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Haile B, Oumer A, Negese T, Temesgen M, Kebede A, Abdurahman D, Motuma A, Roba KT. Factors associated with compliance with weekly iron and folic acid supplementation among school adolescent girls in Debub Achefer district, northwest Ethiopia: school-based cross-sectional study. Sci Rep 2024; 14:9980. [PMID: 38693315 PMCID: PMC11063210 DOI: 10.1038/s41598-024-60800-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 04/26/2024] [Indexed: 05/03/2024] Open
Abstract
Iron deficiency anemia is a public health problem among adolescents that could be addressed by weekly Iron Folic Acid Supplementation (IFAS). The Ethiopian government piloted weekly IFAS in schools, where its effectiveness depends on compliance. We assessed the determinants of compliance with the weekly IFAS in Ethiopia. A school-based survey was conducted in 506 adolescent girls on weekly IFAS. Compliance was considered when girls reported WIFAS for at least three months without discontinuation. Bivariable and multivariable logistic regression models were modeled, with odds ratios reported. Out of 506, 25.8% had limited access to educational resources, and 79.4% had no information on IFAS. Among these, 47.9% (95% CI: 45.5-49.9%) had poor compliance with weekly IFAS. Non-compliance was mainly due to school absenteeism (55.9%). Important predictors of poor compliance were adolescent girls' marital status (AOR = 5.21; 1.55-17.6), academic standing (AOR = 4.37; 2.20-8.70), family income (AOR = 1.85; 1.09-3.15), access to health education materials (AOR = 1.57; 1.02-2.40), problems with IFAS (AOR = 2.44; 1.26-4.74), a discouraging home environment for the program (AOR = 2.27; 1.54-3.34), and a lack of knowledge of the IFAS program (AOR = 1.40; 0.97-2.03). Compliance with weekly IFAS is optimal, which could be improved via strong adherence support and feasible supplementation schedules.
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Affiliation(s)
- Bisrat Haile
- Nutrition Coordination Office, Ministry of Health, Addis Ababa, Ethiopia
| | - Abdu Oumer
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
| | - Tarkegn Negese
- Nutrition Coordination Office, Ministry of Health, Addis Ababa, Ethiopia
| | - Mesfin Temesgen
- College of Health and Medical Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Dureti Abdurahman
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Aboma Motuma
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Roba
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Jolly SP, Roy Chowdhury T, Sarker TT, Afsana K. Water, sanitation and hygiene (WASH) practices and deworming improve nutritional status and anemia of unmarried adolescent girls in rural Bangladesh. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:127. [PMID: 37957706 PMCID: PMC10644610 DOI: 10.1186/s41043-023-00453-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 10/06/2023] [Indexed: 11/15/2023]
Abstract
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.
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Affiliation(s)
- Saira Parveen Jolly
- BRAC James P Grant School of Public Health, BRAC University, 6th Floor, Medona Tower, 28 Mohakhali Commercial Area, Bir Uttom A K Khandakar Road, Dhaka, 1213, Bangladesh.
- BRAC Research and Evaluation Division, BRAC, 75 Mohakhali, Dhaka, 1212, Bangladesh.
| | - Tridib Roy Chowdhury
- BRAC James P Grant School of Public Health, BRAC University, 6th Floor, Medona Tower, 28 Mohakhali Commercial Area, Bir Uttom A K Khandakar Road, Dhaka, 1213, Bangladesh
- BRAC Research and Evaluation Division, BRAC, 75 Mohakhali, Dhaka, 1212, Bangladesh
| | - Tanbi Tanaya Sarker
- BRAC James P Grant School of Public Health, BRAC University, 6th Floor, Medona Tower, 28 Mohakhali Commercial Area, Bir Uttom A K Khandakar Road, Dhaka, 1213, Bangladesh
| | - Kaosar Afsana
- BRAC James P Grant School of Public Health, BRAC University, 6th Floor, Medona Tower, 28 Mohakhali Commercial Area, Bir Uttom A K Khandakar Road, Dhaka, 1213, Bangladesh
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Mekonnen FA, Biks GA, Azale T, Mengistu NW. Dietary practice and nutritional status and the respective effect of pulses-based nutrition education among adolescent girls in Northwest Ethiopia: a cluster randomized controlled trial. Front Nutr 2023; 10:1102106. [PMID: 37818340 PMCID: PMC10560726 DOI: 10.3389/fnut.2023.1102106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 08/28/2023] [Indexed: 10/12/2023] Open
Abstract
Background Thinness and stunting are the most severe public health problems among adolescent girls in Ethiopia. An inadequate intake of protein-source foods is the most critical cause, mainly due to the non-affordability of animal-origin foods. However, research into what extent improving pulses-based food consumption could contribute to decreasing the magnitude of protein-energy undernutrition is limited. Objective This trial aimed to evaluate the effectiveness of pulses-based nutrition education in reducing the proportion of thinness among adolescent girls. Methods A two-arm cluster randomized controlled trial was conducted among adolescent girls in Northwest Ethiopia from December 2021 to June 2022. A total of 602 adolescent girls from four schools were enrolled in the trial. Schools were assigned to intervention and control groups using the stratified cluster randomization method. Pulses-based nutrition education was the intervention, whereas the usual dietary practice of adolescent girls was the comparator. The education was delivered over 4 weeks on a 45-60-min session per week basis. Thinness was the primary outcome of the trial, measured by anthropometry. An intention-to-treat analysis method was used. A log-binomial regression model was fitted to the data. Relative risk with the respective confidence interval and value of p was calculated. A value of p < 0.05 was used to declare statistical significance. Stata 16 software was used for the analysis. Results About 89.37% of the participants in the intervention group and 92.36% in the control group completed the trial. The pulses-based nutrition education intervention did not show a significant difference in reducing the proportion of thinness among the participants in the intervention group compared to the participants in the control group even though a significant difference was observed in terms of the consumption of pulses-based food. Conclusion The present trial was statistically non-significant in reducing thinness among adolescent girls. Similar studies that utilize objective methods for ascertaining pulses-based food consumption need to be conducted.Clinical trial registration: https://pactr.samrc.ac.za/Search.aspx, the trial was registered in the Pan African Clinical Trials Registry (PACTR202111605102515) on November 12, 2021.
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Affiliation(s)
- Fantahun Ayenew Mekonnen
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gashaw Andargie Biks
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Telake Azale
- Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Netsanet Worku Mengistu
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Agedew E, Abebe Z, Ayelign A. Exploring barriers to diversified dietary feeding habits among adolescents in the agrarian community, North West Ethiopia. Front Nutr 2022; 9:955391. [PMID: 36570147 PMCID: PMC9768322 DOI: 10.3389/fnut.2022.955391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 10/31/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Adolescence is a critical and neglected age group of the population in any form of nutritional intervention. A comprehensive study that assesses barriers that influence their diversified feeding habit is not well investigated in qualitative approaches. Therefore, this study was conducted to fill this gap by providing evidence on exploring barriers to diversified feeding habits of adolescents in the agrarian community, North West Ethiopia. Objective The aim of the study was to explore barriers to diversified feeding habits of adolescents in the agrarian community, North West Ethiopia. Methods A phenomenological qualitative study design was conducted among adolescents in the age group of 10-19 years, and adults in the age range of 25 to 64 years (representatives of farmers, agricultural, health, and education sectors). We conducted 24 in-depth interviews (12- adolescents, 4-health, 2- agricultural extension, 3-education, and 3-farmer representative) among purposively selected community groups. In-depth interview guides and observation checklist were utilized for data collection. The audio-recorded qualitative data were transcribed word by word into English. Finally, the translated data were exported to ATLAS ti version 7.1 software for thematic analysis based on inductive content analysis. All coded quotations, including memos written throughout the coding process, were then analyzed to identify themes inductively. Results Dietary habit of adolescents in the study area was predominantly plant-based cereals with low protein, vitamins, and mineral contents. Adolescents have limited consumption of fruits, vegetables, and animal source foods. Adolescents with these feeding habits had suboptimal intake of micronutrients and proteins, which are crucial for their rapid growth stage. Individual-level barriers, family-level influence, dietary tradition of community, agricultural practice (poor agroforestry practice of the community, and poor agricultural practice to produce year-round diverse food items), and week multi-sectorial collaboration for nutritional intervention all influenced adolescent dietary habits. Conclusion Multiple layers of barriers influenced the diverse dietary habits of adolescents in the study setting. These multiple and interconnected influences ranged from individual level to multi-sectorial collaboration. Nutritional interventions should be implemented at the individual, family, agricultural, and multi-sectorial levels to improve adolescents' diverse dietary habits.
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Tafasa SM, Tura MR, Mulu E, Begna Z. Undernutrition and its associated factors among school adolescent girls in Abuna Gindeberet district, Central Ethiopia: a cross-sectional study. BMC Nutr 2022; 8:87. [PMID: 36002840 PMCID: PMC9400317 DOI: 10.1186/s40795-022-00587-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 08/12/2022] [Indexed: 11/20/2022] Open
Abstract
Background Adolescent is the population whose age between 10–19 years old. They are undergoing rapid growth, development and are one of the nutritionally at-risk groups who should need attention. Adolescent undernutrition is a worldwide problem. Even if this stage brings the second window of opportunity to break the intergenerational cycle of undernutrition little is known specifically in the study area. This study was conducted to assess the prevalence of undernutrition and its associated factors among school adolescent girls in Abuna Gindeberet district, Central Ethiopia, 2021. Methods Institution-based cross-sectional quantitative study design was conducted in Abuna Gindeberet district among 10–19 years adolescent girls attending primary and secondary schools from January 1–30, 2021. A systematic random sampling technique was used to select 587 adolescent girls. Data were collected by using interviewer-administered structured and anthropometric measurements. Data were coded, then entered into the Epi-info version 7.2.2.6 and exported to SPSS version 25 and WHO Anthro plus for analysis. Logistic regression analysis was done to identify predictors of under nutrition. Level of statistical significance was declared at p-value < 0.05. Results The overall magnitude of stunting and thinness were 15.4% [95% CI (12–18)] and 14.2% [95% CI (11–17)] respectively. Number of meals per day [AOR = 3.62, 95% C.I (2.16, 6.05)], adolescent girls of lower grades [AOR = 2.08, 95% C.I (1.07, 4.04)] and who did not begin menstruation [AOR = 1.71, 95% C.I (1.06, 2.73)] were significantly associated with stunting. Adolescent girls engaged in vigorous intensity activities [AOR = 2.51, 95% C.I (1.14, 5.54)], poor dietary diversity score [AOR = 4.05, 95% C.I (1.43, 11.46)] and adolescent age [AOR = 3.77, 95% C.I (1.06, 13.37)] were significantly associated with thinness among adolescent girls. Conclusions Adolescent girl's undernutrition is a public health problem in the study area. The number of meals per day, adolescent girls of lower grades and who did not begin menstruation were significantly associated with stunting as well as adolescent girls engaged in vigorous-intensity activities; poor dietary diversity score and adolescent age were significantly associated with thinness among adolescent girls. Therefore, government and other stakeholders should focus on these identified factors to improve the nutritional status of adolescent girls.
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Affiliation(s)
- Segni Mulugeta Tafasa
- Department of Public Health, College of Medicine & Health Sciences, Ambo University, P. O. Box 19, Ambo, Ethiopia.
| | - Meseret Robi Tura
- Department of Nursing, College of Medicine & Health Sciences, Ambo University, Ambo, Ethiopia
| | - Ermiyas Mulu
- Department of Public Health, College of Medicine & Health Sciences, Ambo University, P. O. Box 19, Ambo, Ethiopia
| | - Zenebu Begna
- Department of Public Health, College of Medicine & Health Sciences, Ambo University, P. O. Box 19, Ambo, Ethiopia
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Alemu TG, Muhye AB, Ayele AD. Under nutrition and associated factors among adolescent girls attending school in the rural and urban districts of Debark, Northwest Ethiopia: A community-based comparative cross-sectional study. PLoS One 2021; 16:e0254166. [PMID: 34398878 PMCID: PMC8366968 DOI: 10.1371/journal.pone.0254166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/22/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction Adolescence is the time of puberty in which a substantial changes in physical, mental, and emotional are observed; Nutritional requirements significantly rise as a result. Even though improving adolescent girls’ nutritional status helps to break the intergenerational cycle of malnutrition, many studies in Ethiopia focus on determining the nutritional status of under-five and pregnant women and even they don’t show disparities between urban and rural adolescent girls. Thus, this study was aimed at comparing the rural and urban prevalence’s of stunting and thinness and their associated factors among adolescent girls attending school in Debark district, Northwest Ethiopia, 2020. Method A community-based comparative cross-sectional study was conducted among 792 adolescent girls from February 25th to March 21st 2020. A multi-stage sampling followed by simple random sampling technique was used. Data were collected through a face-to-face interviewer-based questionnaire. Different anthropometric measurements were taken. The collected data were entered to Epi-data and exported into SPSS for analyses. Variables with p-values < 0.25 in the bivariable analysis were exported to multivariable logistic regression model to control confounders and identify the factor. The strength of association and statistical significance was declared using the adjusted odds ratios with its corresponding 95% CI, and p-value ≤ 0.05 respectively. Results A total of 757 adolescent girls with a response rate of 95.6% were participated in the study. The overall prevalence of stunting and thinness were 20.1% and 10.3%, respectively. Stunting among rural adolescent girls was 24.2%; whereas it was 16% among urban residents. Likewise, thinness among rural adolescent girls was 8.5%; whereas it was 12.1% among urban dwellers. No latrine [AOR: 1.95 (95% CI: 1.11, 3.43)], lowest media exposure [AOR: 5.14 (95% CI: 1.16, 22.74)], lower wealth class [AOR:2.58 (95% CI: 1.310, 5.091)], and middle wealth class[AOR: 2.37 (95% CI: 1.230, 4.554)] have risen the likelihood of stunting in rural setting while early adolescent age [AOR:3.17 (95% CI:1.445,6.95)] significantly associated with stunting in urban setting. Food insecurity [AOR: 1.95 (95% CI: 1.01, 3.78)] was associated with stunting in overall adolescent girls. Middle adolescent age groups in rural area have more than three times to experience thinness [AOR: 3.67 (95% CI: 1. 21, 11.149)]. Whereas urban resident girls fall in early adolescent age group developed thinness were eight times [AOR: 8.39 (95% CI: 2.48–28.30)]. Conclusion Stunting was higher among rural adolescent girls as compared to urban. However, thinness was higher among urban dwellers. Lower wealth class, food insecurity, lowest media exposure, and age were significantly associated with stunting and thinness. Hence, increasing latrine coverage, boosting the economic status of the community, and increasing media exposure for adolescent girls should get due attention.
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Affiliation(s)
- Tewodros Getaneh Alemu
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences and Specialized Hospital, University of Gondar, Gondar, Northwest Ethiopia
- * E-mail:
| | - Addis Bilal Muhye
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences and Specialized Hospital, University of Gondar, Gondar, Northwest Ethiopia
| | - Amare Demsie Ayele
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences and Specialized Hospital, University of Gondar, Gondar, Northwest Ethiopia
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Endalifer ML, Andargie G, Mohammed B, Endalifer BL. Factors associated with dietary diversity among adolescents in Woldia, Northeast Ethiopia. BMC Nutr 2021; 7:27. [PMID: 33926578 PMCID: PMC8082914 DOI: 10.1186/s40795-021-00430-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background Consuming diversified food during the adolescent period is essential to build a healthy and active mind for their later life. Food prices increased in the local market due to fewer production of crops. Thus, exploring the dietary diversity of adolescents in this area is crucial to estimate diet quality. So the aim of the study was to identify determinant factors of dietary diversity. Methods An institution-based cross-sectional study was conducted among adolescent students in Woldia town. A total of four hundred eleven students were included in the study. A simple random sampling technique was used to select the participants. The outcome variable was dietary diversity; it was calculated by summing of the number of food group consumed by individuals in the given reference period. Bivariable and multivariable logistic analysis was done. The odds ratio with a 95% confidence interval was computed to measure an association. A variable with a P-value less than 0.05 is considered a significant factor. Results The proportion of inadequate dietary diversity was 49.1% (95% CI 44.5–53.8). Being female (AOR =5.53, 95% CI 3.447–8.859), secondary and above mothers’ education level (AOR=0. 27, 95%CI 0.153–0.477), living in a family size five and above (AOR= 2.09, 95CI% 1.31–3.34), and poor knowledge about nutrition (AOR=4.56, 95% CI 2.727–7.639) were significantly associated with inadequate dietary diversity. Conclusions and recommendations Inadequate dietary diversity was associated with sex, knowledge of nutrition, maternal education level, and family size. It is better to design a nutrition intervention program that focus on nutrition education to scale up diversified food consumption among adolescents. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-021-00430-6.
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Affiliation(s)
- Melese Linger Endalifer
- Department of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia.
| | - Gashaw Andargie
- Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Bekri Mohammed
- Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Bedilu Linger Endalifer
- Department of Pharmacy, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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Abu-Baker NN, Eyadat AM, Khamaiseh AM. The impact of nutrition education on knowledge, attitude, and practice regarding iron deficiency anemia among female adolescent students in Jordan. Heliyon 2021; 7:e06348. [PMID: 33718648 PMCID: PMC7920873 DOI: 10.1016/j.heliyon.2021.e06348] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/15/2020] [Accepted: 02/19/2021] [Indexed: 12/12/2022] Open
Abstract
Iron deficiency anemia (IDA) is a crucial health issue and the most common nutritional deficiency-related problem that affects many adolescents worldwide. Considering its link with the lack of appropriate knowledge, attitude, and practice (KAP), it could be preventable. The aims of this study were (1) assessing hemoglobin levels of female adolescent students, (2) examining their knowledge, attitude, and practice regarding IDA, and (3) evaluating the effect of a nutrition education program on the same. A quasi-experimental design (pretest-posttest control group) involving 363 students from four public secondary schools in Jordan was used. Two schools formed the intervention group (n = 194) and two formed the control group (n = 169). Blood tests for hemoglobin levels and self-report questionnaires were the measures employed. A month-long nutrition education program was conducted with the intervention group. The results revealed that 44.5% of the sample had mild anemia, and 10% had moderate anemia. In terms of knowledge, attitude, and practice, 52.4% exhibited adequate knowledge, 45% engaged in healthy practices, and 42.7% had a positive attitude toward IDA. The intervention group's total KAP scores were significantly higher than the control group (p ≤ .05) post-program. Additionally, the total KAP scores within the intervention group showed significant increase from pre- to post-test (p ≤ .05). It can be concluded that structured educational intervention effectively improves knowledge, attitude, and practice regarding IDA among adolescent females. Health care professionals must not only be oriented about this health problem among this age group, but also be supported to enable their intervention within a school setting.
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Affiliation(s)
- Nesrin N Abu-Baker
- Faculty of Nursing, Community and Mental Health Nursing Department, Jordan University of Science & Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Anwar M Eyadat
- Faculty of Nursing, Community and Mental Health Nursing Department, Jordan University of Science & Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Abdullah M Khamaiseh
- Faculty of Nursing, Community and Mental Health Nursing Department, Mutah University, 61710, P.O.Box 7, Al-Karak, Jordan
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Zhu Z, Sudfeld CR, Cheng Y, Qi Q, Li S, Elhoumed M, Yang W, Chang S, Dibley MJ, Zeng L, Fawzi WW. Anemia and associated factors among adolescent girls and boys at 10-14 years in rural western China. BMC Public Health 2021; 21:218. [PMID: 33499861 PMCID: PMC7836596 DOI: 10.1186/s12889-021-10268-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 01/19/2021] [Indexed: 11/11/2022] Open
Abstract
Background Evidence on anemia and associated factors among young adolescent girls and boys in rural western China is limited. Methods We used data from a follow-up study of adolescents (10–14 years) born to women who participated in a randomized trial of antenatal micronutrient supplementation in western China. Anemia was defined by World Health Organization standards. Logistic regression was used to examine the factors associated with anemia. Results The overall prevalence of anemia was 11.7% (178/1517). Female adolescents were 1.73 (95% CI 1.21, 2.48) times more likely to have anemia as compared to males. Adolescents whose mothers had completed high school were 0.35 (95% CI 0.13, 0.93) times less likely to be anemic, compared to those of whom had < 3 years of formal education. Household wealth was also inversely associated with anemia. The association of puberty status with anemia was modified by adolescent sex (P-value for interaction was 0.04); males with greater than mild pubertal development had reduced odds (OR 0.35, 95% CI 0.15, 0.83) of anemia while there was no association among females (OR 0.72, 95% CI 0.29, 1.78). Consumption of flesh foods (OR 0.58, 95% CI 0.38, 0.89), eggs (OR 0.60, 95% CI 0.38, 0.93), and having a meal frequency of three times or more per day (OR 0.68, 95% CI 0.48, 0.96) were also associated with a lower likelihood of anemia. Conclusions Anemia was a mild public health problem among young adolescents in rural western China. Nutritional and social determinants were identified as predictors, warranting interventions to reduce the risk of anemia among this critical age group. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10268-z.
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Affiliation(s)
- Zhonghai Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Christopher R Sudfeld
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yue Cheng
- Department of Nutrition and Food Safety Research, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Qi Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Shaoru Li
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Mohamed Elhoumed
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China.,National Institute of Public Health Research (INRSP), BP. 695, Nouakchott, Mauritania
| | - Wenfang Yang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Suying Chang
- United Nations Children's Fund, China Office, Beijing, 100600, People's Republic of China
| | - Michael J Dibley
- The Sydney School of Public Health, Faculty of Medicine, The University of Sydney, Sydney, NSW, Australia
| | - Lingxia Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No.76, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China. .,Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China.
| | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Handiso YH, Belachew T, Abuye C, Workicho A, Baye K. Undernutrition and its determinants among adolescent girls in low land area of Southern Ethiopia. PLoS One 2021; 16:e0240677. [PMID: 33434212 PMCID: PMC7802945 DOI: 10.1371/journal.pone.0240677] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 09/30/2020] [Indexed: 11/29/2022] Open
Abstract
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.
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Affiliation(s)
- Yoseph Halala Handiso
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Sodo, Ethiopia
- Center for Food Science and Nutrition, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tefera Belachew
- Human Nutrition Unit, College of Public Health & Medical Science, Jimma University, Jimma, Ethiopia
| | | | - Abdulhalik Workicho
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, United States of America
| | - Kaleab Baye
- Center for Food Science and Nutrition, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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11
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Gebrie A, Alebel A. A systematic review and meta-analysis of the prevalence and predictors of anemia among children in Ethiopia. Afr Health Sci 2020; 20:2007-2021. [PMID: 34394267 PMCID: PMC8351872 DOI: 10.4314/ahs.v20i4.59] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background Anemia is a wide-spread public health problem characterized by a decrease in hemoglobin concentration and/ or red blood cell volume below an established cut-off value. In developing countries including Ethiopia, about half of children are estimated to be anemic. Therefore, the purpose of this study was to determine the pooled prevalence of anemia and its predictor factors among children in Ethiopia. Method The studies were identified through explicit and exhaustive search of reputable databases (PubMed, Google scholar, Science Direct, EMBASE, Cochrane library, and the hand search of reference lists of previous prevalence studies to retrieve more related articles. Thirty-nine studies were selected based on a comprehensive list of inclusion and exclusion criteria. Data were extracted using a standardized and pre-tested data extraction checklist, and the analysis was done using STATA 14 statistical software. To assess heterogeneity, the Cochrane Q test statistic and I2 tests were used. In our analysis, considerable heterogeneity was observed. Therefore, a random effect meta-analysis model was used to estimate the pooled prevalence of anemia. Moreover, the predictor factors of anemia were examined. Results The forest plot of 39 included studies revealed that the overall pooled prevalence of anemia among children in Ethiopia was 34.4% (95% CI: 29.1, 39.7%). Sub-group analysis showed that the highest anemia prevalence was observed in Somali Region with a prevalence of 49.4 % (95% CI: 20.9, 77.8). Also, anemia in children was found to be highest in the age group of less than five years (45.2, 95% CI: 39.6,50.8). Low literacy of families: 1.3 (95% CI: 1.1, 1.7), low family socioeconomic status: 1.9 (95% CI: 1.1,3.01.3), having housewife mothers or with no job: 1.5 (95% CI: 1.4, 1.9) and rural residence: 3.3 (95% CI: 1.7,6.1) were found to be predictors of anemia among children. Conclusion In this study, one in three children were anemic in Ethiopia. It is a moderate public health problem in children in this study. Low literacy, low socioeconomic status as well as rural residence of the families and helminthic infection of the children were found to be predictors of anemia in the children. Community and school-based interventions should be strengthened to improve the problem.
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Affiliation(s)
- Alemu Gebrie
- Department of Biomedical Science, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Animut Alebel
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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12
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Tura MR, Egata G, Fage SG, Roba KT. Prevalence of Anemia and Its Associated Factors Among Female Adolescents in Ambo Town, West Shewa, Ethiopia. J Blood Med 2020; 11:279-287. [PMID: 32982526 PMCID: PMC7494400 DOI: 10.2147/jbm.s263327] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/11/2020] [Indexed: 01/19/2023] Open
Abstract
Objective This study assessed the prevalence of anemia among female adolescents and factors associated with it in Ambo town, West Shewa, Ethiopia. Materials and Methods A community-based cross-sectional study was conducted among 523 randomly selected female adolescents living in Ambo town, Ethiopia from August 5–29, 2018. Data were collected through structured interview using a structured questionnaire. Anthropometric measurements were done and the hemoglobin value was measured on the field and adjusted for the altitude. Logistic regression analysis was done to identify predictors of anemia. Level of statistical significance was declared at P<0.05. Results In this study, 39% (95% CI= 34.8–43%) participants were anemic, of which 63 (30.9%) and 46 (22.5%) female adolescents were stunted and wasted, respectively. Anemia was considerably high among female adolescents with high dietary diversity score. Adolescents born to mothers who were unable to read and write (AOR= 3.27; 95% CI=1.79–5.97), who always take tea and/or coffee within 30 minutes after meal (AOR= 6.19; 95% CI=3.32–11.48), who were wasted (AOR=1.67; 95% CI=1.11–2.52), and who had already attained their menses (AOR=1.93; 95% CI=1.19–3.13) were more likely to be anemic compared to their counterparts. Conclusion Nearly four in ten female adolescents in the study setting were anemic. Anemia among female adolescents was a moderate public health problem. Adolescents born to mothers who were unable to read and write, who consumed tea/coffee within 30 minutes after a meal, who were wasted, and who had already attained menses should be prioritized for interventions aiming at addressing iron-deficiency anemia in female adolescents.
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Affiliation(s)
- Meseret Robi Tura
- Department of Nursing, College of Medicine & Health Sciences, Ambo University, Ambo, Ethiopia
| | - Gudina Egata
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Sagni Girma Fage
- School of Nursing & Midwifery, College of Health & Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Roba
- School of Nursing & Midwifery, College of Health & Medical Sciences, Haramaya University, Harar, Ethiopia
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Fage SG, Egata G, Dessie Y, Kumsa FA, Mizana BA. Anemia among School Adolescents in Haramaya Town, Eastern Ethiopia: Cross-Sectional Study. Nutr Metab Insights 2020; 13:1178638820953131. [PMID: 32922031 PMCID: PMC7457681 DOI: 10.1177/1178638820953131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/31/2020] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Sagni Girma Fage
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Ethiopia
| | - Gudina Egata
- School of Public Health, College of Health Sciences, Addis Ababa University, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Ethiopia
| | - Fekede Asefa Kumsa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Ethiopia
| | - Biru Abdissa Mizana
- Department of Midwifery, Faculty of Health Science, Institute of Health, Jimma University, Jimma, Ethiopia
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Undernutrition and Associated Factors among Adolescent Girls in Damot Sore District, Southern Ethiopia. J Nutr Metab 2020; 2020:5083140. [PMID: 32685206 PMCID: PMC7350169 DOI: 10.1155/2020/5083140] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 05/02/2020] [Accepted: 05/18/2020] [Indexed: 11/18/2022] Open
Abstract
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.
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Prevalence and Associated Factors of Thinness among Adolescent Students in Finote Selam Town, Northwest Ethiopia. ScientificWorldJournal 2020; 2020:9170301. [PMID: 32565753 PMCID: PMC7288196 DOI: 10.1155/2020/9170301] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/16/2020] [Accepted: 05/19/2020] [Indexed: 11/17/2022] Open
Abstract
Even if adolescence is a window of opportunity to break the intergenerational cycle of malnutrition, adolescents are the neglected age groups. Hence, information regarding the nutritional status of adolescents is lacking, making creating and implementing intervention programs difficult. This study aimed to assess the prevalence and determinants of thinness among school adolescents in Finote Selam Town, Northwest Ethiopia. A school-based cross-sectional study among adolescent students aged 10–19 in public primary and secondary schools was carried out in Finote Selam Town from February 05 to March 27, 2018. Stratified and simple random sampling techniques were employed to select study subjects. A total of 397 adolescent students were included in the study. Pretested structured questionnaires were used to collect the data. Data were entered using Epi Info version 7 and analyzed using SPSS version 20 and WHO AnthroPlus software. A multivariable binary logistic regression analysis was employed to identify factors associated with thinness. Crude and adjusted odds ratios with 95% level significance were used to measure the strength of association, and statistical significance was declared at p value less than 0.05. The prevalence of thinness among adolescents was 14.9%. Early adolescent stage (AOR = 4.81; 95% CI : 1.23, 18.51), being male adolescent students (AOR = 2.33; 95% CI : 1.60, 3.40), having less than 1000 birr family monthly income (AOR = 6.54; 95% CI : 3 : 82, 14.89), having 1000–2000 birr family monthly income (AOR = 3.47; 95% CI : 1.15, 7.45), and using well water (AOR = 3.82; 95% CI : 1.46, 10.04) were significantly associated with thinness at 95% confidence interval. The study revealed that prevalence of thinness was high in the study area. Sex, place of residence, and family monthly income were found to be important factors associated with thinness among the respondents.
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An Analysis of Societal Determinant of Anemia among Adolescent Girls in Azad Jammu and Kashmir, Pakistan. Anemia 2020; 2020:1628357. [PMID: 32047664 PMCID: PMC7007924 DOI: 10.1155/2020/1628357] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 12/26/2019] [Indexed: 12/03/2022] Open
Abstract
Societal determinants of health are of recognized importance for understanding the causal association of society and health of an individual. Iron deficiency anemia (IDA) is a challenging public health problem across the globe instigating from a broader sociocultural background. It is more prevalent among pregnant women, children under the age of five years, and adolescent girls. Adolescent girls are vulnerable to develop IDA because of additional nutritional demand of the body needed for growth spurt, blood loss due to onset of menarche, malnourishment, and poor dietary iron intake. In this study, we explore the societal determinants of anemia among adolescent girls in Azad Jammu and Kashmir (AJK), Pakistan. A cross-sectional study was conducted in the Muzaffarabad division of AJK on randomly selected 626 adolescent girls. The data were collected using a pretested self-administered interview schedule comprising mainly closed-ended questions with a few open-ended questions. Descriptive statistics was computed for describing the data, and bivariate regression and logistic regression were used to determine the association of anemia with its societal determinants. Multiple linear regression is used to determine the relationship of different determinants (independent variables) with the hemoglobin level (dependent variable) of the respondents. The prevalence of anemia among adolescent girls is 47.9%, of which 47.7% have mild anemia, 51.7% have moderate anemia, and 5.7% have severe anemia, which reveals that anemia is a severe public health problem among adolescent girls in the study area. The findings aver that anemia occurrence was significantly associated with the respondent's and her parental education, economic well-being, prevalence of communicable diseases, menstrual disorder, exercise habits, meals regularity, and type of sewerage system.
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Berhe K, Kidanemariam A, Gebremariam G, Gebremariam A. Prevalence and associated factors of adolescent undernutrition in Ethiopia: a systematic review and meta-analysis. BMC Nutr 2019; 5:49. [PMID: 32153962 PMCID: PMC7050743 DOI: 10.1186/s40795-019-0309-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 09/11/2019] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND In Ethiopia, there are different pocket studies that assessed adolescent undernutrition which came up with inconsistent and inconclusive findings. Therefore, estimating the pooled prevalence and associated factors of the adolescent undernutrition using meta-analysis is crucial in Ethiopia. METHODS A systematic review of eligible articles was conducted using preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. A comprehensive searching of the literature was made in Pub Med, Scopus, Google, Google Scholar, Cochrane Library and CINAHL. The quality of the articles included in the review was assessed using the Newcastle-Ottawa Scale (NOS) for non-randomized studies in meta-analyses. The pooled prevalence and odds ratio of the associated factors with their 95% confidence interval was computed using STATA version 14 software. RESULTS Twenty-two studies were included in the meta-analysis with a total of 17,854 adolescents. Using the random-effects model analysis, the pooled prevalence of stunting and underweight was 20.7% (95% CI: 16.08, 25.33) and 27.5% (95% CI: 17.9, 57.14), respectively. Rural residence, having family size≥5, households with an unprotected water source for drinking and food-insecure household were significant associated factors for adolescent stunting. Early adolescent age (10-14 years), family size≥5, food-insecure household, lack of latrine, WHO diet diversity score < 4, mother educational status (with no formal education) were significant associated factors for adolescent underweight. CONCLUSION Adolescent undernutrition remains one of the most important public health problems in Ethiopia. Almost a quarter of Ethiopian adolescents were affected by stunting and underweight. Large family size, rural residence and unprotected source of drinking water were the associated factors for adolescent stunting. Similarly, large family size, early age of adolescent, lack of latrine, low dietary diversity score, mother illiteracy, and food insecure household were the associated factors for adolescent underweight. It would be good to give high emphasis on adolescent undernutrition and it is important to address the above mentioned associated factors during adolescent nutritional interventions in Ethiopia.
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Affiliation(s)
- Kidanemaryam Berhe
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Abadi Kidanemariam
- Department of Nursing, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | - Gebrehiwot Gebremariam
- Department of Public Health, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | - Alem Gebremariam
- Department of Public Health, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
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Arage G, Assefa M, Worku T. Socio-demographic and economic factors are associated with nutritional status of adolescent school girls in Lay Guyint Woreda, Northwest Ethiopia. SAGE Open Med 2019; 7:2050312119844679. [PMID: 31019699 PMCID: PMC6469276 DOI: 10.1177/2050312119844679] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 03/27/2019] [Indexed: 12/26/2022] Open
Abstract
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.
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Affiliation(s)
- Getachew Arage
- Department of Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Mekonnen Assefa
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Teshager Worku
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Mengistu G, Azage M, Gutema H. Iron Deficiency Anemia among In-School Adolescent Girls in Rural Area of Bahir Dar City Administration, North West Ethiopia. Anemia 2019; 2019:1097547. [PMID: 31016041 PMCID: PMC6448345 DOI: 10.1155/2019/1097547] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 12/24/2018] [Accepted: 02/03/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Anemia is a major public health problem worldwide. Adolescent girls are the most vulnerable group of population due to different reasons. The aim of this study was to assess the prevalence of anemia and associated factors among school adolescent girls in rural towns of Bahir Dar City Administration, North West Ethiopia. METHODS A cross-sectional study was conducted from March 5 to April 15, 2017, on 443 randomly selected school adolescent girls. Data were collected using pretested structured questionnaire and anthropometric measurements. Blood sample was also collected to assess the hemoglobin (Hgb) value of study participants. SPSS version 20 was used to analyze data. Descriptive statistics were used to describe data. Bivariate and multivariable logistic regression models were used to identify the associated factors with the outcome variable. Crude and adjusted odds ratios with 95% confidence interval (CI) were calculated to identify the variables significantly associated with the outcome variable. RESULT The prevalence of anemia was 11.1%. Household family size [AOR=3.2, 95%CI (1.29-7.89)], average household monthly income <500 ETB [AOR=10; 95%CI (2.49-41.26)], 501-1000 ETB [AOR=6, 95%CI (2.54-14.33)], history of intestinal parasitic infection [AOR=2.7; 95% CI (1.19-6.21)], duration of menstruation flow [AOR=2.4; 95%CI (1.08- 5.44)], and BMI for age [AOR-3.2; 95% CI (1.43-7.05)] were the predictors of anemia. CONCLUSION AND RECOMMENDATION Anemia was a mild public health problem among school adolescent girls in the study area. Household monthly income, family size, intestinal parasite infections, duration of menstruation, and BMI for age are predictors of anemia. Thus, intervention strategies should focus on prevention and early treatment of intestinal parasite, nutritional education, screening, and iron supplementation programs to prevent anemia among school adolescent girls.
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Affiliation(s)
- Getachew Mengistu
- Department of Regulatory, Bahir Dar City Administration Health Office, Post Code 50, Ethiopia
| | - Muluken Azage
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Post Code 79, Ethiopia
| | - Hordofa Gutema
- Department of Health Promotion and Behavioral Sciences, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Post Code 79, Ethiopia
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Hadaye R, Pathak B, Lavangare S. Nutritional status of the student nurses of a tertiary health-care center - A mixed-method study. J Family Med Prim Care 2019; 8:1028-1034. [PMID: 31041246 PMCID: PMC6482778 DOI: 10.4103/jfmpc.jfmpc_314_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Context: Nursing students are the future role model of health; so critical evaluation of their nutritional status is imperative for effective functioning of health sector. Aims: The aim is to assess the nutritional status of nursing students using basal metabolic index and exploring the causes of malnutrition along with uncovering the causes behind these causes of malnutrition. Setting and Design: Nutritional status of student's nurses was assessed by mixed-method study design in tertiary care center of Mumbai, India. Materials and Methods: The method is to use the census method for sampling 280 nursing students of a tertiary care center interviewed using a semistructured interview schedule. Focus group discussions were held with student nurses, which were selected through purposive sampling technique to interpret the instigator causes behind causes of malnutrition. Statistical Analysis: Descriptive statistics was applied on qualitative data. Conceptual model framed on themes and subthemes based upon the codes from qualitative data. Results: Students having BMI less than 18 and more than 24.9 were 189 and 11, respectively, out of 280 students. About 64.20% had acidity and 11.07% performed regular exercises evolving major themes: challenges, stress, attitude, knowledge, social barriers, and motivators. Conclusion: About 67.5% of nursing students had BMI less than 18. Inappropriate dietary pattern, frequent ailments, and improper personal habits ensued their malnourished status. Lack of proper knowledge on balanced diet, work place stress, and challenges such as financial constrain, peer pressure, and health ailments along with improper perception of body image of the student nurses are major triggering factors behind the causes of malnutrition.
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Affiliation(s)
- Rujuta Hadaye
- Department of Community Medicine, Seth G.S. Medical College and K.E.M. Hospital, Mumbai, Maharashtra, India
| | - Barsha Pathak
- Department of Community Medicine, Seth G.S. Medical College and K.E.M. Hospital, Mumbai, Maharashtra, India
| | - Sujata Lavangare
- Department of Community Medicine, Seth G.S. Medical College and K.E.M. Hospital, Mumbai, Maharashtra, India
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Gonete KA, Tariku A, Wami SD, Derso T. Prevalence and associated factors of anemia among adolescent girls attending high schools in Dembia District, Northwest Ethiopia, 2017. ACTA ACUST UNITED AC 2018; 76:79. [PMID: 30598822 PMCID: PMC6302287 DOI: 10.1186/s13690-018-0324-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 11/21/2018] [Indexed: 11/10/2022]
Abstract
Introduction Anemia is a global public health problem affecting both developing and developed countries. In Ethiopia, Adolescent girls are more vulnerable to anemia because of gender norms can leave girls disproportionately impacted by food insecurity, increased iron requirements related to their rapid growth, and menstrual loss. However, evidence on the problem is scarce because it has not been given due attention in Ethiopia. Therefore, this study assessed the prevalence and associated factors of anemia among late adolescent girls attending high schools in Dembia District, northwest Ethiopia. Methods A school based cross-sectional study was conducted in Dembia District from March 1 to April 30/ 2017. Out of the randomly selected three high schools, 462 adolescents were included using the simple random sampling technique. A Standardized structured questionnaire was used to collect data. Capillary blood samples were drawn from adolescents using a portable Hb201+ instrument to measure hemoglobin. A bivariate and multivariable binary logistic regression analyses were employed to identify factors associated with anemia. Adjusted Odds Ratio (AOR) with a corresponding 95% Confidence Interval (CI) was computed to show the strength of associations. Results The overall prevalence of anaemia among adolescent girls was 25.5%, (95%CI, 21.4, and 29.2). Of the total anemic adolescents, 109(92.4%) had mild anaemia, while 7(5.9%) and 2(1.7%) were found with moderate and severe anaemia, respectively. Dietary diversity score ((AOR =4.2(95% CI;1.7, 10.5)), household food security status ((AOR = 4.1(95% CI; 1.3, 13.2)), living status of adolescents with either of the two parents((AOR = 2;(95%CI;1.14,3.6)) and guardians ((AOR = 2.4;(95% CI;1.02,5.6)) showed statistically significant association with anemia. Conclusion Anemia is a moderate public health problem in Dembia District. Dietary diversity score, household food security status, and living status of adolescents were the key determinants of anemia. Therefore, the government should focus on preventing food insecurity with increasing productivity to improve dietary diversification of the adolescent girls. Trial registration Retrospectively registered.
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Affiliation(s)
- Kedir Abdela Gonete
- 1Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Amare Tariku
- 1Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sintayehu Daba Wami
- 2Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Terefe Derso
- 1Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Gebrie A, Alebel A, Zegeye A, Tesfaye B, Ferede A. Prevalence and associated factors of overweight/ obesity among children and adolescents in Ethiopia: a systematic review and meta-analysis. BMC OBESITY 2018; 5:19. [PMID: 30002860 PMCID: PMC6036672 DOI: 10.1186/s40608-018-0198-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 05/22/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Overweight and obesity can be defined as excessive and abnormal fat depositions in our body. They have become one of the emerging and serious public health concerns of the twenty-first century in low income countries like Ethiopia. Hence, the aim of this study was to determine the pooled prevalence and review associated risk factors of overweight/obesity among children and adolescents in Ethiopia. METHOD The articles were identified through explicit and reproducible electronic search of reputable databases (PubMed, Google scholar, Science Direct, EMBASE, Cochrane library), and the hand search of reference lists of previous prevalence studies to retrieve more related articles. The 18 studies were selected based on a comprehensive list of inclusion and exclusion criteria. Data were extracted using a standardized and pre-tested data extraction checklist, and the analysis was done using STATA 14 statistical software. To assess heterogeneity, the Cochrane Q test statistic and I2 tests were used. Since the included studies exhibited considerable heterogeneity, a random effect model was used to estimate the pooled prevalence of overweight/obesity. Moreover, the risk factors of overweight/obesity were reviewed. RESULTS The combined pooled prevalence of overweight and obesity among children and adolescents in Ethiopia was 11.30% (95% CI: 8.71, 13.88%). Also, the separate pooled prevalence of overweight and obesity were 8.92 and 2.39%, respectively. Subgroup analysis revealed that the highest overweight/obesity prevalence among children and adolescents was observed in Addis Ababa, 11.94 (95% CI: 9.39, 14.50). Female gender of the children: 3.23 (95% CI 2.03,5.13), high family socioeconomic status: 3.16 (95% CI 1.87,5.34), learning in private school: 3.22 (95% CI 2.36,4.40), physical inactivity: 3.36 (95% CI 1.68,6.72), sweet nutriments preference: 2.78 (95% CI 1.97,3.93) and less use of fruits/vegetables: 1.39 (95% CI 1.10,1.75) have shown a positive association with the development of overweight/obesity among children and adolescents. CONCLUSION The pooled prevalence of overweight/obesity among children and adolescents in Ethiopia is substantially high, and has become an emerging nutrition linked problem. Female gender, high family socioeconomic status, learning in private school, physical inactivity, sweet nutriments preference and less use of fruits/vegetables were found to be significantly associated with overweight/obesity.
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Affiliation(s)
- Alemu Gebrie
- Department of Biomedical Science, School of Medicine, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Animut Alebel
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Abriham Zegeye
- Department of Biomedical Science, School of Medicine, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Bekele Tesfaye
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Aster Ferede
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Tezera R, Sahile Z, Yilma D, Misganaw E, Mulu E. Prevalence of anemia among school-age children in Ethiopia: a systematic review and meta-analysis. Syst Rev 2018; 7:80. [PMID: 29793528 PMCID: PMC5968474 DOI: 10.1186/s13643-018-0741-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 05/09/2018] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Anemia continued to become a major public health problem in developing nations including Ethiopia. Especially, school children are more vulnerable for anemia and consequences of anemia. Generating accurate epidemiological data on anemia in school children is an important step for health policy maker. There are limited evidences on anemia prevalence in school-age children in Ethiopia. This study aimed to synthesize the pooled prevalence of anemia in school-age children in Ethiopia. METHODS This systematic review and meta-analysis was followed the PRISMA guidelines. Comprehensive searched was conducted in PubMed/MEDLINE, Cochrane Library, Google Scholar, HINARI, and Ethiopian Journal of Health Development for studies published before 2016, supplemented by manual searches to identify relevant studies. Two review authors independently selected studies, extracted data, and assessed quality of studies. The Cochrane Q test and I2 test statistic were used to test heterogeneity through studies. The overall prevalence was calculated using random-effects model of DerSimonian-Laird method. RESULTS From 831 obtained studies, 13 articles included in the meta-analysis. The pooled prevalence of anemia among school children in Ethiopia was 23% (95% CI 18-28%). The prevalence of anemia in male and female school-age children was 27% (95% CI 20 and 34%) and 24% (95% CI 18 and 30%), respectively. CONCLUSIONS This study found that prevalence of anemia was a moderate public health problem in school children. Due to the complications of anemia for school children, preventative planning and control of anemia among school children in Ethiopia is necessary.
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Affiliation(s)
- Robel Tezera
- Department of Medical Radiological Technology, Division of Public Health, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Zekariyas Sahile
- Department of Public Health, College of Health Science and Medicine, Ambo University, Ambo, Ethiopia
| | - Delelegn Yilma
- Department of Public Health, College of Health Science and Medicine, Ambo University, Ambo, Ethiopia
| | - Equilnet Misganaw
- Human Resources for Health (HRH) Department, JHPIEGO/Ethiopia, Addis Ababa, Ethiopia
| | - Ermiyas Mulu
- Department of Public Health, College of Health Science and Medicine, Ambo University, Ambo, Ethiopia
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Anemia and Its Relationship with Academic Performance among Adolescent School Girls in Kebena District, Southwest Ethiopia. ACTA ACUST UNITED AC 2017. [DOI: 10.5812/bhs.13431] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jodhun BM, Pem D, Jeewon R. A systematic review of factors affecting energy intake of adolescent girls. Afr Health Sci 2016; 16:910-922. [PMID: 28479881 PMCID: PMC5398435 DOI: 10.4314/ahs.v16i4.5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Adolescence is considered a critical period marked by an increase in energy intake to meet the body's physiological needs especially during puberty. This study reviews existing literature and critically analyses factors associated with eating habits and energy intake of adolescent girls. METHODS A comprehensive search was conducted to identify at least 200 peer reviewed articles which dealt with the factors affecting energy intake (EI) and eating habits of adolescent girls. Studies were identified using a reference period between 1994 and 2016, based primarily on the PubMed/ CINL/ Science Direct/Google Scholar databases using keywords adolescent/ teenagers, factors/determinants and energy intake. RESULTS No studies investigated all factors affecting energy intake among adolescents. Some studies found mixed association among the determinants of EI in adolescent girls. However, a number of reviews confirm that many factors namely physical activity level, socio-economic status, diet, individual and social factors do contribute to either a higher or a lower EI of adolescents. CONCLUSION There is a dire need to consider factors associated with EI when designing nutritional intervention programs to prevent health problems in adulthood. The goal is not to change behavior of all but to increase the percentage of people adopting healthier lifestyle.
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Affiliation(s)
- Bibi Mushirah Jodhun
- Department of Health Sciences, Faculty of Science, University of Mauritius, Réduit, Mauritius
| | - Dhandevi Pem
- Department of Health Sciences, Faculty of Science, University of Mauritius, Réduit, Mauritius
| | - Rajesh Jeewon
- Department of Health Sciences, Faculty of Science, University of Mauritius, Réduit, Mauritius
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