Magnitude and associated factors of wasting among under five orphans in Dilla town, southern Ethiopia: 2018: a cross-sectional study

Prevalence of wasting and associated factors among children aged 6-59 months in Habro district, Eastern Ethiopia: a cross-sectional study

Background

Globally, five million children under the age of five died in 2021. Asia and African countries contributed to 69% and 27.2% of wasting, respectively. In Ethiopia, out of 901 (10.1%) under-five children, 632 (8.1%) were found to be moderately wasted, and 269 (3.0%) were severely wasted. The purpose of this study was to assess the prevalence of wasting and its associated factors among children between the ages of 6 and 59 months in Habro Woreda, Oromia, Eastern Ethiopia.

Methods

A community-based cross-sectional study was conducted in Habro Woreda from 25 August to 20 September 2020. In total, 306 participants were included in this study through a systematic sampling technique. Data were collected using a pretested structured questionnaire through a face-to-face interview, entered into EpiData version 3.1, and analyzed using SPSS version 25. Predictors were assessed using a multivariate logistic regression analysis model and reported using an adjusted odds ratio (AOR) with a 95% confidence interval (CI). Statistical significance was set at p < 0.05.

Results

Overall, the prevalence of wasting among children aged 6-59 months in the Habro district was 28%, with a 95% confidence interval [26.5, 32.2%]. Factors such as mothers illiterate [AOR = 3.4; 95% CI: 1.14-10.47], households without latrines [AOR = 2.91; 95% CI: 1.33-6.37], food-insecure households [AOR = 4.11; 95% CI: 1.87-9], households that did not receive home visits [AOR = 4.2; 95% CI: 1.92-9.15], did not eat a variety of food [AOR = 7.44; 95% CI: 2.58-21.45], sick children after discharge from the program [AOR = 6.55; 95% CI: 2.85-15.02], readmitted children [AOR = 3.98; 95% CI: 1.43-15.07], and wasting 3.42 [AOR = 3.42; 95% CI: 1.24-9.45] were factors statistically associated with outcome variables.

Conclusion

This study noted that the prevalence of wasting among children aged 6-59 months following discharge from the Outpatient Therapeutic Program remains high. Educational status of the mother, availability of a latrine, separate kitchen in the household, household food insecurity, household dietary diversity, home visit, and admission type were significantly associated with wasting of children after discharge from the outpatient therapeutic program. Therefore, efforts that target these factors should be maximized to reduce the occurrence of wasting among children aged 6-59 months after discharge from the outpatient therapeutic program.

Critically High Burden of Acute Malnutrition and Its Associated Factors Among Children Under 5 Years in the Rural Settings of Southern Ethiopia

BACKGROUND

Globally, acute malnutrition threatens the lives of several million children under 5 years of age. Malnutrition affects the social, economic, and medical aspects of all countries. In Ethiopia, acute malnutrition is not decreasing at the intended rate for unclear reasons.

OBJECTIVE

This study aimed to assess the burden of acute malnutrition and its associated factors among children under 5 years of age in a rural setting of southern Ethiopia.

METHODS

A community-based cross-sectional study was conducted from January to March 2022. A multistage sampling technique was used to select 421 children. Mothers/caretakers were interviewed using interviewer-administered questionnaire, while their children's height/length and weight were measured. Logistic regression analyses were used and presented as the crude odds ratio (COR) and adjusted odds ratio (AOR) with their 95% confidence intervals (CI).

RESULTS

The burden of acute malnutrition among children under 5 years of age in the study area was 22.6% (95% CI = 18.5-26.8). Fathers with primary education (AOR = 4.48; 95% CI = 1.93-10.39), households with improper solid waste disposal (AOR = 2.54; 95% CI = 1.11-5.82), not usually sleeping under insecticide-treated bed net (ITN) (AOR = 1.79; 95% CI = 1.01-3.19), unacceptable children dietary diversity score (DDS) (AOR = 2.56; 95% CI = 1.28-5.14), and unacceptable household DDS (AOR = 2.26; 95% CI = 1.02-5.00) were factors associated with acute malnutrition.

CONCLUSIONS

The prevalence of acute malnutrition among children was critically high. Upgrading paternal educational status, encouraging safe solid waste disposal, ensuring consistent use of ITN, and improving both child and household DDS should be stressed.

Trends of socioeconomic and geographic inequalities in severe wasting among under-five children in Ethiopia from 2000 to 2019: using the WHO Health Equity Assessment Toolkit

Severe wasting is the deadliest form of wasting caused by a lack of nutritious food and repeated attacks of illness. The World Health Assembly has agreed to reduce severe wasting to less than 5% and 3% by the end of 2025 and 2030. Significant disparities were observed worldwide in progress towards the goal. However, limited evidence of disparity in severe wasting was available in Ethiopia. Therefore, this study aimed to assess trends in socioeconomic and geographic inequalities in severe wasting among under-five children in Ethiopia between 2000 and 2019. The trend in socioeconomic and geographic inequality was assessed using the World Health Organization Health Equity Assessment Toolkit, employing both absolute and relative measures of inequality. Difference (D), ratio (R), slope index inequality (SII), relative concentration index (RCI), and population attributable ratio (PAR) were utilized to assess disparity across wealth, education, residence, and subnational regions. The 95% uncertainty interval (UI) was used to declare the significant change in inequality through time. The proportion of severe wasting increased from 3.8% to 4.7% between 2000 to 2005 and dropped to 2.9% in 2011 to remain constant until 2016. However, the proportion of severe wasting significantly declined to 1.1% in 2019. As indicated by RCI, significant fluctuation in wealth-related inequality was observed in all five survey years but a significant change in wealth-related inequality was observed in 2005 and 2019. Whereas the education-related inequality in RCI of severe wasting steadily increased from -8.8% in 2005 to -24.3% in 2019. And the change was significantly widened from 2011 to 2019. On the other hand, residence-related inequality of severe wasting was observed in 2000 in ratio, difference and PAR summary measures but disappeared in 2019. Between 2000 and 2016, regional inequalities in severe wasting fluctuated between 8.7 in 2005 to 5.9 in 2016 taking the difference as a measure of inequality. Overall, Wealth-related inequality has significantly widened over time with under five children from the richest households being less affected by severe wasting. Education-related inequality was not changed with under five children whose mothers had not attended formal education highly affected by severe wasting. Regional disparity in severe wasting is also exhibited in Ethiopia in all-round surveys with children from Addis Ababa being least affected whereas children from Somalia were highly affected by severe wasting. However, no significant disparity in the type of residence in severe wasting was revealed in Ethiopia. Therefore, special attention should be paid to under-five children living in the poorest households, whose mothers did not attend formal education and children living in Somalia region.

Seasonality of associations between production of indigenous foods and food security status of mother-child dyads in Kisumu County, Kenya

BACKGROUND

Food insecurity is a major predicament for rural populations, especially mothers and children, whose livelihoods are often dependent on rain-fed agriculture. Indigenous foods have the potential of mitigating food insecurity as they can thrive in poor agro-ecological conditions. However, the associations between indigenous food production and food security status of mothers and children drawn from rural contexts has not been expansively assessed. Food insecurity evident by high food poverty rates remain high in Kisumu County due to over-reliance on food imports from other counties. The objective of the study was to assess seasonality in associations between production of selected indigenous foods (kidney beans, soya beans, millet, cassava, sweet potatoes, groundnuts, green grams, cow peas, amaranth leaves, spider plant leaves, black night shade leaves, mangoes, guavas, lime, and tamarind) and food security status of mothers and children during planting and harvesting seasons.

METHODS

We used a longitudinal study design adopting both quantitative and qualitative data collection methods. A structured questionnaire assessed production of selected indigenous foods in the sampled households, Household Food Insecurity Access Scale for mother's food security status and Prevalence of Underweight for children's food security status. Ordinal logistic regression was used to derive odds ratio (OR), which assessed strength of associations between dependent variables (mother's and children's food security status) and independent variables (production of selected indigenous foods). Significance was determined at α ≤ 0.05.

RESULTS

Results demonstrated that during planting season, production of kidney beans decreased the odds of mothers being severely food insecure by 53% (OR = 0.469, 95% CI = 0.228-0.964, p = 0.039). In the same season, sorghum production demonstrated 3.5 times increase in odds of children being severely food insecure (OR = 3.498, 95% CI = 1.454-8.418, p = 0.005). During harvesting season, production of kidney beans was associated with a 62% reduction in the odds of children being severely food insecure (OR = 0.379, 95% CI = 0.190-0.754, p = 0.006).

CONCLUSIONS

Production of some of the selected indigenous foods demonstrated significant odds of predicting mother's and children's food security status across both study seasons. An intervention-based study approach that would best establish causal associations of indigenous food production and food security status is recommended.

Discovering new pathways toward integration between health and sustainable development goals with natural language processing and network science

BACKGROUND

Research on health and sustainable development is growing at a pace such that conventional literature review methods appear increasingly unable to synthesize all relevant evidence. This paper employs a novel combination of natural language processing (NLP) and network science techniques to address this problem and to answer two questions: (1) how is health thematically interconnected with the Sustainable Development Goals (SDGs) in global science? (2) What specific themes have emerged in research at the intersection between SDG 3 ("Good health and well-being") and other sustainability goals?

METHODS

After a descriptive analysis of the integration between SDGs in twenty years of global science (2001-2020) as indexed by dimensions.ai, we analyze abstracts of articles that are simultaneously relevant to SDG 3 and at least one other SDG (N = 27,928). We use the top2vec algorithm to discover topics in this corpus and measure semantic closeness between these topics. We then use network science methods to describe the network of substantive relationships between the topics and identify 'zipper themes', actionable domains of research and policy to co-advance health and other sustainability goals simultaneously.

RESULTS

We observe a clear increase in scientific research integrating SDG 3 and other SDGs since 2001, both in absolute and relative terms, especially on topics relevant to interconnections between health and SDGs 2 ("Zero hunger"), 4 ("Quality education"), and 11 ("Sustainable cities and communities"). We distill a network of 197 topics from literature on health and sustainable development, with 19 distinct network communities - areas of growing integration with potential to further bridge health and sustainability science and policy. Literature focused explicitly on the SDGs is highly central in this network, while topical overlaps between SDG 3 and the environmental SDGs (12-15) are under-developed.

CONCLUSION

Our analysis demonstrates the feasibility and promise of NLP and network science for synthesizing large amounts of health-related scientific literature and for suggesting novel research and policy domains to co-advance multiple SDGs. Many of the 'zipper themes' identified by our method resonate with the One Health perspective that human, animal, and plant health are closely interdependent. This and similar perspectives will help meet the challenge of 'rewiring' sustainability research to co-advance goals in health and sustainability.

Relapse of acute malnutrition and associated factors after discharge from nutrition stabilization centers among children in Eastern Ethiopia

Background

Acute malnutrition is a major global health problem primarily affecting under-five children. In sub-Saharan Africa, children treated for severe acute malnutrition (SAM) at an inpatient have high case fatality rate and is associated with relapse of acute malnutrition after discharge from inpatient treatment programs. However, there is limited data on the rate of relapse of acute malnutrition in children after discharge from stabilization centers in Ethiopia. Hence, this study aimed to assess the magnitude and predictors of relapse of acute malnutrition among children aged 6-59 months discharged from stabilization centers in Habro Woreda, Eastern Ethiopia.

Methods

A cross-sectional study was conducted among under-five children to determine the rate and predictors of relapse of acute malnutrition. A simple random sampling method was used to select participants. All randomly selected children aged 6-59 months discharged from stabilization centers between June 2019 and May 2020 were included. Data were collected using pretested semi-structured questionnaires and standard anthropometric measurements. The anthropometric measurements were used to determine relapse of acute malnutrition. Binary logistic regression analysis was used to identify factors associated with relapse of acute malnutrition. An odds ratio with 95% CI was used to estimate the strength of the association and a p-value less than 0.05 was considered statistically significant.

Results

A total of 213 children with mothers/caregivers were included in the study. The mean age in months of children was 33.9 ± 11.4. More than half (50.7%) of the children were male. The mean duration of children after discharge was 10.9 (± 3.0 SD) months. The magnitude of relapse of acute malnutrition after discharge from stabilization centers was 36.2% (95% CI: 29.6,42.6). Several determinant factors were identified for relapse of acute malnutrition. Mid-upper arm circumference less than 110 mm at admission (AOR = 2.80; 95% CI: 1.05,7.92), absence of latrine (AOR = 2.50, 95% CI: 1.09,5.65), absence of follow-up visits after discharge (AOR = 2.81, 95% CI: 1.15,7.22), not received vitamin A supplementation in the past 6 months (AOR = 3.40, 95% CI: 1.40,8.09), household food insecurity (AOR = 4.51, 95% CI: 1.40,15.06), poor dietary diversity (AOR = 3.10, 95% CI: 1.31,7.33), and poor wealth index (AOR = 3.90, 95% CI: 1.23,12.43) were significant predictors of relapse of acute malnutrition.

Conclusion

The study revealed very high magnitude of relapse of acute malnutrition after discharge from nutrition stabilization centers. One in three children developed relapse after discharge in Habro Woreda. Programmers working on nutrition should design interventions that focus on improving household food insecurity through strengthened public Safety Net programs and emphasis should be given to nutrition counseling and education, as well as to continuous follow-up and periodic monitoring, especially during the first 6 months of discharge, to reduce relapse of acute malnutrition.

Evaluation of physical and mental health status of orphan children living in orphanages in Sonitpur district of Assam: a cross-sectional study

BACKGROUND

Orphan children living in orphanages are often neglected. These children's physical and mental health status is essential as they are highly prone to malnourishment and psychosocial distress. We aim to evaluate the orphan children's physical and psychosocial status living in orphanages.

METHODS

This study adopted a cross-sectional research design conducted with the children living in the orphanages using a pretested, predesigned schedule. A total of 83 children (aged 5 to 19 years) living in three different orphanages in the Sonitpur District of Assam were randomly selected for the study. Body Mass Index (BMI) for age and height were then determined using WHO standards. Thinness was defined as BMI for age below -2 SD (Standard Deviation) and thinness as height for age below -2 SD. The behavioural and mental status of children aged 10-19 years were evaluated using the Strengths and Difficulties Questionnaire (SDQ-21) with a cut-off value of SDQ score > 15 as the presence of emotional and behavioural distress.

RESULTS

Almost 50% of orphans were in the age group of 10-14 years, 62.7% were females, and 42.2% had a primary level of education. 52.5% of orphans exhibited severe thinness for < -3 SD. Observed severe thinness more among the 5-9 years and 10-14 years (p-value < 0.05) group and among the male orphans (p-value < 0.05). Of 65 children aged 10-19, 18.5% had behavioural and mental distress. Emotional (32.3%) and poor conduct problems (23%) were observed significantly among male adolescents.

CONCLUSIONS

Orphaned children, particularly those living in orphanages, are at risk of malnutrition and experience behavioural and psychosocial problems. Frequent assessments of their physical and mental health are advocated for early detection, prevention, and timely intervention.

Severe acute malnutrition and associated factors among children under-five years: A community based-cross sectional study in Ethiopia

Background

Despite consistent efforts to reduce child undernutrition, severe acute malnutrition (SAM) continues to be a serious obstacle to child survival and development in Ethiopia. This study aimed to identify severe acute malnutrition and associated factors among children aged 6–59 months in Ethiopia.

Methods

A cross-sectional study was undertaken with 384 under-five children from February to March, 2020 in Ethiopia. A mid-upper arm circumference (MUAC) tape, weight scale, height board (standing) and recumbent length measurements (for children <24 months) were measured. To determine the variables associated with SAM, adjusted odds ratio was computed using multivariable analysis and p < 0.05 was declared as significant.

Results

The prevalence of acute undernutrition was 26%; 18% and 8% of the children were moderately and severely undernourished, respectively. Family size (≥5 members) (AOR: 3.71, 95% CI: 1.55–8.89), younger age group (6–11 months) (AOR: 4.80, 95% CI: 1.61–14.31) and history of diarrhea in the two weeks prior to the survey (AOR: 5.36, 95% CI: 1.97–14.61) were independently associated with SAM in the study population.

Conclusion

Large family size, child age, diarrheal and household insecurity were important determinants of SAM among children. Therefore, aligning social protection programmes and improving health related interventions along with improving optimal breastfeeding, prevention and control of child morbidity, and strengthening family planning services are recommended to reduce child SAM.

Associated Factors of Wasting among Infants and Young Children (IYC) in Kuyu District, Northern Oromia, Ethiopia

Wasting among infants and young children in underdeveloped countries including Ethiopia is one of the most serious public health issues. Therefore, this study was designed to assess the magnitude of wasting and the variables that associate with it among infants and young children in the Kuyu district of Northern Oromia, Ethiopia. A community-based cross-sectional study of 612 infants and young children aged 6-23 months was conducted. To select eligible infants and young children from each family in the Kuyu district, a multilevel sampling approach was used. The amount and determinants related to wasting were investigated using the Statistical Package for Social Sciences (SPSS) version 20.0. In the study area, 14.1% of infants and young children were found to be wasting. Maternal educational status (AOR = 1.8, 95% CI; 1.01, 4.32), diarrhoea (AOR = 2.3, 95% CI; 1.98, 4.56), exclusive breastfeeding (AOR = 2.46, 95% CI, 1.4, 4.58), antenatal care visits (AOR = 2.21; 95% CI, 1.32, 3.48), and wealth index (AOR = 1.66, 95% CI; 1.07, 4.47) were significantly associated with wasting. According to the findings of this study, mother educational status, the occurrence of diarrhoea, exclusive breastfeeding, antenatal care visits, and wealth index have an impact on infants and young children's wasting. Therefore, to lower the burden of wasting among infants and young children in the study, community-based schooling and nutritional interventions are urgently needed.

Prevalence of wasting and associated factors among children aged 6-59 months in Wolkite town of the Gurage zone, Southern Ethiopia, 2020. A cross-sectional study

Background

Undernutrition among children is one of the leading major public health problems and about 49.5 million children were wasted worldwide. Asia and African countries contributed 69% and 27.2% of wasting respectively. In Ethiopia, 7% of children were wasted and 1% was severely wasted. Although Ethiopia has achieved remarkable progress in reducing under-five mortality and designed multi-dimensional approaches to address malnutrition, the data on acute malnutrition among children in the study setting is limited. Therefore, this study was aimed to assess the prevalence of acute malnutrition and associated factors among 6-59-month-old children.

Methods

Community-based cross-sectional study design was conducted at Gurage Zone, Southern Ethiopia. A total of 293 study participants were selected using a systematic sampling technique. Data were collected using structured and pre-tested interviewer-administered questionnaires by face-to-face interview. Data entry and analysis were made using Epi Data version 4.6 and Statistical Package for Social Science (SPSS) version 24 respectively. Descriptive statistical analysis and some of the statistical tests like the odds ratio were carried out. Both Bivariable and multivariable logistic regression analysis with 95% confidence interval was carried out to identify associated factors and variables with P value < 0.05 were taken as statistically significant.

Results

The prevalence of wasting among children aged from 6–59 months in this study was 14.7% (95% CI: 10.9, 18.8). After controlling for all possible confounding factors, the result revealed that age of children between 6–11 months [AOR = 2.78(95% CI: 1.67, 6.19)], caregivers who were unable to read and write [AOR = 2.23 (95% CI: 1.04, 5.34)], presence of diarrheal disease in the past two weeks [AOR = 1.68 (95% CI: 1.23, 5.89)] and mothers who had a history of poor handwashing practice before food preparation and child feeding [AOR = 2.64(95% CI: 1.52, 4.88)] were found to be significantly associated with wasting.

Conclusions

The study findings indicate that respondents’ wasting was mainly affected by age of the child, educational status of caregivers, presence of diarrheal disease and hand washing practice of the mother. Providing acceptable, quality and honorable care for all children is very crucial to prevent child wasting and proper handwashing during breastfeeding and food handling is recommended and interventions aimed at improving maternal health and access to health care services for children are urgently needed.

Predictors of wasting among children under-five years in largely food insecure area of north Wollo, Ethiopia: a cross-sectional study

Child undernutrition is widespread in low- and middle-income countries and is linked with weakened immunity and increased risks of morbidity and mortality. Ethiopia has made a marked reduction in stunting, but there has, however, been little progress in wasting reduction and limited evidence in food insecure areas may hamper the design of effective interventions. Therefore, the aim of the present study was to determine the contributing factors to persistent high prevalence of wasting among 6-59-month-old children. A community-based cross-sectional study was employed in February to March 2020, and included 384 mother-child pairs. Data were collected using a structured interviewer-administered questionnaire. Bivariate and multivariable logistic regression analyses were conducted. The overall prevalence of wasting was 12⋅8 % (95 % CI 9⋅1, 16⋅1); with 5⋅8 % severely wasted. Factors significantly associated with wasting were child age 6-23 (v. 24-59 months), delayed initiation of breast-feeding, diarrhoeal illness in the last 2 weeks, poor dietary diversity and low socioeconomic status. The present findings support that aligning poverty reduction interventions and healthcare services is important to accelerate wasting reduction more equitably and achieve the World Health Assembly's target and SDG goal #2 in the coming years. Improving accessibility and affordability of nutritious foods and early diagnosis and treatment of childhood morbidity are critical to address childhood wasting in the context of food insecure areas.

Factors associated with childhood underweight among orphaned preschool children: A community-based analytical cross-sectional study in Southern Ethiopia

BACKGROUND

Childhood underweight is one of the major public health problems in Ethiopia. In Ethiopia, most of the available evidence is related to the general community children, which had different risk and severity levels than orphan children. Even though under-five orphan children have a higher risk of being underweight, they are the most neglected population.

OBJECTIVE

The study aims to determine the prevalence and factors associated with childhood underweight among orphaned preschool children in Southern Ethiopia.

METHODS

A community-based analytical cross-sectional study was conducted among 367 orphans. The burden of childhood underweight was assessed using World Health Organization standard cutoff points below -2 SD using z-scores. All variables with a p-value of < 0.25 during binary logistic regression analysis were entered into a multivariate logistic regression analysis to identify predictor variables independently associated with underweight at a p-value of 0.05 with 95% CI.

RESULTS

In this study, the prevalence of underweight among orphan children was 27.4%. The main factors associated with underweight were female child (adjusted odds ratio (aOR) = 5.29, 95% confidence interval (CI) (2.83-9.92)), adult food as type of first complementary food (aOR = 2.47; 95% CI (1.24-4.94)), food insecurity (aOR = 1.98; 95% CI (1.23-3.21)), and child age from 24-59 months (aOR = 7.19; 95% CI (3.81-13.60)).

CONCLUSION

Childhood underweight is a public health problem in the study area. The sex of a child, type of first complementary food, household food security status, and child age were the major predictors of underweight. Therefore, appropriate dietary interventions, nutrition education, and increased food security status of orphan children are highly recommended.

Undernutrition and Associated Factors among Under-Five Orphan Children in Addis Ababa, Ethiopia, 2020: A Cross-Sectional Study

Background

Undernutrition contributes to the death of around 3 million children and threatens the futures of hundreds of millions, undermining healthy development and the strength of their societies by preventing children from achieving their full potential. Orphans are at greater risk of undernutrition because they are more likely to be extremely poor and receive less medical and social care. However, there is little information about the prevalence of undernutrition and associated factors among under-five orphan children.

Objective

This study aimed to assess undernutrition and associated factors among under-five orphan children in orphanages in Addis Ababa, Ethiopia.

Methods

An institution-based cross-sectional study was conducted in Addis Ababa from February 28 to March 28, 2020. A simple random sampling technique was employed to recruit a total of 275 orphan children. An interviewer-administered questionnaire and anthropometric measurements were used to collect data. Data were entered using EpiData version 3.1 and analysis was done by WHO Anthro version 3.2.2 and SPSS version 23. Multivariable logistic regression analysis was performed to identify determinants of undernutrition at a p value of less than 0.05 with an adjusted odds ratio of 95% confidence interval.

Results

The prevalence of wasting, stunting, and underweight were 11.1%, 45.8%, and 25.5%, respectively. Presence of illness (AOR = 2.23; 95% CI: 1.41, 12.73), children who received less than three meals per day (AOR = 2.11; 95% CI: 1.58, 7.71), and children who were not vaccinated (AOR = 2.86; 95% CI: 2.07, 11.61) were significantly associated with stunting. Children who were not vaccinated (AOR = 2.04; 95% CI: 1.29, 9.71) and who had inadequate dietary diversity scores (AOR = 1.32, 95% CI: 1.16, 12.65) were significantly associated with wasting and underweight, respectively.

Conclusion

The prevalence of undernutrition was very high compared to national data. Health status, meal frequency, and vaccination status were associated factors of stunting. Vaccination status and dietary diversity score were associated factors with wasting and underweight, respectively. Therefore, improving meal frequency, dietary diversity, and early treatment during childhood illness are important to reduce orphan undernutrition.

Undernutrition and associated factors in orphan children aged 6-59 months in Gambella Southwest, Ethiopia: A community-based cross-sectional study

OBJECTIVE

The study aimed to assess the prevalence of stunting, wasting, underweight and associated factors in orphaned children under 5 years old.

DESIGN

A cross-sectional study.

SETTING

Gambella City, Ethiopia.

PARTICIPANTS

A sample of 419 under 5 orphaned children included in the study. Eligible households with orphans had selected using a systematic random sampling method. The lottery method was used when more than one eligible study participants live in the household. An OR with 95% CI was performed to measure the strength of association between each dependent variable and independent variables. Variables with p<0.05 were declared statistically significant.

PRIMARY OUTCOME

The main outcome of this study was the prevalence of undernutrition among orphaned under 5 and its associated factors.

RESULTS

Prevalence of stunting, wasting and underweight in orphan children under 5 were 12.2%, 37.8% and 21.7%, respectively. The prevalnce of wasting peaks among age group of 36-47 months (42.5%), whereas underweight peaks in 48-59 months (27.7%). Food insecurity, wealth index, family size, vitamin A supplementation, diarrhoea, fever 2 weeks before the survey, children under 5 and parents' death were associated with undernutrition.

CONCLUSION

The prevalence of stunting, wasting and underweight among orphan children under 5 was significantly high. Multisectoral collaborative efforts towards access to health services, improving income-generating activities, micronutrient supplementation and social support and protection targeting orphan and vulnerable populations have to be built up.

Nutritional status among orphans and vulnerable children aged 6 to 59 months in Addis Ababa, Ethiopia: a community-based cross-sectional study

Background

Childhood undernutrition is a global problem contributing to more than a third of under-five mortality. Orphans and vulnerable children (OVC) fare worse than children living with their parents. However, the nutritional and healthcare needs of OVC are under-recognized in Ethiopia.

Methods

A community-based cross-sectional study was conducted among OVC aged 6 to 59 months. Multi-stage sampling technique was applied to select the households and eligible children included in the study (n = 584). An interviewer-administered questionnaire and anthropometric measurements were carried out. The proportions of stunting, wasting and underweight were determined based on the WHO Z-score cut-off. Factors associated with stunting were identified by Multivariable binary logistic regression analysis.

Results

The prevalence of stunting, wasting and underweight were 35.1% (95% CI; 31.3–39.1%), 4.7% (95% CI; 3.2–6.7%) and 12.0% (95% CI; 9.6–14.9%), respectively. Stunting was significantly associated with initiation of complementary feeding after 12 months of age (AOR = 3.61; 95% CI 1.16–14.11), household food insecurity (AOR = 1.90; 95% CI 1.10–3.17), unplanned pregnancy (AOR = 1.90; 95% CI 1.03–3.42), age ≥ 2 years (AOR = 1.80; 95% CI 1.25–2.67), caretaker’s age ≤ 25 years (AOR = 1.50; 95% CI 1.03–2.16) and employment of the caretaker (AOR = 1.50; 95% CI 1.03–2.26).

Conclusion

The prevalence of all forms of undernutrition among OVC was significantly higher than the national estimate that has been reported by consecutive Ethiopian Demographic and Health Surveys (EDHS). Policy makers and programmers working on nutritional interventions should give due emphasis to address the unmet need of OVC and focus on interventions which enhance household food security and caretaker’s awareness on child feeding and pregnancy planning.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40795-021-00431-5.