included geographical region (49.43%), number of antenatal care visits (31.40%) and child age in months (22.20%) in 2000. While in 2016, inequality in stunting was contributed mainly by wealth quintile (46.16%) and geographical region (-13.70%). The main contributors to inequality in underweight were geographical regions (82.21%) and wealth quintile (27.21%) in 2000, while in 2016, wealth quintile (29.18%), handwashing (18.59%) and access to improved water facilities (-17.55%) were the main contributors. Inequality in wasting was mainly contributed to by maternal body mass index (-66.07%), wealth quintile (-45.68%), geographical region (36.88%) and paternal education (33.55%) in 2000, while in 2016, wealth quintile (52.87%) and urban areas of residence (-17.81%) were the main driving factors. CONCLUSIONS This study identified substantial socioeconomic inequalities in CGF, and factors that relatively contributed to the disparities. A plausible approach to tackling rising disparities may involve developing interventions on the identified predictors and prioritising actions for the most socioeconomically disadvantaged groups.
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Affiliation(s)
- Tolesa Bekele
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Patrick Rawstorne
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Bayzidur Rahman
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
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Entezarmahdi R, Houshiarrad A, Gheibi S, Hamisi A, Babayi F, Ajami M, Esmaeili M, Roudsari AH, Khakzad L, Mojarrad H, Abdollahi M. Dietary and Socio-Economic Predictors of Obesity Among 2-5-Year Old in Northwest Iran. Int J Prev Med 2021; 12:116. [PMID: 34760127 PMCID: PMC8551770 DOI: 10.4103/ijpvm.ijpvm_695_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/17/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND As a rising epidemic in developing countries, childhood obesity and overweight need particular attention. METHODS The sample (n = 2432) was randomly selected among children aged 24-59 months living in West Azerbaijan Province whose information was recorded in SIB software. The survey questionnaire is derived from the Demographic and Health Survey and the Multiple Indicator Cluster Survey questionnaires designed by the WHO 2017 and UNICEF 2017, respectively. RESULTS The prevalence of obesity defined as BMIz (body mass index z-score)> +2 was 1.4% among children. Dietary diversity score (DDS) was high in 59.3% of children, moderate in 36.1%, and low in 4.6%. Socio-economic status (SES) of children families was high, moderate, and low in 34%, 28.9%, and 37.1% of families, respectively. Physical activity hours were over 3 in 85.9% of children. The girls were more likely to be obese than the boys (OR = 0.43, P = 0.016). Those with high and moderate DDS were less likely to be obese than those with low DDS (OR = 0.250 and OR = 0.180, respectively). The likelihood of obesity among children with high and moderate SES were 2.6 and 1.6 times more compared to children with low SES, respectively. CONCLUSIONS According to the results, DDS and physical activity levels are related to obesity in children aged 24-59 months. Therefore, establishing proper nutritional behavior and promoting a healthy lifestyle are essential for preventing obesity and non-communicable diseases in this age group.
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Affiliation(s)
- Rasool Entezarmahdi
- Social Determinants of Health Research Center, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Anahita Houshiarrad
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shabnam Gheibi
- Maternal and Childhood Obesity Research Center, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Abdolmajid Hamisi
- Thinking Room's Manager, Deputy of Health, Urmia University of Medical Sciences, Urmia, Iran
| | - Fariba Babayi
- Department of Nutrition, Health Province center, Deputy of health, Urmia University of Medical Sciences, Urmia, Iran
| | - Marjan Ajami
- Department of Food and Nutrition Policy and Planning Research, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mina Esmaeili
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arezoo Haghighian Roudsari
- Department of Community Nutrition, Department of Food and Nutrition Policy and Planning Research, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Khakzad
- Department of Statistics, Deputy of health, Urmia University of Medical Sciences, Urmia, Iran
| | - Hamed Mojarrad
- Public Health Office, Deputy of health, Urmia University of Medical Sciences, Urmia, Iran
| | - Morteza Abdollahi
- Social Determinants of Health Research Center, and National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Risk factors of stunting events in child 6-23 months old in Biromaru Public Health Center Sigi. ENFERMERIA CLINICA 2021. [PMID: 32545031 DOI: 10.1016/j.enfcli.2019.10.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The purpose of this study was to find out the risk factors for stunting in the age group 6-23 months in the Biromaru Public Health Center, Sigi Biromaru Sub-District, Sigi District. METHOD This study is an analytical survey study with a case control design with a sample of 40 cases and 40 controls and using a purposive sampling technique. Data analysis using chi square test and logistic regression. RESULT The results of bivariate analysis showed that the risk factors that influence the incidence of stunting in the age of 6-23 months in the Biromaru Community Health Center were birth length (OR=4.500; p=0.003) and parity (OR=0.850; p=0.026), birth weight, maternal gestational age and maternal middle upper arm circumference size were not risk factors for stunting in this study. CONCLUSION It can be concluded that there is a relationship between birth length, maternal parity, birth weight, body weight between 6 and 23 months with the incidence of stunting.
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Molla A, Egata G, Getacher L, Kebede B, Sayih A, Arega M, Bante A. Minimum acceptable diet and associated factors among infants and young children aged 6-23 months in Amhara region, Central Ethiopia: community-based cross-sectional study. BMJ Open 2021; 11:e044284. [PMID: 33972337 PMCID: PMC8112428 DOI: 10.1136/bmjopen-2020-044284] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE The main objective of this study was to assess the prevalence of a minimum acceptable diet (MAD) and associated factors. DESIGN Community-based cross-sectional study SETTING: Debre Berhan Town, Ethiopia. PARTICIPANTS An aggregate of 531 infants and young children mother/caregiver pairs participated in this study. A one-stage cluster sampling method was used to select study participants and clusters were selected using a lottery method. Descriptive statistics were calculated for all study variables. Statistical analysis was performed on data to determine which variables are associated with MAD and the results of the adjusted OR with 95% CI. P value of <0.05 considered statistically significant. PRIMARY OUTCOME Prevalence of MAD and associated factors RESULTS: The overall prevalence of MAD was 31.6% (95% CI: 27.7 to 35.2). Having mother attending secondary (adjusted OR, AOR=4.9, 95% CI: 1.3 to 18.9) and college education (AOR=6.4, 95% CI: 1.5 to 26.6), paternal primary education (AOR=1.3, 95% CI: 1.5 to 2.4), grouped in the aged group of 12-17 months (AOR=1.8, 95% CI: (1.0 to 3.4) and 18-23 months (AOR=2.2, 95% CI: 1.2 to 3.9), having four antenatal care (ANC) visits (AOR=2.0, 95% CI: 1.0 to 3.9), utilising growth monitoring (AOR=1.8, 95% CI: 1.1 to 2.9), no history of illness 2 weeks before the survey (AOR=2.9, 95% CI: 1.5 to 6.0) and living in the household with home garden (AOR=2.5, 95% CI: 1.5 to 4.3) were positively associated with increase the odds of MAD. CONCLUSION Generally, the result of this study showed that the prevalence of minimum acceptable was very low. Parent educational status, ANC visits, infant and young child feeding advice, child growth monitoring practice, age of a child, a child has no history of illness 2 weeks before the survey, and home gardening practice were the predictors of MAD. Therefore, comprehensive intervention strategies suitable to the local context are required to improve the provision of MAD.
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Affiliation(s)
- Abebaw Molla
- School of Public Health, College of Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
| | - Gudina Egata
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Lemma Getacher
- Department of Public Health, Institute of Health Sciences Debre Birhan University, Debre Birhan, Ethiopia
| | - Bezie Kebede
- School of Pharmacy, College of Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
| | - Alemayehu Sayih
- Department of Nursing, College of Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
| | - Mikyas Arega
- Department of Public Health, Institute of Health Sciences Debre Birhan University, Debre Birhan, Ethiopia
| | - Agegnehu Bante
- School of Nursing, College of Medicine and Health Sciences Arba Minch University, Arba Minch, Ethiopia
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Castro Prieto PA, Trujillo Ramírez KM, Moreno S, Holguín JS, Pineda DM, Tomasi S, Ramirez Varela A. Reduction of chronic malnutrition for infants in Bogotá, Colombia. BMC Public Health 2021; 21:690. [PMID: 33832452 PMCID: PMC8034142 DOI: 10.1186/s12889-021-10620-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 03/14/2021] [Indexed: 11/10/2022] Open
Abstract
Background According to the 2015 National Survey of the Nutritional Situation in Colombia the prevalence of stunting in children under 5 years of age was 10.8%. In terms of region, Bogotá, presented the highest prevalence rate (13%), a figure that exceeded national records. With the collaboration of local and national government, and nongovernmental it was decided to develop a pilot study involving a public health intervention with residents of Bogotá under 1 year of age with nutritional classification by anthropometry compatible with stunting risk or stunting. Methods Pre-experimental, before and after study that sought to determine the magnitude of the change in nutritional status through a 10 months public health nutrition intervention in children under one-year-old residing in 3 prioritized territories of Bogotá. Results The intervention comprised 1126 children living in the following territories in Bogotá: Kennedy, San Cristóbal, and Engativá. A total of 43.3% children presented delay in height for age, and 56.7% presented risk of short stature. In the final measurement, data were obtained from 686 children, identifying that 17% of the children progressed from stunting to a stunting risk and that 4.5% recovered their growth trajectory, achieving an adequate length for their age. Conclusion That children classified as at risk or stunting at the beginning of the intervention showed an increased probability of approaching or being in the appropriate growth trajectory according to the length-for-age indicator after the intervention. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10620-3.
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Affiliation(s)
- Paula Andrea Castro Prieto
- Population Health Axis, Fundación Santa Fe de Bogotá, Carrera 7b # 123-90, 110111, Bogotá, Colombia. .,Centre d'Estudis Demogràfics, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | | | - Sergio Moreno
- Population Health Axis, Fundación Santa Fe de Bogotá, Carrera 7b # 123-90, 110111, Bogotá, Colombia
| | | | - Diana María Pineda
- Social Investment and Knowledge Generation, Fundación Éxito, Medellín, Colombia
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Berrueta M, Ciapponi A, Bardach A, Cairoli FR, Castellano FJ, Xiong X, Stergachis A, Zaraa S, Meulen AST, Buekens P. Maternal and neonatal data collection systems in low- and middle-income countries for maternal vaccines active safety surveillance systems: A scoping review. BMC Pregnancy Childbirth 2021; 21:217. [PMID: 33731029 PMCID: PMC7968860 DOI: 10.1186/s12884-021-03686-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/01/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Most post-licensure vaccine pharmacovigilance in low- and middle-income countries (LMICs) are passive reporting systems. These have limited utility for maternal immunization pharmacovigilance in LMIC settings and need to be supplemented with active surveillance. Our study's main objective was to identify existing perinatal data collection systems in LMICs that collect individual information on maternal and neonatal health outcomes and could be developed to inform active safety surveillance of novel vaccines for use during pregnancy. METHODS A scoping review was performed following the Arksey and O'Malley six-stage approach. We included studies describing electronic or mixed paper-electronic data collection systems in LMICs, including research networks, electronic medical records, and custom software platforms for health information systems. Medline PubMed, EMBASE, Global Health, Cochrane Library, LILACS, Bibliography of Asian Studies (BAS), and CINAHL were searched through August 2019. We also searched grey literature including through Google and websites of existing relevant perinatal data collection systems, as well as contacted authors of key studies and experts in the field to validate the information and identify additional sources of relevant unpublished information. RESULTS A total of 11,817 records were identified. The full texts of 264 records describing 96 data collection systems were assessed for eligibility. Eight perinatal data collection systems met our inclusion criteria: Global Network's Maternal Newborn Health Registry, International Network for the Demographic Evaluation of Populations and their Health; Perinatal Informatic System; Pregnancy Exposure Registry & Birth Defects Surveillance; SmartCare; Open Medical Record System; Open Smart Register Platform and District Health Information Software 2. These selected systems were qualitatively characterized according to seven different domains: governance; system design; system management; data management; data sources, outcomes and data quality. CONCLUSION This review provides a list of active maternal and neonatal data collection systems in LMICs and their characteristics as well as their outreach, strengths, and limitations. Findings could potentially help further understand where to obtain population-based high-quality information on outcomes to inform the conduct of maternal immunization active vaccine safety surveillance activities and research in LMICs.
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Affiliation(s)
- Mabel Berrueta
- Instituto de Efectividad Clínica y Sanitaria (IECS), Dr. Emilio Ravignani 2024 (C1014CPV), Buenos Aires, Argentina.
| | - Agustin Ciapponi
- Instituto de Efectividad Clínica y Sanitaria (IECS), Dr. Emilio Ravignani 2024 (C1014CPV), Buenos Aires, Argentina
| | - Ariel Bardach
- Instituto de Efectividad Clínica y Sanitaria (IECS), Dr. Emilio Ravignani 2024 (C1014CPV), Buenos Aires, Argentina
| | - Federico Rodriguez Cairoli
- Instituto de Efectividad Clínica y Sanitaria (IECS), Dr. Emilio Ravignani 2024 (C1014CPV), Buenos Aires, Argentina
| | - Fabricio J Castellano
- Instituto de Efectividad Clínica y Sanitaria (IECS), Dr. Emilio Ravignani 2024 (C1014CPV), Buenos Aires, Argentina
| | - Xu Xiong
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, 70112, USA
| | | | - Sabra Zaraa
- University of Washington, Seattle, WA, 98195-7631, USA
| | | | - Pierre Buekens
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, 70112, USA
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Geda NR, Feng CX, Janzen B, Lepnurm R, Henry CJ, Whiting SJ. Infant and young child feeding practices in Ethiopia: analysis of socioeconomic disparities based on nationally representative data. ACTA ACUST UNITED AC 2021; 79:35. [PMID: 33726847 PMCID: PMC7968179 DOI: 10.1186/s13690-021-00555-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 02/28/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Undernutrition among children is a priority area of public health concern in Ethiopia. The purpose of this study was to examine disparities in Infant and Young Child Feeding (IYCF) practices among children 6-23 months. METHOD Data were drawn from the 2016 Ethiopian Demographic and Health Surveys (EDHS). A total of 3240 children aged 6-23 months were used for the present analysis. The outcome variable was IYCF practice score (ranging 0-7) which was constructed based on the linear and combined effects of four sets of variables: breastfeeding, avoidance of bottle feeding, diet diversity score and minimum feeding frequency. IYCF practice score was further recoded into three categories. Proportional odds regression was used to assess the determinants of IYCF category. RESULTS The proportional odds regression analysis showed that IYCF scores significantly decreased by 5% (Adjusted Odds Ratio (AOR) = 0.95; 95% CI: 0.93-0.97) for every unit increase in the child's age. Households with fathers of primary and secondary and above level education were 1.37 times (95% CI: 1.14-1.66) and 1.67 times (95% CI: 1.26-2.23) more likely to be in the high IYCF category than in the poor IYCF category. The likelihood of being in the high IYCF practice category decreased for non-working mothers by 30% (AOR = 0.70; 95% CI: 0.59-0.83) compared to those working in gainful employment. The chance of being in the high IYCF practice category decreased by 29% for households with no access to radio (AOR = 0.71; 95% CI: 0.59-0.85). Those with medium and rich/richer wealth category were 1.54 times (95% CI: 1.22-1.94) and 1.40 times (95% CI: 1.11-1.75) more likely to belong to high IYCF practice category than being in poor IYCF category. For every unit increase in health service utilization, the chance of falling in higher IYCF category increases by 1.15 times (95% CI: 1.08-1.23). The chance of falling in higher IYCF practice category decreases for rural residents by 37% (AOR = 0.63; 95% CI: 0.47-0.84) compared to those residing in urban areas. CONCLUSION For a child, the first two years is the time span during which linear faltering of growth is most prevalent and the period when the process of becoming stunted is almost complete. This study recommends improving access to women for gainful employment, provision of economic support to poor rural women, education and promotion of nutrition messages using most accessible media and boosting the positive role of fathers in child feeding practices.
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Affiliation(s)
- Nigatu Regassa Geda
- Center for Population Studies, College of Development Studies, Addis Ababa University, Sidist Kilo Campus, PO Box 1176, Addis Ababa, Ethiopia.
| | - Cindy Xin Feng
- School of Public Health, Health Science E-wing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada.,Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Canada
| | - Bonnie Janzen
- Department of Community Health & Epidemiology, Collège of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Rein Lepnurm
- School of Public Health, Health Science E-wing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada
| | - Carol J Henry
- College of Pharmacy and Nutrition, Health Sciences A-wing, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Susan J Whiting
- College of Pharmacy and Nutrition, Health Sciences A-wing, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
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Muche A, Gezie LD, Baraki AGE, Amsalu ET. Predictors of stunting among children age 6-59 months in Ethiopia using Bayesian multi-level analysis. Sci Rep 2021; 11:3759. [PMID: 33580097 PMCID: PMC7881183 DOI: 10.1038/s41598-021-82755-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 01/22/2021] [Indexed: 11/28/2022] Open
Abstract
In developing countries including Ethiopia stunting remained a major public health burden. It is associated with adverse health consequences, thus, investigating predictors of childhood stunting is crucial to design appropriate strategies to intervene the problem stunting. The study uses data from the Ethiopian Demographic and Health Survey (EDHS) conducted from January 18 to June 27, 2016 in Ethiopia. A total of 8117 children aged 6-59 months were included in the study with a stratified two stage cluster sampling technique. A Bayesian multilevel logistic regression was fitted using Win BUGS version 1.4.3 software to identify predictors of stunting among children age 6-59 months. Adjusted odds ratio (AOR) with 95% credible intervals was used to ascertain the strength and direction of association. In this study, increasing child's age (AOR = 1.022; 95% CrI 1.018-1.026), being a male child (AOR = 1.16; 95%CrI 1.05-1.29), a twin (AOR = 2.55; 95% CrI 1.78-3.56), having fever (AOR = 1.23; 95%CrI 1.02-1.46), having no formal education (AOR = 1.99; 95%CrI 1.28-2.96) and primary education (AOR = 83; 95%CrI 1.19-2.73), birth interval less than 24 months (AOR = 1.40; 95% CrI 1.20-1.61), increasing maternal BMI (AOR = 0.95; 95% CrI 0.93-0.97), and poorest household wealth status (AOR = 1.78; 95% CrI 1.35-2.30) were predictors of childhood stunting at individual level. Similarly, region and type of toilet facility were predictors of childhood stunting at community level. The current study revealed that both individual and community level factors were predictors of childhood stunting in Ethiopia. Thus, more emphasize should be given by the concerned bodies to intervene the problem stunting by improving maternal education, promotion of girl education, improving the economic status of households, promotion of context-specific child feeding practices, improving maternal nutrition education and counseling, and improving sanitation and hygiene practices.
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Affiliation(s)
- Amare Muche
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medical and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Lemma Derseh Gezie
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adhanom Gebre-Egzabher Baraki
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Erkihun Tadesse Amsalu
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medical and Health Sciences, Wollo University, Dessie, Ethiopia.
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Sotoudeh M, Amaniyan S, Jonoush M, Vaismoradi M. A Community-Based Survey of Household Food Insecurity and Associated Sociodemographic Factors among 2-6 Years Old Children in the Southeast of Iran. Nutrients 2021; 13:nu13020574. [PMID: 33572243 PMCID: PMC7915508 DOI: 10.3390/nu13020574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/28/2021] [Accepted: 02/05/2021] [Indexed: 11/23/2022] Open
Abstract
Malnutrition remains a major public health issue in developing and transitional countries and food insecurity is a major indicator of the nutritional status in these societies. This research aimed to investigate the status of household food insecurity and sociodemographic factors affecting it among 2–6 years old children in an urban area in the southeast of Iran. A community-based survey was conducted from September to January 2018 on 421 children aged 2–6 years who were selected using stratified cluster random sampling. They lived in six different areas in an urban area in the southeast of Iran. Data was collected using the U.S. Department of Agriculture Food Security questionnaire and anthropometric measurements. Our study showed that the prevalence of food insecurity among children was 81.7% consisting of 2.6% with low food security, 9.2% with moderate food insecurity, and 69.9% with very low food security. The weight gain of those children who were in the low food security group, was 2.63 times lower than those children in the food security group. Moreover, the chance of weight gain in the low food security and in the moderate food insecurity groups was less as 1.91 and 1.41 times, respectively. Food insecurity in children aged 2–6 years is influenced by various sociodemographic factors including weight and height, mother’s education level, sanitation as access to water closet (WC). Policymakers should plan to improve the quality of life and health of the children through improving their food security.
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Affiliation(s)
- Mitra Sotoudeh
- Iranshahr University of Medical Sciences, Iranshahr 7618815676, Iran;
| | - Sara Amaniyan
- Student Research Center, Semnan University of Medical Sciences, Semnan 3514799422, Iran;
| | - Mona Jonoush
- Department of Nutrition, Mashhad University of Medical Sciences, Mashhad 91778-99191, Iran;
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, 8049 Bodø, Norway
- Correspondence: ; Tel.: +47-7551-7813
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Low Economic Class Might Predispose Children under Five Years of Age to Stunting in Ethiopia: Updates of Systematic Review and Meta-Analysis. J Nutr Metab 2021; 2020:2169847. [PMID: 33489361 PMCID: PMC7789483 DOI: 10.1155/2020/2169847] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 11/19/2020] [Accepted: 11/24/2020] [Indexed: 11/18/2022] Open
Abstract
Background Malnutrition is major public health problem worldwide, particularly in developing countries including Ethiopia. In 2016, out of 667 million children under five years of age, 159 million were stunted worldwide. The prevalence of stunting has been decreasing greatly from 58% in 2000 to 44% in 2011 and 38% in 2016 in Ethiopia. However, the prevalence of stunting is still high and considered as public health problem for the country. The aim of this systematic review and meta-analysis is to assess the prevalence of stunting and its associations with wealth index among children under five years of age in Ethiopia. Methodology. The databases searched were MEDLINE, Scopus, HINARI, and grey literature studies. The studies' qualities were assessed by two reviewers independently, and any controversy was handled by other reviewers using the Joanna Briggs Institute (JBI) critical appraisal checklist. The JBI checklist was used in assessing the risk of bias and method of measurement for both outcome and independent variables. Especially, the study design, study participants, definition of stunting, statistical methods used to identify the associations, results/data presentations, and odds ratios (ORs) with confidence intervals (CIs) were assessed. In the statistical analysis, the funnel plot, Egger's test, and Begg's test were used to assess publication bias. The I2 statistic, forest plot, and Cochran's Q-test were used to deal with heterogeneity. Results In this review, 35 studies were included to assess the pooled prevalence of stunting. Similarly, 16 studies were used to assess the estimated effect sizes of wealth index on stunting. In this meta-analysis, the pooled prevalence of stunting was 41.5% among children under five years of age, despite its considerable heterogeneity (I2 = 97.6%, p < 0.001, Q = 1461.93). However, no publication bias was detected (Egger's test p=0.26 and Begg's test p=0.87). Children from households with a medium or low/poor wealth index had higher odds of stunting (AOR: 1.33, 95% CI 1.07, 1.65 or AOR: 1.92, 95% CI 1.46, 2.54, respectively) compared to children from households with a high/rich wealth index. Both of the estimated effect sizes of low and medium wealth indexes had substantial heterogeneity (I2 = 63.8%, p < 0.001, Q = 44.21 and I2 = 78.3%, p < 0.001, Q = 73.73) respectively). In estimating the effect, there was no publication bias (small-studies effect) (Egger and Begg's test, p > 0.05). Conclusions The pooled prevalence of stunting was great. In the subgroup analysis, the Amhara region had the highest prevalence of stunting, followed by the Oromia and Tigray regions, respectively. Low economic status was associated with stunting in Ethiopia. This relationship was found to be statistically more accurate in Oromia and Amhara regions. The government should emphasize community-based nutrition programs by scaling up more in these regions, just like the Seqota Declaration.
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Geda NR, Feng CX, Henry CJ, Lepnurm R, Janzen B, Whiting SJ. Multiple anthropometric and nutritional deficiencies in young children in Ethiopia: a multi-level analysis based on a nationally representative data. BMC Pediatr 2021; 21:11. [PMID: 33402154 PMCID: PMC7784319 DOI: 10.1186/s12887-020-02467-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 12/11/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND In Ethiopia, child undernutrition and anemia are major public health concerns, resulting in increased childhood morbidity and mortality. Despite progress made to reduce the prevalence of malnutrition (especially stunting) from 50% in 2000 to 38% in 2016, little is known about the magnitude and risk factors for concurrent nutritional deficiencies in Ethiopia. METHODS Analysis for this study was based on a total sample of 9218 children aged 6-59 months drawn from the Ethiopian Demographic and Health Survey (EDHS) conducted in the year 2016. The study used two outcome variables: Multiple nutrition deficit index formed by combining stunting, underweight, wasting and anemia status; and a concurrent stunting and anemia (CAS) index. Two mixed effect regression models, Poisson and Logistic, were used to identify the key risk factors of the two outcome variables, respectively. RESULTS The proportion of children with stunting (length-for-age), underweight (weight-for-age) and wasting children (weight-for-length) was 38%, 25.2% and 9.4%, respectively. About 58% of the children had anemia. The prevalence of children with concurrent stunting and anemia children was 24.8%. Our results showed that the risks of multiple nutritional problems were determined by a range of individual, household and behavioral factors including: sex of the child, age of the child, birth order, parity, parental education, religion, household wealth index and type of family structure. The proximate variables (hygiene and sanitation score, feeding practice, and child health service utilization score) were also found to exert a strong influence on the risk of multiple nutritional deficiencies. The likelihood of co-occurrence of stunting and anemia was determined by certain individual and household factors, including sex of the child, age of the child, maternal education, household asset based wealth, religion and household hygiene and sanitation. CONCLUSIONS This study underscores the importance of improving parental education, household wealth, hygiene and sanitation conditions, promoting feeding practice and child health service utilization. Also, any nutrition sensitive and specific intervention should consider a child's characteristics such as his/her age, gender and birth order.
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Affiliation(s)
- Nigatu Regassa Geda
- Center for Population Studies, College of Development Studies, Addis Ababa University, Sidist Kilo Campus, PO Box 1176, Addis Ababa, Ethiopia
| | - Cindy Xin Feng
- School of Public Health, Health Science E-wing, University of Saskatchewan, 104 Clinic Place, S7N 2Z4 Saskatoon, SK Canada
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Canada
| | - Carol J. Henry
- College of Pharmacy and Nutrition, University of Saskatchewan, Health Sciences A-wing, 107 Wiggins Road, S7N 5E5 Saskatoon, SK Canada
| | - Rein Lepnurm
- School of Public Health, Health Science E-wing, University of Saskatchewan, 104 Clinic Place, S7N 2Z4 Saskatoon, SK Canada
| | - Bonnie Janzen
- Dept of Community Health & Epidemiology, Collège of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Susan J. Whiting
- College of Pharmacy and Nutrition, University of Saskatchewan, Health Sciences A-wing, 107 Wiggins Road, S7N 5E5 Saskatoon, SK Canada
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Mengiste LA, Worku Y, Aynalem YA, Shiferaw WS. Prevalence of Stunting and Its Associated Factors Among Children Aged 6–59 Months in Angolela Tera District, Northeast Ethiopia. NUTRITION AND DIETARY SUPPLEMENTS 2020. [DOI: 10.2147/nds.s287232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Hiliza JN, Germana L, Kasangala A, Joram F. Prevalence and Factors Associated with Stunting among Public Primary School Pupils in Kasulu District, Western Tanzania. East Afr Health Res J 2020; 4:172-181. [PMID: 34308235 PMCID: PMC8279267 DOI: 10.24248/eahrj.v4i2.641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 11/04/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Underfeeding of a child in the first 2 years of life results in irreversible growth damage. Globally, stunting has declined from 39.7% in 1990 to 26.7% in 2010 while in Africa has remained at 40% since 1990. However, stunting is little known in primary pupils.This study estimated the prevalence of stunting and contributing factors among public primary school pupils in Kasulu District. METHOD Cross-sectional study was conducted among public primary pupils. Systematic random sampling was used to select study participants and then stratified to 5-7 and 8-12 years. Socio-economic factors, dietary practices, water, sanitation, and hygiene behaviours; school performance/attendance data were collected using a pretested questionnaire. Measurements were standardised to the World Health Organization HAZ-Scores for both girls and boys. Descriptive statistics, bivariate, and multivariable logistic regression were used to generate results. RESULTS A total of 400 pupils (100%RR) were recruited into the study, mean age of 7.51 (STD= 1.54) years and a half (50.3%) were boys. The prevalence of stunting was 127 (31.8%) (95% CI: 27.2%-36.6%), with no sex difference (63 (31.7%) - girls vs. 64 (31.8%) - boys; p = 0.969). Household wealth influenced stunting; lowest quintile (AOR= 28; 95% CI: 3.64 - 214.6; p<0.001) 2nd quintile (AOR = 17; 95%CI: 2.20 - 138.5; p<0.01), the 3rd quintile (AOR = 8.0; 95%CI: 0.99 - 64.67; p = 0.051) and 4th quintile (AOR = 4.2; 95%CI: 0.49 - 36.75; p = 0.191) when compared to 5th (highest) wealthquintile. Food insecurity (AOR = 10.6; 95%CI: 4.60 - 24.60; p< 0.001), less protein in meal were the risk for stunting (AOR = 14.6; 95%CI: 4.07 - 52.42; p<0.001). Inappropriate hand wash after toilets both at school, (AOR=3.5; 95%CI:1.62-7.58; p=0.001), and home (AOR = 13.0; 95%CI: 2.73 - 61.76; p = 0.001) were the risk for stunting. Stunted pupils had irregular school attendance (AOR = 9.4;95%CI: 4.42 - 19.93; p<0.001) and poor performance (AOR = 23.6; 95%CI: 10.24 -54.19; p<0.001). Food insecurity influenced poor performance (AOR = 3.9; 95%CI:1.67-8.92; p<0.01) and irregular school attendance (AOR=5.4, p=0.000). CONCLUSION Stunting among public primary school pupils is very high despite the prevention effort. Low wealth, food insecurity, poor hand hygiene, and lack of protein in a meal significantly influence stunting. Also, it affects the pupils' academic performance and attendance, availability of food in both quantity and quality, community nutrition.
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Affiliation(s)
- Jairos N. Hiliza
- Department of Epidemiology and Biostatistics Muhimbili University of Health and Allied Sciences
| | - Leyna Germana
- Tanzania Field Epidemiology and Laboratory Training Programme
| | | | - Flora Joram
- Department of Community Development Studies Muhimbili University of Health and Allied Sciences
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Mkhize M, Sibanda M. A Review of Selected Studies on the Factors Associated with the Nutrition Status of Children Under the Age of Five Years in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7973. [PMID: 33142965 PMCID: PMC7662515 DOI: 10.3390/ijerph17217973] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/19/2020] [Accepted: 10/26/2020] [Indexed: 12/20/2022]
Abstract
Malnutrition is a considerable contributor to child mortality and morbidity. Child malnutrition further affects the country's economic development. Child malnutrition in South Africa is persistent, continuing to be an alarming burden. The nutritional status of kids under the age of five years is a critical indicator of the country's economic condition and health status. An understanding of the influencers of the nutritional status of children can act as a catalyst in combatting all forms of malnutrition. The purpose of this paper was to review selected studies concerning the factors that affect the nutritional status of children in South Africa. Studies were selected from electronic databases, which were PubMed, Google Scholar, Science Direct, Sabinet African Journals, and the University of Zululand library catalog. The keywords that were used to search studies and articles from the selected database were: risk factors, child nutritional status, children under the age of five years, South Africa, malnutrition, underweight, stunted, wasting, and over-nutrition. Studies and surveys published from 2010-2019 that reported on the factors influencing the nutritional status of children under the age of five years were included in this review. Twenty-seven articles met the inclusion criteria of the study. The 27 articles were made up of 21 cross-sectional articles and six longitudinal articles. The finding from this review highlights that there is a lack of studies conducted in urban areas. The results show that the nutritional status of children is affected by several factors. These include household food insecurity, low household income, illiterate caregivers, unemployment, inadequate dietary intake, low birth weight, consumption of monotonous diets, poor caregiver's nutritional knowledge, poor access to water and sanitation, poor weaning practices, age of the caregiver, and demographic characteristics of a child (age and gender). It is critical to have an understanding of the factors that affect the nutritional status of children. Such knowledge can significantly contribute to formulating policies that can enhance nutrition security and the country's economy. Moreover, insights into strategic interventions to eradicate all forms of malnutrition can be made.
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Affiliation(s)
| | - Melusi Sibanda
- Department of Agriculture, University of Zululand, Private Bag X1001, KwaDlangezwa 3886, South Africa;
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Persistent Malnutrition and Associated Factors among Children under Five Years Attending Primary Health Care Facilities in Limpopo Province, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207580. [PMID: 33086477 PMCID: PMC7589291 DOI: 10.3390/ijerph17207580] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/10/2020] [Accepted: 10/14/2020] [Indexed: 12/11/2022]
Abstract
Despite years of interventions intended to reduce child malnutrition in South Africa, its negative effects, stunting in particular, persist mainly among children under five years old living in under-resourced regions. A cross-sectional study was conducted to determine the prevalence of malnutrition and associated factors among 404 children under age five attending childcare services with their mothers in selected healthcare facilities of Limpopo Province, South Africa. Anthropometry, socio-demographics and obstetric history were collected. Height-for-age, weight-for-age and body mass index-for-age Z-scores were used to determine stunting, underweight and thinness among children, respectively. Logistic regression analyses were performed to generate the factors associated with malnutrition. Stunting (45.3%) was the prevalent form of malnutrition among children under age five, affecting boys (51.7%) more than girls (38.8%) and children aged 12–23 months (62.4%) more than those <11 months old (40.1%), in addition to the overall prevalence of underweight (29.0%) and thinness (12.6%). Boys had increased odds of stunting (adjusted odds ratio, AOR = 2.07, 95% CI: 1.26–3.41, p = 0.004) and underweight (AOR = 2.17, 95% CI: 1.32–3.57, p = 0.002) than girls. Children aged 12–23 months were more likely to be stunted (AOR = 4.79, 95% CI: 2.36–9.75, p ≤ 0.0001) than children aged ≤11 months. Delayed introduction of solid foods increased the odds of stunting (AOR = 5.77, 95% CI: 2.63–12.64, p ≤ 0.0001) and underweight (AOR = 2.05, 95% CI: 1.08–3.89, p = 0.028). Children with normal birth weight were less likely to be thin (AOR = 0.42, 95% CI: 0.19–0.92, p = 0.029) and underweight (AOR = 0.34, 95% CI: 0.17–0.68, p = 0.003) than children who had low birth weight. Children whose mothers had obtained secondary school education (AOR = 0.39, 95% CI: 0.16–0.97, p = 0.044), and Grade 12 or post-Grade 12 education (AOR = 0.32, 95% CI: 0.12–0.83, p = 0.020) were less likely to be stunted than were children of mothers who had only primary school education. Suboptimal complementary feeding predisposed children to stunting and underweight. National nutrition programs should be context-specific to improve the introduction of complementary foods among children, especially in the remote and poor areas.
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Momberg DJ, Voth-Gaeddert LE, Ngandu BC, Richter L, May J, Norris SA, Said-Mohamed R. Water, sanitation, and hygiene (WASH) factors associated with growth between birth and 1 year of age in children in Soweto, South Africa: results from the Soweto Baby WASH study. JOURNAL OF WATER AND HEALTH 2020; 18:798-819. [PMID: 33095202 DOI: 10.2166/wh.2020.085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Interventions to reduce undernutrition and improve child growth have incorporated improved water, sanitation, and hygiene (WASH) as part of disease transmission prevention strategies. Knowledge gaps still exist, namely, when and which WASH factors are determinants for growth faltering, and when WASH interventions are most effective at improving growth. This study drew cross-sectional data from a longitudinal cohort study and used hierarchical regression analyses to assess associations between WASH factors: water index, sanitation, hygiene index, and growth: height-for-age (HAZ), weight-for-age (WAZ), weight-for-height (WHZ) at 1, 6, and 12 months postpartum among infants a priori born healthy in Soweto, Johannesburg. Household access to sanitation facilities that were not safely managed was associated with a decrease in HAZ scores at 1 month (β = -2.24) and 6 months (β = -0.96); a decrease in WAZ at 1 month (β = -1.21), 6 months (β = -1.57), and 12 months (β = -1.92); and finally, with WHZ scores at 12 months (β = -1.94). Counterintuitively, poorer scores on the hygiene index were associated with an increase at 1 month for both HAZ (β = 0.53) and WAZ (β = 0.44). Provision of safely managed sanitation at household and community levels may be required before improvements in growth-related outcomes are obtained.
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Affiliation(s)
- D J Momberg
- SAMRC/WITS Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Rd, Parktown 2193, Johannesburg, South Africa E-mail: ; DSI-NRF Centre of Excellence in Food Security, University of the Western Cape, Cape Town, South Africa
| | - L E Voth-Gaeddert
- SAMRC/WITS Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Rd, Parktown 2193, Johannesburg, South Africa E-mail:
| | - B C Ngandu
- SAMRC/WITS Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Rd, Parktown 2193, Johannesburg, South Africa E-mail:
| | - L Richter
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - J May
- DSI-NRF Centre of Excellence in Food Security, University of the Western Cape, Cape Town, South Africa
| | - S A Norris
- SAMRC/WITS Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Rd, Parktown 2193, Johannesburg, South Africa E-mail: ; DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - R Said-Mohamed
- SAMRC/WITS Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Rd, Parktown 2193, Johannesburg, South Africa E-mail: ; DSI-NRF Centre of Excellence in Food Security, University of the Western Cape, Cape Town, South Africa; DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa; Department of Archaeology, Biological Anthropology, University of Cambridge, Cambridge, UK
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Tafese Z, Reta Alemayehu F, Anato A, Berhan Y, Stoecker BJ. Child Feeding Practice and Primary Health Care as Major Correlates of Stunting and Underweight among 6- to 23-Month-Old Infants and Young Children in Food-Insecure Households in Ethiopia. Curr Dev Nutr 2020; 4:nzaa137. [PMID: 32923922 PMCID: PMC7475004 DOI: 10.1093/cdn/nzaa137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 02/04/2020] [Accepted: 08/07/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Child undernutrition is a major public health problem in Ethiopia. Stunting is highest in food-insecure areas and insufficient evidence may impair the design of suitable interventions. OBJECTIVES This study aimed to identify key factors contributing to undernutrition among 6- to 23-mo-old children. METHODS A community-based cross-sectional study in food-insecure areas of Amhara and Oromia regions in April-June, 2018, enrolled 464 mother-child dyads. Bivariate and multivariate logistic regression analyses were conducted. RESULTS The prevalence of stunting (43.1%), wasting (12.3%), and underweight (27.3%) were high. Factors significantly associated with both stunting and underweight were child age of 12-23 mo (vs 6-11 mo), female, more siblings, lack of zinc supplement for diarrhea, inadequate diet diversity, and lack of iodized salt in complementary food. Conclusions: Our findings support the need to emphasize appropriate child feeding practices and iodized salt utilization. Improvement of primary health care services related to micronutrient supplementation and family spacing also are important to address child undernutrition in the study area.
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Affiliation(s)
- Zelalem Tafese
- School of Nutrition, Food Science and Technology, Hawassa University, Hawassa, Ethiopia
| | - Fikadu Reta Alemayehu
- School of Nutrition, Food Science and Technology, Hawassa University, Hawassa, Ethiopia
| | - Anchamo Anato
- School of Nutrition, Food Science and Technology, Hawassa University, Hawassa, Ethiopia
| | - Yifru Berhan
- St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Barbara J Stoecker
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
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Mohammed SH, Habtewold TD, Arero AG, Esmaillzadeh A. The state of child nutrition in Ethiopia: an umbrella review of systematic review and meta-analysis reports. BMC Pediatr 2020; 20:404. [PMID: 32847552 PMCID: PMC7448348 DOI: 10.1186/s12887-020-02301-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 08/19/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Malnutrition remains to be a major public health problem in developing countries, particularly among children under-5 years of age children who are more vulnerable to both macro and micro-nutrient deficiencies. Various systematic review and meta-analysis (SRM) studies were done on nutritional statuses of children in Ethiopia, but no summary of the findings was done on the topic. Thus, this umbrella review was done to summarize the evidence from SRM studies on the magnitude and determinants of malnutrition and poor feeding practices among under-5 children in Ethiopia. METHODS PubMed, Embase, Scopus, Web of Sciences, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, and Google Scholar were searched for SRM studies on magnitude and risk factors of malnutrition and child feeding practice indicators in Ethiopia. The methodological quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) tool. The estimates of the included SRM studies on the prevalence and determinants of stunting, wasting, underweight, and poor child feeding practices were pooled and summarized with random-effects meta-analysis models. RESULT We included nine SRM studies, containing a total of 214,458 under-5 children from 255 observation studies. The summary estimates of prevalence of stunting, underweight, and wasting were 42% (95%CI = 37-46%), 33% (95%CI = 27-39%), and 15% (95%CI = 12-19%), respectively. The proportion of children who met the recommendations for timely initiation of breastfeeding, exclusive breastfeeding during the first 6 months, and timely initiation of complementary feeding were 65, 60, and 62%, respectively. The proportion of children who met the recommendations for dietary diversity and meal frequency were 20, and 56%, respectively. Only 10% of children fulfilled the minimum criteria of acceptable diet. There was a strong relationship between poor feeding practices and the state of malnutrition, and both conditions were related to various health, socio-economic, and environmental factors. CONCLUSION Child malnutrition and poor feeding practices are highly prevalent and of significant public health concern in Ethiopia. Only a few children are getting proper complementary feeding. Multi-sectoral efforts are needed to improve children's feeding practices and reduce the high burden of malnutrition in the country.
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Affiliation(s)
- Shimels Hussien Mohammed
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Tesfa Dejenie Habtewold
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Ahmad Esmaillzadeh
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Food Security Research Center, Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran
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Tasic H, Akseer N, Gebreyesus SH, Ataullahjan A, Brar S, Confreda E, Conway K, Endris BS, Islam M, Keats E, Mohammedsanni A, Wigle J, Bhutta ZA. Drivers of stunting reduction in Ethiopia: a country case study. Am J Clin Nutr 2020; 112:875S-893S. [PMID: 32844167 PMCID: PMC7487434 DOI: 10.1093/ajcn/nqaa163] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 06/01/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Chronic undernutrition in children continues to be a global public health concern. Ethiopia has documented a significant decline in the prevalence of childhood stunting, a measure of chronic undernutrition, over the last 20 y. OBJECTIVES The aim of this research was to conduct a systematic assessment of the determinants that have driven child stunting reduction in Ethiopia from 2000 to 2016, focused on the national, community, household, and individual level. METHODS This study employed both quantitative and qualitative methods. Specifically, a systematic literature review, retrospective quantitative data analysis using Demographic and Health Surveys from 2000-2016, qualitative data collection and analysis, and analyses of key nutrition-specific and -sensitive policies and programs were undertaken. RESULTS National stunting prevalence improved from 51% in 2000 to 32% in 2016. Regional variations exist, as do pro-rich, pro-urban, and pro-educated inequalities. Child height-for-age z score (HAZ) decomposition explained >100% of predicted change in mean HAZ between 2000 and 2016, with key factors including increases in total consumable crop yield (32% of change), increased number of health workers (28%), reduction in open defecation (13%), parental education (10%), maternal nutrition (5%), economic improvement (4%), and reduced diarrhea incidence (4%). Policies and programs that were key to stunting decline focused on promoting rural agriculture to improve food security; decentralization of the health system, incorporating health extension workers to improve rural access to health services and reduce open defecation; multisectoral poverty reduction strategies; and a commitment to improving girls' education. Interviews with national and regional stakeholders and mothers in communities presented improvements in health service access, women and girls' education, improved agricultural production, and improved sanitation and child care practices as drivers of stunting reduction. CONCLUSIONS Ethiopia's stunting decline was driven by both nutrition-specific and -sensitive sectors, with particular focus on the agriculture sector, health care access, sanitation, and education.
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Affiliation(s)
- Hana Tasic
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nadia Akseer
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Seifu H Gebreyesus
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Anushka Ataullahjan
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Samanpreet Brar
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Erica Confreda
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kaitlin Conway
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Bilal S Endris
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Muhammad Islam
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Emily Keats
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Afrah Mohammedsanni
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Jannah Wigle
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
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Belayneh M, Loha E, Lindtjørn B. Seasonal Variation of Household Food Insecurity and Household Dietary Diversity on Wasting and Stunting among Young Children in A Drought Prone Area in South Ethiopia: A Cohort Study. Ecol Food Nutr 2020; 60:44-69. [PMID: 32672490 DOI: 10.1080/03670244.2020.1789865] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study was conducted to evaluate seasonal patterns of household food insecurity, dietary diversity, and household characteristics on wasting and stunting among children in households followed for 1 year in the drought-prone areas of Sidama, Ethiopia. A cohort study design was employed. Data were collected on the pre-harvest season (March and June) and post-harvest season (September and December) of 2017. We studied 935 children aged 6 to 47 months. At four seasons over a year, we had 3,449 observations from 897 households and 82% (2,816) (95% CI: 80.3-82.9) were food in-secured households. Severe food insecurity was higher in the pre-harvest (March; food scarcity season) which was 69% as compared to 50% of September (P < .001). From 3,488 observations, 44% (1,533) (95% CI: 42.3-45.6) of children were stunted. Stunting showed seasonal variations with 38% (95% CI: 34.7-41.0) in March and 49% (95% CI: 45.8-52.5) in December. Six percent (95% CI: 5.0-6.6) of children were wasted, with higher prevalence in March (8%) as compared to 3% of September (P < .001). Moreover, household characteristics such as poverty level, education, occupation and the household food insecurity and dietary diversity were associated with subsequent wasting and stunting.
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Affiliation(s)
- Mehretu Belayneh
- School of Public Health, College of Medicine and Health Sciences, Hawassa University , Hawassa, Ethiopia.,Centre for International Health, University of Bergen , Bergen, Norway
| | - Eskindir Loha
- School of Public Health, College of Medicine and Health Sciences, Hawassa University , Hawassa, Ethiopia.,Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine , London, UK
| | - Bernt Lindtjørn
- School of Public Health, College of Medicine and Health Sciences, Hawassa University , Hawassa, Ethiopia.,Centre for International Health, University of Bergen , Bergen, Norway
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Astatkie A. Dynamics of stunting from childhood to youthhood in Ethiopia: Evidence from the Young Lives panel data. PLoS One 2020; 15:e0229011. [PMID: 32032372 PMCID: PMC7006942 DOI: 10.1371/journal.pone.0229011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 01/28/2020] [Indexed: 01/06/2023] Open
Abstract
Introduction Stunting continues to be a public health challenge with grave health, cognitive and economic consequences. Yet, its dynamics along the life course remain not well investigated in Ethiopia and beyond. Methods Longitudinal data generated by following two (younger and older) cohorts of about 3000 children for nearly 15 years were analyzed to investigate the longitudinal dynamics of stunting in Ethiopia. The cross-sectional prevalence of stunting in each round, longitudinal prevalence, and transition probabilities were determined. Multilevel mixed effects ordinal regression was applied to identify the determinants of stunting accounting for child-level and cluster-level variations. Results The cross-sectional prevalence of severe stunting for the younger cohort fluctuated between 21% and 6%, while for the older cohort it fluctuated between 12% and 3%. Moderate stunting fluctuated between 23% and 16% for the younger cohort and between 22% and 8% for the older cohort. The longitudinal prevalence of severe stunting was 10% in both the younger and older cohorts, whereas that of moderate stunting was 20% for the younger cohort and 18% for the older cohort. Children not stunted at baseline had very high probabilities of remaining not stunted through youthhood (87% for the younger and 90% for the older cohorts). Conversely, children with moderate stunting at baseline had high probabilities either remaining moderately stunted or progressing to severe stunting. Furthermore, children who had severe stunting at baseline had high probabilities of either remaining severely stunted or transitioning to moderate stunting. In both cohorts, older age of the child, female sex, having an educated mother, and being from a household with educated head significantly reduced the risk of stunting. Children from households in the top wealth tertile had a significantly lower risk of stunting in the younger cohort, but not in the older cohort. Similarly, Productive Safety Net Programme reduced the risk of stunting in the younger cohort, but not in the older cohort. Conclusion Children not stunted early in life are highly likely to grow into non-stunted adults while children stunted early in life are highly likely to grow into stunted adults. Several child-level, maternal, household and programmatic factors affect the risk of stunting. Efforts to prevent stunting shall commence early in life.
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Affiliation(s)
- Ayalew Astatkie
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
- * E-mail:
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Water, sanitation and hygiene (WASH) in sub-Saharan Africa and associations with undernutrition, and governance in children under five years of age: a systematic review. J Dev Orig Health Dis 2020; 12:6-33. [PMID: 31902390 DOI: 10.1017/s2040174419000898] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Associations between different forms of malnutrition and environmental conditions, including water, sanitation and hygiene (WASH), may contribute towards persistently poor child health, growth and cognitive development. Experiencing poor nutrition in utero or during early childhood is furthermore associated with chronic diseases later in life. The primary responsibility for provision of water and sanitation, as a basic service and human right, lies with the State; however, a number of stakeholders are involved. The situation is most critical in sub-Saharan Africa (SSA), where, in 2015, 311 million people lacked a safe water source, and >70% of SSA populations were living without adequate sanitation. The aim of this paper was to conduct a systematic review to investigate the state of literature concerned with WASH and its association with nutritional status, and governance in children from birth to 5 years of age in SSA. Articles were sourced from PubMed Central, Science Direct and ProQuest Social Science databases published between 1990 and 2017. The PRISMA Statement was utilised and this systematic review is registered with PROSPERO (CRD42017071700). The search terms returned 15,351 articles for screening, with 46 articles included. This is indicative of a limited body of knowledge; however, the number of publications on this topic has been increasing, suggesting burgeoning field of interest. Targeted research on the governance of WASH through the identification of the various role players and stakeholders at various levels, while understanding the policy environment in relation to particular health-related outcomes is imperative to address the burden of child undernutrition.
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Belay E, Handebo S, Derso T, Tariku A, Sisay M. Prevalence and determinants of pre-adolescent (5-14 years) acute and chronic undernutrition in Lay Armachiho District, Ethiopia. Int J Equity Health 2019; 18:137. [PMID: 31477149 PMCID: PMC6721279 DOI: 10.1186/s12939-019-1041-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 08/23/2019] [Indexed: 12/25/2022] Open
Abstract
Background In Ethiopia it is documented that 16% of all grade repetitions in primary school and 33.9% childhood deaths are associated with undernutrition. School aged children are often omitted from public health research. Thus, the present study was carried out to find out the prevalence and determinants of pre-adolescent (5–14 years) acute and chronic undernutrition in Lay Armachiho District. Methods In this community based cross-sectional study, anthropometrics, individual and household characteristics data were collected from December, 2016 to January, 2017. A total of 848 school aged children (5–14 years) were included in the study. Z-scores for height-for-age (HAZ) and body-mass-index-for-age (BAZ) were calculated to illustrate stunting (chronic undernutrition) and thinness (acute undernutrition), respectively with Anthro Plus software version 1.0.4 using the WHO 2007 growth reference standard. Finally, backward stepwise multivariable logistic regression analysis was carried out to identify factors associated with stunting and thinness, individually. Results The overall prevalence of stunting and thinness was 35.5 and 9.9%, respectively. The multivariable analysis showed that child age 10–14 years [AOR = 1.58, 95% CI: 1.17, 2.12] and lack of availability of a latrine at home [AOR = 1.60; 95% CI: 1.17, 2.20)] were associated with increased likelihood of stunting. Nevertheless, child’s hand washing practice before eating [AOR = 0.67; 95% CI: 0.49, 0.91] was protective against stunting. Children who consumed diversified foods [AOR = 0.64; 95% CI 0.39, 0.97] were protected from thinness. Conclusion In Lay Armachiho district, one-third and one in every ten of school aged children were stunted and thin, respectively. Children age 10–14 years, lack of availability of a latrine at home and hand washing practices before eating were associated with stunting, while only dietary diversity was associated with thinness. Ensuring consistent hand washing practices before eating and ensuring availability of latrine should be improved in the region, which can assist in effectively tackling undernutrition. Finally, dietary diversification should be enhanced to rectify burden of acute undernutrition.
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Affiliation(s)
- Eleni Belay
- Medical Ward, University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia
| | - Simegnew Handebo
- Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Terefe Derso
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Amare Tariku
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mekonnen Sisay
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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Tekile AK, Woya AA, Basha GW. Prevalence of malnutrition and associated factors among under-five children in Ethiopia: evidence from the 2016 Ethiopia Demographic and Health Survey. BMC Res Notes 2019; 12:391. [PMID: 31296269 PMCID: PMC6624874 DOI: 10.1186/s13104-019-4444-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 07/05/2019] [Indexed: 11/13/2022] Open
Abstract
Objective The aim of this study was to assess the risk factors for malnutrition among children aged 0–59 months in Ethiopia. The analyzed data were obtained from the 2016 EDHS and 9495 under-5 years’ children were considered in this analysis. The data was extracted, edited and analyzed by using SPSS Version 23.0. Both bivariate and multivariable binary logistic regression model was used to identify the determinants of children malnutrition. Results The prevalence of stunting, wasting, and underweight were 38.3%, 10.1%, and 23.3%, respectively. About 19.47% of children were both stunted and underweighted, and only 3.87% of children had all the three conditions. Among the factors that considered in this study, age of a child, residence region, mothers’ education level, mothers’ BMI, household wealth index, sex of a child, family size, water and toilet facility were significantly associated with malnutrition in Ethiopia. The authors concluded that malnutrition among under-five children was one of the public health problems in Ethiopia. Therefore, the influence of these factors should be considered to develop strategies for reducing malnutrition in Ethiopia. Electronic supplementary material The online version of this article (10.1186/s13104-019-4444-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Abay Kassa Tekile
- Statistics Department, Science College, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia.
| | - Ashenafi Abate Woya
- Statistics Department, Science College, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia
| | - Garoma Wakjira Basha
- Statistics Department, Science College, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia
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Hondru G, Wieringa FT, Poirot E, Berger J, Som SV, Theary C, Laillou A. The Interaction between Morbidity and Nutritional Status among Children under Five Years Old in Cambodia: A Longitudinal Study. Nutrients 2019; 11:E1527. [PMID: 31284369 PMCID: PMC6682948 DOI: 10.3390/nu11071527] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 06/19/2019] [Accepted: 06/23/2019] [Indexed: 01/05/2023] Open
Abstract
Even though limited evidence is available, the relationship between morbidity and under-nutrition among children under-five is likely to be a strong two-way association. This study aims to explore this vicious cycle by employing longitudinal data of four periods within a 24 month follow-up, whereby morbidity was captured between two subsequent anthropometric measures. Malnutrition was classified according to z-scores of anthropometric measures and morbidity by number of sick days experienced inbetween. Mixed-effects models were used to assess this relation, where dependency of morbidity and nutritional status were interchanged; models were adjusted for province, age, gender, wealth index score, maternal education level, diet, and Water, Sanitation, and Hygiene indicators. Stunting and wasting prevalences were 29.9% and 8.9%, respectively, where 21.3% of the children hadmultiple anthropometric failures. Children identified as wasted were 35% more likely to experience prolonged illness periods (OR: 1.35, 95% CI: 1.02-1.56). Those experiencing high proportion of sick days were found to be 64% more likely to become stunted (OR: 1.64, 95% CI: 1.18-2.29). This study suggests that the link between wasting and stunting could be partly explained by acute illness, where wasting increases the likelihood of prolonged epiosed of illness, which increases the risk of stunting.
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Affiliation(s)
- Gabriela Hondru
- Reproductive and Child Health Alliance, No. 160 Street 71, Tonle Bassac, Chamkar Mon, P.O.Box 2471, Phnom Penh 12100, Cambodia.
| | - Frank T Wieringa
- UMR-204 Nutripass, Institut de Recherche pour le Développement, IRD/UM/SupAgro, 34390 Montpellier, France
| | - Etienne Poirot
- United Nations Children's Fund (UNICEF), Integrated Early Childhood Development, Exchange Square, 5th Floor, No. 19&20, Street 106, Sangkat Wat Phnom, Khan Daun Penh, Phnom Penh 12100, Cambodia
| | - Jacques Berger
- UMR-204 Nutripass, Institut de Recherche pour le Développement, IRD/UM/SupAgro, 34390 Montpellier, France
| | - Somphos V Som
- Reproductive and Child Health Alliance, No. 160 Street 71, Tonle Bassac, Chamkar Mon, P.O.Box 2471, Phnom Penh 12100, Cambodia
| | - Chan Theary
- Reproductive and Child Health Alliance, No. 160 Street 71, Tonle Bassac, Chamkar Mon, P.O.Box 2471, Phnom Penh 12100, Cambodia
| | - Arnaud Laillou
- United Nations Children's Fund (UNICEF), Integrated Early Childhood Development, Exchange Square, 5th Floor, No. 19&20, Street 106, Sangkat Wat Phnom, Khan Daun Penh, Phnom Penh 12100, Cambodia
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