Prevalence and associated factors of stunting and thinness among adolescent students in Finote Selam Town, Northwest Ethiopia

BACKGROUND

Undernutrition among adolescents is a major public health problem in developing nations including Ethiopia. Adolescents need to have good-quantity and good-quality nutrients to cope with this rapid growth and other health risks which increase nutritional demand. This study aimed to assess the prevalence and associated factors of stunting and thinness among school adolescents in Finote Selam Town, Northwest Ethiopia.

METHODS

A school-based cross-sectional study among adolescent students aged 10-19 in public schools was carried out in Finote Selam Town from February 5 to March 27, 2018. A total of 397 school adolescents were included in this study. Stratified and simple random sampling techniques were employed to select study subjects. Pretested structured questionnaires were used to collect the data. Data were entered using Epi info version 7 and analyzed using SPSS version 20 and WHO AnthroPlus software. A multivariable logistic regression analysis was employed to identify factors associated with stunting and thinness. Crude and adjusted odds ratios with 95% level significance were used to measure the strength of association, and statistical significance was declared at a P value less than 0.05.

RESULTS

The prevalence of stunting and thinness among school adolescents was 21.8% and 16.9%, respectively. About 9.7% of school adolescents experienced both stunting and thinness. Being male (P = 0.031), coming from rural area (P = 0.046), having a family monthly income of less than $28.37 (P = 0.044) and having less than four dietary diversity (P = 0.021) were significantly associated with stunting. Early adolescent stage (P = 0.034), being male adolescent students (P = 0.37), having a family monthly income of less than $28.37 (P = 0.016), having a family monthly income between $28.37 and $56.74 (P = 0.021) (35.25 Birr = 1 USD) and using well water (P = 0.045) were significantly associated with thinness.

CONCLUSION

Undernutrition was a predominant problem in the study area. Sex, age, place of residence, dietary diversity, sources of drinking water and family monthly income were important factors associated with stunting and thinness among the respondents. Strategies to improve the nutritional status of adolescent students should be given much attention.

Decision-making autonomy of women and other factors of anemia among married women in Ethiopia: a multilevel analysis of a countrywide survey

BACKGROUND

Anemia is one of the world's public health problem, especially in developing nations. The majority of women of childbearing age (15-49) are affected by anemia. Women's role in the decision-making process is significant for their health and related issues such as anemia. So far, there is no evidence of women's decision-making autonomy on anemia. Consequently, this study aimed to robustly examine both individual- and group-level women's decision-making autonomy and other determinants of anemia among married women in Ethiopia.

METHODS

We examined data from an Ethiopian demographic and health survey conducted in 2016. Our analysis included 9220 married women of childbearing age (15-49 years). For bivariate analysis, we applied the chi-squared (X2) test. The relationship between individual and group-level women's decision-making autonomy and anemia was assessed using multilevel binary logistic regression models while adjusting other socio-demographic and economic characteristics.

RESULTS

In this study the magnitude of anemia was 30.5% (95% CI; 29.5-31.4). According to our multilevel analysis, group-level women's autonomy was found to be negatively related with anemia than individual-level women's autonomy (AOR = 0.53, 95% CI = 0.41-0.69). In addition, the indicator of women's wealth index at group level was a protective factor (AOR = 0.68, 95% CI =0.51-0.90) to develop anemia. Among individual-level indicators women's age (AOR = 0.73, 95% CI = 0.60-0.89), use of contraceptive (AOR = 0.66, 95% CI = 0.55-0.81), BMI (AOR = 0.71, 95% CI = 0.59-0.86) and employment status (AOR = 0.88, 95% CI = 0.79-0.98) were negatively related with anemia. While women who follow Muslim religion (AOR = 1.62, 95% CI = 1.32-1.97,), women who had five and above number of children (AOR = 93, 95% CI = 1.53-2.46), and who were pregnant (AOR = 1.21, 95% CI = 1.04-1.40) were positively associated with anemia. Our final model showed that around 27% of the variability of having anemia was because of group-level differences (ICC = 0.27, P < 0.001). In addition, both individual and group-level factors account for 56.4% of the variance in the in the severity of anemia across communities (PCV = 56.4%).

CONCLUSIONS

Our study showed that empowering women within households is not only an important mechanism to reduce anemia among married women but also serves as a way to improve the lives of other women within the society.

Associations of early marriage and early childbearing with anemia among adolescent girls in Ethiopia: a multilevel analysis of nationwide survey

Background

Early marriage and early childbearing are common practices in Ethiopia. Girls who get married and give birth at a very young age are more likely to experience several health problems including anemia among others. However, the effects of early marriage and early childbearing on anemia status of adolescent girls have not been quantified in previous studies. In this study, we assessed whether early marriage and early childbearing measured at both individual and community levels are associated with adolescent anemia.

Methods

We analyzed data from the 2016 demographic and health survey of Ethiopia. Our study focused on 3172 late female adolescents (15–19 years). We used the chi-squared test and spearman correlation coefficients for bivariate analysis. The relationship between early marriage and childbearing with anemia was evaluated using multilevel binary logistic regression models while controlling other determinants.

Results

Overall prevalence of anemia among female adolescents was 23.8% (95% CI; 22.3–25.2). Our multivariable multilevel analysis showed that individual-level marital status (AOR = 1.53, 95% CI = 1.06–2.02) and community-level childbearing status (AOR = 2.80, 95% CI 1.25–6.29) were positively associated with anemia among female adolescents.

Conclusion

Our findings show the presence of significant association between early marriage & early childbearing with adolescent anemia. Therefore, there is a need for effective policies and programs to end the practice of early child marriage and the consequent adolescent pregnancy in Ethiopia. This will help to improve nutritional status of adolescent girls as well as nutritional outcomes of their children.

Complementary feeding and effect of spontaneous fermentation on anti-nutritional factors of selected cereal-based complementary foods

Background

Malnutrition has been responsible directly or indirectly for 10.9 million deaths worldwide annually among children under five. Childhood malnutrition is highly related to poor nutritional quality diet in developing countries where there is limited access to animal based foods. Most foods consumed by young children are cereal based which contain high amounts of anti-nutritional factors. Fermentation is thought to significantly lower the content of anti-nutrients in cereal grains. This study therefore, aimed to determine complementary feeding practices and effect of spontaneous fermentation on anti-nutritional factors and mineral contents of selected cereals.

Methods

Cross sectional survey was conducted in Ebinat district to determine complementary feeding practices among 324 lactating mothers. Laboratory analysis was carried out for teff and wheat cereal grains to determine the effect of spontaneous fermentation on anti-nutrients as well as mineral contents.

Results

Prevalence of appropriate complementary feeding practice was 1.5%. Fermentation of the sampled cereals for 12 h significantly (p < 0.05) reduced total phytate and total tannin. The reduction continued and most of the reduction of phytate and tannin contents occurred during the 72 h of fermentation for both cereal samples. However, the reduction for some fermentation times was not statistically significant. A significant (p < 0.05) variation was also noticed in the total amounts of calcium, iron and zinc in both sampled cereals within the 72 h of fermentation.

Conclusion

Prevalence of appropriate complementary feeding practice was very low. There were significant reductions of phytate and tannin contents with concomitant increments of minerals after fermentation of cereals. Phytate: mineral ratios were significantly decreased after fermentation for all the parameters examined. It is recommended to ferment cereals while preparing complementary foods for children so as to enhance their micronutrient uptake.

Recovery time and associated factors of severe acute malnutrition among children in Bahir Dar city, Northwest Ethiopia: an institution based retrospective cohort study

Background

Malnutrition commonly affects all groups in a community, but infants and young children are the most vulnerable. Worldwide, nearly 24 million under five children experience severe acute malnutrition (SAM) which contributes to one million child deaths yearly and 19 million severely wasted children are living in developing countries. While the treatment of severe acute malnutrition (SAM) is well established, achieving desired outcomes has proven to be challenging. There is limited evidence showing the success of treatments in the study area. Therefore, this study aimed to determine recovery time from severe acute malnutrition and identify predictors among children of 6-59 months of age.

Methods

Facility based retrospective cohort study was conducted among 401 children 6-59 months of age who have been treated for SAM. Both descriptive and analytic analyses were executed. The results were determined using Kaplan-Meier procedure, log-rank test and Cox-regression. Variables having P-value ≤0.2 during binary analysis were entered into multivariate analysis. P value < 0.05 was considered as statistically significant.

Results

The recovery rate was 51.9% and the median recovery time was 16 days (95%CI: 14.233-17.767). Controlling for other factors; having anemia at admission, no plumpy nut provision, failing to enter in to phase 2 on day 10 and a weight gain of more than 8 g/kg/day were significant predictors of recovery time.

Conclusions

Nutritional recovery rate was far outside of the accepted minimum international standard while median recovery time ranged in the accepted minimum international standard. Children had a lower chance of recovering early when they had anemia at admission, not provided plumpy nut, failed to enter phase 2 on day 10 and failed to gain more than 8 g/kg/day. Therefore, efforts should be strengthened to facilitate early recovery of children by considering the identified predictors of recovery time.