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Dana NINDREAR, Yulia DARMAI, Muthia SUKMA, Ainil MARDIAH, Rahman AGUSTIAND, Mursyidah SHOLIHATI. SOCIAL MEDIA USE, KNOWLEDGE, AND ATTITUDES TOWARDS PEOPLE LIVING WITH HIV/AIDS AMONG HIGH SCHOOL STUDENTS IN AN INDONESIAN TOURISM REGION. Afr J Infect Dis 2024; 18:16-21. [PMID: 39156731 PMCID: PMC11327911 DOI: 10.21010/ajidv18i2s.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 06/08/2024] [Accepted: 06/11/2024] [Indexed: 08/20/2024] Open
Abstract
Background Social media has become an integral part of adolescent life in Indonesia, particularly in tourism regions. It serves as a platform for disseminating information, including about HIV/AIDS. However, it also has the potential to spread misinformation and harmful content, which can increase stigma and discrimination against people living with HIV/AIDS (PLWHA). Aim The aim of this study was to determine the relationships between social media use, knowledge, and attitudes towards PLWHA among high school students in an Indonesian tourism region. Methods This research utilized a school-based cross-sectional study design in several high schools located in Bukittinggi City, a renowned tourist destination in West Sumatra Province, Indonesia. The study sample comprised high school students aged 15-18 years, with a total of 118 respondents selected. The sample was chosen using a multistage stratified clustered sampling method. The variables measured in this study included social media usage, HIV/AIDS knowledge, and attitudes towards PLWHA. To test the research hypotheses, data analysis was conducted using structural equation modeling techniques. P<0.05 is considered significant. Results There were relationships between social media use and knowledge of HIV/AIDS (β=0.614, t-value=9.327, p-value=<0.001), knowledge of HIV/AIDS and attitudes towards PLWHA (β=0.601, t-value=8.344, p-value=0.014) and social media use and attitudes towards PLWHA (β=0.218, t-value=2.469, p-value=<0.001). Conclusion This study confirmed significant relationships were found between social media use, knowledge, and attitudes towards PLWHA. The results highlight the necessity for comprehensive interventions and ongoing support to promote the well-being of students amid the dynamic changes in global tourism.
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Affiliation(s)
- NINDREA Ricvan Dana
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, Indonesia, 26181
| | - DARMA Ika Yulia
- Department of Midwifery, Universitas Syedza Saintika, Padang, Indonesia, 25132
| | - SUKMA Muthia
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, Indonesia, 26181
| | - MARDIAH Ainil
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, Indonesia, 26181
| | - AGUSTIAN Dede Rahman
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, Indonesia, 26181
| | - SHOLIHATI Mursyidah
- Department of Medicine, Faculty of Medicine, Universitas Negeri Padang, Bukittinggi, Indonesia, 26181
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Aryanti N, Hadju V, Salam A, Thaha AR, Ansariadi, Masni. Determinants of Stunting in Young Women Age 13-15 Years in South Galesong District, Takalar Regency, Indonesia: a Cross-sectional Study. ACTA MEDICA PHILIPPINA 2024; 58:132-138. [PMID: 38812759 PMCID: PMC11132290 DOI: 10.47895/amp.vi0.6805] [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] [Indexed: 05/31/2024]
Abstract
Background and Objective Malnutrition is a serious public health problem in developing countries, including Indonesia. Based on RISKESDAS 2018, the prevalence of stunting aged 13-15 years in Takalar Regency is 24.83%. This study aimed to assess the prevalence of stunting and the determinants of stunting in adolescent girls aged 13-15 years in the South Galesong District, Takalar Regency. Methods This is a cross-sectional study using purposive sampling method that included 247 adolescent girls in selected junior high schools. Data collection used questionnaires and anthropometric measurements. An anthropometric measurement was converted to the indices of nutritional status using World Health Organization Anthro Plus software. Results The prevalence of stunting was 25.1%. Bivariate analysis showed determinant factors related significantly to stunting were energy intake (p<0.001), protein intake (p<0.001), iron intake (p<0.005), and zinc intake (p<0.001). Multivariate analysis showed determinant factors related significantly to stunting were zinc intake (p<0.001, OR=7.993), protein intake (p<0.05, OR=2.248), and knowledge level (p<0.05, OR=2.032). Conclusion The occurrence of stunting is related to the quality and quantity of food and the level of adolescent knowledge about balanced nutrition. It is necessary to hold educational programs and interventions on improving nutrition initiated by stakeholders and the department of health, in this case, the health center is needed to reduce stunting rates, especially among adolescents.
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Affiliation(s)
- Novi Aryanti
- Department of Nutrition Science, Faculty of Public Health, Hasanuddin University
| | - Veni Hadju
- Department of Nutrition Science, Faculty of Public Health, Hasanuddin University
| | - Abdul Salam
- Department of Nutrition Science, Faculty of Public Health, Hasanuddin University
| | - Abdul Razak Thaha
- Department of Nutrition Science, Faculty of Public Health, Hasanuddin University
| | - Ansariadi
- Department of Epidemiology, Faculty of Public Health, Hasanuddin University
| | - Masni
- Department of Biostatistics, Faculty of Public Health, Hasanuddin University
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Okyere J, Budu E, Aboagye RG, Seidu A, Ahinkorah BO, Yaya S. Socioeconomic determinants of the double burden of malnutrition among women of reproductive age in sub-Saharan Africa: A cross-sectional study. Health Sci Rep 2024; 7:e2071. [PMID: 38742095 PMCID: PMC11089015 DOI: 10.1002/hsr2.2071] [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: 07/02/2023] [Revised: 01/19/2024] [Accepted: 04/11/2024] [Indexed: 05/16/2024] Open
Abstract
Background and Aim The positioning of eliminating all forms of malnutrition within the spirit of the Sustainable Development Goals and the adoption of the United Nations resolution for a Decade of Action on Nutrition are a testament to strong global commitment to combat the double burden of malnutrition (DBM). Yet, there is a knowledge gap in sub-Saharan Africa (SSA) regarding the influence of socioeconomic status on DBM. We investigated the associative effect of socioeconomic status on DBM in SSA. Methods Data for the study were extracted from the most recent Demographic and Health Surveys (DHS) of 29 countries in SSA conducted from 2010 to 2020. Bivariate and multivariate logistic regression models were fitted to examine the association between socioeconomic status and DBM. The results were presented using adjusted odds ratio (aOR) and 95% confidence interval (CI). Results Children of obese mothers were less likely to be stunted compared to those born to mothers who were not overweight/obese [aOR = 0.70; 95% CI = 0.66-0.77]. The odds of stunting increased with wealth index, with children born to poorest mothers having the highest odds compared to those born to richest mother [aOR = 1.79; 95% CI = 1.64-1.95]. The odds of stunting among children was highest among those born to mothers with no formal education compared to those whose mothers had higher education [aOR = 2.73; 95% CI = 2.34-3.18]. Conclusion DBM among children in SSA is predicted by maternal level of education, and wealth status. These results underscore the urgency of tailored interventions and policies that address DBM among women of reproductive age, with a particular focus on the socioeconomic disparities in SSA. To effectively combat this pressing public health issue, it is imperative to direct efforts towards empowering women to attain higher levels of education and to implement strategies that consider the specific needs of women across varying socioeconomic statuses.
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Affiliation(s)
- Joshua Okyere
- Department of Population and HealthUniversity of Cape CoastCape CoastGhana
| | | | - Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public HealthUniversity of Health and Allied SciencesHohoeGhana
| | - Abdul‐Aziz Seidu
- Centre for Gender and AdvocacyTakoradi Technical UniversityTakoradiGhana
- College of Public Health, Medical and Veterinary SciencesJames Cook UniversityAustralia
| | - Bright Opoku Ahinkorah
- School of Clinical MedicineUniversity of New South Wales SydneySydneyAustralia
- School of Public Health, Faculty of HealthUniversity of Technology SydneySydneyAustralia
- REMS Consultancy Services Limited, Sekondi‐TakoradiWestern RegionGhana
| | - Sanni Yaya
- School of International Development and Global StudiesUniversity of OttawaOttawaCanada
- The George Institute for Global Health, Imperial College LondonLondonUK
- Faculty of MedicineUniversity of ParakouParakouBenin
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Nigatu A, Abdureshid N, Abate S, Dagne I, Oumer A. Undernutrition and determinants among adolescent street children in DireDawa City, eastern Ethiopia: Vulnerability assessment. Nutrition 2024; 119:112307. [PMID: 38218049 DOI: 10.1016/j.nut.2023.112307] [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: 09/08/2023] [Revised: 11/05/2023] [Accepted: 11/21/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVES Adolescents go through rapid development and increased nutritional requirements that can put them at higher risk of undernutrition--a problem that can be highest among orphaned or street children. Evidence on nutritional risk and its contributing factors among this segment is lacking in the city of Dire Dawa, where many children are on the streets with limited access to proper care. The aim of this study was to identify determinants of undernutrition among street adolescents in Ethiopia. METHODS A community-based cross-sectional study was conducted with 358 street adolescents 12 to 19 y of age in Dire Dawa from January to February 2022. After conducting a preliminary survey and registering all available street children, a complete enumeration was made. For data collection, an interviewer-administered questionnaire was used along with anthropometric measurements using standard procedures. Height-for-age (HAZ) and body mass index (BMI) for age z scores were computed using World Health Organization (WHO) Anthroplus and statistical analysis was done using SPSS software version 26. Independent variables with P < 0.25 in bivariable analysis were included in multivariable logistic regression, and variables with P < 0.05 were considered statistically significant. A crude and adjusted odds ratio (AOR) with a 95% confidence interval (CI) was reported. RESULTS Among 358 street adolescents, 44% (38.9-49.5) and 56% (50.8-61.4) were thin and stunted, respectively. Thinness among street children could be associated with a longer stay on the street (AOR, 1.65; 95% CI, 1.40-1.90), infrequent meal frequency (AOR, 1.32; 95% CI, 1.19-1.45), unprotected drinking water sources (AOR, 1.55; 95% CI, 1.40-1.71), alcohol drinking (AOR, 2.92; 95% CI, 1.51-4.32), inadequately diversified diet (AOR, 1.21; 95% CI, 1.06-1.36), and illness history (AOR, 1.34; 95% CI, 1.21-1.47). Moreover, odds of stunting were significantly associated with staying on the street (AOR, 1.32; 1.10-1.54), unsafe drinking water (AOR, 1.63; 95% CI, 1.13-2.66), smoking cigarettes (AOR, 1.54; 95% CI, 1.21-2.52), dietary diversity (AOR, 2.34; 95% CI, 1.43-3.82), and acute illness (AOR, 2.12; 95% CI, 1.31-5.23). CONCLUSION Thinness and stunting were prevalent among street children and are associated with infrequent meals, poor dietary diversity, substance abuse, unsafe water sources, and illness histories that could be targeted for multisectoral interventions.
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Affiliation(s)
- Abel Nigatu
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Neil Abdureshid
- Department of Midwifery, College of Medicine and Health Sciences, Dire-Dawa University, Dire-Dawa, Ethiopia
| | - Shambel Abate
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Imam Dagne
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Abdu Oumer
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia.
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Elif Öztürk M, Yabancı Ayhan N. Evaluation of malnutrition and screening tools in hospitalized children. Clin Nutr ESPEN 2023; 57:770-778. [PMID: 37739737 DOI: 10.1016/j.clnesp.2023.08.031] [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: 04/18/2023] [Revised: 07/29/2023] [Accepted: 08/25/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND & AIMS Detecting malnutrition and its related risk factors are crucial, in hospitalized children. Anthropometric z scores are used to assess malnutrition. Screening tools also aim to detect the presence of malnutrition and the developing risk of malnutrition in hospitalized children to determine who may benefit from nutritional support. Therefore, the aims of the study are to detect malnutrition and its related demographic and clinical risk factors in hospitalized children and determining the sensitivity of Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) and Pediatric Yorkhill Malnutrition Score (PYMS) screening tools. METHODS A total of 130 hospitalized children aged between 0 and 18 years were included in to study. A survey including demographic and clinical characteristics, STAMP and PYMS were applied to parents of the children. Patients were classified into nutritional risk groups through screening tools. Anthropometric measurements (body weight, length/height, and middle upper arm circumference (MUAC) of the children were taken. Body mass index-for-age and height-for-age z scores were calculated to assess acute and chronic malnutrition prevalence. MUAC-for-age z scores were calculated as well. To detect independent risk factors for acute and chronic malnutrition multivariable logistic regression models were constructed. RESULTS A total of 14.6% of hospitalized children had acute malnutrition, 21.5% of children had chronic malnutrition and 27.7% of them had low MUAC standard deviation score (SDS) (less than -2). The independent risk factors for acute malnutrition were younger maternal age at birth and long length of stay (p < 0.05). The independent risk factors for chronic malnutrition were being female, younger maternal age at birth, longer illness duration and having urological or allergy and immunological diseases (p < 0.05). However, MUAC for age SDS groups were not related to any demographic and clinical factors, in children of all ages (p > 0.05). Regarding the screening tools, PYMS displayed 100% sensitivity against acute malnutrition. While PYMS displayed better sensitivity to identify acute malnutrition than STAMP, STAMP was more sensitive than PYMS to detect chronic malnutrition and low MUAC SDS. CONCLUSIONS Low MUAC for age SDS was not related to any demographic and clinical factors, in hospitalized children of all ages, unlike acute and chronic malnutrition, in this study. Pediatric screening tools mainly PYMS did not have high sensitivity to detect chronic malnutrition and low MUAC SDS, in hospitalized children. Therefore, the tools have to be used along with z scores of anthropometric parameters.
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Affiliation(s)
- Meryem Elif Öztürk
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Karamanoğlu Mehmetbey University, Karaman, Turkey.
| | - Nurcan Yabancı Ayhan
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ankara University, Ankara, Turkey.
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de Vries Mecheva M, Rieger M, Sparrow R, Prafiantini E, Agustina R. Behavioural and environmental risk factors associated with primary schoolchildren's overweight and obesity in urban Indonesia. Public Health Nutr 2023; 26:1562-1575. [PMID: 37138496 PMCID: PMC10410387 DOI: 10.1017/s1368980023000897] [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: 04/11/2022] [Revised: 04/03/2023] [Accepted: 04/26/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVES To aid the design of nutrition interventions in low- and middle-income countries undergoing a nutrition transition, this study examined behavioural and environmental risk factors associated with childhood overweight and obesity in urban Indonesia. DESIGN Body height and weight of children were measured to determine BMI-for-age Z-scores and childhood overweight and obesity status. A self-administered parental survey measured socio-economic background, children's diet, physical activity, screen time and parental practices. Logistic and quantile regression models were used to assess the association between risk factors and the BMI-for-age Z-score distribution. SETTING Public primary schools in Central Jakarta, sampled at random. PARTICIPANTS Children (n 1674) aged 6-13 years from 18 public primary schools. RESULTS Among the children, 31·0 % were overweight or obese. The prevalence of obesity was higher in boys (21·0 %) than in girls (12·0 %). Male sex and height (aOR = 1·67; 95 % CI 1·30, 2·14 and aOR = 1·16; 95 % CI 1·14, 1·18, respectively) increased the odds of being overweight or obese, while the odds reduced with every year of age (aOR = 0·43; 95 % CI 0·37, 0·50). Maternal education was positively associated with children's BMI at the median of the Z-score distribution (P = 0·026). Dietary and physical activity risk scores were not associated with children's BMI at any quantile. The obesogenic home food environment score was significantly and positively associated with the BMI-for-age Z-score at the 75th and 90th percentiles (P = 0·022 and 0·023, respectively). CONCLUSIONS This study illustrated the demographic, behavioural and environmental risk factors for overweight and obesity among primary schoolchildren in a middle-income country. To foster healthy behaviours in primary schoolchildren, parents need to ensure a positive home food environment. Future sex-responsive interventions should involve both parents and children, promote healthy diets and physical activity and improve food environments in homes and schools.
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Affiliation(s)
- Margarita de Vries Mecheva
- The International Institute of Social Studies of Erasmus University Rotterdam, 2518 AXThe Hague, the Netherlands
| | - Matthias Rieger
- The International Institute of Social Studies of Erasmus University Rotterdam, 2518 AXThe Hague, the Netherlands
| | - Robert Sparrow
- The International Institute of Social Studies of Erasmus University Rotterdam, 2518 AXThe Hague, the Netherlands
- Development Economics Group, Wageningen University, Wageningen, the Netherlands
| | - Erfi Prafiantini
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia – Dr Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Rina Agustina
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia – Dr Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Getacher L, Ademe BW, Belachew T. Double burden of malnutrition and its associated factors among adolescents in Debre Berhan Regiopolitan City, Ethiopia: a multinomial regression model analysis. Front Nutr 2023; 10:1187875. [PMID: 37545577 PMCID: PMC10400360 DOI: 10.3389/fnut.2023.1187875] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/30/2023] [Indexed: 08/08/2023] Open
Abstract
Background The double burden of malnutrition (DBM), contained both undernutrition and overnutrition, is a growing public health concern that presents a significant challenge to the food and nutrition policies of developing nations such as Ethiopia. However, the prevalence and contributing factors of DBM among adolescents in the study area have not been adequately investigated by Ethiopian researchers. Therefore, this study aims to determine the prevalence of DBM and contributing factors among secondary school students in Debre Berhan City, Ethiopia. Methods A school-based cross-sectional study was conducted among 742 adolescents aged 10-19 years from October 13, 2022, to November 14, 2022, using a multi-stage sampling method. Data were collected using the online Kobo toolbox tool. A multinomial logistic regression model was used to analyze the data. The data were cleaned and analyzed in R software 4.2.2. Adolescents who had body mass index for age Z score (BAZ) < -2 SD, > +1 SD, and > +2 from the median value were considered thin, overweight, and obese, respectively. Results The overall prevalence of DBM was 21.5% (14.8% thinness and 6.7% overweight/obesity). In the multivariable multinomial logistic regression analysis models factors such as age [AOR = 0.79, 95% CL: (0.67, 0.93)], sex [AOR = 3.86, 95% CL: (2.35, 6.32)], school type [AOR 5.03, 95% CL: (2.30, 10.99)], minimum dietary diversity score [AOR = 2.29, 95% CL: (1.27, 4.14)], frequency of meals [AOR = 2.09, 95% CL: (1.13, 3.89)], home gardening practice [AOR = 2.31, 95% CL: (1.44, 3.67)], history of illness [AOR = 0.57, 95% CL: (0.36, 0.93)], and knowledge of nutrition [AOR = 4.96, 95% CL: (1.61, 15.33)] were the significant predictors of either thinness or overweight/obesity (DBM). Conclusion More than one-fifth of adolescents were affected by DBM in the study area. This prevalence is higher compared with the national and regional prevalence that found to be a public health concern. Thus, interventions like double-duty interventions should consider the age, sex, school type, minimum dietary diversity score, frequency of meals, home gardening practice, history of illness, and nutritional knowledge of adolescents. Clinical Trial Registration clinicaltrial.gov, identifier NCT05574842.
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Affiliation(s)
- Lemma Getacher
- School of Public Health, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Beyene Wondafrash Ademe
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
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Pham MD, Sawyer SM, Agius PA, Kennedy EC, Ansariadi A, Kaligis F, Wiguna T, Wulan NR, Devaera Y, Medise BE, Riyanti A, Wiweko B, Cini KI, Tran T, Fisher J, Luchters S, Azzopardi PS. Foregone health care in adolescents from school and community settings in Indonesia: a cross-sectional study. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 13:100187. [PMID: 37383556 PMCID: PMC10305962 DOI: 10.1016/j.lansea.2023.100187] [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: 09/15/2022] [Revised: 12/21/2022] [Accepted: 03/22/2023] [Indexed: 06/30/2023]
Abstract
Background Adolescence is a development period marked by the onset of a new set of health needs. The present study sought to quantify the prevalence of foregone care (not seeking medical care when needed) and identify which adolescents are at greater risk of having unmet healthcare needs. Methods A multi-stage random sampling strategy was used to recruit school participants (grade 10-12) in two provinces in Indonesia. Respondent driven sampling was used to recruit out-of-school adolescents in the community. All participants completed a self-reported questionnaire which measured healthcare seeking behaviours, psychosocial wellbeing, use of healthcare services, and perceived barriers to accessing healthcare. Multivariable regression analysis was performed to examine factors associated with foregone care. Findings A total of 2161 adolescents participated in the present study and nearly one in four adolescents reported foregone care in the past year. Experiences of poly-victimisation and seeking care for mental health needs increased the risk of foregone care. In-school adolescents who reported psychological distress [adjusted risk ratio (aRR) = 1.88, 95%CI = 1.48-2.38] or had high body mass index (aRR = 1.25, 95%CI = 1.00-1.57) were at greater risk of foregone care. The leading reason for foregone care was lack of knowledge of available services. In-school adolescents predominantly reported non-access barriers to care (e.g., perception of the health concern or anxiety about accessing care) whereas most out-of-school adolescents reported access barriers (e.g., did not know where to get care or could not pay). Interpretation Foregone care is common among Indonesian adolescents, especially in adolescents with mental and physical health risks. Differences between in-school and out-of-school adolescents suggest that interventions to promote appropriate healthcare use will need tailoring. Further research is needed to determine causal relationships around barriers in access to healthcare. Funding Australia-Indonesia Centre.
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Affiliation(s)
- Minh D. Pham
- Burnet Institute, Melbourne, Australia
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Susan M. Sawyer
- Murdoch Children's Research Institute, Parkville, Melbourne, Australia
- Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Paul A. Agius
- Burnet Institute, Melbourne, Australia
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
- Faculty of Health, Deakin University, Melbourne, Australia
| | - Elissa C. Kennedy
- Burnet Institute, Melbourne, Australia
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
- Murdoch Children's Research Institute, Parkville, Melbourne, Australia
| | - Ansariadi Ansariadi
- Centre for Epidemiology and Population Health Studies, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Fransiska Kaligis
- Department of Psychiatry, Universitas Indonesia, Jakarta, Indonesia
- Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Tjhin Wiguna
- Department of Psychiatry, Universitas Indonesia, Jakarta, Indonesia
- Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | | | - Yoga Devaera
- Department of Child Health, Universitas Indonesia, Jakarta, Indonesia
| | - Bernie E. Medise
- Cipto Mangunkusumo Hospital, Jakarta, Indonesia
- Department of Child Health, Universitas Indonesia, Jakarta, Indonesia
| | - Aida Riyanti
- Department of Obstetrics and Gynaecology, Universitas Indonesia, Jakarta, Indonesia
| | - Budi Wiweko
- Research and Social Services, Universitas Indonesia, Jakarta, Indonesia
| | - Karly I. Cini
- Burnet Institute, Melbourne, Australia
- Murdoch Children's Research Institute, Parkville, Melbourne, Australia
- Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Thach Tran
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Jane Fisher
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Stanley Luchters
- Liverpool School of Tropical Medicine (LSTM), Liverpool, UK
- Centre for Sexual Health and HIV & AIDS Research (CeSHHAR), Harare, Zimbabwe
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Belgium
| | - Peter S. Azzopardi
- Burnet Institute, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- South Australian Health and Medical Research Institute, Adelaide, Australia
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Drysdale RE, Tadesse AW, Worku A, Berhane HY, Shinde S, Madzorera I, Sharma D, Fawzi WW. Burden and contributing factors to overweight and obesity in young adolescents in Addis Ababa, Ethiopia. MATERNAL & CHILD NUTRITION 2023:e13479. [PMID: 37014175 DOI: 10.1111/mcn.13479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 12/14/2022] [Accepted: 01/05/2023] [Indexed: 04/08/2023]
Abstract
The prevalence of overweight/obesity in adolescents has increased globally, including in low- and middle-income countries. Early adolescence provides an opportunity to develop and encourage positive health and behavioural practices, yet it is an understudied age group with limited information to guide and inform appropriate interventions. This study aims to determine the prevalence of overweight/obesity in young adolescents, aged between 10 and 14 years attending public schools in Addis Ababa, Ethiopia, and to explore the contributing factors. A cross-sectional school-based study was conducted. Adolescents completed individual questionnaires. Weight (kg) and height (m) measurements were converted to BMI-for-age and gender z-scores. Multivariate regression analysis was conducted to determine the associated factors. The overall prevalence of overweight/obesity was 8% among adolescents aged 10-14 years and it was significantly higher in females (13%) than males (2%). The diet quality for the majority of the adolescents was inadequate, putting them at risk for poor health outcomes. The contributors to overweight/obesity were different between males and females. Age and no access to a flush toilet were negatively associated with overweight/obesity in males and access to a computer, laptop or tablet was positively associated. In females, menarche was positively associated with overweight/obesity. Living with only their mother or another female adult and an increase in physical activity were negatively associated with overweight/obesity. There is a need to improve the diet quality of young adolescents in Ethiopia and understand the reasons why females are less physically active to limit the risk of poor diet-related health outcomes.
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Affiliation(s)
- Roisin E Drysdale
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Amare W Tadesse
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Alemayehu Worku
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Hanna Y Berhane
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Sachin Shinde
- Department of Global Health and Population, T. H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts, USA
- Center for Inquiry into Mental Health, Pune, India
| | - Isabel Madzorera
- Department of Global Health and Population, T. H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts, USA
| | - Deepika Sharma
- Global Nutrition Cluster, UNICEF, New York City, New York, USA
| | - Wafaie W Fawzi
- Department of Global Health and Population, T. H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts, USA
- Department of Epidemiology, T. H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts, USA
- Department of Nutrition, T. H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts, USA
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Das S, Fahim SM, Rasul MG, Afrin S, Alam MA, Uz Zaman M, Chowdhury M, Arifeen SE, Ahmed T. Nutritional and dietary diversity status of under-5 children and adolescent girls among forcibly displaced Myanmar nationals living in Bhasan Char relocation camp, Bangladesh: a cross-sectional survey. BMJ Open 2023; 13:e068875. [PMID: 36990487 PMCID: PMC10069579 DOI: 10.1136/bmjopen-2022-068875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE To generate baseline evidence regarding the nutritional and dietary diversity status of under-5 children and adolescent girls among forcibly displaced Myanmar nationals (FDMN) relocated to Bhasan Char relocation camp of Bangladesh. DESIGN Cross-sectional survey. SETTING Bhasan Char relocation camp, Bangladesh, 7 November 2021-12 November 2021. PARTICIPANTS 299 under-5 children (both male and female) and 248 adolescent girls (11-17 years) were surveyed. OUTCOME MEASURES Anthropometric indices and nutritional status of the study participants. RESULTS Nearly 17% of the adolescent girls were suffering from severe thinness/thinness, while 5% were overweight/obese. Severe thinness was more prevalent (2% vs 3.9%) in older adolescents (15-17 years) than their younger counterparts (11-14 years). The prevalence of severe stunting and stunting in adolescents were 14% (95% CI 11.21 to 16.87%) and 29% (95% CI 25.93 to 31.59%), respectively. One-third of the surveyed under-5 children were severely (8.50% (95% CI 5.60 to 11.33%)) or moderately (23.08% (95% CI 20.24 to 25.90%)) stunted, 27% were either severely (4.43% (95% CI 1.60 to 7.27%)) or moderately (22.98% (95% CI 20.15 to 25.81%)) underweight and 12% were severely (1.21% (95% CI 0.00 to 4.04%)) or moderately (10.88% (95% CI 8.05 to 13.72%)) wasted. The prevalence of moderate and severe acute malnutrition in children was low. Surveyed adolescents took a mean of 3.10 (SD 1.03) of nine food groups and 25% (95% CI 22.97 to 28.64%) of under-5 children took minimum diversified diet. The survey respondents mostly consumed carbohydrate-based poorly diversified diets. Nutritional status of the participants did not show any statistically significant association to the dietary diversity status. CONCLUSION A significant number of surveyed under-5 children and adolescent girls of relocated FDMN living in Bhasan Char of Bangladesh were suffering from thinness, stunting, underweight and wasting. Dietary diversity was poor among the surveyed population.
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Affiliation(s)
- Subhasish Das
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Shah Mohammad Fahim
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Golam Rasul
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Sazia Afrin
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Ashraful Alam
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mahabub Uz Zaman
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | | | - Shams El Arifeen
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
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Hidayanti L, Rahfiludin MZ, Nugraheni SA, Murwani R. Association of malnutrition and main-meal- and snack-predominant intake among female adolescent students in boarding schools in Tasikmalaya, Indonesia. Nutr Health 2023:2601060231166224. [PMID: 36972509 DOI: 10.1177/02601060231166224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Background: Balanced dietary intake is needed to prevent malnutrition which is one of the nutritional problems faced by adolescents. Aim: To study the association between predominant dietary intake and nutritional status of female adolescent students in boarding schools in Tasikmalaya, Indonesia. Method: This cross-sectional study was conducted on 323 female adolescent students residing full-time in eight boarding schools in Tasikmalaya, West Java. Students' dietary intake was measured using the 3-non-consecutive-day 24-h recall method. The association between the predominant dietary intake and nutritional status was evaluated using binary logistic regression. Results: Of the 323 students, 59 (18.3%) were overweight/obese (OW/OB) and 102 (31.6%) had stunted growth. The predominant dietary intake in the OW/OB group was snacks, whereas, in the stunted group, it was main meals. Snack-predominant dietary intake was a risk factor for overweight and obesity (p = 0.008; adjusted odds ratio [AOR]: 2.276; 95% confidence interval [CI]: 1.244-4.164), but it was a protective factor against stunting (p = 0.008; AOR: 0.521; 95% CI: 0.322-0.842). Conclusion: The predominance of main meals and snacks as components of total dietary intake affected the nutritional status of female adolescent students living in boarding schools. Therefore, the dietary intake interventions should tailor and design the nutritional contents of main meals and snacks according to the nutritional status of the targeted individuals.
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Affiliation(s)
- Lilik Hidayanti
- Nutrition Program, Faculty of Health Science, 175495Universitas Siliwangi, Tasikmalaya, West Java, Indonesia
| | - Mohammad Zen Rahfiludin
- Public Health Nutrition Department, Faculty of Public Health, 95445Universitas Diponegoro, Semarang, Jawa Tengah, Indonesia
| | - Sri Achadi Nugraheni
- Public Health Nutrition Department, Faculty of Public Health, 95445Universitas Diponegoro, Semarang, Jawa Tengah, Indonesia
| | - Retno Murwani
- Faculty of Animal and Agriculture Sciences, 95445Universitas Diponegoro, Semarang, Jawa Tengah, Indonesia
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12
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Tegegnework SS, Derseh BT, Meseret WA, Zeru AB, Assefa HK, Bilchut AH, Ahmed SM. Nutritional Status and Associated Factors Among School Adolescent Girls in North Shoa Zone, Amhara Region, Ethiopia: A Cross-Sectional Study. WOMEN'S HEALTH REPORTS 2023; 4:126-135. [PMID: 37020856 PMCID: PMC10068669 DOI: 10.1089/whr.2022.0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/02/2023] [Indexed: 03/29/2023]
Abstract
Background Adolescents are the most affected group and the group that is least studied when it comes to malnutrition, which is one of the most important public health concerns in underdeveloped countries, including Ethiopia. Therefore, the goal of this study was to assess nutritional status and related factors among teenage females who are in school. Materials and Methods From October 1 to October 25, 2018, 645 young girls in school participated in an institution-based cross-sectional study. Girls in their teen years from the school were selected using a simple random sample method. Anthropometric tests and in-person interviews were used to collect the data. An odds ratio with 95% confidence intervals (CIs) and a p-value under 0.05 were used to declare a statistical association. Results This study found that 12.3% and 9.6% of school adolescent girls were stunted and thin, respectively. Being a rural resident (adjusted odd ratio [AOR]: 1.85, 95% CI: 1.05-3.28) and inadequate dietary diversity score (AOR: 3.02, 95% CI: 1.06-4.60) were significant predictors of stunting. School adolescent girls from merchant father were 71% less likely to develop stunting compared with government employee father. Late adolescent age (AOR: 2.27, 95% CI: 1.28-4.02) and family size ≥5 (AOR: 1.98, 95% CI: 1.05-3.75) were significant predictors of thinness. Conclusions Stunting and thinness were the major public health problems among school adolescent girls in the study area. Being a rural resident and inadequate dietary diversity increases the risk of stunting. However, being late adolescent girl and large family size were risk factors for thinness. There was a need for a school-based instruction program that concentrated on a varied diet and methods of encouraging the adolescent girls' appetites.
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Affiliation(s)
- Sisay Shine Tegegnework
- Public Health Department, Institute of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia
- Address correspondence to: Sisay Shine Tegegnework, BSc, MPH, PhD Candidate, Public Health Department, Institute of Medicine and Health Science, Debre Berhan University, PO Box 445, Debre Berhan, Ethiopia.
| | - Behailu Tariku Derseh
- Public Health Department, Institute of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Wondoson Asegdew Meseret
- Public Health Department, Institute of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Abayneh Birlie Zeru
- Public Health Department, Institute of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Hilina Ketema Assefa
- Nursing Department, Institute of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Awraris Hailu Bilchut
- Public Health Department, Institute of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Sindew Mahmud Ahmed
- Nursing Department, Minlik II College of Medicine and Health Science, Kotebe Metropolitan University, Addis Ababa, Ethiopia
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The Study of Nutrient Intake and Adolescent Girls' Quality of Life in a Rural Area of Indonesia. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9081248. [PMID: 36010138 PMCID: PMC9406564 DOI: 10.3390/children9081248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/06/2022] [Accepted: 08/15/2022] [Indexed: 12/17/2022]
Abstract
An inadequate nutrient intake correlates with malnutrition, a problem affecting many adolescents worldwide. Nutrient intake is associated with quality of life (QoL). Our study analyzed the relationship between nutrient intake and adolescents’ QoL. We conducted a cross-sectional study. Through simple random sampling, 157 adolescent girls were selected. Nutrition status was assessed using anthropometric measurements. Nutrient intake was collected using the food frequency questionnaire (FFQ). WHOQOL BREF was used to explore adolescent girls’ quality of life. The median of nutrient intake: energy (908.25 kcal); protein (24.16 g); carbohydrate (128.89 g); fat (21.89 g); vitamin A (77.10 mg); vitamin E (1.40 mg); vitamin B1 (0.19 mg); vitamin B2 (0.29 mg); vitamin B6 (0.45 mg); folic acid (35.13 mg); vitamin C (12.60 mg); calcium (197.46 mg); magnesium (93.72 mg); iron (2.64 mg); and zinc (2.09 mg). The adolescents’ QoL scores were physical health 44 (25–81), psychological domain 56 (19–94), social relationships 56 (19–94), and environmental domain 56 (31–100). The strongest correlations were between (1) physical health with carbohydrates, vitamin C, and fat; (2) psychological domain with calcium; (3) social relationships with carbohydrates and vitamin C; and (4) environmental domain with BMI and zinc. There was a significant positive correlation between the intake of some nutrients and adolescents’ QoL, despite the observation of some significant negative correlations. The findings of this study indicate that more attention should be focused on adolescents’ nutrient intake in order to improve their QoL.
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Pandurangi R, Mummadi MK, Challa S, Reddy NS, Kaliaperumal V, Khadar Babu C, Telikicherla UR, Pullakandham R, Geddam JJB, Hemalatha R. Burden and Predictors of Malnutrition Among Indian Adolescents (10–19 Years): Insights From Comprehensive National Nutrition Survey Data. Front Public Health 2022; 10:877073. [PMID: 35784251 PMCID: PMC9240318 DOI: 10.3389/fpubh.2022.877073] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/13/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction: Malnutrition among adolescents is a persistent problem with a profound impact on different dimensions of health. The objective of this analysis is to assess the burden of malnutrition (Stunting, Thinness, Overweight, and Obesity) and their associated socio-demographic factors among Indian adolescents (10–19 years) from the Comprehensive National Nutritional Survey (CNNS 2016-18) data. Methods We used Individual-level data of 35,831 adolescents from the CNNS conducted in 2016–18 for this analysis. CNNS collected data on the nutritional status of adolescents along with socio-demographic variables from all states of India. Burden of stunting (Height for age Z score, HAZ < −2 SD), thinness (BMI for age Z score, BAZ < −2 SD), overweight (BAZ > 1 SD) and obesity (BAZ > 2 SD) were estimated for the entire country and individual states. A multivariable logistic regression analysis was used to assess the socio-demographic factors associated with stunting, thinness, and overweight. Results CNNS collected data from 35,831 adolescents, of which 31,941 with BAZ scores, and 32,045 with HAZ scores were included in the final analysis. The burden of stunting and thinness among Indian adolescents was 27.4% (95% CI 26.4, 28.4%) and 24.4% (23.5, 25.4%), respectively. The burden of overweight and obesity was 4.8% (4.5, 5.1%) and 1.1% (0.9, 1.3%), respectively. Adolescents in the age group of 15–19 years (AOR 1.23, 95% CI 1.11, 1.36) compared to 10–14 years, females (AOR 1.20; 1.08, 1.33) compared to males, were at increased odds of getting stunted. Adolescents from lowest wealth index families (AOR 1.66; 1.33, 2.07) were at increased odds of thinness compared to peers of higher wealth index families. Adolescents of 10–14 years (AOR 1.26, 95% CI 1.06, 1.49) compared to 15–19 years, urban residents (AOR 1.43, 95% CI 1.19, 1.71) compared to rural residents, were at increased odds of overweight. Conclusion Indian adolescents face the double burden of malnutrition that is undernutrition (stunting and thinness) alongside overnutrition (overweight and obesity) that are linked with socio-demographic factors. The National Nutritional Programs (POSHAN Abhiyan) should prioritize high-risk groups specifically older age group (15–19 years), females, and low wealth Index quintile families identified in this analysis.
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Affiliation(s)
- Raghavendra Pandurangi
- Division of Public Health Nutrition, Indian Council of Medical Research (ICMR)-National Institute of Nutrition, Hyderabad, India
| | - Mahesh Kumar Mummadi
- Division of Clinical Epidemiology, Indian Council of Medical Research (ICMR)-National Institute of Nutrition, Hyderabad, India
| | - Sairam Challa
- Division of Public Health Nutrition, Indian Council of Medical Research (ICMR)-National Institute of Nutrition, Hyderabad, India
| | - N. Samarasimha Reddy
- Division of Clinical Epidemiology, Indian Council of Medical Research (ICMR)-National Institute of Nutrition, Hyderabad, India
- *Correspondence: N. Samarasimha Reddy
| | - Venkatesh Kaliaperumal
- Division of Pathology and Microbiology, Indian Council of Medical Research (ICMR)-National Institute of Nutrition, Hyderabad, India
| | - Chinta Khadar Babu
- Division of Clinical Epidemiology, Indian Council of Medical Research (ICMR)-National Institute of Nutrition, Hyderabad, India
| | - Usha Rani Telikicherla
- Division of Public Health Nutrition, Indian Council of Medical Research (ICMR)-National Institute of Nutrition, Hyderabad, India
| | - Raghu Pullakandham
- Division of Drug Toxicology, Indian Council of Medical Research (ICMR)-National Institute of Nutrition, Hyderabad, India
| | - J. J. Babu Geddam
- Division of Clinical Epidemiology, Indian Council of Medical Research (ICMR)-National Institute of Nutrition, Hyderabad, India
| | - Rajkumar Hemalatha
- Indian Council of Medical Research (ICMR)-National Institute of Nutrition, Hyderabad, India
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Oddo VM, Roshita A, Khan MT, Ariawan I, Wiradnyani LAA, Chakrabarti S, Izwardy D, Rah JH. Evidence-Based Nutrition Interventions Improved Adolescents' Knowledge and Behaviors in Indonesia. Nutrients 2022; 14:1717. [PMID: 35565685 PMCID: PMC9102904 DOI: 10.3390/nu14091717] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/24/2022] [Accepted: 03/25/2022] [Indexed: 02/04/2023] Open
Abstract
Adolescence is a nutritionally vulnerable and critical life stage. However, few programs and policies focus on improving adolescent nutrition in Indonesia. To address this gap, we implemented a gender-responsive package of interventions: (1) breakfast and weekly iron-folic acid supplementation (WIFS), (2) a school-based nutrition education program, and (3) a social behavior change communication strategy. We surveyed 514 adolescents at baseline (2019) and endline (2020) in Klaten and Lombok Barat districts in Indonesia. The survey included a knowledge assessment on nutrition, as well as indicators of attitudes and behaviors on diet, physical activity, and WIFS. We employed multivariable linear and logistic regression to test for pre-post intervention differences. Overall knowledge was significantly higher post-intervention (β: 3.3; 95% confidence interval [CI]: 2.6, 3.9). Diet diversity was high at both timepoints, however, at post-intervention there was significantly higher odds of consuming vitamin A-rich fruits and vegetables (Odds Ratio [OR]: 1.5; 95% CI: 1.1, 2.0) and lower odds of consuming sugar-sweetened beverages (OR: 0.4; 95% CI: 0.3, 0.5). Post-intervention, there was higher odds of reporting 60 min of daily physical activity (OR: 2.3; 95% CI: 1.7, 3.2) and WIFS among girls (OR: 6.7; 95% CI: 1.5, 30.9). The package of interventions may be a promising first step to improving adolescent nutrition in Indonesia.
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Affiliation(s)
- Vanessa M. Oddo
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL 61612, USA
| | - Airin Roshita
- Nutrition Section, UNICEF Indonesia, Jakarta 12920, Indonesia; (A.R.); (J.H.R.)
| | - Md Tajuddin Khan
- Department of Economics, Spears School of Business, Oklahoma State University, Stillwater, OK 74078, USA;
| | - Iwan Ariawan
- Reconstra Integra Utama, Jakarta 12950, Indonesia;
| | - Luh Ade Ari Wiradnyani
- Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition, Pusat Kajian Gizi Regional (PKGR) Universitas Indonesia, Jakarta 13120, Indonesia;
| | - Suman Chakrabarti
- Department of Global Health, School of Public Health, University of Washington, Seattle, WA 98195, USA;
| | - Doddy Izwardy
- Agency of Health Research and Development, Ministry of Health, Jakarta 12950, Indonesia;
| | - Jee Hyun Rah
- Nutrition Section, UNICEF Indonesia, Jakarta 12920, Indonesia; (A.R.); (J.H.R.)
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Raru TB, Ayana GM, Kure MA, Merga BT, Yuya M, Rob KT. Magnitude and Determinants of Under-Nutrition Among Late Adolescent Girls in East Africa: Evidence From Demographic and Health Surveys (2010-2016). Front Nutr 2022; 9:763047. [PMID: 35445058 PMCID: PMC9014237 DOI: 10.3389/fnut.2022.763047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 03/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background Adolescent girls are vulnerable to undernutrition owing to their increased nutrition demand for growth and development, including sexual development and maturation. Despite its public health importance, undernutrition among late adolescent girls has received little attention in health and nutrition policies. Although undernutrition in adolescent girls has been investigated, most of the previous study reports were based on small sample sizes and limited geographic settings. Therefore, we aimed to estimate the prevalence and determinants of undernutrition among late adolescent girls in East Africa. Methods Secondary data analysis was conducted among 10 East African countries using the most recent Demographic and Health Survey (DHS) reports. A total of 21,779 adolescent girls aged 15-19 years were included in this study. Descriptive statistics were conducted to describe the study population. The binary logistic regression model was fitted to identify the determinants of undernutrition among late adolescent girls. Variables with a p-value of <0.05 in the multivariate analysis were identified as statistically significant determinants of undernutrition. Results The overall magnitude of undernutrition among late adolescent girls in East Africa was 16.50% (95% CI: 16.00-17.00), whereas the overall magnitude of obesity among late adolescent girls in East Africa was 2.41% (95% CI: 2.21-2.62). In the final model of the multivariate analysis, adolescent girls aged 18-19 years [adjusted odds ratio (AOR) = 0.55; 95% CI: 0.51-0.60], having secondary education (AOR = 0.79; 95% CI: 0.68-0.93), being from a rich wealth index family (AOR = 0.63; 95% CI: 0.56-0.69), and being from a medium wealth index family (AOR = 0.80; 95% CI: 0.72-0.89) were negatively and statistically associated with undernutrition. Likewise, having more than seven household members (AOR = 1.36; 95% CI: 1.10-1.67), walking more than 30 min to a water source (AOR = 1.10; 95% CI: 1.01-1.20), and living in Ethiopia (AOR = 1.75; 95% CI: 1.51-2.03) were positive determinants of undernutrition among late adolescent girls. Conclusion In this study, undernutrition in late adolescent girls remains a considerable public health problem in East Africa. Age group, educational status, marital status, family wealth index, family size, time taken to reach a water source, media exposure, and country of resident were significant determinants of undernutrition. Therefore, devising strategies that improve the socioeconomic status of households and/or adolescents would help to reduce the risks of undernutrition in late adolescents.
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Affiliation(s)
- Temam Beshir Raru
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Galana Mamo Ayana
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mohammed Abdurke Kure
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bedasa Taye Merga
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mohammed Yuya
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Rob
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Adams AM, Khan A, Roy AS, Hassan MT, Mridha MK, Ahmed NU, Mustaphi P, Chowdhury I, Khondker R, Hyder Z. Growth dynamics among adolescent girls in Bangladesh: Evidence from nationally representative data spanning 2011-2014. PLoS One 2021; 16:e0255273. [PMID: 34324581 PMCID: PMC8321121 DOI: 10.1371/journal.pone.0255273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/14/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Adolescence is the last opportunity to reverse any growth faltering accumulated from fetal life through childhood and it is considered a crucial period to optimize human development. In Bangladesh, a growing double burden of underweight and obesity in adolescents is recognized, yet limited data exists on how, when, and where to intervene. This study assesses the dynamics of growth among adolescent girls in Bangladesh, providing insight about critical junctures where faltering occurs and where immediate interventions are warranted. METHODS We pooled data from Bangladesh's Food Security and Nutrition Surveillance Project collected between 2011 and 2014 to document the age dynamics of weight and linear growth. 20,572 adolescent girls were measured for height and 19,345 for weight. We constructed growth curves for height, weight, stunting, and underweight. We also stratified growth dynamics by wealth quintile to assess socioeconomic inequities in adolescent trajectories. RESULTS Height-for-age z-score (HAZ) in Bangladeshi girls deteriorates throughout adolescence and especially during the early years. Mean HAZ decreases by 0.20 standard deviations (sd) per year in early adolescence (10-14 years) vs 0.06 sd/year during late adolescence (15-19 years), while stunting increases by 16 percentage points (pp) vs 6.7 pp, respectively. Conversely, BMI-for-age z-score (BAZ) increases by 0.13 sd/year in early adolescence vs 0.02 sd/year in late adolescence, and underweight decreases by 12.8 pp vs 3.2 pp. Adolescent girls in all socioeconomic groups show a similar pattern of HAZ and BAZ dynamics, but the curve for the richest quintile stays above that of the poorest across all ages. CONCLUSIONS Trends and levels of stunting and underweight among adolescent girls in Bangladesh are worrisome, suggesting substantial linear growth faltering in early adolescence, with improving weight-for-age occurring only as linear growth slows and stops. Given the rising burden of non-communicable diseases (NCDs) in Bangladesh and emerging evidence of the link between stunting and later chronic diseases, greater attention to adolescent growth and development is needed. Our findings suggest that, to address stunting, interventions in early adolescence would have the greatest benefits. School-based interventions could be a way to target this population.
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Affiliation(s)
- A. M. Adams
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - A. Khan
- Department of Economics, Uppsala University, Uppsala, Sweden
| | - A. S. Roy
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Md. T. Hassan
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - M. K. Mridha
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - N. U. Ahmed
- Shornokishori Network Foundation, Dhaka, Bangladesh
| | - P. Mustaphi
- UNICEF Bangladesh Country Office, Dhaka, Bangladesh
| | - I. Chowdhury
- UNICEF Bangladesh Country Office, Dhaka, Bangladesh
| | - R. Khondker
- Global Alliance for Improved Nutrition (GAIN), Dhaka, Bangladesh
| | - Z. Hyder
- The World Bank Group Cambodia, Phnom Penh, Cambodia
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Rachmadewi A, Soekarjo D, Maehara M, Alwi B, Mulati E, Rah JH. School Canteens in Selected Areas in Indonesia: A Situation Analysis. Food Nutr Bull 2021; 42:225-246. [PMID: 34282661 DOI: 10.1177/03795721211008021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The school canteen has a massive impact on the dietary intake and nutritional status of school-age children and adolescents. This study aimed at assessing the current situation of school canteens in selected areas in Indonesia and relevant knowledge, attitudes, and behaviors of school-going children and adolescents. METHODS A qualitative study was implemented in a purposive sample of 18 schools in Klaten and West Lombok districts with 2 comparison schools in Jakarta and Klaten. Focus group discussions and in-depth interviews were conducted with a wide range of stakeholders to collect information on nutrition knowledge, food preferences, related policies and governance, and opinions toward school canteens. Data were analyzed using thematic synthesis and narrative analysis. RESULTS Specific government guidelines on healthy foods and beverages to be sold in canteens are not yet in place. Many canteens had inadequate infrastructure and were managed informally, with limited rules, monitoring, and supervision. Although healthy options including vegetables and fruits were available in most canteens, unhealthy foods and beverages were abundant and cheap. Lack of awareness of the importance of nutrition of school-age children and adolescents was pervasive among all stakeholders. Personal preference and availability were main drivers of the students' food choices. CONCLUSIONS Concerted multisectoral and multistakeholders' efforts are warranted to improve the quality of school canteens in Indonesia by developing a comprehensive relevant guideline, improving the capacity of related stakeholders and service providers, enhancing the implementation and monitoring, and generating demand for healthy canteens.
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Affiliation(s)
| | | | | | | | - Erna Mulati
- Directorate of Family Health, 106265Ministry of Health, Republic of Indonesia
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19
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Niswah I, Rah JH, Roshita A. The Association of Body Image Perception With Dietary and Physical Activity Behaviors Among Adolescents in Indonesia. Food Nutr Bull 2021; 42:S109-S121. [PMID: 34282652 DOI: 10.1177/0379572120977452] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Growing evidence highlights the linkage between body image, eating, and exercise behaviors among adolescents. OBJECTIVE This study aims to determine the association between body image perception, nutritional status, and dietary and physical activity behaviors among adolescents in Indonesia. METHODS A cross-sectional household survey was conducted among a representative sample (n = 2160) of adolescent girls and boys aged 12 to 18 years in Klaten and Lombok Barat districts. The association between adolescents' body image, their diets, and physical activity patterns was determined using complex samples Cox's regression analysis. Separate multivariate models were developed for adolescent girls and boys. RESULTS Physical appearance was considered important to nearly all adolescents. Approximately 11% of girls and 14% of boys were overweight or obese, the majority of whom (∼70%) correctly perceived themselves as overweight or obese. More of overweight or obese adolescents felt unhappy about their perceived weight than their thin counterparts. With respect to the overweight/obese girls, the adolescents' perceptions of being overweight or obese was associated with a 63% reduction in the prevalence of overweight/obese girls consuming fatty snacks, such as deep-fried crackers (adjusted prevalence ratio (PR): 0.37, 95% confidence interval (CI): 0.19-0.71) and a 40% reduction in the prevalence of overweight/obese girls engaging in moderate-intensity physical activity (adjusted PR: 0.60, 95% CI: 0.38-0.94), after adjusting for potential confounders. No association between body image and eating and physical activity behaviors was observed among adolescent boys. CONCLUSIONS Body image may be one of the most important determinants of dietary and physical activity behaviors, and thus future efforts to foster healthy eating and physical activity behaviors among Indonesian adolescents need to address body image concerns.
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Affiliation(s)
- Ilyatun Niswah
- Division of Human Nutrition and Health, 4508Wageningen University and Research, Wageningen, the Netherlands
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Wang Q. Underweight, overweight, and tobacco use among adolescents aged 12-15 years: Evidence from 23 low-income and middle-income countries. Tob Induc Dis 2021; 19:37. [PMID: 34017231 PMCID: PMC8114737 DOI: 10.18332/tid/133932] [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: 11/28/2020] [Revised: 02/08/2021] [Accepted: 03/03/2021] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Compared with the number of studies in adults, body weight in relation to tobacco use has been understudied in the adolescent population. This study aimed to examine the association between underweight, overweight and tobacco use in low- and middle-income countries. METHODS Data were derived from the Global School-Based Student Health Survey (GSHS). Data from 71176 adolescents aged 12-15 years residing in 23 countries were analyzed. The Centers for Disease Control and Prevention (CDC) 2000 growth charts were used to identify underweight, normal weight, and overweight/ obesity. Weighted age- and gender-adjusted prevalence of weight categories and tobacco use was calculated. Multivariate logistic regression analysis was performed to estimate the association between weight categories and tobacco use for each country, controlling for covariates. Pooled odds ratios and confidence intervals were computed using random- or fixed-effects meta-analyses. RESULTS A significant association between weight categories and tobacco use was evident in only a few countries. Adolescents reporting tobacco use in French Polynesia, Suriname, and Indonesia, had 72% (95% CI: 0.15-0.56), 55% (95% CI: 0.24-0.84), and 24% (95% CI: 0.61-0.94) lower odds of being underweight, respectively. Adolescents reporting tobacco use in Uganda, Algeria, and Namibia, had 2.30 (95% CI: 1.04-5.09), 1.71 (95% CI: 1.25-2.34), and 1.45 (95% CI: 1.00-2.12) times greater odds of being overweight/obese, but those in Indonesia and Malaysia had 33% (95% CI: 0.50-0.91) and 16% (95% CI: 0.73-0.98) lower odds of being overweight/obese. CONCLUSIONS The association between tobacco use and BMI categories is likely to be different among adolescents versus adults. Associating tobacco use with being thin may be more myth than fact and should be emphasized in tobacco prevention programs targeting adolescents.
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Affiliation(s)
- Qian Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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21
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Bhargava M, Bhargava A, Ghate SD, Rao RSP. Nutritional status of Indian adolescents (15-19 years) from National Family Health Surveys 3 and 4: Revised estimates using WHO 2007 Growth reference. PLoS One 2020; 15:e0234570. [PMID: 32569312 PMCID: PMC7307767 DOI: 10.1371/journal.pone.0234570] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 05/27/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The National Family Health Surveys (NFHS) in India apply adult cutoffs of nutritional status for the estimation of undernutrition/overweight in the 15-19 age group. The prevalence of thinness in boys and girls thus estimated is 58.1% and 46.8% in NFHS-3, and 45% and 42% in NFHS-4 respectively. But the WHO recommends using age and sex-specific reference for adolescents. We reanalyzed the nutritional status of the adolescents using the WHO 2007 Growth Reference to obtain revised estimates of thinness, overweight and stunting across states, rural-urban residence, and wealth quintiles. METHODS AND FINDINGS Demographic information, anthropometric data, and wealth index were accessed from the Demographic and Health Survey (DHS) database. We re-analyzed the anthropometric data using WHO AnthroPlus software which uses the WHO 2007 Growth reference. The revised estimates of thinness assessed by BMI-for-age z-scores in boys and girls was 22.3% (95%CI: 21.6, 23.0) and 9.9% (95%CI: 9.5, 10.3) in NFHS-3 and 16.5% (95%CI: 16.0,17.0) and 9% (95%CI: 8.9, 9.2) in NFHS-4 respectively. Stunting was found to be 32.2% (95% CI: 31.6, 32.9) in boys and 34.4% (95% CI: 34.2, 34.7) in girls in NFHS-4. This was higher than that in NFHS-3; 25.2% (95% CI: 24.4, 26) in boys and 31.2 (95% CI: 30.6, 31.8) in girls. There was a clear socioeconomic gradient as there were higher thinness and stunting in rural areas. There was wide variation among the states with pockets of a double burden of malnutrition. CONCLUSION Using the adult cutoffs significantly overestimates thinness in adolescents in the age group of 15-19 years old in India. Stunting, which is an indicator of long term nutrition is also widely prevalent in them. Future editions of DHS and NFHS should consider adolescents as a separate age group for nutritional assessment for a better understanding of nutritional transition in the population.
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Affiliation(s)
- Madhavi Bhargava
- Department of Community Medicine, Yenepoya Medical College, Mangalore, Karnataka, India
- Center for Nutrition Studies, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
- * E-mail:
| | - Anurag Bhargava
- Center for Nutrition Studies, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
- Department of General Medicine, Yenepoya Medical College, Mangalore, Karnataka, India
| | - Sudeep D. Ghate
- Yenepoya Research Centre, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
| | - R. Shyama Prasad Rao
- Yenepoya Research Centre, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
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