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Goodman M, Theron L, McPherson H, Seidel S, Raimer-Goodman L, Munene K, Gatwiri C. Multisystemic factors predicting street migration of children in Kenya: A multilevel longitudinal study of families and villages. CHILD ABUSE & NEGLECT 2024; 154:106897. [PMID: 38870709 PMCID: PMC11316653 DOI: 10.1016/j.chiabu.2024.106897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 05/22/2024] [Accepted: 06/04/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Street-migration of children is a global problem with sparse multi-level or longitudinal data. Such data are required to inform robust street-migration prevention efforts. OBJECTIVE This study analyzes longitudinal cohort data to identify factors predicting street-migration of children - at caregiver- and village-levels. PARTICIPANTS AND SETTING Kenyan adult respondents (n = 575; 20 villages) actively participated in a community-based intervention, seeking to improve factors previously identified as contributing to street-migration by children. METHODS At two time points, respondents reported street-migration of children, and variables across economic, social, psychological, mental, parenting, and childhood experience domains. Primary study outcome was newly reported street-migration of children at T2 "incident street-migration", compared to households that reported no street-migration at T1 or T2. For caregiver-level analyses, we assessed bivariate significance between variables (T1) and incident street-migration. Variables with significant bivariate associations were included in a hierarchical logistical regression model. For community-level analyses, we calculated the average values of variables at the village-level, after excluding values from respondents who indicated an incident street-migration case to reduce potential outlier influence. We then compared variables between the 5 villages with the highest incidence to the 15 villages with fewer incident cases. RESULTS In regression analyses, caregiver childhood experiences, psychological factors and parenting behaviors predicted future street-migration. Lower village-aggregated depression and higher village-aggregated collective efficacy and social curiosity appeared significantly protective. CONCLUSIONS While parenting and economic strengthening approaches may be helpful, efforts to prevent street migration by children should also strengthen community-level mental health, collective efficacy, and communal harmony.
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Adam SM, Teshoma MS, Ahmed ASD, Tamiru D. Household food insecurity and its association with academic performance among primary school adolescents in Hargeisa City, Somaliland. PLoS One 2024; 19:e0303034. [PMID: 38995972 PMCID: PMC11244796 DOI: 10.1371/journal.pone.0303034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 04/16/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Academic achievement is crucial for the social and economic development of young people and determines the quality of education of a nation. According to different studies, food insecurity adversely affects children's health, nutrition, and subsequent decline in academic performance by impairing students' ability to learn and therefore affects the achievement of the Sustainable Development Goals (SDGs) of quality education and lifelong learning opportunities for all. To provide evidence on the association of food insecurity with academic performance is necessary. The current study assessed household food insecurity and its association with academic performance among primary school adolescents in Hargeisa City, Somaliland. METHODS A school-based cross-sectional study was conducted among 630 primary school adolescents from December 2021 to March 2022. Students were selected using a multistage sampling technique. An interviewer-administered questionnaire was used to collect data on household food security and socio-demographic variables and entered into Epi data version 3.1. The data was exported to SPSS version 26 for descriptive and multivariable logistic regression analysis. Odds ratios and their 95% confidence intervals together with p <0.05 were utilized to declare statistical significance. RESULTS The prevalence of food insecurity among school adolescents was 59.21%. The majority (55.40%) of the school adolescents were poor academic performers. The frequency of adolescents' poor academic performance was significantly high (71.05%) among food insecure households (P < 0.001) as compared to their counterparts whose households were food secure (32.68%). On multivariable analysis, household food insecurity (AOR = 5.24, 95%CI = 3.17-8.65), school absenteeism (AOR = 3.49, 95%CI = 2.20-5.53), spending >2h/day watching TV / screen media use (AOR = 9.08, 95%CI = 4.81-17.13), high and middle wealth households (AOR = 0.51, 95%CI = 0.30-0.88) (AOR = 0.40, 95%CI = 0.21-0.76) and habitual breakfast consumption (AOR = 0.08, 95%CI = 0.03-0.20) had shown statistically significant association with academic performance among primary school adolescents. CONCLUSION The present study revealed that household food insecurity has a high association with adolescents' academic performance. The prevalence of food insecurity is moderate, based on the household food insecurity access scale. The results indicate the need for policies and programs intended to improve household income by developing income-generation programs for lower-income families and enhance feeding programs such as national school lunch and school feeding across schools in the country.
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Affiliation(s)
- Sagal Mohamed Adam
- Department of Nutrition and Dietetics, Faculty of Public Health, Health Institute, Jimma University, Jimma, Ethiopia
| | - Melese Sinaga Teshoma
- Department of Nutrition and Dietetics, Faculty of Public Health, Health Institute, Jimma University, Jimma, Ethiopia
| | - Awale Sh. Dahir Ahmed
- Department of Public Health, Faculty of Allied Health Science, Daffodil International University, Dhaka, Bangladesh
| | - Dessalegn Tamiru
- Department of Nutrition and Dietetics, Faculty of Public Health, Health Institute, Jimma University, Jimma, Ethiopia
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Teshome MS, Bekele T, Verbecque E, Mingels S, Granitzer M, Abessa TG, Lema TB, Rameckers E. Body composition and associated factors among 5-7-year-old children with moderate acute malnutrition in Jimma town in southwest Ethiopia: A comparative cross-sectional study. MATERNAL & CHILD NUTRITION 2024; 20:e13655. [PMID: 38661055 PMCID: PMC11168370 DOI: 10.1111/mcn.13655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 04/26/2024]
Abstract
Acute malnutrition affects not only the growth and development but also the body composition of children. However, its specific effects have not yet been characterized. This study aims to compare the body composition of 5-7-year-old children with moderate acute malnutrition (MAM) to that of their well-nourished (WN) peers and identify associated factors. A school-based comparative cross-sectional study was conducted from June to July 2022 in Jimma town, southwest Ethiopia. The study participants were selected from eight kindergartens and eight primary schools using a simple random sampling technique based on the proportional allocation of the sample to the size of the population in the respective school. Descriptive statistics and multivariable linear regression analyses were used to assess the mean differences and associations between variables and isolate independent predictors of body composition, respectively. The statistical significance was determined using ß-coefficients with 95% confidence intervals and a p value of ≤ 0.05. Data were captured from 388 (194 MAM and 194 WN) children with a response rate of 97.9%. The mean fat-free mass of WN children was significantly higher compared with those with MAM (p < 0.001). The mean (SD) of fat mass of MAM children was 4.23 ± 0.72 kg, 4.36 ± 0.88 kg and 4.08 ± 0.89 kg for 5, 6 and 7-year-olds, respectively. For WN children, the mean (SD) of fat mass was 4.92 ± 0.88 kg for 5 years old, 5.64 ± 1.01 kg for 6 years old and 5.75 ± 1.26 kg for 7 years old (p < 0.001). On the multivariable linear regression analysis after controlling for background variables, WN children exhibited 1.51 times higher fat-free mass compared with MAM children (β = 1.51, p = 0.003). A unit increase in age of the study participants was associated with a 1.37 increment in fat-free mass (β = 1.37, p < 0.001). WN children had 1.07 times higher fat mass compared with children with MAM (β = 1.07, p < 0.001). A unit increase in the age of the child resulted in 0.15 times increment in fat mass (β = 0.15, p = 0.020), and being female was associated with a 0.37 increase in fat mass (β = 0.37, p < 0.001). The results showed that the mean fat mass and fat-free mass were significantly lower among moderately acute malnourished children than in WN children showing the loss of both body compartments due to malnutrition. The body mass index for age, age of the child and sex of the child were significantly linked to both fat-free mass and fat mass.
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Affiliation(s)
- Melese Sinaga Teshome
- Department of Nutrition and Dietetics, Faculty of Public Health, Health InstituteJimma UniversityJimmaEthiopia
- Rehabilitation Research Centre (REVAL), Rehabilitation Sciences and PhysiotherapyHasselt UniversityDiepenbeekBelgium
| | - Tamirat Bekele
- Department of Nutrition and Dietetics, Faculty of Public HealthJimma UniversityJimmaEthiopia
| | - Evi Verbecque
- Rehabilitation Research Centre (REVAL), Rehabilitation Sciences and PhysiotherapyHasselt UniversityDiepenbeekBelgium
| | - Sarah Mingels
- Rehabilitation Research Centre (REVAL), Rehabilitation Sciences and PhysiotherapyHasselt UniversityDiepenbeekBelgium
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation SciencesLeuven UniversityLeuvenBelgium
| | - Marita Granitzer
- Rehabilitation Research Centre (REVAL), Rehabilitation Sciences and PhysiotherapyHasselt UniversityDiepenbeekBelgium
| | - Teklu Gemechu Abessa
- Department of Special Needs and Inclusive EducationJimma UniversityJimmaEthiopia
| | - Tefera Belachew Lema
- Department of Nutrition and Dietetics, Faculty of Public Health, Health InstituteJimma UniversityJimmaEthiopia
| | - Eugene Rameckers
- Rehabilitation Research Centre (REVAL), Rehabilitation Sciences and PhysiotherapyHasselt UniversityDiepenbeekBelgium
- Research School CAPHRI, Department of Rehabilitation MedicineMaastricht UniversityMaastrichtThe Netherlands
- Centre of Expertise in Rehabilitation and AudiologyHoensbroekThe Netherlands
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Delbiso TD, Asfaw FM, Moges T, Ero D, Kotecho MG. Food insecurity among low-income households in Addis Ababa, Ethiopia. Heliyon 2024; 10:e29633. [PMID: 38655327 PMCID: PMC11035032 DOI: 10.1016/j.heliyon.2024.e29633] [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: 05/27/2023] [Revised: 03/30/2024] [Accepted: 04/11/2024] [Indexed: 04/26/2024] Open
Abstract
With the rapid urbanization in developing countries, poverty and food insecurity are becoming increasing prevalent, posing a major challenge to urban areas. The COVID-19 pandemic induced job losses and reduced income combined with inflation have further exacerbated the household food insecurity situation, particularly in cities of low-income countries. Our study aims to assess the extent of food insecurity and its determinants among low-income household in Addis Ababa, Ethiopia. We conducted a community-based cross-sectional study among a sample of 578 households in Addis Ababa. We estimated the household food insecurity status using the Household Food Insecurity Access Scale (HFIAS). An ordinal logistic regression model was used to assess the relationship between household food insecurity status and the socioeconomic and demographic covariates. The STATA 14 software package was used for data analysis. We found that household food insecurity was prevalent among low-income households in Addis Ababa, with a prevalence rate of 92.4 % (95 % CI: 90.2-94.6 %). Of these households, 33.6 % (95 % CI: 29.7-37.4 %) were severely food insecure. To cope with the food shortage, households were forced to reduce their food quantity and quality. We also found that respondent's education, engagement in income generating activities, and household wealth were independently associated with household food insecurity. We conclude that although supporting people living below the poverty line (pro-poor) remains the top priority for social protection programs, adapting the program to accommodate the working poor (informal sector employees and casual workers) is crucial, especially during shocks.
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Affiliation(s)
- Tefera Darge Delbiso
- Department of Public Health Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Fekadu Mulugeta Asfaw
- Department of Educational Planning and Management, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tibebu Moges
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Debebe Ero
- School of Social Work, Addis Ababa University, Addis Ababa, Ethiopia
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Tesfaye A, Adissu Y, Tamiru D, Belachew T. Nutritional knowledge, nutritional status and associated factors among pregnant adolescents in the West Arsi Zone, central Ethiopia. Sci Rep 2024; 14:6879. [PMID: 38519770 PMCID: PMC10959969 DOI: 10.1038/s41598-024-57428-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/18/2024] [Indexed: 03/25/2024] Open
Abstract
When pregnancy occur among teenagers; there is a competition for nutrients between the still-growing adolescent mother and her fetus. Pregnant adolescents' nutrition issues are not addressed well and changes are too slow in Ethiopia. This study aimed to study, nutrition knowledge, nutritional status and associated factors among pregnant adolescents in West Arsi , central Ethiopia. We conducted a cross-sectional study of 426 pregnant adolescents between January 1 and January 25, 2023. Data were collected using kobo collect and analyzed using SPSS version 25. We performed linear regression to identify independent predictors of nutritional status and multivariable logistic regression analyses to identify nutritional knowledge. Odds ratios (ORs) with 95% confidence intervals were estimated to show the strength of the association. Magnitude of good nutrition knowledge was 23.7%, 95% CI (21.4-25.3%), and the odds of having good nutrition knowledge was 7.5 times higher among participants whose education level was above college compared with illiterate participants [(AOR = 7.5, 95% CI = (5.27-9.38)],the odds of having good nutrition knowledge was 8 times higher among adolescent who had ANC visits, [(AOR = 8, 95% CI = (3.63-13.85)], and the odds of having good nutrition knowledge was 5 times higher among adolescents who received nutrition education [(AOR = 5, 95% CI = (3.67- 13.53)]. Receiving nutrition education (β = 0.25, P = 0.002) and good nutrition knowledge (β = 0.08, P < 0.001) were positively associated with nutritional status; however, food insecurity (β = - 0.93, P < 0.001) was negatively associated with nutritional status. The nutrition knowledge of pregnant adolescents was suboptimal; educational status, ANC visits and nutrition education were associated with good nutrition knowledge, whereas food insecurity, low nutrition knowledge, and not receiving nutrition education were predictors of poor nutritional status. Nutritional education interventions, increasing utilization of ANC, and interventions for improving food security are strongly recommended.
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Affiliation(s)
- Adane Tesfaye
- Department of Nutrition, School of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia.
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.
| | - Yohannes Adissu
- Department of Nutrition, School of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Dessalegn Tamiru
- 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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Gutema BT, Tariku EZ, Melketsedik ZA, Levecke B, De Henauw S, Abubakar A, Abbeddou S. Assessing the influence of COVID-19 lockdown measures on cognition and behavior in school age children in Arba Minch Health and Demographic Surveillance site, Southern Ethiopia: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002978. [PMID: 38512931 PMCID: PMC10956753 DOI: 10.1371/journal.pgph.0002978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/07/2024] [Indexed: 03/23/2024]
Abstract
Ethiopian schools were closed for nearly 40 weeks as a measure to control the COVID-19 pandemic. The objective of the study was to evaluate the role of COVID-19 pandemic's restrictive measures on cognition and behavioral difficulties of schoolchildren in Arba Minch Health and Demographic Surveillance Site. Two cross-sectional surveys were conducted in November 2019 (pre-COVID-19-lockdown) and November 2020 (post-COVID-19 lockdown). Data were collected both at the school and homes of the children. Cognitive development of the children was assessed using digit span, Raven's coloured progressive matrices (RCPM) and Visual search using cancellation task. Behavioral difficulties score of the children was assessed using Strengths and Difficulties Questionnaire. Analysis of covariance (ANCOVA) was used to compare between the cognition outcomes and behavioral difficulties score pre- and post-COVID-19-lockdown. In a sub-group of children who provided data in both surveys, the difference in cognitive and behavioral outcomes was tested using a mixed effect model. Compared to the pre-COVID-19-lockdown, schoolchildren post-COVID-19-lockdown scored lower in the standardized performance index for the visual search task, which measures attention (0.27 SD, 95% confidence intervals (95%CI): -0.40, -0.13). However, they scored higher by 0.26 SD (95%CI: 0.13, 0.40) and 0.36 SD (95%CI: 0.22, 0.49) in digit span and RCPM, respectively, measuring working memory and non-verbal intelligence. There was no significant difference in total difficulties score between pre- and post-COVID-19-lockdown (0.01 SD, 95%CI: -0.12, 0.15). The subgroup analysis showed a significant increase in digit span among children post-COVID-19-lockdown while the other domains did not show a significant change. Factors contributing to the improvement of children's cognitive domains while away from the school environment should be explored and utilized to enhance child development. This study was registered at clinicaltrials.gov as NCT04137354 on October 14, 2019.
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Affiliation(s)
- Befikadu Tariku Gutema
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Eshetu Zerihun Tariku
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | | | - Bruno Levecke
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Amina Abubakar
- Kenya Medical Research Institute (KMRI)–Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, Kilifi, Kenya
| | - Souheila Abbeddou
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Tesfaye A, Tamiru D, Belachew T. Effect of nutrition counseling on nutritional status and gestational weight gain of pregnant adolescents in West Arsi, Central Ethiopia: a cluster randomized controlled trial. Sci Rep 2024; 14:5070. [PMID: 38429426 PMCID: PMC10907709 DOI: 10.1038/s41598-024-55709-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/27/2024] [Indexed: 03/03/2024] Open
Abstract
When pregnancy occurs in adolescence, the growth and development of the mother and fetus may be impaired due to strong competition for nutrients between the still-growing adolescent and the fetus. Pregnant adolescents constitute an underserved population; they lack adequate nutritional knowledge. Therefore, this study investigated the effect of nutritional behavior change communication (NBCC) through alliance for development (AFD) on the nutritional status and gestational weight gain (GWG) of pregnant adolescents. A two-arm parallel cluster randomized controlled community trial was conducted in the West Arsi Zone, central Ethiopia, from August 2022 to July 2023. The nutritional status of the pregnant adolescent was assessed using mid-upper arm circumference. Weight was measured at baseline and at the end of the intervention. A total of 207 and 219 pregnant adolescents participated in the intervention and control clusters, respectively. The intervention started before 16 weeks of gestation, and the intervention group attended four NBCC sessions. The NBCC was based on the health belief model (HBM) and was given at the participants' homes with their husbands. The NBCC intervention was delivered by AFDs and community-level health actors. Pregnant adolescents in the control group received routine nutrition education from the health care system. A linear mixed-effects model and difference in difference (DID) were used to measure the intervention effect after adjusting for potential confounders. After the implementation of the trial, the mean mid-upper arm circumference (MUAC) in the intervention arm significantly increased from baseline (p ≤ 0.001), 23.19 ± 2.1 to 25.06 ± 2.9 among intervention group and 23.49 ± 2.1 to 23.56 ± 2.0 among control group and the mean difference in the MUAC (DID) was 1.89 ± 2 cm (p ≤ 0.001); the mean GWG in the intervention arm significantly increased from baseline; 51.54 ± 4.7 to 60.98 ± 4.6 among intervention group and 52.86 ± 5.27 to 58 ± 5.3 among control group; the mean GWG in the intervention group was 9.4 kg, and that in the control group was 5.14 kg, and the difference in difference was 4.23 kg and this was statically significant p ≤ 0.001). This study demonstrated that the use of the HBM for NBCC delivered through the AFD was effective at improving the nutritional status and GWG of pregnant adolescents. These results imply the need for the design of model-based nutritional counseling guidelines.Clinical trial registration: PACTR202203696996305, Pan African Clinical Trials Registry, date of first registration: 16/03/2022.
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Affiliation(s)
- Adane Tesfaye
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.
- Department of Nutrition, School of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia.
| | - Dessalegn Tamiru
- 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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Mulat E, Tamiru D, Abate KH. Impact of indoor Air Pollution on the Linear growth of children in Jimma, Ethiopia. BMC Public Health 2024; 24:488. [PMID: 38365615 PMCID: PMC10870508 DOI: 10.1186/s12889-024-17975-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/03/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Stunting in children is the term for reduced linear growth and development, which is frequently brought on by a persistently inadequate diet, recurrent infections and chronic diseases or poor health conditions. Apart from the classic covariates of stunting, which include diet and illness, the relative contribution of household air pollution to chronic nutrition conditions is least studied. Hence, this study is conducted to investigate the impact of household air pollution on the linear growth of under-five children in Jimma town, Ethiopia. METHODS A prospective cohort study was employed to collect data from 280 under-five children who lived in households using solid fuel (exposed group, n = 140) and clean fuel (unexposed group, n = 140). Height-for-age Z scores were compared in both groups over a 12-month follow-up period. The difference in differences estimators were used for comparison of changes in the height-for-age Z scores from baseline to end line in exposed and non-exposed groups. The independent effect of the use of solid fuels on height-for-age Z scores was analyzed through a multivariable linear regression model. Statistical Significances were declared at P < 0.05 and 95% CI level. RESULTS In an unadjusted model (Model 1), compared with the clean fuel type, the mean difference in the height-for-age Z score of children in households using solid fuel was lower by 0.54 (-0.54, 95% CI -0.97, -0.12, P = 0.011). The beta coefficient remained negative after adjusting for age and sex (Model 2 -0.543, 95% CI -1.373, -0.563) and sociodemographic variables (Model 3: -0.543, 95% CI -1.362, -0.575). In the final model (Model 4), which adjusted for wealth quantile, dietary practice, water, sanitation and hygiene status and household food insecurity access scale, the beta coefficient held the same and significant (beta: -0.543, 95% CI -1.357, -0.579, P < 0.001). Higher HAZ scores were observed among female child (β: = 0.48, 95%CI: 0.28, 0.69), Child with father attended higher education (β: = 0.304 95%CI: 0.304, 95% CI 0.19, 0.41) as compared to male gender and those who did not attend a formal education, respectively. In contrast, child living in households with poor hygiene practices had lower HAZ score (β: -0.226, 95% CI: -0.449, -0.003), P < 0.001. CONCLUSIONS Exposure to indoor air pollution was inversely related to linear growth. Furthermore, sex, educational status and hygiene were found relevant predictors of linear growth. In such a setting, there is a need to step up efforts to design and implement public education campaigns regarding the health risks associated with exposure to household air pollution. Promoting improvements to kitchen ventilation and the use of improved cooking stoves, which will help to mitigate the detrimental effects of indoor air pollution on child growth impairment and its long-term effects.
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Affiliation(s)
- Elias Mulat
- Department of Biomedical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia.
| | - Dessalegn Tamiru
- Department of Nutrition and Dietetics, Food and Nutrition Research Institute, Jimma University, Jimma, Ethiopia
| | - Kalkidan Hassen Abate
- Department of Nutrition and Dietetics, Food and Nutrition Research Institute, Jimma University, Jimma, Ethiopia
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Wagner F, Wagner RG, Makuapane LP, Masango M, Kolanisi U, Gómez-Olivé FX. Mental distress, food insecurity and university student dropout during the COVID-19 pandemic in 2020: evidence from South Africa. Front Psychiatry 2024; 15:1336538. [PMID: 38380123 PMCID: PMC10876832 DOI: 10.3389/fpsyt.2024.1336538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/19/2024] [Indexed: 02/22/2024] Open
Abstract
Background Student dropout has been a key issue facing universities for many years. The COVID-19 pandemic was expected to exacerbate these trends; however, international literature has produced conflicting findings. Limited literature from Africa has investigated the impact of COVID-19 on student dropout trends, despite the documented devastation, including increased risk of food insecurity and mental distress, caused by the pandemic. Objective This work seeks to understand the impact of food insecurity and mental distress on student dropout during the COVID-19 pandemic. Methods Using a cross-sectional research design, first-year undergraduate students from a large South African university were recruited via email to participate in a survey between September and October 2020. The Household Food Insecurity Access Scale (HFIAS) was used to measure food insecurity and the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) was used to measure mental distress. Multivariate regression was used to investigate factors associated with student dropout. Results The student dropout rate was 10.5% (95% CI: 8.2-13.2). The prevalence of severe food insecurity was 25.7% (95% CI: 22.3-29.4) and the prevalence of severe mental distress symptoms was 26.7% (95% CI: 23.3-30.4). Dropout rates and levels of food insecurity were highest among students residing in remote areas during the lockdown at 19.2% and 43.6%, respectively. The multivariate logistic regression revealed that being male increased the probability of dropout almost three-fold (odds ratio (OR) = 2.70; 95% CI: 1.48-4.89, p =0.001)). Being moderately food insecure increased the odds of dropout more than two-fold (OR=2.50; 95% CI:1.12-5.55, p=0.025), and experiencing severe mental distress symptoms increased the odds of dropout seven-fold (OR=7.08; 95% CI:2.67-18.81, p<0.001). Conclusion While acknowledging that various factors and complexities contribute to student dropout, the increased vulnerability to food insecurity and mental distress, stemming from issues such as widespread job losses and isolation experienced during the pandemic, may have also had an impact on dropout. This work reiterates the importance of directing additional support to students who are food insecure and those who are experiencing mental distress in order to mitigate university student dropout.
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Affiliation(s)
- Fezile Wagner
- Analytics and Institutional Research Unit (AIRU), University of the Witwatersrand, Johannesburg, South Africa
| | - Ryan G. Wagner
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lerato P. Makuapane
- Analytics and Institutional Research Unit (AIRU), University of the Witwatersrand, Johannesburg, South Africa
| | - Mxolisi Masango
- Department of Institutional Planning (DIP), University of Pretoria, Pretoria, South Africa
| | - Unathi Kolanisi
- Department of Consumer Sciences, Faculty of Science, Agriculture and Engineering, University of Zululand, KwaDlangezwa, South Africa
| | - Francesc Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Tesfaye A, Gerbaba M, Tamiru D, Belachew T. Inadequate dietary diversity practices and associated factors among pregnant adolescents in the West Arsi Zone, Central Ethiopia: a community-based cross-sectional study. Sci Rep 2024; 14:2871. [PMID: 38311634 PMCID: PMC10838914 DOI: 10.1038/s41598-024-53467-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 01/31/2024] [Indexed: 02/06/2024] Open
Abstract
The aftermath of dietary modifications made during pregnancy has the most substantial effects on nutritional status and birth results, despite the important influence of nutritional reserves. Numerous studies have been conducted on dietary practices and their determinants among pregnant women; however, there is a gap in evidence among pregnant adolescents. Therefore, this study sought to close this gap by examining dietary practices and associated factors among pregnant adolescents in the West Arsi Zone, Central Ethiopia. This community-based cross-sectional study was conducted among 459 pregnant adolescents between February and March 2023. Cluster sampling was used for selecting pregnant adolescents. Structured questionnaires were used for data collection. The data were entered into the Kobo toolbox and exported to SPSS version 25 software for analysis. Dietary diversity was assessed using the 24-h dietary recall method. Binary and multivariable logistic regression analyses were used to identify independent predictors of dietary practices. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated to identify the factors associated with the outcome variables. A p value ≤ 0.05 indicated statistical significance. The prevalence of inadequate dietary practices among the pregnant adolescents was 78.4% (95% CI 74.3%, 82.8%), and a level of nutritional knowledge [AOR = 2.4, 95% CI (1.82-4.74]; an unfavorable attitude toward dietary diversity [AOR = 4.3, 95% CI 2.9-5.83]; a food insecurity status [AOR = 8.7, 95% CI 2.37-10.24]; and a low perceived severity of poor dietary practices [AOR = 4.7, 95% CI 3.26-5.47]. These factors were significantly associated with inadequate dietary practices among pregnant adolescents. The most frequently consumed foods were starchy foods (81.3%) and pulses (79%), and the least consumed foods were meat (2.8%) and fruits (3.48%). The magnitude of inadequate dietary practices was high, and it was significantly associated with educational, behavioral, and economic status. Nutritional interventions focused on communicating nutritional behavioral changes and strengthening sustainable income-generating strategies are recommended to improve the dietary practices of pregnant adolescents.
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Affiliation(s)
- Adane Tesfaye
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.
- Department of Nutrition, School of Public Health, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia.
| | - Mulusew Gerbaba
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Dessalegn Tamiru
- 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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Gutema BT, Levecke B, Sorrie MB, Megersa ND, Zewdie TH, Yesera GE, De Henauw S, Abubakar A, Abbeddou S. Effectiveness of intermittent iron and high-dose vitamin A supplementation on cognitive development of school children in southern Ethiopia: a randomized placebo-controlled trial. Am J Clin Nutr 2024; 119:470-484. [PMID: 37952928 DOI: 10.1016/j.ajcnut.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 11/01/2023] [Accepted: 11/06/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Iron is an essential mineral whose deficiency results in cognitive alteration, impaired emotional behaviors, and altered myelination and neurotransmission. In animal models, it has been shown that vitamin A (VA) could affect cognition. OBJECTIVES The study aimed to evaluate the effectiveness of intermittent iron and VA supplementation on cognitive development of schoolchildren, and to assess the interaction between these supplementations. METHODS Considering a 2 × 2 factorial design, 504 children were randomly assigned to 1 of the 4 arms: placebo VA and placebo iron supplement; high-dose vitamin VA and placebo iron supplement; iron supplement and placebo VA; and iron and high-dose vitamin VA supplements. Cognitive development was assessed using Raven's Coloured Progressive Matrices, digit span, Tower of London, and visual search tasks. RESULTS The mean [± standard deviation (SD)] age of the enrolled children was 9.6 (±1.6) y. One-fifth of the children had iron deficiency or anemia, whereas 2.9%, 3.9%, and 12.1% of children had low iron stores, iron deficiency anemia, and VA deficiency, respectively. Intermittent iron supplementation did not result in any significant improvement of children's cognitive development and had a negative effect on the performance index of the visual search task compared with placebo (-0.17 SD, 95% confidence interval: -0.32, -0.02). Effects were evident among children with stunting, thinness, or children coming from understimulating home environments. High-dose VA supplementation resulted in a significant improvement of digit span z-score with a mean difference of 0.30 SD (95% confidence interval: 0.14, 0.46) compared with placebo VA. VA had a more beneficial impact for girls, children infected with helminths, and those from food secure households. CONCLUSION In a population where the prevalence of iron deficiency is low, intermittent iron supplementation did not have any or negative effect on the child's cognitive development outcomes. Conversely, VA supplementation improved the child's working memory. TRIAL REGISTRATION NUMBER The study is registered at clinicaltrials.gov as NCT04137354 (https://clinicaltrials.gov/study/NCT04137354).
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Affiliation(s)
- Befikadu Tariku Gutema
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Bruno Levecke
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Muluken Bekele Sorrie
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Nega Degefa Megersa
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Tadiwos Hailu Zewdie
- School of Medicine, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Gesila Endashaw Yesera
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Amina Abubakar
- Kenya Medical Research Institute (KMRI)-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, Kilifi, Kenya
| | - Souheila Abbeddou
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Ezzeddin N, Kalantari N, Abdollahi M, Amiri P, Amini B, Zayeri F. Outcomes of a homestead food production program on nutritional knowledge, dietary diversity, food security and empowerment of rural women in Tehran province, Iran. BMC Public Health 2024; 24:118. [PMID: 38191378 PMCID: PMC10775463 DOI: 10.1186/s12889-024-17658-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 01/03/2024] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Food and nutrition insecurity is a major health issue in developing countries. Homestead food production (HFP) programs are strategies for improving food and nutrition security of a country. Iran implemented a HFP program entitled "Nutrition Improvement of Rural and Nomadic Women" in its villages for a five-year period from 2017. The current study assessed the outcomes of this mentioned program and its determinants among rural women in Tehran province. METHODS The population of this cross-sectional study comprised a group covered by the program (n = 143) and a non-covered group (n = 160). The participants were selected randomly from 32 villages of five counties in Tehran province. Data was collected using five questionnaires: (1) General information, (2) Women's empowerment, (3) Nutritional knowledge, (4) Dietary diversity, and (5) Household Food Insecurity Access Scale (HFIAS). Data was analyzed using the IBM SPSS version 21 and the IBM Amos SPSS version 22 software. RESULTS The results of the study showed no significant improvement in the expected indicators, such as frequency of home gardening, nutritional knowledge, dietary diversity, women's empowerment, and household food insecurity status among women covered by the program (p > 0.05). The structural equation modelling (SEM) results indicated that women's empowerment from the dimension of decision-making power (r = 0.151) and nutritional knowledge (r = 0.135) were the significant positive predictors of dietary diversity (p < 0.05), while household food insecurity predicted it negatively (r=-0.138) (p < 0.05). CONCLUSION Because the current evaluated program has not been able to improve the expected indicators, modification of the program implementation may be needed, such as: addressing the probable barriers and challenges and strengthening the facilities in the covered villages. The current study presents a model of the dietary diversity predictors for consideration in redesigning or enhancing the program.
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Affiliation(s)
- Neda Ezzeddin
- Department of Community Nutrition, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Naser Kalantari
- Department of Community Nutrition, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Abdollahi
- Faculty of Nutrition Sciences and Food Technology, and Social Determinants of Health Research Center, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parisa Amiri
- Research Centre for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahareh Amini
- Department of Community Nutrition, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farid Zayeri
- Proteomics Research Center, Department of Biostatistics, Shahid Beheshti University of Medical Sciences, Darband Street, Tehran, Iran.
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Ahmed R, Ejeta Chibsa S, Hussen MA, Bayisa K, Tefera Kefeni B, Gezimu W, Bidira K. Undernutrition among exclusive breastfeeding mothers and its associated factors in Southwest Ethiopia: A community-based study. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241231478. [PMID: 38390653 PMCID: PMC10894535 DOI: 10.1177/17455057241231478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 12/28/2023] [Accepted: 01/22/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND An exclusive breastfeeding period is a time when the infant's feeding depends on only breast milk. Inadequate maternal nutrition during this period could lead to insufficient infant feeding, which can further lead to childhood undernutrition and developmental restrictions. Evidently, the burden of maternal undernutrition was higher in resource-limited countries, including Ethiopia. OBJECTIVES This study aimed to assess the proportion of undernutrition among exclusive breastfeeding mothers and its associated factors in Southwest Ethiopia. DESIGN The study used a community-based cross-sectional design. METHODS The study was conducted among 442 nursing mothers from 10 to 30 June 2022. The participants were selected using multistage sampling techniques. An interviewer-administered structured questionnaire was used to collect information. Statistical software EpiData version 3.1 and SPSS version 20 were used for data entry and analysis, respectively. The factors associated with undernutrition were identified using a binary logistic regression analysis. In the bivariable analysis, a p-value of less than 0.25 was used to include the variable in the multivariable analysis, whereas p-value less than 0.05 was an odds ratio used to declare an independent association at a 95% confidence interval. RESULTS The proportion of undernutrition among the participants was found to be 24.8% in the study area. Poor intake of extra meals (adjusted odds ratio = 2.104; 95% confidence interval: 1.208, 3.664), poor dietary diversity habits (adjusted odds ratio = 3.605; 95% confidence interval: 2.112, 6.153), a lack of nutrition information (adjusted odds ratio = 1.853; 95% confidence interval: 1.070, 3.212), and household food insecurity (adjusted odds ratio = 4.424; 95% confidence interval: 2.639, 7.417) were identified as factors enhancing undernutrition among exclusive breastfeeding mothers in the area. CONCLUSION A quarter of exclusive breastfeeding mothers were undernourished in the area. Poor dietary diversity habits, poor intake of extra meals, a lack of nutrition information, and household food insecurity were found to be the factors determining undernutrition. Hence, it is important to reinforce nutrition intervention programs, including maternal nutrition education and counseling.
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Affiliation(s)
- Riyad Ahmed
- Department of Public Health, College of Health Sciences, Mattu University, Mattu, Ethiopia
| | - Samuel Ejeta Chibsa
- Department of Midwifery, College of Health Sciences, Mattu University, Mattu, Ethiopia
| | - Mustefa Adem Hussen
- Department of Midwifery, College of Health Sciences, Mattu University, Mattu, Ethiopia
| | - Kenbon Bayisa
- Department of Midwifery, College of Health Sciences, Mattu University, Mattu, Ethiopia
| | | | - Wubishet Gezimu
- Department of Nursing, College of Health Sciences, Mattu University, Mattu, Ethiopia
| | - Kebebe Bidira
- Department of Nursing, College of Health Sciences, Mattu University, Mattu, Ethiopia
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14
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Kuma MN, Tamiru D, Belachew T. Effects of nutrition education and home gardening interventions on feto-maternal outcomes among pregnant women in Jimma Zone, Southwest Ethiopia: A cluster randomized controlled trial. PLoS One 2023; 18:e0288150. [PMID: 37862322 PMCID: PMC10588865 DOI: 10.1371/journal.pone.0288150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 05/25/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Although pro-dietary practices and associated malnutrition are modifiable risk factors, they have a significant effect on maternal and neonatal health outcomes. Therefore, this study aimed to assess the effect of nutritional education and home gardening promotion on feto-maternal outcomes among pregnant women. METHODS A three parallel arms community-based cluster randomized controlled trial was carried out in Jimma Zone, Southwest Ethiopia from August 2020 to January 2021. Eighteen selected clusters were randomly assigned into three arms: husband (pregnant woman with her husband), peers (pregnant woman with her peers), and the controls. A total of 348 pregnant women were recruited in a 1:1:1 allocation ratio to the study arms at the baseline and 336 attended the end-line survey. Three nutrition education sessions and four varieties of vegetable seeds were provided for women in the intervention arms (husband and peers) and only routine nutrition education for the controls. Data were collected using a pretested interviewer-administered structured questionnaire. Generalized estimating equation analysis (GEE) and one-way analysis of variance (ANOVA) and Kruskal Wallis test were used to evaluate the effect of the interventions. The intervention effect estimates were obtained through a difference-in-differences approach. RESULT In the final model, neonates born to women in the husband group were 232 g heavier than those in the control groups (β = 232, 95%CI: 228.00, 236.27. Similarly, women in the husband group had a 0.45 g/dl greater hemoglobin level than the control groups (β = 0.45, 95% CI: 36.48, 54.40). Likewise, a minimum diet diversity score was higher in the husband group as compared to the controls (β = 0.87 95% CI: (0.56, 1.18). CONCLUSIONS Therefore, nutrition education and home gardening interventions resulted in a significant positive effect on the mean birth weight and maternal hemoglobin level among the intervention groups. The findings imply the need for enhancing such interventions to improve feto-maternal outcomes. The trial was registered at Pan African Clinical Trial Registry as PACTR202008624731801.
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Affiliation(s)
| | - Dessalegn Tamiru
- Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia
- School of Graduate Studies, Jimma University, Jimma, Ethiopia
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15
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Yasmin SMT, Yasmin SMT, Sultan S, Hong SA. Prevalence of adolescent-reported food insecurity and the determinants including coping strategies living in urban slum communities of Bangladesh during the era of COVID-19: a cross-sectional study. BMC Public Health 2023; 23:2046. [PMID: 37858099 PMCID: PMC10588258 DOI: 10.1186/s12889-023-16984-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 10/13/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND As food insecurity (FI) continues to rise worldwide especially in developing countries like Bangladesh, adolescent experience of FI have received minimal attention globally. This study aimed to identify the prevalence of adolescent-reported FI and its association with individual and socio-environmental factors as well as coping strategies amongst a sample of adolescents living in urban slum areas of Bangladesh in the times of the Coronavirus 19 (COVID-19) pandemic. METHODS A descriptive cross sectional study was conducted amongst 326 adolescents (12-18 years) living in the urban slums of Narayanganj, Dhaka from April to May, 2022. Adolescent-reported FI was assessed using a structured questionnaire adopted from Household Food Insecurity Access Scale (HFIAS). Descriptive statistics, Chi-square tests and ordinal logistic regression were used to draw inference. RESULTS Prevalence of adolescent-reported FI was high (46.6% moderate and 29.8% severe). The likelihood of experiencing moderate or severe FI versus no/mild FI were 1.7 times (95% Confidence Interval (CI) [1.1, 2.5]) higher in younger adolescents and 5 times (95% CI [2.3, 12.7]) higher in unemployed youth. Socio-environmental factors determining the economic status of a household such as higher number of family members, only one earning family member, unemployed father, no household assets, food aid received by the family during pandemic and positive COVID-19 infection in family were associated with moderate and severe FI. Coping strategies such as a higher number of food seeking strategies (Adjusted Odds Ratio (AOR) 3.4, 95% CI [1.9, 5.9]), substance use (AOR 6.2, 95% CI [1.2, 31.7]) and stopping school (AOR 3.3, 95% CI [1.9, 5.7]) increased odds for moderate and severe FI. Stratified by drop-out of school status, an association between food seeking strategies and FI remained significant among those school-going, while there was no association among those dropping out of school. CONCLUSION This study showed that adolescents living in urban slum communities in Bangladesh are at very high risk of FI and resort to harmful coping strategies. Our study highlights the importance of further research in adolescent reported FI and coping strategies in low to middle income countries (LMICs) and create appropriate interventions to lower FI among this group and improve their state of health and wellbeing.
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Affiliation(s)
- S M Taniya Yasmin
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - S M Taslima Yasmin
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - Sarah Sultan
- Social and Economic Enhancement Program, Mirpur, Pallabi, Dhaka, 1216, Bangladesh
| | - Seo Ah Hong
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, 73170, Thailand.
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Adam R, Haileselassie W, Solomon N, Desalegn Y, Tigeneh W, Suga Y, Gebremedhin S. Nutritional status and quality of life among breast Cancer patients undergoing treatment in Addis Ababa, Ethiopia. BMC Womens Health 2023; 23:428. [PMID: 37568125 PMCID: PMC10422709 DOI: 10.1186/s12905-023-02585-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND The prevalence of malnutrition in cancer patients ranges from 30 to 60%. While it is known that malnutrition is prevalent among cancer patients, the relationship between undernutrition and quality of life among breast cancer patients has not been adequately explored. Therefore, the present study was aimed at assessing the association between undernutrition and quality of life among Breast Cancer patients under treatment in Addis Ababa, Ethiopia. METHODS A cross-sectional study on breast cancer patients under treatment at the outpatient and in-patient departments of oncology centers of two tertiary hospitals in Addis Ababa - Tikur Anbessa Specialized Hospital (TASH) and St. Paul Millennium Medical College (SPHMMC) oncology was conducted from May 12 to August 26,2020. Nutritional status was assessed using Subjective Global Assessment (SGA) screening tool. Quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Cancer 30 (EORTC QLQ C30) a standard quality of life measurement scale for cancer patients. To determine the relationship between quality of life scores and nutritional status multivariable linear regression was fitted. RESULTS A total of 411 breast cancer patients with mean age of 44.4 (± 11.47) years. And 393 (95.6%) of them female were included in the study. A high prevalence of moderate 127 (30.9%) and severe 106 (25.8%) malnutrition was observed. Moderate (β = -9.21 CI (- 14.59, - 4.67)) and severe (β = -17.81 CI (- 16.6, 2 - 2.91)) malnutrition were negatively associated with the overall quality of life. Malnutrition also showed negative associations with all domains of functional status (P < 0.05) and strong positive associations with symptom scores covered in the EORTC QLQ C-30 (P < 0.05). CONCLUSION This study indicated that malnutrition is a major problem among breast cancer patients and the nutritional status breast cancer patients was related to their quality of life….
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Affiliation(s)
- Ruth Adam
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Werissaw Haileselassie
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Nabel Solomon
- Department of Pathology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yakob Desalegn
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Wondemagegnhu Tigeneh
- Department of Oncology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yisihak Suga
- Department of Surgery, Saint Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Samson Gebremedhin
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Wakwoya EB, Belachew T, Girma T. Effects of intensive nutrition education and counseling on nutritional status of pregnant women in East Shoa Zone, Ethiopia. Front Nutr 2023; 10:1144709. [PMID: 37469548 PMCID: PMC10352577 DOI: 10.3389/fnut.2023.1144709] [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: 03/06/2023] [Accepted: 06/20/2023] [Indexed: 07/21/2023] Open
Abstract
Background Nutritional status is defined as an individual's health condition as it is influenced by the intake and utilization of nutrients. Maternal malnutrition is widespread throughout the world, with Sub-Saharan Africa and Asia bearing the brunt of the burden. The objective of this study was to evaluate the effect of intensive nutrition education and counseling on nutritional status during pregnancy. Methods and materials The study was a one-year, two-arm parallel design cluster randomized controlled trial conducted in the East Shoa zone, Ethiopia, from January 1, 2021, to February 30, 2022. A total of 374 participants were enrolled in the intervention (n = 185) and control (n = 189) groups. End-line data were collected from 163 women, from each group. The intervention package provided three counseling sessions by trained midwives, three-page take-home brochures prepared in local languages, and the delivery of 18 weekly serial short text messages. The women in the control group received routine nutrition education from the health facilities. After adjusting for potential confounders, a linear mixed-effects model was employed to assess the intervention effect. Results After the intervention, the mean mid-upper arm circumference in the intervention group increased by 1.8% (23.08 vs. 23.44, p < 0.01). Similarly, the proportion of undernutrition in the intervention group was 11% (25 vs. 36%, p = 0.02) lower compared to the control arm. At the end of the trial, women in the intervention arm had significantly better nutritional status than women in the control group (β = 0.47, p < 0.01). Conclusion The findings showed that intensive nutrition education and counseling using the health belief model was effective in improving nutritional status and reducing undernutrition among pregnant women. As a result, nutrition education and counseling using HBM constructs, as well as regular reminder messages, should be provided to pregnant women as part of the routine antenatal care service.
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Affiliation(s)
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia
| | - Tsinuel Girma
- Department of Pediatrics and Child Health, Jimma University, Jimma, Ethiopia
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18
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Fite MB, Tura AK, Yadeta TA, Oljira L, Wilfong T, Mamme NY, Asefa G, Gurmu DB, Habtu W, Waka FC, Demiss NT, Woldeyohannes M, Tessema M, Alemayehu D, Hassen TA, Motuma A, Roba KT. Co-occurrence of iron, folate, and vitamin A deficiency among pregnant women in eastern Ethiopia: a community-based study. BMC Nutr 2023; 9:72. [PMID: 37353841 DOI: 10.1186/s40795-023-00724-x] [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: 12/09/2022] [Accepted: 06/09/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND It is well known that the magnitude of undernutrition in Ethiopia is unacceptably high. The burden of co-occurrence of iron, folate, and vitamin A deficiency, on the other hand, has received less attention. Thus, in this study, we looked at the prevalence of iron, folate, and vitamin A deficiency in pregnant women in eastern Ethiopia. METHODS A community-based cross-sectional study was conducted among 397 pregnant women in Haramaya district, eastern Ethiopia. An interview-assisted questionnaire and blood serum were collected from pregnant women using standard techniques and shipped to an EPHI for micronutrient analysis. Factors associated with the co-occurrence of iron, folate, and vitamin A deficiency were identified using binary and multiple logistic regressions. RESULTS According to this study, 81.6% of the participants were deficient in at least one micronutrient, and 53.53.2% were deficient in two or more. Women who did not receive iron-folic acid supplementation (AOR = 2.44; 95% CI = 1.52-3.92), did not attend Antenatal care (ANC) follow up (AOR = 2.88; 95% CI = 1.81-4.61), and reported low consumption of diversified diet (AOR = 2.18 (95% CI = 1.35-3.51) had a higher risk of co-occurrence of iron, folate, and vitamin A deficiency. CONCLUSION This study found that more than half of pregnant women were in multiple micronutrients, indicating a major public health issue. In addition to the IFA supplementation programs that are already in place, there is a need for multiple micronutrient supplementation.
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Affiliation(s)
- Meseret Belete Fite
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Abera Kenay Tura
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemessa Oljira
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tara Wilfong
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Newas Yusuf Mamme
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Gemechu Asefa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Demiraw Bikila Gurmu
- Department of National Clinical Chemistry Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Wossene Habtu
- Department of National Clinical Chemistry Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Feyissa Challa Waka
- Department of National Clinical Chemistry Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Nahom Tefera Demiss
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Meseret Woldeyohannes
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Masresha Tessema
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Dawit Alemayehu
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Tahir Ahmed Hassen
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Aboma Motuma
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Roba
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
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Abera M, Hanlon C, Fedlu H, Fewtrell M, Tesfaye M, Wells JCK. Stress and resilience during pregnancy: A comparative study between pregnant and non-pregnant women in Ethiopia. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001416. [PMID: 37216320 DOI: 10.1371/journal.pgph.0001416] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 04/10/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND Stress during pregnancy is associated with perturbances in maternal psychology and physiology, and results in adverse pregnancy and birth outcomes. However, little attention has been given to understand maternal stress and its potential negative consequences in many low- and middle-income countries. We aimed to investigate whether pregnancy is associated with greater stress and lower psychological resilience among women living in Jimma, Southwest Ethiopia. METHOD An institution-based comparative cross-sectional study design was implemented in Jimma University Medical Center and Jimma health centers from 15 September to 30 November 2021. Women attending antenatal care and family planning services were invited to participate in the study. Participants were interviewed using the Perceived Stress Scale (PSS-10), Brief Resilience Scale (BRS), distress questionnaire-5, and the Household Food Insecurity Access Scale (HFIAS). Linear regression analysis was used to test associations between pregnancy (exposure) and outcomes of interest (stress and resilience scores), while adjusting for potential confounders. Stress and resilience were mutually adjusted for one another in the final model. RESULTS A total of 166 pregnant and 154 non-pregnant women participated, with mean age of 27.0 SD 5.0 and 29.5 SD 5.3 years respectively. Pregnancy was associated with increased stress score by 4.1 points (β = 4.1; 95% CI: 3.0, 5.2), and with reduced resilience by 3.3 points (β = -3.3; 95% CI: -4.5, -2.2) in a fully adjusted model. In mutually-adjusted models, pregnancy was independently associated with greater stress (β = 2.9, 95% CI 1.8, 3.9) and lower resilience (β = -1.3, 95% CI: -2.5, -0.2) compared to non-pregnant women. CONCLUSION In this low income setting, pregnancy is associated with greater vulnerability in the mental health of women, characterized by greater perceived stress and diminished resilience. Context-relevant interventions to improve resilience and reduce stress could help improve the health and wellbeing of mothers, with potential benefits for their offspring.
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Affiliation(s)
- Mubarek Abera
- Department of Psychiatry, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Charlotte Hanlon
- Department of Health Services and Population Research, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Hikma Fedlu
- Department of Public health officer, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Mary Fewtrell
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Markos Tesfaye
- Department of Psychiatry, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Jonathan C K Wells
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
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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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Wakwoya EB, Belachew T, Girma T. Determinants of nutritional status among pregnant women in East Shoa zone, Central Ethiopia. Front Nutr 2022; 9:958591. [PMID: 36590215 PMCID: PMC9797973 DOI: 10.3389/fnut.2022.958591] [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: 05/31/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Background Undernutrition is an insufficient intake of energy and nutrients to meet an individual's needs to maintain good health. Undernutrition during pregnancy severely affects the health of mothers and her baby. Globally it contributes directly or indirectly to 3.5 million maternal deaths annually. This study aimed to determine the level of undernutrition and identify factors associated with undernutrition among pregnant women attending public health facilities in the East Shoa Zone, Central Ethiopia. Methods Institution-based cross-sectional study was conducted among 472 randomly selected pregnant women from June to August 2021. Sociodemographic, obstetrics, and knowledge related data were collected using a structured interviewer-administered questionnaire, and maternal nutritional status was measured using the Mid Upper Arm Circumference (MUAC). The collected data were entered to EPI-info version 3.5.4 and then exported to SPSS for windows version 26.0 software for analysis. Multivariable regression analysis was fitted to identify determinants of undernutrition. An adjusted odds ratio with 95% confidence intervals and a p-value < 0.05 was considered a statistically significant. Results The prevalence of undernutrition among pregnant women was 13.9% [95% CI: 11.0-17.4]. On multivariable logistic regression model after adjusting background variables, wealth (AOR: 4.9, 95% CI 1.34-18.20), women's decision making power (AOR: 3.31, 95% CI 1.18-7.79), and nutritional counseling (AOR: 3.53, 95% CI 1.29-9.60) were independently associated with nutritional status of pregnant women. Conclusion Findings indicated that significant number of pregnant women in the study were undernourished. Higher wealth index, nutritional counseling, and women's decision-making power were inversely associated with undernutrition. The findings imply the need for economic empowerment of women, enhancing decision-making ability of women and routine and consistent nutritional counseling to decrease undernutrition among pregnant women.
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Affiliation(s)
- Ermias Bekele Wakwoya
- Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia,*Correspondence: Ermias Bekele Wakwoya
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia,Department of Pediatrics and Child Health, Jimma University, Jimma, Ethiopia
| | - Tsinuel Girma
- Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia
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Jemal OM, Callo-Concha D, van Noordwijk M. Does income imply food security in coffee growing communities? A case study in Yayu, Southwestern Ethiopia. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2022.1051502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The impacts on food security of a transition from agriculture focused on local consumption to the participation in global markets are uncertain, with both positive and negative effects reported in the literature. In Ethiopia, coffee production for global markets has attracted growers from across the country to the coffee-forest zones. From a national perspective, the area is not a priority for food security enhancement, as financial indicators suggest food sufficiency. In this setting, we collected food security and dietary intake data from a total of 420 (3X140) units of households, non-breast-feeding children under 5 years, and women of reproductive age. Sampling was done in two-stages, a random selection of 300 households (out of a total of 4,300) Yayu, followed by sub-sampling of households with a child and woman meeting the above-mentioned criteria. Samples were used to determine a number of food and nutrition security indicators. More than 83% of the households were found to be hunger-free in the shortage season, but dietary diversity was suboptimal. More than 50% of children under 5 years of age and women lacked foods containing heme iron in the surplus season and 88% in the shortage season. Household food security during the surplus season did not depend on income, but wealth was significantly correlated (p < 0.01) with all of the food insecurity indicators except the “Body Mass Index” of target women in the shortage season. The strongest and weakest correlation was with the “House Food Insecurity Access Scale” (−0.85), and “Weight-to-Age Z-Score” (0.25), respectively. Overall, Yayu is not fully food secure, though the situation is better than average for the country. While household income helps in achieving calorific sufficiency, greater awareness of the relevance of dietary diversity and the local means to achieve it is needed to further improve nutritional status, regardless of the participation in global markets.
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Goodman ML, Elliott A, Melby PC, Gitari S. Water insecurity, food insecurity and social capital associated with a group-led microfinance programme in semi-rural Kenya. Glob Public Health 2022; 17:3399-3411. [PMID: 35787237 PMCID: PMC9810762 DOI: 10.1080/17441692.2022.2095656] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 06/26/2022] [Indexed: 02/06/2023]
Abstract
ABSTRACTSocial capital predicts many positive health outcomes, including food and water access and sufficiency. Hence, increasing social capital has emerged as one potential strategy to improve food and water security. In this study, we investigate whether social capital generated through participation in a community-based microlending programme based in semi-rural Kenya is associated with water and food insecurity, and explore the interconnectedness of water and food insecurity through mediation analysis. Randomly-selected women participants of the community-based programme (n = 400) were interviewed in June 2018 and again in June 2019. Survey measures included water insecurity, food insecurity and an index of social capital constructs, namely group cohesion, trust, expectations of mutual support, sense of belonging and frequency of attendance in the programme. Random effects linear regression showed that an increase the social capital index was associated with lower water and food insecurity. The mediation analysis indicated that the association between social capital and food insecurity was completely mediated by water insecurity. This study demonstrates the need for further investigation into how social capital-generating programmes can contribute to systems approaches for collaborative food and water security programmes, especially among rural communities in low- and middle-income countries.
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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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Kabalo BY, Lindtjørn B. Seasonality and predictors of childhood stunting and wasting in drought-prone areas in Ethiopia: a cohort study. BMJ Open 2022; 12:e060692. [PMID: 36356996 PMCID: PMC9660553 DOI: 10.1136/bmjopen-2021-060692] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Over centuries, Ethiopia has experienced severe famines and periods of serious drought, and malnutrition remains a major public health problem. The aims of this study were to estimate seasonal variations in child stunting and wasting, and identify factors associated with both forms of child malnutrition in drought-prone areas. METHODS This cohort study was conducted among a random sample of 909 children in rural southern Ethiopia. The same children were followed for 1 year (2017-2018) with quarterly repeated measurements of their outcomes: height-for-age and weight-for-height indices (Z-scores). Linear regression models were used to analyse the association between both outcomes and baseline factors (eg, household participation in a social safety net programme and water access) and some time-varying factors (eg, household food insecurity). RESULTS Child wasting rates varied with seasonal household food insecurity (ᵪ2 trend = 15.9, p=0.001), but stunting rates did not. Household participation in a social safety net programme was associated with decreased stunting (p=0.001) and wasting (p=0.002). In addition to its association with decreased wasting (p=0.001), protected drinking water access enhanced the association between household participation in a social safety net programme and decreased stunting (p=0.009). Absence of a household latrine (p=0.011), lower maternal education level (p=0.001), larger family size (p=0.004) and lack of non-farming income (p=0.002) were associated with increased child stunting. CONCLUSIONS Seasonal household food insecurity was associated with child undernutrition in rural Ethiopia. Strengthening community-based food security programmes, such as the Ethiopian social safety net programme, could help to reduce child undernutrition in drought-prone areas. Improving clean water access and sanitation could also decrease child undernutrition.Key terms: Z-scores; Social safety net program; Water access.
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Affiliation(s)
- Bereket Yohannes Kabalo
- School of Public Health, Hawassa University, Hawassa, Ethiopia
- Centre for International Health, University of Bergen, Bergen, Norway
| | - Bernt Lindtjørn
- School of Public Health, Hawassa University, Hawassa, Ethiopia
- Centre for International Health, University of Bergen, Bergen, Norway
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Mkhize M, Sibanda M. Food Insecurity in the Informal Settlements of Inanda Households Living with Children under 60 Months in Ethekwini Municipality. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101521. [PMID: 36291457 PMCID: PMC9600868 DOI: 10.3390/children9101521] [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: 08/28/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 11/04/2022]
Abstract
Food insecurity is a continuing challenge for many households in South Africa. This challenge poses serious immediate and long-term health and development risks for children. Despite the intensive literature on household food insecurity, there is limited literature on the household food security status in South African informal settlements. Thus, the household food security status and dynamics in informal settlements are not clearly defined. Hence, this study assessed the food security status of households living with children under 60 months in the informal settlements of the Inanda area, eThekwini Municipality. This study employed a cross-sectional quantitative research approach. A non-probability sampling method was used, which used convenience sampling supplemented by a non-discriminative snowball sampling to obtain a sample size of 160 households with children under the age of five. Data was collected through face-to-face interviews, where questionnaires were administered to household child caregivers. Ethical considerations such as informed consent, anonymity, confidentiality, permission from authorities, and cultural considerations were obeyed in this study. The HFIAS and HDDS tools were used to estimate the household food security status. Data were coded and analysed in SPSS version 25 software. This study revealed that higher proportions of the surveyed informal households living with children under 60 months were food insecure. The HFIAS analysis showed that approximately 34, 31, and 28% were severely, mildly, and moderately food insecure, respectively. In contrast, a small (approximately 8%) proportion of the surveyed informal households was estimated to be food secure. The HDDS analysis revealed that most (approximately 77%) of the surveyed informal households had low dietary diversity (deemed food insecure). Cereal, roots, and fatty foods were the main dietary components in the informal settlements of Inanda. It is paramount to improve the food security status of informal households living with children under 60 months through an integrated approach. This study suggests government and private stakeholders' engagement in developing policies and programs directed at informal households living with children under 60 months to alleviate food insecurity.
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Affiliation(s)
| | - Melusi Sibanda
- Correspondence: Correspondence: ; Tel.: +27-(0)35-902-6068
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Kebede TB, Mengesha S, Lindtjorn B, Engebretsen IMS. Anaemia, anthropometric undernutrition and associated factors among mothers with children younger than 2 years of age in the rural Dale district, southern Ethiopia: A community‐based study. MATERNAL & CHILD NUTRITION 2022; 18:e13423. [PMID: 36006033 PMCID: PMC9480945 DOI: 10.1111/mcn.13423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 07/23/2022] [Accepted: 07/29/2022] [Indexed: 11/27/2022]
Abstract
Mothers in resource‐poor settings are affected by different forms of undernutrition. However, the nutritional status of mothers in rural areas, particularly after delivery, is not well documented. This study assessed haemoglobin levels and body mass index (BMI) of mothers with children below 2 years of age in a rural district of southern Ethiopia. Factors associated with low haemoglobin levels and low BMI were analysed. A community‐based cross‐sectional study was conducted among 931 mother‐child pairs. Structured and standard questionnaires were used to collect data on background information, 24 h dietary recalls, and household food insecurity. Anthropometric and haemoglobin level assessments were performed. Anaemia was defined as haemoglobin levels below 12.0 g/dl, and anthropometric undernutrition was defined as a BMI <18.5 kg/m2. Multilevel linear regression was used to determine associations. Out of 931 mothers, 12.8% were anaemic and 12.6% had a BMI <18.5 kg/m2. The prevalence of minimum dietary diversity was 37.8%. The majority (78.5%) of the households were food insecure. Weight (β 0.02; 95% CI: 0.003−0.03), dietary diversity (β 0.08; 95% CI: 0.03−0.12) and secondary school attendance (β 0.34; 95% CI: 0.08−0.59) were associated with the mothers' haemoglobin level. Dietary diversity (β 0.08; 95% CI: 0.01−0.16) and household's wealth (β 0.6; 95% CI: 0.27−0.94) were associated with the mothers' BMI. Findings suggest that education and community‐based nutrition interventions must be strengthened to ensure household food security. Implementation of the national food‐based strategies should be considered, to improve the dietary diversity and nutritional status of mothers. Anaemia and underweight were less prevalent among mothers with young children in the rural Dale district, southern Ethiopia, than the national report of the Ethiopian Demographic and Health Survey in 2016. Dietary diversity is positively associated with haemoglobin level and body mass index among mothers with children younger than 2 years of age. The existing nutrition interventions such as the Productive Safety Net Programme need strengthening, to improve the sustained food access to rural households. Planing and implementing community‐based small‐scale activities, such as school gardening, and fish and poultry farming, to ensure the availability and affordability of nutritious foods.
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Affiliation(s)
- Tsigereda B. Kebede
- College of Medicine and Health Sciences Hawassa University Hawassa Ethiopia
- Centre for International Health University of Bergen Bergen Norway
| | - Selamawit Mengesha
- College of Medicine and Health Sciences Hawassa University Hawassa Ethiopia
- Sidama Regional Health Bureau Sidama region Hawassa Ethiopia
| | - Bernt Lindtjorn
- College of Medicine and Health Sciences Hawassa University Hawassa Ethiopia
- Centre for International Health University of Bergen Bergen Norway
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Abebe GT, Kure MA, Yadeta TA, Roba KT, Amante TD. Immediate postpartum anemia and associated factors among women admitted to maternity ward at public hospitals in Harari Regional State, Eastern Ethiopia: A facility-based cross-sectional study. Front Glob Womens Health 2022; 3:916245. [PMID: 36204254 PMCID: PMC9531123 DOI: 10.3389/fgwh.2022.916245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 08/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background Anemia in the postpartum period remains a considerable public health problem in developing countries, particularly in sub-Saharan Africa. It is the most common indirect cause of maternal morbidity and mortality. It is also a major health problem in women of reproductive age, affecting their quality of life, occupational capacity, lactation, and immunological function. Immediate postpartum anemia has a significant impact on women's quality of life, although its predictors have received little attention in Ethiopia, notably in Harari Regional State. Therefore, this study aimed to determine its magnitude and contributing factors in Eastern Ethiopia. Methods A facility-based cross-sectional study was conducted from June 1st to August 30th, 2021, among 484 postpartum women admitted to two public hospitals in Harari Regional State, Eastern Ethiopia. Data were collected using a pre-tested, structured interviewer-administered questionnaire. About 2 mL of blood samples were collected and analyzed using the cell-Dyne 1,800 machine. The collected data were entered into Epi-Data version 4.6 and analyzed using SPSS version 25. A multivariable logistic regression analysis was conducted to estimate the effect of independent variables on immediate postpartum anemia. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was computed to report the presence of the association. Statistical significance was declared at a p-value of < 0.05. Results The overall magnitude of immediate postpartum anemia was 28.1% [95% CI (23.7, 32.1)]. Lack of formal education [AOR: 3.92; 95% CI: (1.85, 8.33)], having antenatal care < 4 visits [AOR: 3.18; 95% CI: (1.53, 6.61)], a history of cesarean delivery [AOR: 3.40; 95% CI: (1.89, 6.10)], a history of maternal blood loss [AOR: 4.78; 95% CI: (2.22, 10.30)], pre-delivery Hgb level < 11 g/dl [AOR:5.46; 95% CI: (3.09,9.67)], and having no iron-folate supplementation [AOR:3.27; 95% CI: (1.31, 8.15)] were factors statistically associated with immediate postpartum anemia. Conclusions In this study, nearly one-third of mothers admitted for postpartum care developed anemia within 48 h of giving birth. Women's educational level, frequency of antenatal care, mode of delivery, a history of maternal blood loss, pre-delivery hemoglobin level, and iron-folate supplementation status were identified as immediate postpartum anemia risk factors. Therefore, promoting the benefits of adequate antenatal care and iron-folate supplementation during pregnancy is crucial to avoiding the risks of postpartum anemia.
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Affiliation(s)
- Gizaw Taddesse Abebe
- Department of Midwifery, College of Health and Medical Sciences, Dilla University, Dilla, Ethiopia
| | - Mohammed Abdurke Kure
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- *Correspondence: Mohammed Abdurke Kure
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Roba
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tariku Dingeta Amante
- School of Public Health, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
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Girma A, Genetu A, Ayalew E, Getachew D. Determinants of dietary practice among pregnant women at the public hospitals in Bench-Sheko and Kaffa Zones, Southwest Ethiopia. BMC Nutr 2022; 8:88. [PMID: 36002906 PMCID: PMC9400258 DOI: 10.1186/s40795-022-00588-7] [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: 02/02/2022] [Accepted: 08/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUNDS The frequency of poor dietary practice due to inappropriate dietary habits is higher during pregnancy compared to any other stage of the life cycle. Suboptimal dietary practices during pregnancy can increase the risk of intrauterine growth restriction, low birth weight, anemia, prenatal and infant mortality, and morbidity. Therefore, this study aimed to determine the dietary practice and associated factors among pregnant women at the public hospitals of Bench-Sheko and Kaffa zone. METHODOLOGY An institutional-based cross-sectional study design was conducted among 566 pregnant women who attended antenatal care at the public hospitals of the Bench-Sheko and Kaffa zones. A systematic random sampling technique was employed to select the study units. The data were entered into Epi Data 3.1 and exported to Statistical Package for Social Science (SPSS) version 21 software for further analysis. Both Binary and Multivariable logistic regression analyses were used to examine the association between dependent and independent variables. The Crude Odd Ratio (COR) and Adjusted Odd Ratio (AOR) with 95% Confidence interval (CI) were calculated and the variable with P-value < 0.05 was considered statistically significant. RESULT According to this study, only 23.7% (95% CI: 20.1, 27.4) of the study participants had a good dietary practice. The urban residents (AOR = 2.64; 95% CI:1.18, 5.92), monthly income of > 2000ETB (AOR = 2.47; 95% CI: 1.31,4.65), having nutrition information (AOR = 2.5; 95% CI: 1.14,5.52), good dietary knowledge (AOR = 2.79; 95% CI: 1.48,5.27), mothers occupation of employer (AOR = 1.88; 95% CI: 1.04,3.42) and a family size < 5 (AOR = 3.37; 95% CI: 1.32,8.65) were determinate of dietary practice. CONCLUSION Generally, the prevalence of good dietary practice is suboptimal in the study area. Urban residency, monthly income > 2000ETB, good dietary knowledge, having nutrition information, family size < 5, and government employed mothers were the predictors of the good dietary practice in the Bench-Sheko and Kaffa zone. Therefore, providing in-service training for health professionals and assigning nutritionist to each public hospital should be done to provide health and nutrition education; and strengthen the existed nutrition counseling service for pregnant women. Moreover, the government should create sustainable income-generating activities for pregnant women.
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Affiliation(s)
- Abel Girma
- School of Public Health, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia.
| | - Amare Genetu
- Department of Midwifery, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Ermias Ayalew
- Departements of Nursing, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Dawit Getachew
- School of Public Health, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
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Pregnant Mothers Diversified Dietary Intake and Associated Factors in Southwest Ethiopia: A Cross-Sectional Study. J Nutr Metab 2022; 2022:4613165. [PMID: 35958030 PMCID: PMC9363205 DOI: 10.1155/2022/4613165] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 06/28/2022] [Indexed: 11/27/2022] Open
Abstract
Background Dietary diversity is very critical for fetal growth and development, as well as for the health and wellbeing of the mother. In Ethiopia, 41% of pregnant mothers consume diversified diets. There has been no study assessing whether pregnant women in southwest Ethiopia consume a varied diet. Objective To estimate the proportion of adequate diversified dietary intake and to determine whether there is an association between diversified dietary intake and mothers' social capital. Design A community-based cross-sectional study was conducted on 367 pregnant women in South West Ethiopia. A 24-hour multiple-pass dietary recall method was used to measure dietary intake and the 10 food groups of FANTA/FAO 2016 were used to analyze dietary diversity. Social capital was assessed based on the number of social networks in which a mother participated. Result The proportion of diversified dietary intake was 14.7% (95% CI: 11.1, 18.3). Pregnant mothers who had social capital, had their own income, had emotional support from their husbands, were from a rich family, and had a frequent dietary intake were statistically associated with a diversified dietary intake, with an AOR of 7.8 (95% CI 1.02, 2.3 (95% CI 1.12, 4.44), 4.0, (95% CI 1.16, 13.7), 59.19), 2.3 (95% CI 1.04, 5.26), and 1.5 (95% CI 1.04, 2.07), respectively. Conclusion Diversified dietary intake was found to be lower than previously reported, and it was associated with social capital. Methodologically rigorous studies are required to verify the association between social capital and adequate diversified dietary intake.
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Prevalence, predictors of low birth weight and its association with maternal iron status using serum ferritin concentration in rural Eastern Ethiopia: a prospective cohort study. BMC Nutr 2022; 8:70. [PMID: 35883202 PMCID: PMC9327330 DOI: 10.1186/s40795-022-00561-4] [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: 01/14/2022] [Accepted: 07/12/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Low birth weight (LBW) is one of the major predictors of perinatal survival, infant morbidity, and mortality, as well as the risk of developmental disabilities and illnesses in future lives. The effect of the nutritional status of pregnant women on birth outcomes is becoming a common research agenda, but evidence on the level of low birth weight (LBW) and its association with prenatal iron status in Ethiopia, particularly among rural residents, is limited. Thus, this study aimed to assess the prevalence, predictors of LBW, and its association with maternal iron status using serum ferritin concentration in Haramaya district, eastern Ethiopia, 2021. Methods A community-based prospective cohort study design was conducted. Of a total of 427 eligible pregnant women followed until birth, 412 (96.48%) were included in the final analysis. Iron status was determined using serum ferritin (SF) concentration from venous blood collected aseptically from the ante-cubital veins analyzed on a fully automated Cobas e411 (German, Japan Cobas 4000 analyzer series) immunoassay analyzer. Iron deficiency(ID) and iron deficiency anemia (IDA) were classified as having SF less than 15 μg/L and SF less than 15 μg/L and Hb level of < 11.0 g/dl during the first or third trimester or < 10.5 g/dl during the second trimester as well, respectively. Birthweight was measured within 72 h of birth and < 2500 g was considered LBW. Birthweight was measured within 72 h of birth and < 2500 g was considered as LBW. A Poisson regression model with robust variance estimation was used to investigate the factors associated with LBW and the association between maternal iron status and LBW. An adjusted prevalence ratio with a 95% confidence interval was reported to show an association using a p-value < 0.05. Results About 20.2% (95% CI: 16%-24%) of neonates were born with LBW. The prevalence of LBW was 5.04 (95% CI = 2.78–9.14) times higher among women who were iron deficient during pregnancy compared to those who were normal. The neonates of women who were iron deficient during pregnancy had lower birth weight (aPR=5.04; 95% CI = 2.78–9.14) than the neonates of women who were normal. Prevalence of LBW was higher among mothers who were undernourished (MUAC < 23cm) (aPR = 1.92; 95% CI= 1.33–2.27), stunted (height <145cm) (aPR=1.54; 95% CI=1.04–2.27) and among female neonates (aPR=3.70; 95% CI= 2.28–6.00). However, women who were supplemented with iron and folic acid (IFAS) during pregnancy had a 45% decreased chance of delivering low birth weight (aPR= 0.55; 95% CI=0.36–0.84). Conclusion We found that LBW is of public health significance in this predominantly rural setting. ID during pregnancy is found to have a negative effect on birth weight. IFA supplementation, the maternal under-nutrition, height, and sex of neonates were identified as predictors of low weight at birth. To improve maternal nutritional status, health interventions must address targeted strategies promoting desirable food behavior and nutritional practices. These include; promoting the consumption of diversified and rich iron food to improve the maternal nutritional status. A continued effort is needed in enhancing universal access and compliance with IFA supplementation to improve maternal health. Intervention strategies that are complementary and comprehensive across the vulnerable periods for women during pregnancy and their neonates that are based on a life-cycle approach are suggested.
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Household food insecurity and physically demanding work during pregnancy are risk factors for low birth weight in north Shewa zone public hospitals, Central Ethiopia, 2021: a multicenter cross-sectional study. BMC Pediatr 2022; 22:419. [PMID: 35836138 PMCID: PMC9281010 DOI: 10.1186/s12887-022-03480-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 07/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite numerous efforts to improve the quality of maternal and child health medical services, over 20 million babies are born with low birth weights each year globally. However, factors related to low birth weight like physically demanding work during pregnancy, intimate partner violence, and food insecurity have not been explored well in Ethiopia. Thus, this study aimed to assess the prevalence of low birth weight and associated factors among neonates born in public Hospitals in North Shewa Zone, Central Ethiopia. METHODS A hospital-based cross-sectional study design was conducted from June 15 -to July 15, 2021, in North Shewa public hospitals. A total of 441 mothers and newborn pairs were selected by systematic random sampling. Data were collected using a pretested and structured interviewer-administered questionnaire with chart reviewing. Data entry and analysis were done using Epi Data version 3.1 and Statistical Package for the Social Sciences version 26 respectively. Binary logistic regression was done to identify factors associated with low birth weight. Adjusted odds ratio with its 95% confidence interval and a p-value less than 0.05 was considered to declare the statistically significant association. RESULTS The prevalence of low-birth-weight was 17.7% (95% CI: 14.3, 21.5). Pregnancy-related complication [AOR = 2.16; 95% CI:(1.12,4.18)], grand-multiparty [AOR = 2.57; 95% CI:(1.12,5.88)], physically demanding work during pregnancy [AOR = 2.19; 95% CI:(1.11,4.33)], midd-upper arm circumference less than 23 cm [AOR = 2.54; 95% CI:(1.26,5.10)], partner violence during pregnancy [AOR = 3.77; 95% CI:(1.81,7.88)], and being member of household with food insecure [AOR = 2.31; 95% CI:(1.12,4.75)] were factors significantly associated with low birth weight. CONCLUSIONS This study showed that the magnitude of low birth weight was relatively high. Women with pregnancy-related complications, grand multiparty, physically demanding work during pregnancy, intimate partner violence, mid-upper arm circumference less than 23 cm, and food insecurity should be prioritized for mitigating LBW. Health care professionals should focus on Screening pregnant women for intimate partner violence, physically demanding activities, undernutrition and providing appropriate treatment during all maternal continuum of care might be helpful.
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Vuong TN, Van Dang C, Toze S, Jagals P, Gatton M, Gallegos D. Household Food Insecurity in Regions of the Vietnamese Mekong Delta: Prevalence and Risk Factors. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2022.2090883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Thuy Ngoc Vuong
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Kelvin Grove, Queensland, Australia
- Department of Epidemiology, the Institute of Hygiene and Public Health, Ho Chi Minh City, Vietnam
| | - Chinh Van Dang
- Department of Epidemiology, the Institute of Hygiene and Public Health, Ho Chi Minh City, Vietnam
| | - Simon Toze
- Urban Water Futures, The Gap, Brisbane, QLD, Australia
| | - Paul Jagals
- Children’s Health and Environment Program, Child Health Research Centre, The University of Queensland Centre for Children’s Health Research, South Brisbane, QLD, Australia
| | - Michelle Gatton
- School of Public Health and Social Work, Queensland University of Technology (QUT), Kelvin Grove, Queensland, Australia
| | - Danielle Gallegos
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Kelvin Grove, Queensland, Australia
- Woolworths Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology (QUT), South Brisbane, Queensland, Australia
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Minas S, Ayele BH, Sisay M, Fage SG. Undernutrition among khat-chewer and non-chewer lactating women in Chiro district, eastern Ethiopia: Comparative cross-sectional study. SAGE Open Med 2022; 10:20503121221100143. [PMID: 35646352 PMCID: PMC9136449 DOI: 10.1177/20503121221100143] [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: 02/22/2021] [Accepted: 04/22/2022] [Indexed: 11/28/2022] Open
Abstract
Objectives: This study aims to assess the prevalence of undernutrition and factors
associated with it among khat-chewer and non-chewer lactating women at Chiro
district, west Hararghe zone, eastern Ethiopia. Methods: A community-based comparative cross-sectional study was conducted among 446
(223 khat chewers and 223 non-chewers) randomly selected lactating women who
have children aged 6 and 23 months. Data were collected through face-to-face
interviews using structured questionnaires followed by weight and height
measurements to calculate and categorize nutritional status based on body
mass index (kg/m2). Data were entered into EpiData version 3.1
and analyzed using STATA version 14.2. A binary logistic regression model
was fitted to check the association between independent variables and
undernutrition. The level of statistical significance was declared at a
p-value less than 0.05. Results: The overall prevalence of undernutrition among lactating women was 30.7% (95%
confidence interval = 26.6, 35.2). Undernutrition was significantly higher
among khat chewers, 39.0% (95% confidence interval = 32.8, 45.6) than
non-chewers, 22.4% (95% confidence interval = 17.4, 28.4), (χ2
(degree of freedom) = 14.4231, p < 0.0001). Chewing daily (adjusted odds
ratio = 3.14, 95% confidence interval = 1.08, 9.15), reducing number of
meals after chewing (adjusted odds ratio = 3.45, 95% confidence
interval = 1.29, 9.20), and unavailability of latrine (adjusted odds
ratio = 2.98, 95% confidence interval = 1.02, 8.75) were significantly
associated with undernutrition among khat-chewer lactating women.
Furthermore, age at first pregnancy (<18 years) (adjusted odds
ratio = 3.17, 95% confidence interval = 1.17, 8.60), not taking any
additional meals (adjusted odds ratio = 3.41, 95% confidence
interval = 1.08, 10.7), and hand washing after toilet use (adjusted odds
ratio = 6.10, 95% confidence interval = 2.51, 14.8) were significantly
associated with undernutrition among non-chewer lactating women. Conclusion: The overall prevalence of undernutrition is higher than previous studies and
is alarming among khat-chewer lactating mothers. Thus, nutritional and
public health interventions should target khat-chewer lactating mothers
particularly focusing on daily chewer either to improve their dietary
practice during and after chewing or to stop khat chewing if possible, in
order to reduce the effect of khat on food absorption. Besides, improving
latrine coverage and use, and prevention of early pregnancy are of paramount
importance in reducing undernutrition among lactating mothers.
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Affiliation(s)
- Selamu Minas
- West Hararghe Zonal Health Department, Chiro, Ethiopia
| | - Behailu Hawulte Ayele
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mekonnen Sisay
- School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Sagni Girma Fage
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Sebeta A, Girma A, Kidane R, Tekalign E, Tamiru D. Nutritional Status of Postpartum Mothers and Associated Risk Factors in Shey-Bench District, Bench-Sheko Zone, Southwest Ethiopia: A Community Based Cross-Sectional Study. Nutr Metab Insights 2022; 15:11786388221088243. [PMID: 35493421 PMCID: PMC9044780 DOI: 10.1177/11786388221088243] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 02/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Malnutrition affects millions of people in developing countries and contributes to poor health outcomes and nutritional status among women in the postpartum period. Lactation increases high nutritional demands and marks a significant life transition that can impact diet quality and subsequently predispose woman to high risk of overweight and undernutrition. Although, studies have been conducted on the nutritional status of lactating women, there is a gap especially on women’s nutritional status during the postpartum period. Therefore, this study aimed to assess the nutritional status of postpartum women and associated factors in Shey-Bench District, Bench-Sheko Zone, Southwest Ethiopia, 2020. Method: A community-based cross-sectional study was conducted in Shey-Bench District from March 1 to 30/2020 among 359 postpartum mothers. Bivariate analysis was employed to select candidate variables at P-value <.25 as a cut-off point. Multiple multinomial logistic regression analysis was used to identify variables significantly associated with nutritional status of the mother at P < .05 with 95% CI. Results: The study revealed that 10.3% of women were underweight and 16.7% were overweight. Employed mothers (AOR = 4.467, 95% CI [1.05-19.04]), employed husband (AOR = 0.087, 95% CI [0.021-0.370]), farmer husband (AOR = 0.084, 95% CI [0.024-0.293]), trader husband (AOR = 0.19, 95% CI [0.0614-0.616]), married mother (AOR = 0.222, 95% CI [0.088-0.560]), dietary diversity (AOR = 0.181, 95% CI [0.075-0.436]) were significantly associated with underweight and while being overweight was associated with dietary diversity, maternal age of between 15 to 24 and 25 to 34, exclusive breastfeeding, and frequency of breastfeeding. Conclusion: This study found a lower prevalence of underweight compared with overweight in the study area. Occupational status, marital status, age of the mother, dietary diversity, exclusive and frequency of breastfeeding were significantly associated factors with nutritional status of postpartum mother. We recommend strengthening the provision of nutrition education on modifiable factors with collaboration of other sectors.
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Affiliation(s)
- Asresash Sebeta
- Department of Emergency Medicinal Technique, Mizan-Aman Health Science College, Mizan-Aman College, Ethiopia
| | - Abel Girma
- School of Public Health, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Rediet Kidane
- Institute of Health, Faculty of Public Health, Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia
| | - Eyob Tekalign
- Department of Biomedical, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Dessalegn Tamiru
- Institute of Health, Faculty of Public Health, Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia
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Militao EMA, Salvador EM, Uthman OA, Vinberg S, Macassa G. Food Insecurity and Health Outcomes Other than Malnutrition in Southern Africa: A Descriptive Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5082. [PMID: 35564477 PMCID: PMC9100282 DOI: 10.3390/ijerph19095082] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/14/2022] [Accepted: 04/19/2022] [Indexed: 12/15/2022]
Abstract
Food insecurity (FI) is one of the major causes of malnutrition and is associated with a range of negative health outcomes in low and middle-income countries. The burden of FI in southern Africa is unknown, although FI continues to be a major public health problem across sub-Saharan Africa as a whole. Therefore, this review sought to identify empirical studies that related FI to health outcomes among adults in southern Africa. Altogether, 14 publications using diverse measures of FI were reviewed. The majority of the studies measured FI using modified versions of the United States Department of Agriculture Household Food Security Survey Module. A wide range in prevalence and severity of FI was reported (18-91%), depending on the measurement tool and population under investigation. Furthermore, FI was mostly associated with hypertension, diabetes, anxiety, depression and increased risk of human immunodeficiency virus (HIV) acquisition. Based on the findings, future research is needed, especially in countries with as yet no empirical studies on the subject, to identify and standardize measures of FI suitable for the southern African context and to inform public health policies and appropriate interventions aiming to alleviate FI and potentially improve health outcomes in the region.
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Affiliation(s)
- Elias M A Militao
- Department of Health Sciences, Faculty of Humanities, Mid Sweden University, Holmgatan 10, 851 70 Sundsvall, Sweden
- Department of Public Health and Sports Science, Faculty of Occupational and Health Sciences, University of Gävle, Kungsbacksvägen 47, 801 76 Gävle, Sweden
- Department of Biological Sciences, Faculty of Science, Eduardo Mondlane University, 3453 Julius Nyerere Avenue, Maputo 257, Mozambique
| | - Elsa M Salvador
- Department of Biological Sciences, Faculty of Science, Eduardo Mondlane University, 3453 Julius Nyerere Avenue, Maputo 257, Mozambique
| | - Olalekan A Uthman
- Warwick Centre for Global Health, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
| | - Stig Vinberg
- Department of Health Sciences, Faculty of Humanities, Mid Sweden University, Holmgatan 10, 851 70 Sundsvall, Sweden
| | - Gloria Macassa
- Department of Health Sciences, Faculty of Humanities, Mid Sweden University, Holmgatan 10, 851 70 Sundsvall, Sweden
- Department of Public Health and Sports Science, Faculty of Occupational and Health Sciences, University of Gävle, Kungsbacksvägen 47, 801 76 Gävle, Sweden
- EPI Unit, Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal
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Thailand Prevalence and Profile of Food Insecurity in Households with under Five Years Children: Analysis of 2019 Multi-Cluster Indicator Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095065. [PMID: 35564461 PMCID: PMC9105057 DOI: 10.3390/ijerph19095065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/08/2022] [Accepted: 04/20/2022] [Indexed: 11/16/2022]
Abstract
This study aimed to estimate the prevalence and profile of food insecurity in households with children under 5 years old using the Food Insecurity Experience Scale (FIES) in Thailand. We integrated FIES into the 2019 Multiple Indicator Cluster Surveys (MICS). A total of 861 households were successfully interviewed with FIES. The Rasch model was applied to examine the validity and reliability. Multiple logistic regression was used to assess the association between socio-economic status and prevalence of food insecurity, adjusting for geographical regions and characteristics of households. We found that FIES measurement is valid as Infit falls within the normal range of 0.7−1.3 and is reliable (Rasch reliability value of 0.81). The overall prevalence of moderate or severe food insecurity was 2.79%. The wealthiest households were less likely to suffer from food insecurity than the poorest households (adjusted OR: 0.07; 95% CI: 0.02−0.34; p-value < 0.05). Households with children under 5 years old living in rural areas had lower food insecurity severity scores. We recommend social protection policies such as food and nutrition subsidies or conditional cash transfer to poor households with children under the age of 5.
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Seid A, Cherie HA. Dietary diversity, nutritional status and associated factors among lactating mothers visiting government health facilities at Dessie town, Amhara region, Ethiopia. PLoS One 2022; 17:e0263957. [PMID: 35176095 PMCID: PMC8853554 DOI: 10.1371/journal.pone.0263957] [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: 10/07/2020] [Accepted: 02/01/2022] [Indexed: 11/25/2022] Open
Abstract
Background Maternal undernutrition is one of the most common causes of maternal morbidity and mortality in developing countries. Severe undernutrition among mothers leads to reduced lactation performance which further contributes to an increased risk of infant mortality. However, data regarding nutritional status of lactating mothers at Dessie town and its surrounding areas is lacking. This study assessed dietary diversity, nutritional status and associated factors of lactating mothers visiting health facilities at Dessie town, Amhara region, Ethiopia. Methods Institutional based cross-sectional study was conducted from March to April, 2017 among 408 lactating mothers. Systematic random sampling technique was employed to select the study participants. Data on socio-demographic and economic characteristics, health related characteristics, dietary diversity and food security status of participants were collected using interviewer administered questionnaire. Data were entered into EPI-INFO and analyzed using SPSS Version 22. Bivariate and multivariate analyses were performed to identify factors associated with dietary diversity and nutritional status of lactating mothers. Results More than half (55.6%) of lactating mothers had inadequate dietary diversity (DDS<5.3) and about 21% were undernourished (BMI<18.5 kg/m2). Household monthly income [AOR = 2.0, 95% CI (1.15, 3.65)], type of house [AOR = 1.8, 95% CI (1.15, 2.94)], nutrition information [AOR = 1.6, 95% CI (1.05, 2.61)] and household food insecurity [AOR = 1.8, 95% CI (1.05, 3.06)] were factors associated with dietary diversity of lactating mothers. Being young in age 15–19 years [AOR = 10.3, 95% CI (2.89, 36.39)] & 20–29 years [AOR = 3.4, 95% CI (1.57, 7.36)], being divorced/separated [AOR = 10.1, 95% CI (1.42, 72.06)], inadequate dietary diversity [AOR = 3.8, 95% CI (2.08, 7.03)] and household food insecurity [AOR = 3.1, 95% CI (1.81, 5.32)] were factors associated with maternal undernutrition. Conclusion The dietary diversity of lactating mothers in the study area was sub optimal and the prevalence of undernutrition was relatively high. Public health nutrition interventions such as improving accessibility of affordable and diversified nutrient rich foods are important to improve the nutritional status of mothers and their children in the study area.
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Affiliation(s)
- Awel Seid
- Department of Applied Human Nutrition, Bahir Dar Institute of Technology, Bahir Dar University, Bahir Dar, Ethiopia
| | - Hirut Assaye Cherie
- Department of Applied Human Nutrition, Bahir Dar Institute of Technology, Bahir Dar University, Bahir Dar, Ethiopia
- * E-mail:
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Fite MB, Tura AK, Yadeta TA, Oljira L, Roba KT. Prevalence and determinants of dietary practices among pregnant women in eastern Ethiopia. BMC Nutr 2022; 8:3. [PMID: 35012664 PMCID: PMC8751267 DOI: 10.1186/s40795-021-00494-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 12/22/2021] [Indexed: 11/10/2022] Open
Abstract
Introduction Appropriate dietary practices in pregnancy are critical to meet the increased metabolic and physiological demands; however, information about dietary practices among pregnant women, particularly rural residents, is limited. The study aimed to assess the level of appropriate dietary practices and associated determinants among pregnant women in Haramaya District, eastern Ethiopia, 2021. Methods A community-based cross-sectional study was conducted among 448 pregnant women in Haramaya District, Eastern Ethiopia. Data was collected through face-to-face interviews by trained research assistants, using a validated frequency questionnaire. The pregnant women were labeled as “appropriate dietary practice” when they consumed at least four meals daily, had a good food variety score, high dietary diversity score, and high consumption of animal source foods during the reference period. Otherwise, they were defined as “inappropriate.” A Poisson regression model with robust variance estimation was used to investigate the association of the independent variables with the dietary practice. An adjusted prevalence ratio with a 95% confidence interval was reported to show an association using a p-value < 0.05. Results The appropriate dietary practice among the study participants was 15.2% (95% CI = 12–18%). Of the respondents, 29.46, 37.5, and 24.7% had a high dietary diversity, high food variety score, and high consumption of animal source foods. The appropriate dietary practice was more prevalent among merchant women (APR = 2.07; 95% CI 1.07–4.02) and those whose husbands have at least a high school educational level (APR = 1.96; 95% CI 1.06–3.46). However, the prevalence of appropriate dietary practice was significantly lower among those who chewed khat (APR = 0.58; 95% CI 0.37–0.90) and among respondents who reported restriction of the intake of some foods (APR = 0.36; 95% CI 0.20–0.65). Conclusion We found sup-optimal appropriate dietary practice among pregnant women in this predominantly rural setting. Additionally, the lower appropriate dietary practice was observed among women who reported chewing khat and experienced restriction of dietary consumption during pregnancy. Therefore, nutrition policy programs and interventions aimed at encouraging maternal nutritional guidance and counseling are recommended. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-021-00494-4.
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Affiliation(s)
- Meseret Belete Fite
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
| | - Abera Kenay Tura
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.,Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemessa Oljira
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Roba
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Sidote MN, Goodman ZT, Paraggio CL, Tutu RA, Stoler J. Measurement invariance of a household water insecurity metric in Greater Accra, Ghana: Implications for test-retest reliability. Int J Hyg Environ Health 2022; 240:113922. [PMID: 35026673 DOI: 10.1016/j.ijheh.2022.113922] [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: 11/02/2021] [Revised: 12/27/2021] [Accepted: 01/06/2022] [Indexed: 10/19/2022]
Abstract
The mitigation of household water insecurity is recognized as an important component of global poverty alleviation, but until recently was difficult to measure. Several new metrics of household water insecurity have been proposed and validated, but few have been field-tested for reliability in diverse contexts. We used confirmatory factor analysis to test the psychometric equivalence of one such metric-the Household Water Insecurity Experiences (HWISE) scale-across two survey waves administered 18 months apart in similar climatic conditions among households in a peri-urban community outside of Accra, Ghana. The HWISE metric was not equivalent across survey waves, which may be attributable to the metric itself, sample size, subtle instrumentation changes, or other unobserved factors. Test-retest reliability may also be difficult to achieve given the dynamic nature of household water use, and we discuss the implications of using household water insecurity metrics as longitudinal measures of well-being in global anti-poverty programs.
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Affiliation(s)
- Melissa N Sidote
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Zachary T Goodman
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Christina L Paraggio
- Department of Microbiology and Immunology, University of Miami, Coral Gables, FL, USA
| | - Raymond A Tutu
- Department of Sociology and Criminal Justice, Delaware State University, Dover, DE, USA
| | - Justin Stoler
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA; Department of Geography and Sustainable Development, University of Miami, Coral Gables, FL, USA.
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Girma Tilahun A, Molla Kebede A, Ejigu AG. Dietary Practice and Associated Factors Among Pregnant Women at Public Health Institution in Mizan-Aman Town, Southwest Ethiopia. Nutr Metab Insights 2021; 14:11786388211057796. [PMID: 34819735 PMCID: PMC8606983 DOI: 10.1177/11786388211057796] [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: 06/11/2021] [Accepted: 10/17/2021] [Indexed: 11/21/2022] Open
Abstract
Background: A poor dietary intake of key macronutrients and micronutrients adversely affects pregnancy outcomes and neonatal health. The occurrence of dietary inadequacy during pregnancy is higher compared to any other stage of the life cycle. Therefore, this study aimed to assess dietary practice and associated factors among pregnant women. Methods: A facility-based cross-sectional study design was conducted among 378 pregnant women from March to May 2021 at the public health institution of Mizan-Aman town, southwest Ethiopia. A systematic random sampling technique was used to reach the study participants. The short food-frequency questionnaires and nutrition-behaviors checklist measurement were used to assess the dietary practice. Nine questions were applied to assess the dietary attitudes of the respondents. After the summation of the score, the respondent was categorized as favorable attitude if their score was > the median and unfavorable attitude if their score was ⩽ to the median of the score. The data were entered into Epi Data 3.1 and exported to Statistical Package for Social Science (SPSS) version 21 software for analysis. Variables of P-value <.25 during bivariate logistic regression analysis were considered for multivariate analysis. Finally variables with an adjusted odds ratio of P-value <.05 along with a 95% Confidence interval (CI) were declared statistically significant. Results: The overall magnitude of good dietary practice among pregnant women was 25.1% (95% CI: 20.9, 29.71%). In multivariate logistic regression analysis, the variables having television/radio (AOR = 4.2, 95% CI: 1.8, 10.2), household food security (AOR = 3.1, 95% CI: 1.0, 9.9), good dietary knowledge(AOR = 4.1, 95% CI: 1.98, 8.6), favorable dietary attitude (AOR = 4.34, 95% CI: 1.2, 8.7), monthly income of 1000 to 2000 Ethiopian birr (AOR = 3.7, 95% CI: 1.3,11.2) and >2000 Ethiopian birr (AOR = 7.0;95% CI: 3.3,15.4) were significantly associated with good dietary practice. Conclusion: The dietary practice among pregnant women was very low. The factors like having television/radio, good dietary knowledge, household food security, favorable dietary attitude, and monthly income of 1000 to 200 and greater than 2000 Ethiopian birr were significantly associated with the good dietary practice of pregnant women.
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Affiliation(s)
- Abel Girma Tilahun
- Schooll of Public Health, College of Medicine and Health Science, Mizan Tepi University, Mizan-Aman, Ethiopia
| | - Abebaw Molla Kebede
- Schooll of Public Health, College of Medicine and Health Science, Mizan Tepi University, Mizan-Aman, Ethiopia
| | - Amare Genetu Ejigu
- Department of Midwifery, College of Medicine and Health science, Mizan Tepi University, Mizan-Aman, Ethiopia
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Ali S, Talha N. During COVID-19, impact of subjective and objective financial knowledge and economic insecurity on financial management behavior: Mediating role of financial wellbeing. JOURNAL OF PUBLIC AFFAIRS 2021; 22:e2789. [PMID: 34899065 PMCID: PMC8646638 DOI: 10.1002/pa.2789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/05/2021] [Accepted: 10/24/2021] [Indexed: 06/14/2023]
Abstract
The purpose of this research is to look into financial management behavior during the COVID-19. Without a doubt, financial knowledge is an important, but in the COVID-19, the majority of people are experiencing economic insecurity, which is regarded as unique contribution when testing financial management behavior. Furthermore, Pakistan is an Islamic country, so, financial knowledge, is further subdivided into objective, subjective, and Islamic financial knowledge, with financial wellbeing serving as mediating variable. Pakistan has a diverse population of respondents, this model was tested on university students in Pakistan between the ages of 20 and 40, with the majority of respondents experiencing job and food insecurity as a result of COVID-19. The research employs a two-stage method, PLS-SEM, for reliability checking via composite reliability and average variance extract, and discriminant validity checking via HTMT ratio. According to the findings, Islamic financial knowledge as positive, and other financial knowledge as negative, and economic insecurity (food and job insecurity) also has negative and significant impact on students' financial management behavior. Financial well-being significantly acts as a bridge between independents and dependent variables. The findings imply that financial knowledge has a significant impact on financial management behavior. Policymakers and administrators should improve information disclosure while promoting financial education in order to foster trust and responsible financial conduct among people.
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Affiliation(s)
- Shahzad Ali
- Faculty of Management SciencesThe Superior UniversityLahorePakistan
- Universiti Utara Malaysia
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Belayneh M, Loha E, Lindtjørn B. Spatial Variation of Child Stunting and Maternal Malnutrition after Controlling for Known Risk Factors in a Drought-Prone Rural Community in Southern Ethiopia. Ann Glob Health 2021; 87:85. [PMID: 34458109 PMCID: PMC8378086 DOI: 10.5334/aogh.3286] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background Globally, understanding spatial analysis of malnutrition is increasingly recognized. However, our knowledge on spatial clustering of malnutrition after controlling for known risk factors of malnutrition such as wealth status, food insecurity, altitude and maternal characteristics is limited from Ethiopia. Previous studies from southern Ethiopia have shown seasonal patterns of malnutrition, yet they did not evaluate spatial clustering of malnutrition. Objective The aim of this study was to assess whether child stunting and maternal malnutrition were spatially clustered in drought-prone areas after controlling for previously known risk factors of malnutrition. Methods We used a community-based cohort study design for a one-year study period. We used SaTScan software to identify high rates of child stunting and maternal malnutrition clustering. The outcome based was the presence or absence of stunting and maternal malnutrition ([BMI] <18.5 kg/m2). We controlled for previously known predictors of child stunting and maternal malnutrition to evaluate the presence of clustering. We did a logistic regression model with declaring data to be time-series using Stata version 15 for further evaluation of the predictors of spatial clustering. Results The crude analysis of SaTScan showed that there were areas (clusters) with a higher risk of stunting and maternal malnutrition than in the underlying at risk populations. Stunted children within an identified spatial cluster were more likely to be from poor households, had younger and illiterate mothers, and often the mothers were farmers and housewives. Children identified within the most likely clusters were 1.6 times more at risk of stunting in the unadjusted analysis. Similarly, mothers within the clusters were 2.4 times more at risk of malnutrition in the unadjusted analysis. However, after adjusting for known risk factors such as wealth status, household food insecurity, altitude, maternal age, maternal education, and maternal occupation with SaTScan analysis, we show that child stunting and maternal malnutrition were not spatially clustered. Conclusion The observed spatial clustering of child stunting and maternal malnutrition before controlling for known risk factors for child stunting and maternal malnutrition could be due to non-random distribution of risk factors such as poverty and maternal characteristics. Moreover, our results indicated the need for geographically targeted nutritional interventions in a drought-prone area.
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Affiliation(s)
- Mehretu Belayneh
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
- Centre for International Health, University of Bergen, Bergen, Norway
| | - Eskindir Loha
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
- Centre for International Health, University of Bergen, Bergen, Norway
- Chr. Michelsen Institute, Bergen, Norway
| | - Bernt Lindtjørn
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
- Centre for International Health, University of Bergen, Bergen, Norway
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Hashmi S, Safdar NF, Zaheer S, Shafique K. Association between Dietary Diversity and Food Insecurity in Urban Households: A Cross-Sectional Survey of Various Ethnic Populations of Karachi, Pakistan. Risk Manag Healthc Policy 2021; 14:3025-3035. [PMID: 34305415 PMCID: PMC8294809 DOI: 10.2147/rmhp.s284513] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 04/26/2021] [Indexed: 11/30/2022] Open
Abstract
Background and Purpose The world is experiencing a nutritional transition, yet some regions of South East Asia are still living under the shadows of catastrophic nutritional indicators. Pakistan bears a high dual burden of both communicable and chronic diseases. However, a major contributing factor of both is poor diet and nutrition. The causal pathway of stunting, underweight, wasting, and micronutrient deficiencies has beginnings in less dietary diversity and food insecurity. Current literature on Pakistan and other South Asian countries regarding food insecurity and dietary diversity largely focus on women and children aged less than 5 years; however, ethnic and cultural dynamics of the populace concerning their food and dietary practices in Pakistan have not been well explored. It is essential to have a clear insight into the factors involving malnutrition in different clusters, especially different cultures and ethnicities to target specific areas of interventional strategies versus a uniform approach for all. This study aimed to explore the level of food insecurity and dietary diversity in all major ethnic groups of Karachi, the largest city of Pakistan. Methods Using the multistage random sampling, 535 households from five major ethnic groups residing in Karachi were included in the study. To measure food insecurity and dietary diversity (primary and secondary outcome, respectively), we used a FAO standardized questionnaire (version 3, 2007) that was translated first into local languages, piloted, and employed to collect information. Results Severe food insecurity levels had an inverse relationship with the household dietary diversity, which persisted even after adjusting for other variables (β=−0.31, 95% CI=−0.65, −0.07). There was no statistically significant association of age, marital status, or education level on food diversity. The most food secure cultural people were those whose ancestors had migrated from India and were Urdu speaking communities, while Sindhi speakers were the least food secure community. Conclusion It is imperative to investigate more on the cultural causal factors leading to food insecurity to address the root causes of malnutrition and design new cultural-specific interventions that should be employed in large urban centers where different communities reside together.
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Affiliation(s)
- Shahkamal Hashmi
- School of Public Health, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Sidra Zaheer
- School of Public Health, Dow University of Health Sciences, Karachi, Pakistan
| | - Kashif Shafique
- School of Public Health, Dow University of Health Sciences, Karachi, Pakistan
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Orsango AZ, Habtu W, Lejisa T, Loha E, Lindtjørn B, Engebretsen IMS. Iron deficiency anemia among children aged 2-5 years in southern Ethiopia: a community-based cross-sectional study. PeerJ 2021; 9:e11649. [PMID: 34249504 PMCID: PMC8247708 DOI: 10.7717/peerj.11649] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 05/29/2021] [Indexed: 11/20/2022] Open
Abstract
Background Iron-deficiency anemia (IDA) is a common type of nutritional anemia in low-income countries, including Ethiopia. However, there is limited data on iron deficiency anemia prevalence and associated factors in Ethiopia, particularly for children aged 2 to 5 years. Objectives To establish the prevalence of iron deficiency anemia and associated risk factors, focusing on iron-rich food consumption among children aged 2 to 5 years in southern Ethiopia. Methods A community-based cross-sectional study was conducted in southern Ethiopia in 2017, involving 331 randomly selected children aged 2 to 5 years old. A structured questionnaire was used to collect information about the children and the households. Venous blood was collected from each child in a test tube to measure hemoglobin, ferritin, and C-reactive protein (CRP). Hemoglobin levels were determined using Hemocue®301 and adjusted for altitude. Anemia was defined as hemoglobin levels <11 g/dl. Ferritin was adjusted for inflammation based on CRP concentration and low ferritin concentration defined as adjusted ferritin concentration <12 µg/L. IDA was considered when a child had both hemoglobin level <11g/dl and low ferritin concentration. Bi-variable and multivariable logistic regression models were performed to identify factors associated with IDA and iron-rich food consumption. Results The prevalence of iron deficiency anemia was 25%, and the total anemia prevalence was 32%. Only 15% of children consumed iron-rich foods in the preceding 24 h, and 30% of children consumed iron-rich foods at least once in the preceding week. IDA decreased as the height for age z-score increased (Adjusted Odds Ratio 0.7; 95% CI [0.5–0.9]). Mothers with increased educational level (AOR 1.1; 1.0–1.2) and households with increased dietary diversity (AOR 1.4; 1.2–1.6) consumed more iron-rich foods. Conclusions Iron deficiency anaemia was a moderate public health problem in southern Ethiopia, and the iron-rich food consumption was low. Interventions should focus on food supplementation and fortification, food diversification and nutritional education, and promoting women’s education.
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Affiliation(s)
- Alemselam Zebdewos Orsango
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.,Centre for International Health, University of Bergen, Bergen, Norway
| | - Wossene Habtu
- Ethiopian Public Health Institute, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tadesse Lejisa
- Ethiopian Public Health Institute, Addis Ababa University, Addis Ababa, Ethiopia
| | - Eskindir Loha
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.,Centre for International Health, University of Bergen, Bergen, Norway.,Chr. Michelsen Institute, Bergen, Norway
| | - Bernt Lindtjørn
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.,Centre for International Health, University of Bergen, Bergen, Norway
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Hidru HD, Gebremedhine H, Gebretsadik A, Teame H, Negash H, Mengesha MB. Prevalence of Food Insecurity and Its Associated Factors among Adult People with Human Immunodeficiency Virus in Ethiopia: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF FOOD SCIENCE 2021; 2021:7816872. [PMID: 34159189 PMCID: PMC8187070 DOI: 10.1155/2021/7816872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/27/2021] [Accepted: 05/13/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Food insecurity is the shortage of both the quantity and quality of food and a negative impact on the overall nutritional and health status of people with human immunodeficiency virus (HIV). Ethiopia is intensely affected by food insecurity which is about 87.4% of adult people living with human immuno deficiency virus (HIV) are still facing shortage to have access to safe, sufficient, and nutritious food for themselves and their family. However, there is no concrete scientific evidence established at the national level in Ethiopia. Hence, this review gave special emphasis on adult people with human immunodeficiency virus (HIV) to estimate the pooled prevalence of food insecurity and its associated factor at the national level in Ethiopia. METHODS Studies were retrieved from selected electronic data bases, including PubMed/Medlin, Cochrane library, Sciences Direct, Google, and Google Scholar. Random-effects model meta-analysis was used to estimate the pooled prevalence of food insecurity and its associated factors at 95% confidence interval with odds ratio (OR) using statistical R-software version 3.6.1. Moreover, quality appraisal of the included studies, publication bias was checked using the funnel symmetry test, and heterogeneity was checked using forest plot and inverse variance square (I 2). The searches were restricted to articles published in the English language only, and Medical Subject Headings (MeSH terms) was used to help expand the search in advanced PubMed search. RESULT A total of 650 articles were identified through the initial search of which 20 studies were included in the final review yielding a total sample size of 7,797 adult people with human immunodeficiency virus (HIV). The pooled prevalence of food insecurity was 52% (95% CI, 40%, 63%). Cluster of differentiation 4 (CD4) count < 350 cell/mm3 [AOR = 1.29 (95% CI, 1.08, 1.54)], develop opportunistic infection [AOR = 4.09 (95% CI, 2.47, 6.78)], rural residence [AOR = 1.59 (95% CI, 1.09, 2.34)], and World Health Organization (WHO) clinical stages III and IV [AOR = 1.98 (95% CI, 1.23, 3.19)] was among the significantly associated factors. CONCLUSION In this review, there was a high prevalence of food insecurity among adult people with human immunodeficiency virus. Therefore, the responsible stockholders should strengthen the system and procedure for early diagnosis of opportunistic infection, under nutrition, screening of underlying problems.
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Affiliation(s)
- Hagos Degefa Hidru
- College of Medicine and Health Sciences, Department of Public Health, Adigrat University, Adigrat, Ethiopia
| | - Haftay Gebremedhine
- College of Medicine and Health Sciences, Department of Public Health, Adigrat University, Adigrat, Ethiopia
| | - Alem Gebretsadik
- College of Medicine and Health Sciences, Department of Public Health, Adigrat University, Adigrat, Ethiopia
| | - Hirut Teame
- College of Medicine and Health Sciences, Department of Public Health, Adigrat University, Adigrat, Ethiopia
| | - Hadush Negash
- College of Medicine and Health Sciences, Department of Laboratory Unit of Medical Microbiology, Adigrat University, Adigrat, Ethiopia
| | - Meresa Berwo Mengesha
- College of Medicine and Health Sciences, Department of Midwifery, Adigrat University, Adigrat, Ethiopia
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Nsimbo KBA, Erumeda N, Pretorius D. Food insecurity and its impact on glycaemic control in diabetic patients attending Jabulani Dumani community health centre, Gauteng province, South Africa. Afr J Prim Health Care Fam Med 2021; 13:e1-e6. [PMID: 34082551 PMCID: PMC8182565 DOI: 10.4102/phcfm.v13i1.2906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/08/2021] [Accepted: 04/17/2021] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND To the best of our knowledge no studies have been conducted to assess the relationship between food insecurity and poor glycaemic control in diabetic patients in peri-urban settings of the South African context. AIM The study aimed to assess food insecurity and its relationships with glycaemic control and other patient characteristics amongst diabetic patients attending Jabulani Dumani Community Health Centre. SETTING The study was conducted in a primary healthcare facility in the south sub-district of Ekurhuleni health district, the Gauteng province, South Africa. METHODS This was a cross-sectional descriptive study involving 250 patients. Data were collected by using an interview-administered Household Food Insecurity Access Scale questionnaire. Descriptive and inferential statistical analyses by using Stata 14.0 statistical software were performed. Chi square and logistic regression tests assessed the association between socio-demographic characteristics, glycaemic control and food insecurity. RESULTS Amongst 250 recruited participants, 82.4% were above 50 years, 64% women, 88.8% South African citizens and 42.4% had a household size of ≥ 5 people. Sixty-four percent and 69.9% were classified as having food insecurity and poor glycaemic control, respectively. On further analysis, food insecurity was associated with unemployment (adjusted odds ratio [AOR] = 2.94; 95% confidence interval [CI]: 1.51-5.75), being a South African citizen (AOR = 1.60; 95% CI: 0.66-3.86), household size of ≥ 5 people (AOR = 1.77; 95% CI: 0.98-3.19) and uncontrolled glycaemic level (AOR = 5.38; 95% CI: 2.91-9.96). CONCLUSION Food insecurity in diabetic patients constitutes a serious challenge for glycaemic control. It is critical for healthcare providers in primary care settings to ensure screening for early identification and management of food insecurity and take measures to prevent poor glycaemic control.
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Affiliation(s)
- Kayumba B A Nsimbo
- Division of Family Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg.
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Amare HH, Lindtjorn B. Concurrent anemia and stunting among schoolchildren in Wonago district in southern Ethiopia: a cross-sectional multilevel analysis. PeerJ 2021; 9:e11158. [PMID: 33996276 PMCID: PMC8106909 DOI: 10.7717/peerj.11158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/04/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Even if many schoolchildren in Ethiopia are anemic and stunted, few have studied the co-existence of anemia and stunting among schoolchildren in Ethiopia. In addition, multilevel analysis to explore the variation in prevalence of concurrent anemia and stunting (CAS) across schools and classes is rarely applied. Thus, we aimed to assess the prevalence and risk factors of CAS at the individual, household, and school level among schoolchildren in southern Ethiopia. METHODS We recruited 864 students aged 7-14 years from the Wonago district in southern Ethiopia using a three-stage random sampling, assigning four schools to level one, 24 classes to level two. We then randomly selected 36 children from each class, and recorded their weight, height, haemoglobin, intestinal helminthic infections, hygienic practices, dietary practices, household food insecurity, and socio-demographic information. A multivariate, multilevel logistic regression model was applied to detect potential risk factors for CAS. RESULTS The prevalence of CAS was 10.5% (85/810) among schoolchildren, which increased with age in years (adjusted odds ratio [aOR] 1.39 [95% confidence interval 1.13, 1.71, P = 0.002]) and among children who always did not wash their hands with soap after use of latrine (aOR 4.30 [1.21, 15.3, P = 0.02]). Children who walked barefoot (aOR 10.4 [2.77, 39.1, P = 0.001]), were infected with Trichuris trichiura (aOR 1.74 [1.05, 2.88, P = 0.03]), or had head lice infestation (aOR 1.71 [1.01, 2.92, P = 0.04]) had higher CAS prevalence. Prevalence rates of CAS were low in those using treated drinking water (aOR 0.32 [95% CI 0.11, 0.97, P = 0.04]). Most of the risk factors for CAS were identified at the individual level. The clustering effect measured by the intra-cluster correlation coefficient was 6.8% at school level and 19% at class. CONCLUSION CAS prevalence is a moderate public health problem among schoolchildren in southern Ethiopia and varies across classes and schools. After controlling for clustering effects at the school and class levels, we found an association between CAS and increasing age, not always washing hands with soap after using latrine, walking barefoot, and T. trichiura infection. Using treated water for drinking was found to have a protective effect against CAS. Thus, educating children on personal hygiene and provision of safe drinking water could reduce the CAS burden in schoolchildren in rural areas of southern Ethiopia.
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Affiliation(s)
- Hiwot Hailu Amare
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
- Centre for International Health, University of Bergen, Bergen, Norway
- Department of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Bernt Lindtjorn
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
- Centre for International Health, University of Bergen, Bergen, Norway
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Improving the measurement of food insecurity among people with HIV in South Africa: a psychometric examination. Public Health Nutr 2021; 24:3805-3817. [PMID: 33769239 DOI: 10.1017/s1368980021001312] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Food insecurity is a structural barrier to HIV care in peri-urban areas in South Africa (SA), where approximately 80 % of households are moderately or severely food insecure. For people with HIV (PWH), food insecurity is associated with poor antiretroviral therapy adherence and survival rates. Yet, measurement of food insecurity among PWH remains a challenge. DESIGN The current study examines the factor structure of the nine-item Household Food Insecurity Access Scale (HFIAS, isiXhosa-translated) among PWH in SA using a restrictive bifactor model. SETTING Primary care clinics in Khayelitsha, a peri-urban settlement in Cape Town, SA. PARTICIPANTS Participants (n 440) were PWH who received HIV care in Khayelitsha screening for a clinical trial. Most were categorised as severely (n 250, 56·82 %) or moderately (n 107, 24·32 %) food insecure in the past 30 d. RESULTS Revised parallel analysis suggested a three-factor structure, which was inadmissible. A two-factor structure was examined but did not adequately fit the data. A two-factor restrictive bifactor model was examined, such that all items loaded on a general factor (food insecurity) and all but two items loaded on one of two specific additional factors, which adequately fit the data (comparative fit index = 0·995, standardised root mean square residual = 0·019). The two specific factors identified were: anxiety/insufficient quality and no food intake. Reliability was adequate (ω = 0·82). CONCLUSIONS Results supported the use of a total score, and identified two specific factors of the HFIAS, which may be utilised in future research and intervention development. These findings help identify aspects of food insecurity that may drive relationships between the construct and important HIV-related variables.
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Low Economic Class Might Predispose Children under Five Years of Age to Stunting in Ethiopia: Updates of Systematic Review and Meta-Analysis. J Nutr Metab 2021; 2020:2169847. [PMID: 33489361 PMCID: PMC7789483 DOI: 10.1155/2020/2169847] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 11/19/2020] [Accepted: 11/24/2020] [Indexed: 11/18/2022] Open
Abstract
Background Malnutrition is major public health problem worldwide, particularly in developing countries including Ethiopia. In 2016, out of 667 million children under five years of age, 159 million were stunted worldwide. The prevalence of stunting has been decreasing greatly from 58% in 2000 to 44% in 2011 and 38% in 2016 in Ethiopia. However, the prevalence of stunting is still high and considered as public health problem for the country. The aim of this systematic review and meta-analysis is to assess the prevalence of stunting and its associations with wealth index among children under five years of age in Ethiopia. Methodology. The databases searched were MEDLINE, Scopus, HINARI, and grey literature studies. The studies' qualities were assessed by two reviewers independently, and any controversy was handled by other reviewers using the Joanna Briggs Institute (JBI) critical appraisal checklist. The JBI checklist was used in assessing the risk of bias and method of measurement for both outcome and independent variables. Especially, the study design, study participants, definition of stunting, statistical methods used to identify the associations, results/data presentations, and odds ratios (ORs) with confidence intervals (CIs) were assessed. In the statistical analysis, the funnel plot, Egger's test, and Begg's test were used to assess publication bias. The I2 statistic, forest plot, and Cochran's Q-test were used to deal with heterogeneity. Results In this review, 35 studies were included to assess the pooled prevalence of stunting. Similarly, 16 studies were used to assess the estimated effect sizes of wealth index on stunting. In this meta-analysis, the pooled prevalence of stunting was 41.5% among children under five years of age, despite its considerable heterogeneity (I2 = 97.6%, p < 0.001, Q = 1461.93). However, no publication bias was detected (Egger's test p=0.26 and Begg's test p=0.87). Children from households with a medium or low/poor wealth index had higher odds of stunting (AOR: 1.33, 95% CI 1.07, 1.65 or AOR: 1.92, 95% CI 1.46, 2.54, respectively) compared to children from households with a high/rich wealth index. Both of the estimated effect sizes of low and medium wealth indexes had substantial heterogeneity (I2 = 63.8%, p < 0.001, Q = 44.21 and I2 = 78.3%, p < 0.001, Q = 73.73) respectively). In estimating the effect, there was no publication bias (small-studies effect) (Egger and Begg's test, p > 0.05). Conclusions The pooled prevalence of stunting was great. In the subgroup analysis, the Amhara region had the highest prevalence of stunting, followed by the Oromia and Tigray regions, respectively. Low economic status was associated with stunting in Ethiopia. This relationship was found to be statistically more accurate in Oromia and Amhara regions. The government should emphasize community-based nutrition programs by scaling up more in these regions, just like the Seqota Declaration.
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