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Zeleke EA, Fikadu T, Bekele M, Sidamo NB, Temesgen Worsa K. Physical activity status among adolescents in Southern Ethiopia: A mixed methods study. PLoS One 2023; 18:e0293757. [PMID: 37943792 PMCID: PMC10635445 DOI: 10.1371/journal.pone.0293757] [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: 03/29/2023] [Accepted: 10/19/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Adolescents physical activity is associated with current and future health benefits, reduction of cardio-vascular risk factors, improved bone mineral density, and mental health. The aim of the current study is to assess physical activity status and its factors among adolescents in Arba Minch and Jinka towns, Southern Ethiopia. METHODS The study was conducted on 1255 randomly selected schools adolescents of Arba Minch and Jinka town by employing a mixed method. The qualitative data was obtained by Focus Group Discussion. Multiple linear regressions were done to identify factors affecting physical activity. Codes, sub-categories, and main categories were derived from the transcripts and presented in narrative ways to describe adolescent student's perception on physical activity, its barriers and facilitators by comparing with quantitative findings. RESULTS The mean physical activity level was 2.08 (95% CI: 2.04-2.12). A student's self-perception about being physically active, being a member of a sport or fitness team, and engaging in after-school activity to earn money, being older, sex, a self-perception of being healthy, higher levels of vegetable and fruit consumption, having someone who encouraged physical activity, perceiving one's family as being active, self-perception of not being overweight and attending schools that have a sports/playground were factors associated with physical activity. The qualitative finding showed a related finding. Poor awareness on the recommended physical activity, benefits of physical activity, lack of interest, restrictions from family members, peers and the community, uncomfortable environment were barriers to physical activity. CONCLUSION AND RECOMMENDATION The physical activity level of adolescents was low. Age, sex, a positive self-perception about PA and general health, and perception about one's family PA, healthy eating practice, and the presence of role model were associated factors. Lack of self-motivation, interest and family restrictions were barriers to physical activity. PA promotion should be made by incorporating PA into school health programs and strengthening the existing school curriculum.
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Affiliation(s)
- Eshetu Andarge Zeleke
- School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
- Flinders Health and Medical Research Institute, Discipline of Population Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Teshale Fikadu
- School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Muluken Bekele
- School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Negussie Boti Sidamo
- School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Kidus Temesgen Worsa
- School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
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Temesgen K, Andarge E, Fikadu T, Bekele M, Chisha Y, Esubalew H, Toma TM. Early cessation of breastfeeding and the associated factors among mothers with children aged 2 to 3 years in rural Southern Ethiopia: a community-based cross-sectional study. BMC Nutr 2023; 9:22. [PMID: 36721185 PMCID: PMC9887840 DOI: 10.1186/s40795-023-00681-5] [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: 08/26/2022] [Accepted: 01/19/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Breast milk is the first natural food for babies. It has nutritional, immunological, developmental, psychological, societal and environmental advantages. Failing to feed children for twenty-four months has so many negative consequences to children. Though studies have well documented the duration of breast feeding in the first six months, the proportion of women completing the recommended duration and factors associated with it has not been well investigated in rural places of Ethiopia. Therefore, this study aims to fill this gap in evidence among mothers with children aged 2 to 3 years in Arba Minch Health and Demographic Surveillance Site in 2021 E.C. METHODS A community-based cross-sectional study was conducted in all kebeles of the surveillance site by employing multi-stage sampling technique. Descriptive statistics was done to summarize findings and binary logistics regression model was used to identify factors significantly associated with early breast-feeding cessation respectively. OR with its 95% CI was obtained to quantify the degree of association between explanatory variables and early breastfeeding cessation. RESULT The proportion of early cessations of breast feeding was 29.30% (25.02, 33.64%). Being from a household with no fathers 'education or primary education [AOR=0.22; 95%CI (0.07, 0.74)] and [AOR=0.30; 95%CI (0.12, 0.76)], farmer mothers [AOR=6.40; 95%CI: (1.38, 29.74)], birth interval of less than 2 years [AOR=2.07; 95%CI: (1.03, 4.16)], and with mothers' one or two to three antenatal care visits [AOR = 2.73; 95%CI: (1.27,5.88)] were factors significantly associated with early cessations of breast feeding. CONCLUSION AND RECOMMENDATION The proportion of early cessations of breast feeding was high. Father's education, being farmer, birth interval and ante natal care visit were significant factors. Health education about proper breast feeding practice and improving ante natal care attendance might improve premature cessation of breast feeding among women.
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Affiliation(s)
- Kidus Temesgen
- grid.442844.a0000 0000 9126 7261School of public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Eshetu Andarge
- grid.442844.a0000 0000 9126 7261School of public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia ,grid.1014.40000 0004 0367 2697College of Medicine and Public health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia Australia
| | - Teshale Fikadu
- grid.442844.a0000 0000 9126 7261School of public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia ,grid.411903.e0000 0001 2034 9160Department of nutrition and dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Muluken Bekele
- grid.442844.a0000 0000 9126 7261School of public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Yilma Chisha
- grid.442844.a0000 0000 9126 7261School of public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Habtamu Esubalew
- grid.442844.a0000 0000 9126 7261School of public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Temesgen Mohammed Toma
- Department of Public health, Arba Minch College of Health Science, Arba Minch, Ethiopia
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Tsega TD, Tafere Y, Ashebir W, Asmare B. Time to breastfeeding cessation and its predictors among mothers who have children aged two to three years in Gozamin district, Northwest Ethiopia: A retrospective follow-up study. PLoS One 2022; 17:e0262583. [PMID: 35061816 PMCID: PMC8782324 DOI: 10.1371/journal.pone.0262583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 12/30/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction
Globally, breastfeeding duration is below the recommended level. In Ethiopia, more than 24% of mothers ceased breastfeeding before 24 months of age of a child which caused 14,000 preventable childhood deaths annually. To tackle this problem, current and up-to-date information regarding the time to breastfeeding cessation and its predictors is essential. Therefore, this study aims to determine the time to breastfeeding cessation and its predictors among mothers who have children aged two to three years in Gozamin district, Northwest Ethiopia.
Methods
A community-based retrospective follow-up study was used among 502 mothers who have children aged two to three years in the Gozamin district from October 1, 2017, up to September 30, 2020. Interviewer-administered structured questionnaires were used. Cox proportional hazard model was applied after its assumptions and model fitness were checked, to identify predictors for time to breastfeeding cessation.
Results
The overall mean time to breastfeeding cessation was 22.56 (95%CI: 22.21, 22.91) months, and the cumulative survival probability on breastfeeding up to 24 months was 82.5% (95%CI:78.85, 85.53). The overall incidence of early breastfeeding cessation was 7.77 (95%CI:6.31, 9.58) per 1000 person-month observations. Having no antenatal care follow up (AHR:2.15, 95%CI:1.19, 3.89), having ≥4 number of children (AHR:1.76, 95%CI:1.10, 2.80), < 24 months breastfeeding experience (AHR:1.77, 95%CI:1.14, 2.75), and presence of cow milk in the household (AHR:3.01, 95%CI:1.89, 4.78) were significant predictors for time to breastfeeding cessation.
Conclusion
The time to breastfeeding cessation is below the recommendation and therefore, strengthening breastfeeding education and related counseling at the community level is better.
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Affiliation(s)
- Tilahun Degu Tsega
- Epidemiology Unit, Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
- * E-mail:
| | - Yilkal Tafere
- Epidemiology Unit, Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Wassachew Ashebir
- Department of Reproductive Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Biachew Asmare
- Department of Human Nutrition, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Ngbapai JG, Izudi J, Okoboi S. Cessation of breastfeeding and associated factors in the era of elimination of mother to child transmission of HIV at Ndejje health center, Uganda: a retrospective cohort study. Int Breastfeed J 2020; 15:78. [PMID: 32894155 PMCID: PMC7476247 DOI: 10.1186/s13006-020-00323-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 09/02/2020] [Indexed: 11/25/2022] Open
Abstract
Background Breastfeeding an infant exposed to Human Immunodeficiency Virus (HIV) carries the risk of HIV acquisition whilst not breastfeeding poses a higher risk of death from malnutrition, diarrhea, and pneumonia. In Uganda, mothers living with HIV are encouraged to discontinue breastfeeding at 12 months but data are limited. We examined the frequency and factors associated with cessation of breastfeeding at 1 year among mothers living with HIV at Ndejje Health Center IV, a large peri-urban health facility in Uganda. Methods This retrospective cohort study involved all mothers living with HIV and enrolled in HIV care for ≥12 months between June 2014 and June 2018. We abstracted data from registers, held focus group discussions with mothers living with HIV and key informant interviews with healthcare providers. Cessation of breastfeeding was defined as the proportion of mothers living with HIV who had discontinued breastfeeding at 1 year. We summarized quantitative data descriptively, tested differences in outcome using Chi-square and t - tests, and established independently associated factors using modified Poisson regression analysis at 5% statistical significance level. We thematically analyzed qualitative data to enrich and triangulate the quantitative results. Results Of 235 participants, 150 (63.8%) had ceased breastfeeding at 1 year and this was independently associated with the infant being male (Adjusted Risk Ratio [aRR] 1.25, 95% confidence interval [CI] 1.04, 1.50), the mother being multiparous (aRR 1.26, 95% CI 1.04–1.53), and the initiation of breastfeeding being on the same-day as birth (aRR 0.06, 95% CI 0.01–0.41). The reasons for ceasing breastfeeding included male infants over breastfeed than females, maternal literacy and knowledge adequacy about breastfeeding, support and reminders from the partner, and boys can bite once they get teeth. Conclusion Suboptimal proportion of infants were ceased from breastfeeding at 1 year and this might increase the risk of mother to child transmission of HIV. Cessation of breastfeeding was more likely among male infants and multiparous mothers but less likely when breastfeeding was initiated on the same-day as birth. Interventions to enhance cessation of breastfeeding should target none multiparous mothers and those with female infants.
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Affiliation(s)
- Jackslina Gaaniri Ngbapai
- Institute of Public Health and Management, Clarke International University, P.O. Box 7782, Kampala, Uganda
| | - Jonathan Izudi
- Institute of Public Health and Management, Clarke International University, P.O. Box 7782, Kampala, Uganda. .,Department of Community Health, Faculty of Medicine, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Uganda.
| | - Stephen Okoboi
- Institute of Public Health and Management, Clarke International University, P.O. Box 7782, Kampala, Uganda.,Infectious Diseases Institute, Makerere University College of Health Sciences, P.O. Box 22418, Kampala, Uganda.,Global Health Institute, University of Antwerp, Antwerp, Belgium
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5
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Early Cessation of Breastfeeding and Determinants: Time to Event Analysis. J Nutr Metab 2020; 2020:3819750. [PMID: 32399288 PMCID: PMC7210562 DOI: 10.1155/2020/3819750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 03/31/2020] [Indexed: 11/18/2022] Open
Abstract
Background The onset of breastfeeding has a high success rate in most countries, but the time for termination of breastfeeding varies between countries. Objective This survey was aimed to determine the effective factors on the early termination of breastfeeding. Methods This study was conducted in 2018, in Iran. About 410 mothers were enrolled in the study. All considered factors were evaluated as factors influencing the continuity of breastfeeding. Survival analysis was used to analyze data. Results The mean age of the mothers was equal to 29.48 ± 5.8 years. The frequency of termination of breastfeeding before the first 2 years was equal to 34%. The mean of breastfeeding duration was equal to 21.49 ± 5.3 months. The percentage of infants who had been breastfed for 24 months was equal to 65.8%. An infant's birth weight (2500-4000 gr) (hazard ratio: 0.54), neonatal birth order (hazard ratio: 0.69), neonatal pathologic jaundice (hazard ratio: 1.52), starting time of using complementary food (hazard ratio: 2.45), using pacifier (hazard ratio: 2.82), and the status of using artificial milk (hazard ratio: 3.29) were significantly associated with cessation of breastfeeding before 24 months of age. The probability of termination of breastfeeding at 6, 12, 18, and 24 months of age was reported by 6%, 8%, 15%, and 34%, respectively. Conclusions There were notifiable variations in breastfeeding rates both in national and international levels. Nevertheless, in this study, the mean of breastfeeding duration was longer compared to a number of countries and previous national studies.
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Hunegnaw MT, Gelaye KA, Ali BM. Factors associated with the time to cessation of breastfeeding among mothers who have index children aged two to three years in Debre Markos, northwest Ethiopia: a retrospective follow up study. BMC Pediatr 2018; 18:77. [PMID: 29471793 PMCID: PMC5822633 DOI: 10.1186/s12887-018-1012-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 01/28/2018] [Indexed: 12/03/2022] Open
Abstract
Background Breastfeeding of children, which needs to continue until two years and beyond, is one of the essential requirements for child survival. However, in Ethiopia there is scarcity of literatures on the duration of breastfeeding. Therefore, the aim of this study was to assess the rate of cessation of breastfeeding among mothers with index children aged 2 to 3 years, northwest Ethiopia. Methods A retrospective follow-up study was conducted at Debre Markos town from March 1, 2014 to March 30, 2016. A total of 500 mother-child pairs were selected using the systematic random sampling method by moving from house to house with an interval of three eligible houses. A structured questionnaire was used to collect data. The Cox regression model was employed to identify the predictors of breastfeeding cessation. Results The proportion of women breastfeeding until 2 years was 13.70 per 1000 person- months. HIV-positive mothers decreased the time of breastfeeding by 3.4 times compared to HIV-negative mothers (AHR = 3.41, 95% CI: 1.96, 5.94). Government employee mothers decreased the time of breastfeeding by 2.8 times compared to housewives (AHR = 2.8, 95% CI: 1.80, 4.40).Better education increased the time of breastfeeding (AHR = 0.45, 95% CI: 0.24, 0.58). Number of children, family income, and place of delivery were the other significant predictors of time to cessation of breastfeeding (p < 0.05). Conclusion In this study, the rate of cessation of breastfeeding was good. HIV negative mothers, government employment, number of children, place of delivery, and family monthly income were significant predictors to the time of breastfeeding cessation. Therefore, family planning and breastfeeding education in health institutions are essential to increase breastfeeding duration.
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Affiliation(s)
- Melkamu Tamir Hunegnaw
- Department of Human Nutrition, College of Medicine and Health Sciences, the University of Gondar, P.O. Box 196, Gondar, Ethiopia.
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, The University of Gondar, Gondar, Ethiopia
| | - Bekri Mohammed Ali
- Department of Human Nutrition, College of Medicine and Health Sciences, the University of Gondar, P.O. Box 196, Gondar, Ethiopia
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Thomas E, Kuo C, Cohen S, Hoare J, Koen N, Barnett W, Zar HJ, Stein DJ. Mental health predictors of breastfeeding initiation and continuation among HIV infected and uninfected women in a South African birth cohort study. Prev Med 2017; 102:100-111. [PMID: 28694059 PMCID: PMC5802398 DOI: 10.1016/j.ypmed.2017.07.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 06/26/2017] [Accepted: 07/05/2017] [Indexed: 12/19/2022]
Abstract
Breastfeeding is a cost-effective, yet underutilized strategy to promote maternal and infant health in low and middle income countries (LMICs). Breastfeeding remains challenging for mothers living with HIV in LMICs, yet few studies have examined mental health predictors of breastfeeding initiation and continuation. We investigated breastfeeding among mothers by HIV status in South Africa, evaluating predictors of breastfeeding initiation and continuation to identify intervention-targets. Breastfeeding patterns were investigated in a subsample of 899 breastfeeding mothers from the Drakenstein Child Health Study; a prospective birth cohort of 1225 pregnant women, between March 2012 and March 2015 in a peri-urban area. Breastfeeding was assessed at 5 time-points between 6weeks and 24months' infant age. Cox proportional hazard models evaluated breastfeeding initiation and duration. Logistic regression models with breastfeeding non-initiation as the outcome parameter were performed to determine associations with maternal sociodemographic, psychosocial factors and gestational outcomes. More HIV-uninfected mothers initiated breastfeeding (n=685, 97%) than HIV-infected mothers (n=87, 45%). Median duration of exclusive breastfeeding was short (2months), but HIV-infected mothers engaged in exclusive breastfeeding for longer duration than uninfected mothers (3 vs 2months). Despite concerning high rates, mental disorders were not significant predictors of breastfeeding behaviour. Employment and HIV diagnosis during pregnancy predicted a lower likelihood of breastfeeding initiation among HIV-infected mothers, while employment was associated with earlier breastfeeding-discontinuation in HIV-uninfected mothers. Findings indicate that future interventions should target sub-populations such as HIV-infected women because of distinct needs. Workplace interventions appear particularly key for mothers in our study.
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Affiliation(s)
- Eileen Thomas
- Department of Psychiatry and Mental Health, University of Cape Town, J-Block, Groote Schuur Hospital, Observatory, Cape Town 7925, South Africa.
| | - Caroline Kuo
- Department of Psychiatry and Mental Health, University of Cape Town, J-Block, Groote Schuur Hospital, Observatory, Cape Town 7925, South Africa; Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University, 121 South Main Street, Box G-S121-4th Floor, Room 406, Providence, RI 02912, USA
| | - Sophie Cohen
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - Jacqueline Hoare
- Department of Psychiatry and Mental Health, University of Cape Town, J-Block, Groote Schuur Hospital, Observatory, Cape Town 7925, South Africa
| | - Natassja Koen
- Department of Psychiatry and Mental Health, University of Cape Town, J-Block, Groote Schuur Hospital, Observatory, Cape Town 7925, South Africa; Medical Research Council Unit on Anxiety and Stress Disorders, South Africa
| | - Whitney Barnett
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa; Medical Research Council Unit on Child and Adolescent Health, South Africa
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, J-Block, Groote Schuur Hospital, Observatory, Cape Town 7925, South Africa; Medical Research Council Unit on Anxiety and Stress Disorders, South Africa
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Genetu H, Yenit MK, Tariku A. Breastfeeding counseling and support are associated with continuous exclusive breastfeeding from one week to six months of age among HIV exposed infants in north Gondar zone, Ethiopia: a cross-sectional study. Int Breastfeed J 2017; 12:21. [PMID: 28439291 PMCID: PMC5401345 DOI: 10.1186/s13006-017-0113-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 04/18/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Globally, exclusive breastfeeding prevents 1.3 million child deaths and has an added benefit for people living with the Human Immune Deficiency Virus (HIV) by preventing mother-to-child transmission of HIV. However, literature is scarce in Ethiopia; therefore this study aimed to assess the rate of continuous exclusive breastfeeding from the end of the first week to 6 months of age, among HIV exposed infants (aged 7-20 months) who were followed up in government hospitals of North Gondar Zone, Ethiopia, and associated factors. METHODS An institutional based cross-sectional study was conducted from February 21 to March 30, 2016. All mother-child pairs (367) attending the chronic HIV care clinic in government hospitals of North Gondar Zone were included in the study. Exclusive breastfeeding was defined as the practice of feeding only breast milk (including expressed breast milk) during the first 6 months and no other liquids and solid foods except medications. However since prelacteal feeding is a deep rooted norm in the study setting, we report continuous exclusive breastfeeding from the end of first week to 6 months of age of infants, ignoring all prelacteal feeding offered at birth. A binary multivariable logistic regression analysis was employed to identify factors associated with exclusive breastfeeding. RESULTS The overall prevalence of continuous exclusive breastfeeding among HIV exposed infants was 86.4%. According to the multivariable analysis; breastfeeding counseling (Adjusted Odds Ratio [AOR] = 5.1, 95% Confidence Interval [CI] 1.4, 18.2), breastfeeding support (AOR = 3.7, 95% CI 1.3, 10.5), and not experiencing obstetric problems (AOR = 3.4, 95% CI: 1.3, 8.8) were associated with higher odds of continuous breastfeeding. CONCLUSIONS In this study, most HIV exposed infants were continuously breastfed from the end of first week to 6 months of age. Breastfeeding counseling, breastfeeding support and experiencing obstetric problems were identified as significant determinants of continuous breastfeeding. Therefore, breastfeeding counseling and support should be strengthened to improve the coverage of optimal exclusive breastfeeding practice. Moreover, prompt diagnosis and treatment of obstetric problems should be initiated.
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Affiliation(s)
| | - Melaku Kindie Yenit
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Amare Tariku
- Department of Human Nutrition, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Ogwu A, Moyo S, Powis K, Asmelash A, Lockman S, Moffat C, Leidner J, Makhema J, Essex M, Shapiro R. Predictors of early breastfeeding cessation among HIV-infected women in Botswana. Trop Med Int Health 2016; 21:1013-1018. [PMID: 27224454 DOI: 10.1111/tmi.12729] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Infants born to HIV-infected women receiving antiretroviral treatment (ART) can be breastfed through at least 6 months with very low risk of HIV acquisition. We aimed to identify demographic and cultural factors that may influence mothers' willingness to breastfeed for the recommended duration. METHODS We evaluated factors associated with early cessation of breastfeeding (i.e. before 5 months post-partum) in a randomized clinical trial evaluating different ART regimens used for prevention of mother-to-child transmission during breastfeeding in Botswana. Univariate and multivariable Cox regressions were used to describe predictors of early exclusive BF cessation. RESULTS Among 677 women who started breastfeeding, the median time to breastfeeding cessation was 178 days (IQR 150-181) and 25.1% weaned early. In multivariable analysis, urban location (aHR = 1.86 95%CI 1.27-2.73; P = 0.002), salaried employment or being a student (aHR = 2.78 95% CI 1.63-4.75; P < 0.001) and infant hospitalisation before weaning (aHR = 2.04 95% CI 1.21-3.45; P = 0.008) were independently and significantly associated with early BF cessation. CONCLUSIONS Improved support for breastfeeding among employed mothers, especially in urban settings, may allow HIV-infected women who are receiving ART prophylaxis to breastfeed longer.
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Affiliation(s)
- Anthony Ogwu
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.,Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Trinity Medical Centre, Piccadilly, WA, Australia
| | - Sikhulile Moyo
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.,Division of Medical Virology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Kathleen Powis
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.,Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Aida Asmelash
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.,Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Shahin Lockman
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.,Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Brigham and Women's Hospital, Boston, MA, USA
| | - Claire Moffat
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.,Greater Manchester West Mental Health NHS Foundation Trust, Prestwich, UK
| | | | - Joseph Makhema
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.,Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Max Essex
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.,Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Roger Shapiro
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.,Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Beth Israel Deaconess Medical Center, Boston, MA, USA
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