Water, sanitation and hygiene (WASH) practices and deworming improve nutritional status and anemia of unmarried adolescent girls in rural Bangladesh

BACKGROUND

In Bangladesh, undernutrition and anemia are more occurrent among adolescent girls. BRAC, the largest non-governmental organization (NGO), has been implementing a community-based nutrition education service package targeting adolescent girls for reducing their undernutrition and anemia.

OBJECTIVE

We aimed to explore the underlying factors associated with nutritional status and anemia among adolescent girls under the BRAC nutrition program areas to improve their existing intervention package.

METHODOLOGY

We conducted a cross-sectional and comparative study in 2016, in 24 upazilas of Bogra, Barguna, Comilla, Dinajpur, Feni, Jessore, and Meherpur districts where the BRAC nutrition program was implemented while the remaining 27 upazilas of those districts were selected as comparison area. We followed a multistage cluster random sampling for selecting 1620 unmarried adolescent girls aged 10-19 years for interviewing in the intervention and comparison areas. Data were collected on socio-demographic information, dietary intake, morbidity, water, sanitation, and hygiene (WASH) practice, anthropometry, and serum hemoglobin (Hb) level by using a pre-structured questionnaire. The nutritional status of the adolescent girls was expressed as height-for-age Z (HAZ) and body mass index-for-age Z (BMIZ) score, while anemia referred to the serum Hb at the level of below 12 g/dl for adolescent girls. All statistical analyses were done in STATA version 17 (Chicago Inc.).

FINDINGS

The prevalence of stunting (22.9% vs. 22.5%), thinness (12% vs. 14%), and anemia (34.5% vs. 37.3%) exhibited similarities between the intervention and comparison regions. Stunting and thinness were predictors for each other for this population group. Our findings indicated that adolescent girls who were not washing hands with soap after defecation were likely to be stunted [AOR 1.51 (95% CI 1.12-2.04)], and who did not utilize sanitary latrines had an increased likelihood of being thin [AOR 2.38 (95% CI 1.11-5.08)]. Conversely, those who did not watch television [AOR 1.69 (95% CI 1.12-2.56)] and did not have deworming tablets [AOR 1.33 (95% CI 1.07-1.64)] in the 6 months leading up to the interview had a 69% and 33% higher probability of being anemic, respectively.

CONCLUSION

For sustainable improvement in the undernutrition and anemia of adolescent girls, integration of WASH, consistent administration of deworming tablets and broadcasting awareness programs through television are urgent to scale up the nutrition intervention programs in similar settings like Bangladesh.

Nutritional Status and Associated Factors Among School Adolescent Girls in North Shoa Zone, Amhara Region, Ethiopia: A Cross-Sectional Study

Background

Adolescents are the most affected group and the group that is least studied when it comes to malnutrition, which is one of the most important public health concerns in underdeveloped countries, including Ethiopia. Therefore, the goal of this study was to assess nutritional status and related factors among teenage females who are in school.

Materials and Methods

From October 1 to October 25, 2018, 645 young girls in school participated in an institution-based cross-sectional study. Girls in their teen years from the school were selected using a simple random sample method. Anthropometric tests and in-person interviews were used to collect the data. An odds ratio with 95% confidence intervals (CIs) and a p-value under 0.05 were used to declare a statistical association.

Results

This study found that 12.3% and 9.6% of school adolescent girls were stunted and thin, respectively. Being a rural resident (adjusted odd ratio [AOR]: 1.85, 95% CI: 1.05-3.28) and inadequate dietary diversity score (AOR: 3.02, 95% CI: 1.06-4.60) were significant predictors of stunting. School adolescent girls from merchant father were 71% less likely to develop stunting compared with government employee father. Late adolescent age (AOR: 2.27, 95% CI: 1.28-4.02) and family size ≥5 (AOR: 1.98, 95% CI: 1.05-3.75) were significant predictors of thinness.

Conclusions

Stunting and thinness were the major public health problems among school adolescent girls in the study area. Being a rural resident and inadequate dietary diversity increases the risk of stunting. However, being late adolescent girl and large family size were risk factors for thinness. There was a need for a school-based instruction program that concentrated on a varied diet and methods of encouraging the adolescent girls' appetites.

Nutritional status of school-age children and adolescents in low- and middle-income countries across seven global regions: a synthesis of scoping reviews

OBJECTIVE

To summarise available evidence on the nutritional status of school-age children and adolescents (5-19 years) from seven global regions and on interventions implemented to improve malnutrition in this population.

SETTING

Global.

DESIGN

Findings were compiled from seven scoping literature reviews, including data from low- and middle-income countries within the following UNICEF-defined global regions: East Asia and Pacific; Europe and Central Asia; South Asia; West and Central Africa; Eastern and Southern Africa; Middle East and North Africa and Latin America and the Caribbean.

RESULTS

A double burden of malnutrition was evident across the world regions reviewed: stunting, thinness, anaemia and other micronutrient deficiencies persisted, alongside rising overweight and obesity prevalence. Transitions towards diets increasingly high in energy-dense, processed and micronutrient-poor foods were observed. Evidence from intervention studies was limited, but suggested that providing multiple micronutrient-fortified foods or beverages at school may effectively target micronutrient deficiencies and facilitate weight gain in undernourished populations. Interventions to prevent or manage overweight and obesity were even more limited. There was minimal evidence of using novel technological approaches to engage school-age children and adolescents, or of involving them in designing interventions.

CONCLUSION

The limited data available on nutrition of school-age children and adolescents are neither standardised nor comparable. Consensus on methods for assessing nutritional status and its determinants for this age group is urgently needed to set targets and monitor progress. Additionally, strategies are required to ensure that nutritious, safe and sustainable diets are available, affordable and appealing.

Breakfast skipping and its relationship with academic performance in Ethiopian school-aged children, 2019

Breakfast skipping and its relationship with academic achievement among primary school children were investigated in this study. A cross-sectional study was conducted among 848 primary school children. Breakfast skipping was analyzed using a 2-item questionnaire. A 19-item Social Academic and Emotional Behavior Risk Screening questionnaire was used to collect data on children’s behavior. The prevalence of breakfast skipping was found to be 38.1%. Living in a rural area (AOR = 5.2; 95% CI: 3.54, 7.71); having illiterate parents (AOR = 6.66; 95% CI 3.0, 14.7); having parents with a primary education level (AOR 5.18, 95% CI: 2.25, 11.94); living with guardians or other relatives (AOR = 4.06; 95%CI: 2.1, 7.9); and having lower academic achievement (AOR = 2.76; 95% CI: 1.44, 5.29) were factors associated with skipping breakfast.

In conclusion, breakfast skipping has been identified as a significant public health concern that requires an immediate response from stakeholders. It is recommended to intervene based on the identified factors.

Magnitude of Stunting and Associated Factors among Adolescent Students in Legehida District, Northeast Ethiopia

BACKGROUND

Undernutrition including stunting particularly at an adolescent stage was not emphasized by various intervention strategies in the Ethiopian context. Assessing the magnitude and potential risk factors of undernutrition is thus helpful for policymakers to design appropriate intervention strategies. Hence, this study was aimed at assessing the magnitude of stunting and associated factors among adolescent students in Legehida district, Northeast Ethiopia.

METHODS

A school-based cross-sectional study was conducted among 424 adolescent students from February 15th to March 15th, 2018. A stratified sampling followed by a simple random sampling technique was used to select the study participants. A pretested, structured, and self-administered questionnaire was used to collect the required data. Height was measured by using a portable stadiometer and the height-for-age (HFA) z-score was calculated as an indicator of stunting. SPSS version 25 and WHO AnthroPlus software were applied to analyze the data. A multivariable logistic regression analysis was performed to identify factors associated with adolescent stunting. Statistical significance was determined at a p value of <0.05 and association was described by using an odds ratio at a 95% confidence interval.

RESULTS

A total of 406 adolescent students (with a response rate of 95.7%) participated in the study. The magnitude of stunting among adolescent students in this study was 24.9% (95% CI: 24.6%-35.3%).

CONCLUSIONS

Stunting among adolescent students was significantly associated with being male [AOR = 2.1; 95% CI: 1.73-5.90], meal frequency (<3/day) [AOR = 4.6; 95% CI: 2.61-8.24], infrequent handwashing practice [AOR = 3.6; 95% CI: 1.30-9.40], absence of latrine facility (AOR = 5.51; 95% CI: 3.03-9.9), and consumption of unsafe water [AOR = 2.8; 95% CI: 1.35-6.19]. Hence, conducting routine nutrition screenings and assessments, promotion of proper food intake, and emphasis on nutrition education and counseling are needed to be strengthened.

Nutritional Status and Associated Factors among Primary Schoolchildren from Pastoral Communities, Mieso-Mulu District, Sitti Zone, Somali Regional State, Eastern Ethiopia: Institution-Based Cross-Sectional Study

BACKGROUND

Child undernourishment is the disturbance of body function arising from a dietary imbalance between body demand and supply, which is the most serious public health problem in developing countries.

OBJECTIVE

This study aimed to assess the magnitude of nutritional status and associated factors among full-cycle primary schoolchildren in pastoral communities in the Mieso-Mulu district, Sitti Zone, Somali Regional State of Ethiopia.

METHODS

An institution-based cross-sectional study design was used. Study participants were selected using two-stage sampling procedures. Data were collected using structured, translated, pretested, and interviewer-administered questionnaires. The weight and height were measured using a calibrated digital scale and a Seca Rod stadiometer, respectively. Microscopic identification of intestinal parasites was done. Multicollinearity was checked for independent variables. Height for age z scores (HAZ) and body mass index for age z scores (BAZ) were used to determine the nutritional status of children. Logistic regression with both bivariate analysis and multivariate analysis was applied to identify associated factors with the nutritional status of children. Adjusted odds ratios were reported and the level of statistical significance was declared at a P value <0.05.

RESULTS

The magnitudes of thinness and stunting were 13.1% [95% CI: 10.6%, 15.7%] and 24.6% [95% CI: 21.3%, 27.9%], respectively. Being male, not using a bed net, and the presence of intestinal parasitic infection were among the factors associated with thinness. Family size of less than five, household food insecurity, and unavailability of the latrine were among the factors associated with stunting.

CONCLUSION

This study revealed that stunting and thinness are major health problems among schoolchildren. Household food insecurity, intestinal parasitic infection, bed net utilization, and the availability of latrine were some of the major factors significantly associated with undernutrition. Local policymakers, health programmers, nutritionists, health practitioners, and nongovernmental organizations should enhance the nutritional status of schoolchildren by using information dissemination interventions, particularly in improving waste disposal, sanitation/hygiene, latrine facilities, and school-based deworming. Furthermore, awareness creation using nutrition promotion and encouraging communities to attempt to diversify locally available and low-cost nutritionally effective food items to improve food consumption and distribution within a household is recommended to reduce the prevalence of undernutrition among schoolchildren.

Assessment of nutritional status and associated factors among adolescent girls in Afar, Northeastern Ethiopia: a cross-sectional study

BACKGROUND

A body of evidences showed that adolescent undernutrition is a serious public health problem in developing countries including Ethiopia. Adolescence period is the last chance for curbing the consequences of undernutrition and breaking the intergenerational cycle of malnutrition and poor health. Despite this fact, they have been considered as a low-risk group for poor health and nutrition problems than the young children or the very old. This study aimed to assess prevalence of nutritional status and associated factors among adolescent girls in Afar, Northeastern Ethiopia, 2017.

METHODS

A school-based cross-sectional study design was conducted among 736 adolescent girls from February15 to March 05, 2017 in Afar, Northeastern Ethiopia, 2017. Multi-stage sampling technique was used to select study participants. A pretested and structured interviewer-administered questionnaire and anthropometric measurements was used to collect the data. The collected data were entered in to Epi Data version 3.1 and exported to SPSS version 20.0 for further statistical analysis. Body Mass Index for age (thinness) and height for age (stunting) was used to assess undernutrition of adolescent girls by using the new 2007 WHO Growth Reference. Data were analyzed using bivariate and multivariable logistic regression. The degree of association between dependent and independent variables were assessed using odds ratio with 95% confidence interval, and variables with p value < 0.05 were considered significant.

RESULTS

The study revealed that the prevalence of thinness and stunting were 15.8% (95% CI 13.3-18.5%) and 26.6% (95% CI 23.5-29.9%), respectively. Being at an early adolescent age (AOR = 2.89, 95% CI 1.23-6.81) for thinness and being at an early adolescent age (AOR = 1.96, 95% CI 1.02-3.74), household food insecure (AOR = 2.88, 95% CI 1.15-7.21), menstruation status (AOR = 2.42, 95% CI 1.03-5.71), and availability of home latrine (AOR = 3.26, 95% CI 1.15-4.42) for stunting were the independent predictors among the adolescent girls.

CONCLUSIONS

The prevalence of thinness and stunting is above the public health importance threshold level. Thus, Multi-sector-centered nutrition interventions to improve nutritional status of disadvantaged adolescent girls through providing comprehensive nutritional assessment and counseling services at community, school, and health facility levels, and creating household's income-generating activities are recommended before they reach conception to break the intergenerational cycle effect of malnutrition.

Undernutrition and its determinants among adolescent girls in low land area of Southern Ethiopia

BACKGROUND

Undernutrition is one of the most common causes of morbidity and mortality among adolescent girls worldwide, especially in South-East Asia and Africa. Even though adolescence is a window of opportunity to break the intergenerational cycle of undernutrition, adolescent girls are a neglected group. The objective of this study was to assess the nutritional status and associated factors among adolescent girls in the Wolaita and Hadiya zones of Southern Ethiopia.

METHODS

A community-based cross-sectional study was conducted, and a multistage random sampling method was used to select a sample of 843 adolescent girls. Anthropometric measurements were collected from all participants and entered in the WHO Anthro plus software for Z-score analysis. The data was analyzed using EPI-data 4.4.2 and SPSS version 21.0. The odds ratios for logistic regression along with a 95% confidence interval (CI) were generated. A P-value < 0.05 was declared as the level of statistical significance.

RESULT

Thinness (27.5%) and stunting (8.8%) are found to be public health problems in the study area. Age [AOR(adjusted odds ratio) (95% CI) = 2.91 (2.03-4.173)], large family size [AOR (95% CI) = 1.63(1.105-2.396)], low monthly income [AOR (95% CI) = 2.54(1.66-3.87)], not taking deworming tablets [AOR (95% CI) = 1.56(1.11-21)], low educational status of the father [AOR (95% CI) = 2.45(1.02-5.86)], the source of food for the family only from market [AOR (95% CI) = 5.14(2.1-12.8)], not visited by health extension workers [AOR (95% CI) = 1.72(1.7-2.4)], and not washing hand with soap before eating and after using the toilet [AOR (95% CI) = 2.25(1.079-4.675)] were positively associated with poor nutritional status of adolescent girls in the Wolaita and Hadiya zones, Southern Ethiopia.

CONCLUSION

Thinness and stunting were found to be high in the study area. Age, family size, monthly household income, regularly skipping meals, fathers' educational status, visits by health extension workers, and nutrition services decision-making are the main predictors of thinness. Hand washing practice, visits by health extension workers, and nutrition services decision-making are the main predictors of stunting among adolescent girls. Multisectoral community-based, adolescent health and nutrition programs should be implemented.

Undernutrition and Associated Factors Among School Adolescent Girls Attending Schools in Mirab-Armachiho District, Northwest Ethiopia

Substantial proportions of adolescent girls are suffering from undernutrition; despite they are considered as future mothers. Undernourished mothers are more likely to give birth to an offspring with impaired growth and development. Hence, investigating adolescents' undernutrition had a pivotal role to tackle the problem. Therefore, this study aimed to assess undernutrition and associated factors among adolescent girls in Mirabarmacho district, Ethiopia. An institution-based cross-sectional study was conducted from March to April 20, 2018, in the Mirab Armachiho district, using the multistage cluster sampling method. A total of 706 adolescent girls was included in the study. The World Health Organization Anthro Plus software was used to calculate nutritional indices. A Binary Logistic Regression Analysis was used to check the effect of independent variables with adolescent wasting and stunting. The overall prevalence of wasting and stunting was 17.3% (95%CI: 14.6-20.1) and 10.3% (95%CI: 8.2-12.7), respectively. Being in the 10-14 years age group (AOR:2.47,95%CI:1.21-5.06), inadequate Dietary Diversity (Dietary Diversity Score) (AOR:2.46,95%CI:1.45-4.20),food-insecure households (Adjusted Odd Ratio:2.62,95%CI:1.33-5.16),middle wealth index(Adjusted Odd Ratio:1.94,95%CI:1.07-3.51), febrile illness (Adjusted Odd Ratio: 3.12,95%CI:1.94-5.03), diarrheal disease (AOR:3.61,95%CI:2.08-6.28), merchant fathers (Adjusted Odd Ratio:0.40, 95%CI:0.20-0.82),and government employee fathers (Adjusted Odd Ratio:0.27,95%CI:0.09-0.84) were factors significantly associated with thinness, while inadequate Dietary Diversity Score (Adjusted Odd Ratio: 8.07, 95%CI; 4.02-16.20) and febrile illness (Adjusted Odd Ratio; 2.49, 95%CI: 1.48-4.18) were factors relating to the adolescent stunting. Adolescent wasting and stunting are predominant problems in the survey region. Strengthening efforts to ensure household food security, diversified food intake, and prevention and control of infectious diseases are recommended to mitigate adolescent's undernutrition.

Exploration of Barriers to the Uptake of Nutritional Services Among Adolescent Girls from the Rural Communities of Tigray Region, Northern Ethiopia: A Qualitative Study

Background

Adolescence is a time of tremendous physical growth and mental development, with high nutrient requirements. Ethiopia is among the countries with a high prevalence of nutritional deficiencies among the women of reproductive age group, whilst adolescent girls from rural areas suffered disproportionately. However, there is a dearth of evidence regarding the barriers that hinder adolescent girls to utilize the available nutritional services.

Purpose

The current study aimed to qualitatively explore the range of barriers for the uptake of nutritional interventions among adolescent girls in rural communities of Tigray, Northern Ethiopia.

Methods and Participants

We employed an explorative qualitative study among purposively selected adolescent girls and school teachers from rural districts of Tigray region. We conducted 11 focused group discussions with adolescent girls, 17 in-depth interviews (seven with teachers, seven with in-school adolescent girls, and three with out-of-school adolescent girls) using a semi-structured guide. Data was audio-taped, transcribed verbatim in local language, translated into English, and imported into ATLAS.ti version 7.5 qualitative data analysis software for analysis.

Results

Adolescents perceived that stunting, anemia, and thinness are among the main nutritional problems in their community. Food insecurity, limited nutrition awareness in the community, limited access to a water source, high workload, service provider's little attention for adolescents' nutrition, and food taboo have emerged as barriers for the uptake of adolescent girls' nutritional interventions. Though limited in reach, available nutritional interventions include awareness creation, nutritional supplementation, and disease prevention.

Conclusion

Food insecurity poses a strong challenge to adolescent girls' nutrition. As access to safe drinking water continues to be a considerable bottleneck for nutritional interventions, a multi-sectoral response to integrate water, sanitation, and hygiene (WASH) services is required. Bounded by food taboo, high burden of workload among the adolescent girls, women empowerment and nutritional status seem to be the unfinished agenda in resource limited settings such as the rural areas of Tigray region.

Stunting and Its Associated Factors among Early Adolescent School Girls of Gondar Town, Northwest Ethiopia: A School-Based Cross-Sectional Study

Introduction

Stunting is a crucial indicator of long-term chronic undernutrition that reflects a failure to reach a linear growth. Adolescent girls are potentially at a higher risk of stunting as they are traditionally married at an early age in low-income countries. In Ethiopia, stunting has mostly been examined in early childhood, with limited information at the early adolescent age. Therefore, this study is aimed at determining the prevalence of stunting and its associated factors among early adolescent school girls age 10 to 14 in Gondar town.

Methods

We conducted a school-based cross-sectional study. A multistage sampling method was used to sample 662 adolescent girls in selected primary schools. A pretested, structured, and interviewer-administered questionnaire was used to collect the required data. Stata Version 14 and WHO Anthro-plus software were used to analyze the data. The bivariable and multivariable logistic regression model was fitted to identify factors associated with stunting. Adjusted Odds Ratio (AOR) with its 95% confidence interval (CI) was calculated, and a p value ≤ 0.05 was considered to declare statistically significant variables.

Results

The prevalence of stunting was 27.5% [95% CI: 25.5%-29.5%]. The odds of stunting were found to be higher among grade 5 students [AOR; 95% CI: 1.90; 1.13-3.20], those who reported a daily meal frequency of less than three [AOR; 95% CI: 2.37; 1.60-3.50], and those who were from food-insecure families [AOR; 95% CI: 2.52; 1.70-3.73]. Adolescent girls whose mothers were government employees [AOR; 95% CI: 0.48; 0.26–0.89] or merchants [AOR; 95% CI: 0.43; 0.28–0.67] were less likely to be stunted compared to those whose mothers were housewives.

Conclusion

Stunting among early adolescent girls is found to be a moderate public health problem. A school-based nutritional program might be helpful to reduce stunting in this group of adolescent girls.

Prevalence of Anemia and Associated Factors among Secondary School Adolescent Girls in Jimma Town, Oromia Regional State, Southwest Ethiopia

Background

Anemia defined as a low blood hemoglobin concentration is public health importance. The adolescence age group is the most neglected in public health and nutrition research as priorities are usually given to pregnant women, lactating mothers, and their children less than 2 years. Current Ethiopian Food and Nutrition policy included adolescent girls in the most at-risk group for nutritional demands; however, only a few published studies have assessed a deficiency of anemia and associated factors to tackle the intergenerational cycle of malnutrition.

Objective

To assess the prevalence of anemia and associated factors among high school adolescent girls in Jimma town.

Methods

Data were collected from 528 secondary school adolescent girls by a school-based cross-sectional study design in Jimma town from 1/1/2019 to 1/2/2019, southwest Ethiopia. A multistage sampling technique was used to select the study participants. A portable battery-operated HemoCue Hb 301+ analyzer was used to measure the hemoglobin level, and then reading was classified as normal Hb ≥ 12 g\dl and anemic if the hemoglobin value <12 g/dl based on the WHO 2011 recommended cutoff points after adjustments to altitude was made. Bivariate analysis at p value ≤0.25 was considered as a candidate for multivariable logistic regression. Multivariable logistic regression was done to control for confounders and to identify factors independently associated with anemia. Level of statistical significance was declared at p < 0.05.

Results

A total of 528 adolescent girls were included in the study yielding a response rate of 95.8%. The prevalence of anemia was found to be 26.7%, 95% CI (22.7, 30.50). In multivariate logistic regression analysis, those living separately from their family (AOR = 4.430, 95% CI (2.20, 8.90)), low dietary diversity score (AOR = 3.57, 95% CI (1.88, 6.75)), menstrual bleeding more than 5 days (AOR = 2.25, 95% CI (1.17, 4.33)), and low economic status (AOR = 2.16, 95% CI (1.17, 4.33)) were positively associated factors with anemia and only having at least a secondary school in mother's educational status AOR = 0.43, 95% CI (0.18, 0.97) was negatively associated with anemia in the study area.

Conclusion

Prevalence of anemia among school adolescent girls was moderate public health importance according to the World Health Organization prevalence estimation of anemia. The living condition of the adolescent girls, dietary diversity score, duration of menses, and low economic status were positive predictor variables, whereas mothers who are being secondary school and above was a protective factor for anemia. Therefore, iron-rich and diversified food consumption should be given attention.

Anemia among School Adolescents in Haramaya Town, Eastern Ethiopia: Cross-Sectional Study

Background

Anemia is a condition characterized by reduction in the number of red blood cells and/or hemoglobin concentration. It affects 24.8% of the world population. There is little evidence on burden of anemia among adolescents in low income countries like Ethiopia. Thus, this study aimed to assess the magnitude of anemia and factors associated with anemia among school adolescents in eastern Ethiopia.

Methods

School based cross-sectional study was conducted among 493 school adolescents in Haramaya town during February 1 to 28, 2017. Multi stage cluster sampling technique was used. We collected anthropometric data (weight and height) and hemoglobin level of all study participants. The hemoglobin level was adjusted for altitude. Data were entered into EpiData and exported to SPSS version 20 for analysis. Logistic regression model was fitted to identify factors associated with anemia. Level of statistical significance was declared at P < .05.

Results

In this study, the prevalence of anemia was 29.4% [95% CI: (25.6, 33.5)]. Being female adolescent (AOR = 2.31, 95 % CI: [1.51, 3.54]), adolescents attending grades 9th to 10th (AOR = 1.66, 95% CI: [1.004, 2.77]), adolescents born to illiterate mothers [AOR = 2.23, 95% CI: (1.02, 4.89)], and low dietary diversity score (AOR = 2.33, 95% CI: [1.12, 4.86]) were factors that increased the likelihood of getting anemia.

Conclusion

Anemia among school adolescents was a moderate public health problem in the study area. Being female, lower grade levels (9th to 10th), low dietary diversity score and illiterate maternal educational status increased the likelihood of getting anemia. School based Iron/Folic acid supplementation, nutrition education and promotion of diversified foods consumption should be given attention with particular focus on female adolescents.

Double Burden of Malnutrition among Female Adolescent Students in Bahir Dar City, Amhara, Ethiopia

BACKGROUND

Globally, nearly a third of the population suffers from at least one form of malnutrition. Both over- and undernutrition are a growing concern in developing countries particularly among female adolescents. This study was aimed at assessing nutritional status and associated factors among female adolescents in secondary schools of Bahir Dar City, Amhara, Ethiopia, 2019.

METHODS

A school-based cross-sectional study was conducted in secondary schools of Bahir Dar City among 682 female adolescent students in 2019. A simple random sampling technique with proportional allocation was used to select study participants. Data were collected using a self-administered questionnaire. Data were entered into Epi Info version 7.1 and analyzed by SPSS version 21. Underweight and overweight statuses of the participants were determined by using the WHO cutoff point. Bivariable and multivariable logistic regressions were used to identify the significance of association at a 95% confidence interval. P value < 0.05 was used to declare statistical significance.

RESULTS

In this study, the prevalence of underweight, overweight, and obesity was 15%, 8.4%, and 4.7%, respectively. Female adolescents found between age groups of 14-16.5 years old (AOR: 1.7, 95% CI: 1.03-2.69), family size ≥ 4 (AOR: 2.8, 95% CI: 1.05-4.99), participants who did not eat meat once per week (AOR: 1.6, 95% CI: 1.90-2.82), and no onset of menarche (AOR: 4.4, 95% CI: 1.21-15.75) were found to be more likely underweight. In addition, adolescents with family monthly income above 6500 Ethiopian birr (AOR: 12.7, 95% CI: 2.47-65.62), who ate meat two times and more per week (AOR: 2.07, 95% CI: 1.47-9.14), and who ate fruit at least once a week (AOR: 0.20, 95% CI: 0.05-0.78) were more likely to be overweight compared with counterparts. Conclusion and Recommendation. The prevalence of underweight and overweight was found to be high. Design evidence-based adolescent nutritional intervention shall be emphasized by the government and other concerned bodies to avert the dual burden of malnutrition.

Undernutrition and Associated Factors among Adolescent Girls in Damot Sore District, Southern Ethiopia

Background

Adolescent girls were given little health and nutrition attention. Focusing on adolescent girls' nutrition prior to conception is one way to break the intergenerational cycle of malnutrition. Therefore, the aim of this study was to assess the prevalence of undernutrition and associated factors among adolescent girls in rural Damot Sore District, Southern Ethiopia.

Methods

A community-based cross-sectional study was conducted from February to March 2017. Multistage sampling technique was used to select 729 adolescent girls. Structured interviewer-administered questionnaire was used to collect information on different variables. Weight and height were measured by using a well-calibrated digital Seca scale and portable stadiometer by trained data collectors. Height-for-age (HFA) and body mass index-for-age (BMIFA) z-scores were calculated using WHO AnthroPlus software as indicators of stunting and thinness, respectively. Wealth index was generated by using principal component analysis (PCA), and based on the results, household wealth index/status was converted into tertiles and categorized as higher/rich, medium, and lower/poor. Descriptive statistics, bivariable, and multivariable logistic regression analysis were done. Strength of association of variables was presented by odds ratio along with its 95% CI.

Results

The prevalence of stunting and thinness among adolescent girls was 29.6% (95% CI = 26.6%, 32.8%) and 19.5% (95% CI = 16.7%, 22.3%), respectively. Being in older adolescence (AOR = 2.06, 95% CI = 1.08, 3.92), mother occupation (farmer and government employee) ((AOR = 2.38, 95% CI = 1.31, 4.33) and (AOR = 3.05, 95% CI = 1.35, 6.92)), mother education (secondary and above) ((AOR = 0.53, 95% CI = 0.28, 0.98) and (AOR = 0.25, 95% CI = 0.09, 0.69)), and household wealth index (poor) (AOR = 1.94, 95% CI = 1.29, 2.92) were significantly associated with stunting. Father education (primary and secondary) ((AOR = 0.48, 95% CI = 0.31, 0.77) and (AOR = 0.45, 95% CI = 0.26, 0.78)), mother education (primary) (AOR = 0.56, 95% CI = 0.37, 0.87), and meal frequency (<2/day) (AOR = 1.87, 95% CI = 1.12, 3.13) were significantly associated with thinness.

Conclusion

The prevalence of stunting and thinness among adolescent girls was moderate, when compared to the prevalence reported in Sub-Saharan Africa. However, it was a major public health problem, when compared to the national nutrition baseline survey reports in Ethiopia. Parental education was a significant predictor of both stunting and thinness among adolescent girls. Thus, initiation of routine screening, promotion of education, and implementation of evidence based community nutrition programmes required to be improved.

Prevalence and Determinants of Stunting Among Adolescent Girls in Ethiopia

PURPOSE

The purpose of this study was to assess the prevalence of stunting and identify factors associated with it among adolescent girls in Ethiopia.

DESIGN AND METHODS

From 15,683 women participants of the 2016 Ethiopian Demographic and Health Survey (EDHS), a sub-sample of 3,498 adolescents aged 15-19 years were selected; from which 2,733 adolescents who had a complete response to all variables of interest were retained for analysis. Variables were selected using conceptual framework. We used height-for-age Z-score index (HAZ) growth standards less than -2 to identify stunting. We adjusted for weights and sampling design. Bivariable and multivariable regression analysis was carried out.

RESULTS

The prevalence of stunting was 410(15%); comprising of 353 (12.9%) moderate and 57(2.2%) severe stunting cases. The odds of being stunted among respondents living in Tigray (AOR = 3.38, 95%CI: 1.47, 7.79), Amhara (AOR = 2.66, 95%CI: 1.18, 6.012) and Addis Ababa (AOR = 4.24, 95%CI: 1.84, 9.79) were higher compared to respondents living in Dire-Dawa. Adolescent girls living in rural areas (AOR = 2.29, 95%CI: 1.10, 4.75) had higher odds of stunting compared to those living in urban areas. Adolescent girls from the lowest wealth quintile (AOR = 2.38, 95%CI: 1.56, 9.67) had higher odds of stunting compared to the highest wealth quintile. Respondents who have one child (AOR = 3.33, 95%CI: 5.78, 15.31), and two children (AOR = 4.01, 95% CI: 1.39, 7.73) had higher odds of being stunted compared to those who have no children. The odds of stunting among adolescent girls having no access to safe water supply (AOR = 3.17, 95% CI: 1.21-8.37) and having no access to hygienic toilet (AOR = 1.44, 95% CI: 1.17, 1.95) were higher compared to those having access to safe water supply and hygienic toilets respectively.

CONCLUSIONS

The current study revealed that stunting is an important public health problem among adolescent girls in Ethiopia.

PRACTICE IMPLICATIONS

Health care workers should screen nutritional status of adolescent girls and assess the risk factors of stunting giving emphasis to adolescent girls living in rural areas, who are within the lowest wealth quintile, who have children, and those who have no access to safe water supply and have no access to hygienic toilets.

Nutritional Status of School Going Adolescent Girls in Awash Town, Afar Region, Ethiopia

Background

Adolescence is an essential stage in the human life cycle, a transition period between childhood and adulthood that is characterized by rapid growth spurt in which nutritional requirement is high. Adolescents are risk groups for malnutrition, but they are not part of a target in many intervention strategies. Hence, this study was aimed at assessing nutritional status of adolescent girls and its associated factors.

Methods

Institutional based cross-sectional study design was employed among randomly selected 348 school going adolescent girls. Data were entered into Epi Info and transported to SPSS version 20 for further analysis. Binary logistic regression analysis was used to identify predicators of nutritional status of adolescent girls at p value <0.05 and 95% confidence level.

Results

This study revealed that 22.9% and 8.82% of school adolescent girls were stunted and thin, respectively. Being at early adolescent age (14-15 years) [AOR = 1.4, 95% CI (1.04–4.28)], ownership of phone [AOR = 3.3, 95% CI (1.55–7.02)], and dietary diversity score of <4 food groups [AOR = 2.2, 95% CI (1.4–4.54)] were some of the potential predictors of stunting. Similarly, dietary diversity score of <4 food groups [AOR = 1.8, 95% CI (1.14–4.38)] and low food consumption [AOR = 3, 95% CI (1.15–7.90)] were some of the potential predictors of thinness. Conclusion and Recommendation. The prevalence of both stunting and thinness is a public health problem in the study area. Early adolescent age (10–14 years), ownership of phone, and dietary diversity score of <4 food groups were independent predictors of stunting. Dietary diversity score of <4 food groups and eating less than usual were independent predictors of thinness. An integrated nutritional intervention and health related services that meet the needs of adolescent girls in the school community have to be established and strengthened. Since adolescent age is period of growth and development in which growth spurt and nutritional requirement are high, adolescents should be provided with enough meals and diversified foods.

Does dietary diversity predict the nutritional status of adolescents in Jimma Zone, Southwest Ethiopia?

Objective

This study aimed to assess the association between dietary diversity and nutritional status of adolescents in Jimma Zone, Southwest Ethiopia. A secondary data was used to assess the association between dietary diversity and nutritional status of adolescents in Jimma Zone, Southwest Ethiopia. Adolescents in the age of 13–17 years old included in the analysis. The data cleaned, coded and analyzed using Stata version 14.

Results

Over all prevalence of stunting and thinness were 26.1% and 25.3%. Stunting was higher among female adolescents (23.8%) than male (21.9%), while thinness was higher among male (27.5%) than female (25.3%) adolescents. In multivariate binary logistic regression model, being female adolescents were 98% (AOR = 1.98; 95% CI 1.6, 2.4] higher odd of stunted compared with those male adolescents, households had food insecurity were 67% [AOR = 1.67; 95% CI 0.6, 0.9] more likely to be associated with stunted than with those households which had secure foods. Adolescents who had high workload were 2.6 times [AOR = 2.6; 95% CI 1.2, 3.1] more likely to be associated with thinness compared with those adolescents who didn’t had high workload.

Stunting and Its Determinants among Adolescent Girls: Findings from the Nutrition Surveillance Project, Northwest Ethiopia

Under nutrition among adolescents is a major public health problem in Ethiopia and its causes are under investigated. Therefore, this study aimed to assess the prevalence of stunting and its determinants among adolescent girls in Dabat district. A total of 1556 adolescent girls were included in the study. The WHO's Anthro-plus software was used to generate the height for age z-scores. Variables having a p-value<0.2 in the simple logistic regression were entered into multiple logistic regression and a p-value < 0.05 were considered statistically significant. About 47.4%(95%CI; 45.0, 49.6%) of adolescent girls were stunted. Being in the early (AOR = 0.027, 95%CI: 0.08, 0.09) and middle age (AOR = 0.21, 95%CI: 0.06, 0.71) were less likely to be stunted compared with the late adolescent. The odds of stunting were found to be higher among adolescent of rural area (AOR = 1.45; 95%CI: 1.01, 2.10) and from household food in-secured (AOR = 1.33; 95%CI: 1.02, 1.73)families. Higher numbers of adolescent girls are stunted in Dabat district, suggesting severe public health importance of the problem. Age, residence and food security were associated with adolescent stunting. Thus, improving food security strategies targeting rural and food insecure households is recommended. Abbreviations: AOR= Adjusted Odd Ratio,CI= Confidence Interval, COR= Crude Odd Ratio, ENSSPI=Establishing Nutrition Surveillance System and Piloting Interventions HAZ=Height for Age, HDSS=Health and Demographic Surveillance System, HFSS=Household Food Security Status, INDEPTH=International Network of Demographic Evaluation of Population and Their Health, IQR=Inter Quartile Range, NNP=National Nutrition Program, NSHFP=National School Health and Feeding Program, SPSS=Statically Package for Social Science, WHO= World Health Organization.

Undernutrition and its determinants among Ethiopian adolescent girls: a protocol for systematic review and meta-analysis

INTRODUCTION

In Ethiopia, undernutrition is the common public health concern, swaying the lives of lots of adolescent girls. Its sequelae are not only limited to them, but rather their upcoming offspring are vulnerable too. Even though some studies have been carried out in different parts of the country, the national pooled prevalence and determinants of undernutrition are not known. Therefore, this study is aimed at determining the pooled prevalence and determinants of undernutrition among adolescent girls in Ethiopia.

METHODS

Published articles will be retrieved from databases such as Medline and PubMed. Electronic search engines such as Google Scholar and Google will be used. To identify eligible studies, the Joanna Briggs Institute quality appraisal checklists prepared for different study designs will be used. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will be used to maintain the scientific robustness of the study. The presence of heterogeneity among studies will be examined by forest plot as well as I2 heterogeneity test. Potential causes of heterogeneity will be explored by carrying out sensitivity and subgroup analyses. The DerSimonian and Laird random-effects model will be used provided that heterogeneity is observed. Publication bias will be examined by observing funnel plots, and objectively by Egger's regression test. If the funnel plot is asymmetric and/or Egger's test was found to be statistically significant (p<0.05), the trim and fill (Duval and Tweedie's) analysis will be performed. The presence of a statistical association between independent and dependent variables will be declared if the p value is <0.05 with the 95% CI.

ETHICS AND DISSEMINATION

Since this is a systematic review and meta-analysis, ethical clearance will not be a concern. The results of the study will be published in a peer-reviewed reputable journal and presented at different scientific research conferences.

TRIAL REGISTRATION NUMBER

CRD42018106180.

Socio-demographic and economic factors are associated with nutritional status of adolescent school girls in Lay Guyint Woreda, Northwest Ethiopia

Objective:

This study was aimed at assessing socio-demographic and economic factors associated with nutritional status of adolescent school girls in Lay Guyint Woreda, Northwest Ethiopia.

Methods:

The school-based cross-sectional study comprising 362 adolescent girls aged 10–19 years was included in the study. Simple random sampling technique with proportional allocation to size was used to select the participants. An interviewer-administered questionnaire and anthropometric measurement were used to collect the data. An anthropometric measurement was converted to the indices of nutritional status using World Health Organization Anthro Plus software.

Result:

The overall prevalence of stunting and thinness among adolescent girls were 16.3% and 29%, respectively. Adolescents aged 14–15 years (AOR = 3.65; 95% confidence interval: 1.87, 7.11), adolescents living in rural areas (AOR = 1.34; 95% confidence interval: 1.24, 2.33), and adolescents who did not have snack (AOR = 11.39; 95% confidence interval: 1.47, 17.8) were positively associated with stunting. Whereas mother’s occupation was negatively associated with stunting (AOR = 0.12; 95% confidence interval: 0.17, 0.87). Similarly, being a rural resident (AOR = 2.40; 95% confidence interval: 1.13, 5.08) and adolescents aged 14–15 years (AOR = 6.05; 95% confidence interval: 2.15, 17.04) were positively associated with thinness. Educational status of adolescent girls was negatively associated with thinness (AOR = 0.13; 95% confidence interval: 0.05, 0.35).

Conclusion:

Stunting and thinness are prevalent among adolescent girls. The age of adolescents, place of residence, having a snack, and mother’s occupation was significantly associated with stunting and thinness. Having at least a one-time snack in addition to the usual diet is strongly recommended.

A Nutrition Education Intervention to Increase Consumption of Pulses Showed Improved Nutritional Status of Adolescent Girls in Halaba Special District, Southern Ethiopia

This study aimed to determine the effect of a 6-month in-school nutrition education intervention to improve pulse consumption on weight status of adolescent girls in Ethiopia. At the intervention school, 66 girls received bi-monthly lessons that included recipes and tastings. Girls (n = 66) at the control school had usual in-school activities. With pulse-based nutrition education which included discussions and demonstrations, knowledge, attitude and practice scores improved (p < 0.001) in the intervention group while control scores remained low and unchanged. Prevalence of underweight, measured as Body Mass Index (BMI) for age, decreased with the education intervention, from 13.6% to 3% (p = 0.004), while there was no significant change seen in control girls. In Ethiopia, equipping girls in schools with the knowledge and skills to improve food intake by consuming locally grown pulses may mitigate underweight in Ethiopian female adolescents.

Chronic undernutrition (stunting) is detrimental to academic performance among primary schools of adolescent children: a randomized cross sectional survey in Southern Ethiopia

OBJECTIVE

Despite several decades of work in improving childhood nutrition in Ethiopia, stunting remains a major public health concern with lack of evidence on its effect on school performance. Therefore, this study aimed at determining prevalence of stunting and the impact on academic performance among schoolchildren attending primary schools in Meskan District of Southern Ethiopia.

RESULTS

During October 2016, we interviewed primary school children and their parents, collected anthropometric measurements of children, and conducted school record reviews among 408 randomly selected children attending ten primary schools. Univariate and multivariable linear regression were performed to assess stunting associated with academic performance among schoolchildren. A total of 378 primary schoolchildren were involved in the study giving a response rate of 93%. The prevalence of stunting was 16.9%. Grade repetition, place of residence, class rank of students and absenteeism from the class was negatively associated with the academic performance. In general, the present study children had relatively high prevalence of chronic undernutrition. We found that school underperformance was significantly high in the study area. The study underlines the need for nutrition interventions targeting rural areas to improve children's academic performance.

Literature review: nutritional factors influencing academic achievement in school age children

BACKGROUND AND OBJECTIVE

Adolescence is a transition period involving tremendous physical, psychological and cognitive growth. For appropriate growth of adolescents in these aspects, a correct quantity and quality of nourishment is required, as a lack of such nourishment among adolescents can lead to various degrees of malnutrition, which may have implications on their health as well as their academic achievements.

MATERIALS AND METHODS

This review examines the research topics around factors that influence the nutritional status of adolescent students which can affect their academic performance.

RESULTS

Some of the vital factors include knowledge and attitude about nutrition, eating behaviour, physical activity, socio-economic status of the family, the surrounding environment at school and home, the frequency and timing of meals, nutritional contents and amount of food intake.

CONCLUSION

Students who consume a balanced diet perform better in exams, show better behaviour as well as attendance at school and get their assigned tasks done more thoroughly compared with those who do not consume a balanced diet.

Anaemia among adolescent girls in three districts in Ethiopia

BACKGROUND

Adolescence is characterized by rapid growth and development with a significantly increased need for macro and micronutrients. However, there is little empirical evidence on the burden of anaemia among adolescent girls in developing countries such as Ethiopia. This study aims to address this gap by evaluating the magnitude of anaemia with an aim to guide design of intervention modalities to address anaemia among adolescent girls.

METHODS

The study employed a community based cross sectional design. The study was conducted on weekends to capture both in school and out of school adolescent girls. Data was collected from a total 1323 adolescent girls. From each district, we randomly selected villages and ensured that the sampled households had a range geographical spread (lowlands, highlands) within the larger category of rural and urban. We performed anaemia testing using HemoCue B-Haemoglobin analyser. We applied a complex survey data analysis method to estimate the level of anaemia. The hemoglobin level was adjusted for altitude and smoking status. We ran a logistic regression model to evaluate predictors of anaemia.

RESULTS

The overall anaemia prevalence ranged from 24 to 38%, with an average rate of 29%. Less than half of the girls heard the term anaemia, and about one third knew the relationship between anaemia and the intake of iron rich foods. The risk of anaemia is higher among adolescent girls in their early adolescence period (10-14 years) (Adjusted Odds Ratio (AOR); 1.98; 95% CI; 1.03, 3.82] and among adolescent girls who lived in moderately food insecure households (AOR 1.48; 95% CI; 1.05-2.09). However, knowing the term "anaemia" was found to be protective against the risk of anaemia.

CONCLUSIONS

The risk of anaemia was particularly high among adolescent girls in their early age and among those living in food insecure households. The prevalence of anaemia among adolescent girls is a moderate public health problem. According to the WHO set criteria, the districts could be candidates for intermittent iron and Folic acid supplementation program.

Food Security of Adolescents in Selected Khat- and Coffee-Growing Areas in the Sidama Zone, Southern Ethiopia

Whilst pervasive food insecurity exists among adolescents in Ethiopia, the available information is scant and inconsistent. Therefore, the main objective of this cross-sectional study was to contribute to these gaps by assessing the food security of adolescents in the selected khat- and coffee-growing areas. We selected 234 (117 girls and 117 boys) adolescents aged 12⁻18 years via stratified random sampling. We measured the height and weight of the adolescents and asked about their food insecurity experiences. We assessed the prevalence of stunting and thinness using the WHO 2007 growth reference standards. Out of the total, 17 (7.3%) and 30 (12.8%) adolescents were stunted and thin, respectively. In addition, 89 (38.0%) adolescents reported food insecurity experiences and nine (3.8%) were overweight. A regression analyses showed that the stunting was associated with the age of the adolescents and maternal education. Thinness was associated with area, gender, and the number of meals. Food insecurity experiences were associated with health problems in the past 30 days. In general, adolescents from the khat-growing area have better food security than those from the coffee-growing area, and the same is true, gender-wise, for girls compared to boys. We recommend possible interventions primarily for adolescents in coffee-growing areas.

Dual Burden of Malnutrition Among Adolescents of Smallholder Coffee Farming Households of Jimma Zone, Southwest Ethiopia

BACKGROUND

Substantial evidence is emerging on the coexistence of double burden of malnutrition on adolescents of low-income countries, shaping the health challenges of the upcoming adult generation for the worst. Whether nutritional status markers of adolescents in the cash crop setting are on par with economic gains remains uncertain. Thus, we investigated the nutritional outcomes of adolescents and their determinants in coffee farming households.

METHODS

The survey was carried out in 3 top coffee-producing districts of Jimma Zone, Ethiopia. Five hundred fifty mothers/caregivers and their respective adolescents were selected using multistage random sampling. Anthropometric data were converted into height-for-age and body-mass-index-for-age Z scores using WHO Anthroplus software and analyzed by SPSS for windows.

RESULTS

Prevalence of thinness, stunting, and overweight/obesity were 11.6%, 15.6%, and 7.1%, respectively. The odds of stunting among adolescents in households in the lowest wealth tertile was nearly 6-fold higher compared to the highest tertile (adjusted odds ratio [AOR] = 5.6 [2.6-12]). Conversely, the odds of overweight/obesity was higher among adolescents in the households in the middle wealth tertile (AOR = 2.72 [1.08-6.86]) compared to the highest tertile. Adolescents living in households with low-dependent age-groups were more than twice likely to be overweight/obese (AOR = 2.58 [1.06-6.24]).

CONCLUSION

The current study revealed the presence of substantial dual burden of malnutrition. In such a setting, it is critical to draw a fine line and trade-off for eliminating morbidity and mortality of undernutrition, without triggering the risk of overweight/obesity.

Geohelminth Infections and Nutritional Status of Preschool Aged Children in a Periurban Settlement of Ogun State

This study assessed the geohelminth and nutritional status of preschoolers in a periurban community of Ogun state. Fresh stool specimens were collected for laboratory analysis, processed using ether concentration method, and examined under the microscope for geohelminth ova. Demographic characteristics and daily nutrient intake of children were subjectively assessed during an interview session with parents, following anthropometric data collection. Data obtained were analysed using a statistical software for Windows. Nutritional indicators such as underweight, stunting, and wasting were computed from anthropometric data. Results showed an overall prevalence of 39.2% and 12.4% for Ascariasis and Hookworm infection, respectively, with no significant difference (P > 0.05) between the sexes. Prevalence of nutritional indicators was 52.6%, 35.1%, 34.0%, and 9.3% for underweight, stunting, wasting, and thinness conditions, respectively. A good proportion of the malnourished preschoolers were free of Ascaris infection but infected with Hookworm parasite. The adverse effect of geohelminth infection cannot still be ignored in impaired growth, reduced survival, poor development, and cognitive performance of preschoolers. Therefore promotion of adequate health education program on measures of preventing geohelminth infections is needed.

Prevalence and factors associated with stunting and thinness among adolescent students in Northern Ethiopia: a comparison to World Health Organization standards

BACKGROUND

Adolescence is last chance for curbing the consequences of malnutrition and breaking the intergenerational cycle of malnutrition and poor health. This study aimed to assess the prevalence and the factors associated with stunting and thinness among in-school adolescents in northern Ethiopia using the 2006 World Health Organization (WHO) standards.

METHODS

In-school adolescents (n = 348, 10-19 years old) were randomly selected to participate in this cross-sectional study. Anthropometric measurements were carried out to determine the proportion of adolescents who were stunted (height-for-age < -2 Standard Deviation (SD)) and thin (body-mass-index-for-age < -2 SD). T-test was employed to evaluate mean weight and height differences between groups. Pearson chi-square, chi-square trend and Fisher's exact tests were used to explore the crude association of categorical outcome variables and associated factors. Crude and adjusted associations between the outcome variables (stunting and thinness) and independent variables (socio-demographic, eating behavior and sanitation) were also determined using logistic regression. Stata version 11.1 was used to analyze the data.

RESULTS

The height of the adolescents was 147.6 ± 11.2 cm (mean ± SD) and weight was37.2 ± 9.5 kg. The mean Z-scores of height-for-age and body-mass-index (BMI)-for-age of adolescents were -1.49 and -1.29, respectively. The prevalence of stunting and thinness among adolescents was 28.5 % (boys = 37.7 %; girls = 21.2 %; P = 0.001) and 26.1 % (boys = 32.4; girls = 21.6 %; p = 0.017), respectively. Adolescents in 13-15 year old age group (Adjusted Odds ratio (AOR) = 2.23; 95 % CI: 1.22, 4.08), boys (AOR = 2.53; 95 % CI: 1.52, 4.21) and rural residents (AOR = 2.15; 95 % CI: 1.20, 3.86) had significantly higher odds of being stunted compared to their counterparts. Furthermore, boys had higher (AOR = 1.97; 95 % CI: 1.19, 3.25) odds of being thin compared to girls. Compared to those 10 to 12 years of age, adolescents in 16 to 19 years of age were 53 % (AOR = 0.47; 95 % CI: 0.23, 0.95) less likely to be thin.

CONCLUSIONS

Undernutrition is widely prevalent among adolescents in northern Ethiopia. Sex, age and area of residence significantly associated with adolescent undernutrition. The study underlines the need for nutrition interventions targeting rural and boy adolescents.

Risk factors for intestinal parasitosis, anaemia, and malnutrition among school children in Ethiopia

Research on associated risk factors for intestinal parasitic infections and malnutrition in various geographic regions is needed for the development of appropriate control strategies. The aim of this study was to determine the risk factors associated with intestinal parasitic infections, anaemia, and malnutrition in school children, living in urban and rural areas of northern Ethiopia. Six hundred school children, aged 6-15 years, were randomly selected in a cross-sectional survey from 12 primary schools. Sociodemographic and anthropometric data were collected. Faecal samples were examined using direct, concentration, and the Kato-Katz methods. Urine specimens were analysed for Schistosoma haematobium ova. Haemoglobin was measured using a HemoCue spectrometer. The overall prevalence of intestinal parasitosis was 72% (95% confidence interval (CI): 66-76%). The prevalence of anaemia, stunting, and thinness were 11% (95% CI: 8-13%), 35% (95% CI: 31-38%), and 34% (95% CI: 30-38%), respectively. Poor personal hygiene habits were generally associated with anaemia and nutritional deficiency (low body mass index). Multivariate logistic regression models related Schistosoma mansoni infection with boys. Boys were also more likely to be malnourished. Hookworm infection was associated with anaemia and unhygienic finger nails. Access to clean water and latrines, with some hygiene and sanitation communication activities, could improve health of children in Ethiopia. The use of smartphone technology in demographic data collection proved to be successful. The potential advantage offered by this technology for parasitological field surveys merits further investigation.

Food insecurity and linear growth of adolescents in Jimma Zone, Southwest Ethiopia

Background

Although many studies showed that adolescent food insecurity is a pervasive phenomenon in Southwest Ethiopia, its effect on the linear growth of adolescents has not been documented so far. This study therefore aimed to longitudinally examine the association between food insecurity and linear growth among adolescents.

Methods

Data for this study were obtained from a longitudinal survey of adolescents conducted in Jimma Zone, which followed an initial sample of 2084 randomly selected adolescents aged 13–17 years. We used linear mixed effects model for 1431 adolescents who were interviewed in three survey rounds one year apart to compare the effect of food insecurity on linear growth of adolescents.

Results

Overall, 15.9% of the girls and 12.2% of the boys (P=0.018) were food insecure both at baseline and on the year 1 survey, while 5.5% of the girls and 4.4% of the boys (P=0.331) were food insecure in all the three rounds of the survey. In general, a significantly higher proportion of girls (40%) experienced food insecurity at least in one of the survey rounds compared with boys (36.6%) (P=0.045).

The trend of food insecurity showed a very sharp increase over the follow period from the baseline 20.5% to 48.4% on the year 1 survey, which again came down to 27.1% during the year 2 survey.

In the linear mixed effects model, after adjusting for other covariates, the mean height of food insecure girls was shorter by 0.87 cm (P<0.001) compared with food secure girls at baseline. However, during the follow up period on average, the heights of food insecure girls increased by 0.38 cm more per year compared with food secure girls (P<0.066). However, the mean height of food insecure boys was not significantly different from food secure boys both at baseline and over the follow up period. Over the follow-up period, adolescents who live in rural and semi-urban areas grew significantly more per year than those who live in the urban areas both for girls (P<0.01) and for boys (P<0.01).

Conclusions

Food insecurity is negatively associated with the linear growth of adolescents, especially on girls. High rate of childhood stunting in Ethiopia compounded with lower height of food insecure adolescents compared with their food secure peers calls for the development of direct nutrition interventions targeting adolescents to promote catch-up growth and break the intergenerational cycle of malnutrition.

Household food security is inversely associated with undernutrition among adolescents from Kilosa, Tanzania

Household food insecurity contributes to poor nutritional health, with negative consequences on growth and development during childhood. Although early childhood nutrition needs have received much attention, another important nutritional phase is adolescence. In a sample of 670 adolescents from Kilosa District, Tanzania, this study used 3 approaches to better understand the relationship between food insecurity and undernutrition. First, this study examined the associations between 3 commonly used measures of household food security and undernutrition among 670 adolescents from Kilosa District, Tanzania. The measures of household food security, energy adequacy per adult equivalent, dietary diversity score, and coping strategies index, were strongly correlated with each other and household assets (P < 0.05). Second, this study measured the nutritional status of adolescents in this district, finding a high prevalence of undernutrition (21% with BMI-for-age <5th percentile of the National Center for Health Statistics/WHO reference). Third, this study measured the association between the log odds of undernutrition (as the dependent variable) and each of the 3 measures of household food security. In separate models, household energy adequacy per adult equivalent and household dietary diversity score were inversely associated with undernutrition after adjusting for gender, age, puberty, and the interaction between age and puberty. By contrast, a greater use of coping strategies was not associated with undernutrition. Strategies focused on increasing household energy intake and improving dietary diversity among the most vulnerable households could improve the nutritional health of adolescents.

Gender differences in food insecurity and morbidity among adolescents in southwest Ethiopia

OBJECTIVE

Several studies have shown the adverse health consequences of food insecurity on household members. To what extent this relationship is mediated by gender among adolescents has not been documented. We hypothesized that the health consequences of food insecurity would be more pronounced in girls compared with boys.

METHODS

We used the first-round data from a 5-year longitudinal family survey of 2084 adolescents aged 13 to 17 years from urban, semiurban, and rural areas of southwest Ethiopia. Stratified random sampling was used to select households and adolescents. Multivariable logistic regression was used to compare self-reported morbidity according to food-security status and gender after adjusting for nutritional and socioeconomic covariates.

RESULTS

Overall, 29.9% of girls and 19.2% of boys reported illness during the previous 1 month before the survey. Food-insecure girls were twice as likely to report suffering from an illness (P < .01) compared with boys, and the risk of reported illness tripled when girls were food insecure and were part of food-insecure households (P < .01). Girls were 7.4 and 7.0 times more likely to report difficulties with activities because of poor health and having a feeling of tiredness/low energy compared with boys, respectively (P < .001).

CONCLUSIONS

We report that in a food-insecure situation, gender is an important predictor of an adolescent's self-reported health status. Food-security interventions should consider gender as a key variable to narrow the gap in health between boys and girls.