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Daba AK, Abegaz K, Muleta A, Desalegn BB. Hand Washing Practice and Food Insecurity are Associated With Undernutrition of Breastfeeding Mothers in Rural Ethiopia: A Cross-sectional Study. ENVIRONMENTAL HEALTH INSIGHTS 2024; 18:11786302241231708. [PMID: 38356920 PMCID: PMC10865933 DOI: 10.1177/11786302241231708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 01/19/2024] [Indexed: 02/16/2024]
Abstract
Background Breastfeeding mothers are prone to undernutrition. However, factors contributing to maternal undernutrition are not exhaustively understood. Hence, this study aimed to determine prevalence of undernutrition among breastfeeding mothers and identify associated factors. Methods A cross-sectional study was conducted among 606 breastfeeding mothers from selected rural districts in Oromia and Sidama regional states of Ethiopia. Data were collected through an interviewer-administered questionnaire. Nutritional status was assessed using body mass index (BMI) and mid-upper-arm-circumference (MUAC). Logistic regression analysis was used to identify factors associated with maternal undernutrition. Results One out of ten breastfeeding mothers was found undernourished as determined by BMI (12.6%) and MUAC (10.7%). Mothers who did not practice hand washing after cleaning children's bottom were 2 and 3 times more likely to be undernourished compared to their counters, as measured by BMI (AOR = 2.29, P = .002) and MUAC (AOR = 3.03, P < .001), respectively. Mothers living in mildly or moderately food insecure households (AOR = 2.37, P = .019) were more than two times more likely to be undernourished as determined by MUAC. Mothers who breastfed children in the age range of 9 to 11 (AOR = 2.79, P = .025) or 12 to 23 (AOR = 2.57, P = .018) months were more than two and half times more likely to be undernourished as determined by BMI. Conclusions Maternal undernutrition is a medium-level public health problem in rural districts of Oromia and Sidama regional states in Ethiopia. The lack of hand washing practice after cleaning a child's bottom, household food insecurity and higher child age increased the odds of maternal undernutrition. Mothers should prioritize and improve their nutritional care as the age of their breastfed child increases. Nutrition programs in rural districts of Ethiopia should also aim to improve personal hygiene practices and food insecurity integrated with implementation researches to evaluate program's impact on nutritional status of breastfeeding mothers.
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Affiliation(s)
- Alemneh Kabeta Daba
- School of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Kebede Abegaz
- School of Nutrition, Food Science and Technology, College of Agriculture, Hawassa University, Hawassa, Ethiopia
| | - Anbissa Muleta
- Department of Food Science and Nutrition, College of Natural Science, Jigjiga University, Jigjiga, Ethiopia
| | - Beruk Berhanu Desalegn
- School of Nutrition, Food Science and Technology, College of Agriculture, Hawassa University, Hawassa, Ethiopia
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Getacher L, Ademe BW, Belachew T. Understanding the national evidence on the double burden of malnutrition in Ethiopia for the implications of research gap identifications: a scoping review. BMJ Open 2023; 13:e075600. [PMID: 38149415 PMCID: PMC10711832 DOI: 10.1136/bmjopen-2023-075600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 10/31/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND Owing to the unavoidable consequences of nutritional transition, the double burden of malnutrition (DBM) is an emerging public health problem. An increasing number of studies have found that Ethiopians face a DBM. However, country-level evidence has not yet been summarised using a scoping review study design. OBJECTIVE The main objective of this review was to map the national evidence on DBM in Ethiopia for the implications of research gap identifications. ELIGIBILITY CRITERIA The population, concept and context approach was used. All age groups, box sexes, all dates of publication and articles in English language focused on DBM conducted in Ethiopia were included. SOURCES OF EVIDENCE Primary research articles, systematic reviews, meta-analyses and scoping reviews searched from electronic databases such as PubMed, ScienceDirect, Cochrane Library, Wiley Online Library, Google Scholar and Google were the sources of evidence. CHARTING METHODS The Joanna Briggs Institute Reviewer's manual was used as a review methodology. The authors, publication year, region, study design, sample size, population group, measured outcomes and main findings were charted in a table. RESULTS A total of 35 articles met the inclusion criteria among 124 426 participants. The average summarised prevalence of DBM was 33.6%, with the average proportions of undernutrition and overnutrition at 21.5% and 12.1%, respectively. The major factors that influenced the DBM were categorised as child, maternal, adolescent, household and adult-related factors. CONCLUSION In Ethiopia, the overall prevalence of DBM is high, which makes one-third of the population affected by DBM. The foremost determinant factors that influenced the DBM were characterised as child, maternal, adolescent, household and adult-related factors. Therefore, a double-duty interventions should be used to address DBM, considering multilevel factors at the individual, community and societal levels. PROTOCOL REGISTRATION This review was registered on the figshare website on 28 February 2021, with DOI number https://doi.org/10.6084/m9.figshare.14131874. The review protocol was published with a DOI number http://dx.doi.org/10.1136/bmjopen-2021-050805.
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Affiliation(s)
- Lemma Getacher
- School of Public Health, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Beyene Wondafrash Ademe
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
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Getacher L, Ademe BW, Belachew T. Double burden of malnutrition and its associated factors among adolescents in Debre Berhan Regiopolitan City, Ethiopia: a multinomial regression model analysis. Front Nutr 2023; 10:1187875. [PMID: 37545577 PMCID: PMC10400360 DOI: 10.3389/fnut.2023.1187875] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/30/2023] [Indexed: 08/08/2023] Open
Abstract
Background The double burden of malnutrition (DBM), contained both undernutrition and overnutrition, is a growing public health concern that presents a significant challenge to the food and nutrition policies of developing nations such as Ethiopia. However, the prevalence and contributing factors of DBM among adolescents in the study area have not been adequately investigated by Ethiopian researchers. Therefore, this study aims to determine the prevalence of DBM and contributing factors among secondary school students in Debre Berhan City, Ethiopia. Methods A school-based cross-sectional study was conducted among 742 adolescents aged 10-19 years from October 13, 2022, to November 14, 2022, using a multi-stage sampling method. Data were collected using the online Kobo toolbox tool. A multinomial logistic regression model was used to analyze the data. The data were cleaned and analyzed in R software 4.2.2. Adolescents who had body mass index for age Z score (BAZ) < -2 SD, > +1 SD, and > +2 from the median value were considered thin, overweight, and obese, respectively. Results The overall prevalence of DBM was 21.5% (14.8% thinness and 6.7% overweight/obesity). In the multivariable multinomial logistic regression analysis models factors such as age [AOR = 0.79, 95% CL: (0.67, 0.93)], sex [AOR = 3.86, 95% CL: (2.35, 6.32)], school type [AOR 5.03, 95% CL: (2.30, 10.99)], minimum dietary diversity score [AOR = 2.29, 95% CL: (1.27, 4.14)], frequency of meals [AOR = 2.09, 95% CL: (1.13, 3.89)], home gardening practice [AOR = 2.31, 95% CL: (1.44, 3.67)], history of illness [AOR = 0.57, 95% CL: (0.36, 0.93)], and knowledge of nutrition [AOR = 4.96, 95% CL: (1.61, 15.33)] were the significant predictors of either thinness or overweight/obesity (DBM). Conclusion More than one-fifth of adolescents were affected by DBM in the study area. This prevalence is higher compared with the national and regional prevalence that found to be a public health concern. Thus, interventions like double-duty interventions should consider the age, sex, school type, minimum dietary diversity score, frequency of meals, home gardening practice, history of illness, and nutritional knowledge of adolescents. Clinical Trial Registration clinicaltrial.gov, identifier NCT05574842.
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Affiliation(s)
- Lemma Getacher
- School of Public Health, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Beyene Wondafrash Ademe
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
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Stadlmayr B, Trübswasser U, McMullin S, Karanja A, Wurzinger M, Hundscheid L, Riefler P, Lemke S, Brouwer ID, Sommer I. Factors affecting fruit and vegetable consumption and purchase behavior of adults in sub-Saharan Africa: A rapid review. Front Nutr 2023; 10:1113013. [PMID: 37113298 PMCID: PMC10126510 DOI: 10.3389/fnut.2023.1113013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/22/2023] [Indexed: 04/29/2023] Open
Abstract
In order to achieve the Sustainable Development Goals, considerable dietary shifts, including an increase in the consumption of fruit and vegetables (FV) will be required. However, worldwide consumption of FV is far below international recommendations, including in many low- and middle-income countries (LMICs), particularly in Africa. Understanding what, where, when, and how people choose to eat requires an understanding of how individuals are influenced by factors in their social, physical, and macro-level environments. In order to develop effective interventions to increase fruit and vegetable consumption, the factors influencing consumer behavior need to be better understood. We conducted a rapid review to assess and synthesize data on individual, social, physical, and macro-level factors that enable or constrain fruit and vegetable consumption and purchase among adults living in sub-Saharan Africa. Our conceptual framework is based on a socio-ecological model which has been adapted to settings in LMICs and Africa. We systematically searched four electronic databases including Scopus, Medline (PubMed), PsycInfo, and African Index Medicus, and screened Google Scholar for gray literature. We included a total of 52 studies and narratively summarized the existing evidence for each identified factor across the different levels. We found that most studies assessed demographic factors at the individual level including household or family income, socio-economic status and education. Furthermore we identified a variety of important factors that influence FV consumption, in the social, physical, and macro environment. These include women's empowerment and gender inequalities, the influence of neighborhood and retail food environment such as distance to market and price of FV as well as the importance of natural landscapes including forest areas for FV consumption. This review identified the need to develop and improve indicators both for exposure and outcome variables but also to diversify research approaches.
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Affiliation(s)
- Barbara Stadlmayr
- Institute for Development Research, Department of Sustainable Agricultural Systems, University of Natural Resources and Life Sciences, Vienna, Austria
- World Agroforestry (ICRAF), Nairobi, Kenya
| | - Ursula Trübswasser
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | | | | | - Maria Wurzinger
- Institute for Development Research, Department of Sustainable Agricultural Systems, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Laura Hundscheid
- Institute for Development Research, Department of Sustainable Agricultural Systems, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Petra Riefler
- Institute for Marketing and Innovation, Department of Economics and Social Science, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Stefanie Lemke
- Institute for Development Research, Department of Sustainable Agricultural Systems, University of Natural Resources and Life Sciences, Vienna, Austria
- Center for Agroecology, Water and Resilience, Coventry University, Coventry, United Kingdom
| | - Inge D. Brouwer
- Division of Human Nutrition and Health/CGIAR Initiative Sustainable Healthy Diets (SHiFT), Wageningen University, Wageningen, Netherlands
| | - Isolde Sommer
- Department for Evidence-Based Medicine and Evaluation, University for Continuing Education, Krems, Austria
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Berhanu G, Dessalegn B, Ali H, Animut K. Determinants of nutritional status among primary school students in Dilla Town; Application of an ordinal logistic regression model. Heliyon 2023; 9:e13928. [PMID: 36895335 PMCID: PMC9988510 DOI: 10.1016/j.heliyon.2023.e13928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 02/15/2023] [Accepted: 02/15/2023] [Indexed: 02/23/2023] Open
Abstract
Background One of the most frequent reasons for children's poor physical and mental development is malnutrition, becoming a more significant issue in most developing nations, including Ethiopia. Prior research used multiple anthropometric measurements separately to pinpoint undernutrition concerns in children. However, the impact of each explanatory variable on a single response category was not considered in these investigations. This study used a single composite index of anthropometric parameters to identify the factors affecting elementary school students' nutritional condition. Methods In Dilla, Ethiopia, 494 primary school students took part in a cross-sectional institutional survey during the 2021 academic year. Principal component analysis was used to create a single composite measure of nutritional status using z-scores for the anthropometric indices of height-for-age and body mass index-for-age. The relative effectiveness of a partial proportional odds model was compared with several other ordinal regression models to identify the important variables for children's nutritional status. Results 27.94% of primary school students were undernourished (7.29% severely and 20.65% moderately). According to the fitted partial proportional odds model, the mother's education level (secondary or higher) was positively correlated with the nutritional status of primary school students, given that in this case the students ate three or more times per day and had a high dietary diversity score (OR = 5.94; CI: 2.2-16.0). Nevertheless, there was a negative correlation between larger family size (OR = 0.56; CI: 0.32-0.97), unprotected groundwater (OR = 0.76; CI: 0.6-0.96), and severely food insecure households (OR = 0.3; CI: 0.14-0.68). Conclusion In Dilla, Ethiopia, undernutrition among primary school students is a serious issue. It is essential to implement nutrition education and school feeding programs, improve drinking water sources, and boost the community's economy to alleviate the problems.
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Affiliation(s)
- Getasew Berhanu
- Department of Statistics, College of Natural and Computational Science, Dilla University, Dilla, Ethiopia
- Corresponding author.
| | - Behailu Dessalegn
- Department of Statistics, College of Natural and Computational Science, Dilla University, Dilla, Ethiopia
| | - Helen Ali
- Department of Public Health Nutrition, College of Health and Medical Science, Dilla University, Dilla, Ethiopia
| | - Kassahun Animut
- Department of Statistics, College of Natural and Computational Science, Dilla University, Dilla, Ethiopia
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Jalata DD, Mekonnen SA, Taddese HY, Workeneh MZ. Food consumption patterns in employees of Ethiopian institute of agricultural research. Heliyon 2023; 9:e12915. [PMID: 36704267 PMCID: PMC9871231 DOI: 10.1016/j.heliyon.2023.e12915] [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: 10/11/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 01/14/2023] Open
Abstract
In developing countries, including Ethiopia, diet-related non-communicable diseases are prevalent among the working population. Understanding this active group's dietary diversity and food consumption patterns is essential to devise alternative solutions and recommend possible improvements. This study investigates the food consumption patterns of employees of the Ethiopian Institute of Agricultural Research. A cross-sectional survey was conducted from January 1 to March 31, 2022, involving 13 different research centers of the institute situated in different agro-ecological regions of the country. A validated food frequency questionnaire and a 24-h food recall were administered to a total sample size of 355 employees. A systematic random sampling was used for data collection. Stata survey commands version 16.0 and multiple logistic regression were used to analyze the data. The research confirmed that socio-demographic determinants, income, and educational level affect the food consumption patterns of employees. The majority of employees have low consumption of foods like fish, fruits, vegetables, and animal products. Consumption of all kinds of animal products was very low on Wednesday and Friday. This result will help employees to give more attention to low-cost healthier food items, as well as institutional management bodies in designing awareness-creation campaigns and government programs to encourage the production and access of nutritious food.
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Affiliation(s)
- Dassalegn Daraje Jalata
- Department of Food Science and Nutrition Research, Ethiopian Institute of Agricultural Research, Addis Ababa, Ethiopia
- Corresponding author.
| | - Solomon Abate Mekonnen
- Department of Food Science and Nutrition Research, Ethiopian Institute of Agricultural Research, Addis Ababa, Ethiopia
| | - Hana Yeshitila Taddese
- Department of Agricultural Extension and Communication Research, Ethiopian Institute of Agricultural Research, Addis Ababa, Ethiopia
| | - Mulate Zerihun Workeneh
- Department of Food Science and Nutrition Research, Ethiopian Institute of Agricultural Research, Addis Ababa, Ethiopia
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Engidaye G, Aynalem M, Adane T, Gelaw Y, Yalew A, Enawgaw B. Undernutrition and its associated factors among children aged 6 to 59 months in Menz Gera Midir district, Northeast Ethiopia: A community-based cross-sectional study. PLoS One 2022; 17:e0278756. [PMID: 36473009 PMCID: PMC9725165 DOI: 10.1371/journal.pone.0278756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 11/08/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Undernutrition can lead to impaired physical growth, restricted intellectual skills, low school performance, reduced working capacity, and rooted disability in adult life. Thus, this study was designed to assess the prevalence and associated factors of undernutrition among children aged 6 to 59 months. METHODS A community-based cross-sectional study was conducted among 432 children aged 6 to 59 months in the Menz Gera Midir District. A multi-stage sampling technique was applied to recruit the study participants. Socio-demographic and socio-economic variables were collected by using structured questionnaires. Anthropometric measurements of the children were measured according to the World Health Organization's recommendation. A data collection sheet was used to collect information on the types of foods and number of meals consumed by the child. A bivariable and multivariable logistic regression was performed to identify factors associated with undernutrition. RESULT In this study, about 11.3% (95% CI: 8.3-14.3%), 50.2% (95% CI: 45.5-55.0%), and 28% (95% CI: 23.8-32.3%) were wasted, stunted, and underweight, respectively. Children aged 12-23 months (AOR: 1.97; 95% CI: 1.01-3.87), 36-47 months (AOR: 2.05; 95% CI: 1.00-4.19), and being anemic (AOR: 2.92; 95% CI: 1.73-4.92) were found to be an independent predictor of stunting. Moreover, being anemic was found to be significantly associated with wasting (AOR: 6.84; 95% CI: 3.16-14.82). CONCLUSION According to the findings of this study, undernutrition was a serious public health issue among 6-59 month old children in the Menz Gera Midir District. Children's age and anemia status were significantly associated with stunting and wasting. Therefore, community-based nutrition programs are vital to reduce childhood undernutrition.
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Affiliation(s)
- Getabalew Engidaye
- School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Melak Aynalem
- School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Tiruneh Adane
- School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Yemataw Gelaw
- School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Aregawi Yalew
- School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Bamlaku Enawgaw
- School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Ayal BG, Demilew YM, Derseh HA, Kidie AA. Micronutrient intake and associated factors among school adolescent girls in Meshenti Town, Bahir Dar City Administration, Northwest Ethiopia, 2020. PLoS One 2022; 17:e0277263. [PMID: 36445906 PMCID: PMC9707767 DOI: 10.1371/journal.pone.0277263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 10/25/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Adolescent girls have a greater nutrient demand and their poor dietary intake is associated with micronutrient deficiencies and poor maternal outcomes. Having information on micronutrient intake inadequacy in adolescent girls is critical for promoting healthy behavior and breaking the cycle of intergenerational malnutrition. Thus, this study assessed overall micronutrient intake inadequacy and associated factors among school adolescent girls in Meshenti town of Bahir Dar City Administration, North West Ethiopia. METHODS A school-based cross-sectional study was conducted among 401 adolescent girls from February 7 to 23, 2020. A Simple random sampling technique was used to select study participants. A multiple-pass 24-hour dietary recall with portion size estimation method and recommended dietary allowance cut-off point were used to assess micronutrient intake inadequacy. Overall micronutrient intake inadequacy was measured using the mean adequacy ratio. Nutrient databases were developed by ESHA FOOD PROCESSOR version 8.1 software. Data were entered into Epi-data version 3.1 and exported to SPSS version 23 for analysis. Multivariable logistic regression was performed to identify determinants of overall micronutrient intake inadequacy and an adjusted odds ratio at a p-value of less than 0.05 was used to see the strength of statistical association. RESULTS The prevalence of overall micronutrient intake inadequacy was 44.4% (95% CI: 39.7%-49.6%). Early adolescent age (AOR: 2.75, 95% CI: 1.71-4.42), food-insecure household (1.74, 95%CI: 1.087-2.784), low dietary diversity score (AOR = 2.83, 95% CI: 1.35-5.92), and high peer pressure on eating and body concern (AOR = 1.853, 95% CI: 1.201-2.857) were significantly associated factors with overall micronutrient intake inadequacy. CONCLUSION Findings of this study revealed that micronutrient intake inadequacy among adolescent girls was a high public health problem in the study area. Therefore, attention should be given to adolescent girls of the study area, especially the ones in the early adolescent age. Interventions should also focus on nutrition-sensitive activities to address food insecurity, a less diversified diet, and the negative impact of peer influence.
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Affiliation(s)
- Birtukan Gizachew Ayal
- School of public health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
- * E-mail:
| | - Yeshalem Mulugeta Demilew
- Department of Nutrition and Dietetics, School of public health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Hunegnaw Almaw Derseh
- Department of Nutrition and Dietetics, School of public health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Atitegeb Abera Kidie
- School of public health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
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Hart MD, Girma M, Strong MD, Tadesse BT, Taddesse BM, Alemayehu FR, Stoecker BJ, Chowanadisai W. Vitamin D binding protein gene polymorphisms are associated with lower plasma 25-hydroxy-cholecalciferol concentrations in Ethiopian lactating women. Nutr Res 2022; 107:86-95. [PMID: 36206636 DOI: 10.1016/j.nutres.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/29/2022] [Accepted: 09/03/2022] [Indexed: 12/27/2022]
Abstract
Ethiopian women have been reported to have low plasma 25-hydroxy-cholecalciferol (25(OH)D) concentrations despite an abundance of sunshine. Low dietary vitamin D intake, limited skin exposure to sun, and genetics are among factors suggested to affect vitamin D status in this population. In this study (Clinical Trial NCT02210884), we hypothesized that polymorphisms in the vitamin D binding protein (VDBP) gene (rs7041, rs4588) are associated with reduced plasma 25(OH)D concentrations in Ethiopian women. Lactating Ethiopian women (n = 110) were randomly assigned to weekly administration of vitamin D3 (15,000 IU) or a placebo. Plasma 25(OH)D was measured at baseline (within 2 weeks of delivery, before supplementation) and at 3, 6, and 12 months after delivery. Associations between VDBP polymorphism status for rs7041 and rs4588 and plasma 25(OH)D were determined by analysis of variance and multiple linear and logistic regressions. Multiple linear regression with maternal age as a covariate revealed that rs7041 is associated with reduced plasma 25(OH)D (P = .021) and more risk alleles at rs7041 and rs4588 are associated with reduced plasma 25(OH)D (P = .017). Logistic regression models for vitamin D insufficiency showed that additional risk alleles for rs7041 and rs4588 are associated with increased odds ratios (OR = 1.66; 95% CI, 1.10-2.62; P = .019) for plasma 25(OH)D below 40 nmol/L. Supplementation increased plasma 25(OH)D at 3 months in women with fewer risk alleles and across all genotypes at 6 and 12 months. VDBP polymorphisms may contribute to vitamin D insufficiency in Ethiopian lactating women. Furthermore, VDBP polymorphisms may blunt short-term responses to vitamin D supplementation and require longer periods of intervention.
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Affiliation(s)
- Matthew D Hart
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, 74078, USA
| | - Meron Girma
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, 74078, USA; School of Nutrition, Food Science, and Technology, Hawassa University, Hawassa, Ethiopia
| | - Morgan D Strong
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, 74078, USA
| | | | | | - Fikadu Reta Alemayehu
- School of Nutrition, Food Science, and Technology, Hawassa University, Hawassa, Ethiopia
| | - Barbara J Stoecker
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, 74078, USA.
| | - Winyoo Chowanadisai
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, 74078, USA.
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10
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de Quadros VP, Balcerzak A, Allemand P, de Sousa RF, Bevere T, Arsenault J, Deitchler M, Holmes BA. Global Trends in the Availability of Dietary Data in Low and Middle-Income Countries. Nutrients 2022; 14:nu14142987. [PMID: 35889943 PMCID: PMC9324857 DOI: 10.3390/nu14142987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/06/2022] [Accepted: 07/12/2022] [Indexed: 02/05/2023] Open
Abstract
Individual-level quantitative dietary data can provide suitably disaggregated information to identify the needs of all population sub-groups, which can in turn inform agricultural, nutrition, food safety, and environmental policies and programs. The purpose of this discussion paper is to provide an overview of dietary surveys conducted in low- and middle-income countries (LMICs) from 1980 to 2019, analyzing their key characteristics to understand the trends in dietary data collection across time. The present study analyzes the information gathered by the Food and Agriculture Organization of the United Nations/World Health Organization Global Individual Food consumption data Tool (FAO/WHO GIFT). FAO/WHO GIFT is a growing repository of individual-level dietary data and contains information about dietary surveys from around the world, collected through published survey results, literature reviews, and direct contact with data owners. The analysis indicates an important increase in the number of dietary surveys conducted in LMICs in the past four decades and a notable increase in the number of national dietary surveys. It is hoped that this trend continues, together with associated efforts to validate and standardize the dietary methods used. The regular implementation of dietary surveys in LMICs is key to support evidence-based policies for improved nutrition.
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Affiliation(s)
- Victoria Padula de Quadros
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy; (A.B.); (P.A.); (R.F.d.S.); (T.B.); (B.A.H.)
- Correspondence:
| | - Agnieszka Balcerzak
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy; (A.B.); (P.A.); (R.F.d.S.); (T.B.); (B.A.H.)
| | - Pauline Allemand
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy; (A.B.); (P.A.); (R.F.d.S.); (T.B.); (B.A.H.)
| | - Rita Ferreira de Sousa
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy; (A.B.); (P.A.); (R.F.d.S.); (T.B.); (B.A.H.)
| | - Teresa Bevere
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy; (A.B.); (P.A.); (R.F.d.S.); (T.B.); (B.A.H.)
| | - Joanne Arsenault
- Intake—Center for Dietary Assessment, FHI Solutions, Washington, DC 20009, USA; (J.A.); (M.D.)
| | - Megan Deitchler
- Intake—Center for Dietary Assessment, FHI Solutions, Washington, DC 20009, USA; (J.A.); (M.D.)
| | - Bridget Anna Holmes
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy; (A.B.); (P.A.); (R.F.d.S.); (T.B.); (B.A.H.)
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11
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Fekadu T, Cassano A, Angós I, Maté JI. Effect of fortification with eggshell powder on injera quality. Lebensm Wiss Technol 2022. [DOI: 10.1016/j.lwt.2022.113156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Charnley GEC, Kelman I, Murray KA. Drought-related cholera outbreaks in Africa and the implications for climate change: a narrative review. Pathog Glob Health 2022; 116:3-12. [PMID: 34602024 PMCID: PMC8812730 DOI: 10.1080/20477724.2021.1981716] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Africa has historically seen several periods of prolonged and extreme droughts across the continent, causing food insecurity, exacerbating social inequity and frequent mortality. A known consequence of droughts and their associated risk factors are infectious disease outbreaks, which are worsened by malnutrition, poor access to water, sanitation and hygiene and population displacement. Cholera is a potential causative agent of such outbreaks. Africa has the highest global cholera burden, several drought-prone regions and high levels of inequity. Despite this, research on cholera and drought in Africa is lacking. Here, we review available research on drought-related cholera outbreaks in Africa and identify a variety of potential mechanisms through which these outbreaks occurred, including poor access to water, marginalization of refugees and nomadic populations, expansion of informal urban settlements and demographic risks. Future climate change may alter precipitation, temperature and drought patterns, resulting in more extremes, although these changes are likely to be spatially heterogeneous. Despite high uncertainty in future drought projections, increases in drought frequency and/or durations have the potential to alter these related outbreaks into the future, potentially increasing cholera burden in the absence of countermeasures (e.g. improved sanitation infrastructure). To enable effective planning for a potentially more drought-prone Africa, inequity must be addressed, research on the health implications of drought should be enhanced, and better drought diplomacy is required to improve drought resilience under climate change.
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Affiliation(s)
- Gina E. C. Charnley
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
| | - Ilan Kelman
- University of Agder, Kristiansand, Norway
- Institute for Global Health, Faculty of Population Health, University College London, London, UK
- Institute for Risk and Disaster Reduction, Faculty of Mathematical and Physical Sciences, University College London, London, UK
| | - Kris A. Murray
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
- Mrc Unit the Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
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Alamnia TT, Tesfaye W, Abrha S, Kelly M. Metabolic risk factors for non-communicable diseases in Ethiopia: a systematic review and meta-analysis. BMJ Open 2021; 11:e049565. [PMID: 34764168 PMCID: PMC8587382 DOI: 10.1136/bmjopen-2021-049565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Non-communicable diseases (NCDs) are causing a new and yetsignificant health challenge in low-income countries. In Ethiopia, although 39% of deaths are NCD related, the health system remains underprepared, highlighting the clear need for evidence on risk factor distributions to inform resource planning and the health response. Therefore, this review investigates prevalence distributions and sex and age variations of metabolic risk factors among Ethiopian adults. RESEARCH DESIGN AND METHODS This systematic review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies published until 6 January 2021 were searched from PubMed, Scopus, ProQuest and Web of Science databases, reference lists of selected studies and grey literature. Studies reporting prevalence of metabolic risk factors: overweight/obesity, hypertension, impaired glucose homoeostasis and metabolic syndrome among Ethiopian adults were eligible for this systematic review and meta-analysis. Two authors independently extracted data and used the Joanna Briggs Institute tool for quality appraisal. The random effects model was used to conduct meta-analysis using Stata V.16. Subgroup analyses examined prevalence differences by region, study year, sample size and settings. RESULTS From 6087 records, 74 studies including 104 382 participants were included. Most showed high prevalence of metabolic risk factors. Meta-analysis revealed pooled prevalence of metabolic risk factors from 12% to 24% with the highest prevalence observed for overweight/obesity (23.9%, 95% CI 19.9% to 28.0%) and hypertension (21.1%, 95% CI 18.7% to 23.5%), followed by metabolic syndrome (14.7%, 95% CI 9.8% to 19.6%) and impaired glucose tolerance (12.4%, 95% CI 8.7% to 16.1%). The prevalence of overweight/obesity was higher in women. All metabolic risk factors were higher among people aged above 45 years. CONCLUSIONS A signficant proportion of Ethiopian adults have at least one metabolic risk factor for NCDs. Despite heterogeneity of studies limiting the certainty of evidence, the result suggests the need for coordinated effort among policymakers, healthcare providers, non-governmental stakeholders and the community to implement appropriate preventive measures to reduce these factors.
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Affiliation(s)
- Tilahun Tewabe Alamnia
- Department of Global Health, National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
- College of Medical and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Wubshet Tesfaye
- Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Solomon Abrha
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
- College of Medicine and Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Matthew Kelly
- Department of Global Health, National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
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Alamneh YM, Akalu TY, Shiferaw AA, Atnaf A. Magnitude of anemia and associated factors among children aged 6-59 months at Debre Markos referral hospital, Northwest Ethiopia: a hospital-based cross-sectional study. Ital J Pediatr 2021; 47:172. [PMID: 34389033 PMCID: PMC8362241 DOI: 10.1186/s13052-021-01123-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/05/2021] [Indexed: 11/30/2022] Open
Abstract
Background Anemia, the most common micro-nutrient deficiency disorder, is the world’s second leading cause of morbidity and morbidity, affecting 24.8% of the population, of which 47.4% are under-five children. The prevalence of anemia ranges from 44 to 56% in Ethiopia. Although its magnitude has shown decreases across regions; it continues to be a significant public health problem, particularly in developing countries including Ethiopia. Despite this evidence, the magnitude and associated factors of anemia was not systematically explored and there is a limited information or limited evidences in the study area. Hence, the aim of this study was to assess the magnitude and associated factors of anemia among children aged 6–59 months attending at Debre Markos Referral Hospital, Northwest Ethiopia. Methods A hospital-based cross-sectional study was conducted at Debre Markos referral hospital Northwest Ethiopia from September 30 to December 30, 2019. Data on socio-demographic and socio-economic factors, health and nutritional features of children and their mothers were obtained using pre-tested structured questionnaires in a face-to-face interview with child care providers. Blood samples and stool examination for intestinal parasites were performed. Hemoglobin level was analyzed using the HemoCue device (HemoCueHb 301). The collected data were coded, cleared and entered into Epi-Data version 3.1, and analyzed using Stata version 14 software. To identify candidates and predictor variables, bivariate and multivariate logistic regressions were applied respectively. The significance level was determined at a confidence interval of 95% at p-value < 0.05. Results Of the total of 341 participants planned to be participated, about 310 mother-child pairs participated in the study, giving a response rate of 91%; and data were collected from children as well as their parents or guardians. In this study, the magnitude of anemia was 11.9% (95% CI, 8.5, 16.2%). Poor dietary diversity (AOR = 2.3; 95% CI: 1.12, 5.14), food-insecure households (AOR = 3.24; 95% CI: 1.85, 4.52), complementary feeding initiation time (AOR = 3.20; 95% CI:1.23, 6.61), intestinal parasites infection (AOR = 3.20; 95% CI:1.23, 6.61) and family income (AOR = 2.87; 95% CI:1.57, 5.0) were found to be factors significantly associated with anemia. Conclusion Overall, anemia is considered a public health problem among children aged 6–59 months attending at Debre Markos referral hospital, based on the cut-off point of the World Health Organization. Poor dietary diversity, complementary feeding initiation time, household food insecurity, intestinal parasite infection and family income were significantly associated with childhood anemia. Thus, it needs for proven interventions in public health such as food diversification, anti-helmintic drug provision and household food security. In addition, educating women about nutrition and diet diversification, as well as involving them in alternative sources of income-generating activity, can be vital in the study area.
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Affiliation(s)
- Yoseph Merkeb Alamneh
- Department of Biomedical Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia.
| | - Tadesse Yirga Akalu
- Department of Nursing, College of Health Science, Debre Markos University, Debre Markos Ethiopia, P.O. Box 269, Debre Markos, Ethiopia
| | - Abtie Abebaw Shiferaw
- Department of Medical Laboratory Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Aytenew Atnaf
- Department of Medical Laboratory Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
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Daba AK, Murimi M, Abegaz K, Hailu D. Determinants and constraints to household-level animal source food consumption in rural communities of Ethiopia. J Nutr Sci 2021; 10:e58. [PMID: 34422260 PMCID: PMC8358840 DOI: 10.1017/jns.2021.52] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/06/2021] [Accepted: 07/16/2021] [Indexed: 12/28/2022] Open
Abstract
Animal source foods (ASF) contain quality nutrients important for growth, development, immunity and behavioural outcomes. Plant-based foods also provide the nutrients, but with lower bioavailability than ASF. Evidence on household-level ASF consumption frequency, constraints and determinants are limited for Ethiopia. Therefore, the present study aimed to assess the consumption frequency of ASF and to identify determinants and constraints among rural households in Ethiopia. A cross-sectional study was conducted in 422 households. The consumption frequency of ASF was assessed using a food frequency screener over 30 days. Twelve statements with Likert scale responses were used to identify constraints to ASF consumption. Ordinal logistic regression was used to identify determinants of ASF consumption. About a quarter (26 %) of the households consumed milk one to two times per week. One out of five households consumed eggs one to two times per week (20 %) or one to two times per month (19 %). Poultry and meat were never consumed by 92 and 60 % of the households, respectively. Unavailability, unaffordability, consumption tradition and income generation priority were constraints identified. Food insecurity, livestock ownership, income, family size and women's education were associated (P < 0⋅05) with selected ASF consumption. Rural households in Ethiopia did not consume ASF on regular basis. Poor socio-demographic and economic conditions as determined by food insecurity, property ownership, income, educational achievement, family size and ASF unavailability and unaffordability contributed to the lower consumption frequency of ASF by households in rural Ethiopia. Nutrition policies and programmes should focus on nutrition-sensitive agricultural extension, livelihood improvement and women empowerment interventions integrated with nutrition education to improve ASF consumption in rural settings.
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Key Words
- AOR, adjusted odds ratio
- ASF, animal source foods
- Animal source foods
- BMI, body mass index
- Constraints and determinants
- Consumption frequency
- ETB, Ethiopian Birr; ha, hectare
- Households in Ethiopia
- IQR, Inter-quartile Range
- SD, Standard Deviation
- USA, United States of America
- USAID, United States Agency for International Development
- USD, United States' Dollar
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Affiliation(s)
- Alemneh Kabeta Daba
- School of Nutrition, Food Science and Technology, College of Agriculture, Hawassa University, Hawassa, Ethiopia
- School of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Mary Murimi
- Department of Nutritional Sciences, College of Human Sciences, Texas Tech University, Lubbock, TX, USA
| | - Kebede Abegaz
- School of Nutrition, Food Science and Technology, College of Agriculture, Hawassa University, Hawassa, Ethiopia
| | - Dejene Hailu
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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16
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Herter-Aeberli I, Fischer MM, Egli IM, Zeder C, Zimmermann MB, Hurrell RF. Addition of Whole Wheat Flour During Injera Fermentation Degrades Phytic Acid and Triples Iron Absorption from Fortified Tef in Young Women. J Nutr 2020; 150:2666-2672. [PMID: 32805002 DOI: 10.1093/jn/nxaa211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/18/2020] [Accepted: 06/30/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Iron deficiency is a major public health concern in Ethiopia, where the traditional diet is based on tef injera. Iron absorption from injera is low due to its high phytic acid (PA) content. OBJECTIVES We investigated ways to increase iron absorption from FeSO4-fortified tef injera in normal-weight healthy women (aged 21-29 y). METHODS Study A (n = 22) investigated the influence on fractional iron absorption (FIA) from FeSO4-fortified injera of 1) replacing 10% tef flour with whole wheat flour (a source of wheat phytase), or 2) adding an isolated phytase from Aspergillus niger. Study B (n = 18) investigated the influence on FIA of replacing FeSO4 in tef injera with different amounts of NaFeEDTA. In both studies, the iron fortificants were labeled with stable isotopes and FIA was calculated from erythrocyte incorporation of stable iron isotopes 14 d after administration. RESULTS In study A, the median (IQR) FIA from the 100% tef injera meal was 1.5% (0.7-2.8%). This increased significantly (P < 0.05) to 5.3% (2.4-7.1%) on addition of 10% whole wheat flour, and to 3.6% (1.6-6.2%) on addition of A. niger phytase. PA content of the 3 meals was 0.62, 0.20, and 0.02 g/meal, respectively. In study B, the median (IQR) FIA from the 100% tef injera meal was 3.3% (1.1-4.4%) and did not change significantly (P > 0.05) on replacing 50% or 75% of FeSO4 with NaFeEDTA. CONCLUSIONS FIA from tef injera by young women was very low. NaFeEDTA was ineffective at increasing iron absorption, presumably due to the relatively low EDTA:Fe molar ratios. Phytate degradation, however, greatly increased during tef fermentation on addition of native or isolated phytases. Replacing 10% tef with whole wheat flour during injera fermentation tripled FIA in young women and should be considered as a potential strategy to improve iron status in Ethiopia.
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Affiliation(s)
- Isabelle Herter-Aeberli
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Maren M Fischer
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Ines M Egli
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Christophe Zeder
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Michael B Zimmermann
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Richard F Hurrell
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
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Gutema BT, Chuka A, Ayele G, Megersa ND, Bekele M, Baharu A, Gurara MK. Predictive capacity of obesity indices for high blood pressure among southern Ethiopian adult population: a WHO STEPS survey. BMC Cardiovasc Disord 2020; 20:421. [PMID: 32957951 PMCID: PMC7507659 DOI: 10.1186/s12872-020-01686-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 08/25/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND World Health Organization (WHO) consultation experts recommend countries to have guidance to identify public health action points suitable for their country. The objective of the study was to evaluate different obesity indices to predict high blood pressure and its optimal cutoff values among the adult population. METHOD A total of 3368 individuals age from 25 to 64 years were included in this study. Data was collected based on the WHO Stepwise approach. Body mass index (BMI), waist circumference (WstC), waist to hip ratio (WHpR) and waist to height ratio (WHtR) were measured and calculated. High blood pressure was considered for those with systolic blood pressure above 135 mmHg, diastolic blood pressure above 85 mmHg or taking antihypertensive medications. To generate cutoff values, the receiver operator characteristic curve was generated with the maximum Youden index. RESULT Women had a significantly higher hip circumference (P = 0.003), BMI (P = 0.036) and WHtR (P < 0.001) than men. Men had significantly higher WHpR (P = 0.027) than women. There were significantly higher BMI, WstC, WHpR, and WHtR among those with high blood pressure. The cutoff values for BMI, WstC, WHpR and WHtR were 22.86 kg/m2, 84.05 cm, 0.91 and 0.50 for men and 24.02 kg/m2, 79.50 cm, 0.91 and 0.51 for women, respectively. CONCLUSION BMI, WstC, WHpR, and WHtR are a useful predictor of high blood pressure among adults' rural residents of southern Ethiopia. As the sensitivity for the cutoff values of most of indices were low, further surveys in different settings may need to be done before a conclusion can be drawn on whether or not to review the anthropometric cut offs for high blood pressure in Ethiopia.
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Affiliation(s)
- Befikadu Tariku Gutema
- School of Public Health, Arba Minch University, P.O.Box 21, Arba Minch, Ethiopia.
- Arba Minch Health and Demographic Surveillance System (HDSS), Arba Minch, Ethiopia.
| | - Adefris Chuka
- Save the children international, Konso field Office, Knoso, Ethiopia
| | - Gistane Ayele
- School of Public Health, Arba Minch University, P.O.Box 21, Arba Minch, Ethiopia
- Arba Minch Health and Demographic Surveillance System (HDSS), Arba Minch, Ethiopia
| | | | - Muluken Bekele
- School of Public Health, Arba Minch University, P.O.Box 21, Arba Minch, Ethiopia
| | - Alazar Baharu
- Arba Minch Health and Demographic Surveillance System (HDSS), Arba Minch, Ethiopia
- Department of Computer Science, Arba Minch University, Arba Minch, Ethiopia
| | - Mekdes Kondal Gurara
- School of Public Health, Arba Minch University, P.O.Box 21, Arba Minch, Ethiopia
- Arba Minch Health and Demographic Surveillance System (HDSS), Arba Minch, Ethiopia
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18
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Kassie AM, Abate BB, Kassaw MW. Prevalence of overweight/obesity among the adult population in Ethiopia: a systematic review and meta-analysis. BMJ Open 2020; 10:e039200. [PMID: 32764091 PMCID: PMC7412611 DOI: 10.1136/bmjopen-2020-039200] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/12/2020] [Accepted: 06/17/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Overweight and obesity are emerging public health problems in Ethiopia. However, primary study findings on the prevalence of overweight and obesity in Ethiopia are inconsistent. Therefore, this study aimed to estimate the pooled prevalence of overweight and obesity among adults in Ethiopia. METHODS Studies that looked at overweight and obesity among adults were searched from four international databases. The search involved articles published from 1 January 2010 to 10 March 2020. The Cochran's Q χ2 and the I2 test statistics were used to check heterogeneity among the studies. The funnel plot and Egger's regression tests were also used to assess the presence of publication bias. Subgroup analysis was performed by residence, study setting, sample size and year of study. Sensitivity analysis was also done to assess the effect of a single study on the pooled estimates. Data analysis was done using STATA V.14 software program. RESULTS A total of 16 studies with 19 527 study participants were included in this systematic review and meta-analysis. The estimated pooled prevalence of overweight among adults in Ethiopia was 20.4%, and after adjustment for publication bias with the trim-and-fill analysis, the estimated prevalence rate was changed to 19%. Besides, the estimated pooled prevalence of obesity was 5.4%. The prevalence of overweight was higher, 22.6% in studies published since 2015, 22.4% in studies conducted only in urban settings and 24.4% in studies with small sample size (≤384 participants). Similarly, the prevalence of obesity was 6.9% in studies published since 2015, 6.2% in studies conducted only in urban settings, 6.4% in institution-based settings and 9.6% in studies with small sample size. CONCLUSION The prevalence of overweight and obesity is high in Ethiopia compared with previous studies. This needs large scale awareness creation campaigns and situation-based and context-specific prevention strategies.
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Affiliation(s)
- Ayelign Mengesha Kassie
- Department of Nursing, Woldia, College of health sciences, Woldia University, Woldia, Amhara, Ethiopia
| | - Biruk Beletew Abate
- Department of Nursing, Woldia, College of health sciences, Woldia University, Woldia, Amhara, Ethiopia
| | - Mesfin Wudu Kassaw
- Department of Nursing, Woldia, College of health sciences, Woldia University, Woldia, Amhara, Ethiopia
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Mensah DO, Nunes AR, Bockarie T, Lillywhite R, Oyebode O. Meat, fruit, and vegetable consumption in sub-Saharan Africa: a systematic review and meta-regression analysis. Nutr Rev 2020; 79:651-692. [PMID: 32556305 DOI: 10.1093/nutrit/nuaa032] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
CONTEXT The dietary choices people make affect personal health and have consequences for the environment, both of which have serious implications for the 2030 Sustainable Development Agenda. In global reviews, the literature on meat, fruit, and vegetable consumption in sub-Saharan Africa (SSA) is limited. OBJECTIVE This systematic review set out to quantify meat, fruit, and vegetable consumption in SSA populations and to answer the following question: How much meat, fruit, and/or vegetables are being consumed daily by which individuals in SSA over the years? DATA SOURCES Following the PRISMA guidelines, the authors systematically searched the MEDLINE, EMBASE, ASSIA CINAHL, Web of Science, POPLINE, and Google Scholar databases to identify 47 (out of 5922 search results) studies reporting meat, fruit, and/or vegetable consumption in SSA populations. DATA EXTRACTION Three independent investigators extracted data on year of data collection, study country, study population and geographical context, and population intake of meat, fruit, and/or vegetables. DATA ANALYSIS Using STATA SE version 15 software, random-effects meta-regression analyses were used to test the effect of year of data collection and method of data collection on population meat, fruit, and vegetable consumption. The analyses also tested any association between age, sex, rural/urban residence, or a country's economic development and population intake of meat, fruits, and/or vegetables. The review was started in 2017 and completed in 2019. RESULTS Richer SSA countries were likely to consume more meat (ß = 36.76, P = 0.04) and vegetables (ß =43.49, P = 0.00) than poorer countries. Vegetable intake has increased dramatically over the last 3 decades from ≈10 g to ≈110 g (ß = 4.43, P = 0.00). Vegetable (ß= -25.48, P = 0.00) consumption was higher in rural than in urban residents. Although the trend of meat consumption has risen (≈25 g to ≈75 g), the trend is nonsignificant (ß = 0.63, N.S.). Daily average per capita meat consumption was 98 g - above the 70 g recommendation - while fruit and vegetable intake (268 g) remain below the World Health Organization's recommendation (400 g). CONCLUSIONS Given the low intake of plant-based foods, it is likely that SSA populations may be deficient in high-quality protein and micronutrients as suggested by the EAT-Lancet Commission. There is a need to promote both an adequate supply and demand of plant-based protein and micronutrients, including fruit, vegetables, nuts, seeds, and legumes, in SSA countries. While dietary changes in SSA may offer large absolute benefits, consideration of the magnitude of dietary change, particularly increasing or reducing meat consumption, will need to occur in a way that ensures that policy and interventions support the reduction of undernutrition and micronutrient deficiencies without worsening the prevalence and environmental impacts of noncommunicable diseases. There is also the need for preventive action that ensures that SSA populations do not increase their meat consumption as disposable incomes increase and countries' economic development rises, as is seen in most countries undergoing economic transformation. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42018090497.
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Affiliation(s)
- Daniel O Mensah
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Ana R Nunes
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Tahir Bockarie
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Rob Lillywhite
- School of Life Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Oyinlola Oyebode
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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Rasmussen LV, Wood SLR, Rhemtulla JM. Deconstructing Diets: The Role of Wealth, Farming System, and Landscape Context in Shaping Rural Diets in Ethiopia. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2020. [DOI: 10.3389/fsufs.2020.00045] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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21
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Jésus P, Marin B, Pilleron S, Guerchet M, Mbelesso P, Ndamba-Bandzouzi B, Preux PM, Fayemendy P, Desport JC. Predictive formulas for estimation of height in sub-Saharan African older people: A new formula (EPIDEMCA study). Nutrition 2020; 73:110725. [PMID: 32135414 DOI: 10.1016/j.nut.2020.110725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Chumlea's formulas are a way of predicting height from knee height (KHt), including among individuals >60 y of age who cannot stand upright. However, the formulas were developed with white and African American people and have not yet been validated in native Africans >60 y of age. The aims of the study were to assess Chumlea's formulas in older people in central Africa and to propose a new validated formula for the same population. METHODS Height (MHt) and KHt were measured in a population of individuals >65 y of age from the Republic of Congo and the central African Republic. Predicted height (PHt) was calculated using Chumlea's formulas for the American black population (CBP) and for whites (CC). The percentages of accurate predictions (±5 cm) were compared between MHt and PHt. A new formula was estimated after randomization in a derivation sample (n = 877) and assessed for accuracy in a validation sample (n = 877). RESULTS The study included 1754 individuals. Prediction was accurate (±5 cm) in 66.8% and 63.2% of CBP and CC, respectively. Overestimation was as high as 24.1% and 29%, respectively. Because an overestimation is unacceptable in clinical practice and population surveys, a new formula was proposed: height (cm) = 72.75 + (1.86 × KHt [cm]) - (0.13 × age [y]) + 3.41 × sex (0: women; 1: men). This new formula significantly increases accuracy (71.3%) and decreases overestimation (14.7%). The nutritional status based on body mass index did not differ with the MHt and the PHt by the new formula. CONCLUSION Chumlea's formulas provided a poor estimate of height in this population sample. The proposed formula more accurately estimates height in older native Africans. This formula should be tested in other sub-Saharan African countries to extend its use in clinical practice and in future studies.
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Affiliation(s)
- Pierre Jésus
- Nutrition Unit, University Hospital of Limoges, Limoges, France; INSERM, U1094, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; IRD, Associated Unit, Tropical Neuroepidemiology, Limoges, France.
| | - Benoit Marin
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; IRD, Associated Unit, Tropical Neuroepidemiology, Limoges, France; Center of Epidemiology, Biostatistics and Research Methodology, University Hospital of Limoges, France
| | - Sophie Pilleron
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; IRD, Associated Unit, Tropical Neuroepidemiology, Limoges, France
| | - Maëlenn Guerchet
- Nutrition Unit, University Hospital of Limoges, Limoges, France; INSERM, U1094, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; IRD, Associated Unit, Tropical Neuroepidemiology, Limoges, France; King's College London, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, London, UK
| | - Pascal Mbelesso
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; IRD, Associated Unit, Tropical Neuroepidemiology, Limoges, France; Neurology Department, Amitié Hospital, Bangui, Central African Republic
| | - Bébène Ndamba-Bandzouzi
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; IRD, Associated Unit, Tropical Neuroepidemiology, Limoges, France; Neurology Department, University Hospital of Brazzaville, Brazzaville, Republic of Congo
| | - Pierre-Marie Preux
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; IRD, Associated Unit, Tropical Neuroepidemiology, Limoges, France; Center of Epidemiology, Biostatistics and Research Methodology, University Hospital of Limoges, France
| | - Philippe Fayemendy
- Nutrition Unit, University Hospital of Limoges, Limoges, France; INSERM, U1094, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; IRD, Associated Unit, Tropical Neuroepidemiology, Limoges, France
| | - Jean-Claude Desport
- Nutrition Unit, University Hospital of Limoges, Limoges, France; INSERM, U1094, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; IRD, Associated Unit, Tropical Neuroepidemiology, Limoges, France
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Nutritional Status of School Going Adolescent Girls in Awash Town, Afar Region, Ethiopia. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2020; 2020:7367139. [PMID: 32148529 PMCID: PMC7054789 DOI: 10.1155/2020/7367139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 01/24/2020] [Accepted: 02/01/2020] [Indexed: 11/13/2022]
Abstract
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.
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Tadesse AW, Hemler EC, Andersen C, Passarelli S, Worku A, Sudfeld CR, Berhane Y, Fawzi WW. Anemia prevalence and etiology among women, men, and children in Ethiopia: a study protocol for a national population-based survey. BMC Public Health 2019; 19:1369. [PMID: 31651278 PMCID: PMC6814127 DOI: 10.1186/s12889-019-7647-7] [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: 08/26/2019] [Accepted: 09/20/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Anemia remains a public health challenge in Ethiopia, affecting an estimated 56% of children under age 5 years, 23% of women of reproductive age and 18% of adult men. However, anemia etiology and the relative contribution of underlying risk factors for anemia remains unclear and has hindered implementation of anemia control programs. METHODS/DESIGN Anemia Etiology in Ethiopia (AnemEE) is a population-based cross-sectional survey of six regions of Ethiopia that includes children, women of reproductive age, and men from regionally representative households. The survey will include detailed assessment of anemia, iron, inflammatory and nutritional biomarkers, diet, comorbidities, and other factors. The objectives of AnemEE are 1) to generate evidence for decision-making on the etiology of anemia in Ethiopia among men, women and children and 2) to simulate the potential effect of iron fortification and other interventions on the prevalence of anemia and risk of iron overload. DISCUSSION AnemEE will provide the most comprehensive evaluation of anemia etiology in Ethiopia to date due to its detailed assessment of diet, biomarkers, infections and other risk factors in a population-based sample. By generating evidence and simulating potential interventions, AnemEE will inform the development of high-impact anemia control programs and policies. TRIAL REGISTRATION ClinicalTrials.gov, NCT04002466 . Registered on 28 June 2019. Retrospectively registered.
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Affiliation(s)
- Amare Worku Tadesse
- Department of Reproductive Health, Nutrition and Population, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia. .,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Elena C Hemler
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Christopher Andersen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Simone Passarelli
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Alemayehu Worku
- Department of Epidemiology and Evaluation, Addis Continental Institute of Public Health, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Christopher R Sudfeld
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yemane Berhane
- Department of Epidemiology and Evaluation, Addis Continental Institute of Public Health, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Zerfu TA, Mekuria A. Pregnant women have inadequate fiber intake while consuming fiber-rich diets in low-income rural setting: Evidences from Analysis of common "ready-to-eat" stable foods. Food Sci Nutr 2019; 7:3286-3292. [PMID: 31660142 PMCID: PMC6804770 DOI: 10.1002/fsn3.1188] [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] [Received: 06/04/2019] [Revised: 07/29/2019] [Accepted: 08/12/2019] [Indexed: 01/27/2023] Open
Abstract
The intake of fiber-rich foods during pregnancy has several health benefits to the pregnant woman including lowering the risks of diabetes, preeclampsia, and constipation. However, little is known about the content, daily intake levels, and adequacy of fiber among pregnant women in many low-income settings. We aimed to identify common food items and determine adequacy of dietary fiber intake levels among pregnant women in rural Ethiopia. Dietary data were collected from a subsample (n = 55) of pregnant women enrolled to a larger prospective cohort study (n = 414). Dietary intake level was measured using repeated 24-hr dietary recall method and weighing the total amount of daily food. Fiber content was determined using the Weende method supplemented by other sources.The mean [±SD] dietary fiber intake level was 25.89 [±5.09 mg/g] per day, which declined across pregnancy trimester from 26.01 [±9.18 mg/g] to 22.67 [±9.01 mg/g] and 24.56 [±9.98 mg/g] during the first, to second and third pregnancy trimesters, respectively. Boiled cereals and coffee contributed to nearly two-thirds (63.2%) of the daily fiber intake, while the major bulk of daily food, enjera, contributed to less than a quarter (24.3%) of the fiber intake. Though dietary patterns favor diversified intake for fiber, the mean intake levels below the recommended levels and proportion of women getting adequate to the physiologic stages of pregnancy were inadequate compared to the standard. Mothers, in such community, could benefit from increasing overall intake of existing food to satisfy their fiber needs during pregnancy.
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Affiliation(s)
- Taddese Alemu Zerfu
- College of Health SciencesDilla UniversityDillaEthiopia
- Maternal and Child WellBeing (MCW) UnitAfrican Population and Health Research CenterNairobiKenya
| | - Aleme Mekuria
- Department of Public HealthArbaminch College of Health SciencesArba MinchEthiopia
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Sheehy T, Carey E, Sharma S, Biadgilign S. Trends in energy and nutrient supply in Ethiopia: a perspective from FAO food balance sheets. Nutr J 2019; 18:46. [PMID: 31409356 PMCID: PMC6693184 DOI: 10.1186/s12937-019-0471-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 08/02/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Ethiopia is the second-most populous country in Africa. Although most people still live in rural areas, the urban population is increasing. Generally, urbanisation is associated with a nutrition transition and an increase in risk factors for non-communicable diseases (NCDs). The objective of this study was to determine how the nutritional composition of the Ethiopian food supply has changed over the last 50 years and whether there is evidence of a nutrition transition. METHODS Food balance sheets for Ethiopia from 1961 to 2011 were downloaded from the FAOSTAT database and daily per capita supply for 17 commodity groupings was calculated. After appropriate coding, per capita energy and nutrient supplies were determined. RESULTS Per capita energy supply was 1710 kcal/d in 1961, fell to 1403 kcal/d by 1973, and increased to 2111 kcal/d in 2011. Carbohydrate was by far the greatest energy source throughout the period, ranging from 72% of energy in 1968 to 79% in 1998; however, this was mostly provided by complex carbohydrates as the contribution of sugars to energy only varied between 4.7% in 1994 and 6.7% in 2011. Energy from fat was low, ranging from 14% of energy in 1970 to 10% in 1998. Energy from protein ranged from 14% in 1962 to 11% in 1994. Per capita supplies of calcium, vitamin A, C, D, folate and other B-vitamins were insufficient and there was a low supply of animal foods. CONCLUSIONS The Ethiopian food supply is still remarkably high in complex carbohydrates and low in sugars, fat, protein, and micronutrients. There is little evidence yet of changes that are usually associated with a nutrition transition.
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Affiliation(s)
- Tony Sheehy
- School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland
| | - Emma Carey
- School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland
| | - Sangita Sharma
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, 5-10 University Terrace, 8303-112 St, Edmonton, AB T6G 2E1 Canada
| | - Sibhatu Biadgilign
- Friedman School of Nutrition Science and Policy, Tufts University, P.O. Box 24414, Addis Ababa, Ethiopia
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Dietary pattern and its association with iodine deficiency among school children in southwest Ethiopia; A cross-sectional study. PLoS One 2019; 14:e0221106. [PMID: 31408495 PMCID: PMC6692009 DOI: 10.1371/journal.pone.0221106] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 07/12/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Despite the universal iodization of salt in Ethiopia, iodine deficiency disorder remains a major public health problem and continued to affect a large segment of the population. It is thus essential to assess factors contributing to the unacceptably high endemic goiter rate in the country and avail evidence for further additional interventions. In line with this, we examined the association of dietary pattern and iodine deficiency among school-age children in Ethiopia. METHOD We conducted a school-based cross-sectional study among 767 children aged 6 to 12 in southwest Ethiopia. We collected socio-demographic and other important health related information using a pre-tested structured questionnaire through the interview. Dietary pattern of children was measured using modified Hellen Keller's food frequency questionnaire. We measured iodine deficiency using urinary iodine concentration level and total goiter rate, according to the World Health Organization threshold criteria. We used a multivariate linear regression model to identify dietary and sociodemographic factors that affect urinary iodine level among children. RESULT Out of the 767 children included in the study, 12% and 4% of children have grade 1 and grade 2 goiter respectively, making the total goiter rate 16%. While the prevalence of iodine deficiency based on urinary iodine concentration is 58.8% of which 13.7% had severe, 18.6% had moderate and 26.5% had mild form. The proportion of children who consumed godere/taro root/, banana, corn, Abyssinian cabbage, and potato, respectively at daily basis 57.8%, 53.1%, 37.9%, and 31.2%, respectively. Age (β = -0.7, 95%CI = -1.1, -0.4), sex (β = -22.3, 95%CI = -33.8, -10.8), consumption of taro root (β = -27.4, 95%CI = -22.9, -31.8), cabbage (β = -11.7, 95%CI = -5.7, -17.6), Abyssinian cabbage (β = 12.4, 95%CI = 6.7, 18.2), and banana (β = 5.6, 95%CI = 0.01, 11.2) significantly associated with urinary iodine level. CONCLUSION Iodine deficiency remains an important public health problem in southwest Ethiopia. Over-consumption of goitrogenic foods and under-consumption of iodine-rich foods were prevalent and associated with lower urinary iodine level. Therefore, dietary counseling apart from universal salt iodization is recommended.
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Engidaye G, Melku M, Yalew A, Getaneh Z, Asrie F, Enawgaw B. Under nutrition, maternal anemia and household food insecurity are risk factors of anemia among preschool aged children in Menz Gera Midir district, Eastern Amhara, Ethiopia: a community based cross-sectional study. BMC Public Health 2019; 19:968. [PMID: 31324244 PMCID: PMC6642588 DOI: 10.1186/s12889-019-7293-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 07/09/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Ethiopian, the prevalence of anemia among preschool aged children widely varied across regions. Since anemia adversely affects the cognitive and physical development of the children, it is important to determine its burden for implementing appropriate measurements. Therefore, this study was aimed at determining the anemia prevalence and associated factors among preschool aged children. METHOD A community based cross-sectional study was conducted on a total of 432 preschool children in Menz Gera Midir district from January to May, 2017. A multi stage sampling procedure was applied to select the target groups. Hemocue analyzer for Haemoglobin determination; anthropometric measurements for assessment nutritional status, structured questionnaires for socio-demographic and economic variables were used for data collection. The morphological appearance of red blood cell was assessed microscopically to determine type of anemia. Descriptive statistics were employed to summarize the data and binary logistic regression was used for inferential statistics. A p value less than 0.05 was considered as statistically significant. RESULT The overall prevalence of anemia was 123 (28.5%); of which 38 (30.9%) and 85 (69.1%) were moderate and mild, respectively. Morphologically about 50.4, 37.4 and 12.2% were microcytic hypochromic, normocytic normochromic and macrocytic anemias, respectively. Child age 6-11 months (COR: 5.67, 95% CI: 2.2, 14.86), child age 12-23 months (COR: 5.8, 95% CI: 2.3, 14.7), wasting (COR: 3.5, 95% CI: 1.2, 9.8), stunting (COR: 3.8, 95% CI: 1.92, 7.77), underweight (COR: 2.12, 95% CI: 1.07, 4.38), MUAC measurement below 13 cm (COR: 5.6, 95% CI: 2.83, 11.15), household headed by female (COR: 3.24, 95% CI: 1.1, 9.63), maternal anemia (COR: 4, 95% CI: 2.2, 7.23) and household food insecurity (COR: 2.12, 95% CI: 1.09, 4.12) were significantly associated with anemia. CONCLUSION The prevalence of anemia among the children was found to be high and associated with child age group, child nutritional status, house hold headed by female, maternal anemia and household food insecurity. Further studies on nutritional anemia, community based nutritional education, iron supplementation to children at risk should be promoted.
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Affiliation(s)
- Getabalew Engidaye
- Amhara Regional State Debre Berhan Health Science College, Debre Berhan, Ethiopia.,Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulugeta Melku
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Aregawi Yalew
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zegeye Getaneh
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fikir Asrie
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bamlaku Enawgaw
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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Getaneh Z, Melku M, Geta M, Melak T, Hunegnaw MT. Prevalence and determinants of stunting and wasting among public primary school children in Gondar town, northwest, Ethiopia. BMC Pediatr 2019; 19:207. [PMID: 31238889 PMCID: PMC6591879 DOI: 10.1186/s12887-019-1572-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 06/04/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Undernutrition among school age children has an impact on their health, cognition, and educational achievement. Therefore, this study aimed to assess the prevalence and associated factors of stunting and wasting among school age children in Gondar town, northwest, Ethiopia. METHODS An institution-based cross-sectional study was done among school children aged 6-14 years. Data on socio-demographic, nutritional and dietary status of children were collected using structured questionnaire. Anthropometric measurements were carried out to determine the status of stunting and wasting. Data were entered into Epi-Info version 3.5.3 and transferred to SPSS version 20 for further analysis. Bivariable and multivariable logistic regression models were fitted to identify associated factors of stunting and wasting. Both crude odds and adjusted odds ratios with 95% CI were used to measure the strength of associations. In the multivariable analysis, variables with < 0.05 p-values were considered statistically significant. RESULTS A total of 523 school age children were with the median age of 12 (10-13 inter quartile range) years participated in the study. The overall prevalence of stunting and wasting among primary school children was 241(46.1%; 95% CI: 42.3, 50.3) and 47 (9%; 95% CI: 6.7, 11.7), respectively. Child age (AOR = 1.9, 95% CI: 1.29, 2.80), public tab/yard water source (AOR = 2.22; 95%CI: 1.46, 3.39), DDS < 4 (AOR = 1.89 95%CI: 1.08, 3.30), tea drinking habit (AOR = 0.46, 95%CI: 0.27, 0.80) and anemia (AOR = 1.72 95%CI: 1.05, 2.83) were significant predictors of stunting. Moreover, child age (AOR = 3.91; 95% CI: 1.62, 9.44), maternal/care-givers' age ≤ 34 (AOR = 0.34; 95%CI: 0.16, 0.71), maternal education (AOR = 2.55; 95%CI: 1.15, 5.65), family poverty (AOR = 3.23; 95% CI: 1.30, 7.93) and alcohol consumption (AOR = 2.93; 95%CI: 1.16, 7.42) were found significantly associated with wasting. CONCLUSION Stunting and wasting were then major problems among school age children. Child age, water source for dinking, DDS < 4 and anemia resulted in stunting. On the other hand, child age, maternal education and age, family poverty and alcohol drinking were risk factors for wasting. Therefore, launching community based nutritional education programs, implementing school feeding and strengthening economic level of the communities are essential to reduce the problems.
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Affiliation(s)
- Zegeye Getaneh
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Mulugeta Melku
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mekuanint Geta
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tadele Melak
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Melkamu Tamir Hunegnaw
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Wolde T, Belachew T. Chronic undernutrition (stunting) is detrimental to academic performance among primary schools of adolescent children: a randomized cross sectional survey in Southern Ethiopia. BMC Res Notes 2019; 12:142. [PMID: 30876451 PMCID: PMC6419846 DOI: 10.1186/s13104-019-4160-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 03/01/2019] [Indexed: 12/02/2022] Open
Abstract
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.
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Affiliation(s)
- Tsedeke Wolde
- Population & Family Health Department, College of Health Sciences, Jimma University, P.O. Box 378, Jimma, Ethiopia
| | - Tefera Belachew
- Population & Family Health Department, College of Health Sciences, Jimma University, P.O. Box 378, Jimma, Ethiopia
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Chajès V, Gibson LJ, Biessy C, Slimani N, Asiki G, Dossus L, Wild CP, Newton R. Trends of serum phospholipid fatty acids over time in rural Uganda: evidence of nutritional transition? Br J Nutr 2019; 121:130-136. [PMID: 30477593 DOI: 10.1017/s0007114518003227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Non-communicable diseases are projected to become the most common causes of death in Africa by 2030. The impact on health of epidemiological and nutritional transitions in sub-Saharan Africa remains unclear. To assess the trends of dietary fatty acids over time in Uganda, we examined fatty acids in serum collected from individuals in rural south-west Uganda, at three time points over two decades. Independent cross-sectional samples of 915 adults and children were selected from the general population cohort in 1990 (n 281), 2000 (n 283) and 2008 (n 351). Serum phospholipid fatty acids were measured by GC. Multivariate regression analyses were performed to compare the geometric means of fatty acids by time period. Serum fatty acid profiling showed high proportions of SFA, cis-MUFA and industrial trans-fatty acids (iTFA), likely to be biomarkers of high consumption of palm oil and hydrogenated fats. In contrast, proportions of n-6 and n-3 PUFA from vegetable oils and fish were low. From 1990 to 2008, serum phospholipids showed increases in absolute amounts of SFA (17·3 % increase in adults and 26·4 % in children), MUFA (16·7 % increase in adults and 16·8 % in children) and n-6:n-3 PUFA (40·1 % increase in adults and 39·8 % in children). The amount of elaidic acid, iTFA from hydrogenated fats, increased in children (60·1 % increase). In this rural Ugandan population, we show evidence of unfavourable trends over time of dietary fatty acids.
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Affiliation(s)
- Véronique Chajès
- 1Section of Nutrition and Metabolism,International Agency for Research on Cancer,69382 Lyon Cedex 08,France
| | - Lorna J Gibson
- 2Department of Social and Environmental Health Research,London School of Hygiene and Tropical Medicine,London WC1E 7HT,UK
| | - Carine Biessy
- 1Section of Nutrition and Metabolism,International Agency for Research on Cancer,69382 Lyon Cedex 08,France
| | - Nadia Slimani
- 1Section of Nutrition and Metabolism,International Agency for Research on Cancer,69382 Lyon Cedex 08,France
| | - Gershim Asiki
- 3Epidemiology and Prevention Programme,MRC/UBRI,Entebbe,Uganda
| | - Laure Dossus
- 1Section of Nutrition and Metabolism,International Agency for Research on Cancer,69382 Lyon Cedex 08,France
| | | | - Robert Newton
- 3Epidemiology and Prevention Programme,MRC/UBRI,Entebbe,Uganda
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Micronutrient intake adequacy in children from birth to 8 years. Data from the Childhood Obesity Project. Clin Nutr 2018; 37:630-637. [DOI: 10.1016/j.clnu.2017.02.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 02/02/2017] [Accepted: 02/02/2017] [Indexed: 11/16/2022]
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Zheng Y, Ma AG, Zheng MC, Wang QZ, Liang H, Han XX, Schouten EG. B Vitamins Can Reduce Body Weight Gain by Increasing Metabolism-related Enzyme Activities in Rats Fed on a High-Fat Diet. Curr Med Sci 2018; 38:174-183. [DOI: 10.1007/s11596-018-1862-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 07/07/2017] [Indexed: 12/11/2022]
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Mekonnen T, Animaw W, Seyum Y. Overweight/obesity among adults in North-Western Ethiopia: a community-based cross sectional study. Arch Public Health 2018; 76:18. [PMID: 29515803 PMCID: PMC5836379 DOI: 10.1186/s13690-018-0262-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 02/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nowadays adulthood overweight/obesity is an emerging public health problem in developing countries. There is no information on magnitude and contributing factors of adulthood overweight/obesity in Ethiopia, particularly in North West region of the country. Thus, the aim of this study was to assess magnitude and contributing factors of adulthood overweight/obesity in North West region of Ethiopia. METHODS A community-based cross-sectional study was conducted from September1, 2015 to November 30, 2015 in northwest region of Ethiopia particularly Bahir-Dar city and its rural districts. A total of 1484 adult participants were recruited in the study. Stratified multistage followed by systematic random sampling technique was employed to select participants. Overweight/obesity was determined using center for diseases control cutoff points. A multivariable binary logistic regression model was fitted to identify factors associated with overweight/obesity. Adjusted Odds Ratio (AOR) with the corresponding 95% Confidence Interval (CI) was calculated to show the strength of association. RESULTS A total of 1405 adults were participated in the study with a response rate of 94.7%. This study indicated that 11.3 (95% CI: 9.6, 13.1) adults were overweight and obese of which about 9.3% and 2% of adults were overweight and obese, respectively. The higher odds of being Overweight/Obese were noted among urban residents, females and older age. However performing mild to moderate physical activity [AOR = 0.608, 95% CI: 0.37, 0.99] and consumption of fruit and vegetable [AOR = 0.51, 95% CI: 0.34, 0.77] were found to be protective against overweight/obesity. CONCLUSION Though, it was a problem of developed countries adulthood overweight /obesity is emerged as a public health problem among adults in Ethiopia particularly in the study area, northwest region. Hence, preventive interventions focusing on urban residents, females through encouraging Physical activity, fruit and vegetable consumption is essential to prevent emergence of adulthood overweight/obesity.
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Affiliation(s)
- Teferi Mekonnen
- Bahir Dar University, School of Public Health, Public Health Nutrition Unit, Bahir Dar, Ethiopia
| | - Worku Animaw
- Bahir Dar University, Department of Nursing, Bahir Dar, Ethiopia
| | - Yeshaneh Seyum
- Bahir Dar University, Department of Nursing, Bahir Dar, Ethiopia
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Prevalence of anemia and associated factors among school children in Gondar town public primary schools, northwest Ethiopia: A school-based cross-sectional study. PLoS One 2017; 12:e0190151. [PMID: 29284032 PMCID: PMC5746225 DOI: 10.1371/journal.pone.0190151] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 12/08/2017] [Indexed: 02/05/2023] Open
Abstract
Background Anemia is a global public health problem affecting 305 million school children (SC) worldwide. It has deleterious effects in SC, including lower school achievement due to impaired cognitive development and physical growth, fatigue and poor attention span, and increased morbidity because of reduced resistance to infection. Hence, the aim of this study was to assess the prevalence and associated factors of anemia among SC attending public primary schools in Gondar town, northwest Ethiopia. Methods A school-based cross sectional study was conducted on a total of 523 SC aged from 6–14 years old. Multi-stage sampling followed by systematic random sampling techniques were employed to select study participants. Data on socio-demographic and socio-economic characteristics, and dietary status of children were collected using pre-tested structured questionnaire through face-to-face interview of children’s caregivers. Anthropometric measurements were taken. Hemoglobin (Hb) concentration was determined by using HemoCue 301+analyser. Stool and blood samples were collected in the school premises, and examined for intestinal and hemoparasites, respectively. Data were entered into Epi Info version 3.5.3 and transferred to SPSS version 20 for analysis. Bivariate and multivariate binary logistic regression models were fitted to identify associated factors of anemia. P-value < 0.05 was considered as statistically significant. Result Of the total SC participated in the study, 269 (51.4%) were males. The median (inter quartile range (IQR)) age was 12 (10–13) years, and 332 (63.5%) of them were in the age group 11–14 years. About 81 (15.5%; 95%CI: 12.4%, 18.7%) of them were anemic: 56 (69.1%) and 25 (38.9%) of them were mildly and moderately anemic, respectively. Low maternal education (AOR = 2.30; 95%CI: 1.11, 4.78), stunting (AOR = 2.22; 95%CI: 1.30, 3.80), severe food insecurity (AOR = 5.11; 95%CI: 1.53, 17.13), and soil-transmitted helminthic (STH) infection (AOR = 7.13; 95%CI: 3.16, 16.86) were found significantly associated with anemia. Conclusion Anemia among SC was found to be a mild public health problem. It was strongly associated with low maternal education, food insecurity, stunting and intestinal helminthic infection. Focused policies and strategies towards the above factors should be designed to reduce anemia among SC.
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Micronutrient Status and Dietary Intake of Iron, Vitamin A, Iodine, Folate and Zinc in Women of Reproductive Age and Pregnant Women in Ethiopia, Kenya, Nigeria and South Africa: A Systematic Review of Data from 2005 to 2015. Nutrients 2017; 9:nu9101096. [PMID: 28981457 PMCID: PMC5691713 DOI: 10.3390/nu9101096] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 09/25/2017] [Accepted: 09/28/2017] [Indexed: 11/16/2022] Open
Abstract
A systematic review was conducted to evaluate the status and intake of iron, vitamin A, iodine, folate and zinc in women of reproductive age (WRA) (≥15–49 years) and pregnant women (PW) in Ethiopia, Kenya, Nigeria and South Africa. National and subnational data published between 2005 and 2015 were searched via Medline, Scopus and national public health websites. Per micronutrient, relevant data were pooled into an average prevalence of deficiency, weighted by sample size (WAVG). Inadequate intakes were estimated from mean (SD) intakes. This review included 65 surveys and studies from Ethiopia (21), Kenya (11), Nigeria (21) and South Africa (12). In WRA, WAVG prevalence of anaemia ranged from 18–51%, iron deficiency 9–18%, and iron deficiency anaemia at 10%. In PW, the prevalence was higher, and ranged from 32–62%, 19–61%, and 9–47%, respectively. In WRA, prevalence of vitamin A, iodine, zinc and folate deficiencies ranged from 4–22%, 22–55%, 34% and 46%, while in PW these ranged from 21–48%, 87%, 46–76% and 3–12% respectively. Inadequate intakes of these micronutrients are high and corresponded with the prevalence figures. Our findings indicate that nationally representative data are needed to guide the development of nutrition interventions and public health programs, such as dietary diversification, micronutrient fortification and supplementation.
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Siedner MJ. Aging, Health, and Quality of Life for Older People Living With HIV in Sub-Saharan Africa: A Review and Proposed Conceptual Framework. J Aging Health 2017; 31:109-138. [PMID: 28831864 DOI: 10.1177/0898264317724549] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The number of people living with HIV (PLWH) over 50 years old in sub-Saharan Africa is predicted to triple in the coming decades, to 6-10 million. Yet, there is a paucity of data on the determinants of health and quality of life for older PLWH in the region. METHODS A review was undertaken to describe the impact of HIV infection on aging for PLWH in sub-Saharan Africa. RESULTS We (a) summarize the pathophysiology and epidemiology of aging with HIV in resource-rich settings, and (b) describe how these relationships might differ in sub-Saharan Africa, (c) propose a conceptual framework to describe determinants of quality of life for older PLWH, and (d) suggest priority research areas needed to ensure long-term gains in quality of life for PLWH in the region. CONCLUSIONS Differences in traditional, lifestyle, and envirnomental risk factors, as well as unique features of HIV epidemiology and care delivery appear to substantially alter the contribution of HIV to aging in sub-Saharan Africa. Meanwhile, unique preferences and conceptualizations of quality of life will require novel measurement and intervention tools. An expanded research and public health infrastructure is needed to ensure that gains made in HIV prevention and treamtent are translated into long-term benefits in this region.
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Affiliation(s)
- Mark J Siedner
- 1 Harvard Medical School, Boston, MA, USA.,2 Massachusetts General Hospital, Boston, MA, USA.,3 Mbarara University of Science and Technology, Mbarara, Uganda
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Vila-Real C, Pimenta-Martins A, Gomes AM, Pinto E, Maina NH. How dietary intake has been assessed in African countries? A systematic review. Crit Rev Food Sci Nutr 2017; 58:1002-1022. [PMID: 27996293 DOI: 10.1080/10408398.2016.1236778] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Dietary patterns are often considered as one of the main causes of non-communicable diseases worldwide. It is of utmost importance to study dietary habits in developing countries since this work is scarce. OBJECTIVE To summarize the most recent research conducted in this field in African countries, namely the most used methodologies and tools. METHODS A systematic review was conducted on MEDLINE®/PubMed, aiming to identify scientific publications focused on studies of dietary intake of different African populations, in a ten-year period. Papers not written in English/Portuguese/Spanish, studies developed among African people but not developed in African countries, studies aiming to assess a particular nutrient/specific food/food toxin and studies that assessed dietary intake among children were excluded. FINDINGS Out of 99 included studies, the 24-hour recall and the food-frequency questionnaire were the most used dietary intake assessment tools, used to assess diet at an individual level. It was also observed that often country-unspecific food composition databases are used, and the methodologies employed are poorly validated and standardized. CONCLUSIONS There is an emergent need to improve the existing food databases by updating food data and to develop suitable country-specific databases for those that do not have their own food composition table.
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Affiliation(s)
- Catarina Vila-Real
- a Universidade Católica Portuguesa, CBQF - Centro de Biotecnologia e Química Fina - Laboratório Associado , Escola Superior de Biotecnologia , Rua Arquiteto Lobão Vital, Porto , Portugal
| | - Ana Pimenta-Martins
- a Universidade Católica Portuguesa, CBQF - Centro de Biotecnologia e Química Fina - Laboratório Associado , Escola Superior de Biotecnologia , Rua Arquiteto Lobão Vital, Porto , Portugal
| | - Ana Maria Gomes
- a Universidade Católica Portuguesa, CBQF - Centro de Biotecnologia e Química Fina - Laboratório Associado , Escola Superior de Biotecnologia , Rua Arquiteto Lobão Vital, Porto , Portugal
| | - Elisabete Pinto
- a Universidade Católica Portuguesa, CBQF - Centro de Biotecnologia e Química Fina - Laboratório Associado , Escola Superior de Biotecnologia , Rua Arquiteto Lobão Vital, Porto , Portugal.,b Instituto de Saúde Pública, Universidade do Porto , Porto , Portugal
| | - Ndegwa Henry Maina
- c Division of Food Technology, Department of Food and Environmental Sciences , University of Helsinki , Helsinki , Finland
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Aglago EK, Landais E, Nicolas G, Margetts B, Leclercq C, Allemand P, Aderibigbe O, Agueh VD, Amuna P, Annor GA, El Ati J, Coates J, Colaiezzi B, Compaore E, Delisle H, Faber M, Fungo R, Gouado I, El Hamdouchi A, Hounkpatin WA, Konan AG, Labzizi S, Ledo J, Mahachi C, Maruapula SD, Mathe N, Mbabazi M, Mirembe MW, Mizéhoun-Adissoda C, Nzi CD, Pisa PT, El Rhazi K, Zotor F, Slimani N. Evaluation of the international standardized 24-h dietary recall methodology (GloboDiet) for potential application in research and surveillance within African settings. Global Health 2017; 13:35. [PMID: 28629424 PMCID: PMC5477249 DOI: 10.1186/s12992-017-0260-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 06/11/2017] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Collection of reliable and comparable individual food consumption data is of primary importance to better understand, control and monitor malnutrition and its related comorbidities in low- and middle-income countries (LMICs), including in Africa. The lack of standardised dietary tools and their related research support infrastructure remains a major obstacle to implement concerted and region-specific research and action plans worldwide. Citing the magnitude and importance of this challenge, the International Agency for Research on Cancer (IARC/WHO) launched the "Global Nutrition Surveillance initiative" to pilot test the use of a standardized 24-h dietary recall research tool (GloboDiet), validated in Europe, in other regions. In this regard, the development of the GloboDiet-Africa can be optimised by better understanding of the local specific methodological needs, barriers and opportunities. The study aimed to evaluate the standardized 24-h dietary recall research tool (GloboDiet) as a possible common methodology for research and surveillance across Africa. METHODS A consultative panel of African and international experts in dietary assessment participated in six e-workshop sessions. They completed an in-depth e-questionnaire to evaluate the GloboDiet dietary methodology before and after participating in the e-workshop. RESULTS The 29 experts expressed their satisfaction on the potential of the software to address local specific needs when evaluating the main structure of the software, the stepwise approach for data collection and standardisation concept. Nevertheless, additional information to better describe local foods and recipes, as well as particular culinary patterns (e.g. mortar pounding), were proposed. Furthermore, food quantification in shared-plates and -bowls eating situations and interviewing of populations with low literacy skills, especially in rural settings, were acknowledged as requiring further specific considerations and appropriate solutions. CONCLUSIONS An overall positive evaluation of the GloboDiet methodology by both African and international experts, supports the flexibility and potential applicability of this tool in diverse African settings and sets a positive platform for improved dietary monitoring and surveillance. Following this evaluation, prerequisite for future implementation and/or adaptation of GloboDiet in Africa, rigorous and robust capacity building as well as knowledge transfer will be required to roadmap a stepwise approach to implement this methodology across pilot African countries/regions.
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Affiliation(s)
- Elom Kouassivi Aglago
- Nutrition and Metabolism Section (NME), International Agency for Research on Cancer (IARC/WHO), 150 Cours Albert Thomas, 69372 Lyon, France
| | | | - Geneviève Nicolas
- Nutrition and Metabolism Section (NME), International Agency for Research on Cancer (IARC/WHO), 150 Cours Albert Thomas, 69372 Lyon, France
| | - Barrie Margetts
- Institute of Human Nutrition, University of Southampton, Southampton, UK
| | - Catherine Leclercq
- Food and Agriculture Organization of the United Nations (FAO), Rome, Italy
| | - Pauline Allemand
- Food and Agriculture Organization of the United Nations (FAO), Rome, Italy
| | | | | | - Paul Amuna
- Research Section, Primary Health Care Corporation, Doha, Qatar
| | | | | | - Jennifer Coates
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, USA
| | - Brooke Colaiezzi
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, USA
| | - Ella Compaore
- Department of Biochemistry-Microbiology, UFR-SVT, CRSBAN/University of Ouagadougou I Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
| | - Hélène Delisle
- TRANSNUT, Centre Collaborateur OMS sur la transition nutritionnelle et le développement, Département de Nutrition, Faculté of Médecine, Université de Montréal, Montréal, Canada
| | - Mieke Faber
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Robert Fungo
- School of Food Technology, Nutrition & Bio-Engineering, Makerere University, Kampala, Uganda
| | - Inocent Gouado
- Faculty of Science, University of Douala, Douala, Cameroon
| | - Asmaa El Hamdouchi
- Unité mixte de recherche en Nutrition et alimentation; URAC 39; RDC-Nutrition associé à l’AFRA/AIEA (CNESTEN-Université Ibn Tofail), Rabat, Morocco
| | - Waliou Amoussa Hounkpatin
- Department of Food Science and Nutrition, Faculty of Agricultural Science, University of Abomey-Calavi, Cotonou, Benin
| | | | - Saloua Labzizi
- Unité mixte de recherche en Nutrition et alimentation; URAC 39; RDC-Nutrition associé à l’AFRA/AIEA (CNESTEN-Université Ibn Tofail), Rabat, Morocco
- Ministry of Health, Rabat, Morocco
| | | | - Carol Mahachi
- Department of Physiology, University of Zimbabwe, Harare, Zimbabwe
| | | | - Nonsikelelo Mathe
- Faculty of Health Disciplines, Athabasca University, School of Public Health, University of Alberta, Edmonton, Canada
| | - Muniirah Mbabazi
- Division of Nutritional Sciences, School of Biosciences, University of Nottingham, Nottingham, UK
| | - Mandy Wilja Mirembe
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | | | - Karima El Rhazi
- Department of Epidemiology and Public Health, Faculty of Medicine of Fez, Fez, Morocco
| | - Francis Zotor
- University of Health and Allied Sciences, Ho, Volta Region Ghana
| | - Nadia Slimani
- Nutrition and Metabolism Section (NME), International Agency for Research on Cancer (IARC/WHO), 150 Cours Albert Thomas, 69372 Lyon, France
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Validity of equations using knee height to predict overall height among older people in Benin. Nutrition 2017; 42:46-50. [PMID: 28870478 DOI: 10.1016/j.nut.2017.05.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 04/21/2017] [Accepted: 05/31/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Chumlea's formulas are a validated means of predicting overall height from knee height (KH) among people >60 y of age, but, to our knowledge, no formula is validated for use in African countries, including Benin. The aim of this study was to compare height provided by predictive formulas using KH to measured height in an elderly population in Benin. METHODS Individuals >60 y of age in Benin underwent nutritional assessment with determination of weight, body mass index (BMI), height, and KH. A Bland-Altman analysis was carried out by sex and age. The percentage of predictions accurate to ±5 cm compared with the measured height was calculated. The tested formulas were Chumlea's formulas for non-Hispanic Black people (CBP) and two formulas for use among Caucasians. RESULTS Data from 396 individuals (81.1% male) were analyzed. The three formulas achieved 98% accuracy, but with 4.6% risk for error (±2 SD: -6 to +9 cm), which appeared to make them unfit for the whole population. Nevertheless, if a level of prediction ±5 cm is considered acceptable in clinical practice, the CBP formula achieved 83.1% accuracy. Moreover, there was no significant difference in BMI calculated with the measured and the predicted height, and the nutritional status based on BMI did not differ. CONCLUSION CBP formulas seem applicable in 83% of cases (±5 cm) to assess the height with KH of older people in Benin and do not overestimate the prevalence of malnutrition.
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Berihun S, Kassa GM, Teshome M. Factors associated with underweight among lactating women in Womberma woreda, Northwest Ethiopia; a cross-sectional study. BMC Nutr 2017; 3:46. [PMID: 32153826 PMCID: PMC7050864 DOI: 10.1186/s40795-017-0165-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 05/18/2017] [Indexed: 12/02/2022] Open
Abstract
Background Ensuring nutritional status of women is important because the malignant effects of malnutrition are procreated to the next generation through women and their off-springs. Malnutrition causes 3.5 million death of women and children each year and almost 11% of the disease burden in the world. Therefore, this study was conducted to assess nutritional status and factors associated with underweight among lactating women in Womberma woreda, Northwest Ethiopia, 2016. Methods A Community-based cross-sectional study was carried out in Womberma woreda, Northwest Ethiopia. A total of 668 lactating women who have 6–24 months of child were included in the study. Study participants were selected using a multistage sampling technique. Data were collected using interview-administered questionnaire. Body mass index (BMI) was used to measure the nutritional status of lactating women. Women’s body weight and height were measured using the standard anthropometric measurement procedures. Data were entered using EpiData software and analysis was done using SPSS software. Descriptive, bivariate and multivariable logistics regression analysis were used to present the findings. Variables with a p-value less than 0.05 on multiple variable logistic regression were taken as significant variables. Results Lactating women with normal nutritional status (BMI = 18.5–24.99 kg/m2) were 498 (74.5%), and underweight women (BMI < 88.5 kg/m2) were 170(25.4%). Respondents with less than five family size (AOR: 0.46, 95% CI: 0.26, 0.81, p-value = 0.007), women whose age of first pregnancy was less than 18 years old (AOR: 3.72, 95% CI: 2.33, 6.49 at p-value = 0.0001), home delivery for the recent child birth (AOR: 2.36, 95% CI: 1.50, 3.72 at p-value = 0.0001), and the absence of nutritional education programs in the community (AOR: 5.5, 95% CI: 1.8, 16.79 at p-value = 0.003) were the significant variables with underweight of lactating women. Conclusions Nutritional status of lactating women in the study area was poor. One fourth of lactating women was underweight. Factors associated with underweight of lactating women include; respondents with less than five family size, women whose age of first pregnancy was less than 18 years old, home delivery for the recent childbirth, and the absence of nutritional education programs in the community. Early childbearing and short birth intervals between births should be discouraged. Programs which encourage institutional delivery and community-based nutritional education are important to improve women nutritional status.
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Affiliation(s)
- Sileshi Berihun
- College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia, P.O.BOX: 269, Debre Markos, Ethiopia
| | - Getachew Mullu Kassa
- College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia, P.O.BOX: 269, Debre Markos, Ethiopia
| | - Muluken Teshome
- College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia, P.O.BOX: 269, Debre Markos, Ethiopia
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Asayehu TT, Lachat C, Henauw SD, Gebreyesus SH. Dietary behaviour, food and nutrient intake of women do not change during pregnancy in Southern Ethiopia. MATERNAL & CHILD NUTRITION 2017; 13:e12343. [PMID: 27373896 PMCID: PMC6866045 DOI: 10.1111/mcn.12343] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 05/16/2016] [Accepted: 05/16/2016] [Indexed: 11/26/2022]
Abstract
Although pregnant women are required to increase food and nutrient intake to accommodate for the increased nutritional demands, information on dietary behaviour and nutrient intake is limited. This study aimed to identify the adequacy and differences in intake between pregnant and non-pregnant women in a rural community of Butajira district, Southern Ethiopia. Simple random sampling was used to recruit 159 pregnant and 164 non-pregnant women. An interactive multiple pass 24-h recall survey was used to evaluate the food and nutrient intake of the study participants. Except for iron, vitamin A and C, intakes of macro and micronutrient were below the recommendations. Almost all study participants were deficient in energy, protein, calcium, folate and niacin intakes. There was no significant difference in the mean dietary intake of all nutrients between pregnant and non-pregnant women (p > 0.05). The prevalence of inadequacy was comparable between pregnant and non-pregnant women in all of the nutrient intakes except for Zn, where the prevalence of inadequacy was much higher among the pregnant women. Nearly all (99.0%) of the pregnant women were deficient in niacin, folate and calcium. Although all pregnant women considered it important to increase food intake during pregnancy, only a quarter of women reported to do so. In conclusion, pregnant women in the rural community of Butajira district do not make significant dietary intake adjustments to account for increased nutrient needs during pregnancy. In food insecure areas, such as ours, nutritional counselling complemented with supplementary feeding programmes could be key to ensure adequate dietary intake. © 2016 John Wiley & Sons Ltd.
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Affiliation(s)
- Tamene Taye Asayehu
- College of Applied Sciences, Department of Food Science and Applied NutritionAddis Ababa Science and Technology UniversityAddis AbabaEthiopia
| | - Carl Lachat
- Department of Food Safety and Food QualityGhent UniversityBelgium
| | | | - Seifu Hagos Gebreyesus
- School of Public Health, College of Health ScienceAddis Ababa UniversityAddis AbabaEthiopia
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Begashaw B, Tessema F, Gesesew HA. Health Care Seeking Behavior in Southwest Ethiopia. PLoS One 2016; 11:e0161014. [PMID: 27626804 PMCID: PMC5023186 DOI: 10.1371/journal.pone.0161014] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 07/28/2016] [Indexed: 11/19/2022] Open
Abstract
Background Rural and urban populations have disparate socio-demographic and economic characteristics, which have an influence on equity and their health seeking behavior. We examined and compared the health care seeking behavior for perceived morbidity between urban and rural households in Southwest Ethiopia. Methods Analytic cross-sectional study was conducted among urban and rural households living in Esera district of Southwest Ethiopia. A random sample of 388 head of households (126 urban and 262 rural) were selected. A pretested and structured questionnaire was used for data collection with face-to-face interview. In addition to descriptive methods, binary logistic regression was used to identify factors associated with health seeking behavior at p value of less than 0.05. Results Of the sample household heads, 377 (97.2%) (119 urban and 258 rural) were successfully interviewed. Among these, 58.4% (95% CI, 53.3–63.3%) of the households sought care from modern health care that was lower among rural (48.1%) than urban (80.7%) households. The prevalence of self-treatment was 35.3% in urban and 46.1% in rural households. Among the factors considered for modern health care utilization, higher monthly income (AOR, 5.6; 95% CI, 2.04–15.4), perceived severity of disease (AOR, 2.5; 95% CI, 1.1–5.8), acute duration of disease (AOR, 8.9; 95% CI, 2.4–33.3) and short distance from health facilities (AOR, 3; 95% CI, 1.2–8.4) among rural and being married (AOR, 11.3; 95% CI, 1.2–110.2) and perceived severity of disease (AOR, 6.6; 95% CI, 1.1–10.9) among urban households showed statistically significant association. Conclusions The general health seeking behavior of households on perceived morbidity was satisfactory but lower in rural compared to urban households. Self-medication was also widely practiced in the study area. The findings signal the need to work more on accessibility and promotion of healthcare seeking behavior especially among rural households.
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Affiliation(s)
- Bayu Begashaw
- Department of Public Health, Mizan Tepi University, Mizan Teferi, SNNPR, Ethiopia
| | - Fasil Tessema
- Department of Epidemiology, Jimma University, Jimma, Oromiya, Ethiopia
| | - Hailay Abrha Gesesew
- Department of Epidemiology, Jimma University, Jimma, Oromiya, Ethiopia
- Discipline of Public Health, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- * E-mail:
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Santos ACA, Correia CA, de Oliveira DC, Nogueira-Pedro A, Borelli P, Fock RA. Intravenous Glutamine Administration Modulates TNF-α/IL-10 Ratio and Attenuates NFkB Phosphorylation in a Protein Malnutrition Model. Inflammation 2016; 39:1883-1891. [DOI: 10.1007/s10753-016-0424-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Nightingale H, Walsh KJ, Olupot-Olupot P, Engoru C, Ssenyondo T, Nteziyaremye J, Amorut D, Nakuya M, Arimi M, Frost G, Maitland K. Validation of triple pass 24-hour dietary recall in Ugandan children by simultaneous weighed food assessment. BMC Nutr 2016; 2:56. [PMID: 27795836 PMCID: PMC5081093 DOI: 10.1186/s40795-016-0092-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Undernutrition remains highly prevalent in African children, highlighting the need for accurately assessing dietary intake. In order to do so, the assessment method must be validated in the target population. A triple pass 24 hour dietary recall with volumetric portion size estimation has been described but not previously validated in African children. This study aimed to establish the relative validity of 24-hour dietary recalls of daily food consumption in healthy African children living in Mbale and Soroti, eastern Uganda compared to simultaneous weighed food records. METHODS Quantitative assessment of daily food consumption by weighed food records followed by two independent assessments using triple pass 24-hour dietary recall on the following day. In conjunction with household measures and standard food sizes, volumes of liquid, dry rice, or play dough were used to aid portion size estimation. Inter-assessor agreement, and agreement with weighed food records was conducted primarily by Bland-Altman analysis and secondly by intraclass correlation coefficients and quartile cross-classification. RESULTS 19 healthy children aged 6 months to 12 years were included in the study. Bland-Altman analysis showed 24-hour recall only marginally under-estimated energy (mean difference of 149kJ or 2.8%; limits of agreement -1618 to 1321kJ), protein (2.9g or 9.4%; -12.6 to 6.7g), and iron (0.43mg or 8.3%; -3.1 to 2.3mg). Quartile cross-classification was correct in 79% of cases for energy intake, and 89% for both protein and iron. The intraclass correlation coefficient between the separate dietary recalls for energy was 0.801 (95% CI, 0.429-0.933), indicating acceptable inter-observer agreement. CONCLUSIONS Dietary assessment using 24-hour dietary recall with volumetric portion size estimation resulted in similar and acceptable estimates of dietary intake compared with weighed food records and thus is considered a valid method for daily dietary intake assessment of children in communities with similar diets. The method will be utilised in a sub-study of a large randomised controlled trial addressing treatment in severe childhood anaemia. TRIAL REGISTRATION This study was approved by the Mbale Research Ethics committee (Reference: 2013-050). Transfusion and Treatment of severe Anaemia in African Children: a randomized controlled Trial (TRACT) registration: ISRCTN84086586.
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Affiliation(s)
- Helen Nightingale
- Faculty of Medicine, Nutrition and Dietetic Research Group, Division of Diabetes, Endocrinology and Metabolism, Department of Investigative Medicine, Imperial College London, Hammersmith Campus, London W12 0NN, UK
| | - Kevin J Walsh
- Faculty of Medicine, Nutrition and Dietetic Research Group, Division of Diabetes, Endocrinology and Metabolism, Department of Investigative Medicine, Imperial College London, Hammersmith Campus, London W12 0NN, UK
| | - Peter Olupot-Olupot
- Busitema University Faculty of Health Sciences (BUFHS), Mbale Campus, Uganda
- Mbale Regional Referral Hospital Clinical Research Unit (MCRU), Mbale, Uganda
| | - Charles Engoru
- Department of Paediatrics, Soroti Regional Referral Hospital, Soroti, Uganda
| | - Tonny Ssenyondo
- Mbale Regional Referral Hospital Clinical Research Unit (MCRU), Mbale, Uganda
| | - Julius Nteziyaremye
- Mbale Regional Referral Hospital Clinical Research Unit (MCRU), Mbale, Uganda
| | - Denis Amorut
- Department of Paediatrics, Soroti Regional Referral Hospital, Soroti, Uganda
| | - Margaret Nakuya
- Department of Paediatrics, Soroti Regional Referral Hospital, Soroti, Uganda
| | - Margaret Arimi
- Department of Paediatrics, Soroti Regional Referral Hospital, Soroti, Uganda
| | - Gary Frost
- Faculty of Medicine, Nutrition and Dietetic Research Group, Division of Diabetes, Endocrinology and Metabolism, Department of Investigative Medicine, Imperial College London, Hammersmith Campus, London W12 0NN, UK
| | - Kathryn Maitland
- Kilifi Clinical Trials Facility, KEMRI-Wellcome Trust Research Programme, PO Box 230, Kilifi, Kenya
- Wellcome Trust Centre for Clinical Tropical Medicine, and Department of Paediatrics, Faculty of Medicine, Imperial College, London, W2 1PG, UK
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The nutrition transition and adolescents' diets in low- and middle-income countries: a cross-cohort comparison. Public Health Nutr 2016; 20:72-81. [PMID: 27469288 DOI: 10.1017/s1368980016001865] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate changes in dietary diversity and dietary composition among adolescents in four developing countries. DESIGN We analysed dietary diversity and consumption of seven food groups and foods with added sugars as reported by adolescents from two cohorts growing up 8 years apart, when they were aged about 12 years. SETTING Ethiopia, India (Andhra Pradesh), Peru and Vietnam in 2006 and 2013. SUBJECTS Adolescents (n 3659) from the older cohort (OC) born in 1995/96 and adolescents (n 7422) from the younger cohort (YC) born in 2001/02 (N 11 081). RESULTS Controlling for other factors, dietary diversity increased in Peru (OC=4·89, YC=5·34, P<0·001) and Ethiopia (OC=3·52, YC=3·94, P=0·001). Dietary diversity was stable in India (OC=4·28, YC=4·29, P=0·982) and Vietnam (OC=4·71, YC=4·73, P=0·814); however, changes in dietary composition were observed. YC adolescents were more likely to consume eggs (India: +32 %, P=0·038; Vietnam: +50 %, P<0·001) and milk and dairy (India: +12 %, P=0·029; Vietnam: +46 %, P<0·001). Other notable shifts included meat consumption in Peru (+72 %, P<0·001) and consumption of fruit and vegetables in Ethiopia (+36 %, P<0·001). Compared with OC, the prevalence of added sugar consumption was greater among the YC in Ethiopia (+35 %, P=0·001) and Vietnam (+44 % P<0·001). Between 2006 and 2013, disparities in dietary diversity associated with household wealth and place of residence declined, although this varied by country. No marked gender disparities in dietary diversity were evident. CONCLUSIONS We found significant changes over time in dietary diversity among adolescents in four countries consistent with the hypothesis of the nutrition transition.
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Okoro CS, Musonda I, Agumba J. Evaluating the Influence of Nutrition Determinants on Construction Workers' Food Choices. Am J Mens Health 2016; 11:1713-1727. [PMID: 26821794 DOI: 10.1177/1557988315625775] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Nutritional knowledge as well as economic, social, biological, and cultural factors have been known to determine an individual's food choices. Despite the existence of research on the factors which influence nutrition globally, there is little known about the extent to which these factors influence the food choices of construction workers, which in turn influence their health and safety during construction activities. The present article investigates the extent to which construction workers' nutrition is influenced by nutritional knowledge, as well as economic, environmental, social, psychological, and physiological factors. A field questionnaire survey was conducted on site construction workers in the Gauteng Province of South Africa. Principal components analysis and multiple regression analysis were used to analyze the data. Findings revealed that consumption of foods termed alternative foods including dairy products, eggs, nuts, fish, and cereals, was influenced by nutritional knowledge and resources. Foods termed traditional core foods were influenced by cultural background; foods termed secondary core foods comprising fruits and vegetables were influenced by economic factors, resources, and cultural background; while foods termed core foods were mostly influenced by nutritional knowledge. By providing evidence of the factors which most influence selection and consumption of certain foods by construction workers, relevant nutrition interventions will be designed and implemented, taking cognizance of these factors.
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Affiliation(s)
| | | | - Justus Agumba
- 1 University of Johannesburg, Johannesburg, South Africa
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Dake FAA, Fuseini K. Recreation, transportation or labour saving? Examining the association between household asset ownership and body mass index among Ghanaian women. BMC OBESITY 2015; 2:45. [PMID: 26594382 PMCID: PMC4642763 DOI: 10.1186/s40608-015-0075-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 11/07/2015] [Indexed: 11/15/2022]
Abstract
Background In most of the developing world, ownership of modern household assets such as television sets, refrigerators, microwave ovens and washing machines is becoming common. Ownership of these household assets, however, promotes sedentary behaviour which has implications for obesity and non-communicable disease conditions such as hypertension, diabetes, stroke and other cardiovascular conditions. Additionally, increased household asset ownership is an indicator of socio-economic status and is also associated with obesity promoting dietary behaviours especially in urban areas. Very few studies have examined the relationship between household asset ownership and obesity in sub-Saharan Africa where asset ownership is becoming a norm. This paper examined the relationship between ownership of different types of household assets and Body Mass Index (BMI) among a nationally representative sample of Ghanaian women. Methods The study analysed secondary data from the 2008 Ghana Demographic and Health Survey (GDHS) involving a total of 4916 women aged 15–49 years. The analytical sample consist of 4010 (weighted sample) non-pregnant females who had valid data on all the variables used in the analyses. The BMI of the women was used as the dependent variable with three categories of normal weight, overweight and obese based on the standard World Health Organization (WHO) classifications. Multinomial logistic regression models were specified to examine the relationship between ownership of household assets and BMI. Results Obesity was more common among women whose household owned a television-15.60 %, DVD/VCD-18.58 %, computer-20.70 %, refrigerator-17.16 % and washing machine-27.43 %, but less common among women whose household owned a motorcycle/scooter-7.74 % and a bicycle-7.92 %. Household ownership of DVD was significantly associated with increased odds of obesity (OR = 1.59, P < 0.01) while ownership of a motor cycle/scooter (OR = 2.05, P <0.001), a refrigerator (OR = 1.33, P < 0.05), and a television set (OR = 1.27, P < 0.10) were associated with higher odds of overweight. Ownership of each additional household asset was also associated with 15 % and 25 % higher odds of overweight and obesity respectively. Conclusion The findings indicate that at least one asset among the various domains of household assets examined is associated with either overweight or obesity among Ghanaian women. Also, increased household asset ownership is associated with increased odds of overweight and obesity. Interventions that aim at reducing sedentary and unhealthy dietary behaviours in the phase of increasing asset ownership maybe helpful in addressing the rising prevalence of obesity among Ghanaian women.
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Affiliation(s)
- Fidelia A A Dake
- Regional Institute for Population Studies, University of Ghana, P.O. Box LG 96, Legon, Accra Ghana
| | - Kamil Fuseini
- Population Training and Research Unit, North-West University (Mafikeng Campus), Mafikeng, South Africa
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Mesfin F, Berhane Y, Worku A. Anemia among Primary School Children in Eastern Ethiopia. PLoS One 2015; 10:e0123615. [PMID: 25902055 PMCID: PMC4406736 DOI: 10.1371/journal.pone.0123615] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 02/24/2015] [Indexed: 11/19/2022] Open
Abstract
Background Anemia during childhood impairs physical growth, cognitive development and school performance. Identifying the causes of anemia in specific contexts can help efforts to prevent negative consequences of anemia among children. The objective of this study was to assess prevalence and identify correlates of anemia among school children in Eastern Ethiopia. Methods A cross sectional study was conducted from January 2012 to February 2012 in Kersa, Eastern Ethiopia. The study included randomly selected primary school students. Hemoglobin concentration was measured using a Hemocue haemoglobinometer. A child was identified as anemic if the hemoglobin concentration was <11.5 g/dl for children (5–11 yrs) and < 12 g/dl for child older than 12 years age. Poisson regression model with robust variance was used to calculate prevalence ratios. Result The overall prevalence of anemia was 27.1% (95% CI: 24.98, 29.14): 13.8% had mild, 10.8% moderate, and 2.3% severe anemia. Children with in the age group of 5-9 years (APR, 1.083; 95% CI, 1.044- 1.124) were at higher risk for anemia. Paternal education (Illiterate, 1.109; 1.044 - 1.178) was positively associated with anemia. Children who had irregular legume consumption (APR, 1.069; 95% CI, 1.022 -1.118) were at higher risk for anemia. Conclusion About a quarter of school children suffer from anemia and their educational potential is likely to be affected especially for those with moderate and severe anemia. Child age, irregular legume consumption, and low paternal schooling were associated with anemia. Intervention programmes aimed to reduce anemia among school children are crucial to ensure proper growth and development of children.
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Affiliation(s)
- Firehiwot Mesfin
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- * E-mail:
| | - Yemane Berhane
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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Herrador Z, Sordo L, Gadisa E, Buño A, Gómez-Rioja R, Iturzaeta JM, de Armas LF, Benito A, Aseffa A, Moreno J, Cañavate C, Custodio E. Micronutrient deficiencies and related factors in school-aged children in Ethiopia: a cross-sectional study in Libo Kemkem and Fogera districts, Amhara Regional State. PLoS One 2014; 9:e112858. [PMID: 25546056 PMCID: PMC4278675 DOI: 10.1371/journal.pone.0112858] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 10/15/2014] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION The present study describes the distribution of selected micronutrients and anaemia among school-aged children living in Libo Kemkem and Fogera (Amhara State, Ethiopia), assessing differences by socio-demographic characteristics, health status and dietary habits. METHODS A cross-sectional survey was carried out during May-December 2009. Socio-demographic characteristics, health status and dietary habits were collected. Biomarkers were determined for 764 children. Bivariate and multivariable statistical methods were employed to assess micronutrient deficiencies (MD), anaemia, and their association with different factors. RESULTS More than two thirds of the school-aged children (79.5%) had at least one MD and 40.5% had two or more coexisting micronutrient deficiencies. The most prevalent deficiencies were of zinc (12.5%), folate (13.9%), vit A (29.3%) and vit D (49%). Anaemia occurred in 30.9% of the children. Children living in rural areas were more likely to have vit D insufficiency [OR: 5.9 (3.7-9.5)] but less likely to have folate deficiency [OR: 0.2 (0.1-0.4)] and anaemia [OR: 0.58 (0.35-0.97)]. Splenomegaly was positively associated with folate deficiency and anaemia [OR: 2.77 (1.19-6.48) and 4.91 (2.47-9.75)]. Meat and fish consumption were inversely correlated with zinc and ferritin deficiencies [OR: 0.2 (0.1-0.8) and 0.2 (0.1-0.9)], while oil consumption showed a negative association with anaemia and deficiencies of folate and vitamin A [0.58 (0.3-0.9), OR: 0.5 (0.3-0.9) and 0.6 (0.4-0.9)]. Serum ferritin levels were inversely correlated to the presence of anaemia (p<0.005). CONCLUSION There is a high prevalence of vitamin A deficiency and vitamin D insufficiency and a moderate prevalence of zinc and folate deficiencies in school-aged children in this area. The inverse association of anaemia and serum ferritin levels may be due to the presence of infectious diseases in the area. To effectively tackle malnutrition, strategies should target not only isolated micronutrient supplementation but also diet diversification.
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Affiliation(s)
- Zaida Herrador
- National Centre of Tropical Medicine, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Tropical Diseases Research Network (RICET in Spanish), Madrid, Spain
| | - Luis Sordo
- National Centre of Epidemiology, ISCIII, Madrid, Spain
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Complutense University, Madrid, Spain
- Network Biomedical Research Centers, Epidemiology and Public Health (CIBERESP in Spanish), Madrid, Spain
| | | | | | | | | | | | - Agustín Benito
- National Centre of Tropical Medicine, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Tropical Diseases Research Network (RICET in Spanish), Madrid, Spain
| | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Javier Moreno
- National Centre of Microbiology, ISCIII, Madrid, Spain
| | | | - Estefania Custodio
- National Centre of Tropical Medicine, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Tropical Diseases Research Network (RICET in Spanish), Madrid, Spain
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Alavi SM, Bakhtiarinia P, Eghtesad M, Albaji A, Salmanzadeh S. A comparative study on the prevalence and risk factors of tuberculosis among the prisoners in khuzestan, South-west iran. Jundishapur J Microbiol 2014; 7:e18872. [PMID: 25741435 PMCID: PMC4335546 DOI: 10.5812/jjm.18872] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 04/19/2014] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND High prevalence of Tuberculosis (TB) among prisoners is reported as an alarming public health problem in the world, especially in the developing countries. OBJECTIVES Since there is almost no information from TB in this population in Khuzestan province, the current study aimed to assess the prevalence and identify risk factors of TB among the prisoners of this region. PATIENTS AND METHODS In a retrospective study, medical files of patients with Tuberculosis in Khuzestan Health Center (KHC), from 2005 to 2010, were studied. Patients with Pulmonary TB were placed in two groups as the Inmate Prison (IP) and Non-Inmate Prison (NIP) groups. Data extracted from the patients' records in the two groups were compared by SPSS software system using Chi square and Fisher exact tests. P-value was considered less than 0.05. RESULTS From the reported 4562 patients with Tuberculosis, 363 (7.9%) were prison inmates at the time of TB diagnosis. Prevalence of TB cases among the prison inmates was 403.3 per 100'000.The annual TB case rate in the general population during this period was 16.4 per 100,000. Among the TB risk factors close contact [odds ratio (OR), 95% confidence interval (CI), 19.4, 8.9-41.8, P < 001] especially in the recent 2 years, injection drug use (IDU) [OR, 95% CI, 4.61, 1.7-12.4, P = 006], and Human Immunodeficiency Virus (HIV) infection [OR, 95% CI, 2.4, 1.1-5.0, P = 025] were more frequent in the prisoners than in the general population with TB. CONCLUSIONS In the region under study the prevalence of TB among the prisoners was higher than the general population. The main risk factors for Pulmonary TB in this population were close contact, IDU and HIV infection.
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Affiliation(s)
- Seyed Mohammad Alavi
- Health Research Institute, Infectious and Tropical Disease Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Pejman Bakhtiarinia
- Khuzestan Health Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Corresponding author: Pejman Bakhtiarinia, Khuzestan Health Center, Ahvaz Jundishapur University of Medical Sciences, IR Iran. Tel: +98-6113387724, E-mail:
| | - Mehdi Eghtesad
- Khuzestan Health Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Ali Albaji
- Khuzestan Health Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Shokrolah Salmanzadeh
- Infectious Diseases Department of Razi Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
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