Anthropometric failures and its associated factors among preschool-aged children in a rural community in southwest Ethiopia

Prevalence and Correlates of Anthropometric Failure Among Children Aged 0-23 Months in India: Evidence from a Nationally Representative Cross-Sectional Survey (2019-2021)

The present study assesses the burden of anthropometric failure in Indian children aged 0-23 months using the Composite Index of Anthropometric Failure (CIAF). It additionally explores socio-economic, maternal, and child-specific determinants. Analyzing NFHS-5 (2019-2021) data, results show that 48% (95% CI: 47.6%, 48.3%) of children face at least one form of anthropometric failure, with stunting being the most prevalent. Children with low birth weight (AOR: 1.67, 95% CI: 1.60, 1.74), those born to undernourished mothers (AOR: 1.41, 95% CI: 1.36, 1.47), children from lower wealth quintiles (AOR: 1.76, 95% CI: 1.64, 1.88), and those who reportedly lack a minimum acceptable diet (AOR: 1.10, 95% CI: 1.01, 1.22) exhibited a higher prevalence of anthropometric failure. Addressing undernutrition necessitates multifaceted interventions targeting these determinants to improve child nutrition outcomes.

Geo-spatial pattern and determinants of composite index of anthropometric failure among children under five in Ethiopia

Despite significant efforts, undernutrition remains a critical public health issue, particularly in developing countries like Ethiopia. Anthropometric failure, which indicates inadequate child growth and development, has severe consequences. Analyzing the spatial distribution and determinants of anthropometric failure is crucial for evaluating and improving nutritional programs. Understanding these spatial patterns can enhance targeted resource allocation, thereby accelerating progress toward optimal child growth. This study utilized a spatial analysis of anthropometric failure using data from the EMDHS 2019, focusing on a weighted sample of 3,659 children under five. The survey was conducted from March 21, 2019, to June 28, 2019, following a two-stage stratified sampling. Non-spatial analysis was conducted using STATA version 17, while ArcGIS Pro and SatScan version 9.6 were used for spatial visualization. Multiscale geographically weighted regression analysis identified significant determinants, with statistical significance set at a p-value of less than 0.05. The prevalence of anthropometric failure among the sampled children was 36.79% (95% CI 35.22%-38.37%). A clustered distribution was observed (Moran's I = 0.249, p < 0.001), with significant clustering in the Amhara, Tigray, Afar, and Somali regions. Children in these clusters were twice as likely to experience anthropometric failure (RR = 2.01, p < 0.001). Key determinants of spatial variation included mothers with no formal education (Mean = 0.1402, p < 0.001), low household wealth (Mean = 0.1651, p = 0.002), short birth intervals (Mean = 0.1165, p = 0.014), and insufficient postnatal care (Mean = 0.0589, p = 0.004). With a prevalence of 36.79%, anthropometric failure among children under five in Ethiopia is a major concern. The observed clustering highlights the need for targeted interventions, including improving maternal education, increasing household wealth, and enhancing access to family planning and postnatal care. Special emphasis should be placed on hotspot areas to effectively address and reduce undernutrition.

Residence-based disparities of composite index of anthropometric failures in East African under five children; multivariate decomposition analysis

BACKGROUND

Undernutrition remains a global challenge and public health concern, despite the presence of policies, programs and interventions. There is substantial evidence that the majority of the rural children under-5 years old have composite index of anthropometric failure than the urban counter parts. Hence, identifying the main contributors of these disparities will help health policy makers, program designers and implementers for the reduction of composite index of anthropometric failures in children under-5 years old in the study areas.

METHODS

The most recent and nationally representative samples of demographic and health surveys of five East African countries data were used for the current study. To appreciate the residence-based differences of composite index of anthropometric failure in under-5 children, the Blinder-Oaxaca decomposition analysis and its extensions were employed to determine the effects of covariates and coefficients. The country specific survey data analysis was performed.

RESULTS

The current study revealed that the burden of composite index of anthropometric failure (CIAF) in under-5 children were 40.69%, 22.04%, 34.06%, 31.99%, and 33.27% in Ethiopia, Kenya, Rwanda, Uganda, and Tanzania respectively. The residence-based differences in CIAF were 25.49%, 11.38%, 27%, 22.15%, and 20.55% in Ethiopia, Kenya, Rwanda, Uganda, and Tanzania respectively. Results of the Blinder-Oaxaca decomposition analysis and its extensions revealed that 100% of the rural-urban children under-5 composite index of anthropometric failure disparity was explained by endowment characteristics (covariate effect). Wealth index, mother's education, age of child, type of birth, sex of child and birth interval inequality between rural and urban households explains most of the composite index of anthropometric failure disparity in children under-5 years old.

CONCLUSIONS

The residence-based CIAF differences were high in all study countries. The rural-urban CIAF gap is ascribed by household, maternal and child characteristics. This result implies that rural children under-5 is disproportionally disadvantaged with respect to characteristics than their consequences. Through identification of the underlying factors behind the rural-urban CIAF disparities, the result of this study is important in planning effective intervention measures aiming at reducing residence-based inequalities and the population health outcomes. Therefore, should be given for rural children to reduce CIAF by improving house hold wealth index, women education and attentions to older children, and female children.

Anthropometric failures and its predictors among under five children in Ethiopia: multilevel logistic regression model using 2019 Ethiopian demographic and health survey data

BACKGROUND

Composite Index of Anthropometric Failure (CIAF) combines all three forms of anthropometric failures to assess undernutrition status of children. There is no study on CIAF to identify the real and severe form of under nutrition among Ethiopian children that addressed community level factors. So, this study determined CIAF and identified important factors which helps to design appropriate intervention strategies by using multi-level advanced statistical model.

METHODS

The study included 5,530 under five children and utilized a secondary data (EMDHS 2019) which was collected through community-based and cross-sectionally from March 21 to June 28, 2019. Composite index of anthropometric failure among under five children was assessed and a two-stage sampling technique was used to select the study participants. Descriptive summary statistics was computed. A multi-level binary logistic regression model was employed to identify important predictors of CIAF in under five children. Adjusted odds ratio with its 95% CI was estimated and level of significance 0.05 was used to determine significant predictors of CIAF.

RESULTS

The prevalence of composite index of anthropometric failure (CIAF) was 40.69% (95% CI: 39.41, 42.00) in Ethiopia. Both individual and community level predictors were identified for CIAF in under five children. Among individual level predictors being male sex, older age, short birth interval, from mothers who have not formal education, and from poor household wealth quintile were associated with higher odds of CIAF among under five children. Low community women literacy and being from agriculturally based regions were the community level predictors that were associated with higher odds of CIAF in under five children in Ethiopia.

CONCLUSIONS

The burden of composite index of anthropometric failure in under five children was high in Ethiopia. Age of child, sex of child, preceding birth interval, mother's education, household wealth index, community women literacy and administrative regions of Ethiopia were identified as significant predictors of CIAF. Therefore, emphasis should be given for those factors to decrease the prevalence of CIAF in under five children in Ethiopia.

Maternal and household factors affecting the dietary diversity of preschool children in eastern Ethiopia: a cross-sectional study

OBJECTIVE

Investigate the association between the dietary diversity of preschool children and proximate factors including household food insecurity, maternal food choice, preferences, khat use, and levels of depressive symptoms.

DESIGN

Cross-sectional survey of randomly selected households.

SETTING

Haramaya Health and Demographic Surveillance site in Eastern Ethiopia, predominantly smallholder farming households.

PARTICIPANTS

678 preschool children (24-59 months) and their mothers.

METHODS

The key outcome, the adequacy of dietary diversity of preschool children, was calculated using a 24-hour parental dietary recall. Binary logistic regression was then used to identify maternal and household factors associated with dietary adequacy versus inadequacy.

RESULTS

The majority (80.53%) of surveyed children had low dietary diversity (mean Dietary Diversity (MDD)) score of 3.06±1.70 on a 7-point scale). Approximately 80% of households exhibited food insecurity. Households with greater food security (adjusted OR (AOR)=1.96, 95% CI 1.19 to 3.23), healthier maternal food choice (AOR=2.19, 95% CI 1.12 to 4.31) and broader maternal food preferences (AOR=4.95, 95% CI 1.11 to 21.95) were all associated with higher dietary diversity of their preschool children (p≤0.05). Other covariates associated with adequate child dietary diversity included improved household drinking water sources (AOR=1.84, 95% CI 1.16 to 2.92) and family planning use (AOR=1.69, 95% CI 1.00 to 2.86). Despite predictions, however, maternal depression and khat consumption were not identified as factors.

CONCLUSIONS

The dietary diversity of preschool children is extremely low-a pattern observed in both food-secure and food-insecure households. Key factors include maternal selection of food for convenience and ease, preferences that do not include animal protein or healthier food choices, and lack of access to improved drinking water sources. Interventions around maternal food choice and preferences could improve preschool children's nutritional health.

Anthropometric failure and associated factors among children aged 6-23 months in Ethiopia

Undernutrition in childhood is a crucial public health issue in Ethiopia. Yet, more than an assessment of undernutrition using conventional index is needed to conclude the overall prevalence of undernutrition among children aged 6-23 months. Therefore, this study aimed to assess the prevalence of undernutrition using composite index of anthropometric failure and its associated factors among children aged 6-23 months in Southwest Ethiopia. A community-based cross-sectional study was employed among 440 mother-child pairs selected using a two-stage cluster sampling method in the rural Kersa district, Jimma Zone, Southwest Ethiopia. A pretested structured questionnaire was used to collect data. Multivariable logistic regression analysis was employed to identify factors associated with undernutrition. Variables with a p-value of <.05 were considered statistically significant. The proportion of undernutrition using composite indexes of anthropometric failure was 57.3% among children aged 6-23 months. Children being male [AOR = 1.55; 95% CI (1.013, 2.373)], not met minimum acceptable diet (MAD) [AOR = 2.104; 95% CI (1.05, 4.214)], larger family size [AOR = 1.699; 95% CI (1.0791, 2.675)], having comorbidity [AOR = 3.31; 95% CI (2.068, 5.327)], and being in food insecurity household [AOR = 3.12; 95% CI (2.0, 4.868)] were more likely to be in anthropometric failure, whereas children from the mother who attended higher and above schooling [AOR = 0.244; 95% CI (0.093, 0.641)] were less likely to be in anthropometric failure. More than half of children aged 6-23 months were experienced anthropometric failure. Male children, those who have not received the MAD, come from larger families, have comorbidities, live in food-insecure households, and have mothers with higher education levels were found to be at higher risk of anthropometric failure.

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.

Undernutrition and its associated factors among children aged 6 to 59 months in Menz Gera Midir district, Northeast Ethiopia: A community-based cross-sectional study

BACKGROUND

Undernutrition can lead to impaired physical growth, restricted intellectual skills, low school performance, reduced working capacity, and rooted disability in adult life. Thus, this study was designed to assess the prevalence and associated factors of undernutrition among children aged 6 to 59 months.

METHODS

A community-based cross-sectional study was conducted among 432 children aged 6 to 59 months in the Menz Gera Midir District. A multi-stage sampling technique was applied to recruit the study participants. Socio-demographic and socio-economic variables were collected by using structured questionnaires. Anthropometric measurements of the children were measured according to the World Health Organization's recommendation. A data collection sheet was used to collect information on the types of foods and number of meals consumed by the child. A bivariable and multivariable logistic regression was performed to identify factors associated with undernutrition.

RESULT

In this study, about 11.3% (95% CI: 8.3-14.3%), 50.2% (95% CI: 45.5-55.0%), and 28% (95% CI: 23.8-32.3%) were wasted, stunted, and underweight, respectively. Children aged 12-23 months (AOR: 1.97; 95% CI: 1.01-3.87), 36-47 months (AOR: 2.05; 95% CI: 1.00-4.19), and being anemic (AOR: 2.92; 95% CI: 1.73-4.92) were found to be an independent predictor of stunting. Moreover, being anemic was found to be significantly associated with wasting (AOR: 6.84; 95% CI: 3.16-14.82).

CONCLUSION

According to the findings of this study, undernutrition was a serious public health issue among 6-59 month old children in the Menz Gera Midir District. Children's age and anemia status were significantly associated with stunting and wasting. Therefore, community-based nutrition programs are vital to reduce childhood undernutrition.

Risk stratification and prognostic value of prothrombin time and activated partial thromboplastin time among COVID-19 patients

BACKGROUND

COVID-19 is a viral disease caused by a new strain of corona virus. Currently, prognosis and risk stratification of COVID-19 patients is done by the disease's clinical presentation. Therefore, identifying laboratory biomarkers for disease prognosis and risk stratification of COVID-19 patients is critical for prompt treatment. Therefore, the main objective of this study was to assess the risk stratification and prognostic value of basic coagulation parameters and factors associated with disease severity among COVID-19 patients at the Tibebe Ghion Specialized Hospital, COVID-19 treatment center, Northwest Ethiopia.

METHODS

A follow-up study was conducted among conveniently recruited COVID-19 patients attended from March to June 2021. Socio-demographic and clinical data were collected using a structured questionnaire and checklist, respectively. Prothrombin time (PT) and activated partial thromboplastin time (APTT) were analyzed by the HUMACLOT DUE PLUS® machine. Descriptive statistics were used to summarize the socio-demographic and clinical characteristics of study participants. Kruskal Wallis tests were used to compare the difference between parametric and non-parametric continuous variables, respectively. The area under the receiver operating characteristic curve (AUC) was used to evaluate the value of PT and APTT in the risk stratification and disease prognosis of COVID-19 patients. Ordinal logistic regression was used to identify the factors associated with disease severity and prognosis. A P-value < 0.05 was defined as statistically significant for all results.

RESULT

Baseline PT at a cut-off value ≥ 16.25 seconds differentiated severe COVID-19 patients from mild and moderate patients (AUC: 0.89, 95% CI: 0.83-0.95). PT also differentiated mild COVID-19 patients from moderate and severe patients at a cut-off value ≤ 15.35 seconds (AUC: 0.90, 95% CI: 0.84-0.96). Moreover, alcohol drinkers were a 3.52 times more likely chance of having severe disease than non-drinkers (95% CI: 1.41-8.81). A one-year increment in age also increased the odds of disease severity by 6% (95% CI: 3-9%). An increment of ≥ 0.65 seconds from the baseline PT predicted poor prognosis (AUC: 0.93, 0.87-0.99).

CONCLUSIONS AND RECOMMENDATIONS

Prolonged baseline PT was observed in severe COVID-19 patients. Prolonged baseline PT was also predicted to worsen prognosis. An increase from the baseline PT was associated with worsen prognosis. Therefore, PT can be used as a risk stratification and prognostic marker in COVID-19 patients.

Associated Factors of Wasting among Infants and Young Children (IYC) in Kuyu District, Northern Oromia, Ethiopia

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.

Baseline Thrombocytopenia and Disease Severity Among COVID-19 Patients, Tibebe Ghion Specialized Hospital COVID-19 Treatment Center, Northwest Ethiopia

Background

Thrombocytopenia and platelet indices in COVID-19 patients were important for prompt treatment and management of the disease. Therefore, the main objective of this study was to assess the prevalence of thrombocytopenia, platelet indices, and its association with disease severity among COVID-19 patients at the Tibebe Ghion Specialized Hospital, COVID-19 treatment center, Northwest Ethiopia.

Methods

A cross-sectional study was conducted among 117 conveniently recruited COVID-19 patients from March to June 2021. Socio-demographic and clinical data were collected using a structured questionnaire and checklist, respectively. The platelet parameters were analyzed by the Mindray-BC 5800 automated hematological analyzer. ANOVA and Kruskal-Wallis tests were used to compare the difference between parametric and non-parametric continuous variables, respectively. Binary logistic regression was used to identify the factors associated with thrombocytopenia. A P-value < 0.05 was defined as statistically significant for all statistical tests.

Results

Among COVID-19 patients, 45, 43 and 29 were mild, moderate and severe, respectively. 65.8% of the patients were males and 34.2% were alcohol drinkers with a mean age of 50.6 ± 15.4. Moreover, 44.4% of the patients had co-morbidity. Thrombocytopenia was presented in 23.9% of the patients. It was 4.57 (95% CI: 1.30-16.07) and 6.10 (95% CI: 1.54-24.08) times more likely in the moderate and severe cases compared to mild cases, respectively. Disease severity was also associated with PDW (P-value = 0.001).

Conclusion

Even though thrombocytopenia was not presented in most moderate and severe COVID-19 patients, thrombocytopenia and PDW were associated with disease severity.