Under nutrition and associated factors among adolescent girls attending school in the rural and urban districts of Debark, Northwest Ethiopia: A community-based comparative cross-sectional study

Risk of child undernutrition in households with life-limiting illness: A cross-sectional study

BACKGROUND

 An ongoing challenge within the field of undernutrition is to identify children at risk.

AIM

 The objective of this study was to investigate whether children who are living in households inhabiting a household member with a life-limiting illness are at risk of undernutrition.

SETTING

 A comparative cross-sectional study was performed in Uganda.

METHODS

 We collected anthropometric data on children under the age of five and information on household dietary diversity, food security and healthcare barriers. Study participants for the hypothesised high-risk group were recruited within households receiving home-based palliative care. The comparison group included neighbouring households.

RESULTS

 Data collection from 145 paired households was performed from April to July 2021. There was no statistically significant difference in prevalence of undernutrition. For all continuous nutrition indicators there was a trend towards less undernutrition in the hypothesised high-risk group than in the comparison group. We found lower overall prevalence of acute malnutrition than expected. The hypothesised high-risk group was associated with higher food insecurity than the comparison group.

CONCLUSION

 Lower overall acute malnutrition than expected may be because of the season variability. Stunting was higher than expected in both groups, which may suggest season variability in undernutrition. The results suggest a protective effect of receiving home-based palliative care on child nutritional status.Contribution: The study did not show a risk of child undernutrition in households inhabiting a household member with life-limiting illness. Future research may identify key elements responsible for the potential protective effects of home-based palliative care on child undernutrition.

Undernutrition and associated factors among adolescent girls in Diga District, East Wollega Zone, Ethiopia

BACKGROUND

Undernutrition is a significant challenge for adolescent girls globally due to biological, social, and cultural factors. The consequences of undernutrition for adolescent girls are extensive, impacting their cognitive abilities, reproductive health, susceptibility to chronic diseases in later life, and the economies of nations. However, there needs to be a more comprehensive understanding of the nutritional status of adolescent girls in the Diga district, Ethiopia.

OBJECTIVE

This study aimed to assess the prevalence of undernutrition and its associated factors among adolescent girls in the Diga District, East Wollega Zone, Ethiopia.

METHODS

The study employed a community-based cross-sectional study design in Diga District, Ethiopia. Data was gathered from 651 study participants using a systematic random sampling technique, from July 10th to August 10th, 2023. Data analysis involved using Epi-Data 4.6 and SPSS version 26 for data entry and statistical analysis, respectively. The Body Mass Index (BMI) and Height-for-age (HFA) Z-score are generated using WHO AnthroPlus version 1.0.4 software. Descriptive statistics and binary logistic regressions were used for data summarization and analysis, with significance testing at a p-value <0.05.

RESULTS

In this study, 16.3% (95% CI: 13.5-19.3) of adolescent girls were stunted, while 18.5% (95% CI: 15.4-21.5) were thin. Lack of access to health and nutrition information (AOR = 3.36, 95% CI: 1.38-8.23), limited crop variety within household's crops (AOR = 1.66, 95% CI: 1.03-2.65), and household food insecurity (AOR = 2.76, 95% CI: 1.49-5.11) were factors associated with stunting. Poor dietary diversity scores (AOR = 7.52, 95% 95% CI: 2.92-19.39) and household food insecurity (AOR = 3.69, 95% CI: 1.96-6.93) were significantly associated with thinness.

CONCLUSION

Conclusively, there was a low prevalence of stunting and thinness among adolescent girls in the Diga district, Ethiopia. Interventions aimed at enhancing household-level crop diversity, improving food security, providing adequate health and nutrition information, and promoting income-generating activities for adolescent girls can play a crucial role in improving their access to nutritious foods and healthcare, ultimately leading to better nutritional outcomes.

Determinants of stunting among adolescent girls in schools of Digo Tsion Town, Northwest Ethiopia: Unmatched case control study

INTRODUCTION

Stunting is a height-for-age (Z-score) less than minus two standard deviations below the mean of reference standard. It is the most important sign of long-term chronic undernutrition and public health problem in Ethiopia. However, little information was known regarding determinants of stunting among adolescents since it had mostly been investigated in late infancy, especially among children under the age of five. Therefore, identifying determinants of stunting among adolescent girl is still crucial.

OBJECTIVE

To identify determinants of stunting among adolescent girls in schools of Digo Tsion Town, Northwest Ethiopia, 2022.

METHODS AND MATERIALS

Case-control study was conducted among 417 adolescent girls (104 cases and 313 controls) in schools of Digo Tsion Town with computer generated simple random sampling technique. World Health Organization Anthroplus 2007 software was used for analyzing anthropometrics data. Data was collected by epicollect5 mobile application through interview by using structured questionnaire. The data was entered in epi data 4.6 and exported into Statistical Package for Social Science version 26. Variables with p- value ≤ 0.25 in bivariable analysis were candidate for multivariable analysis. Model fitness was checked by Hosmer and Lemon Show fitness of test. Variables having a P-value < 0.05 in multivariable analysis were declared as statistically significant at 95% Cl. The result was presented by statement, figures, and tables.

RESULTS

A total of 409 (100 cases and 309 controls) adolescent girls participated, with a response rate of 96% for cases and 98.72% for controls. Food insecurity (AOR = 2.13, CI [1.15, 3.93]), low dietary diversity score (AOR = 1.99, CI [1.06, 3.73]), drinking coffee/tea immediately while eating meals (AOR = 2.19, CI [1.22, 3.95]), not getting nutritional counsel (AOR = 2.07, CI [1.17, 3.66]), chronic illness (AOR = 3.78, CI [1.16, 12.3]), and not visited by health extension workers at home (AOR = 1.85, CI [1.03, 3.31]) were statistically significant determinants of stunting.

CONCLUSION

Stunting among adolescents is influenced by a low dietary diversity score, a food-insecure household, drinking coffee or tea immediately while eating a meal, not receiving nutritional counseling, having a chronic illness, and not being visited by health extension workers at home. Future researchers would do better to undertake prospective studies. Health extension workers are better able to provide nutritional counsel for adolescent.

The Association between Intrahousehold Food Allocation Social Norms and Thinness among Young Adolescent Girls: A Community-Based Study

Background

Inequalities in food allocation related to social norms among household members significantly affect the nutritional status and well-being of the vulnerable members of the household, such as adolescent girls. This study assesses the association between social norms related to intrahousehold food allocation and young adolescent girls' thinness.

Materials and Methods

The study involved 1,083 pairs of mothers/caregivers and young adolescent girls. Data were collected using a structured and pretested questionnaire. Multilevel mixed-effect logistic regression analysis was employed to examine associations using STATA/SE V.14 statistical software. In addition, a stratified analysis was done to investigate the effect of social norms on thinness in food-secure and food-insecure households.

Result

The overall prevalence of young adolescent girls' thinness was 15.70% (95% CI 13.52-17.86%). Young adolescent girls' thinness was associated with mothers'/caregivers' conformity to inequitable intrahousehold food allocation social norms in food-secure households [Adjusted odds ratio (AOR): 1.43, 95% CI: 1.14-1.80] but not in food-insecure households.

Conclusion

Nearly 16% of adolescent girls were thin. Mothers/female caregivers conforming to inequitable intrahousehold food allocation social norms compromise the nutritional status of adolescent girls, particularly in food-secure households. The lack of statistically significant association in food-insecure households hints at the need to address inequality in food-secure households while addressing food shortage to improve the nutritional status of adolescents in low-income countries. We also recommend more studies in different sociocultural contexts to fully gather the evidence for adopting appropriate policies and practices.

Feature selection and association rule learning identify risk factors of malnutrition among Ethiopian schoolchildren

Introduction

Previous studies have sought to identify risk factors for malnutrition in populations of schoolchildren, depending on traditional logistic regression methods. However, holistic machine learning (ML) approaches are emerging that may provide a more comprehensive analysis of risk factors.

Methods

This study employed feature selection and association rule learning ML methods in conjunction with logistic regression on epidemiological survey data from 1,036 Ethiopian school children. Our first analysis used the entire dataset and then we reran this analysis on age, residence, and sex population subsets.

Results

Both logistic regression and ML methods identified older childhood age as a significant risk factor, while females and vaccinated individuals showed reduced odds of stunting. Our machine learning analyses provided additional insights into the data, as feature selection identified that age, school latrine cleanliness, large family size, and nail trimming habits were significant risk factors for stunting, underweight, and thinness. Association rule learning revealed an association between co-occurring hygiene and socio-economical variables with malnutrition that was otherwise missed using traditional statistical methods.

Discussion

Our analysis supports the benefit of integrating feature selection methods, association rules learning techniques, and logistic regression to identify comprehensive risk factors associated with malnutrition in young children.

Prevalence and correlates of stunting and thinness among adolescent students in Lideta subcity, Addis Ababa, Ethiopia: a cross-sectional study

OBJECTIVES

To determine the prevalence of stunting and thinness and associated factors among adolescents attending public schools in Lideta subcity, Addis Ababa, Ethiopia, in 2021.

DESIGN

Cross-sectional.

SETTING

Public schools in Lideta subcity, Addis Ababa, Ethiopia.

ELIGIBILITY

Adolescents from grades 5-12 in public schools and students whose parents gave consent for participation.

DATA ANALYSIS

Bivariate and multivariable logistic regression analyses were used to examine the association between the independent variables and stunting and thinness. Using a 95% CI and adjusted OR (AOR), factors with a p value of less than 0.05 were determined to have a significant association.

OUTCOME MEASURES

The prevalence of stunting and thinness, as well as the factors associated with stunting and thinness, were secondary outcomes.

RESULTS

The overall prevalence of stunting and thinness was 7.2% (95% CI: 5.3% to 9.3%) and 9% (95% CI: 6.8% to 11.4%), respectively. Stunting was associated with a larger family size (AOR=3.76; 95% CI: 1.58 to 8.94), low dietary diversity (AOR=2.87; 95% CI: 1.44 to 5.74), food insecurity (AOR=2.81; 95% CI: 1.38 to 5.71) and a lower wealth index (AOR=3.34; 95% CI: 1.51 to 7.41). On the other hand, thinness was associated with maternal education in those who were unable to read and write (AOR=2.5; 95% CI: 1.97 to 8.11), inadequate dietary diversity (AOR=4.81; 95% CI: 2.55 to 9.07) and larger family size (AOR=2.46; 95% CI: 1.14 to 5.29).

CONCLUSION

Adolescent stunting and thinness were common in Addis Ababa's public schools. Family size, dietary diversity and food security were the main factors associated with both thinness and stunting. Therefore, to solve the problem of adolescent stunting and thinness, the administration of Addis Ababa city should prioritise minimising food insecurity while boosting productivity to enhance adolescent nutritional diversity. Moreover, nutritional education should be strengthened by healthcare providers working at public schools as well as health extension workers.

Stunting and thinness in school-attending adolescents in Addis Ababa

BACKGROUND

Adolescent population Global Diet Quality Score (GDQS) is uncommon in low-income settings. Though Global Diet Quality Score is a good measure of dietary diversity, it has not been used in assessing nutritional outcomes among adolescents. Therefore, the aim of this study is to assess school-attending adolescents stunting and thinness status and associations with global diet quality scores in Addis Ababa.

METHODS

A school-based cross-sectional study was conducted among school-attending adolescents in the age group of 10-14 years in urban settings in Ethiopia. A multi-stage stratified random sampling procedure was used to select schools and students. A total of 1200 adolescents were included in the study. Binary and Multinomial logistic regression analyses were used to determine the predictors of stunting and thinness respectively.

RESULTS

The proportion of school-attending adolescents stunting was 8.17% (95% CI: 6.74%,9.85%) and their thinness status 12.66% (95% CI: 10.89%, 14.67%). The overall mean GDQS food groups for Seven days period consumed were 19.99 + 2.81 SD. Male adolescents were 1.95 times more likely to be stunted compared to female adolescents (1.95; 95%CI: 1.11,3.39). Frequent consumption of low-fat dairy increased the risk of thinness, while frequent consumption of citrus fruits and white root tubers decreased the risk of school-attending adolescents' thinness.

CONCLUSION

The proportion of thin or stunted adolescents attending school was high still, about 1 in 10. Stunting and thinness have no association with the overall GDQS. Nutritional interventions need to consider frequent consumption of citrus fruits, low-fat dairy, and white roots and tubers in school adolescents' nutritional programs. Further studies should validate the GDQS for stunting and thinness of school adolescents.

Magnitude of under-nutrition among under five children in Ethiopia based on 2019 Mini-Ethiopia Demographic and Health Survey: Generalized Linear Mixed Model (GLMM)

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.