Gender differences in household headship and level of awareness on anaemia among Ethiopian women: Evidences from a nationwide cross-sectional survey

Background: Information on gender difference in household headship in relation to awareness and practice related to anaemia is limited. This study has examined the issue under caption and provides evidence-based information for some program initiatives.Methods: Data from 970 Ethiopian women of reproductive age was extracted from a large data set collected as part of a nation-wide micronutrient programmes surveillance to examine the association between gender difference in household-headship and anaemia awareness. Data were analysed in SPSS version 20.0 for Windows. Proportional differences on some selected variables were determined using χ2 test, and a p-value less than 0.05 was considered statistically significant.Results: Males were found to head more than two third of the households. Significantly lower number of respondents were less educated with just 140 (14.4%) having primary cycle education (grades 1-6th) (P=0.001). About half of the respondents (50.2%) were aware of anaemia, with at least two thirds of the respondents from male-headed households aware of its symptoms (p=0.004) and treatment (p=0.003), and the difference was significant. Fewer women received iron supplementation in female-headed households (28.6%) than male-headed households (71.4%), though the difference was not significant (p=0.9). Unexpectedly, significant number of respondents with low awareness was among those with primary education with some regional variations (p=0.001).Conclusion: Anaemia awareness and treatment seeking behaviour was markedly lower in female-headed households than male-headed households which can be attributed to low levels of education. Thus, to narrow the observed gap, targeted education programs for women headed household is recommended. [Ethiop. J. Health Dev. 2018; 32(2):75-81]Key words: Gender, education, anaemia, iron supplementation, women, Ethiopi

Food security status and vulnerability to anemia among women of reproductive age in pastoralist communities of Somali regional state, Ethiopia: a comparative, community-based, cross-sectional study

Background: Although the impact of food insecurity and anemia has been shown to be more common among women of reproductive age, there is little information available on the issue in relation to women in Fafan Zone, Somali Region, Ethiopia.Objectives: To compare the levels of anemia among women of reproductive age in food-secure versus food-insecure households in Fafan Zone.Methods: A community-based, cross-sectional study design was employed in rural Ethiopia from February to April 2017. In total, 142 women from food-insecure households and 287 women from food-secure households were recruited and their levels of anemia were measured using a HemoCue spectrophotometer, and then compared. Food insecurity was measured using a modified household food insecurity access scale. Data were entered using Epi data 3.1 and analyzed using Stata version 14.0. Bivariate and multivariate logistic regression analyses with 95% confidence intervals were used to examine the association between anemia and food security. A p-value of less than 0.05 was statistically significant.Results: The prevalence of anemia among women in food-insecure households was 79.53% and ranged from 42.0% to 90.0%; among women in food-secure households, the prevalence was 20.47% and ranged from 12% to 34%. The observed difference between Food Security (FS) and Food Insecurity (FI) was statistically significant indicating a correlation between the two groups. Women who reported food insecurity were about 1.4 times more likely to suffer from anemia than their food-secure counterparts (AOR=1.4; 95% CI=1.02-2.10).Conclusions and recommendations: It appears that four in five women in food-insecure households had anemia, and that there was an overall positive relationship between food insecurity and anemia. To address the level of anemia in food-insecure households, more nutritional support is required, in addition to implementing a poverty alleviation program and weekly iron folic acid supplementation. . [Ethiop.J. Health Dev. 2019; 33(1):28-37]Key words: Food insecurity, anemia in women, Somali Region, Ethiopi

Author correction: global dietary quality in 185 countries from 1990 to 2018 show wide differences by nation, age, education, and urbanicity

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Children’s and adolescents’ rising animal-source food intakes in 1990–2018 were impacted by age, region, parental education and urbanicity

Animal-source foods (ASF) provide nutrition for children and adolescents’ physical and cognitive development. Here, we use data from the Global Dietary Database and Bayesian hierarchical models to quantify global, regional and national ASF intakes between 1990 and 2018 by age group across 185 countries, representing 93% of the world’s child population. Mean ASF intake was 1.9 servings per day, representing 16% of children consuming at least three daily servings. Intake was similar between boys and girls, but higher among urban children with educated parents. Consumption varied by age from 0.6 at <1 year to 2.5 servings per day at 15–19 years. Between 1990 and 2018, mean ASF intake increased by 0.5 servings per week, with increases in all regions except sub-Saharan Africa. In 2018, total ASF consumption was highest in Russia, Brazil, Mexico and Turkey, and lowest in Uganda, India, Kenya and Bangladesh. These findings can inform policy to address malnutrition through targeted ASF consumption programmes.publishedVersio

Incident type 2 diabetes attributable to suboptimal diet in 184 countries

The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.8–14.4 million) incident T2D cases, representing 70.3% (68.8–71.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.0–27.1%)), excess refined rice and wheat intake (24.6% (22.3–27.2%)) and excess processed meat intake (20.3% (18.3–23.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.4–87.7%)) and Latin America and the Caribbean (81.8% (80.1–83.4%)); and lowest proportional burdens were in South Asia (55.4% (52.1–60.7%)). Proportions of diet-attributable T2D were generally larger in men than in women and were inversely correlated with age. Diet-attributable T2D was generally larger among urban versus rural residents and higher versus lower educated individuals, except in high-income countries, central and eastern Europe and central Asia, where burdens were larger in rural residents and in lower educated individuals. Compared with 1990, global diet-attributable T2D increased by 2.6 absolute percentage points (8.6 million more cases) in 2018, with variation in these trends by world region and dietary factor. These findings inform nutritional priorities and clinical and public health planning to improve dietary quality and reduce T2D globally.publishedVersio

Incident type 2 diabetes attributable to suboptimal diet in 184 countries

The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.8–14.4 million) incident T2D cases, representing 70.3% (68.8–71.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.0–27.1%)), excess refined rice and wheat intake (24.6% (22.3–27.2%)) and excess processed meat intake (20.3% (18.3–23.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.4–87.7%)) and Latin America and the Caribbean (81.8% (80.1–83.4%)); and lowest proportional burdens were in South Asia (55.4% (52.1–60.7%)). Proportions of diet-attributable T2D were generally larger in men than in women and were inversely correlated with age. Diet-attributable T2D was generally larger among urban versus rural residents and higher versus lower educated individuals, except in high-income countries, central and eastern Europe and central Asia, where burdens were larger in rural residents and in lower educated individuals. Compared with 1990, global diet-attributable T2D increased by 2.6 absolute percentage points (8.6 million more cases) in 2018, with variation in these trends by world region and dietary factor. These findings inform nutritional priorities and clinical and public health planning to improve dietary quality and reduce T2D globally

Burnout and clinical learning environment among residents in Tehran: A cross-sectional study

Purpose: This study aimed to evaluate the quality of the educational environment in Tehran University of Medical Sciences across different medical specialties and its correlation with residents’ burnout. Materials and methods: This cross-sectional study was conducted at Tehran University of Medical Sciences among residents drawn from three largest teaching hospitals affiliated. The Maslach Burnout Inventory and Postgraduate Hospital Educational Environment Measure (PHEEM) questionnaire were used to collect data through web-based, as well as paper-and pencil questionnaires. The data was analyzed using SPSS. Results: A total of 221 residents completed the survey, with a response rate of 82%. Burnout was reported by 67.4% of medical residents. The total PHEEM score had a negative correlation with emotional exhaustion (r = - 0.57, P < 0.001), depersonalization (r = - 0.40, P < 0.001), and a positive one with personal accomplishment (r = 0.42, P < 0.001). Perception of social support significantly predicted burnout subscales (P < 0.05). PHEEM subscales also explained a small proportion of variance in emotional exhaustion (R = 0.55, R2 = 0.308, P < .001). Clinical learning environment independent of personal characteristics was associated with residents' burnout according to multivariate regression analysis [OR = 0.567 (0.170–0.883), P = 0.012]. Conclusion: Clinical learning environment independent of personal characteristics was associated with residents' burnout in Iran. We suggest some initiatives to be introduced ranging from improving the clinical environments, reduce workloads and provide social support to all residents as well as encouraging them to involve in other extracurricular activities like music and physical exercise

Prevalence of Vitamin A Deficiency among Preschool Children in Ethiopia: A Systematic Review and Meta-Analysis

Background. Vitamin A deficiency is a major nutritional concern in lower-income countries. The aim of this systematic review and meta-analysis was to show the magnitude of vitamin A deficiency among preschoolers in Ethiopia. Objective. The present study was aimed at synthesizing qualitatively and quantitatively the existing literature on the prevalence of VAD in preschool children in Ethiopia. Methods. Studies were searched through the search engine of Google Scholar, Hinari, MEDLINE/PubMed, Cochrane Library, and Africa-Wide Information. Searching was made using the keywords/MeSH of vitamin A deficiency, xerophthalmia, night blindness, Bitot’s spot, retinol, children, and Ethiopia. Data were analyzed and compared with the WHO threshold criteria to declare a public health problem. Heterogeneity among studies was assessed using a Cochran Q test and I2 statistics. A random-effects model with 95% confidence interval was used for prevalence estimations. Results. Of the 13 studies included in clinical analysis, 12 of them reported the prevalence of night blindness and/or Bitot’s spot among preschool children in Ethiopia which was above WHO cutoff point for the public health problem 1% and 0.5%, respectively. The prevalence of night blindness significantly decreased from moderate public health problem 4.2% (95% CI: 2.8%-5.7%) in a period from 1990 to 2004 to mild public health problem 0.8% (95% CI: 0.6%-1.0%) in a period from 2005 to 2019. Furthermore, statistically insignificant reduction was observed in the prevalence of Bitot’s spot in a period from 1990 to 2004, 2.2% (95% CI: 1.3%-3.2%) to 1.8% (95% CI: 1.2%-2.3%) in a period from 2005 to 2019. Among 8 studies on subclinical vitamin A deficiency, 7 of them indicated a severe public health problem (>20%). The prevalence of subclinical vitamin A deficiency decreased from 55.7% (95% CI: 39.8%-71.6%) in a period from 1990 to 2004 to 28.3% (95% CI: 9.8%-46.7%) in a period from 2005 to 2019, but not statistically significant. Conclusions. Despite the reduced proportion of night blindness and Bitot’s spot, still both clinical and subclinical vitamin A deficiencies remain a public health problem in Ethiopia requiring strengthen intervention through the newly initiated health extension program