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Minja EG, Mrimi EC, Mponzi WP, Mollel GJ, Lang C, Beckmann J, Gerber M, Pühse U, Long KZ, Masanja H, Okumu FO, Finda MF, Utzinger J. Prevalence and Determinants of Undernutrition in Schoolchildren in the Kilombero District, South-Eastern Tanzania. Trop Med Infect Dis 2024; 9:96. [PMID: 38787029 PMCID: PMC11125975 DOI: 10.3390/tropicalmed9050096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/19/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
Childhood undernutrition is a major issue in low- and middle-income countries, affecting the health, well-being, and educational outcomes of schoolchildren. This study aimed to assess the prevalence and associated factors of stunting, wasting, and underweight among schoolchildren in peri-urban areas in the south-eastern part of Tanzania. A cross-sectional study was conducted involving 930 children aged 6-12 years from four primary schools from July to August 2019. The WHO Anthro Survey Analyzer was employed to estimate the prevalence of stunting, wasting, and underweight, while logistic regression analyses examined sociodemographic background, malaria infection, anaemia, anthropometric measures, and dietary diversity score as potential factors. The prevalence of stunting, wasting, underweight, overweight, and obesity was 11.8%, 4.3%, 3.9%, 11.1%, and 2.0%, respectively. Overall, 1.5% of the children had malaria, as determined by rapid diagnostic tests, and 0.4% had severe anaemia. Univariate analysis indicated higher odds of undernutrition among children aged 9-12 compared to their younger peers. Stunting was more common among children with low and medium dietary diversity. Anaemia was found in 11.2% of schoolchildren, and severe anaemia was associated with wasting. Multivariate analysis revealed that age and low dietary diversity were significantly associated with undernutrition. These findings emphasise the need for school-based health and nutrition programmes targeting children beyond the age of 5 to improve their nutritional status and mitigate potential adverse effects on health, cognition, and academic achievement. Regular assessment of the nutritional status of schoolchildren is warranted.
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Affiliation(s)
- Elihaika G. Minja
- Environmental Health and Ecological Sciences, Ifakara Health Institute, Ifakara P.O. Box 53, Tanzania; (E.C.M.); (W.P.M.); (G.J.M.); (H.M.); (F.O.O.); (M.F.F.)
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland; (K.Z.L.); (J.U.)
- Faculty of Medicine, University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland
| | - Emmanuel C. Mrimi
- Environmental Health and Ecological Sciences, Ifakara Health Institute, Ifakara P.O. Box 53, Tanzania; (E.C.M.); (W.P.M.); (G.J.M.); (H.M.); (F.O.O.); (M.F.F.)
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland; (K.Z.L.); (J.U.)
- Faculty of Medicine, University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland
| | - Winfrida P. Mponzi
- Environmental Health and Ecological Sciences, Ifakara Health Institute, Ifakara P.O. Box 53, Tanzania; (E.C.M.); (W.P.M.); (G.J.M.); (H.M.); (F.O.O.); (M.F.F.)
| | - Getrud J. Mollel
- Environmental Health and Ecological Sciences, Ifakara Health Institute, Ifakara P.O. Box 53, Tanzania; (E.C.M.); (W.P.M.); (G.J.M.); (H.M.); (F.O.O.); (M.F.F.)
- Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania
| | - Christin Lang
- Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, CH-4052 Basel, Switzerland; (C.L.); (J.B.); (M.G.); (U.P.)
| | - Johanna Beckmann
- Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, CH-4052 Basel, Switzerland; (C.L.); (J.B.); (M.G.); (U.P.)
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, CH-4052 Basel, Switzerland; (C.L.); (J.B.); (M.G.); (U.P.)
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, CH-4052 Basel, Switzerland; (C.L.); (J.B.); (M.G.); (U.P.)
| | - Kurt Z. Long
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland; (K.Z.L.); (J.U.)
- Faculty of Medicine, University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland
| | - Honorati Masanja
- Environmental Health and Ecological Sciences, Ifakara Health Institute, Ifakara P.O. Box 53, Tanzania; (E.C.M.); (W.P.M.); (G.J.M.); (H.M.); (F.O.O.); (M.F.F.)
| | - Fredros O. Okumu
- Environmental Health and Ecological Sciences, Ifakara Health Institute, Ifakara P.O. Box 53, Tanzania; (E.C.M.); (W.P.M.); (G.J.M.); (H.M.); (F.O.O.); (M.F.F.)
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow G12 8QQ, UK
- School of Life Science and Bioengineering, Nelson Mandela African Institution of Science & Technology, Arusha P.O. Box 447, Tanzania
| | - Marceline F. Finda
- Environmental Health and Ecological Sciences, Ifakara Health Institute, Ifakara P.O. Box 53, Tanzania; (E.C.M.); (W.P.M.); (G.J.M.); (H.M.); (F.O.O.); (M.F.F.)
- School of Life Science and Bioengineering, Nelson Mandela African Institution of Science & Technology, Arusha P.O. Box 447, Tanzania
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123 Allschwil, Switzerland; (K.Z.L.); (J.U.)
- Faculty of Medicine, University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland
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Wondifraw EB, Tebeje NB, Akanaw W, Chanie ES. Predictors of first-line antiretroviral treatment failure among children on antiretroviral therapy at the University of Gondar comprehensive specialised hospital, North-west, Ethiopia: a 14-year long-term follow-up study. BMJ Open 2022; 12:e064354. [PMID: 36600440 PMCID: PMC9772663 DOI: 10.1136/bmjopen-2022-064354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To determine the incidence and predictors of first-line human immune deficiency virus treatment failure among human immune deficiency virus-infected children at the University of Gondar comprehensive specialised hospital in Ethiopia. DESIGN A retrospective follow-up study. SETTING University of Gondar comprehensive specialised hospital, North-west, Ethiopia. PARTICIPANTS Children were among the HIV infected from January 2005 to December 2018. There were 336 children included in the study. The data were entered into EPi Info V.7.2 and then exported to STATA V.14.0 Software for analysis. Both bivariable and multivariable analyses with Cox proportional hazards models were used to identify the predictors of treatment failure. PRIMARY OUTCOME MEASURES Predictors of first-line antiretroviral treatment failure among children on antiretroviral therapy (ART) during 14 years long-term follow-up study. RESULT A total of 336 human immunodeficiency virus-infected children participated in this study with 27 058 child years of observation. The overall incidence rate was 2.1 (95% CI 1.57 to 2.78) per 100 child years. Poor adherence (adjusted HR (AHR); 6.5 (95% CI 2.03 to 21.39)), fair adherence (AHR; 6.55 (95% CI 2.64 to 16.53), the presence of opportunistic infection (AHR; 4.22 (95% CI 1.44 to 12.30), clinical staging of III/IV (AHR; 3.08 (95% CI 1.17 to 8.08) and a baseline CD4 count less than 200 cells/mm3 (AHR; 3.61 (95% CI 1.12 to 11.54)). CONCLUSION The incidence of first-line ART failure was found to be high. Baseline opportunistic infection, poor and fair adherence, advanced WHO clinical staging III/IV and a CD4 count less than 200 cells/mm3 were all predictors of first-line treatment failure. Early identification of associated factors and monitoring treatment failure has to be important for the optimal management of HIV-infected children who are receiving ART and to prevent further complications.
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Affiliation(s)
| | | | - Worknesh Akanaw
- Department of Pediatrics and Child Health Nursing, University of Gondar, Gondar, Ethiopia
| | - Ermias Sisay Chanie
- Pedatrics and child health Nursing, Debre Tabor University, Debre Tabor, Ethiopia
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